@article {pmid42424858,
year = {2026},
author = {Etemadifar, M and Salari, M and Rezaei, K and Hojjatipour, F},
title = {Multiple sclerosis during an emergency or crisis: A narrative review focused on the effect of war and COVID-19 pandemic.},
journal = {Multiple sclerosis and related disorders},
volume = {113},
number = {},
pages = {107361},
doi = {10.1016/j.msard.2026.107361},
pmid = {42424858},
issn = {2211-0356},
mesh = {Humans ; *Multiple Sclerosis/therapy ; *COVID-19 ; *Pandemics ; SARS-CoV-2 ; *Armed Conflicts ; *Warfare ; },
abstract = {BACKGROUND: Armed conflict fractures the systems that multiple sclerosis (MS) care depends on, yet MS-specific guidance for war is scarce. The aim of this study is to synthesize evidence on MS care during armed conflict and other crises, and to develop practical, crisis-ready recommendations to maintain treatment continuity, reduce inequities, and guide clinicians and policymakers.

METHODS: We reviewed peer-reviewed literature (2000-2025) on MS during conflicts; when MS-war data were scarce, we utilized transferable evidence from COVID-19 MS studies.

RESULTS AND CONCLUSION: War disrupts disease-modifying therapies (DMT) supply, safety monitoring, rehabilitation, and continuity of care, widening inequities. A key controversy was whether to continue higher-risk DMTs with limited labs/MRI, and which monitoring to prioritize. Our recommendations established a five-action basis: create a single MS crisis hub (information, tele-access, patient passports), safeguard DMTs with lean pharmacovigilance and predefined substitutions, adopt tele-first care with a relapse pathway favoring high-dose oral steroids when appropriate, deliver equity-first outreach via mobile clinics and transport/fee support, and run a minimal data loop (stock, relapses, severe adverse events, hospitalizations, brief fatigue screening) for weekly course correction. Additionally, the basis of recommendations was transformed into a three-stage guideline figure.},
}

Humans
*Multiple Sclerosis/therapy
*COVID-19
*Pandemics
SARS-CoV-2
*Armed Conflicts
*Warfare

@article {pmid42424887,
year = {2027},
author = {Hayes, JE and Hayes, SA and Wilkins, D and Lindley, MR and Stuetz, RM},
title = {Olfaction as a diagnostic instrument - a review of current, and future medical applications.},
journal = {Talanta},
volume = {311},
number = {},
pages = {130256},
doi = {10.1016/j.talanta.2026.130256},
pmid = {42424887},
issn = {1873-3573},
mesh = {Animals ; Humans ; *Smell/physiology ; Dogs ; *COVID-19/diagnosis ; SARS-CoV-2 ; Volatile Organic Compounds/analysis ; Pandemics ; Sensitivity and Specificity ; Olfaction Disorders/diagnosis ; },
abstract = {The olfactory sense has evolved to provide environmental and physiological cues through the detection of volatile organic compounds. While historically a clinician's sense of smell was used to assist in diagnosing illness, with some notable exceptions, this has fallen out of favour with the advent of analytical tools. Recently, world events have shown that olfactory methodologies can be highly useful for diagnostic purposes. The emergence of the SARS-CoV-2 virus (causing COVID-19) presented a number of logistical issues with regards to establishing fast and accurate diagnosis-while the idea of detection dogs was proposed at the time, little in the way of routine clinical application was accomplished for this disease. The reasons for this are multifactored, but the use of olfaction as a diagnostic tool can be efficacious, provided appropriate methodological considerations are met. Here, the use of olfaction within a medical diagnostic framework is discussed; with olfactory diagnosis having the potential of very high sensitivity and specificity, but with a low diagnostic cost in terms of expense, time, and patient discomfort. This review will also discuss the ways in which olfactory medical diagnosis can be accomplished using humans, dogs, as well as other animals. Finally, this paper will outline recommendations of how future olfactory diagnostic options can be researched and implemented to ensure best practice.},
}

Animals
Humans
*Smell/physiology
Dogs
*COVID-19/diagnosis
SARS-CoV-2
Volatile Organic Compounds/analysis
Pandemics
Sensitivity and Specificity
Olfaction Disorders/diagnosis

@article {pmid42425738,
year = {2026},
author = {Lac, J and Han, S and Ahmad, M and Starey, H and Ganguly, S and Tett, M and Adeyemi, O and Bray, JJH and Ahmad, MT and Providência, R},
title = {Low-dose corticosteroids in severe pulmonary infection: a meta-analysis of randomised controlled trials.},
journal = {BMJ open respiratory research},
volume = {13},
number = {1},
pages = {},
pmid = {42425738},
issn = {2052-4439},
mesh = {Humans ; Randomized Controlled Trials as Topic ; *Adrenal Cortex Hormones/administration & dosage ; Length of Stay/statistics & numerical data ; Community-Acquired Pneumonia/drug therapy/mortality ; Intensive Care Units ; Respiratory Distress Syndrome/drug therapy/mortality ; COVID-19/mortality ; COVID-19 Drug Treatment ; Pneumonia, Pneumocystis/drug therapy/mortality ; Community-Acquired Infections/drug therapy/mortality ; SARS-CoV-2 ; Sepsis/drug therapy/mortality ; },
abstract = {PURPOSE: Pulmonary infections are one of the leading causes of intensive care unit (ICU) admission and contribute to high mortality rates. This paper aimed to determine the effect of low-dose corticosteroids on outcomes in patients with severe pulmonary infections, including coronavirus disease of 2019, community-acquired pneumonia (CAP), pneumocystis pneumonia, sepsis, septic shock, and acute respiratory distress syndrome.

METHODS: We systematically reviewed randomised controlled trials (RCTs) comparing low-dose corticosteroids (≤400 mg hydrocortisone-equivalent daily) to placebo or standard care in adults with severe pulmonary infections. The primary outcome was short-term mortality (≤90 days). Secondary outcomes included 28-day mortality, 30-day mortality, number of patients with at least one serious adverse event, length of hospital stay and ICU stay.

RESULTS: We analysed twelve RCTs including 4622 patients and 1203 events. The pooled OR showed a short-term mortality benefit: 0.83 (95% CI 0.70 to 0.98; p=0.029; I²=2.0%; number needed to treat: 37.84; Grading of Recommendations Assessment, Development and Evaluation (GRADE): low certainty). There was a reduction in length of ICU stay in patients with CAP, with a pooled mean difference of -0.78 days (95% CI -1.46 to -0.10, p=0.025). The use of corticosteroids did not significantly affect the length of hospital stay or severe adverse events. A significant difference remained in longer courses of steroids, whereas shorter courses had no significant difference (≤7 days vs >7 days; OR: 0.69; 95% CI 0.53 to 0.89; p=0.039 vs OR: 0.96; 95% CI 0.813 to 1.14; p=0.67; subgroup differences: p=0.03). Subgroup analyses in patients with CAP showed a significant benefit in short-term mortality (OR: 0.72, 95% CI 0.54 to 0.98; p=0.034; number needed to treat: 28.10).

CONCLUSION: We found that low-dose corticosteroids significantly reduce 90-day mortality in severe CAP, although evidence for their benefit in other severe pulmonary infections and at shorter follow-up intervals remains inconclusive.

PROSPERO REGISTRATION NUMBER: CRD42024627881.},
}

Humans
Randomized Controlled Trials as Topic
*Adrenal Cortex Hormones/administration & dosage
Length of Stay/statistics & numerical data
Community-Acquired Pneumonia/drug therapy/mortality
Intensive Care Units
Respiratory Distress Syndrome/drug therapy/mortality
COVID-19/mortality
COVID-19 Drug Treatment
Pneumonia, Pneumocystis/drug therapy/mortality
Community-Acquired Infections/drug therapy/mortality
SARS-CoV-2
Sepsis/drug therapy/mortality

@article {pmid42427146,
year = {2026},
author = {Ghosh, AK and Overgaard, JD and Abubeker, I and Rice, EM and Larson, AM and Pagel, EM and Hurt, RT and Gilman, EA},
title = {Consultative General Internal Medicine for Complex Care: The Model, Outcomes, and Lessons Learned.},
journal = {The Permanente journal},
volume = {30},
number = {3},
pages = {153-159},
pmid = {42427146},
issn = {1552-5775},
mesh = {Humans ; *Internal Medicine/organization & administration ; Patient Care Team/organization & administration ; Patient-Centered Care/organization & administration ; Primary Health Care/organization & administration ; *Referral and Consultation/organization & administration ; United States ; },
abstract = {As the landscape of modern medicine evolves, new health care delivery models are needed to meet the growing complexity of medical care. Primary care clinicians are increasingly managing patients with multiple chronic conditions, a challenge that will intensify as the population ages. Complex medical care involves multiple factors that contribute to difficulties in providing optimal quality of care for patients facing these types of medical problems. To address this need, models of consultative general internal medicine have emerged at various tertiary care institutions across the United States to synthesize prior evaluations, recommend appropriate testing and specialty consultations, and integrate findings into a cohesive care plan for implementation by patients' local care teams. Variability in expertise, patient volume, and structure exists across institutions, but the expansion of multidisciplinary care capabilities during the COVID-19 pandemic has created new opportunities for destination-type practices. This narrative review explores how consultative medicine will be crucial to providing integrative, patient-centric care by enhancing diagnostic accuracy, coordinating multidisciplinary input, and communicating actionable care plans to patients.},
}

Humans
*Internal Medicine/organization & administration
Patient Care Team/organization & administration
Patient-Centered Care/organization & administration
Primary Health Care/organization & administration
*Referral and Consultation/organization & administration
United States

@article {pmid42428921,
year = {2026},
author = {Kassymbek, S and Abduldayeva, A and Safonov, N},
title = {Global prevalence of post-COVID-19 condition (Long COVID): a systematic review and meta-analysis of observational studies.},
journal = {Frontiers in public health},
volume = {14},
number = {},
pages = {1839646},
pmid = {42428921},
issn = {2296-2565},
mesh = {Humans ; *COVID-19/epidemiology/complications ; *Global Health/statistics & numerical data ; Observational Studies as Topic ; *Post-Acute COVID-19 Syndrome/complications/epidemiology ; Prevalence ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Long COVID is an umbrella term for persistent, relapsing, or newly developed health problems after SARS-CoV-2 infection, whereas post-COVID-19 condition (PCC) refers more specifically to the World Health Organization clinical case definition. Reported prevalence varies substantially because of differences in terminology, operational definitions, study populations, follow-up duration, hospitalization status, and symptom ascertainment. This systematic review and meta-analysis synthesized global observational evidence on Long COVID/PCC prevalence and examined major sources of variability.

METHODS: A systematic review and meta-analysis was conducted according to PRISMA 2020 principles. PubMed/MEDLINE, Scopus, Web of Science, and the WHO COVID-19 Global Literature Database were searched for studies published from 1 January 2020 to 23 February 2026. Observational studies were eligible if they included individuals with confirmed or probable SARS-CoV-2 infection, reported Long COVID/PCC or persistent post-COVID symptoms at least 4 weeks after acute infection, and provided numerator and denominator data. Terminology and operational case definitions were extracted separately. Prevalence estimates were pooled using a random-effects model with logit transformation and back-transformation. Heterogeneity was assessed using Cochran's Q, I[2], tau[2], and prediction intervals. Subgroup and sensitivity analyses were performed.

RESULTS: Twenty-two studies contributing 27 prevalence estimates and more than 200,000 participants were included. The primary estimate-level pooled prevalence was 30.8% (95% CI 26.8-35.0). Heterogeneity was extreme: Q = 8031.9, df = 26, p < 0.001; I[2] = 99.7%; tau[2] = 0.252 on the logit scale. The prediction interval was 14.0-54.8%. Pooled prevalence was higher among hospitalized cohorts (37.9%, 95% CI 29.5-47.1) than among non-hospitalized, community-based, or mixed cohorts (26.2%, 95% CI 22.0-30.9). WHO-defined PCC yielded lower prevalence (22.8%, 95% CI 14.3-34.4) than broader symptom-based definitions (39.7%, 95% CI 30.5-49.5). Cohort-level sensitivity analysis yielded a similar prevalence of 31.0% (95% CI 26.8-35.4).

CONCLUSION: Long COVID/PCC represents a substantial post-acute public health burden. However, because heterogeneity was extreme, the pooled prevalence should be interpreted as a descriptive summary of heterogeneous observational evidence rather than as a single precise global rate. Standardized definitions, harmonized surveillance, transparent reporting, rehabilitation pathways, and multidisciplinary care models are needed.},
}

Humans
*COVID-19/epidemiology/complications
*Global Health/statistics & numerical data
Observational Studies as Topic
*Post-Acute COVID-19 Syndrome/complications/epidemiology
Prevalence
SARS-CoV-2

@article {pmid42430764,
year = {2026},
author = {Hasenpusch, C and Kuper, P and Skiba, EM and Sprenger, AA and Matterne, U and Kannengießer, L and Grätsch, EI and Shin, J and Li, M and Apfelbacher, CJ},
title = {Interventions to Enhance COVID-19 Pandemic Health Literacy in Health Professionals: Systematic Review.},
journal = {JMIR medical education},
volume = {12},
number = {},
pages = {e70400},
pmid = {42430764},
issn = {2369-3762},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; *Health Literacy/methods ; *Health Personnel/education ; Pandemics ; SARS-CoV-2 ; },
abstract = {BACKGROUND: The COVID-19 pandemic has placed a significant burden on health professionals (HPs). They face higher infection risks due to the nature of their work environment and patient care responsibilities. Their ability to access and apply reliable COVID-19 information affects their own preventive behavior and that of those around them. In this context, health literacy (HL) has become increasingly important. Despite extensive research, information to foster COVID-19-related HL in HPs remains limited.

OBJECTIVE: This systematic review aimed to identify, appraise, and synthesize intervention studies on the effectiveness of COVID-19-related HL interventions in HPs.

METHODS: Five electronic databases (eg, PubMed (MEDLINE), Embase), six clinical trials registries (eg, ISRCTN registry), one preprint server (MEDRXIV), published conference proceedings, and five gray literature databases (eg, opengrey.eu, ProQuest) were searched in May 2022 and updated in August 2025. Reference lists of included studies were screened manually. Two reviewers independently screened titles, abstracts, and full-texts according to eligibility criteria and extracted data; disagreements were resolved by discussion or consultation with a third reviewer. We included randomized controlled trials (RCTs), nonrandomized studies of interventions, and uncontrolled before-and-after studies evaluating the effectiveness of any COVID-19-related HL intervention. Primary outcomes include COVID-19-related HL, its four facets (access, understand, appraise, and apply COVID-19 information), and indicators (eg, COVID-19-related knowledge), assessed at postintervention and follow-up. When studies were sufficiently similar, random-effects meta-analyses were performed; otherwise, a narrative synthesis was provided. Risk of bias was assessed using validated tools based on study design, and the overall certainty of the evidence was evaluated by the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach.

RESULTS: We included 15 RCTs (2034 participants), 4 nonrandomized studies of interventions (291 participants), 74 uncontrolled before-and-after studies (327,298 participants), 5 ongoing studies, and 1 study with awaiting classification. Interventions targeted a broad range of health occupational groups. Intervention type, delivery mode, methods, settings, and comparator varied widely. No outcome measure explicitly referred to an HL model. Most studies aimed to enhance COVID-19-related knowledge and skills, and had a high risk of bias. COVID-19-related interventions may increase knowledge of vaccines (standardized mean difference 1.00; 95% CI 0.33 to 1.67, I2=24%), and the infection prevention control skills, such as donning and doffing of personal protective equipment (standardized mean difference 1.95; 95% CI 1.82 to 3.09, I2=46%), but the evidence remains very uncertain.

CONCLUSIONS: COVID-19-related HL interventions may promote HP's short-term competencies in infection control. However, the evidence remains uncertain, primarily due to the low quality of studies, characterized by a high risk of bias. Interventions specifically designed to enhance the full COVID-19 HL operationalized by its four facets are lacking. High-quality RCTs with sufficient statistical power, grounded in HL theoretical principles, are needed to achieve precise understanding.},
}

Humans
*COVID-19/epidemiology/prevention & control
*Health Literacy/methods
*Health Personnel/education
Pandemics
SARS-CoV-2

@article {pmid42430872,
year = {2026},
author = {Hensley, AA and Jiles, KA and Edwards, S and Clinchard, C and Hosig, K},
title = {Characteristics of successful and unsuccessful strategies to increase vaccine intention and improve vaccine uptake for U.S. adult populations in the Affordable Care Act era (2010-2025): a systematic review and meta-regression.},
journal = {Vaccine},
volume = {88},
number = {},
pages = {128910},
pmid = {42430872},
issn = {1873-2518},
support = {KL2 TR003016/TR/NCATS NIH HHS/United States ; UL1 TR003015/TR/NCATS NIH HHS/United States ; },
mesh = {Humans ; *Patient Protection and Affordable Care Act ; United States ; *Vaccination/psychology/statistics & numerical data ; *Vaccines/administration & dosage ; Adult ; COVID-19/prevention & control ; *Vaccination Coverage ; },
abstract = {BACKGROUND: Vaccine-preventable diseases continue to burden U.S. population health. Despite the Affordable Care Act (ACA) eliminating cost-sharing for recommended vaccines in 2010, adult vaccination rates persistently fall below Healthy People 2030 targets, signaling that access alone is insufficient.

OBJECTIVES: To synthesize peer-reviewed literature (2010-2025) on interventions designed to increase vaccine intention or uptake among U.S. adults; characterize strategies, populations, settings, and study quality; and identify predictors of vaccine uptake rate.

METHODS: Following PRISMA 2020 guidelines, a multi-database search was conducted across PubMed, Web of Science, Ovid/MEDLINE, and EBSCOhost, with a final updated search in December 2025. Dual independent reviewers screened studies in two stages. Quality was assessed using the EPHPP tool and certainty evaluated using GRADE. Strategies were categorized per the WHO Behavioral and Social Drivers of Vaccination (BeSD) Model. A meta-regression was conducted on 79 studies, with narrative synthesis across all 92 included studies.

RESULTS: Of 11,219 records, 92 studies were included. Study designs were predominantly RCTs; Influenza and COVID-19 vaccines were most commonly studied. In the meta-regression (adjusted R[2] = 0.229), prioritizing a specific population (b=0.121, p=.027), using service quality improvement strategies (b=0.226, p=.040), and recruiting through community-based partner organizations (b=0.585, p=.005) or healthcare organizations (b=0.230, p=.040) were associated with significantly higher vaccine uptake rates. Onsite vaccination was associated with lower uptake rates (b=-0.185, p=.033), an effect confirmed as specific to the COVID-19 pandemic emergency-response context rather than a generalizable effect of the strategy in sensitivity analysis. Narrative synthesis identified message framing and educational campaigns as the most frequently deployed strategies, with multi-component designs and community partnerships showing the most favorable outcomes.

CONCLUSIONS: Effective adult vaccination strategies were multifactorial. Service quality improvement, priority population focus, and community-based recruitment were the strongest predictors of higher uptake. Findings support the WHO BeSD model's Practical Issues domain: reducing friction outperformed persuasion alone. GRADE certainty remained LOW to MODERATE, emphasizing the need for higher-quality, equity-focused research.

REGISTRATION: This systematic review was registered at Open Science Framework: 10.17605/OSF.IO/SM7YD.},
}

Humans
*Patient Protection and Affordable Care Act
United States
*Vaccination/psychology/statistics & numerical data
*Vaccines/administration & dosage
Adult
COVID-19/prevention & control
*Vaccination Coverage

@article {pmid42432642,
year = {2026},
author = {Jöud, AS and Thorén, H and Spreco, A and Lundh, T and Timpka, T and Gerlee, P},
title = {Computational forecasting using Swedish data in the vaccination phase of the COVID-19 pandemic: a systematic literature review deliberating modelling relevance for public health and healthcare.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {42432642},
issn = {1472-6963},
mesh = {Sweden/epidemiology ; Humans ; *COVID-19/prevention & control/epidemiology ; Forecasting/methods ; *Public Health ; *Vaccination ; *COVID-19 Vaccines ; Pandemics ; SARS-CoV-2 ; },
abstract = {BACKGROUND: The benefits of computational forecasting in the later phase of the COVID-19 pandemic when vaccines and clinical pharmaceutical interventions were available have seldom been assessed. We aimed to evaluate computational forecasting research applied to Swedish populations in the vaccination phase of the pandemic.

METHODS: A systematic search was performed on March 8, 2024 in the electronic databases PubMed, Scopus, Cochrane library, Embase, Love platform and Epistemikos. An updated version of the Risk of bias Opinion Tool (ROBOT) was used to assess the quality of evidence reported in the papers identified in the search. The articles fulfilling the quality criteria were assessed for suitability for meta-analysis. Data were extracted from the selected articles for synthesis of characteristics, and a thematic analysis was used for a qualitative synthesis of the contents.

RESULTS: Of 2034 unique publications identified in the database search, 6 articles satisfied the selection and quality criteria. Variability in the reporting of forecasting performance results was found to make a quantitative meta-analysis of forecast performance infeasible. The data synthesis showed that statistical modeling using Bayesian calibration was the most common methodological approach. No external model validation was reported, but 5/6 articles included internal model corroboration data. The primary theme resulting from the qualitative synthesis of article content was design or refinement of computational models with demonstration of model use in health service practice as a secondary theme. None of the articles referred to health service policymaking as the primary research context.

CONCLUSION: Computational forecasting research using Swedish population data from the vaccination phase of the COVID-19 pandemic was deployed in a model design context. While methodological knowledge was developed, most of the research was not initiated to solve the public health and healthcare problems at hand. Our results indicate that the alignment between computational forecasting research and policymaking needs in the vaccination phase of pandemics can be enhanced.},
}

Sweden/epidemiology
Humans
*COVID-19/prevention & control/epidemiology
Forecasting/methods
*Public Health
*Vaccination
*COVID-19 Vaccines
Pandemics
SARS-CoV-2

@article {pmid42432664,
year = {2026},
author = {Chandak, A and Chandak, P and Patil, A and Varma, R},
title = {Digital health literacy among university students: a systematic review of global trends, determinants, measurement, and the literacy-to-intervention gap.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42432664},
issn = {1471-2458},
mesh = {Humans ; *Health Literacy/trends/statistics & numerical data ; *Students/statistics & numerical data/psychology ; Universities ; Digital Health ; Evidence Gaps ; },
abstract = {INTRODUCTION: University students interact with the complexities of public health knowledge in digital environments. Digital health literacy (DHL), in this regard, is crucial as an upstream skill for ensuring safe, inclusive, and knowledgeable health care engagement among university students where mis-information, algorithm amplification, and AI-based content exist.

OBJECTIVE: This systematic review synthesizes global evidence on DHL among university students. It examines measurement approaches, socio-demographic determinants, online health information-seeking behaviours, mental health and well-being correlates, and the gap between literacy assessment and tested university-based interventions.

METHODS: This systematic review followed PRISMA 2020 guidance. Searches were conducted in PubMed, Scopus, and Web of Science for peer-reviewed studies indexed up to March 31, 2024; backward and forward citation tracking was updated to January 2025 to capture directly related empirical papers. Two reviewers independently performed screening, data extraction, and quality appraisal using design-appropriate tools: JBI for analytical cross-sectional studies, CASP for qualitative evidence, and AMSTAR 2-informed criteria for review-derived or pilot evidence. Because of heterogeneity in design, instruments, and outcomes, findings were synthesized narratively and thematically.

RESULTS: Twenty-one studies met the eligibility criteria. Most were cross-sectional studies conducted during or after the COVID-19 pandemic. Five themes were identified: DHL as a competence for appraising online health information; socioeconomic, gender, health-status, and contextual determinants of DHL; associations with mental health, well-being, fear, and sense of coherence; measurement heterogeneity and psychometric maturation; and a persistent literacy-to-intervention gap.

CONCLUSION: DHL is a relevant competency for Health Promoting Universities, but the current evidence base remains dominated by descriptive self-report and cross-sectional designs. Future research should prioritize longitudinal studies, objective task-based competence assessment, and theory-driven intervention trials embedded within campus health systems, library infrastructures, and digital mental health pathways. The future research must focus on conducting longitudinal research, assessing task-based competency objectively, and testing theory-based interventions that operate through campus health systems, library infrastructure, and pathways for digital mental health.},
}

Humans
*Health Literacy/trends/statistics & numerical data
*Students/statistics & numerical data/psychology
Universities
Digital Health
Evidence Gaps

@article {pmid42432680,
year = {2026},
author = {Sasso, EM and Eaton-Fitch, N and Thapaliya, K and Marshall-Gradisnik, S},
title = {Neurological impairment in long COVID: implications for neurodegenerative disease.},
journal = {Journal of translational medicine},
volume = {24},
number = {1},
pages = {},
pmid = {42432680},
issn = {1479-5876},
support = {489798//Stafford Fox Medical Research Foundation/ ; 1199502//National Health and Medical Research Council/ ; 47107//Mason Foundation/ ; 49979//McCusker Charitable Foundation/ ; 4676//Ian and Talei Stewart, the Buxton Foundation/ ; 4579//Blake Beckett Trust Foundation/ ; 4570//Alison Hunter Memorial Foundation/ ; 4575//Change for ME Charity/ ; Dr John Hamwood//Dr John Hamwood/ ; 4879//Henty Community/ ; },
mesh = {Humans ; *Nervous System Diseases/physiopathology/virology ; *Neurodegenerative Diseases/physiopathology/virology ; *Post-Acute COVID-19 Syndrome/complications ; },
abstract = {BACKGROUND: It has been six years since the COVID-19 pandemic and, despite substantial advances in management, the disease sequelae known as long COVID continues to represent a significant medical and societal burden. Long COVID is characterised by persistent neurological and neurocognitive symptoms, including brain fog, memory deficits, attention impairments, and fatigue, lasting for months after acute SARS-CoV-2 infection.

MAIN BODY: In this review, we collated emerging neurological findings related to long COVID, discussing neurodegenerative processes associated with long COVID, potential clinical implications and research limitations. Neurological and neurocognitive manifestations arise through multiple mechanisms, including direct SARS-CoV-2 invasion of the central nervous system and peripheral lymphocyte infiltration. Additionally, neurovascular damage potentially contributes to neurodegeneration through neuronal injury, impaired neurogenesis, microvascular abnormality and sustained neuroinflammation.

CONCLUSION: Understanding the mechanisms underlying neurological and neurocognitive symptoms is essential for developing long-term monitoring strategies and targeted interventions to mitigate neurocognitive decline in individuals with long COVID.},
}

Humans
*Nervous System Diseases/physiopathology/virology
*Neurodegenerative Diseases/physiopathology/virology
*Post-Acute COVID-19 Syndrome/complications

@article {pmid42432685,
year = {2026},
author = {Zhou, Z and Luo, B and Zhang, X and Li, Q and Huang, Y and Yang, Y and Qiu, H and Xue, M and Xie, J},
title = {Incidence, mortality and risk factors of invasive pulmonary aspergillosis in critically ill patients during the COVID-19 era: a global systematic review and meta-analysis.},
journal = {Annals of clinical microbiology and antimicrobials},
volume = {25},
number = {1},
pages = {},
pmid = {42432685},
issn = {1476-0711},
support = {2023ZD0506500//Noncommunicable Chronic Diseases-National Science and Technology Major Project/ ; 2024ZD0522700//Noncommunicable Chronic Diseases-National Science and Technology Major Project/ ; 82272210//National Natural Science Foundation of China/ ; },
mesh = {Humans ; *Invasive Pulmonary Aspergillosis/mortality/epidemiology ; *Critical Illness/mortality ; Risk Factors ; *COVID-19/complications/epidemiology/mortality ; Incidence ; Intensive Care Units ; Respiration, Artificial/adverse effects ; SARS-CoV-2 ; Male ; Female ; },
abstract = {BACKGROUND: Invasive pulmonary aspergillosis (IPA) represents a growing threat to critically ill patients, with mortality rates exceeding 50%. The burden of IPA has been exacerbated during the COVID-19 era due to prolonged ICU stays and widespread use of immunosuppressive therapies. This systematic review and meta-analysis aimed to synthesize global evidence on the incidence, mortality, and risk factors of IPA in ICU patients.

METHODS: Observational studies reporting IPA incidence, mortality, or risk factors in ICU settings from their inception between November 1, 2019 to October 11, 2024 for eligible studies were retrieved from PubMed, Embase, Web of Science, and Cochrane Library. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). Meta-analyses were performed using R software to calculate pooled estimates with 95% confidence intervals (CI). Multiple subgroup analysis was conducted.

RESULTS: Fifty-six studies involving 15,385 ICU patients (2,381 IPA cases) were included. The pooled incidence of IPA was 11.9% (95% CI: 9.7-14.6%). Subgroup analyses revealed higher incidence in mechanically ventilated patients (15.0%, 95% CI: 11.7-19.0%). Factors associated with an increased risk of IPA included male sex (OR = 1.29), smoking history (OR = 1.52), chronic lung diseases (OR = 1.30), chronic kidney disease (OR = 1.70), chronic liver disease (OR = 1.79), heart disease (OR = 1.20), malignant tumor (OR = 1.75), hematological malignancy (OR = 2.65), glucocorticoids use before ICU (OR = 2.13), immunosuppression (OR = 2.26), EORTC host factors (OR = 2.13), vasopressor use (OR = 3.28), mechanical ventilation (OR = 3.69), and renal replacement therapy (OR = 2.31). The overall mortality rate was 59.6% (95% CI: 55.0-64.0%), escalating to 61.9% in mechanically ventilated patients. Mortality-associated factors included age ≥ 65 years (OR = 2.85), ICU-administered glucocorticoids (OR = 1.95) and mechanical ventilation (OR = 1.93).

CONCLUSIONS: During the COVID-19 era, IPA remains a life-threatening complication in critically ill patients, particularly those with COVID-19, and is associated with immunosuppression, organ dysfunction, and invasive therapies. Our findings, predominantly reflecting CAPA epidemiology, generate the hypothesis that early screening in high-risk populations and tailored antifungal strategies warrant prospective evaluation to determine whether they improve outcomes.

TRIAL REGISTRATION: Ethical approval and patient consent were not required for this meta-analysis, as it was based on previously published studies. The protocol for this meta-analysis was registered on PROSPERO: International prospective register of systematic reviews (CRD42025631579).},
}

Humans
*Invasive Pulmonary Aspergillosis/mortality/epidemiology
*Critical Illness/mortality
Risk Factors
*COVID-19/complications/epidemiology/mortality
Incidence
Intensive Care Units
Respiration, Artificial/adverse effects
SARS-CoV-2
Male
Female

@article {pmid42433760,
year = {2026},
author = {Magsi, IA and Advani, A and Alokozay, E and Qutub, Z and Hamid, M and Kharka, M and Kunwar, R and Ahsan, S and Msheik, A and Waqas, SA and Hassan, A and Waseem, N and Patel, T and Ahmed, R and Hemida, MF},
title = {Trends and disparities in HIV before and after COVID-19 from 1999 to 2023.},
journal = {Annals of medicine and surgery (2012)},
volume = {88},
number = {7},
pages = {4306-4313},
pmid = {42433760},
issn = {2049-0801},
abstract = {Despite advances in human immunodeficiency virus (HIV) treatment, disparities in HIV-related mortality persist across demographic groups in the United States. The COVID-19 pandemic disrupted healthcare systems and may have influenced established mortality trends. This study evaluates HIV-related mortality in the U.S. from 1999 to 2023, with emphasis on changes following the onset of COVID-19. Data were obtained from the CDC WONDER database, identifying HIV-related deaths (ICD-10: B20-B24) among adults aged 25 to 85+. Age-adjusted mortality rates (AAMR) per 100 000 were calculated. Trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). From 1999 to 2023, there were 271 932 HIV-related deaths in the U.S. The overall AAMR declined by an AAPC of -4.34%, with a slower post-COVID decline of -4.19% (P < 0.05) from 2020 to 2023. Gender-stratified analysis showed greater post-COVID declines in women (APC: - .58%) than in men (APC: -3.90%). Older adults (85+) experienced a post-COVID increase in mortality (APC: +12.37%). Urban centers showed an APC increase (+2.33%), while rural areas continued to decline. Racial disparities narrowed modestly. Black and Hispanic populations saw sharper post-COVID declines (APCs: -6.21% and -6.26%, respectively) compared to White populations (-1.33%). The Southern U.S. remained the highest-burdened region across both timeframes. Observed mortality trends were temporally associated with demographic characteristics and urbanization patterns during the COVID-19 period. While HIV mortality continues to decline, the COVID-19 pandemic has disrupted progress, especially among elderly and urban populations. Persistent disparities demand targeted, equitable public health interventions.},
}

@article {pmid42433775,
year = {2026},
author = {Abera, EG and Himbaro, SA and Megersa, SW and Ashine, AH and Tukeni, KN and Gebremichael, EH},
title = {Emerging trends in post-COVID immune dysregulation: a narrative review.},
journal = {Annals of medicine and surgery (2012)},
volume = {88},
number = {7},
pages = {4362-4370},
pmid = {42433775},
issn = {2049-0801},
abstract = {BACKGROUND: Long coronavirus disease (COVID), or post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is a multi-system condition associated with persistent immune dysregulation, autoimmunity, and vascular perturbations. Understanding these immunological mechanisms is essential for guiding clinical management and therapeutic strategies.

METHODS: We conducted a narrative review of peer-reviewed human studies published between January 2020 and August 2025, using PubMed/Medline, Scopus, and Web of Science, supplemented by manual searches. Studies reporting immunological assessments in long COVID patients, recovered individuals, or healthy controls were included. Findings were extracted and synthesized thematically across six domains: humoral and cellular immunity, autoimmune signatures, proteomic/metabolic and vascular dysregulation, viral persistence, complement/coagulation/thromboinflammation, and pediatric long COVID.

RESULTS: Long COVID is characterized by persistent low-grade inflammation, T- and B-cell dysregulation, and prolonged adaptive immune activation. Humoral responses remain elevated, while T-cell exhaustion and loss of coordination between immune compartments are common. Autoimmune phenomena, including latent and polyautoimmunity targeting cytokines, thyroid antigens, and interferons, are frequently observed. Proteomic, metabolic, and vascular perturbations, complement activation, and thromboinflammatory processes contribute to ongoing symptoms. Viral persistence and early immune biomarkers predict long COVID development. These immune alterations correlate with fatigue, cognitive impairment, respiratory dysfunction, and reduced quality of life in both adults and children.

CONCLUSION: SARS-CoV-2 infection leaves a lasting immunological footprint marked by chronic inflammation, adaptive immune dysregulation, autoimmunity, and vascular perturbations. Integrating longitudinal immune assessments, biomarker profiling, and early predictive markers is critical for identifying high-risk individuals and informing interventions to reduce long COVID morbidity.},
}

@article {pmid42434515,
year = {2026},
author = {Chen, B and Tao, X and Wang, Y},
title = {Emerging Strategies for Antitumor Immunotherapy and Antiviral Defense Through the cGAS-STING Pathway.},
journal = {International journal of nanomedicine},
volume = {21},
number = {},
pages = {593033},
pmid = {42434515},
issn = {1178-2013},
mesh = {Humans ; cGAS-STING Signaling Pathway ; *Immunotherapy/methods ; *Neoplasms/therapy/immunology ; *Membrane Proteins/metabolism ; *Nucleotidyltransferases/metabolism ; Animals ; STING Protein ; Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase ; Immunity, Innate ; Antiviral Agents/pharmacology ; Signal Transduction ; Virus Diseases/immunology/therapy ; Host-Directed Therapy ; },
abstract = {The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway is a central regulator of innate immunity and plays a critical role in inducing pro-inflammatory cytokines and type I interferons (IFN-I). This pathway has emerged as a promising target for cancer immunotherapy and antiviral treatments. Despite its promise, the clinical translation of STING agonists is hindered by several challenges, including structural instability, high production costs, and inefficient delivery systems. These barriers underscore the urgent need for further research and innovation to optimize STING-based therapies. This review provides a comprehensive overview of the cGAS-STING pathway, focusing on its activation mechanisms and recent advances aimed at enhancing its therapeutic efficacy. Alternative activators of STING, including metal ions, exogenous DNA, and endogenous DNA, are discussed for their potential to stimulate this pathway. Furthermore, synergistic therapeutic strategies combining cGAS-STING activation with reactive oxygen species (ROS)-based treatments, such as photodynamic therapy, radiotherapy, sonodynamic therapy, and chemodynamic therapy, are highlighted. Finally, recent progress in harnessing STING activation for antiviral defense against emerging pathogens, such as SARS-CoV-2 and influenza viruses, is summarized to provide insights into the future development of cGAS-STING-targeted immunotherapies.},
}

Humans
cGAS-STING Signaling Pathway
*Immunotherapy/methods
*Neoplasms/therapy/immunology
*Membrane Proteins/metabolism
*Nucleotidyltransferases/metabolism
Animals
STING Protein
Cyclic Guanosine Monophosphate-Adenosine Monophosphate Synthase
Immunity, Innate
Antiviral Agents/pharmacology
Signal Transduction
Virus Diseases/immunology/therapy
Host-Directed Therapy

@article {pmid42434765,
year = {2026},
author = {Joshi, A and Ogbemudia, H and Cruess, C and Livinski, AA and Hall, R and Roback, E and Jain, J and Sharma, A and Smith-Davidson, P and Xu, M and Asher, V and Joseph, PV and Levy, JM},
title = {Point-of-care smell testing for evaluation of olfactory function: a narrative review of clinical utility.},
journal = {Frontiers in allergy},
volume = {7},
number = {},
pages = {1882615},
pmid = {42434765},
issn = {2673-6101},
abstract = {IMPORTANCE: Olfactory dysfunction (OD) is increasingly recognized as a clinically relevant biomarker for a wide range of health conditions, including neurodegenerative diseases, respiratory infections such as COVID-19, psychiatric disorders, and age-related sensory decline. Despite its diagnostic value, olfactory testing remains underutilized in routine clinical care due to challenges related to test accessibility, cultural adaptability, cost and practical implementation.

OBSERVATIONS: This narrative review provides a clinically focused synthesis of olfactory tests suitable for point-of-care (POC), focusing on their diagnostic accuracy, administration methods, user-friendliness, and applicability across diverse clinical populations. Commonly used tests such as the University of Pennsylvania Smell Identification Test (UPSIT®) and Sniffin' Sticks® are discussed alongside emerging rapid screening tools, pediatric assessments, and culturally adapted tests. Attention is given to distinguishing screening tools from comprehensive diagnostic batteries and to the role of point-of-care (POC) testing in primary care, neurology, and otorhinolaryngology settings. Practical considerations including assessment time, workflow feasibility, and clinical decision pathways are also examined. This review emphasizes the translation of available psychophysical tests into a practical POC framework for real-world clinical use.

CONCLUSIONS AND RELEVANCE: Available olfactory tests vary substantially in diagnostic accuracy, feasibility, and clinical applicability, highlighting the importance of selecting tests based on clinical indication and practice setting. Brief POC tests are best positioned as screening tools, while comprehensive batteries remain necessary when diagnostic precision is required. The main contribution of this review is a clinically oriented framework that distinguishes screening from diagnostic testing and aligns test selection with adult and pediatric clinical scenarios, workflow constraints, and referral needs. A tiered clinical approach using rapid screening followed by targeted comprehensive testing may represent the most practical, cost and time effective strategy for integrating olfactory assessment into routine care. Broader implementation of clinically feasible olfactory testing may improve early disease detection, support clinical decision making, and enhance patient care across conditions associated with OD.},
}

@article {pmid42435889,
year = {2026},
author = {Gazda, J and Koky, T and Robinska, A and Bo, N and Bjornsson, ES and Drazilova, S and Janicko, M and Díaz, LA and Rhoads, F and Jarcuska, P and Arab, JP},
title = {Epidemiology of Alcohol-Associated Hepatitis: A Systematic Review of Population-Based Studies.},
journal = {Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.cgh.2026.06.032},
pmid = {42435889},
issn = {1542-7714},
abstract = {BACKGROUND & AIMS: Alcohol-associated hepatitis is an acute and severe manifestation of alcohol-related liver injury that can occur at any stage of fibrosis. Despite its high mortality, reliable epidemiologic data on alcohol-associated hepatitis remain limited. We conducted a systematic review to synthesize available population-based estimates of alcohol-associated hepatitis annual incidence and point prevalence from 2000 to 2025.

METHODS: A comprehensive literature search of MEDLINE (PubMed), Scopus, and the Cochrane Library was performed. Eligible studies reporting population-based rates of alcohol-associated hepatitis were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data.

RESULTS: Eleven population-based studies from 7 countries were included. Reported annual incidence rates of alcohol-associated hepatitis ranged from 1.02 per 100,000 inhabitants in Iceland to 98.5 per 100,000 inhabitants in the United States, with a median incidence rate of 6.8 cases per 100,000 inhabitants (interquartile range, 4.2-19). Among the 9 studies reporting at least 2 estimates over time, 7 demonstrated an increasing incidence rate, whereas 2 reported a decrease. A prepandemic sensitivity analysis excluding studies affected by the COVID-19 pandemic showed a similar pattern, with incidence rates increasing in 5 of the 7 studies. Two studies reported a surge in incidence during the COVID-19 pandemic, whereas 1 of them extended follow-up beyond the pandemic period and observed a gradual return toward prepandemic levels. No studies reported prevalence data.

CONCLUSIONS: The global burden of alcohol-associated hepatitis remains poorly characterized. Existing population-based estimates are highly heterogeneous, reflecting differences in case definitions as well as probable true epidemiologic variation across countries, and collectively suggest an increasing trend over the past 25 years. These findings underscore the urgent need for prospective studies employing standardized and harmonized methodologies to more accurately define the burden of this condition.},
}

@article {pmid42436688,
year = {2026},
author = {Hernandez, J and Delgado, S and McCarthy, M and Nelson, F and Rammohan, K},
title = {The Impact of COVID-19 Infection and Vaccination on Neuromyelitis Optica Spectrum Disorder and Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Narrative Review.},
journal = {Journal of central nervous system disease},
volume = {18},
number = {},
pages = {11795735261467600},
pmid = {42436688},
issn = {1179-5735},
abstract = {Despite the estimated 776 million coronavirus disease 2019 (COVID-19) cases globally, little is known about its impact on immune-mediated neurological disorders such as neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody disorder (MOGAD). Scattered case reports, and reviews address this association, but none have collectively examined the impact of COVID-19 infection or vaccination on established and new-onset NMOSD and MOGAD. Reviewing all published reports of COVID-19 infection and vaccination in NMOSD and MOGAD from December 2019 to October 2024, this report examined the effects of infection and vaccination on patients with established disease and the occurrence of new-onset NMOSD and MOGAD. Outcomes associated with COVID-19 infection in NMOSD and MOGAD patients revealed similar hospitalization rates but a notable difference in deaths in NMOSD patients treated with rituximab. Following COVID-19 infection, twice as many patients developed new-onset MOGAD compared to NMOSD, with a similar larger number of patients who developed MOGAD than NMOSD post-COVID-19 vaccination. While the heavy female predominance in NMOSD is well-established, a greater ratio of male to female patients developed MOGAD post-infection and post-vaccination. Clinicians should closely monitor NMOSD patients with COVID-19 infection, particularly those receiving B-cell depleting therapies, among whom mortality was more frequently reported. The rise in NMOSD and MOGAD following COVID-19 infection and vaccination cases warrants further investigation of the underlying immunological mechanisms. Molecular mimicry and a bystander immune-mediated injury likely play a greater role in central nervous system damage than does direct viral injury.},
}

@article {pmid42438709,
year = {2026},
author = {Torres-Pasillas, HA and Luna-García, H and Celaya-Padilla, JM and Espino-Salinas, CH and Acra-Despradel, C and Villalba-Condori, K and Cárdenas Núñez, YM},
title = {Metabolomic datasets in COVID-19 research: a systematic literature review of availability, characteristics, and methodologies.},
journal = {PeerJ},
volume = {14},
number = {},
pages = {e21313},
pmid = {42438709},
issn = {2167-8359},
mesh = {Humans ; *Metabolomics/methods ; *COVID-19/metabolism ; *Biomedical Research ; SARS-CoV-2 ; *Datasets as Topic ; Information Dissemination ; },
abstract = {The COVID-19 pandemic has accelerated the integration of metabolomics and Machine Learning in biomedical research, resulting in the creation of numerous datasets with high potential for reuse. However, information regarding their accessibility, quality, and usability remains scattered and inconsistent. This systematic review aims to identify and evaluate publicly available human metabolomic datasets related to COVID-19, providing detailed information on their main characteristics and how to access them, with the goal to inform their potential for reuse in future research. Following PRISMA guidelines and the Kitchenham methodology, we conducted a comprehensive search of the scientific literature and specialized metabolomics repositories, identifying 110 unique datasets. Each dataset was assessed based on 15 variables related to data availability, accessibility, collection methodologies, sample sizes, and the extent of participant metadata provided. These datasets offer significant value for secondary analyses and ML applications, contributing to insights into disease mechanisms, early diagnosis, and patient stratification. By offering a structured overview of dataset characteristics, this review aims to support researchers in identifying suitable resources, encourages data reuse, and promotes best practices for data sharing and standardization in the context of COVID-19 and metabolomics. Nonetheless, our findings reveal critical limitations, including the underuse of dedicated repositories, frequent unavailability of raw data, lack of standardization in processed data, and insufficient metadata-particularly regarding participant demographics and clinical information. Inconsistencies in data formats and reporting standards further hinder dataset findability, interoperability, and reuse. To enhance the value and impact of future metabolomic research, we recommend adopting standardized reporting guidelines, improving metadata completeness, ensuring the availability of raw data, and promoting the use of interoperable repositories to facilitate reproducibility, integration, and broader application of shared datasets.},
}

Humans
*Metabolomics/methods
*COVID-19/metabolism
*Biomedical Research
SARS-CoV-2
*Datasets as Topic
Information Dissemination

@article {pmid42438902,
year = {2026},
author = {Kim, JH},
title = {Use of corticosteroids in sepsis and infectious diseases: a narrative review.},
journal = {The Korean journal of internal medicine},
volume = {41},
number = {4},
pages = {585-596},
pmid = {42438902},
issn = {2005-6648},
mesh = {Humans ; *Adrenal Cortex Hormones/therapeutic use/adverse effects ; *Anti-Inflammatory Agents/therapeutic use/adverse effects ; Community-Acquired Pneumonia/drug therapy ; COVID-19 ; *COVID-19 Drug Treatment ; Critical Illness ; Pandemics ; SARS-CoV-2 ; *Sepsis/drug therapy ; Shock, Septic/drug therapy ; Treatment Outcome ; },
abstract = {Critically ill patients with septic shock exhibit dysregulated host inflammatory responses. Critical illness-related corticosteroid insufficiency (CIRCI) has been recognized as a potential contributor to poor outcomes in critically ill patients. CIRCI is characterized by dysregulation of the hypothalamic-pituitary-adrenal axis, which results in a state of systemic inflammation through altered cortisol metabolism and tissue resistance to corticosteroids, all of which may lead to systemic inflammation. Based on these pathophysiological mechanisms, the beneficial anti-inflammatory effects of corticosteroids have been proposed and evaluated in several clinical trials. However, evidence of the beneficial effects of corticosteroids has been evolving for years. While some studies have demonstrated beneficial outcomes, such as accelerated shock reversal, reduced duration of mechanical ventilation, and reduced mortality, other studies have failed to demonstrate significant mortality benefits. Such disparity in studies suggests the heterogeneity of critical illnesses and the difficulty in identifying optimal indications for corticosteroids. Recent studies demonstrated the beneficial role of corticosteroids in patients with severe COVID-19 and community-acquired pneumonia. Given the evolving body of evidence, this review discusses the utility of corticosteroids in critically ill patients, including those with sepsis, septic shock, COVID-19, and severe community-acquired pneumonia.},
}

Humans
*Adrenal Cortex Hormones/therapeutic use/adverse effects
*Anti-Inflammatory Agents/therapeutic use/adverse effects
Community-Acquired Pneumonia/drug therapy
COVID-19
*COVID-19 Drug Treatment
Critical Illness
Pandemics
SARS-CoV-2
*Sepsis/drug therapy
Shock, Septic/drug therapy
Treatment Outcome

@article {pmid42438903,
year = {2026},
author = {Kong, J and Hong, S and Oh, J and Lee, S and Smith, L and Branda, F and Cho, H and Hwang, J and Yon, DK},
title = {Autoimmune diseases in the era of COVID-19: emerging mechanisms, clinical implications, vaccine considerations, and future directions.},
journal = {The Korean journal of internal medicine},
volume = {41},
number = {4},
pages = {597-619},
pmid = {42438903},
issn = {2005-6648},
support = {//Institute of Information & Communications Technology Planning & Evaluation/ ; RS-2024-00509257//Ministry of Science and ICT/ ; },
mesh = {Humans ; *COVID-19/immunology ; *Autoimmune Diseases/immunology/drug therapy/epidemiology ; *COVID-19 Vaccines/adverse effects ; SARS-CoV-2/immunology ; Immunosuppressive Agents/therapeutic use/adverse effects ; Immunocompromised Host ; Pandemics ; Risk Factors ; },
abstract = {The coronavirus disease 2019 (COVID-19) pandemic has highlighted a complex, bidirectional relationship between SARSCoV-2 infection and autoimmune diseases. This review examines how SARS-CoV-2 infection influences the incidence, progression, and outcomes of five major autoimmune conditions: systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, inflammatory bowel disease, and Guillain-Barré syndrome. Patients with autoimmune diseases are at increased risk of severe COVID-19 due to intrinsic immune dysregulation and the use of immunosuppressive therapies, both of which impair antiviral host defenses. Conversely, COVID-19 has been implicated in the initiation and exacerbation of autoimmune responses through mechanisms such as molecular mimicry and bystander activation. Concerns have also arisen regarding the safety and efficacy of COVID-19 vaccines in immunocompromised populations. Although vaccines are generally tolerated in these individuals, certain immunosuppressive therapies may attenuate humoral and cellular immune responses. Strategies such as adjusting immunosuppressive regimens and optimizing the timing of vaccination have been proposed to improve vaccine efficacy. Disease-specific considerations are essential to balance infection risk with adequate control of autoimmune activity. Overall, this review underscores the importance of individualized treatment strategies, close clinical monitoring, and interdisciplinary care in managing patients with autoimmune diseases during the COVID-19 pandemic. A deeper understanding of these interactions will be critical for improving patient outcomes and preparing for future pandemics involving immune-mediated diseases.},
}

Humans
*COVID-19/immunology
*Autoimmune Diseases/immunology/drug therapy/epidemiology
*COVID-19 Vaccines/adverse effects
SARS-CoV-2/immunology
Immunosuppressive Agents/therapeutic use/adverse effects
Immunocompromised Host
Pandemics
Risk Factors

@article {pmid42441431,
year = {2026},
author = {Warkentin, TE and Greinacher, A},
title = {Platelet-Activating Anti-Platelet Factor 4 Disorders.},
journal = {The New England journal of medicine},
volume = {395},
number = {5},
pages = {478-491},
doi = {10.1056/NEJMra2502459},
pmid = {42441431},
issn = {1533-4406},
mesh = {Humans ; *Autoantibodies/blood/immunology ; COVID-19 Vaccines/adverse effects/immunology ; Heparin/adverse effects/immunology ; Paraproteinemias/blood/diagnosis/drug therapy/immunology ; *Platelet Activation/drug effects/immunology ; *Platelet Factor 4/immunology ; Purpura, Thrombocytopenic, Idiopathic/blood/diagnosis/drug therapy/immunology ; *Thrombocytopenia/blood/diagnosis/drug therapy/immunology ; *Thrombosis/blood/diagnosis/drug therapy/immunology ; Platelet Count ; Adenoviruses, Human/immunology ; Anticoagulants/administration & dosage ; Immunoglobulins, Intravenous/administration & dosage ; Tyrosine Kinase Inhibitors/administration & dosage ; Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors ; },
abstract = {Platelet-activating antibodies against platelet factor 4 (PF4) cause highly prothrombotic disorders with reduced platelet counts. In heparin-induced thrombocytopenia (HIT), these antibodies bind PF4-heparin complexes, causing heparin-dependent platelet activation. Less common autoimmune and spontaneous HIT variants that are triggered by heparin and nonpharmacologic polyanions, respectively, have atypical clinical features and antibodies with additional heparin-independent platelet-activating properties. Vaccine-induced immune thrombocytopenia and thrombosis (VITT) antibodies directly target PF4. Initially, VITT was linked to adenoviral vector-based coronavirus disease 2019 vaccines, but in rare cases, an immune thrombocytopenia and thrombosis disorder that is clinically nearly identical to VITT can be caused by infection resulting from natural exposure to viruses, especially adenovirus. In persons with the IGLV3-21*02/*03 gene, anti-adenovirus protein VII antibody specificity shifts to PF4 by way of a specific somatic hypermutation (K31E) that creates VITT antibodies. In VITT-like monoclonal gammopathy of thrombotic significance, monoclonal anti-PF4 antibodies cause chronic prothrombotic conditions. Accurate diagnosis relies on distinct assays for HIT and VITT antibodies. Beyond anticoagulation, inhibition of FcγIIa receptor-mediated platelet activation may be needed for anti-PF4 disorders with heparin-independent reactivity (e.g., high-dose immune globulin in acute disease manifestations and Bruton's tyrosine kinase inhibitors in chronic manifestations).},
}

Humans
*Autoantibodies/blood/immunology
COVID-19 Vaccines/adverse effects/immunology
Heparin/adverse effects/immunology
Paraproteinemias/blood/diagnosis/drug therapy/immunology
*Platelet Activation/drug effects/immunology
*Platelet Factor 4/immunology
Purpura, Thrombocytopenic, Idiopathic/blood/diagnosis/drug therapy/immunology
*Thrombocytopenia/blood/diagnosis/drug therapy/immunology
*Thrombosis/blood/diagnosis/drug therapy/immunology
Platelet Count
Adenoviruses, Human/immunology
Anticoagulants/administration & dosage
Immunoglobulins, Intravenous/administration & dosage
Tyrosine Kinase Inhibitors/administration & dosage
Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors

@article {pmid42441648,
year = {2026},
author = {Capodici, A and Filippeschi, A and Noci, F and Michelucci, A and El Motarajji, S and Benedetto, V and Vandelli, A and Passino, C and Emdin, M and Nuti, S and Avizzano, CA and Bellè, N and Giannoni, A},
title = {Mapping global inequities in telemedicine implementation: An umbrella review of barriers and facilitators.},
journal = {PloS one},
volume = {21},
number = {7},
pages = {e0351885},
pmid = {42441648},
issn = {1932-6203},
mesh = {Humans ; *Telemedicine ; *COVID-19/epidemiology ; SARS-CoV-2/isolation & purification ; Digital Health ; Global Health ; *Healthcare Disparities ; Evidence Gaps ; },
abstract = {Telemedicine expanded rapidly during the COVID-19 pandemic, yet its diffusion has remained uneven across health systems. Whether implementation challenges differ systematically across economic contexts, and what implications these differences hold for global digital health equity, has not been comprehensively characterized. This study presents an umbrella review (PROSPERO CRD42024615998) of systematic reviews and meta-analyses indexed in PubMed and Scopus through December 2025 that reported barriers and/or facilitators to telemedicine implementation. Methodological quality was appraised using R-AMSTAR. Reported items were extracted verbatim, embedded with the Universal Sentence Encoder, and grouped into thematic clusters using HDBSCAN density-based clustering, with parameters optimized by SLSQP for cluster cohesion (median intra-cluster similarity ≥ 0.5). Analyses were stratified by World Bank country income group to characterize context-specific implementation profiles, identify evidence gaps, and detect orphaned barriers, defined as challenges lacking any corresponding documented facilitator. A total of 161 systematic reviews were included, yielding 1,333 barriers and 504 facilitators (corresponding to a barrier-to-facilitator ratio of 2.6:1). Across all settings, the most frequently reported barriers were high costs (n = 106), technical issues (n = 94), and training and knowledge (n = 91). Thematic profiles differed markedly by income group: high-income countries reported predominantly second-generation challenges centered on workflow integration, interoperability, and user experience, whereas lower-middle-income countries reported foundational barriers centered on infrastructures and costs. Evidence produced from low-income countries was entirely absent. Several high-frequency barriers lacked corresponding facilitator clusters, indicating challenges for which the published literature provides no documented solutions. The global telemedicine evidence base is itself inequitably distributed and risks reinforcing the disparities it is intended to reduce. High-income settings require implementation research focused on human and organizational factors, whereas lower-income settings require foundational research and investment in basic infrastructures before workflow-level optimization becomes meaningful. Without context-specific, equity-oriented strategies, telemedicine risks widening rather than narrowing the global digital health divide.},
}

Humans
*Telemedicine
*COVID-19/epidemiology
SARS-CoV-2/isolation & purification
Digital Health
Global Health
*Healthcare Disparities
Evidence Gaps

@article {pmid42441796,
year = {2026},
author = {da Costa, ECR and Santana, RF and Rembold, SM and Sales, FM and Cavalcante, RB},
title = {Nursing Diagnosis "Maladaptive Coping with Infodemic": A Concept Analysis.},
journal = {International journal of nursing knowledge},
volume = {37},
number = {3},
pages = {466-479},
doi = {10.1177/20473087261443259},
pmid = {42441796},
issn = {2047-3095},
mesh = {Humans ; *Adaptation, Psychological ; Coping Skills ; *Nursing Diagnosis ; },
abstract = {ObjectivesTo analyze the concept of infodemic in health as a theoretical basis for proposing the nursing diagnosis "Maladaptive Coping with the Infodemic".MethodsA conceptual analysis guided by the Walker and Avant method was conducted, following the steps of identifying the uses of the concept, attributes, antecedents, consequences, empirical referents, and model and contrary cases. To construct the definitions, an integrative literature review was carried out in June 2024.ResultsThirty-three studies addressing the concept of infodemic in individual health were identified. The core elements of the concept include information overload, disinformation, misinformation, fake news. The antecedents include the pandemic, low educational level, low income, and low health literacy with depression identified as an associated condition. The consequences include incorrect health actions (e.g., refusal to vaccinate), risk-prone behaviors (e.g., lack of protective measures), anxiety, stress, fear, social isolation, and insomnia, substance abuse.ConclusionsThe proposed nursing diagnosis, "Maladaptive Coping with the Infodemic," provides a theoretical framework to support nurses in identifying behaviors and psychological impacts associated with misinformation and to guide targeted nursing interventions.},
}

Humans
*Adaptation, Psychological
Coping Skills
*Nursing Diagnosis

@article {pmid42442307,
year = {2026},
author = {Alaka, M and Tuaillon, E and Desnues, B},
title = {Intravenous immunoglobulin therapy in viral infections: Lessons learned from COVID-19.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {201},
number = {},
pages = {119762},
doi = {10.1016/j.biopha.2026.119762},
pmid = {42442307},
issn = {1950-6007},
mesh = {Humans ; *Immunoglobulins, Intravenous/therapeutic use/pharmacology ; *COVID-19/immunology ; *COVID-19 Drug Treatment ; *Virus Diseases/drug therapy/immunology ; SARS-CoV-2/immunology ; Animals ; Antiviral Agents/therapeutic use ; Immunologic Factors/therapeutic use ; },
abstract = {OBJECTIVES: Intravenous immunoglobulin (IVIg) exerts both antiviral and immunomodulatory effects, but its role in viral infections remains incompletely defined. This review aims to provide an integrated overview of IVIg mechanisms of action and to evaluate its clinical relevance in viral diseases, with particular emphasis on coronavirus disease 2019 (COVID-19).

METHODS: A structured narrative literature review was conducted using PubMed (MEDLINE) and complemented by manual screening of the reference lists of relevant publications. The search included studies available through early 2026 addressing the mechanisms of action of IVIg and its clinical application in viral infections. Records were screened by title, abstract, and full-text evaluation according to predefined eligibility criteria, and the evidence was synthesized qualitatively.

RESULTS: IVIg acts through multiple mechanisms, including fragment antigen binding (Fab)-mediated neutralization, fragment crystallizable (Fc) receptor modulation, complement inhibition, cytokine regulation, and neonatal Fc receptor (FcRn)-mediated immunoglobulin G clearance. In immunodeficient patients, IVIg provides passive antiviral immunity and improves viral control. In contrast, in severe viral infections such as COVID-19, disease severity is largely driven by immune dysregulation. In this context, IVIg may exert benefit primarily through immunomodulatory effects rather than direct antiviral activity. Clinical studies in COVID-19 have shown heterogeneous results, influenced by treatment timing, patient selection, dosing strategies, and concomitant therapies.

CONCLUSIONS: IVIg should be considered a context-dependent immunomodulatory therapy rather than a universal antiviral strategy. Its clinical efficacy likely depends on alignment between its mechanisms and disease-specific immunopathology, highlighting the need for biomarker-guided and stage-specific therapeutic approaches.},
}

Humans
*Immunoglobulins, Intravenous/therapeutic use/pharmacology
*COVID-19/immunology
*COVID-19 Drug Treatment
*Virus Diseases/drug therapy/immunology
SARS-CoV-2/immunology
Animals
Antiviral Agents/therapeutic use
Immunologic Factors/therapeutic use

@article {pmid42442360,
year = {2026},
author = {Kazer, SW and Walsh, JML and Juttukonda, LJ and Ordovas-Montanes, J},
title = {Nasal immunity in respiratory viral infection, transmission, and protection.},
journal = {Immunity},
volume = {59},
number = {10},
pages = {2623-2642},
pmid = {42442360},
issn = {1097-4180},
support = {R01 DE031928/DE/NIDCR NIH HHS/United States ; R01 HL162642/HL/NHLBI NIH HHS/United States ; T32 HD098061/HD/NICHD NIH HHS/United States ; },
mesh = {Humans ; Animals ; *Nasal Mucosa/immunology/virology ; *COVID-19/immunology/transmission/prevention & control ; *SARS-CoV-2/immunology ; *Immunity, Mucosal ; Mice ; Vaccination ; Immunologic Memory ; *Respiratory Tract Infections/immunology/transmission ; Administration, Intranasal ; },
abstract = {The nasal mucosa plays key roles in protecting against airborne pathogens as the major barrier to the airway. Catalyzed by the COVID-19 pandemic, recent studies focusing on nasal immunity have begun to elucidate how epithelial and immune cells work in concert to fight viral infection, reduce spread to the lower airways, and limit onward transmission. Technologies such as single-cell RNA sequencing and air-liquid interface models are enabling high-resolution views of the cell states and responses that dictate infection resolution and memory formation. Here, we review our current understanding of the cells of the nasal mucosa at homeostasis and their responses during and following viral infection in mice and humans. We discuss emerging correlates of protection before and after exposure, noting the differences between infection and intramuscular vaccination. Finally, we examine novel intranasal vaccination strategies and propose approaches to program tissue-scale memory into the nose to prevent disease and viral spread.},
}

Humans
Animals
*Nasal Mucosa/immunology/virology
*COVID-19/immunology/transmission/prevention & control
*SARS-CoV-2/immunology
*Immunity, Mucosal
Mice
Vaccination
Immunologic Memory
*Respiratory Tract Infections/immunology/transmission
Administration, Intranasal

@article {pmid42442743,
year = {2026},
author = {Lee, DH and Kakeya, H},
title = {Reassessing Early COVID-19 Strategies in East Asia: Insights From Japan and Korea.},
journal = {Journal of preventive medicine and public health = Yebang Uihakhoe chi},
volume = {59},
number = {4},
pages = {343-351},
pmid = {42442743},
issn = {2233-4521},
mesh = {Humans ; Japan/epidemiology ; Republic of Korea/epidemiology ; *COVID-19/prevention & control/mortality/epidemiology/diagnosis ; Quarantine ; SARS-CoV-2 ; Public Health ; Pandemics/prevention & control ; COVID-19 Testing ; },
abstract = {East Asian countries had remarkably low coronavirus disease 2019 (COVID-19) mortality in 2020, a pattern widely cited as evidence of effective public health interventions. However, Japan and Korea-often classified as having followed similar early intervention strategies-adopted substantially different approaches. These differences are largely obscured by commonly used stringency indices and policy score analyses. While neither country implemented a lockdown, Korea pursued an aggressive, government-mandated strategy based on extensive testing, isolation, quarantine, and compulsory data collection. In contrast, Japan relied on a voluntary model with limited mass testing, a policy that drew strong criticism during the early phase of the pandemic. Because asymptomatic COVID-19 infection was highly prevalent, these divergent testing policies were particularly important in shaping patterns of community transmission. Using excess mortality as a comprehensive outcome metric, Japan's outcomes were as favorable as Korea's through the pre-Omicron period, despite Japan's limited testing. In 2020, excess mortality was negligible in both countries (-1.7% in Japan vs. +0.3 to +2.1% in Korea). In 2021, excess mortality increased modestly (+2.2% vs. +4.0 to +5.6%). However, in 2022, despite approximately 80% vaccination coverage in both countries, excess mortality reached +7.6% in Japan and about +20% in Korea-three times the Japanese level despite Korea's much higher booster rate. These patterns of excess mortality in 2 countries with contrasting testing strategies challenge the view that East Asia's early success stemmed primarily from stringent virus suppression measures. They highlight the need to consider alternative explanations, including the possibility that pre-existing immunity differed substantially across geographical regions.},
}

Humans
Japan/epidemiology
Republic of Korea/epidemiology
*COVID-19/prevention & control/mortality/epidemiology/diagnosis
Quarantine
SARS-CoV-2
Public Health
Pandemics/prevention & control
COVID-19 Testing

@article {pmid42445051,
year = {2026},
author = {Balcha, WF and Kassahun, EA and Nega, AT and Abie, A and Demsie, DG and Negesse, CT and Feyisa, K and Mekonnen, BA and Biadigilign, TM and Addisu, ZD and Ayenew, W and Siraj, EA and Zewdie, S and Anagaw, YK and Alene, GM and Yismaw, MB and Yehualaw, A and Kebede, SY and Mihiretie, EA and Awoke, AM and Bante, SA and Tesfu, AA and Sendeku, FW and Demissie, BA and Shiferaw, WG and Megule, SM and Abebe, YM and Tessema, LW and Chekole, FA},
title = {Labor Pain Management Practices and Associated Factors Among Licensed Obstetric Care Providers in Ethiopia: A Systematic Review and Meta-Analysis.},
journal = {Health science reports},
volume = {9},
number = {7},
pages = {e72770},
pmid = {42445051},
issn = {2398-8835},
abstract = {BACKGROUND AND AIMS: Labor pain is a multidimensional experience influenced by emotional, cognitive, and cultural factors. It can be managed using pharmacological, non-pharmacological, or combined approaches. Licensed obstetric care providers (OCPs) are ethically obligated to ensure maternal comfort while safeguarding fetal safety. Evidence on labor pain management practices (LPMP) in Ethiopia remains inconsistent, as prior studies often included students or had unclear inclusion criteria. This systematic review and meta-analysis estimated the pooled prevalence of LPMP among licensed OCPs, identified associated factors, and examined trends before and during the COVID-19 pandemic.

METHODS: We searched major databases and repositories for studies published between January 1, 2018 and October 3, 2025. Risk of bias was assessed using the Joanna Briggs Institute checklist and modified Newcastle-Ottawa Scale, with inter-rater reliability analyses. Meta-analysis was conducted in STATA 17 using random or fixed-effects models. Heterogeneity was assessed using Cochran's Q test and quantified with I[2] statistic. Certainty of evidence rated using GRADE.

RESULTS: Twenty studies involving 7,202 participants were included. LPMP prevalence varied substantially across studies and settings. The pooled prevalence of overall LPMP was 46.9% (95% CI: 42.7-51.1; I[2] = 92.4%). Non-pharmacological practice was 42.8% (95% CI: 36.6-49.1), whereas pharmacological practice was 21.1% (95% CI: 12.5-29.7), decreasing to 15.2% after adjustment for publication bias. Pharmacological practice was modestly higher during COVID-19 (23.7% vs. 18.0%). Factors positively associated with LPMP included provider knowledge, attitudes, training, drug/protocol availability, supportive environments, higher education, longer experience, positive perceptions, being a midwife, and female sex. Certainty of evidence ranged from low to moderate.

CONCLUSION: LPMP prevalence varied considerably across studies and settings. While the pooled estimate suggests that fewer than half of Ethiopian OCPs practiced LPMP, substantial unexplained heterogeneity warrants cautious interpretation. Non-pharmacological methods were more commonly used than pharmacological approaches, highlighting opportunities to strengthen provider training, institutional support, and resource availability.},
}

@article {pmid42445255,
year = {2026},
author = {Jha, S and Chaliha, LB and Pandey, K and Patel, R},
title = {Reimagining tuberculosis elimination in India: diagnostics, drug resistance, and digital health strategies.},
journal = {Frontiers in epidemiology},
volume = {6},
number = {},
pages = {1868261},
pmid = {42445255},
issn = {2674-1199},
abstract = {Tuberculosis (TB) remains a major global public health challenge and one of the leading infectious causes of mortality worldwide, with India contributing approximately 26% of the global TB burden. Despite substantial progress under the National Tuberculosis Elimination Programme (NTEP), India's efforts to achieve the ambitious 2025 TB elimination target continue to face major challenges due to the COVID-19 pandemic, multidrug-resistant tuberculosis (MDR-TB), healthcare disparities, and limitations in surveillance and reporting systems. This review provides a comprehensive overview of the epidemiology of TB in India and critically evaluates the impact of COVID-19, drug resistance, healthcare accessibility, and emerging diagnostic technologies on TB control efforts. A structured literature search was conducted using PubMed, Scopus, and Google Scholar, along with reports from the World Health Organization and the Government of India. The reviewed evidence indicates that the COVID-19 pandemic significantly disrupted TB diagnosis, treatment, surveillance, and healthcare accessibility, leading to declines in case notification and the possible accumulation of undiagnosed TB cases. In addition, the increasing burden of MDR/RR-TB, fragmented private healthcare systems, underreporting, and unequal access to diagnostics and treatment continue to hinder progress toward TB elimination. Although advancements including molecular diagnostics, digital surveillance platforms such as Nikshay, AI-assisted screening, and patient-support programmes have strengthened TB control strategies, important challenges related to implementation, infrastructure, scalability, and antimicrobial stewardship remain unresolved. This review highlights the need for integrated and patient-centred TB control strategies that combine rapid diagnostics, strengthened surveillance, public-private healthcare integration, health systems strengthening, and interventions addressing broader socioeconomic determinants such as poverty, malnutrition, and healthcare inequity. Coordinated multisectoral approaches will be essential for accelerating TB elimination efforts in India in the post-COVID era.},
}

@article {pmid42446912,
year = {2026},
author = {Li, N and Yan, Y and Li, Y and Ni, J and Gao, J and Piao, X and Hou, X},
title = {The effect of high-dose of vitamin C on mortality among aged patients with severe COVID-19: A systematic review and meta-analysis.},
journal = {Clinical and investigative medicine. Medecine clinique et experimentale},
volume = {49},
number = {2},
pages = {31-42},
doi = {10.3138/CIM-2024-0302},
pmid = {42446912},
issn = {1488-2353},
mesh = {Humans ; *Ascorbic Acid/administration & dosage/therapeutic use ; *COVID-19/mortality ; Aged ; Critical Illness/mortality ; SARS-CoV-2 ; *COVID-19 Drug Treatment ; Randomized Controlled Trials as Topic ; },
abstract = {BACKGROUND: Critically ill patients are frequently deficient in vitamin C. Given the significant mortality rates in the elderly population associated with COVID-19, we aimed to systematically review the literature and evaluate whether high-dose vitamin C can reduce COVID-19 mortality in this population.

METHODS: Multiple data sources (PubMed, Web of Science, ScienceDirect, and medRxiv) were searched using the keywords "COVID-19" AND "vitamin C" up to November 2024. Randomized controlled trials (RCTs) involving COVID-19 patients with relevant data were collected. We used a random or fixed effects meta-analysis to calculate the pooling effect.

RESULTS: Eight RCTs comprising 2,104 patients were ultimately included in the meta-analysis. The pooling effect (odds ratio [OR] 0.97[95% CI 0.80-1.18, P = 0.76) suggested no significant difference in mortality rates between patients treated with high-dose vitamin C and those who were not.

CONCLUSIONS: Vitamin C supplementation might reduce the risk of COVID-19 mortality in critically ill patients; however, this effect varied by study. Additional research is necessary to arrive at a definitive conclusion on this subject.},
}

Humans
*Ascorbic Acid/administration & dosage/therapeutic use
*COVID-19/mortality
Aged
Critical Illness/mortality
SARS-CoV-2
*COVID-19 Drug Treatment
Randomized Controlled Trials as Topic

@article {pmid42447883,
year = {2026},
author = {Naidoo, T and Morgenstern, C and Doohan, P and Earl, R and Rawson, T and Sheppard, RJ and Hicks, JT and Radhakrishnan, S and Johnson, R and Hartner, AM and Cattarino, L and McCain, K and Vicco, A and Imai-Eaton, N and Elsland, SV and Cori, A and McCabe, R and Bhatia, S and , },
title = {A systematic review of Nipah virus disease epidemiological parameters, outbreaks, and mathematical models.},
journal = {The Lancet. Infectious diseases},
volume = {26},
number = {10},
pages = {e409-e422},
doi = {10.1016/S1473-3099(26)00239-2},
pmid = {42447883},
issn = {1474-4457},
mesh = {Humans ; *Henipavirus Infections/epidemiology/transmission/virology ; *Disease Outbreaks ; *Nipah Virus ; Models, Theoretical ; Seroepidemiologic Studies ; Risk Factors ; },
abstract = {Our systematic review, based on PRISMA guidelines (PROSPERO CRD42023393345), characterised the epidemiology, outbreaks, and mathematical models of Nipah virus, an important public health threat in south and southeast Asia. We searched PubMed and Web of Science from database inception to March 14, 2025, and extracted 243 parameters, 89 risk factors, 39 models, and 23 distinct outbreaks from 119 papers. IgG seroprevalence estimates in the general population ranged from 0% to 12·5%. Nipah virus causes severe disease, with pooled case-fatality ratio estimates ranging widely from 9·1% (95% CI 0·2-41·3) in Singapore to 81·9% (95% CI 71·9-88·9) in Bangladesh. The infection timeline and clinical course of Nipah virus remain poorly characterised; we estimated a median incubation period of 8·77 days (165, 95% CI 7·53-10·02) from eight estimates in seven articles with sufficient information. Transmission parameter estimates were scarce, and all but one of five central estimates of the basic reproduction number were less than one. Nipah virus mathematical models (39) were rarely fitted to data (eight). All extracted information is accessible via our R package, epireview.},
}

Humans
*Henipavirus Infections/epidemiology/transmission/virology
*Disease Outbreaks
*Nipah Virus
Models, Theoretical
Seroepidemiologic Studies
Risk Factors

@article {pmid42448011,
year = {2026},
author = {Thapa, N and Jin, Y and Han, JH},
title = {Innate immune surveillance and nucleic acid sensing: Gatekeepers of inflammatory cell death in respiratory infectious diseases.},
journal = {Pharmacological research},
volume = {231},
number = {},
pages = {108340},
doi = {10.1016/j.phrs.2026.108340},
pmid = {42448011},
issn = {1096-1186},
mesh = {Humans ; Animals ; Innate Immunity Recognition ; *Nucleic Acids/immunology ; *Immunity, Innate ; *Respiratory Tract Infections/immunology/virology/pathology ; Cell Death/immunology ; Inflammation/immunology ; Receptors, Pattern Recognition/immunology ; *Immunologic Surveillance ; Signal Transduction ; },
abstract = {Respiratory infections caused by viral pathogens, including influenza A virus, respiratory syncytial virus, and SARS-CoV-2, as well as bacterial pathogens, remain major contributors to global morbidity and mortality. The outcomes of these infections are largely determined by how the host innate immune system detects pathogen-derived nucleic acids and regulates subsequent inflammatory responses. Pattern recognition receptors (PRRs) located in endosomal and cytosolic compartments, including toll-like receptors, RIG-I-like receptors, absent in melanoma 2, and Z-DNA-binding protein 1, as well as the cyclic GMP-AMP synthase-stimulator of interferon genes pathway, recognize viral and bacterial nucleic acids and initiate signaling cascades that promote cytokine production and antimicrobial defense. However, dysregulated PRR activation can trigger inflammatory programmed cell death, including apoptosis, pyroptosis, necroptosis, and PANoptosis. This review summarizes recent advances in understanding how nucleic acid sensing orchestrates inflammatory cell death during respiratory infections, with particular emphasis on pathogen- and cell type-specific mechanisms that shape disease outcomes. We further highlight the dual nature of these pathways, which are essential for pathogen clearance but can drive immunopathology when excessively activated. Defining how nucleic acid-sensing pathways shape inflammatory cell death in respiratory infections may guide host-directed therapies that enhance pathogen clearance while preserving lung function. Overall, the field remains constrained by the predominance of virus-focused and murine preclinical studies, whereas bacterial nucleic acid sensing during respiratory infections remains poorly defined. Future studies should integrate major bacterial infection models with human-relevant respiratory epithelial systems to better translate PRR-mediated immune mechanisms into host-directed therapeutic strategies.},
}

Humans
Animals
Innate Immunity Recognition
*Nucleic Acids/immunology
*Immunity, Innate
*Respiratory Tract Infections/immunology/virology/pathology
Cell Death/immunology
Inflammation/immunology
Receptors, Pattern Recognition/immunology
*Immunologic Surveillance
Signal Transduction

@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 {pmid42448413,
year = {2026},
author = {Viknesh, K and Vijayalakshmi, P and Alex, AM and Muthumani, LN and Muthupandian, S and Desai, D and Ramanathan, S and Likson, A and Selvaraj, C},
title = {Energetic landscapes and fuzzy complexes: Computational targeting of viral intrinsically disordered proteins.},
journal = {Advances in protein chemistry and structural biology},
volume = {153},
number = {},
pages = {351-407},
doi = {10.1016/bs.apcsb.2026.04.009},
pmid = {42448413},
issn = {1876-1631},
mesh = {Humans ; *Intrinsically Disordered Proteins/chemistry/metabolism/antagonists & inhibitors ; *Viral Proteins/chemistry/metabolism/antagonists & inhibitors ; *Antiviral Agents/chemistry/pharmacology ; SARS-CoV-2 ; Machine Learning ; },
abstract = {The increased recognition of intrinsically disordered proteins (IDPs) as critical mediators in viral infections has shifted attention toward fuzzy drug targets, challenging the conventional structure-based paradigms of drug discovery due to their inherent conformational flexibility. The binding of viral IDPs and IDRs to host factors occurs in dynamic, multivalent, and context-dependent interactions and constitute flexible complexes, which form the basis of pathogenicity and immune evasion. In this review, the disordered proteins of viruses are considered with a combination of molecular, computational, and translational insights to assess the next-generation antiviral targets. In this, we have discuss about the energetic landscapes that control the disorder, functional disorder order transitions and the fuzzy interfaces as centers of the networks of virus-host interactions. Special focus is kept on the new lines of computational and AI-directed technologies such as ensemble-based docking, machine-learning computational models of IDP ligand recognition, and multi-omics-driven target prioritization. The experimental approaches that are modified to characterize disordered systems, including NMR spectroscopy and hybrid structural biology, are also reviewed. The translational applicability of the targeting of viral fuzziness is highlighted by case studies of HIV-1, influenza, SARS-CoV-2, and emerging viral pathogens. We also provide directions about the future involving adaptive pharmacophores, customized antiviral approaches, and AI-driven ensemble targeting making disordered viral proteins a paradigm shift in antiviral drug discovery.},
}

Humans
*Intrinsically Disordered Proteins/chemistry/metabolism/antagonists & inhibitors
*Viral Proteins/chemistry/metabolism/antagonists & inhibitors
*Antiviral Agents/chemistry/pharmacology
SARS-CoV-2
Machine Learning

@article {pmid42449828,
year = {2026},
author = {Hetta, HF and Haseeb, A and Bukhari, SQ and Alatawi, Z and Mahrous, AJ and Elrggal, ME and Masri, MA and Kotb, AA},
title = {Emerging Multimodal Point-of-Care Diagnostic Strategies for Rapid Detection and Management of Respiratory Viruses: A State-of-the-Art Review.},
journal = {Diagnostics (Basel, Switzerland)},
volume = {16},
number = {13},
pages = {},
pmid = {42449828},
issn = {2075-4418},
support = {26UQU4310470GSSR02//Umm al-Qura University/ ; 26UQU4310470GSSR03//Umm al-Qura University/ ; },
abstract = {The co-circulation of respiratory viruses, including SARS-CoV-2, influenza A/B, and respiratory syncytial virus (RSV), represents a significant global health challenge that requires rapid, accurate, and differential diagnosis to support infection control and appropriate clinical decision-making. This narrative review summarizes emerging multimodal point-of-care testing (POCT) strategies for the detection and management of these respiratory viruses. Relevant studies were identified through literature searches of major scientific databases, including PubMed, Scopus, and Web of Science, focusing on recent advances in molecular diagnostics, biosensors, microfluidics, and digital health technologies. To improve clinical interpretation and comparative assessment, current POCT platforms were organized into four operational tiers based on infrastructure dependence, degree of portability, and level of decentralization of testing. Tier 1 (Professional Clinical Systems) includes fully integrated automated molecular diagnostic platforms designed for use in hospital and emergency care settings. Tier 2 (Field-Deployable Systems) comprises portable molecular and isothermal amplification technologies designed for use in decentralized or resource-limited environments. Tier 3 (Hardware-Lite Assays) includes simplified diagnostic approaches that minimize instrument requirements and are suitable for near-patient or low-infrastructure settings. Tier 4 (Consumer-Digital Diagnostics) encompasses emerging smartphone- and IoT-integrated diagnostic platforms that support user-driven testing and digital health connectivity. This tier-based framework reflects a proposed stratification of POCT technologies along a decentralization continuum and aims to facilitate comparison and selection of diagnostic strategies across diverse healthcare settings.},
}

@article {pmid42450061,
year = {2026},
author = {Lim, S and Martina, B},
title = {Immune Mechanisms and Translational Study Design in Viral Vaccine Development.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
pmid = {42450061},
issn = {1422-0067},
mesh = {Humans ; Animals ; *Translational Research, Biomedical ; *Viral Vaccines/immunology ; *Vaccine Development/methods ; COVID-19/prevention & control/immunology ; SARS-CoV-2/immunology ; Adaptive Immunity ; Immunity, Innate ; COVID-19 Vaccines/immunology ; },
abstract = {Viral vaccine development requires both mechanistic understanding of protective immunity and translational study designs that connect preclinical data with human outcomes. Animal models remain important for early assessment of safety, immunogenicity and protective efficacy, but their predictive value depends on the question being asked, the pathophysiology of infection, the immune mechanisms expected to mediate protection, and the biomarkers chosen to bridge animal and human data. This review focuses on viral vaccines and examines innate and adaptive mechanisms of vaccine-induced protection, including B cell and antibody responses, Fc-mediated functions, Fc glycosylation, T cell memory and CD8+ cytotoxic responses. We discuss common reasons for clinical failure and show how preclinical endpoints can be classified as human-counterpart, surrogate or comparative/mechanistic readouts. Influenza and COVID-19 examples illustrate how different models can be combined across discovery, challenge, transmission and late-stage bridging studies. Emerging tools such as systems serology, omics, AI/ML and new approach methods can improve candidate prioritization, but their value depends on assay standardization, biological validation and cautious interpretation. A mechanism-driven model cascade, paired with human-relevant immunological readouts, can improve preclinical interpretation and reduce the risk of advancing candidates that are unlikely to succeed in clinical trials.},
}

Humans
Animals
*Translational Research, Biomedical
*Viral Vaccines/immunology
*Vaccine Development/methods
COVID-19/prevention & control/immunology
SARS-CoV-2/immunology
Adaptive Immunity
Immunity, Innate
COVID-19 Vaccines/immunology

@article {pmid42450077,
year = {2026},
author = {Russjan, E and Zając, D and Kaczyńska, K},
title = {Therapeutic Potential of Glucagon-like Peptide-1 Receptor Agonists in Respiratory Disorders.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
pmid = {42450077},
issn = {1422-0067},
mesh = {Humans ; *Glucagon-Like Peptide-1 Receptor Agonists ; Pulmonary Disease, Chronic Obstructive/drug therapy ; Glucagon-Like Peptide-1 Receptor/metabolism ; Glucagon-Like Peptide 1/metabolism ; Animals ; COVID-19/metabolism ; Asthma/drug therapy ; Pulmonary Fibrosis/drug therapy ; Sleep Apnea, Obstructive/drug therapy ; SARS-CoV-2 ; },
abstract = {Glucagon-like peptide-1 (GLP-1) is an incretin hormone secreted in response to food intake that acts biologically by binding to GLP-1 receptors. The primary function of GLP-1 is to stimulate insulin secretion and inhibit glucagon secretion, which helps limit after-meal spikes in blood glucose. GLP-1 reduces intestinal contractility, slows down gastrointestinal motility and emptying, and also acts directly on the hypothalamus, thereby regulating appetite and food intake. Due to its metabolic effects, GLP-1 forms the basis of medications currently used to treat type 2 diabetes (T2DM) and obesity. However, it has also been observed that the use of GLP-1 agonists in the treatment of obesity or diabetes has a beneficial effect on comorbid respiratory conditions. This narrative review analyzes the scientific literature and describes the most recent information on the impact of GLP-1 receptor agonist (GLP-1 RA) therapies on the most common respiratory disorders-both the beneficial and undesirable effects. We discuss evidence that acute lung injury, COVID-19, pulmonary fibrosis, asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea can benefit from therapies with various GLP-1 RAs. They can complement existing lung-targeted treatments, but as research progresses, they are likely to play an ever more important role in the treatment of respiratory diseases.},
}

Humans
*Glucagon-Like Peptide-1 Receptor Agonists
Pulmonary Disease, Chronic Obstructive/drug therapy
Glucagon-Like Peptide-1 Receptor/metabolism
Glucagon-Like Peptide 1/metabolism
Animals
COVID-19/metabolism
Asthma/drug therapy
Pulmonary Fibrosis/drug therapy
Sleep Apnea, Obstructive/drug therapy
SARS-CoV-2

@article {pmid42450260,
year = {2026},
author = {Angamarca-Iguago, J and Parise-Vasco, JM and Reytor-González, C and Cagua-Ordoñez, J and Simancas-Racines, D},
title = {Temporal Dynamics of Innate Immune Activation and Viral Interference During Sequential Co-Infection with Influenza A Virus and SARS-CoV-2: Molecular Mechanisms, Clinical Evidence, and Therapeutic Implications.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
pmid = {42450260},
issn = {1422-0067},
mesh = {Humans ; *Immunity, Innate ; Animals ; *Influenza A virus/immunology ; *Influenza, Human/immunology/virology/drug therapy ; *SARS-CoV-2/immunology/physiology ; *COVID-19/immunology/virology ; *Coinfection/immunology/virology ; *Viral Interference ; Host-Pathogen Interactions/immunology ; Interferons ; Antiviral Agents/therapeutic use ; },
abstract = {The concurrent circulation of influenza A virus (IAV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unveiled complex host-pathogen interactions governed by temporal dynamics of innate immune activation. This narrative review synthesizes evidence from human air-liquid interface (ALI) epithelial models, animal studies (hamster, ferret), clinical cohorts, and randomized controlled trials (2015-2026) to delineate the molecular mechanisms underlying viral interference between these two major respiratory pathogens. Prior IAV infection induces a robust type I/III interferon (IFN) response and broad interferon-stimulated gene (ISG) upregulation that restricts subsequent SARS-CoV-2 replication within a critical 24-72 h temporal window. Conversely, SARS-CoV-2 employs a multi-layered immune evasion strategy that blunts IFN induction, providing minimal heterologous protection. Simultaneous co-infection tends to exacerbate disease severity. Host genetic determinants, including OAS1 and TLR7 variants, modulate interference capacity. Therapeutically, early pegylated IFN-λ shows clinical benefit, while experimental evidence from in vitro and animal models suggests oseltamivir may paradoxically reduce IAV-induced interference. These findings underscore the need for multi-pathogen diagnostics, temporally informed clinical decision-making, and IFN-based therapeutic strategies during co-circulation periods.},
}

Humans
*Immunity, Innate
Animals
*Influenza A virus/immunology
*Influenza, Human/immunology/virology/drug therapy
*SARS-CoV-2/immunology/physiology
*COVID-19/immunology/virology
*Coinfection/immunology/virology
*Viral Interference
Host-Pathogen Interactions/immunology
Interferons
Antiviral Agents/therapeutic use

@article {pmid42450302,
year = {2026},
author = {Basu, S and Adhikary, D and Ghosh, K and Chattopadhyay, S and Deb, S and Mondal, R and Roy, J and Chowdhury, A and Benito-León, J},
title = {Machine Learning and Deep Learning Frameworks for Human-Virus Protein-Protein Interaction Prediction: Emerging Architectures, Methods, Benchmarks, and Challenges.},
journal = {International journal of molecular sciences},
volume = {27},
number = {13},
pages = {},
pmid = {42450302},
issn = {1422-0067},
support = {R01 NS039422/NS/NINDS NIH HHS/United States ; R01 NS094607/NS/NINDS NIH HHS/United States ; },
mesh = {Humans ; *Deep Learning ; *Machine Learning ; SARS-CoV-2 ; COVID-19/virology ; *Viral Proteins/metabolism ; Host-Pathogen Interactions ; *Protein Interaction Mapping/methods ; Protein Interaction Maps ; Prediction Algorithms ; Benchmarking ; },
abstract = {The outbreak of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged as one of the most significant global health crises in recent history. Coronaviruses are a diverse group of RNA viruses classified into alpha, beta, gamma, and delta genera, with SARS-CoV-2 belonging to the beta-coronavirus family. The virus exhibits high transmissibility and causes a wide spectrum of clinical manifestations ranging from mild respiratory symptoms to severe complications such as acute respiratory distress syndrome, multi-organ failure, and death, particularly among elderly and immunocompromised individuals. Structurally, SARS-CoV-2 possesses a large single-stranded RNA genome encoding major structural proteins, including spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins, which play critical roles in host-cell recognition and viral infection. Understanding the molecular mechanisms of virus-host interactions, especially protein-protein interactions (PPIs), is essential for uncovering viral pathogenesis and identifying potential therapeutic targets. Traditional experimental techniques for PPI detection, such as yeast two-hybrid and affinity purification methods, are often expensive, labor-intensive, and prone to inaccuracies. Consequently, computational approaches based on machine learning (ML) and deep learning (DL) have gained significant attention for efficient and scalable PPI prediction. These methods use diverse biological information, including protein sequences, structural features, genomic data, Gene Ontology annotations, and interaction networks, to model complex biological relationships. This survey reviews computational approaches to PPI prediction, highlighting ML- and DL-based techniques, methodological advances, performance evaluation practices, and limitations that affect benchmark comparability. It also discusses biological databases and data sources commonly used in PPI studies and explicitly considers how models trained in coronavirus-centered settings may generalize to other viral families with different mechanisms of host interaction.},
}

Humans
*Deep Learning
*Machine Learning
SARS-CoV-2
COVID-19/virology
*Viral Proteins/metabolism
Host-Pathogen Interactions
*Protein Interaction Mapping/methods
Protein Interaction Maps
Prediction Algorithms
Benchmarking

@article {pmid42450918,
year = {2026},
author = {Latzer, Y and Stein, D},
title = {The Impact of Recent Collective Trauma in Israel on Eating Disorders and Disordered Eating: An Overview and Clinical Perspective.},
journal = {Healthcare (Basel, Switzerland)},
volume = {14},
number = {13},
pages = {},
pmid = {42450918},
issn = {2227-9032},
abstract = {Background: Periods of collective crises are associated with substantial deterioration in mental health. Whereas trauma-related psychopathology has received considerable clinical and policy attention during such periods, eating disorders (EDs) and disordered eating (DE) remain comparatively under-recognized. EDs and DE are well recognized in the Israeli context; however, accumulating evidence indicates a significant increase in their prevalence during periods of collective crisis. Objective: We sought to synthesize empirical findings and clinical observations in Israel about the impact of the COVID-19 pandemic and the October 2023 War on the emergence and exacerbation of DE and EDs, and to examine the implications for clinical practice and mental health policy. Methods: We conducted a narrative review integrating epidemiological data, findings from Israeli healthcare organizations, scientific studies, and clinical insights from specialized ED services. Results: Across both crises, Israel experienced a marked increase in the full spectrum of eating-related disturbances, ranging from emotional eating and subclinical DE to severe full-blown EDs. Adolescents and young adults were particularly affected, but increased ED-related disturbance was also observed among adults and individuals with pre-existing EDs. These findings coincide with a prolonged duration period before receiving treatment and with limited service capacity. In response, the mental health system attempted to implement rapid adaptations, including expanded telemedicine, short-term targeted interventions, and new ambulatory and day treatment programs. Conclusions: Our findings indicate that DE and EDs constitute a significant and escalating mental health burden during periods of collective crises that is comparable to other trauma-related conditions. Just as comprehensive short- and long-term intervention frameworks have been developed for trauma-related conditions, similar models are urgently required for EDs.},
}

@article {pmid42452468,
year = {2026},
author = {Rada, M and Petculescu, IM and Pah, AM and Avram, A and Velimirovici, DE and Velciov, AB and Tudoran, C and Iurciuc, S and Utu, D and Gheorghe, DR and Craciun, ML},
title = {Valvular Heart Disease and Heart Failure in the Post-COVID-19 Era: A Narrative Review of Mechanisms, Diagnosis, Differential Assessment, and Clinical Outcomes.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
pmid = {42452468},
issn = {2077-0383},
support = {Victor Babeș University of Medicine and Pharmacy Timișoara//Victor Babeș University of Medicine and Pharmacy Timișoara/ ; },
abstract = {Background/Objectives: Cardiovascular involvement is among the most consequential sequelae of SARS-CoV-2 infection. Myocardial injury, arrhythmia, and thromboembolic disease have been characterized in depth, yet the relationship between COVID-19 and valvular heart disease (VHD), and its interplay with heart failure (HF), has received comparatively limited synthesis. This narrative review consolidates current evidence on the mechanisms, diagnosis, differential assessment, and clinical outcomes linking acute and post-acute COVID-19 to valvular dysfunction and to incident or worsening heart failure, with emphasis on practical implications for cardiologists and internists. Methods: We searched PubMed, Scopus, and Web of Science (January 2020-January 2026) for studies on valvular dysfunction, heart failure, myocardial injury, and endothelial pathology in SARS-CoV-2 infection, and synthesized findings narratively. Results: Convergent pathways-endothelial injury, systemic hyperinflammation, micro- and macrovascular thrombosis, and pressure-volume overload-contribute to functional and, less frequently, structural valvular changes. Available evidence suggests that clinically relevant post-COVID valvular abnormalities are more often secondary/functional (mitral and tricuspid regurgitation) than primary structural lesions, although dedicated prospective valvular studies remain scarce. Pre-existing severe VHD markedly worsens acute COVID-19 prognosis. Elevated NT-proBNP, troponin, and interleukin-6 consistently predict decompensation and mortality, and a substantial minority of survivors show persistent fibrotic pulmonary changes and restrictive ventilatory defects on follow-up (pulmonary rather than cardiac findings). Conclusions: Post-COVID valvular dysfunction appears, on currently available but largely indirect evidence, predominantly functional and inflammation-related, and may overlap with HFpEF phenotypes in selected patients when objective diagnostic criteria are fulfilled. Biomarker-guided, multimodality follow-up is reasonable in high-risk survivors, and prospective longitudinal studies with standardized valvular endpoints remain a priority. Dedicated longitudinal evidence on valvular outcomes specifically remains very limited.},
}

@article {pmid42452593,
year = {2026},
author = {Kasiak, P and Procyk, G},
title = {COACH Study: COVID-19 Influence on Cardiorespiratory Fitness in Athletes-A Systematic Review and Meta-Analysis.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
pmid = {42452593},
issn = {2077-0383},
abstract = {Objectives: We aimed to systematically review and meta-analyze the impact of COVID-19 infection on cardiorespiratory fitness (CRF): (1) within-athlete (the same participants before and after infection), and (2) between-athlete (infected vs. healthy reference participants). Methods: In this systematic review (PROSPERO Registry: CRD42024540430) we included observational studies enrolling recreational or competitive athletes ≥18 years old with laboratory confirmation of SARS-CoV-2 infection. The primary outcome was change in relative maximal oxygen uptake (VO2max). Secondary outcomes included changes in absolute VO2max, maximal ventilation (VEmax), and maximal heart rate (HRmax). We searched Embase, PubMed, Medline, Scopus, and Web of Science up to August 9th, 2025. Risk of bias was assessed with the JBI critical appraisal tool. Meta-analyses were performed with a random-effects model. Results: Twelve studies enrolling a total of 1595 participants met the eligibility criteria. COVID-19 infection was associated with lower relative VO2max (MD = -1.83 mL·kg[-1]·min[-1]; 95%CI [-3.16, -0.49]; p = 0.007; I[2] = 54%) and absolute VO2max (MD = -0.15 L·min[-1]; 95%CI [-0.29, -0.01]; p = 0.03; I[2] = 0%). COVID-19 infection was associated with lower VEmax (MD = -7.99 L·min[-1]; 95%CI [-12.94, -3.04]; p = 0.002; I[2] = 0%) but not with HRmax (MD = -0.34 bpm; 95%CI [-1.54, 0.86]; p = 0.58; I[2] = 0%). High heterogeneity of included studies was addressed with subgroup analyses. The risk of bias in most studies was high. The certainty of evidence was very low for each outcome. Conclusions: COVID-19 infection in athletes was associated with reduced VO2max and VEmax. The relationships were highly dependent on the quality of the studies. CRF and athlete profile should be considered when making shared decisions regarding safe return to sport after infection.},
}

@article {pmid42452704,
year = {2026},
author = {Olarewaju, A and Adebowale, A and Odutola, P and Arnold, A},
title = {Use of Natriuretic Peptides in Critically Ill Patients: A Narrative Review.},
journal = {Journal of clinical medicine},
volume = {15},
number = {13},
pages = {},
pmid = {42452704},
issn = {2077-0383},
abstract = {Background: Natriuretic peptides, including B-type natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), are established biomarkers of myocardial stress and circulatory overload. Although originally validated for diagnosis and exclusion of heart failure, their diagnostic and prognostic applications have expanded significantly in the context of critical illness. However, interpretation in critically ill patients is complicated by confounding factors such as systemic inflammation and renal dysfunction. Objective: This review synthesizes current evidence on the diagnostic, monitoring, and prognostic applications of natriuretic peptides in critically ill adults. It further outlines practical considerations, confounding variables, and emerging complementary biomarkers pertinent to clinical decision-making. Methods: A structured search of PubMed, Embase, and the Cochrane Library (January 2000 to October 2025) identified studies evaluating BNP, NT-proBNP, and atrial natriuretic peptide (ANP) in intensive care unit (ICU) patients. Eligible studies and review articles assessed diagnostic utility, volume status, hemodynamic monitoring, and prognostic performance. Narrative synthesis was employed using information obtained from eligible studies. Results: Twenty-four studies met the inclusion criteria. BNP and NT-proBNP facilitate differentiation between cardiogenic and noncardiogenic respiratory failure, identification of mixed shock states, and assessment of volume status when used in association with other modalities such as echocardiography and ultrasonography. Elevated natriuretic peptide concentrations consistently predict mortality, acute kidney injury, prolonged mechanical ventilation, and adverse outcomes in several disease states, including sepsis, acute respiratory distress syndrome [ARDS], postoperative cardiac dysfunction, and COVID-19-related critical illness. However, interpretation remains limited by confounders, including renal impairment, age, systemic inflammation, brain injury, mechanical ventilation, and right-ventricular strain/dysfunction. Conclusions: Natriuretic peptides serve as valuable adjuncts for diagnostic assessment, hemodynamic monitoring, and risk stratification in the ICU. When interpreted with attention to biological kinetics and clinical context, these biomarkers enhance multimodal monitoring and support individualized management. Future research should refine ICU-specific cutoffs and assess natriuretic peptide-guided therapeutic strategies in prospective multicenter trials.},
}

@article {pmid42453219,
year = {2026},
author = {Neogi, SB and Saroha, E and Mishra, SS and Tolani, H and Samtani, R},
title = {Telemedicine: An exploration of global impact and Indian perspectives on healthcare delivery, effectiveness, and challenges.},
journal = {Journal of family medicine and primary care},
volume = {15},
number = {4},
pages = {1473-1478},
pmid = {42453219},
issn = {2249-4863},
abstract = {Telemedicine represents a transformative approach to healthcare delivery, leveraging information and communication technologies to bridge geographical barriers between patients and healthcare providers. This paper explores telemedicine's historical development, global applications, and specific relevance in India, particularly focusing on the eSanjeevani program. Despite its potential, telemedicine faces challenges, such as the digital divide, regulatory frameworks, patient acceptance, and technical limitations. Addressing these challenges requires collaborative efforts among stakeholders to ensure equitable access, data security, and interoperability of telemedicine platforms. Telemedicine has demonstrated its efficacy in enhancing access to healthcare services, particularly in underserved regions, and has emerged as a vital tool during the COVID-19 pandemic. The eSanjeevani program in India serves as a prominent example of successful telemedicine implementation, facilitating millions of consultations and bridging the urban-rural healthcare divide. Looking ahead, telemedicine holds promise in revolutionizing healthcare delivery, fostering ecological responsibility, and advancing toward universal health coverage. Embracing telemedicine represents a significant step toward a healthier, greener, and more sustainable future for healthcare systems worldwide.},
}

@article {pmid42453257,
year = {2026},
author = {Rajeh, DA and Amer, KA and Alasmari, R and Brema, I and Aljumah, M and Aljuaid, S},
title = {Diabetic ketoacidosis after COVID-19 infection in newly diagnosed patients with diabetes in the Middle East and African countries: A systematic review and meta-analysis.},
journal = {Journal of family medicine and primary care},
volume = {15},
number = {4},
pages = {1527-1539},
pmid = {42453257},
issn = {2249-4863},
abstract = {INTRODUCTION: The risk of diabetic ketoacidosis (DKA) is increased following the severe acute respiratory syndrome coronavirus 2 infection, "COVID-19," however, little evidence is available regarding the prevalence and outcomes of DKA in newly diagnosed patients with diabetes in the Middle East and African countries. Our objective was to conduct a systematic review of case reports detailing the prevalence and outcomes of DKA in COVID-19 infected in the above referenced countries.

METHODS AND SUBJECTS: Our search encompassed Medline (via PubMed), Embase (via OVID), Web of Science, Scopus, grey literature sources such as Open Access Theses and Dissertations (OATD), and the reference lists of the included studies.

RESULTS: The results of the current meta-analysis study showed that 17 studies met the search criteria and a total of 22 patients (15 patients with newly type 1 diabetes and seven patients with newly diagnosed type 2 diabetes). About 69.5% of the patients were of Arabian ethnicity. Body mass index (BMI) was reported only for seven patients, with a mean of 25.04 k g/m[2]. Two patients died in patients with newly diagnosed type 2 diabetes, giving a mortality rate of 14.3%, while all patients were in type 1 diabetes, who had DKA survived.

CONCLUSIONS: Covid 19 infection in patients with new diabetes from the Middle East and African countries was associated with increased risk of DKA with high mortality in patients with newly diagnosed type 2 diabetes.},
}

@article {pmid42453521,
year = {2026},
author = {Hsu, PC and Tsai, CC and Chu, TY and Kuo, CY},
title = {Jing-Si Herbal Tea as a multitargeted complementary therapy: Evidence from preclinical and clinical studies.},
journal = {Tzu chi medical journal},
volume = {38},
number = {3},
pages = {289-299},
pmid = {42453521},
issn = {2223-8956},
abstract = {Jing-Si Herbal Tea (JSHT) is a traditional multi-herbal preparation composed of flavonoids, polyphenols, triterpenoid saponins, glycyrrhizin, and other bioactive constituents that collectively contribute to a wide spectrum of biological activities. Emerging laboratory and clinical studies indicate that JSHT is associated with modulation of oxidative stress, inflammatory responses, and immune-related pathways, with reported antiviral and cytoprotective effects primarily observed in experimental models and exploratory clinical settings. This review synthesizes current evidence describing the diverse pharmacological actions of JSHT and its potential applications across oncologic, inflammatory, metabolic, and infectious disease contexts. Experimental findings suggest that JSHT may be associated with modulation of tumor progression-related processes, including epithelial-mesenchymal transition and aberrant nuclear factor kappa B activity, while being associated with intracellular oxidative stress-related activation of apoptosis- and ferroptosis-related pathways in cancer cell models. Its immunoregulatory capacity is reflected in the attenuation of pro-inflammatory cytokines and the promotion of anti-inflammatory macrophage phenotypes. In respiratory and infectious diseases such as coronavirus disease 2019 and chronic obstructive pulmonary disease, JSHT has been reported to attenuate hyperinflammatory responses and preserve cellular or organ function and has been associated with clinical improvement in selected observational studies, which should be interpreted cautiously. Early clinical data, including results from a randomized study in functional dyspepsia, suggest benefits for gastrointestinal symptoms and anxiety, accompanied by increases in serum butyrate that may indicate involvement of the gut-brain axis. Across available studies, JSHT has shown good tolerability with few reported adverse effects. Overall, the accumulating evidence suggests that JSHT may have potential relevance as a multitarget complementary approach, pending confirmation through well-controlled clinical studies. Nonetheless, more extensive, well-controlled clinical investigations are warranted to validate its efficacy and clarify its mechanistic pathways.},
}

@article {pmid42454043,
year = {2026},
author = {Wendt, K and Schieck, M and Gille, C and Marschollek, M and Illig, T and Wolff, D and Nee, S},
title = {Biomarkers of post-acute infection syndrome: a systematic literature review.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1741761},
pmid = {42454043},
issn = {1664-3224},
mesh = {Humans ; *Biomarkers/metabolism ; Post-Acute COVID-19 Syndrome ; *COVID-19/complications ; *SARS-CoV-2 ; *Fatigue Syndrome, Chronic/diagnosis ; },
abstract = {BACKGROUND: Post-acute infection syndrome (PAIS) remained underrecognized before the COVID-19 pandemic, which further increased exposure by introducing a novel global cause. The global burden of post-acute COVID syndrome (PACS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) alone is estimated at several tens of millions affected worldwide. Biomarker discovery is central to improving PAIS diagnosis and may provide therapeutic targets. This review summarizes current knowledge on biomarkers for PAIS, including PACS and ME/CFS.

METHODS: A systematic literature search was conducted in PubMed and Web of Science. Inclusion criteria were: (1) studies including PAIS patients; (2) reporting laboratory or omics biomarkers; and (3) investigating biomarkers or pathomechanisms of PAIS. Although Guillain-Barré syndrome (GBS) is not PAIS, we have included it as a separate mechanistic comparator due to its prevalence in search results and its clinical and immunological similarities to PAIS.

RESULTS: A total of 142 studies analyzing PAIS biomarkers were included. GBS was analyzed separately and later compared with the other results. Overall, the reviewed studies employed heterogeneous approaches. While similar types of data were frequently investigated, analytical methods varied and often focused only on a subset of molecules. The results indicate that amino acid, energy, and lipid metabolism, microbiome, mitochondrial stress, and miRNA networks are affected. All pathways are connected via NF-κB.

DISCUSSION: PAIS is a multisystem disorder rooted in persistent immune activation, metabolic reprogramming, and systemic inflammation, driven not by active viral infection, but by dysregulated host responses. The NF-κB pathway serves as a unifying hub, connecting molecular, cellular, and clinical phenotypes. Our framework enables a shift from symptom-based to mechanism-based classification, paving the way for biologically grounded interventions.

CONCLUSION: This review synthesizes a broad spectrum of biomarkers in PAIS, integrating findings across pathogens and molecular levels rather than restricting to individual conditions or symptom clusters. This study highlights the differences and commonalities among pathogens and diseases that lead to post-acute sequelae, fills a critical knowledge gap, and provides a foundation for future research and clinical practice. Future studies incorporating multi-omics approaches, longitudinal designs, and larger patient cohorts are needed to validate specific biomarkers and advance the understanding of PAIS.},
}

Humans
*Biomarkers/metabolism
Post-Acute COVID-19 Syndrome
*COVID-19/complications
*SARS-CoV-2
*Fatigue Syndrome, Chronic/diagnosis

@article {pmid42454050,
year = {2026},
author = {Sanz-Muñoz, I and Farre-Avella, M and Barroso-Santos, PJ and Eiros, JM},
title = {State-of-the-art of the high dose influenza vaccine in Spain.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1843611},
pmid = {42454050},
issn = {1664-3224},
mesh = {Humans ; *Influenza Vaccines/administration & dosage/immunology ; Spain/epidemiology ; *Influenza, Human/prevention & control/immunology/epidemiology ; Vaccination ; Aged ; *COVID-19/prevention & control/epidemiology ; Middle Aged ; SARS-CoV-2 ; },
abstract = {High-dose (HD) influenza vaccines have demonstrated robust effectiveness in preventing severe influenza-related outcomes, including pneumonia, cardiorespiratory complications, and mortality, with evidence from randomized clinical trials, meta-analyses, and real-world studies consistently showing superiority over standard-dose (SD) vaccines and supporting international recommendations for adults aged ≥60 years. This is increasingly relevant in the context of global aging and immunosenescence, which weakens vaccine-induced immune responses and heightens biological frailty, functional decline, and the risk of severe complications in older adults, especially those with comorbidities. The objective of this work is to describe the introduction, uptake, and current use of HD influenza vaccines in Spain and to summarize the evidence supporting their broader adoption in adults ≥60 years of age. Methods include a narrative synthesis of clinical evidence and an analysis of vaccination strategies implemented across Spanish autonomous communities since the introduction of HD vaccines during the COVID-19 pandemic. Available evidence supports extending HD vaccine use as a population-based strategy to enhance protection and promote equitable access. The results show that the incorporation of HD influenza vaccines marked a significant shift in national vaccination strategies, with heterogeneous uptake across regions: while some prioritized institutionalized or dependent populations, others implemented mixed approaches that also included community-dwelling adults aged ≥60 years. In conclusion, a clear trend toward wider adoption is emerging, with an increasing number of autonomous communities incorporating HD vaccines into their programs and progressively lowering the recommended age threshold, in alignment with international guidance and the biological rationale for strengthened protection in older adults.},
}

Humans
*Influenza Vaccines/administration & dosage/immunology
Spain/epidemiology
*Influenza, Human/prevention & control/immunology/epidemiology
Vaccination
Aged
*COVID-19/prevention & control/epidemiology
Middle Aged
SARS-CoV-2

@article {pmid42454876,
year = {2026},
author = {Albini, TA and Yeh, S and Regillo, CD and Schwartz, R and Ferrone, PJ and Baumal, CR and Wykoff, CC},
title = {Expert Opinion: Management of Intraocular Inflammation and Vasculitis After Intravitreal Pegcetacoplan for Geographic Atrophy.},
journal = {Ophthalmic surgery, lasers & imaging retina},
volume = {57},
number = {8},
pages = {492-498},
doi = {10.3928/23258160-20260521-03},
pmid = {42454876},
issn = {2325-8179},
mesh = {Humans ; Intravitreal Injections ; *Geographic Atrophy/drug therapy ; Female ; Visual Acuity ; *Retinal Vasculitis/diagnosis/drug therapy/chemically induced ; Glucocorticoids/therapeutic use ; Aged ; *Angiogenesis Inhibitors/adverse effects ; Male ; *Vasculitis/drug therapy/diagnosis/chemically induced ; },
abstract = {BACKGROUND AND OBJECTIVE: This expert opinion review is intended to provide guidelines for diagnosis and management of intraocular inflammation (IOI) and vasculitis following pegcetacoplan.

PATIENTS AND METHODS: A case series of all post-marketing reports classified by experts as definite or suspected vasculitis over an 18-month period was assessed.

RESULTS: A total of 306,000 pegcetacoplan intravitreal injections were given in the real world between March 1, 2023, and August 31, 2024. Twenty-four eyes from 22 patients (mean age 76 years, 59% female) with definite or suspected vasculitis were evaluated. Comorbidities included hypertension (55%), hypothyroidism (27%), and recent COVID-19 infection (14%). Twelve eyes were classified as vasculitis with occlusion, seven as vasculitis without occlusion, and five as suspected vasculitis. Median time from intravitreal injection to symptoms was 10 days and 88% (n = 21) occurred after the first injection. Symptoms included reduced vision (71%), eye pain (33%), and elevated intraocular pressure (50%). All patients received corticosteroids and 29% received antibiotics. At last follow-up, six eyes recovered visual acuity to within one line of baseline, seven lost between 2 to 5 lines, and 11 lost 6 lines or more.

CONCLUSION: While IOI and vasculitis are rare, patients can be educated to call a retina specialist promptly if symptoms or any vision loss develop, especially within the 2 weeks following the first injection. In addition to excluding an infectious etiology, individualized management with multiroute corticosteroids can be considered.},
}

Humans
Intravitreal Injections
*Geographic Atrophy/drug therapy
Female
Visual Acuity
*Retinal Vasculitis/diagnosis/drug therapy/chemically induced
Glucocorticoids/therapeutic use
Aged
*Angiogenesis Inhibitors/adverse effects
Male
*Vasculitis/drug therapy/diagnosis/chemically induced

@article {pmid42456241,
year = {2026},
author = {Dietrich, N and Stubbert, B},
title = {Artificial intelligence for chest imaging in hantavirus pulmonary syndrome: A review of practical considerations for rare-disease imaging.},
journal = {Clinical imaging},
volume = {138},
number = {},
pages = {110895},
doi = {10.1016/j.clinimag.2026.110895},
pmid = {42456241},
issn = {1873-4499},
mesh = {Humans ; *Artificial Intelligence ; *Hantavirus Pulmonary Syndrome/diagnostic imaging ; *Rare Diseases/diagnostic imaging ; COVID-19 ; SARS-CoV-2 ; Pandemics ; *Radiography, Thoracic/methods ; },
abstract = {Hantavirus pulmonary syndrome (HPS) is an uncommon zoonotic respiratory illness with a high case fatality rate. Recent travel-associated Andes orthohantavirus clusters have renewed interest in early radiographic recognition of the disease outside its usual geographic range. Artificial intelligence (AI) tools developed during the COVID-19 pandemic now inform several radiology workflows, but the application of AI to HPS chest imaging remains largely unexplored. This narrative review summarises the imaging features of HPS across modalities, considers lessons from AI applications in COVID-19 and viral pneumonia imaging, and discusses practical development considerations for HPS-aware imaging AI, including dataset development, label standardisation, realistic comparator inclusion, candidate modelling approaches, external validation, and clinical workflow integration. The review also considers challenges to HPS-aware imaging AI, including data scarcity, low pretest probability in non-endemic settings, overlapping imaging findings, and translational pitfalls from recent AI literature. As HPS is unlikely to support conventional disease-specific model development without coordinated data collection, future work will likely require multi-institutional datasets, prevalence-aware evaluation, and multimodal workflow integration that combines imaging with clinical, laboratory, and epidemiologic context.},
}

Humans
*Artificial Intelligence
*Hantavirus Pulmonary Syndrome/diagnostic imaging
*Rare Diseases/diagnostic imaging
COVID-19
SARS-CoV-2
Pandemics
*Radiography, Thoracic/methods

@article {pmid42459265,
year = {2026},
author = {Vera, E and Galanis, P and Mangoulia, P and Pesiridis, T},
title = {Factors affecting nurses' professional quality of life in Europe - A systematic review.},
journal = {AIMS public health},
volume = {13},
number = {2},
pages = {485-512},
pmid = {42459265},
issn = {2327-8994},
abstract = {BACKGROUND: Nursing care involves both cognitive and emotional aspects, significantly impacting nurses' professional quality of life (ProQOL). This systematic review investigated the factors affecting nurses' professional quality of life in Europe.

METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting framework and was registered in the International Prospective Register of Systematic Reviews (registration number: CRD420251133948). Searches were conducted in PubMed, Scopus, CINAHL, ScienceDirect, and EBSCOhost from inception to August 2025. Eligible peer-reviewed quantitative studies from European Union countries utilized the ProQOL instrument, reporting on all three dimensions: compassion satisfaction, burnout, and secondary traumatic stress. Two reviewers independently screened records, extracted data, and appraised methodological quality using the Joanna Briggs Institute critical appraisal tool.

RESULTS: A total of 3407 records were initially identified, and 35 studies were ultimately included, comprising 8580 nursing staff across diverse clinical settings, predominantly hospitals, with 13 studies conducted during the coronavirus disease period in 2019. Most studies reported moderate levels of compassion satisfaction and moderate levels of burnout and secondary traumatic stress. Higher compassion satisfaction was generally associated with greater age and professional experience, relevant education and training, work engagement, supportive work environments, better perceived control over workload, and stronger psychosocial resources, including resilience, psychological flexibility, self-compassion, mindfulness, and social support. Higher burnout and secondary traumatic stress related to indirect exposure were consistently linked to a high workload, overtime, rotating schedules, job stress, workplace violence, employment in high-intensity clinical areas, and adverse psychological states, including persistent stress, fear related to the coronavirus disease, and moral distress.

CONCLUSIONS: Professional quality of life among European nursing staff is influenced by a combination of demographic, occupational, and psychosocial factors. Multilevel strategies addressing organizational stressors while strengthening individual and team-based resources are warranted to improve compassion satisfaction and reduce burnout and secondary traumatic stress.},
}

@article {pmid42459266,
year = {2026},
author = {Du, D and Sun, G and Yuan, L and Yao, Y and Yang, T and Gao, J and Zhang, L},
title = {Internet healthcare in Chinese public hospitals: Towards high-quality development (1986-present).},
journal = {AIMS public health},
volume = {13},
number = {2},
pages = {598-621},
pmid = {42459266},
issn = {2327-8994},
abstract = {BACKGROUND: Internet healthcare has become a key part of China's hospital-centered health system. Driven by "Internet Plus Healthcare", Healthy China 2030, and public-hospital high-quality development policies, it has evolved from remote consultation experiments into regulated online-offline care pathways. This review traces its development from the first documented remote medical practice in 1986 to the present, focusing on policy, institutional models, clinical evidence, governance challenges, and reform.

METHODS: We conducted a structured narrative review of English- and Chinese-language sources on internet healthcare in Chinese public hospitals. PubMed/MEDLINE, Web of Science Core Collection, China National Knowledge Infrastructure (CNKI), and official policy sources were searched. Eligible sources addressed internet hospitals, telemedicine, online follow-ups, remote monitoring, e-prescriptions, insurance payments, digital governance, clinical outcomes, patient safety, equity, or implementation barriers in mainland China.

RESULTS: Internet healthcare progressed through early telemedicine, institutional network expansion, internet-hospital development, and pandemic-driven normalization. The 2018 regulatory framework positioned internet hospitals as extensions of licensed physical medical institutions, thereby permitting online follow-ups for common and chronic diseases while preserving offline accountability. During COVID-19, online consultation, e-prescriptions, drug delivery, and insurance payments rapidly expanded. Evidence suggests benefits for chronic disease management, medication adherence, cardiovascular secondary prevention, and reduced travel burden. However, evidence remains limited for diagnostic accuracy, adverse events, emergency escalation, and long-term outcomes. Persistent barriers include quality variation, workload, cybersecurity, data fragmentation, artificial intelligence (AI) accountability, reimbursement design, regional inequity, and digital exclusion among older adults.

CONCLUSION: China's model may be understood as a hospital-centered extension of public-hospital functions rather than a stand-alone virtual-care system. Future development should prioritize outcome-based evaluations, safety governance, equitable access, data interoperability, and accountability for internet-based and AI-assisted care.},
}

@article {pmid42459503,
year = {2026},
author = {Larrain, D and Parker, CM},
title = {Beyond Prison Walls: A Scoping Review of Incarceration's Public Health Impacts in Latin America.},
journal = {Wellcome open research},
volume = {11},
number = {},
pages = {193},
pmid = {42459503},
issn = {2398-502X},
support = {/WT_/Wellcome Trust/United Kingdom ; },
abstract = {BACKGROUND: Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities.

OBJECTIVE: This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies.

RESULTS: From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces.

CONCLUSIONS: Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge.},
}

@article {pmid42460684,
year = {2026},
author = {Foláyan, MO and Arobo, A and Oyeyemi, E and Bhayat, A and Tantawi, ME},
title = {Integrating Oral Health Into Pandemic Preparedness and Response: Missed Opportunities and Strategic Imperatives for Global Health System Resilience and Security.},
journal = {Community dentistry and oral epidemiology},
volume = {},
number = {},
pages = {},
doi = {10.1111/cdoe.70092},
pmid = {42460684},
issn = {1600-0528},
abstract = {BACKGROUND: Despite evidence linking oral health to severe COVID-19 outcomes and its potential role in surveillance and service delivery, integration remained absent. This study enquired about: (1) representation of oral health in national COVID-19 taskforces and funding; (2) policy-level barriers to inclusion; (3) lessons from maintaining essential services; and (4) strategies for mobilizing oral health professionals in future emergencies.

METHODS: We conducted a scoping review guided by the PRISMA-ScR framework. Systematic searches were performed in PubMed/MEDLINE and Scopus (2000-2025) using tailored search strings combining key terms: oral health, pandemic preparedness, COVID-19, dentistry, health systems and related MeSH terms. Eligible evidence included peer-reviewed studies, reviews, policy documents and commentaries in English. Non-human studies were excluded. Data were charted using the WHO Health System Building Blocks framework.

RESULTS: After dual-reviewer screening, 2569-3860 records were screened, yielding 5-8 eligible studies per question (26 studies total). The evidence revealed a consistent narrative of systemic exclusion yet operational resilience. For representation, oral health professionals were almost universally absent from national COVID-19 task forces, with dedicated financial support entirely lacking. Regarding barriers, policy integration was hindered by the framing of oral care as non-essential, its omission from global health security architectures like the International Health Regulations, and limited professional advocacy. In contrast, lessons from service adaptation demonstrated that essential care was maintained through the rapid adoption of triage, teledentistry, robust infection control and effective communication. On workforce mobilization, while consensus existed on the potential for OHPs to expand into roles such as vaccination and surveillance, implementation was obstructed by a lack of pre-emergency training, formal deployment mechanisms and regulatory frameworks with minimal linkage to international instruments.

CONCLUSION: The review reflects systemic neglect of oral health, with the literature dominated by descriptions of clinical and operational adaptations rather than formal policy integration. We identify missed opportunities in leveraging OHPs for pandemic response and propose embedding oral health within One Health governance, financing, surveillance and emergency response structures to build more resilient health systems.},
}

@article {pmid42461048,
year = {2026},
author = {Översti, S and Lytras, S and Kawakubo, S and Ito, J and Ghafari, M},
title = {From sites to structure to serology: a roadmap for structure-aware molecular evolution of antigenically evolving viruses.},
journal = {Journal of virology},
volume = {100},
number = {8},
pages = {e0168725},
pmid = {42461048},
issn = {1098-5514},
support = {/WT_/Wellcome Trust/United Kingdom ; 309205/Z/24/Z//Wellcome Trust Early Career/ ; },
mesh = {*Evolution, Molecular ; *Antigens, Viral/genetics/immunology/chemistry ; Phylogeny ; *SARS-CoV-2/genetics/immunology ; Humans ; Genome, Viral ; Machine Learning ; Mutation ; Epitopes/immunology/genetics ; },
abstract = {The genomic deluge has pushed viral molecular evolution into a site-resolved era. For antigenically evolving viruses such as influenza and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), dense genomic sampling now supports mutation-annotated phylogenies and per-site estimates of mutation and substitution processes. These data highlight strong effects of sequence context, genomic region, RNA structure, and protein-level constraints that are blurred by classic uniform substitution models. In parallel, accurate structure prediction and emerging structure-aware phylogenetic and machine-learning approaches provide practical ways to map mutations onto three-dimensional constraints, identify structurally plausible escape routes, and interpret evolutionary rate variation through solvent exposure, packing, stability, glycosylation, receptor-binding interfaces, and epitope geometry. Finally, antigenic cartography translates some forms of genetic change into an epidemiologically meaningful phenotype-antigenic distance-while predictive modeling increasingly enables sequence-to-antigenicity inference for variants that have not yet been tested experimentally. Here, we outline a practical framework linking sites, structure, and serology for viruses in which antigenic evolution is a major component of immune escape and lineage turnover; highlight why genetic and antigenic "clocks" can diverge; and discuss how integrating genomic surveillance data, phylogenetics, structural analysis, and predictive modeling could support more prospective variant assessment and improved vaccine and therapeutic design.},
}

*Evolution, Molecular
*Antigens, Viral/genetics/immunology/chemistry
Phylogeny
*SARS-CoV-2/genetics/immunology
Humans
Genome, Viral
Machine Learning
Mutation
Epitopes/immunology/genetics

@article {pmid42461075,
year = {2026},
author = {Hashemi, S and Pati, D},
title = {Healthcare Design for Pandemic Resilience: A Systems Thinking Approach.},
journal = {HERD},
volume = {19},
number = {4},
pages = {256-276},
doi = {10.1177/19375867261466289},
pmid = {42461075},
issn = {2167-5112},
mesh = {Humans ; *COVID-19/epidemiology/prevention & control ; Systems Analysis ; Infection Control/organization & administration ; Pandemics ; SARS-CoV-2 ; Pandemic Preparedness ; Surge Capacity/organization & administration ; *Delivery of Health Care/organization & administration ; *Hospital Design and Construction ; Patient Safety ; },
abstract = {BackgroundThe COVID-19 pandemic created unprecedented operational challenges (such as surge-capacity demands and infection-control requirements) that disturbed the equilibrium of healthcare work systems worldwide. Physical environments can play a pivotal role in mitigating or exacerbating these challenges.PurposeThis article aims to strengthen healthcare-system resilience in future pandemics by synthesizing the findings of existing literature to identify environmental factors that supported or hindered healthcare work systems during the COVID-19 pandemic.MethodsWe conducted a systematic search of the CINAHL, MEDLINE, PubMed, and ScienceDirect databases and complemented this search with handsearching. We included studies if they addressed the COVID-19 pandemic, focused on physical healthcare environments, and were published in English in peer-reviewed journals. With a focus on environmental influences, we deductively coded the findings using components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.ResultsForty-two studies met the inclusion criteria. The analysis revealed six major operational challenges: (1) surge capacity, (2) infection control, (3) increased risk of errors, (4) rethinking of care models, (5) financial losses, and (6) the pandemic's adverse psychological impacts on staff and patients. The article documents environmental factors that influenced either the overall healthcare work system or its individual components during the COVID-19 pandemic. We identified three overarching roles for these environmental factors: they served as barriers, solutions, or facilitators.ConclusionsUsing the SEIPS framework can enable well-orchestrated pandemic-response planning by guiding the creation of design strategies that will strengthen resilience, flexibility, and safety in future health crises.},
}

Humans
*COVID-19/epidemiology/prevention & control
Systems Analysis
Infection Control/organization & administration
Pandemics
SARS-CoV-2
Pandemic Preparedness
Surge Capacity/organization & administration
*Delivery of Health Care/organization & administration
*Hospital Design and Construction
Patient Safety

@article {pmid42461270,
year = {2026},
author = {Farrag, MA},
title = {The Role of Artificial Intelligence and Machine Learning in Predictive Virology: Forecasting, Tracking, and Combating Viral Threats.},
journal = {Vector borne and zoonotic diseases (Larchmont, N.Y.)},
volume = {26},
number = {12},
pages = {733-755},
doi = {10.1177/15303667261469037},
pmid = {42461270},
issn = {1557-7759},
mesh = {*Artificial Intelligence ; Humans ; *Machine Learning ; Forecasting ; *Virology/methods ; Animals ; Predictive Learning Models ; *COVID-19/epidemiology/prevention & control ; Prediction Algorithms ; *Virus Diseases/epidemiology/prevention & control ; },
abstract = {The escalating threat of viral pandemics, dramatically illustrated by the COVID-19 crisis, has exposed the critical shortcomings of conventional reactive virology in addressing rapidly evolving pathogens. This review introduces predictive virology (PV) as an artificial intelligence (AI)-driven discipline within broader epidemic intelligence and public health surveillance that uses advanced computational tools to forecast viral threats and accelerate countermeasure design. The current review systematically examines how AI-driven approaches (e.g., machine learning and deep learning) are reshaping virology by integrating vast genomic datasets, multimodal surveillance signals, and advanced computational models to anticipate viral emergence and evolution before widespread transmission occurs. Core pillars of PV discussed include zero-shot mutational fitness and antigenic escape prediction using large protein language models; multimodal early-warning systems that fuse wastewater monitoring, digital epidemiology, mobility data, and social media; neural differential equation-based transmission modeling; generative AI for de novo design of broad-spectrum antivirals and vaccines; and ecological risk assessment of zoonotic spillovers. In retrospective benchmarks against deep mutational scanning experiments and real-world epidemiological outcomes (SARS-CoV-2 variants, influenza, and other outbreaks), several AI-powered tools have demonstrated performance comparable to or exceeding traditional methods, although prospective validation at scale remains limited. Despite remarkable progress, significant challenges persist, including data bias, overfitting to historical patterns, lack of prospective validation, and limited generalizability across settings. In addition, there are concerns about mechanistic interpretability, equitable global data integration, and responsible deployment. This review also critically addresses the ethical, governance, and equity implications of deploying predictive capabilities at a global scale. By consolidating cutting-edge AI methodologies with virological insights and acknowledging current limitations, this work provides a comprehensive framework for transitioning virology from a reactive to a truly predictive discipline, ultimately strengthening global health security and pandemic preparedness.},
}

*Artificial Intelligence
Humans
*Machine Learning
Forecasting
*Virology/methods
Animals
Predictive Learning Models
*COVID-19/epidemiology/prevention & control
Prediction Algorithms
*Virus Diseases/epidemiology/prevention & control

@article {pmid42461676,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 1: Pandemics: Overview, history, and vulnerability for a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {109-118},
doi = {10.5055/ajdm.0531},
pmid = {42461676},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics/history ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; *Surge Capacity/organization & administration ; United States ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity, with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCNs) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern, disaster, COVID-19, vulnerable population, individuals with access and functional needs, special healthcare needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population, but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics/history
COVID-19/epidemiology
*Disaster Planning/organization & administration
Pandemic Preparedness
SARS-CoV-2
*Surge Capacity/organization & administration
United States

@article {pmid42461677,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 2: The origins of a pandemic: Emerging infectious diseases, bioterrorism, and laboratory accidents.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {119-131},
doi = {10.5055/ajdm.0527},
pmid = {42461677},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Bioterrorism ; *Disaster Planning/organization & administration ; COVID-19 ; *Communicable Diseases, Emerging/epidemiology ; Surge Capacity/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and CMIST (communications, medical care, independence, supervision, and transportation). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are -possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics
*Bioterrorism
*Disaster Planning/organization & administration
COVID-19
*Communicable Diseases, Emerging/epidemiology
Surge Capacity/organization & administration
Pandemic Preparedness
SARS-CoV-2

@article {pmid42461678,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 3: Surge capacity and communications in a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {133-148},
doi = {10.5055/ajdm.0525},
pmid = {42461678},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Pandemics ; *Surge Capacity/organization & administration ; COVID-19/epidemiology ; *Disaster Planning/organization & administration ; Pandemic Preparedness ; SARS-CoV-2 ; United States ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, COVID-19, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Pandemics
*Surge Capacity/organization & administration
COVID-19/epidemiology
*Disaster Planning/organization & administration
Pandemic Preparedness
SARS-CoV-2
United States

@article {pmid42461679,
year = {2026},
author = {Mace, SE and Doyle, CJ and Biddinger, PD and Bradin, S and Burdash, S and Lefort, R and Noll, S and Moriber, MR and Cornelius, A},
title = {Disaster preparedness for vulnerable populations during a pandemic: Part 4: Pandemics: Planning for those with access and functional needs in a pandemic.},
journal = {American journal of disaster medicine},
volume = {21},
number = {2},
pages = {149-159},
doi = {10.5055/ajdm.0526},
pmid = {42461679},
issn = {1932-149X},
mesh = {Humans ; *Vulnerable Populations ; *Disaster Planning/organization & administration ; *Pandemics ; *Surge Capacity/organization & administration ; *Health Services Accessibility ; Pandemic Preparedness ; COVID-19/epidemiology ; Health Services Needs and Demand ; },
abstract = {OBJECTIVE: To provide an overview of the literature on disaster preparedness regarding surge capacity with a particular focus on vulnerable populations during a pandemic.

DESIGN: The Disaster Preparedness and Response Committee of the American College of Emergency Physicians addressed the topic of vulnerable populations during a pandemic. A workgroup of nine physicians with academic and/or disaster deployment experience was formed. A literature review focused on individuals with access and functional needs, also referred to as special healthcare needs (SHCN) or vulnerable individuals, was performed. Search terms included pandemic, public health emergency of international concern (PHEIC), disaster, vulnerable population, individuals with access and functional needs, special health care needs (SHCN), surge capacity, and communications, medical care, independence, supervision, and transportation (CMIST). Search strategies included medical sources such as PubMed, Medline, Google Scholar, ScienceDirect, Scopus, and the Cochrane Database of Systematic Reviews. Reviews were performed by a librarian. In addition, relevant articles from the bibliographies of included studies and more recent articles identified by committee members were included. The workgroup evaluated the literature and identified issues regarding surge capacity occurring during a pandemic that particularly impacted the SHCN population. Potential solutions were identified.

RESULTS: Vulnerable individuals are at greater risk during a pandemic than the general population, although potential solutions to mitigate the impact of a pandemic on vulnerable individuals are possible.

CONCLUSIONS: Although pandemics can have significant adverse effects on the general population, vulnerable individuals have the greatest morbidity and mortality and are at the greatest risk. Efforts are warranted to better address the negative impact of a pandemic, not just for the general population but also for individuals with access and functional needs, and to find solutions that can help mitigate the consequences of a pandemic.},
}

Humans
*Vulnerable Populations
*Disaster Planning/organization & administration
*Pandemics
*Surge Capacity/organization & administration
*Health Services Accessibility
Pandemic Preparedness
COVID-19/epidemiology
Health Services Needs and Demand

@article {pmid42461883,
year = {2026},
author = {Sheybani, F and Haddad, M},
title = {Community-Acquired CNS Infections in Western Asia (2010-2025): A Systematic Review.},
journal = {Neuroepidemiology},
volume = {},
number = {},
pages = {1-16},
doi = {10.1159/000553536},
pmid = {42461883},
issn = {1423-0208},
abstract = {BACKGROUND: This systematic review aimed to summarize the epidemiology, etiology, diagnostic challenges, antimicrobial resistance, and clinical outcomes of community-acquired central nervous system (CNS) infections in Western Asian countries.

METHODS: A systematic search of PubMed was conducted for studies published from January 2010 to July 2025. Eligible studies included original research and case reports on CNS infections, while unrelated studies or studies outside the region were excluded. Data were extracted and synthesized narratively by pathogen group. Risk of bias was assessed based on study design, sample size, and methodological quality.

RESULTS: Of 1,790 retrieved articles, 450 studies met the inclusion criteria, including case reports and observational studies across neonates, children, and adults. Streptococcus pneumoniae and Neisseria meningitidis were the most common bacterial pathogens; Listeria monocytogenes and multidrug-resistant Gram-negative organisms were notable. Among viral pathogens, Enteroviruses, herpes simplex virus type 1, and West Nile virus predominated, with increasing reports of post-COVID-19 autoimmune encephalitis. Tuberculous meningitis and neurobrucellosis remained significant causes of chronic CNS infections in endemic areas. Pneumococcal penicillin resistance exceeded 40% in some countries. Molecular diagnostic capacity and surveillance were limited.

LIMITATIONS: Evidence was limited by heterogeneity in study design, regional data gaps, and variable reporting of antimicrobial resistance, which may affect the comprehensiveness of the review.

CONCLUSIONS: Community-acquired CNS infections continue to impose a substantial health burden in Western Asia. Expanded vaccination, improved molecular diagnostics, strengthened surveillance, and regional antimicrobial resistance monitoring are essential to reduce preventable mortality and long-term neurological sequelae.},
}

@article {pmid42462434,
year = {2026},
author = {Wołowiec, Ł and Wesołowska, W and Skibicka, K and Jaśniak, A and Banach, J and Osiak, J and Wołowiec, A and Skibicki, T and Grześk, G},
title = {Pleiotropic effects of direct oral anticoagulants on the coagulation-inflammation-endothelium axis: A phenotype-stratified narrative review.},
journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie},
volume = {202},
number = {},
pages = {119768},
doi = {10.1016/j.biopha.2026.119768},
pmid = {42462434},
issn = {1950-6007},
mesh = {Humans ; *Blood Coagulation/drug effects ; *Inflammation/drug therapy/metabolism ; Animals ; Phenotype ; Administration, Oral ; *Anticoagulants/pharmacology/administration & dosage ; Factor Xa Inhibitors/pharmacology/administration & dosage ; *Endothelium, Vascular/drug effects/metabolism ; },
abstract = {AIMS: Direct oral anticoagulants (DOACs) - dabigatran (a thrombin inhibitor) and rivaroxaban, apixaban, and edoxaban (factor Xa [FXa] inhibitors) - modify oxidative stress, endothelial inflammation, and barrier integrity beyond anticoagulation. We ask whether this reflects distinct pharmacology or silencing of proteases at protease-activated receptors (PARs), and propose a three-condition framework for when it becomes clinically measurable.

METHODS: Narrative review (PubMed, Scopus, Web of Science; primary search 2019-2026, with foundational earlier references retained) with claims graded on a six-tier hierarchy; A‡ marks trials formally negative or inconclusive owing to insufficient statistical power.

RESULTS: DOAC effects largely converge on one node - reduced PAR-1 signalling under thrombin inhibition and dual PAR-1/PAR-2 blockade under FXa inhibition - rather than independent targets; the FXa-PAR-2 axis is cross-validated across macrophages, liver sinusoidal endothelial cells, and neutrophils; and dabigatran plausibly differs qualitatively rather than only in degree - a working hypothesis whose mechanistic linchpin (residual exosite-I signalling) currently rests on a single unreplicated in-vitro study (level D). Clinically the signal sorts by phenotype and disease phase, not class: low-dose rivaroxaban benefits stable atherosclerosis (COMPASS) but not heart failure in sinus rhythm (COMMANDER-HF), and COVID-19 benefit appears only in convalescence (MICHELLE), not acutely or in outpatients (ACTIV-4B, A‡). A nationwide cohort linked DOACs to lower acute kidney injury and chronic kidney disease progression than vitamin K antagonists, pending separation from their nephrotoxicity.

CONCLUSIONS: Pleiotropy emerges where three conditions coincide - the protease is available at PARs, its generation is chronic, and PAR signalling is rate-limiting. This supports within-indication molecule selection (selection, not extension) and biomarker co-primary trials, not extension of indications.},
}

Humans
*Blood Coagulation/drug effects
*Inflammation/drug therapy/metabolism
Animals
Phenotype
Administration, Oral
*Anticoagulants/pharmacology/administration & dosage
Factor Xa Inhibitors/pharmacology/administration & dosage
*Endothelium, Vascular/drug effects/metabolism

@article {pmid42462528,
year = {2026},
author = {Ganesan, K and Chen, J},
title = {Dual-targeting cancer and SARS-CoV-2: The host-directed mechanisms of Spatholobus suberectus Dunn (Jixueteng).},
journal = {Phytomedicine : international journal of phytotherapy and phytopharmacology},
volume = {159},
number = {},
pages = {158560},
doi = {10.1016/j.phymed.2026.158560},
pmid = {42462528},
issn = {1618-095X},
mesh = {Humans ; *SARS-CoV-2/drug effects ; Host-Directed Therapy ; *Fabaceae/chemistry ; *Antiviral Agents/pharmacology ; Animals ; *Drugs, Chinese Herbal/pharmacology/therapeutic use ; *COVID-19 Drug Treatment ; COVID-19 ; *Neoplasms/drug therapy ; *Antineoplastic Agents, Phytogenic/pharmacology ; Antineoplastic Agents/pharmacology ; },
abstract = {BACKGROUND: Spatholobus suberectus Dunn (SSD), known in traditional Chinese medicine as Jixueteng, has historically been used to treat conditions characterized by blood stasis. Modern research has validated its anticancer potential. Recent studies reveal broad-spectrum antiviral activity.

PURPOSE: This review synthesizes these two research frontiers. It proposes a unified host-directed therapy paradigm as the core mechanism underlying SSD's dual therapeutic capability.

METHODS: A comprehensive analysis of peer-reviewed literature was conducted. This included phytochemical studies, in vitro and in vivo pharmacological investigations, and computational modeling related to SSD. Emphasis was placed on integrating the latest mechanistic findings on its antiviral action against SARS-CoV-2 with its established anticancer profile.

RESULTS: SSD contains bioactive flavonoids, such as isoliquiritigenin and procyanidins. These compounds enable multi-target interactions with host proteins. In cancer, SSD acts as a host-directed anticancer agent by inhibiting lactate dehydrogenase A, activating AMP-activated protein kinase, inducing apoptosis and pyroptosis, and arresting the cell cycle at the G2/M checkpoint. Against SARS-CoV-2, SSD functions as a direct inhibitor of the host angiotensin-converting enzyme 2 receptor. It blocks viral entry with pan-variant efficacy validated in vivo. The anticancer evidence for SSD is extensive and derived from multiple independent laboratories. The antiviral data are currently more limited. Published studies have identified SSD as active against SARS-CoV-2 and demonstrated that isoliquiritigenin inhibits viral replication via NRF2 activation. Mechanistic ACE2-targeting data remain preliminary. A comparative synthesis reveals that SSD's efficacy in both oncology and virology converges on the modulation of host protein targets. SSD targets dysregulated host enzymes in cancer and a hijacked host receptor in viral infection. This strategy provides a high barrier to therapeutic resistance.

CONCLUSION: SSD represents a promising natural host-directed therapeutic platform. Its dual ability to disrupt cancer cell physiology and inhibit SARS-CoV-2 entry via distinct host targets positions it as a potential template for developing resistance-evasive strategies against complex diseases. Future efforts must focus on isolating the precise ACE2-inhibiting compounds, optimizing disease-specific delivery, and advancing translational studies to realize its clinical potential.},
}

Humans
*SARS-CoV-2/drug effects
Host-Directed Therapy
*Fabaceae/chemistry
*Antiviral Agents/pharmacology
Animals
*Drugs, Chinese Herbal/pharmacology/therapeutic use
*COVID-19 Drug Treatment
COVID-19
*Neoplasms/drug therapy
*Antineoplastic Agents, Phytogenic/pharmacology
Antineoplastic Agents/pharmacology

@article {pmid42463201,
year = {2026},
author = {Byambasuren, O and Atkins, T and Baptista, S and Glasziou, P and Chakraborty, S},
title = {Effect of low-dose naltrexone for long COVID: a systematic review and meta-analysis.},
journal = {BMJ open},
volume = {16},
number = {7},
pages = {e111253},
pmid = {42463201},
issn = {2044-6055},
mesh = {Humans ; *COVID-19 Drug Treatment ; Fatigue/drug therapy/etiology ; *Naltrexone/administration & dosage/therapeutic use ; *Narcotic Antagonists/administration & dosage/therapeutic use ; *Post-Acute COVID-19 Syndrome/complications ; Quality of Life ; SARS-CoV-2 ; },
abstract = {OBJECTIVE: Long covid is a debilitating chronic condition, and the effect of low-dose naltrexone (LDN) on its symptoms is unclear. We aimed to determine the effectiveness of LDN on symptoms of long covid.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: PubMed, Embase and Cochrane Library for published studies; ClinicalTrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) for registered ongoing studies were searched through 5 May 2026.

ELIGIBILITY CRITERIA: We included randomised controlled trials and pre-post studies of patients with long covid reporting on fatigue, quality of life, cognitive symptoms or function and other long covid symptoms.

DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search, screen and select included studies. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models.

RESULTS: Of 397 titles and abstracts screened, no randomised controlled trials were identified. Four observational pre-post studies from the USA and Ireland (n=155) met inclusion criteria. LDN doses varied from 1 mg/day to 6 mg/day. Pooled pre-post analyses showed moderate effects for reducing fatigue (Hedges' g=-0.74; 95% CI -1.11 to -0.37; p<0.001), brain fog (Hedges' g=-0.53; 95% CI -1.01 to -0.05; p=0.03) and improving sleep quality (Hedges' g=-0.60; 95% CI -0.91 to -0.30; p=0.0001), and large effects for pain (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.001) and daily functioning (Hedges' g=-0.93; 95% CI -1.29 to -0.57; p<0.0001) in favour of LDN. Heterogeneity ranged from 0% to 62%. No serious adverse events were reported in the two studies that assessed safety.

CONCLUSION: Limited evidence from small pre-post studies suggests LDN may improve fatigue, cognition, sleep, pain and functioning in long covid. However, certainty of evidence is low. Well-powered trials are needed to confirm efficacy, determine dosing and duration and identify subgroups most likely to benefit.

TRIAL REGISTRATION: https://doi.org/10.17605/OSF.IO/C2VKX.},
}

Humans
*COVID-19 Drug Treatment
Fatigue/drug therapy/etiology
*Naltrexone/administration & dosage/therapeutic use
*Narcotic Antagonists/administration & dosage/therapeutic use
*Post-Acute COVID-19 Syndrome/complications
Quality of Life
SARS-CoV-2

@article {pmid42464199,
year = {2026},
author = {Pham, ANQ and Akram, I and Tiwana, MH and Smith, J},
title = {Waiting times for primary care appointments among older adults: a scoping review.},
journal = {BMC public health},
volume = {26},
number = {1},
pages = {},
pmid = {42464199},
issn = {1471-2458},
mesh = {Aged ; Humans ; Access to Primary Care ; *Appointments and Schedules ; Health Services Accessibility ; Pandemics ; *Primary Health Care ; Social Determinants of Health ; *Waiting Lists ; },
abstract = {BACKGROUND: Healthcare service waiting times have worsened due to the COVID-19 pandemic, particularly impacting older adults who need timely access to primary care to manage chronic conditions and prevent hospitalizations. This scoping review aims to fill a research gap by examining whether delays in primary care appointments for older adults occurred and, if so, how these delays have affected their access to primary care, with a focus on the role of social determinants of health.

METHODS: Following PRISMA guidelines, a systematic search was conducted across three health databases-MEDLINE (Ovid), CINAHL, and EMBASE-as well as one AI platform (typeset.io). To be included, articles needed to discuss waiting times for primary care appointments, include older adults in their target population, and be published in English since 2014. Non-English articles were excluded due to language proficiency constraints among the review team. The review also examined the impact of social determinants of health on equity in access to care.

RESULTS: This review identified a significant lack of research on primary care waiting times for older adults, with only twelve studies addressing the issue. Findings indicate that prolonged wait times act as a major barrier to accessing timely care, resulting in patient frustration, delayed treatment, and increased reliance on emergency services. The COVID-19 pandemic has exacerbated these challenges, particularly through care interruptions and the shift to virtual care, which is understudied regarding its impact on waiting times.

CONCLUSIONS: Prolonged waiting times for primary care disproportionately affect older adults, exacerbated by age-related health conditions and intersecting social determinants. Healthcare systems must address these barriers and prioritize research into tailored interventions to ensure equitable access to care for older adults.},
}

Aged
Humans
Access to Primary Care
*Appointments and Schedules
Health Services Accessibility
Pandemics
*Primary Health Care
Social Determinants of Health
*Waiting Lists

@article {pmid42465772,
year = {2026},
author = {Feya, Q and Mkhize-Kwitshana, ZL and Milase, RN and Wadee, A and Naidoo, N and Maiga, M and Senzani, S and Nakiyingi, L and Mvubu, NE},
title = {Molecular signaling in coinfection: how M. tuberculosis and respiratory viruses rewire host immunity and alter TB outcomes.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1863302},
pmid = {42465772},
issn = {1664-3224},
support = {D43 CA260658/CA/NCI NIH HHS/United States ; INV-033558//Bill & Melinda Gates Foundation/United States ; R21 AI148033/AI/NIAID NIH HHS/United States ; D43 TW010350/TW/FIC NIH HHS/United States ; /WT_/Wellcome Trust/United Kingdom ; },
mesh = {Humans ; *Coinfection/immunology ; *Mycobacterium tuberculosis/immunology ; Signal Transduction/immunology ; Animals ; *Tuberculosis/immunology ; Immunity, Innate ; Host-Pathogen Interactions/immunology ; *Respiratory Tract Infections/immunology ; },
abstract = {Tuberculosis (TB) caused by Mycobacterium tuberculosis (M. tuberculosis) and respiratory viral infections remain major, intersecting global health challenges, and their co-occurrence imposes a disproportionate burden in high-HIV/high-TB regions such as sub-Saharan Africa. Coinfection biology is heterogeneous and dynamic, driven by viral diversity including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A/B, Respiratory Syncytial Virus (RSV), parainfluenza, metapneumovirus, rhinovirus, adenovirus, and bocavirus, and by the underlying TB stage, from latent and subclinical to active and reactivation disease. Innate sensing pathways, such as Toll-like receptors (TLR), retinoic acid-inducible gene I (RIG-I), and cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING), converge during coinfection, reshaping type I interferon (IFN-I), Nuclear Factor kappa-light-chain-enhancer of activated B cells (NF-κB), and AP-1-driven responses and triggering a network of autocrine and paracrine signaling that reprograms macrophages, dendritic cells, and T-cell subsets. This immune rewiring alters granuloma equilibrium through suppressed Th1/IFN-γ coordination, exaggerated Th17/IL-17-driven neutrophilia, and regulatory T-cell or IL-10-mediated dampening, which together destabilize macrophage activation and tissue architecture. Oxidative stress, mitochondrial dysfunction, and Matrix Metalloproteinases (MMP)-driven matrix remodeling further integrate with these pathways, converting inflammatory signals into epithelial damage, cavitation, and fibrosis. Consequently, disease outcomes depend critically on timing, viral burden, pathogen order, host immune endotype, and TB stage, such that the same virus can either preserve containment or drive progression depending on the local immunological context. Importantly, the effects of respiratory viral coinfection vary across the TB disease continuum, influencing early granuloma formation, latent infection, reactivation risk, and established disease through distinct immunological mechanisms. Host-directed therapies (HDT) targeting interferon, IL-1, TNF, inflammasome, or metabolic checkpoints hold mechanistic promise but exhibit variable clinical translation, underscoring the need for precision approaches that integrate stage- and endotype-specific biomarkers. This narrative review proposes an integrated systems framework that links viral sensing, immune rewiring, granuloma biology, and tissue-remodeling to TB-respiratory virus coinfection, and emphasizes how timing-aware, biomarker-guided strategies can refine diagnosis, clinical management, prognosis, and vaccine design in vulnerable populations.},
}

Humans
*Coinfection/immunology
*Mycobacterium tuberculosis/immunology
Signal Transduction/immunology
Animals
*Tuberculosis/immunology
Immunity, Innate
Host-Pathogen Interactions/immunology
*Respiratory Tract Infections/immunology

@article {pmid42466633,
year = {2026},
author = {Li, Z and Han, X and Ren, Y},
title = {Global epidemiological and aetiological patterns of hand, foot, and mouth disease: a country-level scoping synthesis.},
journal = {Journal of global health},
volume = {16},
number = {},
pages = {04220},
pmid = {42466633},
issn = {2047-2986},
mesh = {*Hand, Foot and Mouth Disease/epidemiology/etiology/virology ; Humans ; *Global Health/statistics & numerical data ; Incidence ; Disease Outbreaks ; Enterovirus ; COVID-19/epidemiology ; },
abstract = {BACKGROUND: Hand, foot, and mouth disease (HFMD) has historically been predominantly reported in the Asia-Pacific region, while its global epidemiology and aetiology remain fragmented and incompletely characterised. We aimed to synthesise currently available country-level evidence to describe global epidemiological and aetiological patterns of HFMD.

METHODS: We conducted a country-level scoping synthesis of published studies and publicly available surveillance reports through August 2025. Studies were eligible for inclusion if they reported epidemiological or aetiological data on HFMD at the national or subnational level, including case numbers, incidence, outbreaks, and enterovirus (EV) serotype distributions. We qualitatively synthesised the data, with a focus on surveillance availability, epidemiological trends, and major circulating EV serotypes.

RESULTS: Reported HFMD incidence declined during the COVID-19 pandemic and subsequently rebounded in many settings, in some settings exceeding pre-pandemic levels. Aetiological evidence suggests an increasing circulation of coxsackievirus A6 in multiple regions, with coxsackievirus A16 and EV A71 continuing to co-circulate in specific settings. However, routine epidemiological and aetiological surveillance remained largely concentrated in the Asia-Pacific region. In many other countries, available data were limited and primarily derived from outbreak-driven or sporadic studies. Heterogeneity was observed in surveillance systems and data availability across countries.

CONCLUSIONS: Global HFMD epidemiological and aetiological patterns are characterised by disparities in surveillance capacity and data availability. Developing standardised surveillance and aetiological monitoring is essential to further understand the global landscape of HFMD, improve data comparability, support early detection of epidemiological changes, and inform evidence-based prevention and control strategies.},
}

*Hand, Foot and Mouth Disease/epidemiology/etiology/virology
Humans
*Global Health/statistics & numerical data
Incidence
Disease Outbreaks
Enterovirus
COVID-19/epidemiology

@article {pmid42466786,
year = {2026},
author = {Szynal, D and Olszowski, T},
title = {Nurse burnout as a public health issue and Its impact on patient care quality. A narrative review.},
journal = {Roczniki Panstwowego Zakladu Higieny},
volume = {77},
number = {1},
pages = {21-32},
doi = {10.32394/rpzh/225226},
pmid = {42466786},
issn = {0035-7715},
mesh = {Humans ; *Burnout, Professional/psychology/prevention & control/epidemiology ; *Quality of Health Care ; Quality of Life ; *Nurses/psychology ; Workload/psychology ; Public Health ; Emotional Exhaustion ; },
abstract = {Occupational burnout among nurses is a significant public health issue. It affects both nurses' well-being and the quality of patient care. The aim of this narrative review is to provide a comprehensive synthesis of four key aspects of occupational burnout among nurses, namely its prevalence, determinants, consequences for patient care and mental health, and available prevention strategies. Literature was identified through searches of PubMed and Google Scholar. Articles published in English between 2015 and 2026 were reviewed and selected according to predefined inclusion and exclusion criteria. Burnout develops through the interaction of organizational, psychosocial, and individual factors. The most important contributors include work overload, staffing shortages, low autonomy, psychosocial stress, personality traits, and health status. Higher burnout levels are associated with increased medical errors, patient falls, and missed nursing care. Burnout also contributes to lower patient satisfaction and poorer perceived quality of care. Prolonged stress increases the risk of depression, anxiety, sleep disturbances, reduced psychological resilience, and intentions to leave the profession, negatively impacting nurses' quality of life and social functioning. Effective preventive and therapeutic strategies include mindfulness-based programs, cognitive-behavioral therapy, physical exercise, and resilience training. These interventions may be delivered both in person and digitally. Their effectiveness improves in supportive environments with allocated participation time and leadership engagement. Interventions at individual, team, and system levels reduce emotional exhaustion and depersonalization, enhance staff well-being, and improve patient safety. In the context of a global nursing shortage and increased workloads following the COVID-19 pandemic, multi-level strategies to prevent occupational burnout are essential for protecting nurses' mental health and maintaining high-quality healthcare. The review highlights the importance of multi-level preventive interventions to reduce burnout and improve healthcare outcomes.},
}

Humans
*Burnout, Professional/psychology/prevention & control/epidemiology
*Quality of Health Care
Quality of Life
*Nurses/psychology
Workload/psychology
Public Health
Emotional Exhaustion

@article {pmid42467815,
year = {2026},
author = {Mastrovito, B and Abou Chakra, CN and Mahé, C and Nunes, MC},
title = {How Pandemics Have Reshaped the Respiratory Virus Data Landscape in Europe: Scoping Review.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e92917},
pmid = {42467815},
issn = {1438-8871},
mesh = {Humans ; Europe/epidemiology ; *Respiratory Syncytial Virus Infections/epidemiology ; *Pandemics ; *Influenza, Human/epidemiology ; *COVID-19/epidemiology ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Acute respiratory infections caused by influenza, respiratory syncytial virus (RSV), and SARS-CoV-2 remain a major public health challenge in Europe. Although surveillance systems for these pathogens are well established, the past 2 decades have seen a rapid diversification of data streams supporting surveillance and research. This expanding data landscape, combined with fragmentation across institutions, sectors, and countries, may limit timely evidence synthesis and effective public health decision-making.

OBJECTIVE: This scoping review aimed to identify and characterize data sources used for surveillance and research on influenza, RSV, and SARS-CoV-2 in Europe over the past 20 years, and to examine their evolution over time, their alignment with research objectives, and geographic variation in data availability and use.

METHODS: We conducted a scoping review using an objective-driven analytical framework. Empirical reports published between January 2005 and September 2025 were identified in MEDLINE, Web of Science, and Embase. Eligible reports focused on influenza, RSV, or SARS-CoV-2 and included data from 12 European countries. Clinical and interventional studies were excluded. Reports were classified according to 4 research objectives: epidemiological monitoring, evaluation of interventions, assessment of disease burden and health outcomes, and analyses of population adherence and trust toward public health measures. Data sources were grouped into 9 categories, including surveillance systems, electronic health records (EHRs), registries, claims, surveys, digital, environmental, integrated datasets, and others.

RESULTS: A total of 2564 empirical reports were included. Over time, respiratory virus research relied on an increasingly diverse set of data streams. While surveillance systems remained central, particularly for epidemiological monitoring, their relative dominance declined. From 2020 onward, there was a marked expansion in the use of EHRs, registries, claims data, digital sources, and linked or integrated datasets, alongside increased use of open-access data. Data source use varied by research objective: surveillance data predominated in monitoring and intervention evaluation; EHRs in studies of risk factors and treatment effectiveness; surveys in seroprevalence and public trust analyses; and claims data in assessments of economic burden. Substantial geographic disparities were observed. Northern European countries more frequently used linked and multisource datasets, whereas Southern Europe relied more often on open-access or single-source data.

CONCLUSIONS: This scoping review provides a multipathogen, cross-country mapping of data sources for respiratory virus surveillance and research in Europe over 2 decades, applying an innovative objective-driven framework. Unlike prior reviews focused on single pathogens or data types, it offers a consolidated, comparative perspective based on 2564 reports to inform public health decision-making. The COVID-19 pandemic accelerated innovation in data generation and access, but progress remained largely centered on SARS-CoV-2, while structural fragmentation continues to limit timely, integrated data across Europe. Strengthening preparedness will require interoperable infrastructures, federated analysis platforms, sustainable funding for surveillance innovations, and cross-sectoral data sharing.},
}

Humans
Europe/epidemiology
*Respiratory Syncytial Virus Infections/epidemiology
*Pandemics
*Influenza, Human/epidemiology
*COVID-19/epidemiology
SARS-CoV-2

@article {pmid42467983,
year = {2026},
author = {Tholo, N and Markey, G and Harrigan, R and Pandey, P and Prasad, B and Barai, RS and Gibson, DS and Shukla, P},
title = {The critical role of artificial intelligence and bioinformatics in accelerating peptide-based vaccine discovery for tackling global infectious diseases.},
journal = {Briefings in bioinformatics},
volume = {27},
number = {4},
pages = {},
pmid = {42467983},
issn = {1477-4054},
support = {//Department for the Economy/ ; },
mesh = {Humans ; *Artificial Intelligence ; *Computational Biology/methods ; Protein Subunit Vaccines ; Immunoinformatics ; *Vaccines, Subunit/immunology ; *Vaccine Development ; Epitopes, T-Lymphocyte/immunology ; Machine Learning ; COVID-19 Vaccines/immunology ; COVID-19/prevention & control/immunology ; *Communicable Diseases/immunology ; Epitopes, B-Lymphocyte/immunology ; },
abstract = {Peptide-based vaccines, enabled by bioinformatics and machine learning (ML), have emerged as one of the most promising approaches for rapid, safe, and cost-effective vaccine design against infectious diseases. Unlike conventional approaches that depend heavily on whole-pathogen cultures or recombinant protein expression, peptide vaccines can be designed in silico and synthesized quickly. Rational and targeted in silico approaches for the discovery of peptide-based vaccine candidates include B-cell and T-cell epitope prediction, immunogenicity, antigenicity, allergenicity, autoimmunity, population coverage, sequence conservation, molecular docking, molecular dynamics simulation, in silico cloning, and immunological simulation analyses. The combination of these comprehensive computational methods can effectively generate high-quality vaccine candidates for subsequent validation via in vitro and in vivo experiments. This review contextualizes the historical trajectory of peptide-based vaccinology, from early linear epitope discoveries in the 1960s to multi-epitope constructs and clinically tested candidates such as UB-612 and PepGNP-Covid19. It examines critical challenges in immunoinformatics, including performance gaps in epitope prediction tools, complexities in human leucocyte antigen (HLA) mapping, and the need for extensive manual intervention in pipelines. Artificial intelligence-driven approaches, spanning deep learning, and interpretable ML, are positioned to transform epitope prediction, reduce human error, and standardize reproducibility. These advances have the potential to support global outbreak response targets such as the Coalition for Epidemic Preparedness Innovations (CEPI) 100 Days Mission and the World Health Organization (WHO) Research and Development (R&D) Blueprint. However, their performance remains constrained by data quality, dataset imbalance, limited benchmark standardization, and persistent underrepresentation of many HLA alleles and population groups. Key Points Peptide-based vaccines, accelerated by bioinformatics and machine learning, offer a potentially rapid, relatively safe, and cost-effective alternative to traditional vaccine design, enabling in silico development and swift synthetic manufacturing. Computational methods such as B-cell and T-cell epitope prediction, immunogenicity analysis, and molecular simulations allow for rational and targeted vaccine candidate discovery, enhancing quality and efficiency. The field has evolved from early linear epitope discoveries in the 1960s to sophisticated multi-epitope constructs and clinically tested candidates like UB-612 and PepGNP-Covid19. Major challenges in immunoinformatics include performance limitations in epitope prediction tools, complexities in HLA mapping, and the necessity for manual intervention in data pipelines. Artificial intelligence-driven models, including deep learning and interpretable machine learning, promise to overcome these challenges by improving prediction accuracy, reducing errors, and supporting global epidemic response efforts such as CEPI's 100 Days Mission and the WHO R&D Blueprint.},
}

Humans
*Artificial Intelligence
*Computational Biology/methods
Protein Subunit Vaccines
Immunoinformatics
*Vaccines, Subunit/immunology
*Vaccine Development
Epitopes, T-Lymphocyte/immunology
Machine Learning
COVID-19 Vaccines/immunology
COVID-19/prevention & control/immunology
*Communicable Diseases/immunology
Epitopes, B-Lymphocyte/immunology

@article {pmid42468359,
year = {2026},
author = {Kelly, JB and Brodie, G and Zeden, MS},
title = {Antisense oligonucleotides: design, implementation and future perspectives in microbiology.},
journal = {Current opinion in microbiology},
volume = {93},
number = {},
pages = {102794},
doi = {10.1016/j.mib.2026.102794},
pmid = {42468359},
issn = {1879-0364},
mesh = {*Oligonucleotides, Antisense/pharmacology/genetics/therapeutic use ; Humans ; *Anti-Bacterial Agents/pharmacology ; *Bacteria/genetics/drug effects ; Bacterial Infections/drug therapy ; SARS-CoV-2 ; },
abstract = {Advances in molecular biology have expanded antimicrobial strategies that traditionally targeted proteins or metabolic pathways to now include RNA, enabling a previously unattainable precision through control of gene expression. The clinical potential of RNA-therapeutics was demonstrated during the COVID-19 pandemic, when mRNA vaccines marked a transformative milestone for RNA-based interventions for viral infections. Increasingly, similar principles are emerging for the treatment of bacterial infections. Antisense oligonucleotides (ASOs) bind complementary mRNA sequences to induce RNase H-mediated degradation or block their translation. Initially developed for genetic and neurodegenerative disorders, ASOs are now emerging as next-generation antibacterials, termed ASOBiotics, designed to silence essential bacterial genes. In this review, we explore the advances of ASO technologies with applications in bacterial pathogens, outlining design considerations while discussing the challenges and opportunities for making precision antibacterial therapeutics.},
}

*Oligonucleotides, Antisense/pharmacology/genetics/therapeutic use
Humans
*Anti-Bacterial Agents/pharmacology
*Bacteria/genetics/drug effects
Bacterial Infections/drug therapy
SARS-CoV-2

@article {pmid42469771,
year = {2026},
author = {Kassie, AM and Endalamaw, A and Khatri, RB and Assefa, Y},
title = {Barriers and facilitators to diabetes service uptake and self-care management in Australia: a scoping review.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {42469771},
issn = {1472-6963},
mesh = {Humans ; Australia ; *Diabetes Mellitus/therapy ; *Health Services Accessibility ; *Patient Acceptance of Health Care/statistics & numerical data ; *Self Care ; *Self-Management ; },
abstract = {BACKGROUND: Diabetes represents a major and increasing public health burden in Australia. Despite this, there remains limited consolidated evidence on patterns of diabetes-related service uptake and self-management, particularly among priority population groups. This scoping review synthesizes existing evidence on diabetes-related health service utilization and self-management practices in Australia, focusing on key barriers and facilitators that affect access to care and engagement in self-management.

METHODS: We conducted a scoping review of journal articles published up to 20 October 2025. Major databases: PubMed, Embase, Scopus, and Web of Science, were utilized along with manual reference searches. Articles were screened in two stages, and data were extracted using a piloted template. A descriptive thematic analysis was performed focusing on the three major themes: service uptake, self-care management, and the associated barriers and facilitators. Diabetes service uptake was categorized into three subthemes: practitioner-based primary care, allied health and preventive services, and acute and emergency care. Moreover, the barriers and facilitators were organized using the socioecological framework.

RESULTS: Thirty-two articles were included in this review. The general population showed consistent engagement with practitioner-based routine diabetic services, with studies reporting up to 92% of adults visiting their general practitioners and having at least one HbA1c test over a six-month period. Aboriginal and Torres Strait Islander people also showed an improvement in primary care engagement despite a historical high dependency in acute care. In contrast, areas containing a higher proportion of overseas-born residents tended to rely more on acute services. The uptake of preventive services and allied health care was inconsistent and generally low. For example, up to 40% of adults had no contact with diabetes educators, dietitians, or podiatrists in some rural populations. One study has also reported that only 55.2% of high-risk adults were screened at least once for diabetes over a three-year period. Key barriers to service uptake and/or self-care management included limited health literacy, fragmented care pathways, financial constraints, cultural and language barriers, geographic remoteness, and variable digital capability. In contrast, coordinated multidisciplinary care, structured management plan, strong patient-provider relationship, social support, and access to digital health services were reported as important facilitators. Telehealth has also emerged as an effective facilitator for maintaining engagement, particularly during the COVID-19 pandemic.

CONCLUSION: Despite high engagement with routine primary care, significant gaps remain in preventive services and allied health use among people with diabetes in Australia, particularly among younger adults, rural residents, and socioeconomically disadvantaged or culturally diverse populations. Addressing these gaps requires equitable, person-centered, and integrated multidisciplinary care that aligns with patients' cultural values and everyday lives, alongside efforts in improving health literacy.},
}

Humans
Australia
*Diabetes Mellitus/therapy
*Health Services Accessibility
*Patient Acceptance of Health Care/statistics & numerical data
*Self Care
*Self-Management

@article {pmid42469840,
year = {2026},
author = {Riley, A and Doughty, H and Hill, JE and Giebel, C and Harris, M and Williams, NH},
title = {Barriers to and facilitators of the implementation of Community Health Worker programmes in high-income countries: a systematic review.},
journal = {BMC health services research},
volume = {26},
number = {1},
pages = {},
pmid = {42469840},
issn = {1472-6963},
support = {NIHR200182/ARCNWC161//National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care North West Coast/ ; },
mesh = {Humans ; *Community Health Workers/organization & administration ; *Developed Countries ; Primary Health Care/organization & administration ; Public Health Infrastructure ; },
abstract = {BACKGROUND: Global interest in Community Health Workers (CHWs) is rising as health systems seek to address persistent health inequities and the social determinants of health. However, in high-income countries (HICs), CHW implementation remains fragmented. This systematic review synthesises evidence on the factors that act as barriers and facilitators to the implementation and integration of CHW programmes across HIC primary healthcare settings.

METHODS: We searched MEDLINE, Scopus, PsycINFO, and CINAHL for studies published between January 2001 and August 2025. Inclusion focused on qualitative, quantitative, and mixed-methods papers regarding CHW implementation in HICs. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Data were synthesised using a 'Best Fit' Framework Synthesis and confidence in the findings was assessed via GRADE-CERQual.

RESULTS: Seventy-two papers were included (US n = 64; UK n = 4; Australia n = 3; Belgium n = 1), primarily comprising qualitative and mixed methods designs. Key facilitators included leadership buy-in, the presence of implementation champions, and established community partnerships that enabled resource sharing. Prominent barriers included precarious, short-term funding models that prioritised quantitative outputs over relational labour; hierarchical medical power dynamics; and disconnected IT systems that necessitated redundant data entry. The COVID-19 pandemic acted as a catalyst, elevating the CHW role within public health infrastructure while simultaneously exposing digital divides and structural fragility. GRADE-CERQual ratings indicated high confidence in findings regarding funding sustainability, training, and integration.

CONCLUSIONS: The evidence synthesised in this review reveals a fundamental misalignment within current health services: while CHWs are valued for their unique relational capacity, they remain systemically undermined by transactional health system designs. Achieving sustainability requires a strategic shift toward long-term, flexible funding models and the workforce development of supportive infrastructure, including reflective supervision and standardised training. Integration must move beyond short-term, project-based initiatives toward a resilient and permanent public health workforce capable of addressing structural health inequities.

TRIAL REGISTRATION: PROSPERO: CRD42022310789.},
}

Humans
*Community Health Workers/organization & administration
*Developed Countries
Primary Health Care/organization & administration
Public Health Infrastructure

@article {pmid42470742,
year = {2026},
author = {N, B and Radhakrishnan, SSR and V, RS and J, PK and Srinivasan, S and Lamech, T and S, RK and Mani, R and Sharma, M and Vasudeva, K and Mahadevan, A and Hb, V},
title = {Emerging importance of bio-bank for precision diagnostics and research in neuroinfections - a narrative review.},
journal = {Diagnostic microbiology and infectious disease},
volume = {116},
number = {3},
pages = {117546},
doi = {10.1016/j.diagmicrobio.2026.117546},
pmid = {42470742},
issn = {1879-0070},
mesh = {*Biological Specimen Banks/standards ; *Central Nervous System Infections/diagnosis ; Humans ; Biomarkers ; *Tissue Preservation/methods/standards ; Quality Control ; Cerebrospinal Fluid ; Brain ; *Specimen Handling/methods/standards ; },
abstract = {The diagnosis of neuroinfectious diseases, including Tuberculous Meningitis (TBM), viral encephalitis, Human Immunodeficiency Virus (HIV), and post COVID-19 neurological syndromes, remains challenging due to limited surveillance, non-specific symptoms, inadequate laboratory sensitivity, and restricted availability of high-quality CSF or tissue specimens. The critical need for early and precise diagnosis and the development of reliable, validated biomarkers highlight the importance of biospecimen-driven approaches that leverage CSF and other biobanked materials, as evidenced by the emerging literature. This review aims to summarize the need for biobanks, discuss sample preservation and tracking, examine quality control frameworks, and evaluate current advances, translational applications, and ongoing challenges of biobanking in neuroinfectious disease research. We extracted evidence from existing neuroinfection biobanks, reviewed global standards governing bio-specimen preservation and storage, and analyzed studies demonstrating how archived CSF, blood, and brain tissue have enabled pathogen characterization, biomarker discovery, and translational research. Our analysis shows that biobanked specimens have facilitated high-resolution pathogen genotyping, immune profiling, and identification of diagnostic and prognostic biomarkers, such as neuro-filament light chain (NfL) and CSF proteomic signatures. Strengthening biobanking infrastructure, harmonized governance, established FAIR-aligned data systems, and the integration of AI and digital analytics will help accelerate biomarker validation, drive diagnostic innovation, and ultimately improve clinical outcomes for patients worldwide.},
}

*Biological Specimen Banks/standards
*Central Nervous System Infections/diagnosis
Humans
Biomarkers
*Tissue Preservation/methods/standards
Quality Control
Cerebrospinal Fluid
Brain
*Specimen Handling/methods/standards

@article {pmid42471030,
year = {2026},
author = {Kumar, CS and Joe Thomas, M and Thomas, NP and Kotwani, VS},
title = {Domestic robots: recent trends and innovations.},
journal = {Disability and rehabilitation. Assistive technology},
volume = {},
number = {},
pages = {1-27},
doi = {10.1080/17483107.2026.2702778},
pmid = {42471030},
issn = {1748-3115},
abstract = {PURPOSE: Domestic Service Robots (DSRs) are employed to perform personalised tasks in domestic/household environments. Recent times, especially after the COVID-19 pandemic, have shown a rapid increase in demand for household companion bots. Despite the development of several such service robots, there are still potential challenges that need to be addressed. Domestic robots that perform basic household chores such as vacuum cleaning are the most popular and commercially a big hit. It is desirable to have an advanced multipurpose robot that can interact with humans and the surrounding environment in real time.

METHODS: A comparative analysis of existing DSRs and their corresponding gaps is highlighted in this article. Emphasis is given to the design/appearance, choice of sensors and actuators, cognition, effectiveness in manipulating domestic objects, control and task planning algorithms, safety measures and reliability of DSRs validated in real-world settings.

RESULTS: This article presents a systematic review of the latest developments in DSR and outlines the future direction of research to tackle the unsolved problems. Key highlights from 83 research articles published after 2020 in reputed journals/platforms are studied and analysed to understand the latest trends in DSR.

CONCLUSION: This review highlights current progress, identifies existing gaps, and outlines future research directions essential for deploying reliable domestic service robots in real world environments.},
}

@article {pmid42471883,
year = {2025},
author = {Inuwa, U and Bakari, MA and Kaitafi, MT and Kadas, S},
title = {Analysis of Caesarean Deliveries (CD) at a Tertiary Hospital in Northeastern Nigeria: A 5 Year Review.},
journal = {Nigerian medical journal : journal of the Nigeria Medical Association},
volume = {66},
number = {5},
pages = {1768-1776},
pmid = {42471883},
issn = {0300-1652},
abstract = {BACKGROUND: One of the most commonly performed surgical procedures in Obstetrics is caesarean delivery (CD), and certainly the oldest surgical operation. Caesarean delivery is life-saving, especially when there is a failure or contraindication to vaginal delivery. However, the health risk and the cost of the surgery may be quite challenging, especially in low-resource countries like Nigeria. The observed increased prevalence rate in recent times is alarming and has become a major public health concern, calling for regular appraisal of its indications in order to reduce the prevalence. This study was undertaken to determine the prevalence, trend, indications, maternal and foetal outcomes at Modibbo Adama University Teaching Hospital, Yola, Adamawa State. Nigeria.

METHODOLOGY: It was a hospital-based retrospective study of all the cases of CD undertaken between 1st January 2018 and 31st December 2022. Names and hospital numbers of patients were identified; the case folders were traced and retrieved. Necessary information was obtained and analyzed using SPSS version 17 software. Results were presented in percentages, simple graphs, and ratios.

RESULTS: During the years under review, there were 8568 deliveries, out of which 2707 had cesarean delivery, giving a cesarean delivery rate of 31.6%. The major maternal indication was prolonged obstructed labor, 627 (23.09%), while that of foetal indication was foetal distress, 418 (15.44%). The trend of caesarean delivery in this study showed a steady increase between 2018 and 2019 and 2021 to 2022, with a drop in 2020. This was due to the lockdown following the COVID-19 pandemic in that year. The maternal mortality ratio was 776/100,000 live births, and case fatality was 0.8%, while perinatal mortality was 41/1000 births.

CONCLUSION: The caesarean delivery rate in this study was very high when compared to most teaching hospitals in Nigeria. Effort should therefore be made to reverse the ugly trend. Therefore, a thorough and meticulous assessment of patients should be done before a decision is taken for surgery, especially elective caesarean deliveries.},
}

@article {pmid42472491,
year = {2026},
author = {Bijkerk, HJC and Antonis, AFG and Wagenaar, JA and Lam, TJGM and van Doorn, DCK},
title = {Anthelmintic stewardship: An essential step towards sustainable dairy farming.},
journal = {Veterinary parasitology},
volume = {347},
number = {},
pages = {110846},
doi = {10.1016/j.vetpar.2026.110846},
pmid = {42472491},
issn = {1873-2550},
mesh = {Animals ; Cattle ; *Anthelmintics/therapeutic use ; *Cattle Diseases/drug therapy/prevention & control/parasitology/diagnosis ; *Dairying/methods ; *Helminthiasis, Animal/drug therapy/prevention & control ; Drug Resistance ; },
abstract = {Helminth infections in grazing dairy cattle can lead to asymptomatic infections, subclinical- or clinical disease. Whether the course of infection leads to disease depends on various factors, leading to a broad variety of prevalence rates and severity of disease between farms, between groups of cattle in a farm and between individual animals. Production losses related to helminth infections, the difficulty in diagnosing helminth disease and the wide availability and high efficacy of anthelmintics have led to overreliance on these products. Combined with management and other factors, this results in the development of anthelmintic resistance and an environmental hazard of drug residues. To slow down the development of anthelmintic resistance and to reduce the consequences of anthelmintic use on the environment, anthelmintic stewardship (AHS) is urgently needed. We define AHS as a systematic approach to optimize the management of helminth infections with the goal to minimize their negative consequences through minimizing the usage of anthelmintics, reducing the development of anthelmintic resistance and reducing environmental contamination. Implementation of AHS requires an approach that considers the complexity of helminth infections weighing different interests, while transferring them to practical applications. An integrated approach implementing AHS on dairy farms is proposed, consisting of four steps: risk assessment, prevention, diagnostics, and treatment. For each of these steps, implementation possibilities and gaps are reviewed. Although there are knowledge and implementation gaps in each of the steps, enough tools are currently available to implement AHS based on the proposed four step approach on dairy farms.},
}

Animals
Cattle
*Anthelmintics/therapeutic use
*Cattle Diseases/drug therapy/prevention & control/parasitology/diagnosis
*Dairying/methods
*Helminthiasis, Animal/drug therapy/prevention & control
Drug Resistance

@article {pmid42472528,
year = {2027},
author = {Dai, T and Wu, W and Wang, B and Feng, G and Wang, J and Hu, T and Lin, Y and Sun, F and Wei, G and Xia, Y and Chen, T and Liu, B},
title = {Advances in lateral flow immunoassays: from technological innovations to diverse applications.},
journal = {Talanta},
volume = {312},
number = {Pt A},
pages = {130269},
doi = {10.1016/j.talanta.2026.130269},
pmid = {42472528},
issn = {1873-3573},
mesh = {Humans ; Immunoassay/methods/instrumentation/trends ; *COVID-19/diagnosis ; *SARS-CoV-2/isolation & purification ; *Point-of-Care Testing/trends ; Artificial Intelligence ; Rapid Diagnostic Tests ; Smartphone ; },
abstract = {Lateral flow immunoassay (LFIA), as a rapid, simple, and cost-effective point-of-care testing (POCT) method, has made remarkable progress over the past few decades, especially demonstrating its unique public health value during the global 2019 coronavirus disease (COVID-19) pandemic. This review aims to systematically introduce the technical principles, core components, technological innovations of LFIA, applications in the field of analytical testing, and to explore the current challenges and future development directions. The review first introduces the basic principle and structural composition of LFIA. Then, it highlights the strategies related to performance improvement in LFIA, including structural engineering, nanomaterial innovations, buffer optimization, signal amplification, smartphone-based image analysis and the integration of artificial intelligence (AI) techniques. Subsequently, the main applications of LFIAs in analytical testing are discussed in detail, including the detection of pathogens, protein markers, and small molecule substances. Finally, this review points out the current status and emerging challenges of LFIAs, and elaborates on their future development trends, aiming to promote further technological advancements and wider application of this technology in the field of POCT.},
}

Humans
Immunoassay/methods/instrumentation/trends
*COVID-19/diagnosis
*SARS-CoV-2/isolation & purification
*Point-of-Care Testing/trends
Artificial Intelligence
Rapid Diagnostic Tests
Smartphone

@article {pmid42473682,
year = {2026},
author = {Bamberg, S and Schulte-Frankenfeld, PM and Kreye, J},
title = {Associations of viral infections and antiviral vaccinations with anti-NMDAR and other forms of autoimmune encephalitis.},
journal = {Brain, behavior, & immunity - health},
volume = {56},
number = {},
pages = {101301},
pmid = {42473682},
issn = {2666-3546},
abstract = {BACKGROUND: Autoimmune encephalitis (AIE) comprises a diverse group of neurological disorders characterized by autoantibodies targeting specific antigens of the central nervous system (CNS). While the pathophysiological effects of these autoantibodies have been extensively studied, the principles and immunological triggers underlying their generation remain less well understood. Viral infections and antiviral vaccinations have been reported as potential immunological triggers. However, a systematic overview of their specific associations and frequencies across AIE subtypes is lacking.

METHODS: Here, we performed a systematic literature review in PubMed to identify published cases of AIE linked to viral infections or antiviral vaccinations, and to test whether herpes simplex virus (HSV)-associated anti-N-methyl-D-aspartate receptor encephalitis (NMDAR-E) represents a disproportionately strong association. We quantified the frequencies of viral infection- or vaccine-related AIE across ten common antibody-defined subtypes, and characterized their epidemiological and clinical features, complemented by data from 23 population-based viral encephalitis cohorts.

RESULTS: We identified 556 cases, of which 488 were infection-associated and 68 followed vaccination. The most frequent combination was HSV infection in association with NMDAR-E, which outnumbered all other reported virus-AIE associations combined and was almost exclusively attributable to preceding HSV encephalitis (HSE). Other recurrent associations included Japanese encephalitis virus, Epstein-Barr virus (EBV), and SARS-CoV-2 infections, although EBV- and SARS-CoV-2-associated cases were less clearly suggestive of causal post-infectious autoimmunity. Across 23 population-based viral encephalitis cohorts from five continents, HSV was the leading causative pathogen. Despite this high background frequency, HSV was significantly overrepresented among viral CNS infection-associated NMDAR-E cases in our dataset compared with the reference cohorts (P < 0.0001), indicating a disproportionate association. Most reported HSE-associated NMDAR-E cases originated from Europe and occurred in young children (median age 6 years), with a balanced sex distribution and a median interval between infection and NMDAR-E onset of 30 days.

CONCLUSION: Collectively, these findings provide the most comprehensive overview of viral infection- and antiviral vaccination-associated AIE to date and support a pathogen-specific link between HSE and secondary NMDAR-E as the most dominant virus-AIE association in the published literature. They underscore the need to elucidate the underlying immunological mechanisms and to develop biomarkers predictive of secondary NMDAR-E.},
}

@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 {pmid42473975,
year = {2026},
author = {Natarajan, RA},
title = {Stage-specific circulating transcriptomic and proteomic biomarkers and regulators in colorectal cancer: bridging affordable diagnostics and translational therapeutics.},
journal = {Critical reviews in clinical laboratory sciences},
volume = {},
number = {},
pages = {1-25},
doi = {10.1080/10408363.2026.2682852},
pmid = {42473975},
issn = {1549-781X},
abstract = {Colorectal cancer (CRC) remains a leading cause of cancer-related mortality worldwide, driven largely by pronounced molecular heterogeneity and delayed clinical detection. Although high-throughput sequencing technologies have substantially advanced the understanding of CRC biology, their routine clinical implementation remains constrained by high costs, infrastructural requirements, and limited accessibility. This review addresses these translational barriers by systematically synthesizing circulating transcriptomic and proteomic biomarkers within a clinically scalable framework. Particular emphasis is placed on biomolecules detectable using reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), two widely accessible platforms that underwent extensive global optimization during the COVID-19 pandemic and are readily adaptable to liquid biopsy workflows. Through a stage-resolved analysis, we identify 9 genomic and 7 proteomic biomarkers associated with early-stage (I-II) CRC, alongside 9 genomic and 4 proteomic biomarkers linked to advanced-stage (III-IV) disease progression. Beyond biomarker cataloging, these molecules are integrated with Cancer Hallmark pathways, clinical-stage associations, and available clinical trial evidence to evaluate their biological relevance and translational readiness. In addition, we summarize standardized operating procedure (SOP) considerations and multiplex detection strategies to improve assay reproducibility, scalability, and cross-border clinical implementation. Collectively, this review bridges molecular discovery with clinically deployable laboratory workflows and provides a translational roadmap for the development of affordable, liquid biopsy-based diagnostic strategies aimed at improving CRC detection, patient stratification, longitudinal monitoring, and early therapeutic intervention.},
}

@article {pmid42474420,
year = {2026},
author = {Czepiel, D and van der Ven, E and Sijbrandij, M and Hoek, HW},
title = {Rethinking mental disorders in COVID-19: evidence from prepandemic longitudinal data.},
journal = {Current opinion in psychiatry},
volume = {39},
number = {5},
pages = {375-384},
pmid = {42474420},
issn = {1473-6578},
mesh = {Humans ; *Mental Disorders/epidemiology/psychology ; *COVID-19/psychology/epidemiology ; Longitudinal Studies ; },
abstract = {PURPOSE OF REVIEW: To synthesize longitudinal evidence of mental health outcomes, including prepandemic symptom measurements, among individuals with preexisting mental disorders during the COVID-19 pandemic.

RECENT FINDINGS: Symptom exacerbation commonly occurred in bulimia nervosa, binge-eating disorder, substance use disorders and in obsessive-compulsive psychopathology related to contamination, while symptom improvement was consistently observed in bipolar disorders. In autism spectrum, schizophrenia spectrum and posttraumatic stress disorders, contrasting symptom patterns were reported, possibly reflecting differences in preexisting demographic and clinical profiles and contextual influences. Symptoms in depressive and anxiety disorders, anorexia nervosa and obsessive-compulsive psychopathology unrelated to contamination remained largely stable. Across most disorders, individuals with chronic mental disorders or higher prepandemic symptom levels more frequently showed stable or improving trajectories than those with milder presentations or recent-onset disorders.

SUMMARY: Given the small number of methodologically diverse studies, definitive statements regarding differential impact of the pandemic across disorders or underlying mechanisms remain premature. Nevertheless, current evidence does not indicate a generalised deterioration in individuals with preexisting mental disorders, including those with the highest prepandemic symptom burden. While some disorder-specific differences emerged, likely reflecting interactions between contextual changes and preexisting disorder processes, the overall picture is more nuanced than frequently portrayed in pandemic-related literature.},
}

Humans
*Mental Disorders/epidemiology/psychology
*COVID-19/psychology/epidemiology
Longitudinal Studies

@article {pmid42474726,
year = {2026},
author = {Ehrmann, S and Li, J and Liu, L and Guérin, C},
title = {Prone positioning in ARDS.},
journal = {Intensive care medicine},
volume = {52},
number = {9},
pages = {1881-1894},
pmid = {42474726},
issn = {1432-1238},
mesh = {Humans ; Prone Position/physiology ; *Respiratory Distress Syndrome/therapy/physiopathology ; *COVID-19/therapy/complications ; Respiration, Artificial/methods ; *Patient Positioning/methods ; Ventilator-Induced Lung Injury/prevention & control ; SARS-CoV-2 ; },
abstract = {Over the past five decades, prone positioning has evolved from single case reports to an evidence-based intervention. Initially used as a rescue therapy, it is now recognized as an integral component of lung-protective mechanical ventilation strategies, applied early in intubated patients with acute respiratory distress syndrome (ARDS) with a PaO2/FIO2 ratio < 150 mmHg. The COVID-19 pandemic further expanded its use to non-intubated patients, the so-called awake prone position (APP), with promising results. APP requires confirmation in non-COVID patients and in a more routine ICU practice. Improved oxygenation is a consistent and well-recognized effect of prone positioning in both intubated and non-intubated patients with ARDS. Beyond its effects on gas exchange, prone positioning mitigates ventilator-induced lung injury by reducing lung stress and strain and may also confer favorable hemodynamic effects. This article reviews the physiologic rationale for prone positioning, evidence from randomized controlled trials, current guideline recommendations, practical aspects of implementation, and ongoing questions in both intubated and non-intubated patients.},
}

Humans
Prone Position/physiology
*Respiratory Distress Syndrome/therapy/physiopathology
*COVID-19/therapy/complications
Respiration, Artificial/methods
*Patient Positioning/methods
Ventilator-Induced Lung Injury/prevention & control
SARS-CoV-2

@article {pmid42475596,
year = {2026},
author = {Müller, F and Tomczyk, S and Fiedrich, F},
title = {Analyzing Social Media to Infer Mental Health Status and Affective States for Crisis and Disaster Management: Scoping Review.},
journal = {Journal of medical Internet research},
volume = {28},
number = {},
pages = {e79762},
pmid = {42475596},
issn = {1438-8871},
mesh = {Humans ; *Social Media ; *Mental Health ; *Disasters ; *Affect ; },
abstract = {BACKGROUND: The use of social media (SoMe) during crisis and disaster situations (CaDs) has gained increasing attention across disciplines. However, existing research is highly fragmented and often focused on technical aspects, with a limited understanding of how and which psychosocial information is derived from SoMe in CaDs.

OBJECTIVE: This scoping review provides an overview of the current research landscape regarding the analysis of SoMe data during CaDs to obtain information about public mental health and psychosocial needs. It identifies key themes, methodological approaches, and research gaps, with a particular focus on relevance for the German context.

METHODS: Following a scoping review protocol, a structured database search was conducted in PubMed, Web of Science, and Scopus to identify peer-reviewed studies published up to 2025. A method of triangulation combining qualitative and quantitative approaches was applied. The studies were analyzed regarding the type of CaDs, geographical focus, classification systems, methods of analysis used, and inclusion of psychosocial aspects (such as affect and mental health status).

RESULTS: Overall, we identified 179 studies that examined 267 CaDs. Of the included studies, 76% (136/179) focused on natural disasters, with biological CaDs representing 23% (41/179) of these events. For Germany, 5 studies were found, with only one covering storms, floods, or extreme temperatures, despite these making up most of the disasters in Germany per EM-DAT (Emergency Events Database) data. Most studies used datasets from Asia (especially China), while Africa was examined less often, pointing to differences in geographical representativeness. To infer mental health status or affective state, 47 studies used machine learning, 87 studies used lexicon-based approaches, and 25 studies used a combination; 14 studies used manual coding, and few studies did not explicitly mention their approach. Mental health outcomes ranged from affective valence (positive, negative, or neutral) to specific primary (eg, fear) and secondary (eg, denial) emotions and needs (eg, resources). Yet, few studies were based on theoretical models or included end-user perspectives. No study conducted real-time analysis; instead, all were retrospective. Additionally, current research focuses primarily on deficits (eg, psychological needs, negative affect, or stress), and often neglects positive mental health outcomes (eg, resilience and collective coping).

CONCLUSIONS: This scoping review underlines the rising popularity of SoMe analysis in CaDs regarding public mental health and needs. Although different techniques were developed and tested, there remain major gaps in real-time application, end-user integration, and contextual adaptation-particularly for underrepresented regions such as Africa, but also in countries such as Germany. As most models were developed or tested retrospectively (eg, using data from the COVID-19 pandemic), future research should examine the validity and tenability of such models in real-time monitoring and data, and emphasize more user-centered design and participatory research, theoretical grounding, and practical utility.},
}

Humans
*Social Media
*Mental Health
*Disasters
*Affect

@article {pmid42479201,
year = {2026},
author = {Stathopoulos, P and Kalogerakos, G and Kakoullis, SA and Michaeloudes, C and Falagas, ME},
title = {Pharmacological thromboprophylaxis in hospitalized patients with acute infectious diseases: a meta-analysis.},
journal = {European journal of clinical pharmacology},
volume = {82},
number = {8},
pages = {},
pmid = {42479201},
issn = {1432-1041},
mesh = {Humans ; *Venous Thromboembolism/prevention & control/etiology ; *Anticoagulants/therapeutic use/adverse effects ; Acute Disease ; *Communicable Diseases/complications/drug therapy ; Hospitalization ; Randomized Controlled Trials as Topic ; Hemorrhage/chemically induced ; Fondaparinux/therapeutic use ; },
abstract = {INTRODUCTION: Venous thromboembolism (VTE) may be a significant complication in medical patients, and infectious disease has been highlighted as an additional risk factor. Pharmacological thromboprophylaxis can prevent VTE and is recommended in at-risk populations, but not routinely in patients with infectious diseases.

METHODS: We conducted a systematic review and meta-analysis of studies on the effectiveness of pharmacological thromboprophylaxis in patients with acute infections, excluding those involving COVID-19. The primary outcome was VTE events. Secondary outcomes were mortality and adverse events related to anticoagulant therapy.

RESULTS: Data from seven studies (four randomized controlled trials and three observational studies) involving 16,994 patients with infectious diseases were analyzed. Pharmacological thromboprophylaxis regimens consisted of unfractionated heparin, low-molecular-weight heparin (enoxaparin or dalteparin), and fondaparinux. The severity of the disease varied from acute infections to sepsis. Six studies reported fewer VTE events with thromboprophylaxis. The meta-analysis yielded a pooled odds ratio of 0.50 [95% CI: 0.37-0.69, I[2] = 47%]. Three studies reported bleeding or bruising outcomes: one observational study reported significantly more bleeding with thromboprophylaxis, while two randomized trials reported either no significant difference in severe bleeding or in mild bleeding-related adverse events. Two studies assessed mortality, but neither found a statistically significant difference with or without thromboprophylaxis. One study was at high risk of bias, and another was at critical risk of bias.

CONCLUSION: This analysis quantifies the effect of thromboprophylaxis in patients with acute infectious diseases. Although available results show that thromboprophylaxis is associated with fewer VTE events, limited data, sparse safety and mortality reporting, and heterogeneity among studies preclude reliable risk-benefit evaluation. Further prospective research is warranted.},
}

Humans
*Venous Thromboembolism/prevention & control/etiology
*Anticoagulants/therapeutic use/adverse effects
Acute Disease
*Communicable Diseases/complications/drug therapy
Hospitalization
Randomized Controlled Trials as Topic
Hemorrhage/chemically induced
Fondaparinux/therapeutic use

@article {pmid42480062,
year = {2026},
author = {Alqarni, AA and Al-Kuraishy, HM and Alqarni, M and Eliwa, D and Al-Gareeb, AI and Bahaa, MM and Batiha, GE},
title = {Adiponectin Signaling as an Immunometabolic Regulator in COVID-19: Mechanistic Insights and Therapeutic Potential.},
journal = {Immunological investigations},
volume = {},
number = {},
pages = {1-24},
doi = {10.1080/08820139.2026.2704902},
pmid = {42480062},
issn = {1532-4311},
abstract = {BACKGROUND: Adiponectin is a pleiotropic adipocytokine with anti-inflammatory, antioxidant, and insulin-sensitizing functions. Its regulatory role in glucose and lipid metabolism, endothelial homeostasis, and immune responses positions it as a key determinant of immunometabolic resilience. Dysregulated adiponectin signaling has been increasingly implicated in adverse COVID-19 outcomes, particularly among individuals with metabolic comorbidities.

OBJECTIVE: To synthesize mechanistic, preclinical, and translational evidence on adiponectin signaling in COVID-19 and evaluate its potential as a therapeutic and lifestyle-modulated target.

METHODS: A critical review of published literature on adiponectin biology, AdipoR1/R2 receptor signaling, AMPK and PPAR-α pathways, cytokine regulation, oxidative stress, and infection-induced metabolic reprogramming was conducted.

RESULTS: COVID-19 is consistently associated with reduced circulating adiponectin, with the greatest declines observed in obesity, diabetes, and metabolic syndrome. Mechanistic and animal studies show that adiponectin activation attenuates hyperinflammation, oxidative stress, endothelial dysfunction, and multi-organ injury. These effects are mediated through AMPK activation, PPAR-α modulation, NF-κB suppression, and restoration of metabolic-immune balance.

CONCLUSIONS: Adiponectin signaling represents a promising therapeutic target for mitigating COVID-19 severity, especially in metabolically vulnerable populations. Pharmacological agonists and lifestyle interventions that enhance adiponectin pathways warrant further translational investigation.},
}

@article {pmid42481378,
year = {2026},
author = {Raiten, DJ and Bundy, DA and DeBernardo, D and Steiber, AL and Papoutsakis, C and Jimenez, EY and Proaño, GV and Rozga, M and Bremer, AA},
title = {The "Biomarkers of Nutrition for Development: Knowledge Indicating Dietary Sufficiency (BOND-KIDS)" Project-Justification and Conceptual Approach.},
journal = {The Journal of nutrition},
volume = {},
number = {},
pages = {101614},
pmid = {42481378},
issn = {1541-6100},
support = {Z99 OD999999/ImNIH/Intramural NIH HHS/United States ; },
abstract = {The global food and nutrition enterprise is confronted with daunting challenges to all aspects of the food system, from social/economic/political crises to pandemic diseases to climate change, all of which impact our ability to meet the health needs of a growing population. The response has been focused on vulnerable groups and critical periods of human development, starting with the "first 1000 d" (i.e., pregnancy and the first 2 y of life). However, another critical developmental period, the "next 7000 d" (i.e., 2-21 y of age), has received less attention in terms of efforts to inform our understanding of the role of nutrition in the health and development of children and adolescents. Although significant effort has gone into providing nutritional support to school-aged children (particularly via school-based programs), a lack of research (and thus evidence) has constrained our ability to assess the need for and impact of these programs on health and development. The recent impact of the COVID-19 pandemic on our ability to provide services to this vulnerable age group has highlighted not only the need to redouble efforts to address the effects of food and nutrition insecurity on these children but also a daunting lack of evidence to inform the development and evaluation of such programs. When viewed as a complex biological system, we can understand that school-aged children interact with both internal (biological, genetic, and nutritional) and external (social/behavioral/economic/political, home, community, and physical) environments (i.e., an ecology). The "Biomarkers of Nutrition for Development: Knowledge Indicating Dietary Sufficiency (BOND-KIDS)" Project was initiated to apply a transdisciplinary approach to address this ecology and help inform the range of communities involved in providing nutritional support to school-aged children in the United States and globally. This Executive Summary provides an overview of the conceptual approach, goals, objectives, and process of the BOND-KIDS Project.},
}

@article {pmid42481444,
year = {2026},
author = {Martins, D and Beckman, D and Loggia, M and Costanza, A and Borsini, A},
title = {Understanding neuroinflammation in post-COVID-19 syndrome: biological mechanisms, diagnostic biomarkers, and therapeutic prospects.},
journal = {Translational psychiatry},
volume = {16},
number = {1},
pages = {},
pmid = {42481444},
issn = {2158-3188},
mesh = {Humans ; *Neuroinflammatory Diseases/immunology/diagnosis/physiopathology ; Biomarkers/metabolism ; *COVID-19/complications/immunology ; *Brain/immunology/diagnostic imaging/physiopathology ; Post-Acute COVID-19 Syndrome ; SARS-CoV-2 ; },
abstract = {Post-COVID-19 syndrome (PCS) is an escalating global health concern, marked by persistent cognitive, neurological, and psychiatric symptoms following acute SARS-CoV-2 infection. Although its underlying mechanisms remain incompletely understood, mounting evidence implicates chronic neuroinflammation as a key driver. Sustained microglial and astrocyte activation, blood-brain barrier disruption, and aberrant cytokine signaling contribute to prolonged immune dysregulation within the central nervous system, promoting long-term brain dysfunction. In this expert review, we synthesize emerging insights into how neuroimmune processes impair brain function in PCS. We explore novel mechanistic pathways - including local sleep intrusions, impaired memory reconsolidation, and astrocyte-mediated destabilization of functional networks - that may underlie the syndrome's fluctuating and heterogeneous presentation. We evaluate fluid biomarkers of neuroinflammation, including glial fibrillary acidic protein (GFAP), soluble TREM2, S100β, and pro-inflammatory cytokines such as interleukin-6 and tumor necrosis factor-α. In parallel, we highlight converging neuroimaging biomarkers derived from PET and MRI studies. These include increased TSPO-PET binding in limbic and frontal regions, alterations in cerebral blood flow and oxygen metabolism, neurometabolic changes detected via MR spectroscopy (e.g., elevated myo-inositol and choline), and increased free water content on diffusion imaging - each suggestive of glial activation and network-level dysfunction. We propose a multiscale, longitudinal framework that integrates molecular, neuroimaging, and behavioral data to link immune dysregulation with brain network instability and symptom emergence. Such integrative approaches are critical for advancing precision diagnostics and informing the development of targeted, mechanism-based treatments for individuals affected by PCS.},
}

Humans
*Neuroinflammatory Diseases/immunology/diagnosis/physiopathology
Biomarkers/metabolism
*COVID-19/complications/immunology
*Brain/immunology/diagnostic imaging/physiopathology
Post-Acute COVID-19 Syndrome
SARS-CoV-2

@article {pmid42482056,
year = {2026},
author = {Arthur, SE and Turkson, G and Quarcoo, JA and Cudjoe, MAP and Trotter, C},
title = {From trial site to research emerging research hub: mapping Ghana's vaccine research ecosystem, 1977-2025.},
journal = {Health research policy and systems},
volume = {24},
number = {1},
pages = {},
pmid = {42482056},
issn = {1478-4505},
mesh = {Ghana ; Humans ; *Vaccine Development ; COVID-19/prevention & control/epidemiology ; *Biomedical Research ; *Vaccines ; Pandemics ; Clinical Trials as Topic ; SARS-CoV-2 ; },
abstract = {BACKGROUND: Ghana's vaccine research ecosystem has evolved substantially alongside national and global immunisation efforts. However, the extent and distribution of research activity across the full vaccine development continuum have not been systematically synthesised. This review maps peer-reviewed publications and institutional reports across a nine-stage vaccine development framework from 1977 to 2025, comparing patterns between the pre-pandemic (2000-2020) and post-pandemic (2021-2025) periods.

MAIN BODY: Before 2020, vaccine-related research in Ghana was concentrated predominantly in downstream domains, including disease surveillance, programme implementation, and Phase II-III clinical trials, with notable contributions to malaria and pneumococcal vaccine development. Following the COVID-19 pandemic, publication output increased more than fivefold and diversified into emerging areas such as genomic surveillance, regulatory science, behavioural research, and digital health systems, accompanied by stronger leadership from domestic institutions. Despite this expansion, engagement in upstream domains, including discovery science, preclinical development, Phase I clinical trials, and local vaccine manufacturing, remains limited, reflecting persistent structural and infrastructure constraints.

CONCLUSIONS: Ghana has transitioned from a primarily implementation-focused setting to an increasingly active contributor to multidisciplinary vaccine evidence. Sustained investment in upstream research infrastructure, early-phase clinical trial capacity, sustainable financing mechanisms and behavioural intervention research will be essential to strengthen national vaccine sovereignty. The Ghanaian experience offers transferable lessons for other low- and middle-income countries seeking to build resilient and locally driven vaccine research ecosystems.},
}

Ghana
Humans
*Vaccine Development
COVID-19/prevention & control/epidemiology
*Biomedical Research
*Vaccines
Pandemics
Clinical Trials as Topic
SARS-CoV-2

@article {pmid42482485,
year = {2026},
author = {Ruting, W and Jiale, L and Hongxi, W and Zhenjin, H and Ruohan, Z and Yuanbo, S and Rongxin, Z and Hongzhen, T and Feng, J},
title = {Intestinal Organoids as Models to Study Viruses: Current Application and Future Perspective.},
journal = {Journal of microbiology and biotechnology},
volume = {36},
number = {},
pages = {e2603016},
pmid = {42482485},
issn = {1738-8872},
mesh = {*Organoids/virology ; Humans ; Animals ; *Intestines/virology ; *Viruses/growth & development ; Virology/methods ; Intestinal Mucosa/virology ; Host Microbial Interactions ; Models, Biological ; Microphysiological Systems ; Host-Pathogen Interactions ; Coculture Techniques ; },
abstract = {Intestinal organoids have emerged as a transformative model system in virology, bridging the gap between conventional cell lines and animal models by recapitulating the complex cellular diversity, three-dimensional architecture, and key functions of the human intestinal epithelium. This review highlights how this technology has enabled groundbreaking studies of enteric viruses, including the successful cultivation of previously uncultivable human norovirus, and has provided critical insights into the infection mechanisms of rotavirus, enterovirus A71, and Severe Acute Respiratory Syndrome Coronavirus 2. We discuss how emerging technologies, such as co-culture systems for host-microbiome interactions, vascularization techniques, and CRISPR/Cas9 gene editing, are being integrated with organoids to create more physiologically relevant microphysiological systems. Despite challenges related to immune component integration and model standardization, intestinal organoids offer a promising platform for elucidating virus-host interactions, advancing antiviral drug screening, and promoting personalized infectious disease research.},
}

*Organoids/virology
Humans
Animals
*Intestines/virology
*Viruses/growth & development
Virology/methods
Intestinal Mucosa/virology
Host Microbial Interactions
Models, Biological
Microphysiological Systems
Host-Pathogen Interactions
Coculture Techniques

@article {pmid42483585,
year = {2026},
author = {Hirvonen, A and Pellegrinelli, L and Binda, S and Pariani, E},
title = {Wastewater-Based Epidemiology for Infectious Diseases: A New Trick for an Old Threat.},
journal = {Environment & health (Washington, D.C.)},
volume = {4},
number = {7},
pages = {1309-1316},
pmid = {42483585},
issn = {2833-8278},
abstract = {Wastewater-based epidemiology (WBE) is an innovative approach to epidemiology that offers unique opportunities for public health surveillance. Its potential had been recognized in various applications over the years, but it was the global scale of the response to the SARS-CoV-2 pandemic that truly brought WBE to the fore. In this perspective paper we explore the untapped potential of WBE as a catalyst for infectious disease surveillance and as a One Health epidemiological tool, and the future horizons and innovative applications of WBE. It is clear that WBE will address a growing number of pathogens of concern to human health, such as avian influenza viruses, mpox, enterovirus D68, Candida auris, and antimicrobial resistance. In addition, it will contribute to epidemic intelligence by monitoring mass gathering events, and by predictive modeling and forecasting in combination with artificial intelligence to mitigate and prevent infectious diseases from reaching the highest level of clinical complexity. We believe that the maximum performance and complete institutional integration into public health of WBE is yet to be realized on a global scale.},
}

@article {pmid42484844,
year = {2026},
author = {Fette, F and Roll, F and Kranke, P and Koscielny, J and Zacharowski, K and Weber, CF and Lindner, ML},
title = {[Hereditary disorders of hemostasis in obstetrics 2/2-Anesthesiological aspects of secondary hemostasis].},
journal = {Die Anaesthesiologie},
volume = {75},
number = {9},
pages = {667-680},
pmid = {42484844},
issn = {2731-6866},
mesh = {Humans ; Female ; Pregnancy ; *Pregnancy Complications, Hematologic/therapy/genetics ; *Hemostasis/physiology/genetics ; *Anesthesia, Obstetrical/methods ; *Blood Coagulation Disorders, Inherited/therapy/genetics/complications ; },
abstract = {Hemophilia A and B as well as von Willebrand diseases account for 95-97% of all congenital blood coagulation disorders and the rare factor deficiency conditions (factors I, II, V, VII, X, XI, XIII) account for the remaining 3-5%. The clinical presentation varies considerably, whereby the correlation between factor activity and bleeding phenotype is only insufficiently expressed, especially for factor VII deficiency. Pregnancy represents a special challenge as the physiological alterations of hemostasis can compensate for the underlying defect to different extents. These heterogeneous dynamics require an individualized monitoring, which also includes the individual history of bleeding as the central instrument of risk stratification, in addition to factor activities. From an anesthesiological perspective two core aspects are prioritized, the safe performance of neuraxial anesthesia procedures and the management of peripartum hemorrhage.},
}

Humans
Female
Pregnancy
*Pregnancy Complications, Hematologic/therapy/genetics
*Hemostasis/physiology/genetics
*Anesthesia, Obstetrical/methods
*Blood Coagulation Disorders, Inherited/therapy/genetics/complications

@article {pmid42485161,
year = {2026},
author = {Camilleri, M},
title = {Gastroparesis: A Review.},
journal = {JAMA},
volume = {336},
number = {7},
pages = {587-602},
doi = {10.1001/jama.2026.12181},
pmid = {42485161},
issn = {1538-3598},
mesh = {Female ; Humans ; Male ; *Gastroparesis/etiology/therapy/diagnosis/epidemiology ; Prevalence ; Risk Factors ; Sex Factors ; Nausea/diagnosis/epidemiology/etiology/therapy ; Vomiting/diagnosis/epidemiology/etiology/therapy ; Abdominal Pain/diagnosis/epidemiology/etiology/therapy ; Gastric Emptying/drug effects/physiology ; Radionuclide Imaging ; Tomography, X-Ray Computed ; Gastroscopy ; Antiemetics/therapeutic use ; Gastrointestinal Agents/pharmacology/therapeutic use ; Enteral Nutrition ; Pyloromyotomy ; },
abstract = {IMPORTANCE: Gastroparesis is a condition of delayed gastric emptying in the absence of gastric outlet obstruction. Based on a 2018 US administrative health insurance claims database study, prevalence of definite gastroparesis (with documented delayed gastric emptying) was 21.5 per 100 000 persons.

OBSERVATIONS: Gastroparesis, which is caused by reduced contractions of the distal stomach or abnormal pyloric relaxation, is more common among females than males (ratio, 2:1-4:1) and typically causes nausea, vomiting, early satiety, bloating, and abdominal pain or discomfort. In a large US epidemiological study involving 82.6 million patients, the most common causes of gastroparesis were type 2 diabetes (51.7%), postsurgical effects (15%), medication-induced (11.8%), idiopathic (11.3%), type 1 diabetes (5.7%), and other (4.5%). Other risk factors include neurological disorders (eg, Parkinson disease), hypothyroidism, amyloidosis, connective tissue disorders (eg, scleroderma), and viral infections (eg, norovirus, cytomegalovirus, Epstein-Barr virus, SARS-CoV-2). The 2022 American College of Gastroenterology and the 2025 American Gastroenterological Association (AGA) guidelines define the criterion standard diagnostic test for gastroparesis as gastric emptying scintigraphy with more than 10% gastric retention at 4 hours in patients with symptoms of gastroparesis without mechanical obstruction based on upper endoscopy or abdominal imaging such as computed tomographic (CT) scan. The carbon 13 spirulina stable isotope breath test is also approved for diagnosing gastroparesis by the US Food and Drug Administration. Based on the percentage of gastric retention at 4 hours, gastroparesis is categorized in the 2022 AGA clinical practice update as mild (10%-15%), moderate (16%-35%), or severe (>35%). Treatment includes discontinuation of medications that delay gastric emptying such as opioids, cannabis, anticholinergics, and glucagon-like peptide-1 receptor agonists and for patients with diabetes, optimizing glycemic control. First-line therapies according to the AGA 2022 clinical practice update are a small particle diet (food that is blended or chopped into small pieces) that is low in fat and nondigestible fiber and antiemetics (eg, serotonin 5-hydroxytryptamine 3 [5-HT3] receptor antagonists, histamine H1 receptor antagonists) for mild gastroparesis; antiemetics and prokinetics (metoclopramide, erythromycin) for moderate gastroparesis, and liquid diet or jejunal enteral feeding for severe gastroparesis. Severe refractory gastroparesis may be treated with gastric peroral endoscopic myotomy (G-POEM), which involves endoscopic-guided incision of the pylorus sphincter muscle, or gastric electrical simulation, in which an implanted neurostimulator sends electrical pulses to the stomach muscle.

CONCLUSIONS AND RELEVANCE: Gastroparesis is a condition of delayed gastric emptying without gastric outlet obstruction that is diagnosed based on a gastric emptying study. First-line treatments include a small particle diet and antiemetics and prokinetics. Severe refractory gastroparesis may be treated with procedures such as G-POEM or gastric electrical simulation.},
}

Female
Humans
Male
*Gastroparesis/etiology/therapy/diagnosis/epidemiology
Prevalence
Risk Factors
Sex Factors
Nausea/diagnosis/epidemiology/etiology/therapy
Vomiting/diagnosis/epidemiology/etiology/therapy
Abdominal Pain/diagnosis/epidemiology/etiology/therapy
Gastric Emptying/drug effects/physiology
Radionuclide Imaging
Tomography, X-Ray Computed
Gastroscopy
Antiemetics/therapeutic use
Gastrointestinal Agents/pharmacology/therapeutic use
Enteral Nutrition
Pyloromyotomy

@article {pmid42486051,
year = {2026},
author = {Okoli, GN and Sullivan, SG and Harper, DM and Tsang, TK and Cowling, BJ},
title = {A systematic meta-analytic comparative evaluation of seasonal influenza vaccine effectiveness from test-negative design studies in the Northern Hemisphere pre/post COVID-19 pandemic.},
journal = {Vaccine},
volume = {88},
number = {},
pages = {128956},
doi = {10.1016/j.vaccine.2026.128956},
pmid = {42486051},
issn = {1873-2518},
mesh = {Humans ; *Influenza Vaccines/immunology/administration & dosage ; *Influenza, Human/prevention & control/immunology/epidemiology ; *Vaccine Efficacy ; Adolescent ; Influenza A Virus, H3N2 Subtype/immunology ; Influenza B virus/immunology ; *COVID-19/epidemiology/prevention & control/immunology ; Influenza A Virus, H1N1 Subtype/immunology ; Seasons ; Child, Preschool ; Middle Aged ; Adult ; Child ; Young Adult ; Infant ; Pandemics ; Aged ; },
abstract = {BACKGROUND: Influenza circulation was substantially reduced during the COVID-19 pandemic. The consequent reduction in population immunity may have resulted in increased influenza vaccine effectiveness (VE) after the pandemic via reduced immunity in unvaccinated individuals compared to the pre-pandemic period.

METHODS: We systematically reviewed published peer-reviewed test-negative design (TND) studies of seasonal influenza VE against medically-attended, laboratory-confirmed influenza in the Northern Hemisphere. We compared pooled VE estimates before (2010/11-2019/20) and after (2022/23-2024/25) the COVID-19 pandemic (defined as 2020/21-2021/22). Pooled VE against A(H1N1)pdm09, A(H3N2), influenza B, and B/Victoria was calculated for three age groups (6 months-17 years, 18-64 years, ≥65 years) using inverse-variance random-effects meta-analysis. Heterogeneity was quantified with the I[2] statistic, and differences between pooled VE estimates pre- and post-pandemic periods were tested with the χ[2] statistic.

RESULTS: Eighty-five publications were included. Post-pandemic VE against A(H3N2) was significantly higher than pre-pandemic VE in 6-month-17-year-olds (53% [42-64%] vs 37% [30-45%]) and 18-64-year-olds (35% [25-45%] vs 21% [13-29%]). Similarly, VE against influenza B was higher post-pandemic in both age groups (85% [78-93%] vs 52% [45-60%] and 73% [59-87%] vs 49% [41-57%], respectively). Conversely, VE against A(H1N1)pdm09 was lower post-pandemic in 18-64-year-olds (37% [27-46%] vs 55% [47-62%]). No significant differences were observed for ≥65-year-olds, and data for B/Victoria were limited.

CONCLUSIONS: The evidence suggests slightly higher VE against seasonal influenza after the COVID-19 pandemic although there may be factors other than population immunity that may explain our observations.},
}

Humans
*Influenza Vaccines/immunology/administration & dosage
*Influenza, Human/prevention & control/immunology/epidemiology
*Vaccine Efficacy
Adolescent
Influenza A Virus, H3N2 Subtype/immunology
Influenza B virus/immunology
*COVID-19/epidemiology/prevention & control/immunology
Influenza A Virus, H1N1 Subtype/immunology
Seasons
Child, Preschool
Middle Aged
Adult
Child
Young Adult
Infant
Pandemics
Aged

@article {pmid42486492,
year = {2026},
author = {Kao, CM and Bahakel, H and Heald-Sargent, TA and Minniear, TD and Statler, VA and Thomas, SJ and Weakley, KE and Cao, Q and Ardura, MI and Danziger-Isakov, L and Foca, M and Herold, BC},
title = {Influenza, COVID-19, and RSV Vaccinations for Immunocompromised Children and Household Contacts.},
journal = {Pediatrics},
volume = {158},
number = {2},
pages = {},
doi = {10.1542/peds.2026-075971},
pmid = {42486492},
issn = {1098-4275},
mesh = {Humans ; *Immunocompromised Host ; Child ; *Influenza, Human/prevention & control/immunology ; *Influenza Vaccines/administration & dosage/immunology ; *COVID-19/prevention & control/immunology ; *Respiratory Syncytial Virus Infections/prevention & control/immunology ; *COVID-19 Vaccines/administration & dosage ; *Respiratory Syncytial Virus Vaccines/administration & dosage/immunology ; *Vaccination ; },
abstract = {Immunocompromised pediatric patients, including hematopoietic cell and solid organ transplant recipients, those undergoing chemotherapy for malignancy, and those receiving biologic response modifiers for autoimmune or inflammatory conditions, are at risk for severe disease from vaccine-preventable respiratory viral infections such as influenza, SARS-CoV-2 (COVID-19), and respiratory syncytial virus (RSV). These children face higher rates of hospitalization, intensive care admissions, and mortality, reflecting contributions from an immature immune system, absence of immunologic memory, and/or increased environmental exposures. Immunization recommendations for immunocompromised children are largely extrapolated from studies conducted among healthy children and/or immunocompromised adults due to a paucity of primary data on immunological responses and vaccine efficacy in immunocompromised children. Trends in vaccine hesitancy in the general population, ongoing transmission of respiratory viral infections in the community, and suboptimal vaccination rates among immunocompromised children and their household contacts further compound the risk for this vulnerable population. As the number of children with immunocompromising conditions expands, it is imperative that primary care practitioners and subspecialists who care for immunocompromised children ensure appropriate immunizations are provided to these patients and their household and community contacts. We will review available data supporting the current guidelines regarding vaccine dosing, scheduling, and formulations to prevent influenza, COVID-19, and RSV infections in immunocompromised children. Furthermore, we highlight key knowledge gaps and areas of current investigation aimed at improving respiratory viral vaccine immunogenicity and optimize protection.},
}

Humans
*Immunocompromised Host
Child
*Influenza, Human/prevention & control/immunology
*Influenza Vaccines/administration & dosage/immunology
*COVID-19/prevention & control/immunology
*Respiratory Syncytial Virus Infections/prevention & control/immunology
*COVID-19 Vaccines/administration & dosage
*Respiratory Syncytial Virus Vaccines/administration & dosage/immunology
*Vaccination

@article {pmid42486499,
year = {2026},
author = {Clemén, H and Ramu, S and Uller, L},
title = {The triple-hit hypothesis: exploring pulmonary e-cigarette, PM2.5 and viral polyexposure.},
journal = {European respiratory review : an official journal of the European Respiratory Society},
volume = {35},
number = {181},
pages = {},
pmid = {42486499},
issn = {1600-0617},
mesh = {Humans ; *Electronic Nicotine Delivery Systems ; *Vaping/adverse effects ; Animals ; *Particulate Matter/adverse effects ; *Lung/virology/immunology/drug effects/physiopathology/metabolism/pathology ; Risk Factors ; *Respiratory Tract Infections/virology/immunology ; Particle Size ; Host-Pathogen Interactions ; Aerosols ; *Inhalation Exposure/adverse effects ; *E-Cigarette Vapor/adverse effects ; },
abstract = {Exposure to e-cigarette aerosols, particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5) and respiratory viruses rarely occurs in isolation, but rather in complex polyexposure contexts during daily life. On a cellular and molecular level, vaping induces a distinct lipid-laden macrophage phenotype, alters pulmonary neutrophilic infiltration and impairs epithelial differentiation and ciliary function. In contrast, PM2.5 alters the macrophage polarisation equilibrium, temporally favouring an acute pro-inflammatory phenotype and a subsequent chronic tissue-remodelling phenotype, while also driving an oxidative inflammatory epithelial milieu. Both exposures thus impair antiviral defences and enhance susceptibility to respiratory viral infections such as influenza A, rhinovirus and severe acute respiratory syndrome coronavirus 2. The triple-hit hypothesis proposes that concurrent exposure to vaping aerosols, PM2.5 and respiratory viruses may exert additive or synergistic effects on chronic airway inflammation. PM2.5 may amplify vaping-induced macrophage lipid accumulation, thereby reducing the macrophage clearance capacity. Decreased efferocytosis and autophagy may further exacerbate inflammation by increasing secondary necrosis from apoptotic cells and debris. This persistent inflammatory state coupled with epithelial injury and impaired antiviral responses may increase the risk of infection and accelerate the development or progression of chronic respiratory diseases such as asthma and COPD. These insights highlight the crucial need for polyexposure models to accurately reflect real-world environmental and behavioural exposures and evaluate their impact on respiratory health and disease exacerbations. Understanding this exposure triad is also crucial for refining exposure guidelines, updating risk assessments and implementing preventive strategies.},
}

Humans
*Electronic Nicotine Delivery Systems
*Vaping/adverse effects
Animals
*Particulate Matter/adverse effects
*Lung/virology/immunology/drug effects/physiopathology/metabolism/pathology
Risk Factors
*Respiratory Tract Infections/virology/immunology
Particle Size
Host-Pathogen Interactions
Aerosols
*Inhalation Exposure/adverse effects
*E-Cigarette Vapor/adverse effects

@article {pmid42486943,
year = {2026},
author = {Vaidya, N and Zhang, Z and Agunbiade, K and Keggin, G and Hedi, K and Winterer, J and Bobou, M and Broulidakis, J and King, S and Robinson, L and Zhang, Y and Barker, GJ and Bokde, AL and Brühl, R and Grigis, A and Lemaître, H and Lett, T and Nees, F and Papadopoulos, D and Poustka, L and Schmidt, U and Sinclair, J and Stringaris, A and Whelan, R and Walter, H and Desrivières, S and Schumann, G},
title = {Brain network-based stratification of mental health disorders: design and cohort description of the STRATIFY and ESTRA studies.},
journal = {Molecular psychiatry},
volume = {},
number = {},
pages = {},
pmid = {42486943},
issn = {1476-5578},
support = {695313//EC | Horizon 2020 Framework Programme (EU Framework Programme for Research and Innovation H2020)/ ; 2023YFE0199700//Chinese Ministry of Science and Technology | Department of S and T for Social Development (Department of S&T for Social Development)/ ; 82150710554//National Science Foundation of China | National Natural Science Foundation of China-Yunnan Joint Fund (NSFC-Yunnan Joint Fund)/ ; 675346//Deutsche Forschungsgemeinschaft (German Research Foundation)/ ; MRF-058-0014-F-ZHAN-C0866//RCUK | MRC | Medical Research Foundation/ ; MRF-058-0004-RG-DESRI//RCUK | MRC | Medical Research Foundation/ ; MR/R00465X/1//RCUK | Medical Research Council (MRC)/ ; },
abstract = {The STRATIFY (Brain Network-Based Stratification of Reinforcement-Related Disorders) and ESTRA (Eating Disorders Stratification) studies were established as harmonised "sibling" cohorts to develop a mechanistically informed framework for stratifying psychiatric disorders. Here, we describe the study design, methodology, and cohort characteristics. Both studies investigate how network properties of brain structure and function, together with biological markers derived from blood-based genomics, epigenetics, and proteomics, relate to reinforcement-related behaviours that cut across major depressive disorder, alcohol use disorder, psychosis, and eating disorders. A further objective is to identify discriminative multimodal features that predict disease onset, symptom course, and functional outcomes, thereby supporting the development of targeted interventions. STRATIFY and ESTRA recruited 674 patients and 70 healthy controls aged 18-30 years (76% females), supplemented by 199 age- and sex-matched healthy controls from the population-based IMAGEN cohort assessed at the same sites using harmonised protocols. Multimodal assessment included structured clinical interviews, self-report measures, cognitive testing, biosamples for molecular analyses, and multimodal MRI (structural, diffusion, resting-state, and task-based fMRI). ESTRA participants additionally completed longitudinal follow-up, and all cohorts were assessed during the COVID-19 pandemic. STRATIFY and ESTRA together constitute a large-scale, open-science resource integrating multimodal brain, behavioural, and biological data across transdiagnostic patient cohorts in early adulthood. The anonymised dataset is available to the research community through managed access, supporting international collaboration and accelerating the development of mechanistically informed classification systems and predictive tools in psychiatry.},
}

@article {pmid42488644,
year = {2026},
author = {Yamashita, M and Park, J and Park, S and Kang, HJ and Chung, YS and Lim, SA and Lee, S},
title = {Convergent innate immune and regulated cell-death pathways in selected myopathies.},
journal = {Frontiers in immunology},
volume = {17},
number = {},
pages = {1871966},
pmid = {42488644},
issn = {1664-3224},
mesh = {Humans ; *Immunity, Innate ; Animals ; *Muscular Diseases/immunology/pathology ; Signal Transduction/immunology ; Muscle, Skeletal/immunology/pathology ; *Regulated Cell Death/immunology ; Innate Immunity Recognition ; Inflammasomes/immunology/metabolism ; Cytokines/metabolism ; },
abstract = {Myopathies are a heterogeneous group of skeletal muscle disorders caused by genetic mutations or acquired insults, including inflammation, infection, endocrine imbalance, and toxic exposure. Myopathies affect a substantial number of individuals worldwide and are a significant cause of chronic muscle weakness and disability. Despite diverse etiologies, progressive myofiber injury and degeneration underlie the functional decline across disease subtypes. Accumulating evidence indicates that innate immune activation and regulated myofiber death pathways, including apoptosis, necroptosis, and pyroptosis, contribute to disease progression in selected genetic and acquired myopathies and may represent increasingly actionable therapeutic targets. This review focuses specifically on the interplay between innate immune signaling and the regulation of cell death pathways in skeletal muscle across diverse myopathies. We discuss pattern recognition receptors, inflammasome activation, and cytokine-driven pathways, such as tumor necrosis factor-alpha (TNF-α), type I interferons (IFNs), and interleukin (IL) family signaling, highlighting how these mechanisms amplify inflammation, impair regeneration, and promote myofiber degeneration. To illustrate category-specific mechanisms, we selected representative disorders from each major myopathy group, including Duchenne muscular dystrophy (DMD) as a prototypical DAMP-driven muscular dystrophy, myotonic dystrophy type 1 (DM1) as a model of secondary innate immune activation associated with RNA toxicity-induced cellular stress, dermatomyositis (DM) as a representative inflammatory myopathy, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated myopathy as a clinically relevant model of virus-related muscle involvement and systemic inflammation-associated muscle injury. By integrating evidence across these disease contexts, this review highlights convergent mechanisms in which innate immune dysregulation and regulated myofiber death drive muscle pathology and provide rational targets for mechanism-based therapeutic strategies.},
}

Humans
*Immunity, Innate
Animals
*Muscular Diseases/immunology/pathology
Signal Transduction/immunology
Muscle, Skeletal/immunology/pathology
*Regulated Cell Death/immunology
Innate Immunity Recognition
Inflammasomes/immunology/metabolism
Cytokines/metabolism

@article {pmid42488856,
year = {2025},
author = {Attah, FA and Obame-Nkoghe, J and Osayomi, T and Omobowale, OC and Chachage, M and Lakoh, S and Adediji, AO and Ogunmolasuyi, AM and Nsojo, A and Famuyide, IM and Ilesanmi, O and Adenomon, M and Adekanmbi, O and Mohammed, Y and Fowotade, A},
title = {Combating Emerging Zoonotic Diseases Using One Health Strategies To Curb Local, National, Regional And Global Transmission And Mortality: A Scoping Review.},
journal = {Nigerian medical journal : journal of the Nigeria Medical Association},
volume = {66},
number = {6},
pages = {2082-2102},
pmid = {42488856},
issn = {0300-1652},
abstract = {BACKGROUND: Emerging zoonotic diseases account for 75% of new infectious threats worldwide due to increasing human-animal-environment interactions, land-use change, wildlife trade, and climate variability. The COVID-19 pandemic underscored the need for integrated, joint approaches such as One Health to strengthen prevention, early detection, and response to zoonotic risks. The study objective is to synthesize evidence on the burden, drivers, challenges, and One Health strategies for combating emerging zoonotic diseases, and to identify actions to improve implementation at local, national, regional, and global levels.

METHODOLOGY: A systematic literature search was conducted across PubMed, EMBASE, Scopus, and Google Scholar. Studies were included if they examined zoonotic diseases using a One Health approach and were published in English. Data were synthesized thematically to identify key patterns, intervention strategies, and gaps.

RESULTS: Zoonotic diseases impose morbidity, mortality, and economic losses. Evidence shows that One Health interventions such as integrated surveillance, joint outbreak investigations, and targeted vaccination have improved detection and control of diseases. However, implementation remains hindered by fragmented communication across sectors, policy inconsistencies, limited laboratory and surveillance capacity, inadequate cross-border cooperation, and limited funding. Vulnerabilities are particularly pronounced in low- and middle-income countries.

CONCLUSION: Effective implementation needs improved governance, sustainable financing, aligned policies, robust surveillance and laboratory systems, and meaningful community engagement. Investing in interdisciplinary research, early warning systems, and integrated response mechanisms will enhance preparedness and reduce zoonotic disease transmission. A well-resourced One Health framework is essential to protect human, animal, and environmental health.},
}

@article {pmid42488877,
year = {2025},
author = {Stephen, RI and Reyes, JA and Tyndall, J and Zawaya, K and Inyang, V and Rapheal, F and Yunusa, D and Simnawa, SF and Ayogu, S and Nuhu, YB and Dunga, J},
title = {COVID-19's Hidden Impact on Chronic Liver Disease Mortality in Nigeria: Findings from an 18-Year Retrospective Review.},
journal = {Nigerian medical journal : journal of the Nigeria Medical Association},
volume = {66},
number = {6},
pages = {2312-2327},
pmid = {42488877},
issn = {0300-1652},
abstract = {BACKGROUND: The COVID-19 pandemic disrupted healthcare systems globally, disproportionately affecting patients with decompensated chronic liver disease (DCLD) due to interrupted care, resource diversion, and the immunosuppressive state associated with DCLD.In Nigeria, where viral hepatitis is endemic, evidence on the pandemic's indirect impact on DC LD mortality remains scarce. This study examined 18-year mortality trends among patients who died from DCLD in North-eastern Nigeria and evaluated the influence of the COVID-19 pandemic on DCLD-related mortalities.

METHODOLOGY: A retrospective review of 436 adult decedents with confirmed DCLD (2006-2024) was conducted at Modibbo Adama University Teaching Hospital, Adamawa State. Sociodemographic and clinical data were abstracted from records. Mortality trends were analysed using Poisson regression, changepoint detection, and joinpoint analysis to identify inflection years, focusing on 2020-2022 as the pandemic window.

RESULTS: The mean age at death was 50.3 ± 14.4 years; 74.5 % were male, and 76.1 % were from low-income households. Viral Hepatitis B & C infections were linked to 67.8 % of deaths, followed by alcohol use (30.1 %). Common complications included hepatic encephalopathy (83.8 %) and portal hypertension (58.2 %). Mortality rose steadily over 18 years, with an abrupt 8.7 % increase in 2020 (p < 0.01). Joinpoint analysis identified 2013 and 2020 as major inflection points.

CONCLUSION: Mortality from DCLD in North-eastern Nigeria increased sharply during the COVID-19 pandemic. Viral hepatitis remains the dominant cause, compounded by late presentation and poor access to care. Strengthening hepatitis prevention, integrating CLD management into non-communicable disease programs, and maintaining chronic care continuity during health emergencies are crucial to mitigating future excess deaths.Top of FormBottom of Form.},
}