INTRODUCTION There remains uncertainty whether global influenza seasonality, viral dynamics and epidemic duration have re-established after 2021. AIM We describe global circulation patterns of influenza viruses from 2021 to 2025 and discuss implications for prevention and surveillance. METHODS We analysed World Health Organization (WHO) FluNet sentinel and non-sentinel/not-defined virological data from week 1/2021 to 26/2025, stratifying by latitude, region and season. We calculated influenza positivity rate, proportion of virus (sub)types, typical peak timing and duration of influenza epidemics (applying the 75% annual average percentage method). RESULTS Sentinel surveillance in 120 countries reported 500,870 detections in this period; positivity rate rose globally from 3.0% in 2021 to 23.7% in 2024. Type A viruses caused over two-thirds of cases, with variability across WHO Regions and seasons. Among A subtypes, A(H3N2) dominated in 2021/22 and A(H1N1)pdm09 in 2023/24, while all but three influenza B cases were B/Victoria. Epidemic peaks typically occurred from December to March and May to August in northern and southern hemispheres countries, respectively, while tropical countries showed highly heterogeneous timing. The median epidemic duration was ca 10 weeks above 30° north, and it varied between 15 and 30 weeks at more southern latitudes. Non-sentinel/not-defined feeds showed stronger A-skew and lower characterisation. CONCLUSION Influenza virus circulation shows convergence toward seasonal architectures described before the COVID-19 pandemic, although changes in lineage ecology and epidemic duration persist. Our results confirm the need for latitude-tailored vaccination schedules, consolidation of trivalent vaccines, and strengthened surveillance to better anticipate changes in influenza circulation and support preparedness.

[This corrects the article DOI: 10.1016/j.eclinm.2025.103662.].

Supplementary Table S2. Features comparison with previous studies. Each row represents a metabolite with its observed mass and retention time (RT), alongside the corresponding feature identified in our dataset. Differences in mass (ppm) and RT (seconds) are shown. The columns summarize findings from previous studies comparing metabolite levels in colorectal cancer (CRC) vs. control, and CRC-precancerous lesions. Values are reported as mean ratios with 95% confidence intervals. References include Geijsen et al. (2019), Alcolea et al. (2023), Rius-Sansalvador et al., and Gumpenberger et al. (2020).

Circulating microRNAs (miRNAs) are promising minimally invasive biomarkers for cancer risk assessment, yet prospective evidence for breast cancer (BC) remains limited. We conducted a nested case-control study within a prospective cohort to examine whether pre-diagnostic circulating miRNAs are associated with subsequent BC risk and to explore their potential relevance in prospective population-based settings. Baseline serum from 160 women (80 incident BC cases; 80 matched controls) was analyzed, with a median time to diagnosis of 8.9 years. Eight candidate miRNAs were quantified by droplet digital PCR (ddPCR) and normalized to miR-484. Group differences were evaluated by non-parametric tests, and odds ratios for BC were estimated using logistic regression models adjusted for established risk factors, with Bonferroni correction for multiple testing. Cases and controls were comparable at baseline. Among the candidates, lower circulating miR-181 levels showed a suggestive inverse association with BC risk in fully adjusted models, while lower Let7 levels showed only a non-significant, hypothesis-generating inverse trend that did not survive Bonferroni correction. No other miRNA displayed clear associations with BC risk. These findings, while preliminary, support further large-scale prospective investigations specifically designed to assess predictive performance and external validation. employing standardized pre-analytical and analytical protocols, repeated sampling, and independent replication/external validation to clarify the etiologic relevance and potential risk-prediction value of circulating miRNAs for BC.

Supplementary Table S1. Top-ranked metabolic features associated with colorectal neoplasia progression prior to multiple testing correction. Features with nominal p-values <0.01 from linear trend models across diagnostic groups are shown. Beta coefficients represent the direction and magnitude of association across disease progression. Direction indicates whether metabolite levels increase or decrease with advancing disease stage.

Supplementary Table S3. Sensitivity analyses of Acisoga associations with CRC risk in the EPIC cohort stratified by tumour site, sex, and dietary factors. Odds ratios (OR) and 95% confidence intervals (CI) for CRC per 1 standard deviation (SD) increase in log-transformed metabolite levels are shown for three metabolic features corresponding to Acisoga-related ions and 248.0997@0.6454001. d stratification Sex, tumour anatomical site (proximal and distal colon), and tertiles (T1–T3) of dietary factors including red/processed meat intake, dietary fiber intake, and vegetable intake. Further models additionally adjusted for vegetable intake and dietary fiber intake. P-values for interaction were obtained from multiplicative interaction terms between metabolite levels and the corresponding stratification variable.

The study aims to describe the methodology for developing the PIECES repository and to present its content. The PIECES repository is a digital catalogue compiling evidence-based primary cancer prevention (PCP) programs targeting six behavioral risk factors (tobacco, alcohol, diet, physical activity, HPV infection, and UV exposure), providing standardized, context-specific information to support local implementation. The repository was designed and assembled as part of the EU-funded PIECES project (2023–2027), and built through a structured search of the Cochrane Library (up to Nov 2023), the NCI Evidence-Based Cancer Control Programs (EBCCP) database, and project partners’ contributions. Inclusion criteria required experimental/quasi-experimental designs, positive behavioral effects, and publication from 2010 onward. Two independent reviewers screened articles. For each selected program, implementation data (target population, settings, resources) were extracted. As of January 2026, the repository includes 136 evidence-based programs: tobacco control (n = 57), physical activity (n = 23), diet (n = 8), alcohol (n = 5), UV exposure (n = 11), HPV (n = 6), and mixed targets (n = 26). To operationalize implementation support, the repository translates each program into a standardized logic model detailing required prerequisites, core activities, mechanisms of action, outputs, and underlying mechanisms of behavioral change. The PIECES repository represents a structured tool designed to support policymakers and practitioners in implementing PCP programs. By making the implementation components and mechanisms of action explicit, it has the potential to bridge the gap between evidence-based research and local implementation, although future real-world evaluation is needed to confirm its practical impact.

BACKGROUND:Despite improved treatments and survival, breast cancer (bc) remains a leading cause of cancer mortality in women. Thyroid dysfunction has been linked to bc risk, but its impact on bc survival is less clear. We investigated associations between pre-diagnosis thyroid-related biomarkers and all-cause and bc-specific survival. METHODS:A prospective cohort study including 1,513 women with invasive bc from 7 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) was conducted. We measured thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and anti-thyroid peroxidase antibodies (Anti-TPO) in samples collected ∼8 years pre-diagnosis. We evaluated associations between these markers and all-cause and bc-specific mortality using Cox proportional hazards models adjusted for relevant covariates. RESULTS:After mean follow-up postdiagnosis of 7 years, 223 deaths occurred, including 161 from bc. We observed no overall associations between circulating levels of TSH, thyroid hormones, thyroid autoimmunity, and mortality. However, in stratified analyses, TSH was inversely associated with all-cause (HR1-standard deviation (SD)=0.70; 95%CI = 0.52-0.94) and bc-specific-mortality (HR1-SD=0.61(0.44-0.84) in premenopausal women, while fT4 was associated with all-cause mortality in metastatic bc (HR1-SD=1.67(1.20 to 2.32), and with bc-specific mortality among users of menopausal/contraceptive hormones (HR1-SD=2.76(1.47-5.19). Anti-TPO-positivity was inversely associated with all-cause mortality in women with body mass index <25kg/m2 and in women with oestrogen receptor-negative tumours, separately. CONCLUSIONS:Thyroid function before diagnosis does not appear to play a major role in bc survival. Although subgroup-specific associations were identified, these findings should be interpreted with caution due to limited statistical power and warrant confirmation in independent populations.

BACKGROUND:Stereotactic body radiation therapy (SBRT) is increasingly used for bone metastases, but inconsistent endpoint definitions and reporting hinder evidence synthesis and clinical application. This study aimed to establish international consensus recommendations for standardised endpoints, definitions, and reporting parameters in SBRT studies for bone metastases. METHODS:A systematic review of prospective SBRT studies (2014-2024) informed a three-round modified Delphi consensus process conducted from 2024 to 2025. Consensus was predefined as at least 75% agreement. Candidate items were refined through iterative online surveys, qualitative feedback, and a final prioritisation vote by an international multidisciplinary expert panel. RESULTS:Of 114 invited experts, 82 from 20 countries participated in at least one Delphi round. Review of 58 prospective studies showed substantial variability in endpoint definitions, pain and toxicity assessment, radiological response criteria, and timing of outcome evaluation. The panel endorsed 46 reporting items (41 required, 5 recommended) and prioritised core endpoint sets across three clinical contexts: oligometastatic, oligoprogressive, and asymptomatic high-risk bone metastases. Strong consensus was reached for definitions of vertebral compression fracture (92%), time to salvage local therapy (93%), duration of pain response (92%), and time to local progression (90%); pain flare achieved 89% agreement. A revised clinical response framework (C-BRAC), introducing a stable disease category, achieved 91% agreement and was recommended for exploratory use alongside existing criteria. CONCLUSIONS:These recommendations provide a structured framework for designing and reporting SBRT studies in bone metastases and may improve consistency, comparability, and future guideline development.

BACKGROUND:Human adenoviruses (HAdV) circulate globally, but their seasonal patterns remain poorly defined. We aimed to characterize the timing, amplitude, and duration of HAdV epidemics worldwide and to compare patterns before and after the COVID-19 pandemic. METHODS:Virological surveillance data on HAdV were obtained from the WHO FluNet database: data from 65 countries were analyzed to estimate epidemic peak timing, amplitude, and duration across the Northern and Southern Hemispheres and the intertropical belt, comparing prepandemic (2016-2019) with postpandemic (2021-2024) periods. To ensure robustness, analyses were restricted to country-seasons with ≥ 30 reporting weeks. RESULTS:From 2016 to 2024, 65 countries reported roughly 148,000 HAdV detections across 335 country-seasons; 46% of seasons had ≥ 50 detections. In the 20 countries with sufficient data for seasonality analyses, median epidemic duration was 31 weeks (range 5-42) and median peak amplitude 70% (40%-98%). Peak timing followed latitude: June-July in Southern Hemisphere, November-December in high-latitude Northern countries, March-April in lower latitude. After COVID-19, several countries showed marked timing shifts, with concurrent changes in amplitude. CONCLUSIONS:After the onset of the COVID-19 pandemic, the usual seasonal patterns of HAdV were altered, with pronounced shifts in peak timing across settings and latitudes. These results underscore the need for strong, ongoing, type-specific surveillance to guide public health strategies.

Radiation dermatitis (RD) affects up to 90

Moderately hypofractionated radiotherapy (m-HRT) is a standard of care in the radical treatment of localized prostate cancer (PCa). Still, its role after radical prostatectomy (RP) is yet to be defined. We present long-term outcome and toxicity results of m-HRT in the post-prostatectomy setting. Retrospective analysis of 172 PCa patients treated with daily volumetric image-guided Tomotherapy-based m-HRT between 2013 and 2020. For outcome and toxicity endpoints, we used Kaplan–Meier survival curves and the chi-square test for univariate analysis. The median time from RP to m-HRT was 11 months (interquartile [IQR], 8.3–31.4). The median total dose to the prostate bed was 69.75 Gy (IQR, 65.25–72 Gy) (2.25 Gy per fraction). With a median follow-up of 8.25 years (IQR 7.06–9.17 years), 10-year overall survival (OS), metastasis-free survival (MFS), and biochemical relapse-free survival (b-RFS) were 98.8

Supplementary Figure S4. Supporting information for the annotations in EPIC. Supporting information for the annotations after re-analysing the pooled quality control sample of the EPIC study and the pure chemical standard for N-(3-acetamidopropyl)pyrrolidin-2-one. The top panels show the chromatograms of the selected chemical formula of the metabolite of interest (left) and the isotopic patterns (right; expected in red, observed in black). The bottom panels display the fragmentation patterns obtained at 5 V (left) and 10 V (right).

Supplementary Figure S1. MS/MS spectra of Acisoga. MS/MS spectra of the metabolite annotated as N-(3-acetamidopropyl)pyrrolidin-2-one (Acisoga) in pooled study samples (collision energies 15 eV and 30 eV, respectively) and in the authentic chemical standard. The fragmentation patterns show overlapping peaks between study samples and the standard, supporting annotation at MSI Level 1.

Supplementary Figure S2. Stratified analysis of Acisoga levels across colorectal neoplasia stages. Log2-transformed Acisoga intensities across diagnostic groups (C, controls; LRL, low-risk lesions; IRL, intermediate-risk lesions; HRL, high-risk lesions; CRC, colorectal cancer), stratified by participant characteristics. a) Sex: males (purple triangles) and females (coral diamonds). b) Age: <61 years (blue triangles) and ≥61 years (light green diamonds). c) Body mass index (BMI): <27.7 kg/m² (orange triangles) and ≥27.7 kg/m² (dark pink triangles). d) Alcohol intake: <5.5 alcohol g/day (maroon triangles) and ≥5.5 alcohol g/day (dark green diamonds). Black circles represent mean intensities for all individuals.