Search Results (569)

Hemato-oncological patients with chemotherapy-induced thrombocytopenia are a major recipient group of frequent platelet (PLT) transfusion. Prophylactic platelet transfusions are administered when platelet counts fall below 10 × 10⁹ PLT/L, to prevent severe or fatal bleeding. However, these prophylactic platelet transfusions do not always result in the prevention of bleeding. Pre- or post-transfusion acquired dysfunction of donor platelets in this respect could play a role. We previously reported intrinsic and transfusion-dependent platelet alterations in hemato-oncological patients. In particular, the expression of relevant platelet receptors was affected in donor platelets after incubation with patient’s plasma, which could explain, at least in part, the variable efficacy of platelet transfusions in these patients. In the present manuscript we show that plasma from acute myeloid leukemia (AML) patients undergoing chemotherapy inhibits functionality of allogenic platelets. Further proteomic analysis allowed us to observe alterations in the composition of plasma samples, and to identify key plasma components which could be responsible for platelet function inhibition and explain bleeding in patients notwithstanding platelet transfusions. We anticipate that with the obtained results, platelet transfusion support can be further personalized in patients receiving chemotherapy and applications might expand to maximize the clinical efficacy of procedures such as bone marrow transplantation. Full article

Background: Immune effector cell-associated hemophagocytic lymphohistiocytosis-like syndrome (IEC-HS) is a rare, life-threatening complication following CAR T-cell therapy. Diagnosis is challenging due to overlap with severe CRS, sepsis and lack of standardized criteria. Clinical data remain limited. Methods: We retrospectively analyzed 301 patients treated with CD19- or BCMA-directed CAR T-cells for hematologic malignancies at a single center from January 2019 to January 2026. IEC-HS was defined according to American Society for Transplantation and Cellular Therapy criteria. Results: Median follow-up was 31 months. IEC-HS was diagnosed in 14 patients (4.7%), median age 67 years. Underlying diseases included diffuse large B-cell lymphoma (n = 4), multiple myeloma (n = 7), mantle cell lymphoma, Burkitt lymphoma and B-lymphoblastic leukemia (n = 1 each). All patients had hyperferritinemia and cytopenias at baseline; most had high tumor burden (9/14) and elevated LDH (10/14). CRS occurred in all patients and ICANS in 6/14. IEC-HS occurred at median 10 days and was characterized by hyperferritinemia (median 15,321 µg/L), neutropenia, thrombocytopenia, hepatic dysfunction and high CAR-T-cell expansion in peripheral blood. Treatment included corticosteroids and anakinra (12/14). Refractory patients received IVIG (5/14), tocilizumab (3/14), siltuximab, ruxolitinib, emapalumab or etoposide (each n = 1). Infections occurred in 11/14; 4/14 had mixed infections. IEC-HS resolved in 7/14 (median 7 days). Mortality was 79% (11/14), mainly due to IEC-HS (7/14). Three patients were alive at last follow-up. One-year OS was lower vs. the whole cohort (31% vs. 69%, p < 0.0001). Conclusions: IEC-HS was associated with severe cytopenias, hyperferritinemia, hepatic dysfunction and high infection risk. Despite intensive immunosuppressive therapy, outcomes remain poor. Early biomarker-driven identification and multicenter studies are needed. Full article

Immunotherapy with immune checkpoint inhibitors (ICIs) has profoundly transformed the therapeutic landscape of lung cancer. Although ICIs are generally associated with a more favorable toxicity profile compared with traditional chemotherapy, rare and potentially severe immune-related adverse events (irAEs) may occur, sometimes posing significant diagnostic challenges. We report a case of macrophage activation syndrome (MAS) following a single administration of the anti-PD-L1 antibody atezolizumab in a patient with advanced non-small-cell lung cancer (NSCLC). A 62-year-old woman was diagnosed in February 2024 with stage IIIB NSCLC according to the 8th TNM classification. The patient was deemed ineligible for radiotherapy because of previous thoracic irradiation for breast cancer. First-line therapy with carboplatin plus pemetrexed was administered from March to June 2024, resulting in stable disease; this was followed by pemetrexed maintenance from July to October 2024, at which time thoracic disease progression was documented. Second-line treatment with atezolizumab was initiated in November 2024. Ten days after the first infusion, the patient was admitted to the emergency department for fever and confusion. Laboratory investigations revealed markedly elevated C-reactive protein and hyperferritinemia. Despite empirical antibiotic therapy, fever and thrombocytopenia persisted. Bone marrow biopsy demonstrated findings consistent with MAS. Corticosteroid therapy with prednisone at 1 mg/kg was promptly initiated under rheumatologic supervision, leading to a rapid clinical and biochemical improvement. During tapering, inflammatory markers relapsed when prednisone was reduced to below 12.5 mg/day. Given the occurrence of a grade 4 (CTCAE v5.0) immune-related adverse event, atezolizumab was permanently discontinued. The patient remains in follow-up without radiological evidence of disease progression. This case highlights the diagnostic challenge of MAS secondary to ICIs, which may initially present with nonspecific symptoms such as fever, confusion, and elevated inflammatory markers. Early recognition and timely initiation of high-dose corticosteroids were essential for effective management and full recovery. Clinicians should maintain a high index of suspicion for MAS among rare but severe hematologic irAEs during immunotherapy. Full article

Background/Objectives: Vaccine-preventable diseases remain a persistent public health challenge in regions characterized by structural vulnerabilities, including suboptimal vaccination coverage, socioeconomic deprivation, and limited access to healthcare. In structurally vulnerable regions, such as the South-West Romanian region, characterized by persistent vaccination gaps and recurrent outbreaks, these conditions generate a sustained public health burden that requires ongoing preventive risk management strategies. In such contexts, digital risk stratification tools may support preventive decision-making by enabling early identification of patients at increased risk of severe outcomes. This study applied machine learning techniques to routinely collected measles surveillance data from South-West Romania to identify severe disease cases and determine key predictors of severity, offering a pragmatic alternative to outbreak forecasting in a resource-constrained setting. Methods: An open epidemiological dataset of laboratory-confirmed measles cases reported by the Regional Center for Public Health Surveillance Craiova was analyzed. The dataset defined severe cases as those with pneumonia, thrombocytopenia, a hospital stay exceeding three days, or other documented complications requiring medical intervention. Random Forest (RF) and Logistic Regression (LR) classifiers were trained and compared using a 10-fold cross-validation framework across 200 resampling iterations. Model performance was assessed using accuracy, AUC-ROC, sensitivity, specificity, positive predictive value, and F1-score. Feature importance was quantified using permutation-based measures, and the highest-ranked predictors were further evaluated through chi-square tests of independence. Results: RF significantly outperformed LR in accuracy (0.84 vs. 0.82), AUC (0.87 vs. 0.80), specificity (0.87 vs. 0.84), positive predictive value (0.89 vs. 0.86), and F1-score (0.84 vs. 0.83), with p ≤ 0.001 for most metrics. Sensitivity was equivalent between models (approximately 0.81; p = 0.328). Feature importance analysis identified seven key predictors: county of residence, vaccination status, outbreak status, presence of other symptoms, occupation, cough, and conjunctivitis. All seven were significantly associated with disease severity, and six showed significant geographic variation across counties. Vâlcea County had the highest concentration of severe cases. The model was trained on a regional surveillance cohort in which symptomatic and hospitalized cases are over-represented and should be interpreted as a triage-support tool within this surveillance context rather than as a population-level severity estimator. Conclusions: Machine learning, particularly RF, can effectively identify severe measles cases using routinely collected surveillance data in settings where robust outbreak prediction is not feasible. The county of residence functioned as a composite proxy for structural determinants, including healthcare access, vaccination coverage, and socioeconomic deprivation. These findings support the use of ML-based severity classification as a pragmatic tool for clinical risk stratification and targeted public health intervention in resource-constrained environments. Full article

Crimean–Congo hemorrhagic fever virus (CCHFV) and severe fever with thrombocytopenia syndrome virus (SFTSV) are tick-borne pathogens that cause severe illness and high mortality. Early diagnosis is critical, particularly in resource-limited settings, to enable timely intervention. Host gene expression profiling offers a promising approach to identify potential biomarkers for early detection, disease staging, and logical treatment decision-making. Using a transient IFN-α/β receptor-suppressed mouse model, we performed targeted transcriptomic analysis on blood samples collected at 2, 3, and 4 days after CCHFV or SFTSV challenge. A significant increase in viral load and changes in gene expression were observed as early as two days post-challenge. CCHFV induced a progressively evolving interferon-driven response, while SFTSV triggered rapid, sustained immune activation. Affected targets included interferon-stimulated genes, chemokines, cytokines, Toll-like receptors, and genes associated with viral evasion and innate immune response. Despite shared expression patterns, unique genes were identified as potential biomarkers to distinguish between CCHFV and SFTSV infections. Differential gene expression revealed distinct immune response dynamics, with suppression of critical immune regulatory genes suggesting transcriptional signatures associated with viral evasion mechanisms contributing to disease severity. These findings provide a comparative analysis of molecular pathways and gene expression changes, offering critical insights for biomarker discovery, effective triage, and evaluation of appropriate medical intervention. Full article

Background and Objectives: Romania reported the highest measles incidence in the European Union during the 2023–2024 epidemic, largely driven by declining vaccination coverage. We aimed to characterize the epidemiological, clinical, and laboratory profile of hospitalized measles patients and to identify age-related differences, with particular emphasis on systemic and hepatic involvement. Materials and Methods: We conducted a retrospective observational study including 360 consecutive patients with laboratory-confirmed measles admitted to a tertiary infectious disease hospital in northeastern Romania between 1 January and 31 December 2024. Demographic, clinical, laboratory, therapeutic, and outcome data were collected. Pediatric (<15 years) and adult patients were compared using appropriate statistical tests. Results: Children accounted for 71.4% of cases, including 16.1% infants under one year. Over 90% of patients were unvaccinated or incompletely vaccinated. Household transmission represented the most frequent identifiable source. Adults presented significantly higher inflammatory markers and more pronounced hepatic involvement than children. ALT elevation occurred in 63.1% of adults versus 34.2% of children (p < 0.001), with moderate-to-severe cytolysis predominantly observed in adults (34.9% vs. 1.9%, p < 0.001). Pulmonary complications were documented in 28% of cases, mainly viral interstitial pneumonia. Thrombocytopenia was significantly more frequent in adults (p < 0.001). Overall mortality was 0.27%, occurring in an unvaccinated infant with secondary bacterial pneumonia. Conclusions: The 2024 measles epidemic in our area was characterized by sustained transmission among unvaccinated individuals and frequent systemic involvement. Hepatic dysfunction emerged as a prominent feature in adults, suggesting a shifting clinical phenotype in contemporary outbreaks. Strengthening vaccination coverage and early recognition of systemic complications remain critical to reducing measles-related morbidity and mortality. Full article

Background: Elevated anticardiolipin IgG (aCL IgG) has been reported in end-stage renal disease (ESRD), but its association with specific etiologies of kidney failure remains unexplored. The unique pathophysiology of diabetic–hypertensive nephropathy may be associated with a microenvironment that could potentially contribute to antiphospholipid antibody production and thrombotic complications. This study aimed to investigate whether aCL IgG elevation in hemodialysis (HD) patients is associated with combined diabetes–hypertension (DM + HTN) etiology and thrombocytopenia, thereby identifying a clinically distinct potential high-risk subgroup. In this hypothesis-generating study, we focused on within-HD patient comparisons rather than healthy controls. Methods: We enrolled 242 participants: 150 healthy controls (included only to establish local reference ranges) and 92 patients with maintenance HD. The study was conducted from 01 September to 20 November 2025 in Madinah, Saudi Arabia. Serum aCL IgG was measured by chemiluminescence immunoassay (positive ≥ 12 GPL units). Comprehensive hematological and biochemical parameters were analyzed. Multivariable logistic regression identified predictors of aCL positivity. Results: In the HD cohort, 21% demonstrated aCL positivity; this represents a substantially higher rate than the 2% observed in local healthy controls (p < 0.001). This elevation was not uniform across etiologies. Strikingly, 94.7% (18/19) of aCL-positive HD patients had DM + HTN aetiology, compared with only 17.8% of aCL-negative patients (p < 0.001). Thrombocytopenia was significantly more severe in aCL-positive patients (median platelets: 100 vs. 191 × 10⁹/L, p < 0.001). In multivariable analysis, DM + HTN etiology (HTN-alone vs. DM + HTN odds ratio [OR]: 0.0013, 95% confidence interval [CI]: 0.00002–0.0999, p = 0.003; confirmed by Firth’s penalized logistic regression sensitivity analysis, and lower platelet count (OR: 0.92 per 1 × 10⁹/L increase, 95% CI: 0.87–0.98, p = 0.006) independently predicted aCL positivity. Conclusions: These hypothesis-generating findings suggest a potential association between metabolic–vascular disease and antiphospholipid immunity in ESRD. Causality cannot be inferred from this cross-sectional design. At present, routine aCL screening is not recommended outside of research protocols; prospective studies are needed to confirm these associations. Full article

Background: Sepsis remains a leading cause of mortality in the intensive care unit (ICU). Platelets (PLTs) are central to coagulation, inflammation, and the maintenance of endothelial integrity. Although thrombocytopenia is an established prognostic marker in sepsis, alterations in PLT function and morphology may provide additional insight into disease progression. Methods: This retrospective pilot study examined adult ICU patients diagnosed with sepsis or septic shock. Extracted data included demographic characteristics, clinical variables, and laboratory parameters. Platelet function was evaluated using impedance aggregometry and rotational thromboelastometry (ROTEM), while PLT morphology metrics were obtained from complete blood counts. Statistical analyses comprised Spearman’s rank correlation and logistic regression. Results: Twenty patients were included. Platelet aggregation was impaired across ASPI, ADP, and TRAP-6 assays despite normal PLT counts and morphology. ROTEM-derived measure of PLT contribution to clot strength was within normal ranges. No correlations were observed between PLT function and PLT morphology parameters. An inverse correlation was identified between ROTEM-derived PLT contribution to clot strength and SOFA score (r = −0.60, p = 0.03). Neither PLT function nor PLT morphology was associated with ICU mortality. Conclusions: Functional PLT deficits may occur in sepsis in the absence of structural abnormalities. ROTEM-derived PLT contribution to clot strength may inversely reflect sepsis severity. Platelet function parameters appear unlikely to predict short-term mortality in septic patients. Full article

Objective: To evaluate overall survival and to identify clinical, pathological, and demographic factors associated with survival in patients with stage III colon cancer. Methods: This retrospective cross-sectional study included 452 patients with stage III colon cancer who were followed at Ankara Bilkent City Hospital between 2005 and 2025. Patient data, including age, sex, ECOG performance status, comorbidities, tumor characteristics, treatment-related toxicities, and recurrence, were analyzed using PASW Statistics 18.0 (SPSS Inc., Chicago, IL, USA). Kaplan–Meier and log-rank tests were used for survival analysis. Prognostic factors, survival, mortality, and recurrence predictions were evaluated using machine learning algorithms, including coarse tree, bagged trees, support vector machines, and k-nearest neighbors. Furthermore, an explainable artificial intelligence framework was incorporated to improve model transparency and reveal clinically meaningful feature contributions. Model performance was assessed using accuracy, sensitivity, specificity, and F-score. Results: According to statistical analyses, older age, ECOG performance score ≥ 2, stage IIIC disease, N2-level lymph node metastasis, and the presence of comorbidities—particularly diabetes mellitus—were significantly associated with worse survival (p < 0.05). Machine learning analyses identified key prognostic factors, including positive surgical margins, rash, mucositis, thrombocytopenia, number of chemotherapy cycles, pathological tumor subtype, diarrhea, age at diagnosis, and anemia. SHAP analysis further demonstrated that treatment-related variables, particularly surgical margin positivity and chemotherapy-associated toxicities, were among the most influential predictors of survival. Several machine learning models outperformed traditional statistical methods in predicting mortality and recurrence, with the highest accuracy observed in ensemble methods such as coarse tree (87%) and bagged trees. Conclusions: This study identifies key prognostic factors influencing survival in stage III colon cancer and demonstrates that machine learning-based approaches can complement conventional statistical methods. The integration of clinical and treatment-related variables may improve individualized risk stratification and support clinical decision-making. These findings may also guide future large-scale, multicenter, and prospective studies. Full article

Background and Objectives: Thrombocytopenia complicates 6.6–11.6% of pregnancies. While gestational thrombocytopenia (GT) is usually benign, etiologies such as immune thrombocytopenia (ITP), preeclampsia, and HELLP syndrome require individualized management. This study aimed to characterize the etiological spectrum, maternal peripartum hematologic outcomes, blood product utilization, and mode of delivery in a tertiary-center cohort of thrombocytopenic pregnancies and to assess whether platelet count should influence delivery mode decisions. Materials and Methods: This retrospective cohort study included 137 thrombocytopenic pregnant women at a tertiary center (2010–2019), categorized by etiology and severity. Peripartum hemoglobin, hematocrit, and platelet counts were compared between delivery groups. Blood product utilization was recorded and analyzed using t-test, ANOVA, chi-square, Fisher’s exact, and Fisher–Freeman–Halton tests; binary logistic regression was used for multivariable analysis. Results: GT (43.1%) and ITP (32.1%) were the most prevalent diagnoses; cesarean delivery rate was 52.6%. Postpartum Hb was higher in the vaginal delivery group (10.24 ± 1.28 vs. 9.80 ± 1.26 g/dL; p = 0.003), while platelet counts were paradoxically lower (p = 0.039). Platelet transfusion rates did not differ significantly between delivery modes (23.1% vs. 27.8%; p = 0.621). Severe thrombocytopenia required platelet transfusion in 92.6% of cases versus 11.6% (moderate) and 0% (mild) (p < 0.001). RBC transfusion was highest in gestational hypertensive disease (41.2%) versus GT (5.1%) and ITP (2.3%) (p < 0.001). General anesthesia was used in 75% of cesarean cases. Conclusions: Delivery mode in thrombocytopenic pregnancies should be guided by obstetric indications, not platelet count alone. Although postpartum platelet counts declined more steeply after vaginal delivery, this did not increase transfusion requirements. Gestational hypertensive disorders carried the greatest hemorrhagic burden, highlighting the need for etiology-specific multidisciplinary planning. The high general anesthesia rate warrants prospective institutional audit of anesthetic decision-making protocols to determine adherence to current neuraxial anesthesia thresholds. This study is limited to maternal peripartum hematologic outcomes; neonatal outcomes were not captured and should be addressed in future prospective research. Full article

Background and Objectives: Alloantibodies directed against human platelet antigens and human leukocyte antigens are implicated in several immune-mediated platelet disorders, including platelet transfusion refractoriness, post-transfusion purpura and fetal and neonatal alloimmune thrombocytopenia. Reliable and simultaneous detection of these antibodies is essential for accurate diagnosis and appropriate clinical management. The aim of this study was to determine the prevalence and specificity spectrum of anti-HLA and anti-HPA alloantibodies in patients with suspected immune-mediated platelet disorders using a multiplex bead-based assay, and to evaluate its diagnostic utility in a Serbian cohort. Materials and Methods: A bead-based glycoprotein-specific antibody detection assay was performed using monoclonal antibodies specific for platelet glycoproteins and HLA class I molecules, separately coupled to Luminex microbeads. Serum samples were collected from 259 patients, including 234 patients with thrombocytopenia, 11 with neonatal alloimmune thrombocytopenia, and 14 with suspected platelet transfusion refractoriness. All samples were tested using the PakLx Luminex assay, and results were interpreted with MatchIt! Antibody software. Results: Of the 259 tested samples, 72 (27.8%) were positive for HLA and/or platelet-specific antibodies. Among the positive samples, 29.2% contained HLA class I antibodies, 45.8% contained platelet-specific antibodies, and 25% showed combined HLA and platelet antibody positivity. The most frequently detected platelet-specific antibodies were directed against GPIIb/IIIa (HPA-1, -3, -4) and GPIa/IIa (HPA-5). Conclusions: This first analysis of platelet alloantibodies in a Serbian cohort demonstrates a high prevalence of antibody positivity in patients with neonatal alloimmune thrombocytopenia and platelet transfusion refractoriness, with anti-HPA-1a as the predominant specificity. The significant association between clinical presentation and antibody profile underscores the need for targeted diagnostic testing. Multiplex bead-based technology provides comprehensive alloantibody detection, facilitating optimized transfusion management in immune-mediated platelet disorders. Full article

Introduction: The majority of progressive multifocal leukoencephalopathy (PML) cases is still represented by patients affected by acquired immunodeficiency syndrome (AIDS). Diagnosis of PML relies on histopathological findings or by the combination of clinical signs, radiological evidence, and molecular positivity of the JC virus in cerebrospinal fluid. However, AIDS status predisposes to various diseases involving the brain, testing the diagnostic ability of the clinician. Case description: We describe a PML case in a patient with AIDS, in whom lumbar puncture was initially impossible for severe thrombocytopenia and magnetic resonance showed an hyperintense lesion and was unable to distinguish between PML and lymphoma. In this case, [¹⁸F]-fluorodeoxyglucose (FDG)-PET imaging showing a hypometabolism of the lesion helped to initially orient toward PML, as diagnosis was later confirmed by lumbar puncture. We collected 21 cases in the literature in which [¹⁸F]-FDG-PET was helpful in cases of PML. Discussion and Conclusions: PET imaging is not considered a standard diagnostic tool for PML. However, in selected cases, it may provide valuable information to direct the diagnosis towards PML. Full article

Ticks serve as primary vectors for a wide array of RNA viruses, yet the diversity and distribution of tick-associated RNA viruses remain incompletely characterized in Hebei province. To address this gap, we conducted a systematic metatranscriptomic investigation of 986 ticks representing six species, collected from the diverse ecological landscapes of Hebei Province in northern China. Our analysis recovered 25 complete or near-complete viral genomes spanning 12 families, including Phenuiviridae, Flaviviridae, and Nairoviridae. Of critical public health significance, we identified Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) in both Haemaphysalis longicornis and Dermacentor nuttalli. Phylogenetic reconstruction revealed marked geographic stratification where strains from the coastal plains clustered with the dominant Genotype F, while those from the mountainous north formed a characteristic and divergent lineage phylogenetically linked to isolates from Inner Mongolia. Furthermore, a novel viral agent provisionally named Zhangjiakou Hepacivirus was discovered in Haemaphysalis japonica. This virus shared less than 80% nucleotide identity with the rodent-associated Hepacivirus P, consistent with a rodent origin and possible cross-species transmission. Collectively, these findings reveal descriptive variation associated with vector identity, physiological status, and ecological context in shaping viral evolution and underscore the need for continuous metagenomic surveillance to mitigate emerging tick-borne disease risks within a One Health framework. Full article

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease with high case-fatality rates in East Asia. The causative agent, SFTS virus (SFTSV; also known as Dabie bandavirus), exhibits genotype-dependent differences in pathogenicity. However, infection models that recapitulate these variations and can be applied for vaccine and therapeutic evaluation are still lacking. In this study, we assessed the pathogenicity of two Korean SFTSV isolates representing the F and B genotypes in a murine infection model. Wild-type C57BL/6 and IFNAR knockout (IFNAR−/−) mice were intraperitoneally infected with two different doses of SFTSV (2 and 2 × 10⁻¹ FFU). All C57BL/6 mice survived regardless of viral genotype or dose. In IFNAR−/− mice, infection with either F- or B-type virus at the 2 FFU dose resulted in mortality beginning at 5 days post-infection, with all mice succumbing within 6 days. At the higher dose (2 × 10⁻¹ FFU), mortality differed by genotype: B-type infection led to 20% lethality, whereas F-type infection caused 40% lethality by day 5. Infected and deceased mice exhibited body weight loss as a characteristic clinical outcome. Collectively, these findings demonstrate genotype-associated differences in SFTSV pathogenicity in mice and establish a murine challenge model that may be useful for the preclinical evaluation of candidate vaccines and antiviral agents. Full article

On 9–10 December 2025, the Coalition for Epidemic Preparedness Innovations (CEPI) and the International Vaccine Institute (IVI) convened a workshop in Seoul under CEPI’s Disease X Program. The primary objective was to identify existing gaps needing to be filled and streamline vaccine development and preparedness for Severe Fever with Thrombocytopenia Syndrome (SFTS). CEPI’s partners and experts discussed a multifaceted agenda, ranging from understanding the evolving epidemiology to the refinement of animal models and immunological assay harmonization. Key outcomes included the refinement of Target Product Profiles (TPPs) specifying use cases for both peacetime and outbreak contexts, alongside a recommendation for a core immunoassay panel aimed at harmonizing evaluation frameworks and mitigating the challenges posed by low SFTS prevalence. Integration of the One Health approach emerged as a critical strategy for SFTS prevention, complemented by proactive regulatory engagement to compress vaccine development timelines. This report summarizes these key insights from the workshop, delineating a strategic framework for delivering safe, effective, and accessible vaccines for SFTS and broader Disease X threats. Full article