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Article History
Received: 26 January 2025
Accepted: 29 May 2026
First Online: 22 July 2026
Ethics
Competing interests: S. Afzal reports support for this Article from the Institute of Public Health Lahore; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Dean Institute of Public Health Lahore; support for attending meetings and travel from the Dean Institute of Public Health Lahore Pakistan; participation on a data safety monitoring board or advisory board with the Pakistan National Bioethics Committee, Institution Review Board of Fatima Jinnah Medical University, Ethical Review Board and Data Monitoring Board for the Institute of Public Health Lahore Pakistan, Annals of King Edward Medical University Advisory Board, and is in charge of the Clinical Research Organization King Edward Medical University; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with the Pakistan Higher Education Commission Research Committee, Pakistan Medical and Dental Commission Research and Journals Committee, Pakistan National Bioethics Committee, Pakistan Society of Internal Medicine, Pakistan Association of Medical Editors, Medical Microbiology and Infectious Diseases Society, Fellow of Leads International, Fellow of Faculty of Public Health UK, and Fellow of College of Physicians and Surgeons, Pakistan; receipt of equipment, materials, drugs, medical writing, gifts or other services from Bergen University for research writing; and other financial or non-financial interests with the Dean Public Health Institute of Public Birdwood Lahore who provided time and intellectual contributions; all outside the submitted work. M.L.B. reports grants or contracts from the NIH, Hutchinson Postdoctoral Fellowship, the Health Effects Institute, the Robert Wood Johnson Foundation and the Wellcome Trust Foundation, all paid to their institution; consulting fees from Clinique and ToxiMap, paid to them; honoraria from speaking events from the Colorado School of Public Health, Duke University, the University of Texas, Data4Justice, Korea University, Brown University, Konkuk University, the Research and Management Center for Health Risk of Particular Matter; honorarium for editorial duties from IOP Publishing; honoraria for grant reviews from the NIH, Environmental Health and Safety, the University of Texas, FNRS, Health and Medical and Research Fund; honorarium for research from Korea University; honorarium for external advisory committee from Harvard University; and honorarium for online survey or workshop from SciQuest; support for attending meetings and/or travel from Colorado School of Public Health, the University of Texas, Duke University, Harvard University, the American Journal of Public Health , Columbia University, the CMAS conference, the Nature conference, Boston University and Konkuk University; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid from the Fifth National Climate Assessment, Lancet Countdown, the John Hopkins EHE Advisory Board, the Harvard University external advisory committee for training grant, and the WHO Global Air and Pollution and Health Technical Advisory group, and paid from the US EPA Clean Air Scientific Advisory Committee, all outside the submitted work. S. Bhaskar reports grants or contracts from the Japan Society for the Promotion of Science (JSPS), the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT), Grant-in-Aid for Scientific Research (KAKENHI; grant ID 23KF0126), JSPS and the Australian Academy of Science, and JSPS International Fellowship (grant ID P23712); leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, with Rotary District 9675, the Global Health and Migration Hub Community, the Global Health Hub Germany, PLoS ONE , BMC Neurology , Frontiers in Neurology , Frontiers in Strok e , Frontiers in Public Health , Journal of Aging Research , Neurology International , Diagnostics and BMC Medical Research Methodology , College of Reviewers, Canadian Institutes of Health Research (CIHR), Government of Canada, the World Headache Society, Cariplo Foundation, the National Cerebral and Cardiovascular Center, Department of Neurology, Division of Cerebrovascular Medicine and Neurology Japan, the Cardiff University Biobank, the Rotary Reconciliation Action Plan and Japan Connect, all outside the submitted work. D.B. reports grants or contracts from the NIH and the Florida Department of Health; support for attending meetings and/or travel from the NIH and the Florida Department of Health; participation on the Advisory Board of the Self-Made Health Network and the Prevent Cancer Foundation, all outside the submitted work. E.C.D. reports support for this Article from the Prostate Cancer Foundation Young (Investigator Award and through the Cancer Center Support Grant from the National Cancer Institute (P30 CA008748)), and the National Cancer Institute (Prostate Cancer Foundation Young Investigator Award and through the Cancer Center Support Grant from the National Cancer Institute (P30 CA008748)), all outside the submitted work. N.E.I. reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, with the Bursar and Council, the Malaysian Academy of Pharmacy, the Malaysian Pharmacists Society Education Chapter Committee and the IT Service Management Society of Malaysia, all outside the submitted work. J. Khubchandani reports grants or contracts from the National Science Foundation, Merck Pharmaceuticals and NMINBRE, NIGMS; and other financial interests from Elsevier for serving as a journal editor, all outside the submitted work. M.-C.L. reports grants or contracts from the National Science and Technology Council, Taiwan (NSTC 113-2314-B-003-002) and the ‘Higher Education Sprout Project’ of National Taiwan Normal University; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a technical editor for the Journal of the American Heart Association , all outside the submitted work. S.A.M. reports grants or contracts from the Deanship of Scientific Research, King Saud University, all outside the submitted work. F. Nainu reports grants or contracts from Thematic Research Group Research Grant 2025 (no. 00518/UN4.22/PT.01.03/2025) and Riset Kolaborasi Indonesia (RKI)—Scheme C Program (grant no. 01319/UN4.22/PT.01.03/2025) from Hasanuddin University, all outside the submitted work. S. Nomura reports support for this Article from the Ministry of Education, Culture, Sports, Science and Technology of Japan (grant no. 24H00663) and Precursory Research for Embryonic Science and Technology from the Japan Science and Technology Agency (grant no. JPMJPR22R8), all outside the submitted work. V.C.F.P. reports payment of honoraria for lectures, presentations, speakers, bureaus, manuscript writing or educational events from the Zuellig Family Foundation, all outside the submitted work. Y.L.S. reports grants or contracts from Taipei Medical University and NSTC-EPM NTU; consulting fees from the NTU Hospital Research Team; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a co-founder of the Benang Merah Research Center; and other financial or non-financial interests from Jago Beasiswa, all outside the submitted work. J.A.S. reports consulting fees from ROMTech, Atheneum, Clearview Healthcare Partners, Yale, Hulio, Horizon Pharmaceuticals, DINORA, ANI/Exeltis, USA Inc., Frictionless Solutions, Schipher, Crealta/Horizon, Medisys, Fidia, PK Med, Two labs, Adept Field Solutions, Clinical Care Options, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM, Trio Health, Medscape, WebMD, Practice Point communications, the NIH and the American College of Rheumatology; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Simply Speaking; support for attending meetings and/or travel from OMERACT as a past steering committee member; participation on a data safety monitoring board or advisory board with the Food and Drug Administration Arthritis Advisory Committee as a previous member, no financial support; leadership or fiduciary roles in other board, society, committee or advocacy groups, paid or unpaid, as a past steering committee member of OMERACT; stock or stock options in Atyr Pharmaceuticals, Atai Life Sciences, Kintara Therapeutics, Intelligent Biosolutions, Acumen Pharmaceutical, TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals Holding, Aebona Pharmaceuticals and Charlotte’s Web Holdings; and previously owned stock options in Amarin, Viking and Moderna Pharmaceuticals, all outside the submitted work. R.T.-S. reports grants or contracts from the Valencian Regional Government’s Ministry of Education (PROMETEO/CIPROM/2022/58) and the Spanish Ministry of Science, Innovation and Universities (PID2021-129099OB-I00), all outside the submitted work. M. Tanwar reports grants or contracts from the University of Alabama at Birmingham Health Service Foundation, all outside the submitted work. J.H.V.T. reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as a co-founder of the Benang Merah Research Center, all outside the submitted work. G.T. reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as president-elect for the International Society of Electrocardiology and as a board of trustees member for the International Society for Holter and Noninvasive Electrocardiology, all outside the submitted work. E.U. reports the following published patents: ‘a system and method of reusable filters for anti-pollution mask’, ‘a system and method for electricity generation through crop stubble by using microbial fuel cells’, ‘a system for disposed personal protection equipment (PPE) into biofuel through pyrolysis and method’, ‘a novel herbal pharmaceutical aid for formulation of gel and method thereof’, ‘herbal drug formulation for treating lung tissue degenerated by particulate matter exposure’ and ‘a method to transform cow dung into the wall paint by using natural materials and composition thereof’, and the following filed patents: ‘biodegradable packaging composition and method of preparation thereof’, ‘eco-friendly bio-shoe polish from banana and turmeric’, ‘honey-based polyherbal syrup composition to treat air pollution-induced inflammation and preparation method thereof’, ‘process for preparing a caffeine-free, antioxidant and nutrient-rich beverage’, ‘polyherbal oral mist composition for dual relief and method for preparation thereof’ and ‘method for fabricating sustainable waterproof material sheets from LDPE plastic wastes’; leadership or fiduciary roles in other board, society, committee or advocacy groups, paid or unpaid, as the former Joint Secretary of the Executive Council Member of the Indian Meteorological Society, Jaipur Chapter and as Member Secretary of the DSTPURSE Program, all outside the submitted work. S.V. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the University of Milano-Biocca, payments made to them; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid, as the President of Italian Society of Medical Statistics and Clinical Epidemiology, all outside the submitted work. R.W. reports grants or contracts from no. 5T32CA057711-32, all outside the submitted work. S.Wang reports support for this Article from the Beijing Natural Science Foundation (7264268), payments made to them, all outside the submitted work. R.G.W. reports consulting fees from Merck, Sharp and Dohme, payments made to them, all outside the submitted work. H.X. reports support for this Article from the Public Health Sciences Division of Fred Hutch Cancer Center, all outside the submitted work. Y. Yasufuku reports grants or contracts from Shionogi, payments paid to a joint research fund to the University of Osaka, all outside the submitted work. S. M. Alif reports a leadership or fiduciary role in the Thoracic Society of Australia and New Zealand. R. Bai reports support for this Article from the Open Research Fund of Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education (fund no. 2023JYBZDSYS012). R.C.B. reports leadership or fiduciary roles in other board, society, committee or advocacy groups as a funding panel member for the NIHR Pre-doctoral Fellowship and as a member of the College of Experts, Arthritis UK. B.T.B. reports grants or contracts from the Wellcome Trust, the European Union Horizon Europe program, and NRW.Health, all outside the submitted work. E. Chung reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid, as president-elect of the ISSM on a pro bono basis. V. Sharma reports other financial or non-financial interests from DFSS (MHA)’s research project (DFSS28(1)2019/EMR/6) at the Institute of Forensic Science and Criminology, Panjab University, RUSA 2.0 grant to Panjab University and PAIR grant (ANRF/PAIR/2025/000006/PAIR) from ANRF, outside the submitted work. J.I.S. reports other financial or non-financial interests from the Yonsei Fellowship, funded by Lee Youn Jae. Satwinder Singh reports grants or contracts from any entity from the Anusandhan National Research Foundation and the Central University of Punjab. M. Zielińska reports other financial or non-financial interests as a rare disease employee of Alexon, AstraZeneca. J.B.A. reports support for this Article from the University of Eastern Pangasinan, all outside the submitted work. J. Liu declares grants from the Prevention and Control of Emerging and Major Infectious Diseases-National Science and Technology Major Project (2025ZD01900800) and Beijing Youth Scholar Program (087). R. Mehrotra reports receiving consulting fees from MSD. G. Micha reports having received payment or honoraria from None Related for lectures, presentations, speakers bureau participation, manuscript writing and educational events. A. Kusnali reports support for this Article from the National Research and Innovation Agency, Republic of Indonesia, including access to scientific literature databases containing paid and unpaid online journals such as Scopus and Web of Science.