Competing interests: S. Ansari reports grants or contracts from the Australian Government Department of Health Medical Research Future Fund and Royal Australian College of General Practitioners (payment made to UNSW Sydney, administering institution for the grants); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Asthma Australia toward participation in the Quality Use of Medicines for Chronic Airways Disease Program funded by the Australian Government Department of Health and Honoraria from the National Health and Medical Research Council for participation in two Grant Assessment Committees for the Australian Government Department of Health; support for attending meetings and/or travel from Asthma Australia toward participation in the Quality Use of Medicines for Chronic Airways Disease Program design thinking workshop in Brisbane, Australia; and other support from UNSW Sydney through two Australian Government Medical Research Future Fund grants, outside the submitted work. A. Min reports patents planned, issued or pending: US20200253891A1 Method of Liver Cancer Treatment with Safranal-Based Formulations (Pending); US20200254049A1 Combination Therapy for Cancer (Pending); and US20200253890A1 Suppression and Inhibition of CDC25B with Safranal-Based Formulations (Pending), outside the submitted work. R. Ancuceanu reports consulting fees from AbbVie and Merck Romania; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AbbVie, Laropharm, Reckitt and Merck Romania; and support for attending meetings and/or travel from Merck Romania and Reckitt, outside the submitted work. J. A. Al-Tawfiq reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as a member of the executive board of the International Society for Infectious Diseases, outside the submitted work. M. Asghariahmadabad reports support for attending meetings and/or travel from the ASNR member in training travel grant to attend ASNR 2025, outside the submitted work. E.F.A. reports support for the present manuscript from the following grants: NIH/NHLBI K23 HL129888, Fred Hutch/UW CFAR AI027757 and NIH/NHLBI R03 HL160251 (all grant funding payments made to institution). M. Ausloos reports support for the present manuscript from the project ‘A better understanding of socio-economic systems using quantitative methods from physics’ funded by European Union—NextgenerationEU and Romanian Government, under National Recovery and Resilience Plan for Romania, contract no. 760034/23.05.2023, code PNRR-C9-I8-CF 255/29.11.2022, through the Romanian Ministry of Research, Innovation and Digitalization, within Component 9, ‘Investment I8’. A. Beloukas reports grants or contracts from Gilead (Research Grant and Sponsorship to the University of West Attica) and GSK/ViiV (Research Grant and Sponsorship to the University of West Attica); payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Gilead and GSK (paid to the University of West Attica); support for attending meetings and/or travel from Gilead and GSK (paid to the University of West Attica); and receipt of equipment, materials, drugs, medical writing, gifts or other services from Cepheid, outside the submitted work. E.J.B. reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Korean Diabetes Association, International Society for the Diabetic Foot, Diabetes Association of the R.O.C. (Taiwan) and the American Diabetes Association and support for attending meetings and/or travel from Korean Diabetes Association, Diabetes Association of the R.O.C. (Taiwan) and the International Society for the Diabetic Foot, outside the submitted work. P.J.G.B. reports the following patents planned, issued or pending: WO2020229805A1, BR112021022592A2, EP3965809A1, OA1202100511, US2023173050A1, EP4265271A2, EP4275700A2, outside the submitted work. A.J.C. reports support for the present manuscript from the Health Effects Institute. J.C. reports grants or contracts from the European Research Council Starting Grant (ERC-StG-2019-848325) and patents planned, issued or pending SURFACTANT-BASED HYDROGEL, METHODS AND USES THEREOF (Universidade Nova de Lisboa), outside the submitted work. N.C.-M. reports consulting fees from Signant Health outside the submitted work. X.D. reports support for the present manuscript from the Institute for Health Metrics and Evaluation, University of Washington. A. Faro reports support for the present manuscript from the National Council for Scientific and Technological Development, CNPq, Brazil, Researcher Grant (Bolsa Produtividade). R.F.G. reports other support from Elsevier as an associate editor outside the submitted work. Z. Guan reports grants or contracts from Dementia Centre of Excellence, Curtin enAble Institute and Curtin University outside the submitted work. I.M.I. reports support for the present manuscript from Ministry of Science, Technological Development and Innovation of the Republic of Serbia (no. 451-03-137/2025-03/200110). M.D.I. reports support for the present manuscript from Ministry of Science, Technological Development and Innovation of the Republic of Serbia (no. 451-03-47/2023-01/200111). N.E.I. reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as The Bursar and Council Member of Malaysian Academy of Pharmacy and as Committee Member of Education Chapter, Malaysian Pharmacists Society, outside the submitted work. T. Joo reports support for the present manuscript from the National Research, Development and Innovation Office in Hungary (RRF-2.3.1-21-2022-00006, Data-Driven Health Division of National Laboratory for Health Security). M. Kivimaki reports grants or contracts from the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/Y014154/1), the National Institute on Aging (National Institutes of Health grants R01AG056477 and R01AG062553) and the Research Council of Finland (350426) outside the submitted work. K. Krishan reports non-financial support from the UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University (Chandigarh, India) outside the submitted work. M.-C.L. reports support for the present manuscript from the National Science and Technology Council, Taiwan (NSTC 113-2314-B-003-002), and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as technical editor, Journal of the American Heart Association, outside the submitted work. G. Liu reports grants or contracts from Al & Val Rosenstrauss Fellowship from Rebecca L. Cooper Medical Research Foundation, Australia, outside the submitted work. J. Liu reports support for the present manuscript from the National Natural Science Foundation (grant 72122001). A. Malinovschi reports payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Boehringer Ingelheim and Chiesi and receipt of sensors for exhaled nitric oxide measurements from NIOX in an investigator-initiated study from Uppsala University outside the submitted work. H. R. Marateb reports grants or contracts from The Beatriu de Pinós postdoctoral program from the Office of the Secretary of Universities and Research from the Ministry of Business and Knowledge of the Government of Catalonia program: 2020 BP 00261, and by the LLavor A grant, funded by the Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya, under the Programa Indústria del Coneixement: PREPARE (2024 LLAV 00083), outside the submitted work. S. Martini reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid from the Indonesian Public Health Association, outside the submitted work. A.G.M. reports consulting fees from Sanofi; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GlaxoSmithKline; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as chair, European Respiratory Society (ERS) Airway Diseases Pharmacology and Treatment Group (5.1); stock or stock options in Health Networks; and other non-financial support from Verona Pharma, outside the submitted work. R. J. Maude reports support for the present manuscript from Wellcome Trust (grant number 220211). A.-F.A.M. reports grants or contract funding from ‘MilkSafe: A novel pipeline to enrich formula milk using omics technologies’, a research cofinanced by the European Regional Development Fund of the European Union and Greek national funds through the Operational Program Competitiveness, Entrepreneurship and Innovation, under the call RESEARCH - CREATE - INNOVATE (project code: T2EDK-02222), as well as from ELIDEK (Hellenic Foundation for Research and Innovation, MIMS-860) (both outside of the present manuscript); payment for expert testimony as an external peer-reviewer for Fondazione Cariplo, Italy; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as editorial board member for Systematic Reviews and Annals of Epidemiology and as associate editor for Translational Psychiatry; stocks on a family winery; and other support from having been a senior scientific officer at BGI Group (Shenzhen, China), outside the submitted work. L. Monasta reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017) and payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. L. Muccioli reports support for attending meetings and/or travel from Jazz Pharma and Angelini, outside the submitted work. S. Nomura reports support for the present manuscript from grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan (24H00663) and Precursory Research for Embryonic Science and Technology from the Japan Science and Technology Agency (JPMJPR22R8). B.O. reports grants or contracts from the Ministry of Research, Innovation and Digitization, project PNRR-I8 no. 842027778, contract no. 760096, outside the submitted work. A. Ortiz reports grants from Sanofi to institution IIS-FJD UAM and to Universidad Autonoma de Madrid (UAM); consulting fees from Astellas, AstraZeneca, Bioporto, Boehringer Ingelheim, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Lilly, Chiesi, Otsuka, Novo Nordisk and Sysmex; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Astellas, AstraZeneca, Bioporto, Boehringer Ingelheim, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Sobi, Menarini, Lilly, Chiesi, Otsuka, Novo Nordisk, Sysmex and Vifor Fresenius Medical Care Renal Pharma and Spafarma; support for attending meetings and/or travel from Astellas, AstraZeneca, Fresenius Medical Care, Boehringer Ingelheim, Bayer, Sanofi-Genzyme, Chiesi, Sobi and Bayer; participation on a Data Safety Monitoring Board or Advisory Board from Astellas, AstraZeneca, Boehringer Ingelheim, Fresenius Medical Care, Bayer, Sanofi-Genzyme, Chiesi, Otsuka, Novo Nordisk and Sysmex; and leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as Council ERA SOMANE, outside the submitted work. R.P. reports participation on a Data Safety Monitoring Board or Advisory Board as a member of the Data Safety Monitoring Board dello studio ‘Consolidation with ADCT-402 (loncastuximab tesirine) after immunochemotherapy: a phase II study in BTKi-treated/ineligible Relapse/Refractory Mantle Cell Lymphoma (MCL) patients’—FIL, Fondazione Italiana Linfomi, Alessandria; leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as a member of the EBMT Statistical Committee, European Society for Blood and Marrow Transplantation, Paris (F), and as a past member 2020–2023 (biostatistician) of the IRB/IEC Comitato Etico AO SS. Antonio e Biagio Alessandria-ASL AL-VC; outside the submitted work. V.C.F.P. reports grants or contracts from Sanofi Consumer Healthcare to conduct research on self-care in the Philippines and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from the Zuellig Family Foundation to write papers on health systems strengthening, outside the submitted work. M.J.P. reports stock or stocks options from Health-Ecore and PAG BV, outside the submitted work. L. Ronfani reports support for the present manuscript from the Italian Ministry of Health (Ricerca Corrente 34/2017) and payments made to the Institute for Maternal and Child Health IRCCS Burlo Garofolo. L.F.R. reports grants or contracts from GSK, MSK and Pfizer; consulting fees from GSK; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from GSK; and support for attending meetings and/or travel from GSK and Pfizer, outside the submitted work. B. Sartorius reports grants or contracts from the Australian National Health and Medical Research Council Fellowship (grant number 2034827), outside the submitted work. B.M.S. reports grants or contracts from Else Kröner-Fresenius Foundation Research Grant, Deutsche Forschungsgemeinschaft Research Grant and PharmaCept GmbH research grant; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca; and support for attending meetings and/or travel from Bayer AG, outside the submitted work. V. Sharma reports other support from DFSS (MHA)’s research project (DFSS28(1)2019/EMR/6) at Institute of Forensic Science & Criminology, Panjab University (Chandigarh, India), outside the submitted work. J.I.S. reports other financial or non-financial interests from Yonsei Fellowship, funded by Lee Youn Jae (JIS), outside the submitted work. L.M.L.R.S. reports grants or contracts with SPRINT, Sport Physical Activity and Health Research & Innovation Center, Polytechnic of Guarda, 6300-559 6 Guarda, Portugal, and collaborations with RISE–UBI, Health Sciences Research Centre, University of Beira Interior (6201-506 Covilhã, Portugal), outside the submitted work. J.A.S. reports consulting fees from ROMTech, Atheneum, Clearview healthcare partners, American College of Rheumatology, Yale, Hulio, Horizon Pharmaceuticals, DINORA, ANI/Exeltis, 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 and the National Institutes of Health; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events as a member of the speaker’s bureau of Simply Speaking; support for attending meetings and/or travel as a past steering committee member of OMERACT; participation on a Data Safety Monitoring Board or Advisory Board from the FDA Arthritis Advisory Committee; leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as a past steering committee member of the OMERACT (an international organization that develops measures for clinical trials and receives arm’s length funding from 12 pharmaceutical companies); stock or stock options in Atai Life Sciences, Kintara Therapeutics, Intelligent Bio Solutions, Acumen Pharmaceuticals, TPT Global Tech, Vaxart Inc., Aytu BioPharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals Holding Corp., Abeona Therapeutics and Charlotte’s Web Holdings; and previously owned stock options in Amarin, Viking and Moderna, outside the submitted work. J.B.S. reports pharmaceutical company grants from 2021 to 2025 from Chiesi, GSK, Linde and Novartis via Hospital Universitario de La Princesa and participated in speaking activities, advisory committees and consultancies from 2021 to 2025 sponsored by Air Liquide, Almirall, AstraZeneca, Boehringer Ingelheim, CHEST, Chiesi, CNPT, ERS, FTH, Gebro, Grifols, GSK, IHME, Laminar Pharma, Linde, Lipopharma, Menarini, Mundipharma, Novartis, OMS/WHO, Pfizer, ResApp, RiRL, ROVI, SEPAR, Seqirus, WHO EUR, Takeda and Zambon. J.S.B. did not receive funding, directly or indirectly, from tobacco manufacturers or their affiliates. I.N.S. reports leadership or fiduciary role in other board, society, committee or advocacy group, unpaid as Trustee of the Citizens Advice Bureau for Hull & East Riding, United Kingdom, outside the submitted work. S.J.T. reports grants or contracts from Jazz Pharmaceuticals related to reviewing the impact of medicinal cannabis on patients with the epilepsy syndromes Lennox-Gastaut syndrome and Dravet syndrome and the 2023 Adult Psychiatric Morbidity Survey team, collecting epidemiological data on community-based adults living in England. This is a contracted study from NHS Digital, via the Department of Health and Social Care; the National Institute for Health and Care Research related to reviewing a national training program for health and social care professionals relating to learning disability and autism (all paid to the University of Leicester); and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as academic secretary for the Neurodevelopmental Psychiatry Special Interest Group and Psychiatry of Intellectual Disability Faculty at the Royal College of Psychiatrists, editorial board member for Progress in Neurology and Psychiatry, Advances in Mental Health and Intellectual Disabilities, Advances in Autism and BMC Psychiatry, and editor of Psychiatry of Intellectual Disability Across Cultures (Oxford University Press), outside the submitted work. E.U. reports the following published patents, that is, 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, and Herbal drug formulation for treating lung tissue degenerated by particulate matter exposure, and the filed patent, that is, A method to transform cow dung into the wall paint by using natural materials and composition thereof, and reports leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid as executive council member, Indian Meteorological Society (Jaipur Chapter, India), and member secretary of DST PURSE Program, outside the submitted work. P.W. reports consulting fees from Novartis Pharmaceuticals outside the submitted work. Y. Yasufuku reports grants or contracts from Shionogi outside the submitted work. M. Zielińska reports other financial support as an Alexion, AstraZeneca Rare Disease, employee outside the submitted work. The other authors declare no competing interests.