Respiratory syncytial virus vaccination in older adults and patients with chronic disorders: A position paper from the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine.

Background: Respiratory syncytial virus (RSV) is an important cause of lower respiratory tract infection, hospitalisation and death in adults.

Methods: Based on evidence regarding the impact of RSV on adult populations at risk for severe infection and the efficacy and safety of RSV vaccines, the Portuguese Society of Pulmonology, the Portuguese Association of General and Family Medicine, the Portuguese Society of Cardiology, the Portuguese Society of Infectious Diseases and Clinical Microbiology, the Portuguese Society of Endocrinology, Diabetes and Metabolism, and the Portuguese Society of Internal Medicine endorses this position paper with recommendations to prevent RSV-associated disease and its complications in adults through vaccination.

Conclusion: The RSV vaccine is recommended for people aged ≥50 years with risk factors (chronic obstructive pulmonary disease, asthma, heart failure, coronary artery disease, diabetes, chronic kidney disease, chronic liver disease, immunocompromise, frailty, dementia, and residence in a nursing home) and all persons aged ≥60 years.

Patterns in progression from early-stage melanoma to late-stage melanoma: implications for survivorship follow-up.

This study determined the characteristics of patients with early-stage melanoma (IA-IIA) who later had stage IV recurrence. We retrospectively examined 880 melanoma patients and identified those who progressed to stage IV disease from an initial early-stage (n = 50). We observed a median latent period of 4 years between early-stage diagnosis and metastatic disease.

Apixaban to Prevent Covert Infarcts After Cryptogenic Stroke in Patients With Atrial Cardiopathy: A Secondary Analysis of the ARCADIA Randomized Clinical Trial.

Importance: In the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) randomized clinical trial, anticoagulation did not prevent recurrent stroke among patients with a recent cryptogenic stroke and atrial cardiopathy. It is unknown whether anticoagulation prevents covert infarcts in this population.

Objective: To test the use of apixaban vs aspirin for prevention of nonlacunar covert infarcts after cryptogenic stroke in patients with atrial cardiopathy.

A Framework to Optimize Primary Care of Older Surgical Patients: A Qualitative Study of Geriatricians.

Importance: An increasing number of older adults are undergoing surgery. Older adults face significant challenges throughout the spectrum of perioperative care. No frameworks exist to support primary care clinicians in helping older adults navigate perioperative care beyond preoperative medical clearance.

The underlying mechanisms of the association of bone health with depression - an experimental study.

Background: Depression constitutes a risk factor for osteoporosis, but underlying molecular and cellular mechanisms are not fully understood. MiRNAs influence gene expression and are carried by extracellular vesicles (EV), affecting cell-cell communication.

Aims: (1) Identify the difference in miRNA expression between depressed patients and healthy controls; (2) Analyze associations of these miRNAs with bone turnover markers; (3) Analyze target genes of differentially regulated miRNAs and predict associated pathways regarding depression and bone metabolism.

Sleep Quality Among a Sample of Medical Students and the Association with Academic Performance: An Updated Data.

Sleep is influenced by various factors, including social, economic, genetic, and medical factors, and work and study schedules. Medical students are highly susceptible to sleep-related problems. In this study, we aimed to evaluate the sleep patterns and quality of medical students and determine their correlation with academic achievement.

Concurrent Micra Leadless Pacemaker Implantation and AVN Ablation: Computer Modeling of Novel Risk Mitigation Strategy.

Background: Concurrent Micra leadless pacemaker (Medtronic, Minneapolis, Minnesota) implantation and atrioventricular node (AVN) ablation has been shown to be feasible and safe in patients with symptomatic, drug-refractory atrial fibrillation (AF). However, major complications within the 30 days after concurrent Micra implantation and AVN ablation have been reported. We evaluated the efficacy and safety of the concurrent procedure at our institution.

Integrated care for mental health in epilepsy: A systematic review and meta-synthesis by the International League Against Epilepsy Integrated Mental Health Care Pathways Task Force.

Mental health (MH) comorbidities are prevalent among people with epilepsy (PWE), but many experience challenges accessing care. To address this, suggestions have been made to integrate MH care into epilepsy care settings, yet the current approaches, benefits, and implementation determinants to MH care integration are unclear. This review aims to synthesize existing integrated MH care models for PWE to inform the development and planning of future initiatives.

Acid-Triggered Dual-Functional Hydrogel Platform for Enhanced Bone Regeneration.

Stem cell implantation holds promise for enhancing bone repair, but risks of pathogen transmission and malignant cell transformation should not be ignored. Compared to stem cell implantation, recruitment of endogenous stem cells to injured sites is more critical for in situ bone regeneration. In this study, based on the acidic microenvironment of bone injury, an HG-AA-SDF-1α composite hydrogel with a dual-control intelligent switch function is developed by incorporating stromal cell-derived factor (SDF-1α), arginine carbon dots (Arg-CDs), and calcium ions (Ca) into the oxidized hyaluronic acid/gelatin methacryloyl (HG) hydrogel.

Association of Pretreatment Serum Indirect Bilirubin Levels With Prognostic and Therapeutic Value in Patients With Newly Diagnosed Acute Myeloid Leukemia.

Background: Bilirubin has anti-inflammatory, antioxidant, and anti-cancer properties, with an inverse relationship between its levels and cancer risk and prognosis. However, the prognostic value of serum bilirubin in acute myeloid leukemia (AML) remains uncertain.

Methods: This retrospective study analyzed pretreatment serum total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) in 284 AML patients and 316 healthy controls.

Comprehensive Analysis of the Spectrum of Osteoarticular Infections in Children.

Background: Studies of pediatric osteoarticular infections (OAIs) mostly focus on acute hematogenous osteomyelitis (AHO) and acute bacterial arthritis (ABA). A comprehensive descriptive analysis of pediatric OAIs, including subacute, chronic, and non-hematogenous types, is lacking.

Methods: A detailed analysis of all pediatric OAIs was undertaken at two academic centers, Hasbro Children's Hospital, Providence, RI, and Nationwide Children's Hospital, Columbus, OH.

Effector genes of type III secretion system and biofilm formation in virulent isolates carrying and genes in hospital environment.

In critically ill patients, the occurrence of multidrug-resistant infection is a significant concern, given its ability to acquire multidrug-resistant, form biofilms and secrete toxic effectors. In Brazil, limited data are available regarding the prevalence of dissemination, and the impact of the type III secretion system (T3SS) on toxin production and biofilm formation in clinical isolates of . This study investigates the dissemination of virulent harbouring the and genes, the presence of T3SS genes and their biofilm-forming capability.

Childhood maltreatment and brain aging during adulthood.

Importance: Childhood maltreatment (CM) is associated with the early onset of psychiatric and medical disorders and accelerated biological aging.

Objective: To identify types of maltreatment and developmental sensitive periods that are associated with accelerated adult brain aging.

Design: Participants were mothers of infants recruited from the community into a study assessing the effects of CM on maternal behavior, infant attachment, and maternal and infant neurobiology.

A reproducible framework for monitoring the impact of randomized clinical trials on clinical practice using large-scale real-world data: application to gynaecological surgical trials using the French national healthcare database.

Background: Randomized clinical trials (RCTs) are fundamental to evidence-based medicine, but their real-world impact on clinical practice often remains unmonitored. Leveraging large-scale real-world data can enable systematic monitoring of RCT effects. We aimed to develop a reproducible framework using real-world data to assess how major RCTs influence medical practice, using two pivotal surgical RCTs in gynaecologic oncology as an example-the LACC (Laparoscopic Approach to Cervical Cancer) and LION (Lymphadenectomy in Ovarian Neoplasms) trials.

The dilemma of X-linked agammaglobulinemia carriers.

Background: Many patients with X-linked agammaglobulinemia (XLA) nowadays have reached adulthood, as well as their sisters, possibly carriers of a deleterious Bruton tyrosine kinase variant. Studies on motherhood outcomes in families with XLA are lacking.

Objective: We sought to investigate adherence to carrier status screening, interest in preconception and prenatal genetic counseling, and reproductive decisions in relatives with XLA.

Prognostic Value of the Tricuspid Regurgitation Impact on Outcomes (TRIO) Score in Patients Undergoing Transcatheter Aortic Valve Implantation.

Background: Prognosis assessments for transcatheter aortic valve implantation (TAVI) patients remain challenging, particularly as the indications for TAVI expand to lower-risk patients. This study assessed the prognostic value of the tricuspid regurgitation impact on outcomes (TRIO) score in patients after TAVI.

Methods: This single-center study included 530 consecutive patients who underwent TAVI.

A mind-body resilience intervention for emotional distress in cardiac arrest survivors and their informal caregivers - Recovering together after cardiac arrest: Protocol for an open pilot trial.

Background: Chronic emotional distress among cardiac arrest (CA) survivors and their caregivers is prevalent and worsens quality of life and recovery. Interventions to prevent chronic distress post-CA are needed. We developed (RT-CA), an intervention to increase resiliency in CA survivor-caregiver dyads (pairs).

Seeing Ourselves in Others: Understanding and Addressing Biases in Medical School Admissions Processes.

Purpose: Medical school admissions is a vital area for advancing diversity, equity, and inclusion (DEI). Integrating bias recognition and management (BRM) within the context of admissions is critical in advancing DEI. However, there is a dearth of empirically informed literature on BRM in the admissions context.

Diagnosis and management of de novo non-specific spinal infections: European Association of Neurosurgical Societies (EANS) Spine Section Delphi consensus recommendations.

Introduction: The management of de novo non-specific spinal infections (spondylodiscitis - SD) remains inconsistent due to varying clinical practices and a lack of high-level evidence, particularly regarding the indications for surgery.

Research Question: This study aims to develop consensus recommendations for the diagnosis and management of SD, addressing diagnostic modalities, surgical indications, and treatment strategies.

Material And Methods: A Delphi process was conducted with 26 experts from the European Association of Neurosurgical Societies (EANS).

Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder: Factor Structure and Construct Validity of Subfactors.

The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) is a semi-structured interview designed to assess the severity of current BDD. The aim of the study was to examine the factor structure and construct validity of the BDD-YBOCS. The sample included 366 adults with BDD who completed the BDD-YBOCS and other measures of BDD severity/impairment, psychiatric distress (i.

FOXR2 in cancer development: emerging player and therapeutic opportunities.

Cancer, a leading cause of global mortality, remains a significant challenge to increasing life expectancy worldwide. Forkhead Box R2 (FOXR2), identified as an oncogene within the FOX gene family, plays a crucial role in developing various endoderm-derived organs. Recent studies have elucidated FOXR2-related pathways and their involvement in both tumor and non-tumor diseases.

Binge eating behaviours are associated with recurrent weight gain after metabolic and bariatric surgery.

Background: Recurrent weight gain (RWG) is a major post-operative challenge among metabolic and bariatric surgery (MBS) patients. Binge eating behaviours (BEB) and food addiction (FA) have been identified as significant predictors of post-MBS RWG. However, limited research has investigated their independent associations with post-MBS RWG.

Combined use of cleft and truncated triangle signs helps improve the preoperative MRI diagnosis of lateral meniscus posterior root tears in patients with ACL injuries.

Purpose: This study aimed to investigate whether combining the analysis of different magnetic resonance imaging (MRI) signs enhances the diagnostic accuracy of lateral meniscus posterior root tears (LMPRTs) in patients with anterior cruciate ligament (ACL) injuries. We hypothesised that analysing the cleft, ghost and truncated triangle signs and lateral meniscus extrusion (LME) measurement together would improve the preoperative MRI-based diagnosis of LMPRTs.

Methods: This retrospective study used prospectively collected registry data from two academic centres, including patients undergoing primary or revision ACL reconstruction (ACLR) and LMPRT repair.

The Association Between Hearing Loss and Depression in a Large Electronic Health Record System.

Objective: Hearing loss (HL) is associated with depression, but existing datasets are limited by the type of data available for both hearing and mental health conditions. The purpose of this study is to determine if there is an association between HL and depressive disorders within a large bi-institutional electronic health record (EHR) system containing more granular diagnostic information.

Study Design: Cross-sectional epidemiologic study.

NumSimEX: A method using EXX hydrogen exchange mass spectrometry to map the energetics of protein folding landscapes.

Hydrogen exchange mass spectrometry (HXMS) is a powerful tool to understand protein folding pathways and energetics. However, HXMS experiments to date have used exchange conditions termed EX1 or EX2 which limit the information that can be gained compared to the more general EXX exchange regime. If EXX behavior could be understood and analyzed, a single HXMS timecourse on an intact protein could fully map its folding landscape without requiring denaturation.