Review of current and emerging estrogen receptor agonists for vaginal atrophy.

Introduction: Vulvovaginal atrophy (VVA) predominantly affects postmenopausal women due to hormonal decline but can also occur in premenopausal women with conditions such as primary ovarian insufficiency or exposure to anti-estrogen medications. Contributing factors include smoking and certain medical treatments. Symptoms like dyspareunia and loss of sexual function affect many women but are underreported due to stigma and lack of awareness.

The Open Anatomy Explorer - a journey towards accessible open-source 3D learning environments.

Anatomy learning has traditionally relied on drawings, plastic models, and cadaver dissections/prosections to help students understand the three-dimensional (3D) relationships within the human body. However, the landscape of anatomy education has been transformed with the introduction of digital media. In this light, the Open Anatomy Explorer (OPANEX) was developed.

Serological Evidence of Cryptic Rift Valley Fever Virus Transmission Among Humans and Livestock in Central Highlands of Kenya.

Although the highlands of East Africa lack the geo-ecological landmarks of Rift Valley fever (RVF) disease hotspots to participate in cyclic RVF epidemics, they have recently reported growing numbers of small RVF clusters. Here, we investigated whether RVF cycling occurred among livestock and humans in the central highlands of Kenya during inter-epidemic periods. A 2-year prospective hospital-based study among febrile patients (March 2022-February 2024) in Murang'a County of Kenya was followed by a cross-sectional human-animal survey.

Evaluating the Impact of N-Glycan Sequon Removal in the p27 Peptide on RSV F Protein Immunogenicity and Functionality.

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections in young children, elderly and immunocompromised patients worldwide. The RSV fusion (F) protein, which has 5-6 N-glycosylation sites depending on the strain, is a major target for vaccine development. Two to three of these sites are located in the p27 peptide, which is considered absent in virions.

Fluconazole-Resistant Vulvovaginal Candidosis: An Update on Current Management.

Currently, the rising prevalence of resistant species, particularly , as well as non-albicans isolates such as and , represent challenges in their management. In this review, we aimed to explore the current management of fluconazole-resistant vulvovaginal candidiasis (FRVVC). Identified studies focused on alternative antifungal therapies, including boric acid, nystatin, and newer agents like oteseconazole and ibrexafungerp.

Genomic Investigation and Comparative Analysis of European High-Risk Clone of ST2.

Multidrug-resistant is a major concern in healthcare institutions worldwide. Several reports described the dissemination of high-risk clones that are responsible for a high number of difficult-to-treat infections. In our study, 19 multidrug-resistant strains from Budapest, Hungary, were investigated based on whole-genome sequencing (WGS).

Assessing Educational Impact of Worldwide Webinar on Management of Myopia Progression in Children.

Objective: To assess the educational impact of a worldwide webinar approach to myopia progression management in children <8 years and 8-12 years old.

Design: Cross-sectional study.

Methods: A self-administered survey was conducted for attendees of a 3 h worldwide webinar held in two parts on consecutive days on the management of myopia progression in children.

Robotic Pancreaticoduodenectomy for Pancreatic Head Tumour: A Single-Centre Analysis.

: The robotic approach is an appealing way to perform minimally invasive pancreaticoduodenectomy. We compare robotic cases' short-term and oncological outcomes to a historical cohort of open cases. : Data were collected in a prospective database between 2016 and 2024; complications were graded using the ISGPS definition for the specific pancreas-related complications and the Clavien-Dindo classification for overall complications.

Errors in the Spontaneous Language of Survivors of Pediatric Cerebellar Tumors.

Pediatric cerebellar tumor survivors may present with spontaneous language impairments following treatment, but the nature of these impairments is still largely unclear. A recent study by Svaldi et al. (Cerebellum.

Obstacles and drivers in the adoption of Standardized Structured Reporting (SSR): insights from pathologists.

The adoption of Standardized Structured Reporting (SSR) in pathology offers significant potential to improve data consistency, completeness, and interoperability. This study combines quantitative data from an online survey of Belgian pathologists with qualitative insights from focus group interviews to identify key factors influencing SSR implementation. Survey results demonstrate strong support for SSR, particularly in enhancing report uniformity, completeness, and efficiency, especially in multidisciplinary teams and for secondary data use.

Autogene cevumeran with or without atezolizumab in advanced solid tumors: a phase 1 trial.

Effective targeting of somatic cancer mutations to enhance the efficacy of cancer immunotherapy requires an individualized approach. Autogene cevumeran is a uridine messenger RNA lipoplex-based individualized neoantigen-specific immunotherapy designed from tumor-specific somatic mutation data obtained from tumor tissue of each individual patient to stimulate T cell responses against up to 20 neoantigens. This ongoing phase 1 study evaluated autogene cevumeran as monotherapy (n = 30) and in combination with atezolizumab (n = 183) in pretreated patients with advanced solid tumors.

Impact and cost-effectiveness of scaling up HCV testing and treatment strategies for achieving HCV elimination among people who inject drugs in England: a mathematical modelling study.

Background: England aims to reach the World Health Organization (WHO) elimination target of decreasing HCV incidence among people who inject drugs (PWID) to <2 per 100 person-years (/100pyrs) by 2030. We assessed what testing and treatment strategies will achieve this target and whether they are cost-effective.

Methods: A dynamic deterministic HCV transmission model among PWID was developed for four England regions, utilising data on the scale-up of HCV treatment among PWID in prisons, drug treatment centres (DTC, where opioid agonist therapy is provided), and any other setting (e.

Systematic review: REM sleep, dysphoric dreams and nightmares as transdiagnostic features of psychiatric disorders with emotion dysregulation - Clinical implications.

Background: Fragmented rapid eye movement (REM) sleep disrupts the overnight resolution of emotional distress, a process crucial for emotion regulation. Emotion dysregulation, which is common across psychiatric disorders, is often associated with sleep disturbances. This systematic review explores how REM sleep and nightmares affect emotion processing and regulation in individuals with psychiatric disorders where emotion dysregulation is a key concern, suggesting novel sleep-related treatment pathways.

Effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders: A comprehensive systematic review with meta-analysis.

Background: Usually, patients with hand, wrist/forearm disorders report musculoskeletal complaints in the shoulder. Although, role of scapula is fundamental for movement and functional stability across the upper limb kinetic chain; however, there are no systematic reviews and meta-analyses that have analyzed the effect of scapular exercises in these patients.

Purpose: This study aimed to determine the effectiveness of a scapular exercise program on functional outcomes in patients with hand, wrist or elbow disorders.

Using routine data to examine factors associated with stillbirth in three tertiary maternity facilities in Kabul, Afghanistan.

Background: Over one-third of the global stillbirth burden occurs in countries affected by conflict or a humanitarian crisis, including Afghanistan. Stillbirth rates in Afghanistan remained high in 2021 at over 26 per 1000 births. Stillbirths have devastating physical, psycho-social and economic impacts on women, families and healthcare providers.

Fight or Flight: Emergency Health Care Workers' Willingness to Work during Crises and Disasters. A Cross-Sectional Multicenter Study in the Netherlands.

Objective: Expanding staff levels is a strategy for hospitals to increase their surge capacity. The aim of this study was to evaluate whether emergency health care workers (HCWs) are willing to work during crises or disasters, and which working conditions influence their decisions.

Methods: HCWs in the emergency departments (EDs) and intensive care units (ICUs) of 5 Dutch hospitals were surveyed about various disaster scenarios.

Radiation therapy volumes after primary systemic therapy in breast cancer patients: an international EUBREAST survey.

Purpose: After primary systemic therapy (PST), agreement on the extent of locoregional therapy is lacking in breast cancer patients who convert from a node-positive to a node-negative status. The aim of this survey was to investigate radiation therapy approaches after PST according to different axillary surgical strategies and disease responses.

Materials And Methods: The European Breast Cancer Research Association of Surgical Trialists developed a web-based survey containing 39 questions on locoregional management based on clinical scenarios in initially node positive breast cancer patients undergoing PST.

Context-aware analysis enhances autoscoring accuracy of home sleep apnea testing.

Study Objectives: Home sleep apnea testing based on peripheral arterial tonometry (P-HSAT) is increasingly being deployed because of its ability to test for multiple nights. However, P-HSATs do not have access to modalities such as airflow and cortical arousals and instead rely on alternative sources of information to detect respiratory events. This results in an a-priori performance disadvantage.

Same-session dual chromophore riboflavin/UV-A and rose bengal/green light PACK-CXL in Acanthamoeba keratitis: a case report.

Background: Acanthamoeba keratitis (AK) is the most challenging corneal infection to treat, with conventional therapies often proving ineffective. While photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) with riboflavin/UV-A has shown success in treating bacterial and fungal keratitis, and PACK-CXL with rose bengal/green light has demonstrated promise in fungal keratitis, neither approach has been shown to effectively eradicate AK. This case study explores a novel combined same-session treatment approach using both riboflavin/UV-A and rose bengal/green light in a single procedure.

TILTomorrow today: dynamic factors predicting changes in intracranial pressure treatment intensity after traumatic brain injury.

Practices for controlling intracranial pressure (ICP) in traumatic brain injury (TBI) patients admitted to the intensive care unit (ICU) vary considerably between centres. To help understand the rational basis for such variance in care, this study aims to identify the patient-level predictors of changes in ICP management. We extracted all heterogeneous data (2008 pre-ICU and ICU variables) collected from a prospective cohort (n = 844, 51 ICUs) of ICP-monitored TBI patients in the Collaborative European NeuroTrauma Effectiveness Research in TBI study.

Sexual dimorphism in pathogenic variant-harbouring individuals.

Background: Individuals harbouring pathogenic variants are at risk for aneurysms/dissections throughout the arterial tree. Based on prior reports of sex differences in thoracic aortic aneurysm/dissection, we investigated the sexual dimorphism for vascular events in variant-harbouring patients.

Methods: We analysed two large pedigrees comprising 84 individuals segregating pathogenic missense variants affecting the same p.

Artificial Intelligence-Enhanced Electrocardiography for Prediction of Incident Hypertension.

Importance: Hypertension underpins significant global morbidity and mortality. Early lifestyle intervention and treatment are effective in reducing adverse outcomes. Artificial intelligence-enhanced electrocardiography (AI-ECG) has been shown to identify a broad spectrum of subclinical disease and may be useful for predicting incident hypertension.