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Effects of automated massage chair therapy on mental health and physical health: A comprehensive study.

BACKGROUND AND OBJECTIVE: Automated massage chair therapy is a non-pharmacological intervention widely believed to enhance wellness, yet evidence regarding its effects remains limited. This 3-part study evaluated the effects of automated massage chair therapy on mental and physical health. METHODS: In Part 1, 20 moderately stressed students were randomized to receive a 20-minute automated massage chair therapy session followed by a 20-minute control session, or vice versa, with a 48-hour washout period. Blood pressure (BP), heart rate (HR), electroencephalogram (EEG), State-Trait Anxiety Inventory (STAI), and Visual Analog Scale (VAS) were measured. In Part 2, 20 hypertensive hospital staff received three 20-minute automated massage chair therapy sessions on alternate days. BP, HR, and skin blood flow (SBF) were measured. In Part 3, 20 hospital staff with chronic low back pain received three 20-minute automated massage chair therapy sessions on alternate days. Electromyogram (EMG) and VAS were measured. RESULTS: Automated massage chair therapy significantly reduced diastolic blood pressure (DBP), HR, stress, and anxiety among moderately stressed students. In hospital staff with hypertension, SBF did not change significantly, whereas BP and HR decreased significantly after automated massage chair therapy. In hospital staff with chronic low back pain, low back function improved, and pain was significantly reduced after automated massage chair therapy. CONCLUSION: These findings indicate that automated massage chair therapy may help reduce stress, lower blood pressure, and alleviate low back pain.

Humans

Sexual Abuse in Girls Aged ≤14: A Retrospective Observational Swiss Study.

INTRODUCTION: Child sexual abuse (CSA) is a critical public health concern with enduring physical and psychological consequences. OBJECTIVE: This study aimed to describe the sociodemographic profiles, contextual circumstances, and clinical findings of reported CSA cases involving girls aged ≤14, recorded between 2018 and 2021 at two university hospitals in Switzerland: Lausanne University Hospital (Centre Hospitalier Universitaire Vaudois - CHUV) and Geneva University Hospitals (Hôpitaux Universitaires de Genève - HUG) to inform prevention and intervention strategies. METHODS: This retrospective observational study included 95 cases identified through forensic consultations at CHUV and HUG. All eligible cases recorded between 2018 and 2021 were analyzed. Collected data included sociodemographic characteristics, assault circumstances, perpetrator-victim relationship, and clinical findings. RESULTS: The median age of children exposed to sexual assault was 7 years (IQR 4-14). Intra-familial abuse predominated among premenarcheal girls (41.7%), while postmenarcheal girls were more frequently assaulted by non-familial perpetrators (76.2%) and experienced higher rates of physical violence (47.6%). Genital lesions were documented in 41% of cases, with a higher prevalence among younger patients, and were rarely specific to CSA. CONCLUSION: This study provides a detailed descriptive overview of CSA cases involving girls aged ≤14 in two Swiss cantons. It highlights age-related patterns in perpetrator profiles, assault characteristics, and clinical findings. Prevention strategies should be age-specific, addressing intra-familial risk in younger children and peer-related or situational vulnerabilities in adolescents. These findings support the implementation of standardized forensic practices, improved surveillance systems, and targeted prevention and care strategies.

Child sexual abuse Intra-familial abuse Pediatric

From human papillomavirus (HPV) infection to HPV-associated cancers in systemic lupus erythematosus: A systematic review and Meta-analysis.

OBJECTIVE: The current cervix-focused screening paradigm in systemic lupus erythematosus (SLE) may underestimate extra-cervical anogenital cancer risk. This meta-analysis aimed to quantify the risk of human papillomavirus (HPV) infection and HPV-associated cancers in SLE patients. METHODS: A comprehensive search was conducted in PubMed (2010), Embase (2010), and Cochrane Library (2010) to August 8, 2025. Odds Ratios (ORs) and Standardized Incidence Ratios (SIRs) with 95% Confidence Intervals (CIs) were calculated. The study protocol was registered with PROSPERO (CRD420251122192). RESULTS: SLE was associated with significantly increased odds of HPV infection (OR = 4.12, 95% CI 2.03, 8.32). We further assessed the risk of HPV-associated malignancies in SLE patients. SLE patients exhibited substantially elevated risks across multiple HPV-associated cancers (SIR = 1.90, 95% CI 1.51, 2.38). The risk of cervical cancer was more than doubled (SIR = 2.25, 95% CI 1.75, 2.89). Notably, even higher risks were observed for extra-cervical anogenital cancers, namely vulvar/vaginal cancers (SIR = 5.60, 95% CI 3.71, 8.43). CONCLUSIONS: SLE is associated with elevated risks of HPV infection and a broad spectrum of HPV-associated cancers. Subgroup analyses suggested that cyclophosphamide use, multiple sexual partners, and Asian populations may constitute higher-risk subgroups. These findings highlight the need for additional prospective evidence to better characterize HPV-associated cancer risks in SLE patients.

Humans

Degradation of a graphene-reinforced polyamide by fungi: When culture conditions matter.

The large-scale production, marketing and disposal of polymer-based graphene products can lead to the dispersal of graphene-enriched plastic particles into terrestrial ecosystems, where they might accumulate if not degraded by organisms. The objective of this work is to test the degradability and compatibility of one polyamide-6 polymer reinforced with reduced graphene-oxide (PA6-rGO) and its base constituents (polyamide-6, PA6; reduced graphene oxide, rGO) using mono- and co-cultures of two lignin-degrading fungi (Bjerkandera adusta and Morchella esculenta) grown under different nutrient conditions. Fungal (co-)cultures were exposed to pure rGO or abraded powders of PA6 and PA6-rGO in two different liquid media, and monitored over time for biomass growth, H2O2 production, and activity of two lignolytic enzymes (i.e., Laccase, Lac, and Lignin peroxidase, LiP). The changes in polyamide structure were evaluated by proton nuclear magnetic resonance and mass spectrometry, and changes in rGO were evaluated by Raman spectroscopy. The materials had no effect on fungal growth. PA6 increased Lac secretion only in low nutrient medium, while PA6-rGO slightly suppressed LiP activity. Only M. esculenta promoted polyamides oxidation when cultured in a low nutrient medium, as evidenced by a change in mass distribution values (m/z: 400-420) and the appearance of a new resonance peak (at 5.37 ppm). Lignolytic exudates in co-cultures low in nutrients caused a greater change in rGO, as shown by the increase in the ID/IG ratio. The degradation of rGO, PA6 and PA6-rGO depended on culture conditions.

Graphite

Measuring economic efficiency in adult intensive care units: A systematic review of methods, metrics, and evidence.

OBJECTIVES: Intensive care units (ICUs) consume substantial hospital resources, yet "efficiency" is inconsistently defined and measured. This study systematically reviewed how economic efficiency has been conceptualised and quantified in adult ICUs and appraised the quality of evidence. METHODS: Following PRISMA 2020 and a PROSPERO-registered protocol (CRD420251107866), we searched MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science (2000-August 2025), plus global grey sources. Eligible studies explicitly defined efficiency and reported an efficiency metric/model linking ICU inputs (e.g., staff, beds/capacity, time, consumables, or costs) to outputs/outcomes (e.g., throughput/discharges, length of stay/resource use, risk-adjusted mortality). Dual independent screening and extraction were performed. Study quality was appraised using MMAT, and findings were synthesised narratively (SWiM), given heterogeneity. RESULTS: 39 studies (2001-2025) from 17 countries were included, all from high-income or upper-middle-income settings. Four methodological families were identified: (1) frontier modelling (predominantly DEA; occasional SFA/RFDH), (2) benchmarking indicators (risk-adjusted mortality and LOS/resource-use ratios; "efficiency matrix" quadrant classification), (3) cost-outcome evaluations, and (4) operational/process metrics. Across families, variation in decision-making units, input/output selection, and risk adjustment limited comparability; long-term and patient-reported outcomes were absent, and equity considerations were uncommon. CONCLUSIONS: ICU efficiency research is feasible but fragmented and often methodologically limited. Standardised definitions, validated risk adjustment, uncertainty quantification, and inclusion of patient-centred and equity-relevant outcomes are needed before efficiency metrics can reliably inform value-based decision making.

Intensive Care Units

Asthma Exacerbation Risk and School Asthma Readiness.

OBJECTIVES: School-based asthma management is a key facet of child asthma care. We aimed to describe the proportion of students whose schools have child-specific components of asthma care, derive a composite metric of these components ("school asthma readiness"), and assess its association with asthma exacerbations (asthma risk) in the preceding year. METHODS: Within a nested cohort of children enrolled in a larger randomized clinical trial, we assessed the baseline proportion of children whose school had elements of necessary asthma care. We then derived a "school asthma readiness" composite and used ordinal logistic regression to model the association between number of asthma exacerbations in the preceding year and the composite, accounting for demographic, clinical, and school characteristics. RESULTS: Of 202 participants aged 5 to 13 years, most identified as Black (95%) and non-Hispanic (98%), and most participants (73%) had an emergency department visit for asthma in the year before enrollment. Most students' schools (79%) had awareness of the child's asthma diagnosis, whereas fewer had reliever medications and valved holding chambers (both 31%) and asthma care plans (7%). Asthma exacerbations in the prior year were associated with a significantly higher school asthma readiness in bivariate (odds ratio [OR], 1.44 [95% CI, 1.14-1.82]; P = .002) and multivariable analysis (OR, 1.31 [95% CI, 1.02-1.7]; P = .037). CONCLUSIONS: A minority of children attended schools that were equipped to manage asthma symptoms. More past exacerbations were associated with higher school readiness, suggesting that more work is needed to support proactive asthma care in schools.

Humans

Genetic Screening of Colombian Patients With Early-Onset Parkinson Disease.

BACKGROUND AND OBJECTIVES: Early-onset Parkinson disease (EOPD), defined as symptom onset before 50 years of age, accounts for approximately 10% of patients and is suggested to have a greater genetic component than typical late-onset forms of the disease. Recessive variants in PRKN, PINK1, and DJ-1, are the most common genetic cause of EOPD, however, most studies are in patients of white ancestry. This study aims to analyze genetic variants in PRKN, PINK1, and DJ-1 in Colombian patients to help address the gap in EOPD genetic research of South American populations. METHODS: We analyzed 43 unrelated patients with EOPD using Sanger sequencing for the PRKN, PINK1, and DJ-1 genes and employed multiplex ligation-dependent probe amplification to detect copy number variants. Additionally, long-read whole-genome sequencing was conducted on 3 unresolved patients with age at onset before 30 years of age (long-read sequencing [LRS] patient A-C). RESULTS: We identified known pathogenic single-nucleotide variants and copy number variants in the PRKN gene accounting for 2 patients' disease (4.6% of patients). We observed 2 pathogenic variants in PRKN (c.155delA; p.N52Mfs*29 and c.1083+1G>A) in patient 1, who reported an age at onset of 16 years. We further detected a homozygous duplication of PRKN exons 5-6 in an additional patient, age at onset of 18 years. DISCUSSION: Our study helps characterize genetic contributors to EOPD in Colombian patients, demonstrating genetic forms (PRKN, PINK1, and DJ-1) are rare. Our results highlight a need to include diverse populations in research to improve genetic understanding of disease.

Journal Article

Continuous Ultrasound-guided Erector Spinae Plane Block Versus Thoracic Paravertebral Block for Postoperative Analgesia in Patients Undergoing Thoracotomy.

OBJECTIVES: To compare postoperative analgesia using continuous ultrasound-guided erector spinae plane block (ESPB) versus thoracic paravertebral block (TPVB), with dynamic visual analog scale (VAS) during coughing as the primary outcome. Secondary outcomes included static VAS (at rest), hemodynamic changes, side effects, total opioid consumption, time of first rescue analgesia, length of hospitalization, anesthesia recovery time, postanesthesia care unit stay, time to first ambulation, and patient satisfaction. METHODS: The study included 40 cases scheduled for elective thoracotomy admitted to the cardiothoracic surgery unit of Menoufia University Hospital. Patients were equally randomized into 2 groups, 20 patients each receiving either ultrasound-guided ESPB or TPVB (control group). Both groups received 20&#xa0;mL of 0.25% bupivacaine as a loading dose followed by continuous infusion of 0.125% bupivacaine at 5&#xa0;mL/h, with patient-controlled boluses of 20&#xa0;mL on demand. RESULTS: Dynamic visual analogue pain scale scores were significantly lower in the ESPB group at 6, 9, 12, and 24 hours ( P =0.008, 0.035, 0.001, 0.006). Morphine consumption was significantly reduced in the ESPB group ( P < 0.001). Hypotension was more frequent in TPVB (40% vs. 10%, P =0.028). No significant differences were observed in hospital stay or patient satisfaction. DISCUSSION: The utilization of continuous ultrasound-guided ESPB demonstrated better postoperative visual analogue pain scale scores and a significant decrease in opioid consumption, with fewer side effects than TPVB.

Humans

Influence of Immediate Post-Bleaching Polishing on Enamel Color, Morphology, and Sensitivity: A Randomized Clinical Trial.

OBJECTIVE: This study evaluated the influence of polishing on enamel color change after in-office bleaching treatment on tooth morphology and sensitivity. MATERIALS AND METHODS: A total of 50 volunteers were randomized into two groups (n&#x2009;=&#x2009;25): in-office bleaching with 35% hydrogen peroxide gel for 45&#x2009;min without polishing (GSEM) or with polishing (GP). Color analysis was performed four times, at the beginning of the starting line and immediately after the first, second, and third bleaching sessions with a spectrophotometer. A qualitative analysis of enamel morphology was performed under a scanning electron microscope. Tooth sensitivity was assessed daily using the Visual Analog Scale (&#x3b1;&#x2009;=&#x2009;0.05). RESULTS: There was no statistically significant difference (p&#x2009;>&#x2009;0.05) in tooth color change when comparing &#x394;E, &#x394;E00, and &#x394;WID between the groups. The enamel surface showed larger areas of irregularities and depressions in the GP group than in the GSEM group. There was no difference in tooth sensitivity (p&#x2009;>&#x2009;0.05) between the groups. CONCLUSIONS: Polishing after whitening in the office does not change the color and sensitivity of the tooth but promotes greater changes in the morphology of the enamel, such as increased surface roughness. CLINICAL RELEVANCE: Polishing immediately after teeth whitening causes greater changes in enamel surface morphology.

Humans

Evaluating the Efficacy of Electronic Screening, Brief Intervention, and Referral to Treatment (e-SBIRT) for Gambling: An Online Pilot Randomised Trial.

OBJECTIVES: To investigate the efficacy of electronic screening, brief intervention, and referral to treatment (e-SBIRT) at improving gambling outcomes and increasing help-seeking. METHODS: We conducted a two-arm, randomised online pilot trial (n&#x2009;=&#x2009;83) comparing an e-SBIRT intervention with an active control over 12 weeks. The brief intervention was informed by motivational interviewing and incorporated personalised normative feedback, information provision, and relapse-prevention components. Eligible participants were aged 18 or older, resided in the UK and had scores indicating at least moderate severity gambling. RESULTS: Participants (54 [65.1%] male; mean [SD] age&#x2009;=&#x2009;40.58 [12.75] years, mean [SD] PGSI&#x2009;=&#x2009;7.16 [5.58]) in the e-SBIRT and control conditions showed improvements in gambling harms (p&#x2009;=&#x2009;0.033) and perceived ability to control gambling (p&#x2009;=&#x2009;0.029). No significant effects of condition assignment or condition x time interactions were observed. However, exploratory analyses of individual model coefficients suggested greater improvement in perceived ability to control gambling among participants receiving e-SBIRT at 12 weeks (p&#x2009;=&#x2009;0.043). Exploratory analyses also suggested higher rates of help-seeking at 12-week follow-up among participants receiving e-SBIRT. CONCLUSION: Overall, e-SBIRT did not demonstrate clear advantages over assessment and information provision alone. Further research should prioritise refining intervention components and evaluating SBIRT approaches in settings that better reflect its opportunistic delivery model.

Humans

Evaluation of the intraoperative analgesic effects of perioperative electroacupuncture: a randomised, blinded clinical trial in dogs.

OBJECTIVE: To evaluate the effect of perioperative electroacupuncture (EA) on intraoperative analgesic requirements in dogs undergoing tibial tuberosity advancement (TTA) surgery. STUDY DESIGN: Prospective, randomised, blinded, controlled clinical study. ANIMALS: A group of 29 client-owned dogs diagnosed with cranial cruciate ligament rupture that underwent TTA surgery. METHODS: Dogs were treated with EA at predefined acupuncture points (LI-4, ST-36, LIV-3, SP-6 and GB-34) perioperatively as additional analgesia (group EA, n = 14) or were allocated to the control group (group C, n = 15). All dogs were anaesthetised with a standardised protocol including methadone, dexmedetomidine, propofol and ketamine. The intraoperative delivery of sevoflurane and fentanyl was guided in response to signs of nociception by a purpose-designed flowchart, by the same anaesthetist who was blinded to treatment group. A Wilcoxon rank sum test was applied for the fentanyl consumption analysis. Heart rate, mean arterial blood pressure and end-tidal sevoflurane were descriptively analysed between groups for specific time points. A p value < 0.05 was considered significant. RESULTS: The EA group needed significantly less fentanyl with 0.7 (0-2.7) &#x3bc;g kg-1 hour-1 administered versus 2.0 (1.2-5.5) &#x3bc;g kg-1 hour-1 in group C (p = 0.031). Fifty percent of the EA group was not administered a fentanyl bolus, whereas all dogs in group C required at least one bolus. CONCLUSIONS AND CLINICAL RELEVANCE: Perioperative EA reduced mean fentanyl consumption by more than 60% in dogs undergoing TTA surgery.

Animals

Neighborhood Deprivation and Screening Mammography Utilization: A Retrospective Cross-Sectional Study.

RATIONALE AND OBJECTIVES: Access to screening mammography reduces breast cancer mortality disparities. The Area Deprivation Index (ADI) is a validated measure of neighborhood socioeconomic disadvantage linked to adverse health outcomes. There is limited data evaluating mammography utilization among patients residing in areas of higher deprivation. This study evaluated the association between ADI and screening mammography utilization within an accountable care organization (ACO) affiliated with a multicenter academic medical center in the Upper Midwest. METHODS: This retrospective cross-sectional study included women aged 40-85 years attributed to the ACO in 2022, based on Wisconsin Collaborative for Healthcare Quality criteria. The primary outcome was receipt of screening mammography within two years. The primary exposure was ADI, analyzed by decile (ordinal) and as low (deciles 1-5) versus high (deciles 6-10) deprivation. The logistic regression models evaluated associations between ADI and screening, unadjusted and adjusted for age, race, ethnicity, and preferred language. RESULTS: Among 7463 participants with geographic data, 74.4% completed screening. Screening rates were 75.7% in low-deprivation areas versus 66.2% in high-deprivation areas. Increasing ADI decile was associated with reduced screening in unadjusted (OR 0.891, 95% CI 0.87-0.91, p<0.001) and adjusted analyses (OR 0.897, 95% CI 0.88-0.92, p<0.001). Black participants (OR 0.444, p<0.001) and individuals preferring non-English languages (OR 0.333, p<0.001) had lower screening odds after adjustment. CONCLUSION: Higher neighborhood deprivation is independently associated with lower screening mammography utilization. Targeted, equity-focused interventions addressing neighborhood, racial, and language-related barriers are needed to reduce screening disparities.

Area deprivation Index

Discarding Bedside Cart Paper-Packaged Supplies Between Patients: What Evidence Is Required?

BACKGROUND: Discarding paper-packaged sterile supplies from bedside supply carts between patients in pediatric intensive care units (PICUs) is a potential practice to target for environmental stewardship. OBJECTIVES: To determine opinions about this practice, including what evidence should be required to implement and what evidence would be adequate to abandon it. METHODS: A survey was distributed to all pediatric intensivists engaged in multicenter research in Canada and to all PICU nurses at one institution in Canada. RESULTS: The response rate was 75 of 254 (30%). The practice occurred in 54 (72%) of the respondents' units. Ten respondents (13%) agreed the practice was effective in preventing nosocomial infections. Most respondents agreed the practice should be based on empirical evidence, including a combination of improved patient outcomes (n = 57, 76%), rate of contamination of supplies within the supply carts (n = 55, 73%), and survivability of pathogens inoculated onto paper (n = 56, 75%). Most respondents agreed they would be comfortable with a randomized controlled trial (n = 52, 69%) and would support action based on the results (n = 54, 72%). The potential trial outcome most highly ranked was next-patient nosocomial infection with pathogen from the previous patient (n = 23, 31%); this was ranked more often by intensivists (P = .005). Other outcomes highly ranked included next-patient colonization with pathogen from the previous patient (n = 44, 59%) and pathogen detection on supplies within the supply cart (n = 43, 57%). CONCLUSIONS: Most respondents agreed that the practice was not based on empirical evidence, agreed the practice should be based on empirical evidence, and would agree to a randomized trial with patient-important outcomes.

Humans

Neonatal outcomes following antenatal corticosteroid administration before planned caesarean birth at late preterm or early term (36-38 weeks' gestation): a retrospective cohort study.

OBJECTIVE: To investigate the benefits and harms associated with antenatal corticosteroids (ACS) prior to planned caesarean birth at late preterm or early term. DESIGN: Retrospective cohort study. SETTING: South Australia, Australia, 2005-2018. PATIENTS: Women with singleton pregnancies undergoing planned caesarean birth between 36+0 and 38+6 weeks' gestation. METHODS: We used routinely collected electronic maternity and neonatal data. Adjusted risk differences (aRD) with 95% CIs were calculated for neonatal and maternal outcomes. OUTCOME MEASURES: Neonatal outcomes included respiratory distress requiring oxygen, hypoglycaemia requiring glucose, neonatal unit (NNU) admission and prolonged NNU admission (&#x2265;48&#x2009;hours). RESULTS: Among the cohort of 4049 women, the proportion receiving ACS was 54.8%, 48.4% and 5.6% at 36, 37 and 38 completed weeks' gestation, respectively. ACS administration was associated with a significant reduction in respiratory distress across all gestations, with the greatest reduction seen at 36 weeks' gestation (aRD -12.5%; 95% CI -21.4% to -3.6%). At 38 weeks' gestation, ACS administration was associated with an increased risk of neonatal hypoglycaemia (aRD 5.7%; 95% CI 1.1% to 10.2%), NNU admission (aRD 5.4%; 95% CI 0.1% to 10.7%) and prolonged NNU admission (aRD 4.6%; 95% CI 0.2% to 8.9%). CONCLUSIONS: ACS administration prior to late preterm and early term planned caesarean birth was associated with reduced risk of respiratory distress. The net benefit of ACS administration before planned caesarean birth remains unclear; however, there was evidence of potential neonatal harm when birth occurred after 37 weeks' gestation.

Epidemiology

Implementation outcomes of a dementia-focused intervention for family care partners and clinicians in home hospice care.

OBJECTIVES: End-of-life care for persons living with dementia in home hospice relies heavily on coordination between family care partners (FCPs) and clinicians (e.g., hospice social workers and nurses). FCPs and clinicians have reported support and knowledge gaps in end-of-life dementia care. Interventions are needed to improve FCPs' support and clinicians' educational gaps. METHODS: A pilot randomized controlled trial was designed to examine implementation outcomes for a dementia-focused end-of-life intervention for FCPs (n&#xa0;=&#xa0;37) and clinicians (n&#xa0;=&#xa0;15). Data on survey completion and acceptability were collected at baseline, during 4 follow-up visits, and at the conclusion of the study. RESULTS: Twenty-eight (75%) caregivers completed the post-study survey, and 10 (27%) reported using the structured worksheet. Thirteen (87%) clinicians completed the post-training survey, 8 (53%) completed the post-study survey, and 8 (100%) used the worksheet. Clinicians (n&#xa0;=&#xa0;8) were satisfied or highly satisfied with the instructional videos, and half (50%) used the information frequently with patients. Both groups reported the worksheet helpful, easy to use, and satisfactory, though clinicians rated helpfulness slightly higher (mean&#xa0;=&#xa0;3.88 vs. 3.70 for FCPs). Clinicians liked the worksheet's structured guidance and the enhanced collaboration. SIGNIFICANCE OF RESULTS: This study provides preliminary evidence for implementation outcomes of a dementia-focused end-of-life intervention in home hospice. Findings suggest the intervention can be implemented in a hospice setting, with moderate worksheet uptake and perceived value among FCPs and clinicians.

Humans

Interest holder-driven research priorities in sexual and reproductive health for migrant and refugee adolescents and young adults in Australia.

OBJECTIVE: To identify and prioritise sexual and reproductive health research priorities for migrant and refugee adolescents and young adults in Australia using a priority setting partnership approach. METHODS: A James Lind Alliance priority setting partnership was conducted with 92 interest holders: 31 youth from migrant and refugee backgrounds and 61 professionals (healthcare providers, researchers, policymakers and community leaders), recruited online and in-person. The priority setting partnership process included a rapid evidence scan, an online uncertainty survey, evidence verification, interim prioritisation and a final consensus workshop. RESULTS: Eighty-three research uncertainties yielded 11 final priorities across four sexual and reproductive health domains: sexual and reproductive health literacy, sexual violence prevention, accessible services and maternal health. A striking divergence emerged between youth and professional priorities only 3 achieved combined high-priority consensus. Youth prioritised a broader range of topics, including abortion access (rated high by youth but low by professionals), while professionals prioritised fewer areas. Two priorities achieved consensus: community-based maternal health support and barriers to reporting gender-based violence. CONCLUSION: This is the first priority setting partnership to identify sexual and reproductive health research priorities for migrant and refugee youth in Australia and to uniquely highlight substantial misalignment between youth and professional priorities. IMPLICATIONS FOR PUBLIC HEALTH: These identified priorities provide a foundation for targeted research, culturally responsive policy and more equitable sexual and reproductive health service provision for migrant and refugee adolescents and young adults.

Australia

Artificial Intelligence in Diagnosing Depression Through Behavioural Cues: A Diagnostic Accuracy Systematic Review and Meta-Analysis.

AIM: To synthesise existing evidence concerning the application of AI methods in detecting depression through behavioural cues among adults in healthcare and community settings. DESIGN: This is a diagnostic accuracy systematic review. METHODS: This review included studies examining different AI methods in detecting depression among adults. Two independent reviewers screened, appraised and extracted data. Data were analysed by meta-analysis, narrative synthesis and subgroup analysis. DATA SOURCES: Published studies and grey literature were sought in 11 electronic databases. Hand search was conducted on reference lists and two journals. RESULTS: In total, 30 studies were included in this review. Twenty of which demonstrated that AI models had the potential to detect depression. Speech and facial expression showed better sensitivity, reflecting the ability to detect people with depression. Text and movement had better specificity, indicating the ability to rule out non-depressed individuals. Heterogeneity was initially high. Less heterogeneity was observed within each modality subgroup. CONCLUSIONS: This is the first systematic review examining AI models in detecting depression using all four behavioural cues: speech, texts, movement and facial expressions. IMPLICATIONS: A collaborative effort among healthcare professionals can be initiated to develop an AI-assisted depression detection system in general healthcare or community settings. IMPACT: It is challenging for general healthcare professionals to detect depressive symptoms among people in non-psychiatric settings. Our findings suggested the need for objective screening tools, such as an AI-assisted system, for screening depression. Therefore, people could receive accurate diagnosis and proper treatments for depression. REPORTING METHOD: This review followed the PRISMA checklist. PATIENTS OR PUBLIC CONTRIBUTION: No patients or public contribution.

Humans

Pelvic lymph node dissection in prostate cancer: current evidence, controversies, and future directions.

BACKGROUND: Pelvic lymph node dissection (PLND) remains controversial in the management of prostate cancer. Although it provides the most accurate pathological staging, its therapeutic value beyond staging has long been debated due to conflicting evidence and concerns regarding procedure-related morbidity. OBJECTIVE: To critically evaluate the contemporary role of PLND, particularly extended pelvic lymph node dissection (ePLND), in prostate cancer management in the context of modern imaging, risk stratification tools, and evolving oncologic endpoints. EVIDENCE ACQUISITION: A narrative review of recent literature was conducted, focusing on high-level evidence including randomized trials, observational studies, and contemporary guideline recommendations addressing the indications, extent, oncologic outcomes, and complications of PLND. EVIDENCE SYNTHESIS: Recent randomized and observational studies suggest that ePLND improves nodal staging accuracy and may be associated with modest improvements in metastasis-free survival (MFS) in selected patients with intermediate- and high-risk prostate cancer, although the absolute benefit remains limited and causality is not definitively established. Advances in molecular imaging, particularly prostate-specific membrane antigen (PSMA) PET/CT, together with multiparametric MRI, validated nomograms, and emerging genomic classifiers, now allow more precise identification of patients most likely to benefit from ePLND. The integration of these tools supports a more individualized surgical strategy, including image-guided and sentinel lymph node approaches designed to maximize staging accuracy while minimizing unnecessary dissection. CONCLUSIONS: In the contemporary PSMA imaging era, ePLND continues to play an important role in nodal staging and may contribute to improved oncologic outcomes in carefully selected patients.

Humans