Overview of evidence synthesis types and modes.

Background And Objectives: Evidence syntheses systematically compile and analyze information from multiple sources to support health care decision making. As many different types of questions need to be answered in health care, different evidence synthesis types have emerged. In this article, we introduce the most common types of evidence synthesis.

Obesity in Cardiac Rehabilitation: Considerations in Offering Weight Management as Part of Cardiac Rehabilitation Programs.

Despite its relevance to cardiovascular health, obesity is rarely targeted during cardiac rehabilitation (CR). The objective of this paper was to review evidence regarding whether measures to address excess body fat should be offered as a standard component of CR for patients with obesity. We organize the paper around three themes: 1) outcomes of obesity management, 2) the complexity of obesity management, and 3) patient attitudes, experiences, and preferences.

Subjective cognitive fatigability is associated with worse patient-reported physical disability in multiple sclerosis.

Background: Fatigue is highly prevalent in multiple sclerosis (MS) and contributes to disability and functional decline. While associations between physical fatigue and disability have been well characterized, how subjective cognitive fatigue and fatigability relates to disability in MS remains understudied.

Methods: People with MS (PwMS; N = 100) completed self-report measures to capture secondary disease characteristics (e.

Dengue among immunocompromised patients: a systematic review and meta-analysis.

Background: Although there is a rising trend in both dengue cases and immunocompromised conditions, there is limited research on how common severe dengue is in immunocompromised individuals. This data is key for those advising the ever-increasing numbers of immunocompromised travellers.

Methods: We conducted a systematic review and meta-analysis of studies reporting dengue frequency or outcomes in immunocompromised populations.

Drug-induced regeneration of pancreatic beta cells: An approach to cellular therapeutic targets.

Diabetes mellitus is a common and serious metabolic disease globally, characterized by increased blood glucose levels. The major pathogenesis is the functional impairment of insulin-producing beta cells in the pancreas and the lack of insulin secretion. Although both type 1 and type 2 diabetes develop through distinct pathological mechanisms, they lead to the destruction and/or dysfunction of beta cells, resulting in inadequate beta cell mass to maintain normal blood glucose levels.

The surgical burden score: a novel continuous metric to predict postoperative complications after hepatectomy for hepatocellular carcinoma.

Background: No validated model incorporates surgical parameters for complication risk in hepatocellular carcinoma (HCC) resection. We evaluated a novel Surgical Burden Score (SBS), integrating adjusted blood loss (aBL; mL/kg) and operative time (hours) via a Pythagorean formula, and developed an SBS-based model to predict complications.

Methods: Patients undergoing curative-intent hepatectomy for HCC(2000-2023) were identified from an international database.

Insights Into How Digital Health Interventions Shape Outcomes for Emerging Adults Living With Type 1 Diabetes: Qualitative Realist Process Evaluation.

Background: Emerging adults living with type 1 diabetes (T1D) need targeted support to equip them with the knowledge and motivation required for self-management, particularly as they transition from pediatric to adult care. While multicomponent digital health interventions have shown promise in addressing their multifaceted needs, traditional effectiveness studies provide little, if any, insights into which components work effectively, how they function, and for whom.

Objective: This study aims to explore the implementation of a multicomponent, text message-based digital intervention (Keeping in Touch; KiT) to provide early insights into which components may shape participants' transition experiences and how.

Metabolomics reveal distinct molecular pathways associated with future risk of Crohn's Disease.

Host - microbiome interactions are central to Crohn'sdisease (CD) pathogenesis; yet the early metabolic alterations that precededisease onset remain poorly defined. To explore preclinical metabolicsignatures of CD, we analyzed baseline serum metabolomic profiles in a nestedcase-control study within the Crohn's and Colitis Canada - Genetics, Environment, Microbiome (CCC-GEM) Project, a prospective cohort of 5,122 healthyfirst-degree relatives (FDRs) of CD patients. We included 78 individuals wholater developed CD and 311 matched FDRs who remained disease-free.

Recalibrating Self-Assessment: Navigating Imposter Syndrome Through Metacognitive Reflection.

Background: Accurate self-assessment is foundational for life-long learning, professional development and patient safety, yet many learners struggle to develop this fundamental skill. Even skilled self-assessors-or savvy calibrators-may sometimes struggle with self-assessment accuracy, particularly during professional transitions and challenges. This study explored the metacognitive processes employed by high-performing physicians to maintain or recalibrate accurate self-assessment across diverse professional contexts.

Summary of the National Advisory Committee on Immunization (NACI) statement on the prevention of respiratory syncytial virus (RSV) in older adults.

Background: Respiratory syncytial virus (RSV) is a common respiratory virus. In addition to infants, older adults are at higher risk of severe outcomes due to RSV, particularly advanced-age older adults and those with chronic medical conditions. The authorization of three vaccines, one for adults 50 years of age and older (Arexvy) and two for adults 60 years of age and older (Abrysvo and mRESVIA), offers the opportunity to protect older Canadians from RSV disease.

Lung lobe segmentation: performance of open-source MOOSE, TotalSegmentator, and LungMask models compared to a local in-house model.

Background: Lung lobe segmentation is required to assess lobar function with nuclear imaging before surgical interventions. We evaluated the performance of open-source deep learning-based lung lobe segmentation tools, compared to a similar nnU-Net model trained on a smaller but more representative clinical dataset.

Materials And Methods: We collated and semi-automatically segmented an internal dataset of 164 computed tomography scans and classified them for task difficulty as easy, moderate, or hard.

Benefit-risk of colchicine and spironolactone in acute myocardial infarction: a prespecified generalised pairwise comparisons analysis of the CLEAR trial.

Background: Composite outcomes in cardiovascular trials often group events of unequal clinical importance, and conventional analyses may obscure treatment trade-offs. Generalised pairwise comparisons (GPC), expressed as a win ratio (WR), allow for hierarchical ranking of events and incorporation of recurrent outcomes, providing a potentially more intuitive assessment of benefit-risk.

Methods: In a prespecified exploratory analysis of the 2×2 factorial, randomised CLEAR (Colchicine and Spironolactone in Patients with Myocardial Infarction) trial (7062 patients within 72 hours of acute myocardial infarction (MI) and percutaneous coronary intervention), we applied both time-to-first and recurrent-event GPC to reassess low-dose colchicine (0.

European Respiratory Society statement on advanced telemedicine for obstructive sleep apnoea (e-Sleep).

Telemedicine (TM) as a means of remote patient-physician interaction is gaining popularity in nearly every field, and (respiratory) sleep medicine is no exception. Because obstructive sleep apnoea (OSA) is a chronic condition, and requires a continuous treatment and monitoring of therapy success, telematic communications could be useful to establish diagnostic and therapeutic strategies. This Statement summarises the evidence and efficacy of TM options in OSA.

Efficacy of Stereotactic Ablative Body Radiotherapy (SABR) in uncommon subtypes of primary kidney cancer: An analysis from the International Radiosurgery Oncology Consortium of the Kidney.

Background: While stereotactic ablative body radiotherapy (SABR) is associated with excellent local control for primary renal cell carcinoma (RCC), outcomes based on clear-cell (ccRCC) and non-clear cell (nccRCC) histologies are not well defined.

Methods And Materials: Individual data of adult patient with biopsy confirmed primary RCC receiving SABR between 2007 and 2021 from 16 institutions in Australia, Canda, Germany, Japan and USA pooled. Patients with metastatic disease or upper tract urothelial carcinoma were excluded.

Neuropeptide-mediated synaptic plasticity regulates context-dependent mating behaviors in Drosophila.

Neuropeptides play crucial roles in regulating context-dependent behaviors, but the underlying mechanisms remain elusive. We investigate the role of the neuropeptide SIFa and its receptor SIFaR in regulating two distinct mating duration behaviors in male Drosophila: Longer-Mating-Duration (LMD) and Shorter-Mating-Duration (SMD). We found that SIFaR expression in specific neurons is required for both LMD and SMD behaviors.

SIFa peptidergic neurons orchestrate the internal states and energy balance of male Drosophila melanogaster.

Neuropeptide SIFamide (SIFa) neurons in Drosophila melanogaster have been characterized by their exceptionally elaborate arborization patterns, which extend from the brain into the ventral nerve cord (VNC). SIFa neurons are equipped to receive signals that integrate both internal physiological cues and external environmental stimuli. These signals enable the neurons to regulate energy balance, sleep patterns, metabolic status, and circadian timing.

Arterial Ischemic Stroke in Children: Navigating Diagnostic and Management Pathways.

Pediatric stroke is garnering increased attention due to its rising incidence and significant impact on affected children, families, and the health care system. Arterial ischemic stroke (AIS) is a major subtype of pediatric stroke and often results from arterial occlusion. Diagnosis and treatment of acute ischemic stroke in children pose unique challenges, primarily because of nonspecific symptoms, lack of pediatric-focused imaging protocols, distinct causes (compared with in adults), and the large number of stroke mimics.

Association of patient and physician characteristics with androgen-deprivation-therapy intensification in patients with de novo hormone-sensitive metastatic prostate cancer: A population-based study.

Introduction: Treatment intensification with androgen receptor signaling inhibitors and/or chemotherapy is guideline recommended for patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC). However, most patients only receive androgen deprivation therapy monotherapy. The aim was to identify physician-, patient-, and tumor-related factors associated with the receipt of treatment intensification.

The Bidirectionality of Psychosocial Stress and Cardiovascular Disease Risk in Women; Recognition and Strategies for Management.

Purpose Of Review: This review describes and summarizes the relationships between psychosocial stress and cardiovascular disease risk in women and offers strategies and recommendations to improve health outcomes.

Recent Findings: Psychosocial stress plays a pivotal role in the cardiovascular health of women, acting both as a precipitant and an outcome of CVD. As a precipitant, chronic stressors such as caregiving responsibilities, socioeconomic adversity, intimate partner violence, and gendered barriers to healthcare can exacerbate stress-related CVD risk factors which in turn predispose to upregulation of inflammatory factors.

Neoadjuvant Chemotherapy Without Radiation for Locally Advanced Rectal Cancer: A Meta-analysis of Surgical Outcomes after Total Mesorectal Excision.

Background: Neoadjuvant chemotherapy alone (with radiation omission) for locally advanced rectal cancer has been evaluated in several randomized controlled trials. While oncologic outcomes have been well described, the impact of this treatment strategy on surgical outcomes is unknown.

Objective: To evaluate how important surgical outcomes were reported in previous trials comparing neoadjuvant chemotherapy to chemoradiation for locally advanced rectal cancer and to perform a meta-analysis of available data.

Updates to Recurrent Uncomplicated Urinary Tract Infections in Women: AUA/CUA/SUFU Guideline (2025).

Purpose: Our perceptions of recurrent UTI (rUTI) have evolved due to additional insights into rUTI pathophysiology, an appreciation for the adverse effects of repetitive antimicrobials ("collateral damage"), rising rates of bacterial antimicrobial resistance, and better reporting of the natural history of localized cystitis and rUTI. This document seeks to guide the evaluation and management of patients with rUTIs to prevent inappropriate antibiotic use, decrease the risk of antibiotic resistance, reduce adverse effects of antibiotics, provide guidance on strategies for rUTI prevention, and improve outcomes and quality of life for women with rUTIs.

Materials And Methods: In 2024, this Guideline was reviewed via the AUA Update Literature Review process, which identified 87 studies for full-text review published between June 1, 2021 and November 1, 2024.

Critical Care Outreach Team Nurses' Approaches to End-of-Life Conversations: An Interpretive Descriptive Study.

Background: Critical care outreach team (CCOT) nurses are part of hospital emergency response teams, assessing and mobilising resources for decompensating patients. Although a significant proportion of this role involves addressing end-of-life (EOL) issues, this role is ill-defined in the literature and in practice.

Aim: To explore the experiences of CCOT nurses with EOL conversations.