Mapping advance care planning and advance directives in Latin America.

Background/aims: The extent to which low- and middle-income countries have implemented Advance Care Planning (ACP) and Advance Directives (AD) remains unclear. We aimed to map the current status of ACP/AD in Latin America.

Methods: This cross-sectional, mixed-methods survey of ACP/AD in LA comprised interviews with 18 key informants from 18 out of 20 countries, most of whom were appointed by national Palliative Care Associations.

Initial results in the automatic visual recognition of endometriosis lesions by artificial intelligence during laparoscopy: a proof-of-concept study.

Objective: To develop a machine learning method for the automatic recognition of endometriosis lesions during laparoscopic surgery and evaluate its feasibility and performance.

Design: Collecting and annotating surgical videos and training, validating, and testing a deep neural network.

Setting: Multicenter proof-of-concept study using surgical videos from expert centers in France, Hungary, Brazil, and Denmark.

Persistent Human T-Lymphotropic Virus Type 1 (HTLV-1) Infection in the Placenta of Pregnant Women.

Mother-to-child transmission (MTCT) is the primary route of human T-lymphotropic virus type 1 (HTLV-1) infection. Although formula feeding reduces breastfeeding-associated transmission, MTCT still occurs, implicating pregnancy or delivery as key transmission windows. In this study, placental tissues from nine HTLV-1-positive mothers were analyzed using DNA/RNAscope, revealing low HTLV-1 DNA and RNA levels and a low RNA/DNA ratio, consistent with latent infection in the placenta and potentially explaining the low MTCT rate.

Ocular Motor and Vestibular Profile in Spinocerebellar Ataxia Type 27B: Toward a Practical Bedside Diagnostic Framework.

Spinocerebellar ataxia type 27B (SCA27B), caused by GAA repeat expansions in FGF14, is an increasingly recognized form of late-onset cerebellar ataxia. However, early diagnosis remains challenging due to mild or absent cerebellar motor signs and often normal brain magnetic resonance imaging (MRI). Oculovestibular abnormalities, although prevalent, are frequently overlooked and not captured by standard clinical scales such as the Scale for the Assessment and Rating of Ataxia (SARA).

Oral and Maxillofacial Pathology in Latin America and the Caribbean: A Comprehensive Survey of Recognition, Training, and Practice.

Background: Oral and maxillofacial pathology (OMFP) is a dental specialty that studies the causes, processes, and effects of diseases in the oral and maxillofacial area, while also contributing to diagnosis and treatment. Its recognition, training, and professional practice vary across the globe. This study aimed to explore the training and professional development of OMFP in Latin America and the Caribbean (LAC), including important issues such as specialty recognition, service regulation, postgraduate education, number of specialists, career opportunities, and perceived barriers.

Effect of a brief, focal acceptance and commitment therapy (ACT) protocol to accelerate repetitive transcranial magnetic stimulation treatment with theta-burst stimulation (TBS) for elderly patients with depression: A randomized, blinded, controlled clinical trial.

Background: Major depressive disorder (MDD) is one of the leading causes of disability, especially among elderly. Repetitive transcranial magnetic stimulation (rTMS) is an effective non-pharmacological treatment and theta burst stimulation (TBS) technique offers shorter sessions. Acceptance and Commitment Therapy (ACT) is a proven effective intervention in the treatment of MDD.

Psychedelics for substance use disorders: are women being addressed? A scoping review.

Introduction: Substance use disorders (SUDs) are a prevalent health issue that affects individuals globally. Research is currently being conducted on the potential use of psychedelics as a new approach to treating SUDs. Women have been shown to respond differently than men to SUDs treatments and women-specific approaches have been recommended.

High-Power Short-Duration Ablation Versus Conventional Power Ablation in Pulmonary Vein Isolation in Patients With Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: High-power short-duration (HPSD) ablation has emerged as a promising alternative to conventional power delivery (CPD) for pulmonary vein isolation (PVI) among patients with atrial fibrillation (AF), though its efficacy, procedural efficiency, and safety profile remain uncertain.

Aims: To evaluate and compare the efficacy, procedural efficiency, and safety of HPSD versus CPD ablation strategies for PVI in patients with AF through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Materials And Methods: PubMed, Embase, Cochrane Library, and ClinicalTrials.

Intracellular and Extracellular Vesicle miRNA Signatures in Human iPSC-Derived Neural Stem Cells and Floor Plate Progenitors.

Refined control of intrinsic and extrinsic signals is critical for specific neuronal differentiation. Here, we differentiated human induced pluripotent stem cells (hiPSCs) from three different healthy donors into neural stem cells (NSCs) and floor plate progenitors (FPPs; progenitors of dopaminergic neurons) and further performed intracellular and extracellular vesicles' (EVs) miRNA profiling. While NSC and FPP cells differed significantly in levels of only 8 intracellular miRNAs, their differences were more evident in the EV miRNAs with 27 differentially expressed miRNAs.

Case Report: Diagnosis of cervical carcinoma from pelvic tumor during pregnancy.

Cervical cancer, the fourth most prevalent cancer in women, is the most common malignant tumor of the female reproductive system and one of the most frequently diagnosed cancers during pregnancy. In Brazil, cervical cancer screening is conducted via Pap smear examination of the cervix, with a false-negative rate ranging between 2 and 50%. Colposcopy is recommended when the Pap smear results reveal abnormalities suggestive of malignancy, and biopsy is reserved for patients who are pregnant only when invasive lesions are suspected.

Laboratory Identification of Lupus Anticoagulant (LA) Using Different Activated Partial Thromboplastin Time (APTT) Assays.

Introduction: The International Society of Thrombosis and Hemostasis (ISTH) guidelines suggest a three-step evaluation for the detection of lupus anticoagulant (LA), including screening, mixing, and confirmation. According to the guidelines, the LA assay based on activated partial thromboplastin time (APTT) should include an initial screening step followed by a confirmatory step that uses a higher concentration of phospholipids in either bilayer or hexagonal form. For the activator, the guidelines recommend using silica, though ellagic acid is also an option.

6-Nitrodopamine Release From Mouse Seminal Vesicles Is Dependent on Endothelial Nitric Oxide Synthase (eNOS) Activation.

Human seminal vesicles present basal release of epithelium-derived 6-nitrodopamine (6-ND) and this catecholamine potentiates noradrenaline-induced contractions. Since nitric oxide synthase (NOS) activation is a determining factor involved in 6-ND biosynthesis, this study aimed to investigate which NOS isoform is responsible for the 6-ND release in mouse isolated seminal vesicles (MISV). Male control, eNOS, NOS, iNOS, and e/n/iNOS mice were used.

Integration of CT and MRI imaging with plastination for enhanced veterinary anatomy education: a study on the crab-eating fox ().

Introduction: With the advancements in diagnostic imaging and its increasing use in veterinary medicine, it is essential for professionals to continuously update their knowledge and seek training in the anatomy of various wild animal species. Plastination allows for the preservation of biological tissues and their anatomical details, enhancing the study and identification of structures.

Methods: This study aimed (1) to describe in detail the anatomy of the thoracic and pelvic limbs of the crab-eating fox () using plastinated metameric sections correlated with computed tomography (CT) and magnetic resonance imaging (MRI), and (2) to analyze tissue shrinkage resulting from plastination.

Transcranial direct current stimulation plus cognitive training for cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection: A randomized, double-blind, sham-controlled trial.

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) is characterized by persistent cognitive deficits alongside anxiety and depression symptoms that adversely affect quality of life. Cognitive training (CT) programs and non-invasive neuromodulation, specifically transcranial direct current stimulation (tDCS), have each shown promise for alleviating similar deficits in non-clinical populations. However, their combined efficacy has not yet been evaluated in PASC patients.

Survival patterns and prognostic stratification based on distant metastasis characteristics in oral squamous cell carcinoma.

Aim: Despite advances in the treatment of oral squamous cell carcinoma (OSCC), distant metastasis (DM) remains a major obstacle to improving its prognosis. This study aimed to predict survival based on DM characteristics and to detail related outcomes.

Methods: We conducted a multicenter retrospective cohort of patients diagnosed with OSCC and treated at two centers.

Acute heart failure in non-cardiac surgery.

More than 64 million people worldwide have heart failure (HF), and these numbers are expected to rise. Acute HF (AHF) is the leading cause of hospitalization in patients over 65 years old and is linked to high mortality and readmission rates. AHF may also be a frequent complication in patients hospitalized for other medical reasons as well as after cardiac or non-cardiac surgery.

Human nerve growth factor delivery to the retina: Quantitative methodology and mathematical modeling in preclinical settings.

Nerve growth factor (NGF) plays a critical neuroprotective role in retinal health, supporting neuronal survival and regeneration. Recombinant human NGF (rhNGF) holds promise for treating retinal degenerative diseases such as glaucoma, retinitis pigmentosa, and optic neuropathies. However, efficient retinal delivery of rhNGF remains a major challenge due to anatomical barriers and rapid clearance from conventional routes.

How Can We Reduce Cardiovascular Risk in Women and Improve Risk Stratification?

Purpose Of Review: To explore sex-specific dimensions of cardiovascular disease (CVD) by addressing key questions: (1) What is the true burden of CVD in women, and how does it compare with that in men across diverse populations? (2) Do risk factors for CVD differ between sexes in prevalence, biological impact, and prognostic significance? (3) Should we adopt sex-specific cardiovascular risk stratification tools to improve diagnostic precision in women? (4) Is there a need for earlier or more aggressive preventive strategies in women, particularly for those with sex-specific or predominant risk factors?

Recent Findings: CVD remains the leading cause of morbidity and mortality among women worldwide. Despite advances in care, significant sex-based disparities persist in awareness, diagnosis, risk stratification, and treatment. Women often present with distinct biological and psychosocial risk factors that are underrecognized in standard assessments.

Insula Deep Brain Stimulation for Neuropathic Pain: A Cross-Over, Randomized, Sham-Controlled Trial.

Objective: Despite neuropathic pain affecting a significant portion of the population, many people still experience refractory conditions. Here, we evaluated the efficacy and safety of posterior-superior insula deep brain stimulation for pharmaco-resistant neuropathic pain.

Materials And Methods: This was a phase 2 randomized, double-blind, sham-controlled, cross-over trial.