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Research continues to inadequately integrate gender and diversity, reflecting the longstanding model in which the male body has been considered the universal standard. To address these gaps, initiatives like the SAGER (Sex And Gender Equity in Research) and SAGER-swissethics guidelines have emerged, to encourage the integration of sex and gender into research, from the design to the dissemination of results. Clinical guidelines rarely include sex- or gender-specific recommendations. It is unclear whether this lack reflects the absence of differences or, conversely, a lack of data to establish specific differences. While awaiting an update in the data, clinicians are invited to critically read the literature, adjust dosages to body compositions, and value patients' experiences to ensure equitable care. La recherche continue à manquer de données intégrant le genre et la diversité, du fait d’un modèle masculin érigé en norme universelle. Pour combler ces lacunes, plusieurs initiatives existent. Les recommandations SAGER (Sex And Gender Equity in Research) et SAGER-swissethics sont un guide pour l’intégration du sexe et du genre dans la recherche, de la conception à la diffusion des résultats. Les recommandations cliniques incluent rarement des indications selon le sexe ou genre. On ignore donc si ces lacunes reflètent une réelle absence de différences ou un manque de données pour le prouver. En attendant de nouvelles données, les clinicien-ne-s sont invité-es à adopter une lecture critique de la littérature, adapter les posologies selon la composition corporelle et valoriser l’expérience des patient-e-s pour garantir des soins équitables.

Fiber contamination originating from disposable dental microapplicators has received limited attention despite its potential influence on adhesive procedures. The aim of this pilot in vitro study was to evaluate fiber-like structure release associated with different microapplicator types during the application of universal adhesive systems. Three universal adhesives (Clearfil Universal Bond Quick, Gluma Universal, and G-Premio BOND) and five microapplicator types (X-Slim, Clinique, Prima, Single TIM, and ZerofloX silicone-bristle microapplicators) were evaluated. A total of 75 adhesive applications were performed on standardized sandblasted glass substrates under controlled laboratory conditions. Adhesives were actively applied for 10 s, and fiber-like structures were quantified microscopically using ImageJ software. Statistical analysis included descriptive statistics, two-way ANOVA, and Tukey post hoc testing (α = 0.05). Significant differences were observed among microapplicator types. X-Slim applicators produced the highest fiber counts, whereas Single TIM applicators demonstrated substantially lower values. No detectable fiber-like structures were observed in specimens treated with the ZerofloX silicone-bristle microapplicator. Adhesive system type showed a comparatively smaller influence on fiber counts than microapplicator design. Within the limitations of this pilot in vitro study, microapplicator type appeared to be the primary factor influencing visible fiber contamination during adhesive application. Further studies are required to determine whether the contamination patterns observed influence adhesive performance under clinically relevant conditions.

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Artificial intelligence (AI) is increasingly used in surgery, but its role in reconstructive urology remains insufficiently studied. The aim of this work was to evaluate the theoretical knowledge of several AI platforms and compare their performance with that of experts from the Young Academic Urologists (YAU) group of the European Association of Urology. This cross-sectional comparative study included 11 YAU experts and 4 AI platforms. Thirty-one multiple-choice questions from Chapter 82 of the Campbell-Walsh-Wein Urology Review, 3rd edition (2020), were used. Total scores and thematic scores were compared. The mean score of YAU experts was 14 of 31 (SD 5.28). AI platforms achieved a mean score of 15 of 31 (SD 5.53), with no significant difference between groups (p=0.802). ChatGPT-4 achieved 24 correct answers and was surpassed by only one human expert. Subgroup analyses showed no significant differences between YAU experts and AI platforms for anatomy (p=0.272), physiology (p=0.923), therapeutic management (p=0.51) and diagnosis (p=0.611). AI platforms, particularly ChatGPT-4, achieved high scores on MCQs in reconstructive urology, and no statistically significant difference was observed compared with YAU experts. These findings support a potential role for AI in educational settings and for answering well-defined theoretical questions, but their use alone is not suitable for clinical reasoning. Further validation on real clinical cases is required before considering clinical implementation.

Although recommendations for structured transition programs in adolescents with Inflammatory Bowel Diseases (IBD) have been published, few studies have addressed the implementation of transition in real-life settings at a national level. The aim of this study was to report nationwide transition practices in IBD patients. Data were collected using two anonymous questionnaires sent to pediatric gastroenterologists (PGs) and adult gastroenterologists (AGs) via the newsletters of French societies and groups specializing in adult and pediatric gastroenterology, between December 2023 and March 2024. A total of 127 questionnaires were analyzed (PGs: n = 83; AGs: n = 44). Transition was structured for 44% of respondents, more frequently among PGs than AGs (51%vs 32%, p = 0.042). Among those, 52% had a designated transition coordinator and 64% provided an educational program. Structured practices and joint consultations were more common in University Hospitals (UHs) than in General Hospitals (GHs) or private practice (PP), for both PGs (p = 0.002 and p = 0.003, respectively) and AGs (p = 0.008 and p < 0.001, respectively). Although the prerequisites expected of patients before transition differed between PGs and AGs, patient adherence was considered essential by 91% of respondents. Among PGs, transfer occurred mainly after the age of 17 years (91%). For AGs, 66% considered 17-18 years as the optimal age for transfer, with no significant difference across practice settings. While some structured processes are in place, broader efforts are needed to enhance IBD transition practices nationwide.

Bronchopneumonia is a major reason for antimicrobial use in young calves, especially in large groups of commingled calves. The clinical diagnosis may be challenging, and lung ultrasonography (LUS) has emerged as an effective calf-side diagnostic test. However, little is known about the applicability of this test at the group level in deciding whether a large group of calves should be treated. The objective of this study was to use a simulation-based assessment of the practical use of LUS to determine the optimal combination for deciding when to treat a group of calves. Therefore, we determined different plausible scenarios. We assessed the performance of LUS as a group test when assessing a random number of calves (N&#x202f;=&#x202f;12, 20, and 30) and defining the group positive test based on the number of calves with lung consolidation (k; from 1 to 6), the true prevalence of bronchopneumonia in the tested population (TP; from 0.05 to 0.3), and the prevalence of positive herds (HTP; from 0.1 to 0.7). Accuracy of LUS at the individual level (sensitivity (Se) and specificity (Sp)) was assessed using a literature review and modeled using a beta distribution. Two thousand iterations of Se and Sp were then obtained, accounting for the negative correlation between these two parameters (known as the threshold effect). Then, group accuracy parameters (Herd Sensitivity, HSe; Herd Specificity, HSp) were obtained based on Se, Sp, k, N, and TP. The misclassification cost term (MCT), which accounts for different plausible cost ratios (r) between false negative and false positive groups, was also obtained to assess the robustness of the findings. Finally, the group-positive and negative predictive values (HPPV and HNPV) were calculated. For each parameter, the median, 5th, and 95th percentiles of obtained distributions were used to present the results. The results indicate important variations of HSe and HSp depending on N, k, and TP. The HSe decreased with decreased N, increased k, or decreased prevalence, whereas the opposite was observed for HSp. The context of use (TP, HTP, N and k) also impacted the HPPV and HNPV. Interestingly, whereas the HNPV increased and HPPV decreased for increasing k for TP&#x2264;&#x202f;0.15, the opposite was observed where TP&#x2265;&#x202f;0.2. The MCT varied as complex interactions between k, N, and TP. This study shows that the context of application of LUS as a group-level test was very important to consider to tailor antimicrobial use in calves.

Salmonella remains one of the most critical zoonotic pathogens in the poultry sector, linked to animal disease, foodborne illness, and the global crisis of antimicrobial resistance (AMR). Poultry acts as a major reservoir, enabling Salmonella transmission from hatchery to retail products through horizontal, vertical, and environmental routes. Despite the use of biosecurity, vaccination, antibiotics, and chemical decontamination, effective and sustainable control across the poultry value chain remains difficult, particularly in the face of rising multidrug-resistant strains and growing consumer concerns over chemical residues. Bacteriophages (phages), viruses that selectively infect and lyse bacteria, have emerged as a promising biological alternative for Salmonella control. Although many studies have reported the effectiveness of phages against bacterial species, including Salmonella, in the poultry industry, reports on their full potential to combat antimicrobial-resistant Salmonella across the entire poultry value chain remain limited. Therefore, this review synthesizes current evidence on the application of phages throughout the poultry value chain, including on-farm interventions, processing plant decontamination, and food packaging and storage. Findings from the reviewed articles indicate over a 90% reduction in Salmonella spp. in poultry farms and post-harvest meat, along with lower mortality in phage-treated groups compared to untreated groups; however, these outcomes depend on several factors (e.g., phage strains, concentrations, application methods, and environmental conditions). Laboratory, pilot, and field studies consistently demonstrate that phage preparations, especially when formulated as cocktails or combined with complementary interventions, can achieve substantial reductions in Salmonella, including antibiotic-resistant serovars, in live birds, eggs, poultry environments, and meat products. Unlike antibiotics and chemical sanitizers, phages act with high specificity, preserving beneficial microbiota and maintaining the sensory and nutritional quality of poultry products. Their safety has been supported by toxicological and genomic assessments, and several phage-based products have obtained regulatory approval, including Generally Recognized as Safe (GRAS) status for food applications in the United States. By integrating efficacy, safety, regulatory, and practical deployment data, this review highlights bacteriophages as a scientifically validated and One Health-aligned tool capable of reducing Salmonella transmission from farm to fork across the poultry value chain, thereby laying the foundation for their future adoption in the poultry industry. Phage-based interventions offer a sustainable pathway to enhance food safety, limit antimicrobial resistance (AMR) dissemination, and strengthen consumer confidence in poultry products. However, the major limitation is the emergence of phage-resistant bacterial strains, as well as the potential involvement of some phages in the transfer of resistance and virulence genes, which could raise public concern. Nevertheless, the use of phage cocktails and whole-genome sequencing, involving tools such as ResFinder and virulence finder, can facilitate the selection of safe phages for application.

Eosinophilic chronic rhinosinusitis (eCRS) is an upper respiratory condition frequently associated with olfactory dysfunction (OD). Despite its high prevalence, the mechanisms underlying OD remain poorly understood. Several eCRS models have been described, but their olfactory phenotypes are poorly characterized. In this study, we compared two of the most frequently used mouse models of eCRS in order to standardize in vivo research on eCRS-related OD. Male and female mice were challenged with ovalbumin (OVA) combined with Staphylococcus aureus enterotoxin B (SEB) over a 13-week protocol or with OVA combined with Aspergillus oryzae protease (AP) for 6 or 12 weeks. Olfactory function was assessed using the buried food test and habituation/dishabituation test. After sacrifice, the integrity and inflammation of the olfactory epithelium were assessed on coronal skull sections by (immuno)histology, including sex as a biological variable. Both models exhibited impaired olfactory function, reduced olfactory epithelium surface area and thickness, and eosinophil infiltration of the olfactory mucosa. The OVA-AP model showed additional presence of neutrophils in the olfactory mucosa, suggesting a mixed inflammatory response. No functional or histological difference was detected between male and female mice, except for epithelial thickness in OVA-SEB control mice. Overall, both murine models are suitable for mechanistic studies of OD in eCRS, with the AP-12-week model displaying the most pronounced inflammation.

The API-CAT trial demonstrated that reduced-dose apixaban (2.5 mg twice daily) was noninferior to full-dose apixaban (5 mg twice daily) for the prevention of recurrent venous thromboembolism in patients with cancer, while resulting in fewer clinically relevant bleeding events. Although these findings are expected to influence clinical practice, real-world data on physicians' anticoagulation decisions in this setting remain limited. To describe investigators' anticoagulant treatment decisions for patients enrolled in the API-CAT trial after discontinuation of blinded study treatment and prior to trial unblinding and dissemination of results. This descriptive analysis included patients from the prospective, multicenter, randomized, double-blind API-CAT trial who received at least one dose of study medication. Investigators prospectively documented anticoagulation management following either premature or planned discontinuation of blinded apixaban. Decisions were categorized as treatment discontinuation, continuation at a reduced dose, or continuation at a full dose. Descriptive analyses examined treatment choices according to patient characteristics, cancer features, and contextual factors. Of 1,766 randomized patients, 1,458 (82.6%) were included in the analysis. After discontinuation of study treatment, anticoagulation was stopped in 198 patients (13.6%) and continued in 1,260 (86.4%). Among those continuing therapy, 790 patients (62.7%) received full-dose anticoagulation, 465 (36.9%) received a reduced dose, 5 unknown. Direct oral anticoagulants (DOACs) were prescribed in 89.6% of cases, and low-molecular-weight heparin in 9.9%. Treatment decisions were generally consistent across patient and cancer characteristics but varied according to timing of treatment discontinuation, physician specialty, and country. Prior to unblinding of the API-CAT trial, treatment decisions appeared poorly driven by clinical characteristics, reflecting a "therapeutic grey zone" where anticoagulation was continued in most patients but with highly variable dosing. This exploratory snapshot provides a baseline to monitor the anticipated shift toward wider adoption of reduced-dose apixaban for extended anticoagulation following publication of the API-CAT results. The substantial proportion of treatment discontinuation highlights the need for further studies to identify patients who may safely stop therapy.

Background: Oesophagogastric cancer is associated with poor survival and major alterations in body composition. This study investigated the relationship between myopenia and myosteatosis in patients with oesophagogastric cancer and evaluated their prognostic significance and association with systemic inflammation. Methods: In this retrospective single-centre study, 161 consecutive patients diagnosed with oesophagogastric cancer between 2019 and 2023 underwent computed tomography-based body-composition analysis at diagnosis. Skeletal muscle index (SMI) and skeletal muscle density (SMD) were measured at the third lumbar vertebra. Myopenia and myosteatosis were defined using Martin's criteria. Associations with overall survival (OS) and progression-free survival (PFS), and systemic inflammation assessed using C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were analysed using Kaplan-Meier and Cox regression analyses. Results: Among the 161 patients included (67.1% male; median age 66 years), myopenia and myosteatosis were highly prevalent (62.7% and 87.6%, respectively), despite a median body mass index (BMI) within the normal range. Lowest SMI tertile was significantly associated with poorer OS and PFS, whereas lowest SMD tertile showed markedly reduced OS. On multivariate analyses, lower SMD remained independently associated with OS and with PFS, whereas SMI lost significance after adjustment for clinical and inflammatory factors. The coexistence of myopenia and myosteatosis was associated with significantly worse survival outcomes. An exploratory continuous muscle score integrating muscle quantity and muscle quality was associated with OS (hazard ratio 1.28 per SD increase) and demonstrated moderate prognostic discrimination (concordance-index 0.63). Conclusions: Muscle quantity and quality represent complementary dimensions of cancer-associated muscle impairment in oesophagogastric cancer. Collectively, these results suggest that a continuous measure integrating both muscle quantity and muscle quality provides a more clinically informative assessment of muscle impairment than traditional binary definitions of myopenia and myosteatosis.

Microvascular decompression has been shown in multiple long-term series to provide durable pain freedom in 75-95% of patients with classical trigeminal neuralgia, defined as neuralgia related to an identified neurovascular conflict, frequently arterial. Surgical success relies on an effective decompression, achieved by displacing the offending arteries while avoiding neo-compression(s) by implanted material. The procedure is performed through a keyhole retrosigmoid (retromastoid) craniectomy, using an infratentorial, supracerebellar corridor to the trigeminal root that minimizes traction on the facial-vestibulocochlear complex. In this video, we demonstrate the step-by-step technique as applied in patients in whom high-resolution MRI demonstrated the conflict preoperatively.

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Unilateral diaphragmatic dysfunction can cause exertional and postural dyspnoea, along with sleep-related breathing disturbances. Diaphragm plication alleviates daytime symptoms, but its effects on sleep have not been evaluated in detail. We analysed prospectively collected observational data in 12 patients undergoing surgical plication for unilateral diaphragmatic dysfunction. Standardised pre- and postoperative assessments included ratings of exertional dyspnoea, orthopnoea and antepnoea (D-VAS), quality of life (VSRQ), spirometry (sitting and supine), transdiaphragmatic twitch pressures, and polysomnography (PSG). Sleep-disordered breathing was evaluated using standard PSG indices including the obstructive apnoea-hypopnoea index (oAHI), measured globally and during REM. Following plication, dyspnoea decreased and orthopnoea and antepnoea were nearly abolished (p = 0.0123 and p = 0.0001, respectively). VSRQ improved (p = 0.0078). Supine vital capacity rose from 52.5% to 75.0% predicted (p = 0.0010), and supine VC drop decreased from 15.1% to 2.65% (p = 0.0068). Twitch pressures increased significantly. oAHI decreased from 15.5 to 8.5 events&#xb7;h&#x207b;&#xb9; (not significant after multiplicity correction). REM AHI decreased from 43.0 [24.5-66.9] to 19.0 [11.5-23.3] events&#xb7;h&#x207b;&#xb9; (p = 0.0020), and REM hypopnoea index from 19.5 to 11.0 (p = 0.0098). Strong correlations were found between REM AHI changes and both FRC and expiratory reserve volume (ERV). In patients with unilateral diaphragmatic dysfunction, diaphragm plication is associated with improved REM-related obstructive events. This may relate to lung volume restoration. These exploratory findings suggest that prospective studies are needed to determine the usefulness of systematic pre-post plication PSG for patient selection and outcome evaluation.

Systemic mastocytosis (SM) is a spectrum of hematologic disorders characterized by accumulation of atypical mast cells (MCs) in extracutaneous organs. SM with an associated hematologic neoplasm (SM-AHN), the most frequent subtype of advanced SM, is predominantly associated with myeloid neoplasms, consistent with shared clonal architecture. Because of its rarity and heterogeneity, robust outcome data aligned with contemporary classifications are needed to inform risk stratification. We analyzed the 10th data wave of the European Competence Network on Mastocytosis registry (34 European centers and 1 US center). SM and AHN diagnoses followed the 2022 World Health Organization classification. Baseline characteristics and overall survival (OS) were compared between patients with myeloid SM-AHN and SM without AHN (SM-no-AHN). Within SM-AHN, outcomes were analyzed by SM component (advanced: aggressive SM [ASM] or MC leukemia [MCL] vs. non-advanced: bone marrow mastocytosis, indolent SM, or smoldering SM) and AHN subtype. Among 3,925 patients with SM, 467 (11.9%) had myeloid SM-AHN. Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) were the most frequent AHN category (41.1%), with chronic myelomonocytic leukemia as the most common subtype (29.6%). Compared with SM-no-AHN, SM-AHN patients were older, more often male, and less frequently had skin involvement. The SM component was advanced in 55.0% of SM-AHN versus 5.8% of SM-no-AHN (p&#x2009;<&#x2009;0.001). OS was shorter in SM-AHN than SM-no-AHN (median 36.1 vs. 340.9 months; p&#x2009;<&#x2009;0.001) and was reduced across SM subtypes, including ASM (31.0 vs. 81.1 months) and MCL (7.1 vs. 23.2 months). Within SM-AHN, advanced SM-AHN had shorter OS than non-advanced SM-AHN (28.3 vs. 70.9 months; p&#x2009;<&#x2009;0.001). Median OS differed by AHN subtype (57.0 months in SM-MPN, 35.7 in SM-MDS, 34.2 in SM-MDS/MPN, and 14.7 in SM associated with acute myeloid leukemia; p&#x2009;<&#x2009;0.001). In multivariable analysis, non-advanced SM (vs. advanced) remained independently associated with improved OS (hazard ratio&#x2009;=&#x2009;0.44; p&#x2009;<&#x2009;0.001). SM-AHN is associated with reduced survival compared with SM without AHN across SM subtypes. Outcomes in SM-AHN are driven primarily by the aggressiveness of the mastocytosis component, supporting recognition and classification of SM in patients with concomitant myeloid neoplasms, given approved KIT-targeted tyrosine kinase inhibitors for advanced SM.

The inaugural European Ovary Workshop (EOW 2025), that was held on February 17-20, 2025 in Lagos, Portugal, brought together 165 scientists, clinicians, and early career researchers from 28 countries to advance ovarian biology from fundamental mechanisms to clinical translation. The program featured 12 scientific sessions, 17 keynote lectures, 15 selected short talks, 89 flash talks, and >90 posters spanning meiosis, folliculogenesis, ovarian reserve, aging, microenvironment, bioengineering, fertility preservation, environmental toxicology, wildlife conservation, patient-public involvement in science, and ethics. A comprehensive networking program combined formal and informal activities to stimulate scientific exchange and interaction across disciplines and career stages. Post-workshop feedback (n&#x2009;=&#x2009;86) reflected high satisfaction with scientific content (rated 4.6/5), speaker quality (4.7/5), and networking (4.4/5), while identifying opportunities to expand clinical topics, diversify model organisms, and improve poster logistics. EOW 2025 established a unique community and a biennial platform to accelerate discovery and translation in ovarian research.

Classical descriptions state that diaphragmatic motor innervation arises predominantly from the fourth cervical nerve root (C4), with additional contributions from C3 and C5. However, clinical evidence supporting the functional involvement of C3 and C5 remains limited. Study aimed to reassess cervical root contribution to diaphragmatic innervation through intraoperative observations. Eighteen consecutive patients undergoing dorsal root entry zone (DREZ) lesioning for refractory pain in upper-limb mostly due to brachial plexus injury were included. The procedure allowed intradural exposure of the C4 and C5 roots. During surgery, cervical roots were evaluated for anatomical integrity, and electrical stimulation of the ventral roots of C4 and C5 was performed to assess their functional contribution to diaphragmatic activation. The functional role of the C3 ventral root, not directly exposed, was not explored. Stimulation of an intact C4 ventral root (n&#xa0;=&#xa0;10) or damaged but with preserved responsiveness (n&#xa0;=&#xa0;2) constantly produced diaphragmatic contraction; when C4 was avulsed or unresponsive (n&#xa0;=&#xa0;6), diaphragmatic paralysis was present in all but one patient (p&#xa0;<&#xa0;0.001); Stimulation of an intact C5 ventral root (n&#xa0;=&#xa0;6) never elicited diaphragmatic contraction (p&#xa0;>&#xa0;0.05). In one patient with normal C5 but avulsed C4, diaphragm was paralyzed. Intraoperative observations support C4 as the critical contributor to diaphragmatic motor innervation. No functional contribution of C5 was identified. These findings, harvested in clinical conditions, refine the functional anatomy of the phrenic motor pathways and may assist neurological evaluation, and surgical planning in cervical and brachial plexus pathologies.