Adult Granulosa Cell Tumors (AGCTs) are uncommon ovarian neoplasms typically characterized by low-grade malignant behavior. However, AGCTs can occasionally undergo high-grade transformation, which may substantially impact clinical outcomes. In this study, we report the first documented instance of AGCT with high-grade hepatoid transformation (AGCT-HGHT) and perform a review of previously reported cases of AGCT with high-grade/sarcomatoid transformation (AGCT-HST). This case expands the spectrum of AGCT-HST and ovarian tumors with hepatoid morphology and emphasizes the need for further research into the molecular mechanisms and clinical significance of these genetic alterations as potential prognostic markers and therapeutic targets in AGCTs.

Cardiovascular disease (CVD) remains one of the leading causes of mortality in England, with its burden disproportionately concentrated in the North. Studies in the last few decades have highlighted that factors such as low education, high levels of unemployment, poor housing and reduced access to healthy food are strongly associated with the higher incidence of lifestyle risks-smoking, obesity and physical inactivity. These in turn increase rates of hypertension, dyslipidaemia and diabetes in the population. Beyond lifestyle factors, psychosocial mechanisms such as chronic stress and associated increase in allostatic load, due to long-standing deprivation, contribute to the biological risk of CVD. Early life disadvantage, ethnic and gender inequalities, and delayed management of intermediate risk factors further exacerbate the regional divide in England. Furthermore, the long-term impacts of COVID-19 and healthcare-associated national policies, including austerity-related funding deductions, have intensified pre-existing disparities. Evidence demonstrates that current preventative strategies, such as the National Health Service Health Check, have had limited success in reaching underserved communities, highlighting the need for targeted therapies. The National Institute of Health and Care Research Inequalities Challenge is a remarkable opportunity for the United Kingdom's (UK) leading research organisations to help tackle these inequalities associated with CVD and make a significant difference. Without such efforts, the excess CVD burden is likely to persist, perpetuating entrenched health inequalities. This review examines the different social determinants of health underlying these disparities, with a particular focus on socioeconomic deprivation, lifestyle risk factors, environmental and structural issues.

Hemoglobin (Hb) concentration is a fundamental physiological marker widely used in the diagnosis of anemia and the assessment of cardiovascular health. Although invasive blood testing provides high accuracy, its reliance on laboratory infrastructure limits scalability and real-time applicability. Here, we present Hb-PPG, a four-wavelength photoplethysmography (PPG) dataset designed to support research on non-invasive hemoglobin assessment and cardiovascular monitoring. The dataset comprises 1008 PPG signal segments acquired at 660, 730, 850, and 940 nm from 252 adult subjects, alongside reference measurements of hemoglobin, fasting blood glucose, and brachial artery systolic and diastolic blood pressure. Hb-PPG enables systematic investigation of wavelength-dependent PPG signal characteristics and their relationships with hematological and hemodynamic parameters. By providing high-quality, multi-wavelength optical signals with clinically grounded reference data, this dataset facilitates the development, validation, and benchmarking of non-invasive approaches for hemoglobin estimation and related vascular health applications. The dataset is intended to support algorithm development, benchmarking, and methodological studies in non-invasive hemoglobin estimation, rather than direct clinical diagnosis.

This prospective cohort study describes clinical, laboratory factors and virological factors associated with in-hospital mortality among 227 Intensive Care Unit (ICU) patients with SARS-CoV-2 infection admitted in Brazil during the pre-vaccination, pre-Omicron phase of the pandemic (September 2020 to March 2021).

Clinical and laboratory data were extracted from medical records, and viral load was quantified by RT-qPCR Cycle threshold (Ct) values. Independent predictors of mortality were evaluated using multivariable Cox proportional hazards regression, and survival was analyzed with Kaplan-Meier curves.

Non-survivors were significantly older (p < 0.001) and more likely to have hypertension (p = 0.014) and chronic respiratory disease (p = 0.042). At admission, they exhibited higher leukocyte counts (p = 0.001), D-dimer (p = 0.028), and creatinine levels (p = 0.001), as well as more frequent tracheal intubation (p < 0.001). During hospitalization, non-survivors showed persistently elevated leukocyte counts and developed more complications, including acute kidney injury, septic shock, and cardiac arrest (p < 0.001). Viral load was higher in non-survivors (p = 0.026) and among those requiring intubation (p = 0.042) or with cardiovascular disease (p = 0.016). In the multivariable Cox model, only creatinine at admission remained independently associated with mortality (HR = 1.18; 95% CI: 1.00-1.39; p = 0.049). Survival analysis showed reduced survival among patients aged ≥ 65-years (p = 0.004) and those with chronic respiratory disease (p = 0.029).

This study integrates clinical, laboratory, and viral load data to detail the early COVID-19 severity and mortality patterns in a Brazilian ICU.

Familial hypercholesterolemia (FH) is a common genetic disorder characterized by elevated low-density lipoprotein cholesterol (LDL-C) from early life, significantly increasing lifetime risk of atherosclerotic cardiovascular disease. Early identification and initiation of lipid-lowering therapy (LLT) are crucial. This study aimed to describe the timing, pharmacological approach, and early outcomes of LLT initiation in children and adolescents with FH from the Italian LIPIGEN registry.

We analysed 341 paediatric FH patients who were untreated at baseline and had follow-up data within 3 years. Data included clinical features, LDL-C levels, genetic testing results, and treatment patterns. Outcomes included time to LLT initiation, type of therapy, LDL-C reduction, and achievement of guideline-recommended goals.

Mean age at baseline was 10.8 years. At the end of the first year of follow-up, 51.6% initiated LLT, increasing to 78.9% after 3 years (mean age at treatment initiation: 10.9 years), with earlier initiation among those with higher baseline LDL-C. Statins were the most used agents (43.9%), especially in children ≥8 years, followed by combination statin-ezetimibe (11.5%). Nutraceuticals were more common in children <8 years. LLT was associated with a mean LDL-C reduction of 25.7%, reaching 50.2% with statin-ezetimibe. Only 26.1% achieved LDL-C goals, with highest rates among those on combination therapy.

Despite increased use of pharmacological therapy, therapeutic inertia remains common in paediatric FH, resulting in few children reaching recommended LDL-C targets. These findings highlight the need for earlier intervention, closer follow-up, and optimization of treatment strategies to improve long-term cardiovascular outcomes.

Background Research indicates that university students experience higher levels of stress, anxiety, and depression (SAD) than the general population. In Uganda, existing psychological interventions for addressing SAD among students are primarily delivered face to face, which limits effective diagnosis and treatment due to stigma, a shortage of counsellors, and long waiting times, which contribute to significant unmet mental health needs. Consequently, there is an urgent need for innovative approaches to improve access to mental health services.

This study aims to assess the feasibility and effectiveness of a supportive text-message program (Wellness4Students) in reducing the prevalence of stress, anxiety, and depression among University students in Uganda.

This is a quantitative longitudinal research design. We will target 4,494 undergraduate students aged 18-24 years who will be recruited from Makerere University, Uganda. Through advertisements on social media platforms (WhatsApp and X (Twitter)) and websites, students will receive a link to the Wellness4students website with information about the intervention. Eligible students will voluntarily self-subscribe in the wellness4students program by providing their email address. Subscription will be an indicator of consent required for participation in receiving the intervention. Subscribers will receive daily supportive messages for 6 months. Data will be collected from subscribers at baseline (program initiation), 1 month, 3 months (midpoint), and at 6 months (program completion) through web-based surveys. Students will complete questionnaires regarding stress, anxiety, depression, and well-being. We will conduct both descriptive and inferential statistical analyses using STATA version 17.

The results of this study are expected within one year after program initiation. Data will be collected from February 2026 through October 2026. The development of the Wellness4Students application and the survey instrument has been completed. Co-creation of mental health messages with 15 undergraduate students and 2 University psychologists has been completed.

The wellness4students intervention is feasible. The Wellness4Students program will provide essential insight into the prevalence and correlates of stress, anxiety, and depression among Makerere University students. We will identify students who are most at risk of poor mental health outcomes.

Planned to be done later.

eHealth and self-management interventions for informal caregivers of people with dementia show promising positive results for various health outcomes. However, their successful implementation in practice remains inconsistent. The aim of this study is to gain insight into facilitating factors and barriers of the implementation of eHealth interventions with a self-management approach for informal caregivers of people with dementia.

This narrative review included a systematic search of the databases PsycINFO, PubMed and Web of Science. Papers were screened against the inclusion criteria and then the text of eligible papers was qualitatively analyzed both manually and by computer assisted software. Findings were then mapped into the Consolidated Framework for Implementation Research (CFIR).

Twenty papers were selected and seven themes emerged from the qualitative analysis: (1) Organizational, financial, and structural considerations in healthcare; (2) Characteristics of the eHealth interventions; (3) Attitudinal perspectives; (4) Awareness, familiarity and confidence; (5) Resource allocation and support; (6) Personal characteristics of the informal caregivers; and (7) Wider context factors to eHealth intervention implementation. Mapping the findings into the CFIR framework revealed that little is known about the implementation process.

The alignment of eHealth interventions with current policy objectives and digital progress underlines their importance in real-world application.

Pharmacogenetics is considered a promising method to improve pharmacotherapy, yet its implementation in clinical practice is hampered, limiting its potential benefits to the public. Previously, its uptake has been investigated within a variety of healthcare professional groups. Commonly cited barriers by prescribing physicians are lack of knowledge and insurance coverage. An important occupational group who may support physicians due to their expert knowledge are pharmacists. However, they have been understudied in research on pharmacogenetics implementation thus far. Therefore, we investigated the experience and attitudes of pharmacists regarding pharmacogenetics using an online questionnaire.

Using Qualtrics software, an online survey was distributed nationally from April 1st to December 1st 2024. Respondents were recruited during a national conference organized by the Dutch pharmacy residents, through email-invites, and via newsletters of national pharmacist-associations.

In total, data of n = 281 respondents were analyzed in the study, the majority of which were working professionals (±15.8 years of experience). Although only 44.4% had ever requested a pharmacogenetic test, 88.6% of respondents had experience with test result interpretation. Cost, lack of reimbursement through insurance, and lack of availability of pharmacogenetic guidelines including clinical evidence, were found as key barriers. Importantly, respondents generally felt confident regarding their own pharmacogenetics-related knowledge and skills, while maintaining caution in situations where pharmacogenetic evidence is limited.

Successful adoption of pharmacogenetics in practice may benefit from interprofessional collaboration, expanding the pharmacogenetics evidence base, and prioritizing pharmacogenetics in updated health policy.