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Misunderstanding precision psychiatry
(Cambridge University Press (CUP), 2021-07-01) Vieta i Pascual, Eduard, 1963-; Salagre Muñoz, Estela
We thank van Os and Kohne for their reply to our commentary. It is true, we are in love with the concept of precision psychiatry. But we are not blindly in love. Our love for precision psychiatry is based on remarkable and rapid advances in biological psychiatry – closely linked to advances in technology – that support the potential of this paradigm shift.
Is it time to align adolescent diets with the Planetary Health Diet? An observational study on early cardiovascular health
(Frontiers Media, 2026-12-01) Santos-Beneit, Gloria; Fernández Alvira, Juan Miguel; Fernandez-Jimenez, Rodrigo; Lamuela Raventós, Rosa Ma.; Castro-Barquero, Sara; Murcia-Lesmes, D.; Laveriano-Santos, Emily P.; Estruch Riba, Ramon; Corrado, Marina; Arancibia Riveros, Camila; Ruíz León, Ana María; Casas Rodríguez, Rosa M.; Camafort Babkowski, Miguel; Martínez Gómez, Jesús; de Cos-Gandoy, Amaya; Bodega, Patricia
Background: As the impact of early adoption of a sustainable plant-based diet on cardiometabolic biomarkers remains unexplored, we assessed whether they are associated with the Planetary Health Diet Index (PHDI) in adolescents.Methods: This prospective study was conducted within the SI! Program for Secondary Schools trial (SI! Program) in 886 adolescents (12 years ± 0.4 at cohort entry; 49.1% female) followed during 4 years in Spain. The PHDI scores were derived from validated food frequency questionnaires. Multivariable-adjusted Cox proportional-hazards models (HRs) analyzed the association between PHDI and risk of new-onset high blood pressure (BP), obesity, and elevated plasma cardiometabolic biomarkers. Additionally, mixed models assessed changes in those parameters.Results: High adherence to the PHDI(Q4 vs. Q1) is associated with a reduced risk of high BP by 81% (HR: 0.19 [95% CI: 0.11, 0.34]), plasma glucose by 47% (HR: 0.53 [95% CI: 0.48, 0.58]), triglycerides (TG) by 66% (HR: 0.34 [95% CI: 0.18, 0.65]), total cholesterol by 51% (HR: 0.49 [95% CI: 0.34, 0.69]), and non-high density lipoprotein cholesterol (non-HDL-C) by 74% (HR: 0.26 [95% CI: 0.13, 0.50]) in Cox models. Mixed models show inverse associations with higher PHDI and blood glucose (−5.23 mg/dL [95% CI: −10.35, −0.10]), TG (−2.48 mg/dL [95% CI: −3.65, −1.30]), and body mass index (BMI) z-score (−0.02 [95% CI: −0.03, 0.00]).Conclusion: This study stands out as greater adherence to the PHDI is inversely associated with cardiometabolic biomarkers in adolescents, highlighting nutritional benefits of the Planetary Health Diet and its role in preventing the development of cardiovascular diseases and early detection.
Is it time to align adolescent diets with the Planetary Health Diet? An observational study on early cardiovascular health
(Frontiers Media, 2026-12-01) Santos-Beneit, Gloria; Fernández Alvira, Juan Miguel; Fernandez-Jimenez, Rodrigo; Lamuela Raventós, Rosa Ma.; Castro-Barquero, Sara; Murcia-Lesmes, D.; Laveriano-Santos, Emily P.; Estruch Riba, Ramon; Corrado, Marina; Arancibia Riveros, Camila; Ruíz León, Ana María; Casas Rodríguez, Rosa M.; Camafort Babkowski, Miguel; Martínez Gómez, Jesús; de Cos-Gandoy, Amaya; Bodega, Patricia
Background: As the impact of early adoption of a sustainable plant-based diet on cardiometabolic biomarkers remains unexplored, we assessed whether they are associated with the Planetary Health Diet Index (PHDI) in adolescents.Methods: This prospective study was conducted within the SI! Program for Secondary Schools trial (SI! Program) in 886 adolescents (12 years ± 0.4 at cohort entry; 49.1% female) followed during 4 years in Spain. The PHDI scores were derived from validated food frequency questionnaires. Multivariable-adjusted Cox proportional-hazards models (HRs) analyzed the association between PHDI and risk of new-onset high blood pressure (BP), obesity, and elevated plasma cardiometabolic biomarkers. Additionally, mixed models assessed changes in those parameters.Results: High adherence to the PHDI(Q4 vs. Q1) is associated with a reduced risk of high BP by 81% (HR: 0.19 [95% CI: 0.11, 0.34]), plasma glucose by 47% (HR: 0.53 [95% CI: 0.48, 0.58]), triglycerides (TG) by 66% (HR: 0.34 [95% CI: 0.18, 0.65]), total cholesterol by 51% (HR: 0.49 [95% CI: 0.34, 0.69]), and non-high density lipoprotein cholesterol (non-HDL-C) by 74% (HR: 0.26 [95% CI: 0.13, 0.50]) in Cox models. Mixed models show inverse associations with higher PHDI and blood glucose (−5.23 mg/dL [95% CI: −10.35, −0.10]), TG (−2.48 mg/dL [95% CI: −3.65, −1.30]), and body mass index (BMI) z-score (−0.02 [95% CI: −0.03, 0.00]).Conclusion: This study stands out as greater adherence to the PHDI is inversely associated with cardiometabolic biomarkers in adolescents, highlighting nutritional benefits of the Planetary Health Diet and its role in preventing the development of cardiovascular diseases and early detection.
Sex- and Age-Stratified Outcomes of Colonoscopy Versus Faecal Immunochemical Testing: Post-Analysis of the COLONPREV Study
(SAGE Publications, 2026-03) Castells Garangou, Antoni; Quintero, Enrique; Serra Burriel, Miquel; Bujanda, Luis; Castán-Cameo, Susana; Cubiella, Joaquin; Díaz-Tasende, José; Lanas, Angel; Ono, Akiko; Coll-Vinent i Puig, Blanca; Frías Arrocha, Eladio; Hernández, Cristina; Jover, Rodrigo; Andreu, Montserrat; Carballo, Fernando; Morillas, Juan Diego; Salas, Dolores; COLONPREV study investigators
Background Colorectal cancer (CRC) screening is effective and cost-effective in average-risk individuals. The COLONPREV study recently showed that individuals invited to a faecal immunochemical test (FIT) were more likely to participate in screening than those invited to colonoscopy, and that FIT-based screening was non-inferior to colonoscopy with respect to CRC-related mortality and CRC incidence. Objective To assess whether the outcomes of colonoscopy- and FIT-based screening differ according to sex and age in the invited population. Methods Presumptively healthy men and women aged 50–69 years were randomised to either a one-time screening colonoscopy or biennial FIT. In this analysis, we report participation and crossover rates, CRC-related mortality, CRC incidence, all-cause mortality, and diagnostic yield for both screening strategies, stratified by sex and by age group (50–59 and 60–69 years). Results The eligible population consisted of 26,332 individuals assigned to colonoscopy and 26,719 assigned to FIT. As expected, participation and crossover rates were higher in women than in men and in older individuals compared with younger individuals. Participation was also consistently higher in those invited to FIT screening than in those assigned to colonoscopy across both sexes and age groups. The observed reductions in CRC-related mortality and CRC incidence, which were consistent across both screening strategies, were independent of sex or age. However, CRC-related mortality, all-cause mortality, and CRC incidence remained higher in men and older participants than in women and younger participants. Colonoscopy screening showed a higher diagnostic yield of premalignant precursor lesions across all demographic subgroups. Conclusion Participation and reductions in CRC-related mortality and incidence were consistent across sex and age groups for both FIT- and colonoscopy-based screening strategies. The higher baseline risk observed in men could not be fully mitigated by screening.
Characterizing Aeromonas spp. as a Potential Sentinel Organism for Antimicrobial Resistance Dissemination in Wastewater and Drinking Water Treatment Systems: A Case Study in the Barcelona Metropolitan Area, Spain
(MDPI, 2026-03-01) Mondéjar, Laura; Gabasa, Yaiza; Castellsagués, Laura; Vilaró, Carles; Galofre, Belén; González-Díaz, Aida; Martí Martí, Sara; Sanz, Sergi; Soto González, Sara M.; Ballén, Victoria; Pinar-Méndez, Anna
Background: Wastewater treatment plants (WWTPs) are hotspots of antimicrobial resistance (AMR) due to inputs from diverse anthropogenic sources. Aeromonas spp., ubiquitous in aquatic environments, often carry clinically relevant antibiotic resistance genes (ARGs) and can persist beyond fecal contamination indicators, making them promising sentinel organisms for AMR dissemination. The aim of this study was to assess the suitability of Aeromonas spp. in this role by characterizing resistance profiles, associated virulence factor genes (VFGs), genetic mobility, and persistence across wastewater and drinking water treatment processes in the Barcelona metropolitan area, Spain. Methods: Isolates were phenotypically characterized and screened for ARGs, VFGs, integrons, and heavy metal tolerance genes, followed by whole-genome sequencing (WGS). Biofilm formation was assessed in vitro. Conjugation assays with Escherichia coli evaluated horizontal gene transfer (HGT) potential. Results: A total of 428 antibiotic-resistant Aeromonas spp., the most abundant antibiotic-resistant bacteria isolated during the 2023 sampling campaigns from two WWTPs and one drinking water treatment plant (DWTP), were characterized. Trimethoprim/sulfamethoxazole (SXT) non-susceptibility was most frequent (72%), followed by cefoxitin resistance (65.4%). The sul1 (57.5%) and blaMOX (78.6%) genes predominated among SXT- and β-lactam-resistant isolates. The merA gene was detected in 23.6%; 97.9% harbored at least one VFG (aerA, act, fla, alt, or hlyA), and 70.3% carried intI1. Half formed biofilm. Conjugation confirmed bi-directional HGT, and WGS revealed persistent ST3458 clones across treatment stages. Conclusions: WWTPs and DWTPs act as reservoirs of antibiotic-resistant Aeromonas spp., demonstrating persistence and HGT potential. Findings support their use as sentinel organisms for AMR surveillance in aquatic environments and for assessing treatment efficacy, highlighting variability across treatment types and locations, and reinforcing their relevance for urban water reclamation monitoring. Keywords: Aeromonas spp.; antimicrobial resistance; antibiotic resistance genes; wastewater treatment plants; drinking water treatment; horizontal gene transfer; biofilms; environmental surveillance
Characteristics of Colonoscopy- and Fecal Immunochemical Test-Based Screen-Detected Premalignant Neoplastic Lesions: Results From the COLONPREV Study
(Elsevier, 2026-03-01) Castells Garangou, Antoni; Quintero, Enrique; Pellisé Urquiza, Maria; Frías Arrocha, Eladio; Hernández, Cristina; Serra Burriel, Miquel; COLONPREV Study Investigators
Evidence from several studies have shown that colorectal cancer (CRC) screening is effective and cost-effective in average-risk individuals. The most common screening strategies are fecal immunochemical test (FIT) and colonoscopy. Whereas the former is predominantly implemented in Europe and Australia, the latter is the dominant screening modality in the US. . We have recently published the long-term results of COLONPREV study, the first randomized controlled trial comparing colonoscopy and FIT head-tohead, demonstrating that individuals invited to FIT were more likely to participate in screening than those invited to colonoscopy. More importantly, FIT-based screening program appeared not to be inferior to one based on primary colonoscopy in terms of CRC-related mortality and CRC incidence.
Can Colonoscopy Still Be Promoted as the Best Choice for Colorectal Cancer Screening?
(Elsevier, 2026-03-01) Ladabaum, Uri; Weinberg, David S.; Castells Garangou, Antoni
Upon hearing a speaker disclose potential conflicts of interest years ago at Digestive Disease Week, an eminent American leader in gastroenterology whispered to one of us: “These disclosures are nonsense. Our main conflict of interest is that we all do colonoscopy.” American gastroenterologists usually avoid discussing this uncomfortable truth. The delivery of high-quality colonoscopy is a source of professional pride for us. Colonoscopy is the final common pathway of all colorectal cancer (CRC) screening strategies, preventing CRC through polypectomy.
Molecular Epidemiology of Travel-Associated and Locally Acquired Dengue Virus Infections in Catalonia, Spain, 2019
(MDPI, 2025-05-01) Bou-Monclús, Maria Assumpció; Martínez Calleja, Itziar; Jané, Mireia; Rius, Cristina; Vargas Leguas, Hernán; Escudero Pérez, Beatriz; Albarracín, Rosa; Navarro Ponz, Alfons; Navarro Calafell, Mercè; Navero Castillejos, Jessica; Sánchez-Montalvá, Adrián; Sulleiro, E.; Silgado, Aroa; Montalvo, Tomás; Barahona, Laura; Busquets, Núria; Muñoz Gutiérrez, José; Camprubí Ferrer, Daniel; Valdivia, Meica; Barrachina, Josep; Martínez, Ana; Martínez Yoldi, Miguel Julián
Dengue virus (DENV) is the most important arbovirus worldwide. In 2019, a significant increase in dengue cases was reported worldwide, resulting in a peak of imported cases in some European countries such as Spain. We aimed to describe travel-associated and locally acquired DENV strains detected in 2019 in the Catalonia region (northeastern Spain), a hotspot for dengue introduction in Europe. Through sequencing and phylogenetic analysis of the envelope gene, 75 imported viremic cases and two local strains were described. Autochthonous transmission events included an infection of a local mosquito with an imported dengue strain and a locally acquired human dengue infection from a locally infected mosquito. Overall, all four DENV serotypes and up to 10 different genotypes were detected. Phylogenetic analysis revealed transcontinental circulations associated with DENV-1 and DENV-2 and the presence of DENV-4 genotype I in Indonesia, where few cases had been previously described. A molecular study of the autochthonous events determined that local Ae. albopictus mosquitoes were infected by an African DENV-1 genotype V strain, while the locally acquired human case was caused by a DENV-3 genotype I of Asian origin. These findings underline the wide variability of imported strains and the high risk of DENV introduction into this territory, emphasizing the importance and usefulness of molecular characterization and phylogenetics for both local and global surveillance of the disease.
Resting-state brain connectivity following extra virgin olive oil intake in healthy adults: a randomised crossover pilot neuroimaging substudy
(Royal Society of Chemistry, 2026-04-08) Estruch Riba, Ramon; Lamuela Raventós, Rosa Ma.; Gutiérrez-Romero, Rocío M.; Donat Vargas, Carolina; Muñoz-Moreno, Emma; Hinojosa-Moscoso, Alejandro; Galkina, Polina; Arancibia Riveros, Camila; Domínguez-López, Inés; Hurtado Barroso, Sara; Pérez Bosch, Maria; Vallverdú i Queralt, Anna; Casas Rodríguez, Rosa M.
This pilot randomised crossover neuroimaging substudy (n = 9) identified increased resting-state occipital functional connectivityfollowing daily consumption of (poly)phenol-rich extra virgin olive oil compared with regular olive oil. Urinary hydroxytyrosol-glucuronideexcretion increased significantly, and a significant interaction between intervention and metabolite levels was observed on occipitalconnectivity. These preliminary findings require replication in larger, adequately powered studies.
CAR-T cell therapy for cancer: current challenges and future directions
(Springer Nature, 2025-07-04) Zugasti, Inés; Espinosa-Aroca, Lady; Fidyt, Klaudyna; Mulens-Arias, Vladimir; Díaz Beyà, Marina; Juan, Manel; Urbano Ispizua, Álvaro; Esteve, Jordi; Velasco-Hernandez, Talia; Menéndez Buján, Pablo
Chimeric antigen receptor T (CAR-T) cell therapies have transformed the treatment of relapsed/refractory (R/R) B-cell malignancies and multiple myeloma by redirecting activated T cells to CD19- or BCMA-expressing tumor cells. However, this approach has yet to be approved for acute myeloid leukemia (AML), the most common acute leukemia in adults and the elderly. Simultaneously, CAR-T cell therapies continue to face significant challenges in the treatment of solid tumors. The primary challenge in developing CAR-T cell therapies for AML is the absence of an ideal target antigen that is both effective and safe, as AML cells share most surface antigens with healthy hematopoietic stem and progenitor cells (HSPCs). Simultaneously targeting antigen expression on both AML cells and HSPCs may result in life-threatening on-target/off-tumor toxicities such as prolonged myeloablation. In addition, the immunosuppressive nature of the AML tumor microenvironment has a detrimental effect on the immune response. This review begins with a comprehensive overview of CAR-T cell therapy for cancer, covering the structure of CAR-T cells and the history of their clinical application. It then explores the current landscape of CAR-T cell therapy in both hematologic malignancies and solid tumors. Finally, the review delves into the specific challenges of applying CAR-T cell therapy to AML, highlights ongoing global clinical trials, and outlines potential future directions for developing effective CAR-T cell-based treatments for relapsed/refractory AML.
Efficacy, acceptability, and related outcomes of pharmacological interventions for acute bipolar depression: A systematic review and dose-related network meta-analysis across different age groups
(Elsevier B.V., 2026-06-23) Fornaro, Michele; Di Lorenzo, Chiara; Oliva, Vincenzo; De Prisco, Michele; Vieta i Pascual, Eduard, 1963-
Background: Acute bipolar depression poses a significant burden and socioeconomic costs. We investigated the comparative efficacy/response/acceptability of pharmacological interventions for acute bipolar depression, considering dose effects across different age groups. Methods: We conducted a network meta-analysis (NMA), searching for randomized controlled trials (RCTs) comparing pharmacological interventions against each other/or placebo in patients with acute bipolar depression (Type-I/Type-II/other), indexed in PubMed/MEDLINE, Embase, Web-of-Science/and Scopus (database inception up to 2025.11.25). Co-primary outcomes were change in depressive symptoms/response/and acceptability. Tolerability/remission/change in anxious symptoms/and risk-of-manic/hypomanic switches were secondary outcomes. Confidence-In-Network-Meta-Analysis was likewise appraised. Results: 103 RCTs, encompassing 71 distinct treatment combinations, included 20,941 participants. Sensitivity analysis including low-risk-of-bias studies only and excluding outliers for possible effect modifiers indicated that lamotrigine 50 mg/day or 200 mg/day, quetiapine extended-release 150 mg/day and 300 mg/day, and lumateperone 42 mg/day outperformed placebo for depressive symptoms, with estimates ranging from -1.53(95%C.I. = -2.13;-0.93) for lamotrigine 50 mg/day, to -0.36(95%C.I. = -0.68;-0.04) for lumateperone 42 mg/day. Several additional drugs might be efficacious, although they emerged as outliers for either mean age of participants/proportion of females/BD-II participants/psychotic features/rapid cycling/baseline severity of depression/and trial duration. No treatment outperformed placebo for response/remission/acceptability/tolerability/and manic/hypomanic switches. Conclusions: Our findings are consistent with previous NMAs and current guidelines, thereby expanding knowledge by concurrently appraising different drugs, doses, and age groups.
Neuroprogression in bipolar disorder: why right is wrong
(Cambridge University Press (CUP), 2024-07-01) Vieta i Pascual, Eduard, 1963-
The controversy on whether bipolar disorder is a neurodevelopmental versus a neuroprogressive illness is still around, despite some reductionistic claims that only one model is right. The current diagnostic classifications are not helpful to address this issue, and there is conflicting evidence in favor and against either model. In practice, though, understanding that many patients may show a progressive cognitive and functional decline which may be correlated with the number and severity of episodes may lead to better outcomes through early intervention strategies.
Neuroprogression happens
(Cambridge University Press (CUP), 2024-10-01) Vieta i Pascual, Eduard, 1963-
I read with interest the contribution by Samamé on neuroprogression in bipolar disorder (Samamé, in press) in response to a commentary on the same topic (Vieta, 2024), and appreciate the opportunity to further discuss the nuances around the origin and course of cognitive impairment in patients with bipolar disorder from a scientific perspective. The neuroprogression model fits well in some patients, but not all. When addressing cognition and functioning in conditions such as bipolar disorder, heterogeneity is the rule.
Predicting the past: The risks and rewards of post-hoc findings
(Elsevier B.V., 2025-03-01) Oliva, Vincenzo; Vieta i Pascual, Eduard, 1963-
Given the age of this sophism, one could say that it is human nature to connect existing elements—events, outcomes, or data—and link them in a way that feels coherent. However, there is the risk that this coherence is artificial
Bipolar disorder
(Elsevier B.V., 2016-04-09) Grande, Iria; Berk, Michael; Birmaher, Boris; Vieta i Pascual, Eduard, 1963-
Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression. Moreover, there are currently no valid biomarkers for the disorder. Therefore, the role of clinical assessment remains key. Detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance.
Discovery of Donor-Derived Exosomal DNA as an Exploratory Biomarker of Kidney Graft Rejection: A Cross-Sectional Study
(Frontiers Media, 2026-03-18) Cuadrado Payán, Elena; Ramírez Bajo, María José; Bañón Maneus, Elisenda; Rovira Juárez, Jordi; Hierro García, Natalia; Serrano Jorcano, Daniel; Argudo, María; Montagud Marrahi, Enrique; Rodríguez Espinosa, Diana; Arana, Carolt; Molina Andújar, Alícia; Gonzalez Rojas, Ángela; Esforzado Armengol, Núria; Torregrosa, Vicens; Ventura Aguiar, Pedro; Broseta, José Jesús; González Roca, Eva; Palou Rivera, Eduard; Diekmann, Fritz; Cucchiari, David; Revuelta, Ignacio
Circulating donor DNA has emerged as a valuable tool for clinical decision-making in kidney transplantation. While most studies focus on cell-free DNA, the role of donor DNA associated with extracellular vesicles (EVs) remains unexplored. To address this, we analyzed donor-derived exosomal DNA (dd-exoDNA) in 100 kidney transplant recipients (KTR) undergoing surveillance or indicated biopsies. Serum exosomes were isolated using precipitation-based technology, and dd-exoDNA was analyzed via digital PCR targeting donor/recipient HLA-DRB1 mismatches. Dd-exoDNA levels were higher in rejection versus non-rejection (2.66 [0.56-7.10] ×10-3 vs. 0.69 [0.28-1.71] ×10-3, p = 0.004) and were associated with Banff score items: glomerulitis ≥1 (p = 0.037), peritubular capillaritis ≥1 (p = 0.040), and tubulitis ≥2 (p = 0.043). In multivariate analysis, dd-exoDNA remained independently associated with rejection, although with wide confidence intervals (OR [95%CI] 3.68 [1.32-10.26], P = 0.013). Exploratory threshold analyses suggested moderate discriminative performance. These findings indicate that donor DNA associated with circulating EVs may offer complementary information to existing biomarkers, warranting validation in external cohorts and comparison with established assays.
Short-term Safety of one Anastomosis Gastric Bypass (OAGB) Versus Single Anastomosis Duodeno-Ileal Bypass with Sleeve Gastrectomy (SADI-S): 30-day Results from the OASIS trial.
(Springer Verlag, 2026-04-01) Lopez Gonzalez, Ruth; Sanchez Cordero, Sergi; Hermoza, Rodrigo; Pujol Gebelli, Jordi
BACKGROUND: Metabolic and bariatric surgery (MBS) is an effective treatment for obesity, but selecting the optimal technique remains challenging. One Anastomosis Gastric Bypass (OAGB) and Single Anastomosis Duodeno-Ileal with Sleeve Gastrectomy (SADI-S) are increasingly used, yet direct comparisons are scarce. OBJECTIVES: To compare 30-day outcomes of OAGB and SADI-S in patients with a BMI of 45–50 kg/m², focusing on safety and short-term efficacy within the OASIS trial. METHODS: In this randomized, single-blind trial, 89 patients underwent laparoscopic OAGB (n = 48) or SADI-S (n = 41). The primary endpoint is 5-year weight loss; this manuscript reports a planned 30-day safety analysis. Complications were graded using the Clavien-Dindo scale. Secondary outcomes included operative time, hospital stay, and early weight loss. RESULTS: Severe complications (Clavien-Dindo ≥ IIIb) occurred in 7.3% of SADI-S and 2.1% of OAGB patients (p = 0.33). Reoperations were also more common in SADI-S (7.3% vs. 2.1%; p = 0.33). Operative time was significantly longer for SADI-S (103.8 ± 18.4 vs. 82.2 ± 23.9 min; p < 0.001). No significant differences were found in early weight loss or comorbidity resolution. No 30-day mortality was recorded. CONCLUSIONS: OAGB was associated with fewer complications and shorter operative times compared to SADI-S, although differences in severe complications and reoperations were not statistically significant. Long-term data are needed to fully evaluate outcomes.
Operational performance of a programmatic mass drug administration campaign for malaria in southern Mozambique: a comprehensive mixed-methods evaluation of implementation outcomes
(BioMed Central, 2026-04-07) Fuente Soro, Laura; Tusell Rabassa, Maria; Vecchio, Jacopo; Nhangave, Amancio; Bapu, Khalid; Riley, Christina; Materrula, Felisbela; Dimene, Mércia; Sibindy, Samira; Candrinho, Baltazar; Aide, Pedro Carlos Paulino; Guinovart, Caterina
BACKGROUND: The World Health Organization (WHO) recommends Mass Drug Administration (MDA) to reduce malaria transmission in low-transmission settings, with a target coverage of at least 80%. To maximize impact, the development of effective and sustainable programmatic implementation strategies is essential. Between December 2022 and February 2023, two rounds of programmatic MDA (pMDA) were implemented in Chidenguele, in Gaza province, Mozambique. The target population was approximately 59,271 individuals. Door-to-door drug distribution, using dihydroartemisinin-piperaquine, was guided by satellite imagery-based mapping. METHODS: A mixed-methods evaluation was conducted to assess operational performance —including acceptability, appropriateness, coverage, feasibility, fidelity, and adoption— using a community household survey (n = 770), a health staff survey (n = 28), and field observations (n = 149). RESULTS: Among household survey participants eligible for medication during round 2, 96,2% (607/631) accepted to participate in the pMDA. All health staff survey participants and 91,3% (703/770) of household survey participants considered taking antimalarials while asymptomatic to be an acceptable preventive measure. All health staff survey participants (28/28) and 84,1% (648/770) of household survey participants felt the intervention was appropriate for reducing malaria transmission in the community. Programmatic or contact coverage (proportion of survey participants that received pMDA treatment) reached 73,9% (569/770), while operational coverage (proportion of those present at the time of the intervention that received pMDA treatment) was 90,2% (569/631). All health staff survey participants (28/28) considered the pMDA implementation strategy feasible to implement. In terms of fidelity, direct observations of pMDA household visits showed that pMDA distribution teams correctly explained the purpose of the visit in 74,5% (111/149) of interactions, requested verbal consent in 86,6% (129/149), and emphasized the importance of completing the treatment in 60,4% (90/149). Health staff survey participants showed strong willingness to adopt the procedures, with 86.0% (24/28) and 96.0% (27/28) expressing high commitment in rounds 1 and 2, respectively. CONCLUSIONS: Despite the pMDA delivery strategy being implemented with good operational performance and being well accepted by the community and health staff, reaching the 80% coverage target remains challenging. Sustained collaboration and active engagement from communities, partners, and policymakers, and enhancement of some key outcomes, such as the fidelity of the implementation, are critical to improving coverage and ensuring the success of pMDA campaigns.
Cognition Assessment in Virtual Reality (CAVIR)-Spanish Version: Validation of a Novel Virtual Reality Test for Daily-Life Cognitive Skills in Bipolar Disorder
(John Wiley & Sons, 2026-06-01) Fares Otero, Natalia Elena; Solé Cabezuelo, Brisa; Elleby Jespersen, Andreas; Roberto, Natalia; Martín Parra, Sara; López Escribano, Ricardo; Pérez Ramos, Anaid; Piazza, Flavia; Ruiz Muñoz, Andrea; Varo, Cristina; Lumbye, Anders; Vieta i Pascual, Eduard, 1963-; Martínez-Arán, Anabel, 1971-; Woznica Miskowiak, Kamilla
Objectives: There is a need for ecologically valid measures of real-life cognitive functioning. We investigated: (I) the sensitivity of the Cognition Assessment in Virtual Reality (CAVIR) test, which assesses daily-life cognitive skills in an immersive virtual reality kitchen scenario, to capture cognitive impairments in a Spanish sample of patients with bipolar disorder (BD) compared to healthy controls (HCs); (II) the convergent validity of CAVIR against standard neuropsychological tests and functional measures. Methods: Patients with BD in full/partial remission (n = 40) and HCs (n = 40) completed the CAVIR–Spanish version and standard neuropsychological tests; the Hamilton Depression Rating Scale (HRDS-17), the Young Mania Rating Scale (YMRS), the Functioning Assessment Short-Test (FAST) and the Brief University of California Performance-based Skills Assessment (UPSA-B). Between-group comparisons of CAVIR global and subtask scores were conducted, together with correlation and linear regression analyses adjusting for age and mood symptoms. Results: CAVIR was sensitive to cognitive impairments in BD, with patients showing poorer performance than HCs on CAVIR global composite (BD = −1.09, 95% CI [−1.44, 0.74] vs. HCs = −0.19, 95% CI [−0.53, 0.15]) (F(1,72) = 9.52, p = 0.003, 2 = 0.12) and subtasks of sustained attention (BD = −1.25, 95% CI [−1.83, −0.70] vs. HCs = −0.14, 95% CI [−0.66, 0.37]) (F(1,69) = 6.12, p = 0.016, 2 = 0.08), processing speed (BD = −1.64, 95% CI [−2.11, −1.18] vs. HCs = −0.20, 95% CI [−0.66, 0.25]) (F(1,68) = 13.67, p < 0.001, 2 = 0.17) and working memory (BD = −0.91, 95% CI [−1.42, −0.41] vs. HCs = 0.05, 95% CI [−0.42, 0.52]) (F(1,71) = 5.50, p = 0.022, 2 = 0.07). The global CAVIR composite and subtasks scores were associated with standard global neurocognitive composite and domains, respectively (σ = 0.50–0.74, p < 0.001). The global CAVIR and all subtasks scores were associated with both observed/interview-based (FAST; σ = −0.29 to −0.55, p < 0.001) and performance-based (UPSA-B; σ = 0.29–0.49, p < 0.05) functional outcomes. Conclusions: The CAVIR-Spanish version is a sensitive and valid instrument for measuring real-life cognitive skills in BD and may be implemented in clinical settings and treatment trials targeting cognition following further studies.
Resilience in Bipolar Disorder Compared to Clinical and Non-Clinical Populations: A Systematic Review and Meta-Analysis
(John Wiley & Sons, 2026-01-01) Clougher, Derek; De Prisco, Michele; Solé Cabezuelo, Brisa; Montejo Egido, Laura; Serra Navarro, Maria; Forte, Maria Florencia; Camprodon Boadas, Patricia; Serna, Elena de la, 1978-; Oliva, Vincenzo; Martín Parra, Sara; Sánchez-Moreno, José; Amann, Benedikt L.; Garriga, Marina; Verdolini, Norma; Ribasés Haro, Marta; Miskowiak, Kamilla W.; Martínez-Arán, Anabel, 1971-; Vieta i Pascual, Eduard, 1963-; Amoretti Guadall, Silvia; Torrent Font, Carla
Introduction: Resilience is present in both clinical and non-clinical populations; yet, there is a paucity of literature examining its role in bipolar disorder (BD). The goal of the present systematic review and meta-analysis was to substantiate the extant literature investigating resilience in BD in comparison to clinical and non-clinical populations. Method: PubMed/MEDLINE, PsycINFO, and Scopus were systematically searched from inception to August 8th, 2024. Results: Twenty-eight studies using a validated resilience scale with a total of 3094 people with BD, 4100 healthy controls, and 1768 with other mental diagnoses were included in the systematic review, and 21 were analyzed in a random effects meta-analysis. A statistically significant result with a medium effect (SMD = −0.787, p < 0.001) indicated that people with BD reported lower levels of resilience than healthy controls. Similarly, patients with BD showed higher levels of resilience than patients with schizophrenia (SCZ) (SMD = 0.336, p = 0.013). No significant differences were found between BD and major depressive disorder (MDD). Conclusion: Findings should be interpreted with caution due to the high heterogeneity observed and methodological challenges in the definition and measurement of resilience. Future research should aim to better characterize resilience in BD by improving its assessment as a standardized element of clinical evaluation. This will provide a basis for strategies to reduce the burden of this chronic condition.

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Amb motiu del tancament d'estiu, la validació de documents es reprendrà a partir del 28 d'agost de 2026. Disculpeu les molèsties.

Con motivo del cierre de verano, la validación de documentos se reanudará a partir del 28 de agosto de 2026. Disculpad las molestias

Due to the summer closure, document validation will resume starting August 28, 2026. We apologize for any inconvenience.

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