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Colorectal cancers comprise a complex mixture of malignant cells, nontransformed cells, and microorganisms. Fusobacterium nucleatum is among the most prevalent bacterial species in colorectal cancer tissues. Here we show that colonization of human colorectal cancers with Fusobacterium and its associated microbiome—including Bacteroides, Selenomonas, and Prevotella species—is maintained in distal metastases, demonstrating microbiome stability between paired primary and metastatic tumors. In situ hybridization analysis revealed that Fusobacterium is predominantly associated with cancer cells in the metastatic lesions. Mouse xenografts of human primary colorectal adenocarcinomas were found to retain viable Fusobacterium and its associated microbiome through successive passages. Treatment of mice bearing a colon cancer xenograft with the antibiotic metronidazole reduced Fusobacterium load, cancer cell proliferation, and overall tumor growth. These observations argue for further investigation of antimicrobial interventions as a potential treatment for patients with Fusobacterium-associated colorectal cancer.

While empirical research on obstetric violence has focused primarily on women's experiences, the perspectives of healthcare personnel remain relatively neglected. Consequently, this study synthesized qualitative evidence regarding healthcare professionals' perceptions of obstetric violence to understand how their views are constructed and which contextual factors influence the reproduction of these practices. A qualitative systematic review was conducted, covering literature published between 2019 and 2025. The search encompassed the ProQuest Central, Sage Journals, Web of Science, Scopus, SciELO, and PubMed databases. Following PRISMA guidelines, 22 studies that met the inclusion criteria and addressed the research question were included. The data were analyzed using a hermeneutic approach oriented toward recovering the meanings attributed to obstetric violence within its specific production contexts. The reviewed studies reveal tension between recognizing and denying obstetric violence among professionals. Some discourses justify institutionalized practices under biomedical logic, while others express discomfort and internal contradictions toward actions perceived as violent yet considered part of the clinical routine. Medical hierarchy, professional training, work overload, and lack of awareness of reproductive rights were identified as factors shaping these perceptions. Differences were also observed between disciplines (e.g., midwifery vs. obstetrics) and levels of experience (e.g., professionals vs. students). Findings suggest that obstetric mistreatment is a systemic and modifiable phenomenon rather than merely a product of individual intent. Empirical intervention literature demonstrates that professional perceptions can be shifted through structured institutional reforms and training. Eradicating obstetric violence requires moving towards a systemic thinking approach that addresses institutional stressors and promotes humanized, woman-centered care models.

Many adsorbent materials are now commercially available; however, studies have focused on modifying them to enhance their properties. In this study, an activated carbon (AC) and hydroxyapatite (HAp) composite was synthesized by the immersion of ACs in a simulated body fluid solution, varying the AC oxidation degree along with the addition of CaSiO3. The resulting composites were characterized by ash %, X-ray fluorescence (XRF), Fourier-transformed infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and point of zero charge (PZC). The characterization results indicated that the addition of CaSiO3 and the oxygenated functional groups in the AC surface are key factors for HAp growth. The composites were tested on methylene blue (MB) adsorption as a potential application for the synthesized materials. Adsorption isotherms were modeled with Langmuir and Freundlich isotherms, and the composites were fitted to a Langmuir model with the highest qmax value of 9.82. The kinetic results indicated that for the pseudo-second-order model, the composites fitted, with a contact time of 180 min to remove a 95.61% average of the MB. The results indicate that composite materials can be an efficient adsorbent for the removal of MB from aqueous solutions at low concentrations since the material with the highest amount of HAp growth removed 99.8% of the MB in 180 min.

Widespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10; Synflorix, GSK) and 13-valent PCV (PCV13; Prevenar 13, Pfizer) globally. IPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5–17 years, 18–49 years, and ≥50 years). The analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3–12·9) of IPD cases in children younger than 5 years and 15·5% (13·4–19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2–65·4) and 45·6% (40·0–50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3–30·0) of IPD cases in children younger than 5 years and 29·5% (27·5–33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2–43·1]) and adults aged 50 years or older (14·8% [11·9–17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age and PCV10 or PCV13 strata, the proportion of IPD targeted by higher-valency PCVs beyond PCV13 was 4·1–9·7% for PCV15, 13·5–36·0% for PCV20, 29·9–53·8% for PCV21, 15·6–42·0% for PCV24, and 31·5–50·1% for PCV25. All top-ten ranked non-PCV13 serotypes are included in at least one higher-valency PCV. The proportion of IPD due to serotypes included in PCVs in use was low in mature PCV10 and PCV13 settings. Serotype distribution differed between PCV10 and PCV13 sites and age groups. Higher-valency PCVs target most remaining IPD and are expected to extend impact. Bill & Melinda Gates Foundation as part of the WHO Pneumococcal Vaccines Technical Coordination Project.

Venetoclax plus azacitidine (V+A) is standard for older, intensive-ineligible patients with acute myeloid leukemia (AML). Its expanding use in younger, curative-eligible adults lacks comparative evidence against conventional 7+3 induction, raising uncertainty about potential survival compromise. We performed an age-stratified, retrospective comparative effectiveness study using de-identified TriNetX electronic health records (2018-2025). Adults receiving first-line V+A or 7+3 were propensity-matched 1:1 within prespecified age groups (18-59; ≥60) by demographics, comorbidities, socioeconomic factors, and performance status. The primary endpoint was 1-year all-cause mortality; secondary endpoints included complete remission and ICU admission. After matching, 214 younger and 1724 older adults per arm were analyzed. Among younger adults, V+A was associated with significantly higher 1-year mortality versus 7+3 (20.6% vs. 8.9%; HR 2.55), with a number needed to harm of nine. Remission rates favored intensive induction (53.3% vs. 44.9%), while ICU use was similar. In older adults, mortality differences were smaller (23.1% vs. 20.5%; HR 1.34; NNH 38), though remission again favored 7+3. V+A appears markedly inferior to 7+3 as first-line therapy in younger, curative-eligible AML, producing a nearly fourfold greater harm signal than in older adults. These findings support restricting V+A to intensive-ineligible patients pending randomized confirmation. The authors have confirmed clinical trial registration is not needed for this submission.

Cereals are an important source of nutrients, especially used in complementary feeding. The objective of this study is to review the nutritional composition of cereal-based foods for infants from 4 months and toddlers that are offered in Spain and Ecuador, countries selected because of the opportunity to work in them, and due to their socio-economic differences (industrialized and developing countries, respectively). The number of these products was 105 cereals in Spain and 22 in Ecuador. The products were classified as gluten-free cereals, five cereals, eight cereals, multigrain cereals, and cookies. A 25 g serving was used to determine the percentage in which the samples analyzed can cover the Reference Nutrient Intake (RNI) for micronutrients in infants from 7 months and toddlers according to the European Food Safety Authority (EFSA). Nutritional information per 100 g of dry product was collected according to medium, minimum, and maximum units, and nutrient density was calculated. The age range in which these products are recommended is different in both countries. The nutritional composition presents some differences; Spanish cereals show a lower content of sodium, added sugars, hydrolyzed cereals, and maltodextrin than Ecuadorian cereals. Commercialized cereals could contribute to satisfying the nutritional needs of infants and toddlers; however, they can also be a source of non-recommended components.

Purpose To investigate the role of adiposity in the associations between ultra-processed food (UPF) consumption and head and neck cancer (HNC) and oesophageal adenocarcinoma (OAC) in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Methods Our study included 450,111 EPIC participants. We used Cox regressions to investigate the associations between the consumption of UPFs and HNC and OAC risk. A mediation analysis was performed to assess the role of body mass index (BMI) and waist-to-hip ratio (WHR) in these associations. In sensitivity analyses, we investigated accidental death as a negative control outcome. Results During a mean follow-up of 14.13 ± 3.98 years, 910 and 215 participants developed HNC and OAC, respectively. A 10% g/d higher consumption of UPFs was associated with an increased risk of HNC (hazard ratio [HR] = 1.23, 95% confidence interval [CI] 1.14–1.34) and OAC (HR = 1.24, 95% CI 1.05–1.47). WHR mediated 5% (95% CI 3–10%) of the association between the consumption of UPFs and HNC risk, while BMI and WHR, respectively, mediated 13% (95% CI 6–53%) and 15% (95% CI 8–72%) of the association between the consumption of UPFs and OAC risk. UPF consumption was positively associated with accidental death in the negative control analysis. Conclusions We reaffirmed that higher UPF consumption is associated with greater risk of HNC and OAC in EPIC. The proportion mediated via adiposity was small. Further research is required to investigate other mechanisms that may be at play (if there is indeed any causal effect of UPF consumption on these cancers).

Background Some studies have evaluated vaccine effectiveness in preventing outpatient influenza while others have analysed its effectiveness in preventing hospitalizations. This study evaluates the effectiveness of the trivalent influenza vaccine in preventing outpatient illness and hospitalizations from laboratory-confirmed influenza in the 2010–2011 season. Methods We conducted a nested case–control study in the population covered by the general practitioner sentinel network for influenza surveillance in Navarre, Spain. Patients with influenza-like illness in hospitals and primary health care were swabbed for influenza testing. Influenza vaccination status and other covariates were obtained from health care databases. Using logistic regression, the vaccination status of laboratory-confirmed influenza cases was compared with that of test-negative controls, adjusting for age, sex, comorbidity, outpatient visits in the previous 12 months, health care setting, time between symptom onset and swabbing, period and A(H1N1)pdm09 vaccination. Effectiveness was calculated as (1-odds ratio)x100. Results The 303 confirmed influenza cases (88% for A(H1N1)pdm09 influenza) were compared with the 286 influenza test-negative controls. The percentage of persons vaccinated against influenza was 4.3% and 15.7%, respectively (p<0.001). The adjusted estimate of effectiveness was 67% (95% CI: 24%, 86%) for all patients and 64% (95% CI: 8%, 86%) in those with an indication for vaccination (persons age 60 or older or with major chronic conditions). Having received both the 2010–2011 seasonal influenza vaccine and the 2009–2010 pandemic influenza vaccine provided 87% protection (95% CI: 30%, 98%) as compared to those not vaccinated. Conclusion The 2010–2011 seasonal influenza vaccine had a moderate protective effect in preventing laboratory-confirmed influenza.

► We evaluated the 2010–2011 seasonal influenza vaccine effect in preventing hospitalizations. ► In a cohort analysis the adjusted estimate of the vaccine effectiveness was 58%. ► The test-negative case–control analysis gave an adjusted estimate of 59%. ► The close estimates obtained in both analyses suggest good control of bias. We evaluated the 2010–2011 seasonal influenza vaccine effectiveness in preventing hospitalizations. Using healthcare databases we defined the target population for vaccination in Navarre, Spain, consisting of 217,320 people with major chronic conditions or aged 60 years and older. All hospitalized patients with influenza-like illness (ILI) were swabbed for influenza testing. A total of 269 patients with ILI were hospitalized and 61 of them were found positive for influenza virus: 58 for A(H1N1)2009 and 3 for B virus. The incidence rates of hospitalization with laboratory-confirmed influenza were compared by vaccination status. In the Cox regression model adjusted for sex, age, children in the household, urban/rural residence, comorbidity, pandemic vaccination, pneumococcal vaccination, outpatient visits and hospitalization in the previous year, the seasonal vaccine effectiveness was 58% (95% CI: 16–79%). The nested test-negative case–control analysis gave an adjusted estimate of 59% (95% CI: 4–83%). These results suggest a moderate effect of the 2010–2011 seasonal influenza vaccine in preventing hospitalization in a risk population. The close estimates obtained in the cohort and the test-negative case–control analyses suggest good control of biases.

•We analyse the trend of invasive pneumococcal disease in the 13-valent vaccine era.•The incidence of cases has declined notably in children and moderately in adults.•The incidence of cases due to vaccine serotypes decreased 81% in children <5 years.•The moderate decline in adults suggests the indirect effect of vaccination.•No changes indicating serotype replacement have been detected. Pneumococcal conjugate vaccines (PCVs) were licensed for use in children and became available for private purchase in Spain in 2001 (PCV7), 2009 (PCV10) and 2010 (PCV13). This study evaluates changes in the incidence of invasive pneumococcal disease (IPD) and the pattern of serotypes isolated in Navarre, Spain, between the period of use of PCV7 (2004–2009) and that of PCV13 (2010–2013). The percentage of children <2 years who received at least one dose of PCV in these periods ranged from 25 to 61% and 61 to 78%, respectively. Between the periods 2004–2009 and 2010–2013 IPD incidence declined by 37%, from 14.9 to 9.4 cases/100,000 inhabitants (p<0.001). In children <5 years it fell by 69% (p<0.001), in persons aged 5–64 years, by 34% (p<0.001), and in those ≥65, by 23% (p=0.024). The incidence of cases due to PCV13 serotypes declined by 81% (p<0.001) in children <5 years and by 52% (p<0.001) in the whole population. No significant changes were seen in the distribution of clinical presentations or in disease severity. The incidence of IPD has declined and the pattern of serotypes causing IPD has changed notably in children and moderately in adults following the replacement of PCV7 by PCV13.