Veterans Affairs Medical Centers offer multiple weight-loss treatments, including a comprehensive lifestyle intervention program (i.e., MOVE!), anti-obesity medications (AOMs) and bariatric surgery. Yet, most eligible veterans do not receive these treatments.

To describe the design, rationale, and planned evaluation of a comprehensive Weight Management and Metabolic Health program (WMMHP), consisting of (1) weight-focused visits with physicians or pharmacists trained in obesity medicine; (2) patient-centered use of available weight-loss treatments; and (3) coordinated, team-based care.

This is a quality improvement program implemented within the VA Ann Arbor Healthcare System. WMMHP eligibility criteria include body mass index (BMI) ≥ 30 kg/m2 or BMI ≥ 27 kg/m2 and ≥ 1 weight-related condition and participation in the MOVE! program. We plan to conduct an 18-month retrospective program evaluation using a propensity-matched cohort analysis to estimate the added benefit of WMMHP vs. MOVE! alone. The primary outcome will be mean change in weight at 18 months after baseline. Secondary outcomes will include mean weight loss at 6, 12, and 24 months, percentage of patients achieving thresholds of ≥ 5%, ≥ 10%, and ≥ 15% weight loss, initial prescriptions for and refilled prescriptions as a measure of adherence to AOMs, and referrals to, engagement with, and completion of bariatric surgery. We will also examine between-group differences in health system resource utilization.

The WMMHP is an innovative approach to improving treatment and outcomes for veterans with overweight and obesity. If effective, its components may inform obesity care delivery in VA and non-VA settings.

To map the spread of research on legumes, including beans, peas and other pulses; to identify research gaps and opportunities relating to the use of legumes for improved human nutrition, health and environmental outcomes; and to develop a novel method for clarifying research priorities.

Prospective mapping review, identifying and mapping ongoing research (2019–2023) across the value chain.

UK.

Academic research studies in three databases.

Fifty ongoing research projects were identified, revealing a focus on the two ends of the value chain: production (twenty-one projects) and consumption (twenty-one projects). Only four projects encompassed the entire value chain from producer to consumer. Research on production includes the role of legumes in crop rotations for soil health and reduced fertiliser use, productivity interventions and improved breeds. Research on consumption includes dietary and health outcomes, predominantly cardiometabolic impacts, and legumes as an alternative protein source. Few projects focused on the middle of the value chain (four projects on product development) with none focused on processing, food service or retail.

Further interdisciplinary projects, linking producers to consumers and with a greater focus on middle-chain actors, are needed. The food processing/manufacturing, food service and retail sectors hold significant power in food systems practice and governance. They play a crucial role in transitioning to a healthier and more sustainable food system. Understanding the drivers and barriers for these food systems actors in increasing production and consumption of beans, peas and pulses is required to inform future food policy and practice.

The growing frequency of global disasters highlighted the need to integrate technology into disaster management. This systematic review describes the global landscape of mobile phone technologies for natural hazard-induced disaster prevention, preparedness, response, and recovery.

A systematic review was conducted by searching databases, including Embase and MEDLINE, for studies published in English between 2000 and March 2024 that examined mobile applications for disaster management.

The review included 26 studies covering 77 mobile apps across 14 countries. Most apps were privately owned (78.26%), supported multiple disaster phases (41.56%), and favored the Android platform (46.67%), with GPS being the most common technology (15.58%). Apps primarily targeted the general public (63.64%) and focused on earthquakes (32.47%) and hurricanes (31.17%). Despite their potential, adoption remains low; only 11.33% (6 apps) exceeded 1 million downloads, while 33.96% failed to surpass 1,000 downloads.

This review highlights significant gaps in the development, adoption, and impact of disaster management apps, especially in high-risk regions. Future efforts must focus on enhancing accessibility, addressing user needs, expanding features, and fostering stakeholder collaboration to improve the effectiveness of mobile technologies in disaster preparedness, response, and recovery.

Auditory verbal hallucinations (AVH) in schizophrenia spectrum disorders (SSDs) may arise from misattributed inner speech. However, it is unclear if inner speech frequency and phenomenology differ in schizophrenia-spectrum voice-hearers compared with healthy individuals, and how different inner speech varieties relate to AVH and affect. Using experience sampling methodology (ESM), this study examined the moment-to-moment dynamics between inner speech varieties, AVH, and affect.

Participants completed 6 days of ESM on an electronic device, responding to 10 daily prompts on inner speech varieties (i.e. dialogic, evaluative, other people, condensed, and positive), AVH, and affect. Responses from 32 individuals with SSDs with current AVH (‘SSD’) and 34 healthy controls (‘HC’) were analyzed using linear mixed modeling.

SSD reported significantly more inner speech moments and higher momentary intensity of evaluative, other people, condensed, and positive inner speech compared with HC, but not for dialogic inner speech. Within SSD, higher momentary intensities of dialogic, evaluative, other people, and condensed inner speech were associated with higher AVH levels. Momentary negative affect (NA) moderated the association between evaluative inner speech and AVH, with a stronger association at higher NA levels.

SSDs with current AVH experience more frequent inner speech and exhibit a distinct phenomenological profile compared with healthy individuals. Several inner speech varieties are associated with AVH severity momentarily, supporting the hypothesis that inner speech contributes to AVH at the phenomenological level. This study highlights the emotional state as an important moderator of the inner speech–AVH relationship and as a potential therapeutic target.

To synthesize the available experimental study evidence to estimate the effects of ketamine on suicide ideation (SI) in high-risk individuals.

We conducted a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Double-blind randomized controlled trials and open-label studies investigating the safety and effectiveness of ketamine on SI published up to October 2025 were identified. Data were pooled using random-effects meta-analysis. The main outcome was standardized mean difference on SI in high-risk individuals. Secondary outcomes were the percentage of adverse events and the moderator effects.

We identified 21 studies with a total of 927 participants meeting our inclusion criteria. The pooled effect size for the reduction of SI after ketamine treatment was significant and clinically meaningful (large effect size of −1.40, 95% confidence interval: −2.15 to −0.66, P < 0.001, low–quality evidence). Dissociation (38.8%, P = 0.014), nausea (31.6%, P < 0.001), dizziness (24.7%, P = 0.003), headache (22.0%, P = 0.011) and anxiety (15.8%, P < 0.001) were the frequently reported adverse events. Moderator analyses indicated that the effect was higher in younger individuals and those with severe SI.

Our findings highlight the effectiveness of ketamine in reducing SI in high-risk individuals, especially younger individuals and those with severe ideation. Nonetheless, additional research is required to better understand optimal dosing regimens and the potential long-term effects of ketamine treatment.

To investigate whether taste perception of two artificial sweeteners—aspartame and neohesperidin dihydrochalcone (NHDC)—is causally associated with the risk of site-specific cancers.

A two-sample Mendelian randomisation (MR) study.

Genetic instruments for taste perception (6 for aspartame; 13 for NHDC) were obtained from a genome-wide association study (GWAS) of Australian adolescents, and cancer outcome data were sourced from publicly available GWAS datasets.

Genetic data for taste perception from 1757 Australian adolescents and genetic data for cancers from large-scale GWAS cohorts, including UK Biobank (n 500 000) and FinnGen (n 500 000).

A one sd increase in the genetically predicted perceived intensity of NHDC was associated with an increased risk of male genital cancer (OR = 1·11, 95 % CI: 1·04, 1·19) and prostate cancer (OR = 1·03, 95 % CI: 1·01, 1·08) based on FinnGen data. These associations persisted after multivariable MR adjustment for glucose and aspartame perception but were not replicated in the UK Biobank. A weak protective association between aspartame perception and cervical cancer (OR = 0·998, 95 % CI: 0·997, 0·999) was observed, but this attenuated to null in sensitivity analyses.

This study found no compelling evidence that perception of aspartame or NHDC during adolescence causally influences later-life cancer risk. The findings highlight the importance of evaluating individual artificial sweeteners separately in future research examining potential health effects.

Ocrelizumab (OCR) and rituximab (RTX) are anti-CD20 monoclonal antibodies (CD20Mabs) used in the treatment of relapsing multiple sclerosis (RMS). While both are effective at reducing relapses and new MRI lesions in clinical trials, real-world data on discontinuation rates and reasons for stopping therapy are limited.

This observational retrospective chart review included patients from two MS clinics in British Columbia, Canada. RMS patients treated with at least one infusion of OCR or RTX between January 2017 and March 2023 were included. Primary outcomes were reasons for discontinuation and discontinuation rates, with a secondary outcome of time to discontinuation.

In total, 881 RMS patients were included, with 478 on OCR and 403 on RTX. A total of 16.9% of patients on OCR and 14.9% on RTX discontinued therapy over 1643 and 694 patient-years, respectively (p = 0.46). Reasons for discontinuation included: side effects (33.3%), insurance coverage (17.0%) and clinical or radiological disease activity (11.3%). Discontinuation rates at 12, 24 and 36 months were 3.5%, 8.2% and 12.5% for OCR, and 6.4%, 14.8% and 22.2% for RTX, respectively (p = 0.0089). Median time to discontinuation was 21 months on OCR and 11.5 months on RTX (p < 0.0001). On Cox regression analysis, treatment with RTX was the only variable associated with discontinuation (hazard ratio 1.72, 95% CI 1.20–2.45).

Discontinuation rates of CD20Mabs were low, and the most common reason for stopping was side effects. Although not designed for comparison, our study suggests RMS patients may persist longer on OCR than RTX.

To assess the efficacy of intranasal cryotherapy to treat chronic rhinitis refractory to medical therapy.

An evaluation was performed for all patients (n = 36) with chronic rhinitis refractory to medical treatment who underwent intranasal cryotherapy between 2022 and 2024 at this centre. The primary outcome measures were changes in validated pre- and post-operative scoring systems (Total Nasal Symptom Score, Sino-Nasal Outcome Test 22 (SNOT-22), Nasal Obstruction Symptom Evaluation and peak inspiratory nasal flow).

Objective scoring pre- and post-procedure showed statistically significant improvement across all measures (p < 0.001): mean Total Nasal Symptom Score (12 hours) 8.4 to 5.3, Total Nasal Symptom Score (2 weeks) 9.2 to 5.9, SNOT-22 56 to 31, Nasal Obstruction Symptom Evaluation 57.5 to 28.5 and peak inspiratory nasal flow 98 to 138 l/min.

This is the only dataset for patients receiving intranasal cryotherapy in the UK to date and follows patients over a two-year period. The results support the ongoing use of intranasal cryotherapy for sustained treatment of refractory chronic rhinitis.

Nutrition plays a valuable role in health promotion and disease prevention. Nutrition education for healthcare professionals (HCPs) has been widely explored globally. However, it has not been investigated extensively within Ireland. This research aimed to assess references to nutrition within education programmes, accreditation curricula standards and registration requirements of professional bodies for primary care and community HCPs in Ireland.

A cross-sectional content analysis was conducted. Data collection was carried out in October 2024.

Ireland

A sample of primary care and community HCPs was included (n 10). An online search identified education programmes (undergraduate and postgraduate), accreditation curriculum standards and registration requirements from professional bodies governing primary care and community HCPs. Relevant webpages and documentation were reviewed to determine direct references to nutrition (e.g. ‘diet’, ‘nutrition’, ‘eating’, ‘food’) and/or indirect references to nutrition (e.g. ‘health promotion’ and ‘well-being’).

Out of fifty-two education programmes, 26·9 % (n 14) made direct reference to nutrition, with the majority (n 8) of these being postgraduate level. Furthermore, 20 % (n 2) of the HCP bodies referred directly to nutrition within their registration requirements (one of which was for dietitians), and 50 % (n 5) referred directly to nutrition within their accreditation standards.

This research demonstrates a sparsity of nutrition within key education standards for primary care and community HCPs in Ireland. Key recommendations include a call to action for formal and consistent embedding of nutrition within education for medical professionals in Ireland, in line with international best practice.