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Type d'Item : Item , Equipping the next generation: addressing the unmet need for artificial intelligence education at research performing organizations(2026-10-16) Ng, Jeremy Y.; Al-Khafaji, Wid A.; Moher, DavidAbstract Background The integration of generative artificial intelligence (GenAI) tools into higher education is rapidly accelerating, yet the educational ecosystem appears largely unprepared for the scale and speed of adoption. Our recent international survey of over 1,200 university students and postdoctoral fellows in the medical and life sciences found that while more than 80% had used GenAI tools, the vast majority had received no formal training, and many were unaware of any institutional policies governing their use. This gap between adoption and institutional preparedness may pose risks to research integrity if left unaddressed. Main body Existing research supports a coordinated, evidence-informed approach to AI education in research performing organizations (RPOs), grounded in principles of research integrity, equity, and critical engagement with technology. First, GenAI literacy must be embedded as a core competency in scientific and clinical education, equipping students to critically evaluate tool outputs, recognize hallucination and bias, and understand the distinction between AI-generated inaccuracy and deliberate research misconduct. Second, traditional frameworks for academic integrity would benefit from re-examination. Today, GenAI tools have fundamentally disrupted established notions of authorship, originality, and plagiarism, and the absence of coherent institutional guidance leaves students and educators navigating these questions without support. Third, RPOs must develop clear, transparent, and context-sensitive policies on GenAI use by embedding responsible AI education into curricula, equipping learners not only to use these tools effectively, but to question, verify, and critique their outputs in ways that uphold scientific standards. Conclusion RPOs have an urgent responsibility to move beyond reactive responses and toward proactive strategies that uphold scientific standards, promote equity of access, and prepare the next generation of researchers and clinicians to engage with GenAI responsibly and ethically.Type d'Item : Item , Performance status and outcomes in patients with cancer receiving thromboprophylaxis: a subanalysis of the AVERT trial(2026-07-22) Potere, Nicola; Xu, Yan; Mallick, Ranjeeta; Wang, Tzu-Fei; Hill, Danny; Lazo-Langner, Alejandro; Tagalakis, Vicky; Shivakumar, Sudeep; Di Nisio, Marcello; Wells, Philip S.; Carrier, MarcAbstract Background The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is central to cancer care planning and prognostication. Whether ECOG-PS also carries prognostic value in the setting of primary thromboprophylaxis for cancer-associated venous thromboembolism (VTE) remains unknown. Objectives To evaluate the impact of ECOG-PS on clinical outcomes in ambulatory patients with cancer initiating chemotherapy. Methods This was a post-hoc analysis of the AVERT randomized controlled trial that evaluated apixaban (2.5 mg twice daily) for thromboprophylaxis in patients at intermediate-to-high VTE risk. Multivariable survival models assessed the association between ECOG-PS (0–1 versus 2–3) and the composite primary outcome of VTE or clinically relevant bleeding (CRB), as well as its individual components and all-cause mortality, over 180 days. Results Of 428 patients included, 368 (86.0%) and 60 (14.0%) had an ECOG-PS of 0–1 and 2–3, respectively. The primary composite outcome occurred in 12.8% (n = 47) in those with ECOG 0–1 and 18.3% (n = 11) with ECOG-PS 2–3 (6-month cumulative incidence: 13.0% [95% CI: 9.8%–16.7%] versus 19.9% [95% CI: 10.5%–31.4%], respectively). Worse performance status was associated with higher risks for the composite outcome (aHR: 1.76; 95% CI: 1.14–2.72; p = 0.011), CRB (aHR: 1.58; 95%CI: 1.53–1.63; p < 0.0001), and all-cause mortality (aHR: 5.77; 95% CI: 4.98–6.67; p < 0.0001). In exploratory treatment-effect analyses, apixaban reduced VTE risk across ECOG-PS strata, including among participants with ECOG-PS 2–3, without clear evidence of excess CRB in this subgroup. Conclusions ECOG-PS predicts VTE-related outcomes in ambulatory patients with cancer and may inform individualized, value-based shared decision-making regarding anticoagulant thromboprophylaxis. Graphical AbstractType d'Item : Item , Duration of untreated illness in eating disorders: a comprehensive systematic review and meta-regression(2026-08-19) de Geus, Gyselle; Trott, Mike; Monteleone, Alessio M.; Firth, Joseph; Siskind, Dan; Teasdale, Scott; Arnautovska, Urska; Iyer, Ravi; Stubbs, Brendon; Demidenko, Natasha; Martin, David; Antochi, Ruxandra; Fiedorowicz, Jess G.; Austin, Amelia; Schmidt, Ulrike; Wade, Tracey; Fernandez-Aranda, Fernando; Herpertz-Dahlmann, Beate; Hoek, Hans W.; Voderholzer, Ulrich; Kolar, David; Zipfel, Stephan; Pike, Kathleen M.; Karwautz, Andreas; Wonderlich, Stephen; Smith, Lee; Carfagno, Marco; Solmi, MarcoAbstract Introduction Eating disorders (EDs) substantially impair physical health, psychological well-being, and social functioning. Shorter untreated illness duration has been proposed to be associated with better outcomes, though evidence for this relationship remains mixed. Nonetheless, delays in accessing treatment remain common and contribute to prolonged suffering and risk of lasting harm. This study aimed to estimate the duration of untreated eating disorder (DUED) and examine potential moderators. Methods A PRISMA 2020-compliant systematic review and meta-analysis was conducted. Searches were performed from inception to March 2026 in PubMed, Embase, PsycINFO, and CINAHL. Random-effects models were used to estimate pooled DUED of available studies, with subgroup and meta-regression analyses to explore moderators. Study quality and risk of bias were assessed using National Institutes of Health (NIH) tools. Results Of 2,776 records identified, 29 studies (n = 17,433) were included. The pooled DUED of available studies was 21.9 months (95% CI 18.0–25.8), with substantial heterogeneity (I² = 99.7%). In subgroup analyses, DUED was longer in bulimia nervosa than anorexia nervosa (41.5 vs. 19.9 months). Meta-regression identified mean age as a significant moderator (β = 1.91, 95% CI 1.1 to 2.7, p < 0.001), indicating longer delays in older individuals. DUED also differed across country, continent, age group, and study design, while decade subgroup estimates were lower in studies from the 2020s than the 2010s. Conclusion Individuals with EDs experience substantial delays before accessing treatment, with untreated illness exceeding 20 months on average. Older age was associated with longer DUED, suggesting potential gaps in detection and help-seeking among adults. DUED varies across demographic, geographic and methodological factors. While decreasing DUED over time is encouraging, these findings highlight the need for earlier identification and streamlined care pathways to reduce delays and improve outcomes in people with ED.Type d'Item : Item , African recommendations for diagnosis and management of systemic juvenile idiopathic arthritis (sJIA) – a PAFLAR initiative(2026-10-13) Hashad, Soad; Migowa, Angela N.; Seri, Ahmed; Gacem, Ourida; Sobh, Ali; Etayari, Hala; Almsillati, Eman A.; Ravelli, Angelo; Quartier, Pierre; Faleye, Ayodele; Hassan, Waleed; Mosad, Doaa; Palalane, Elisa; Teferi, Temesgen; Fuseini, Yaninga H.; Hassan, Mohammed; Lishan, Hanna; Messadi, Wassila; Ngandeu, Madeleine; Taha, Yassmin; Hamdi, Wafa; Ismail, Samah; Ferjani, Hanane L.; Dahou, Chafia M.; Makhlouf, Yasmine; Slimani, Samy; Scott, Christiaan; Hadef, DjohraAbstract Objectives To develop evidence-based recommendations for diagnosis and treatment of children and adolescents with systemic juvenile idiopathic arthritis (sJIA), taking into consideration the socioeconomic status and availability of medications in African countries. Methods A steering group composed of five PAFLAR members formulated questions in PICO format (Patient/Population, Intervention, Comparison, Outcome), conducted a systematic literature review, and identified experts in pediatric rheumatology throughout Africa. The Delphi method was used to reach consensus among the experts on the recommendations for diagnosis and treatment of sJIA patients. Results The online Delphi questionnaire was sent to the 22 experts selected by the steering committee, who were asked to vote for each statement and to provide their suggestions for modifications or rewording. A 100% response rate was obtained. A minimum agreement of 70% among the voting panel was required. A total of 15 recommendations were formulated, 4 regarding diagnosis and 11 regarding treatment. The percentage of agreement with the recommendations ranged from 72.7% to 95%. Conclusion We present the first African recommendations for diagnosis and management of sJIA. The feedback about the application of these recommendations in pediatric rheumatology centers will serve as the basis for future revisions in the light of African-specific experiences and insights.Type d'Item : Item , Effects and moderators of a 16-week intervention on contextual physical activity in adults with moderate to severe depressive symptoms: short and long-term results of a randomized clinical trial(2026-07-21) Bertuol, Cecília; Silva, Kelly S.; Veber Lopes, Marcus V.; Kazimoto Alves, Deborah; Soares da Silva, Caroline; Baggio do Amaral, Marcelo; Ribeiro Streb, Anne; Firpo Del Duca, GiovaniAbstract Background Depression is associated with reduced physical activity (PA), and evidence on the long-term effects of interventions and their potential moderators remains limited. Thus, this study aimed to evaluate the short- (post-intervention) and long-term (six-month follow-up) effects of a PA-promoting intervention on contextual PA and to explore potential moderators in adults with depressive symptoms. Methods A randomized, controlled, and assessor-blinded clinical trial was conducted with adults presenting depressive symptoms. The intervention lasted 16 weeks, with two sessions per week. Strategies were grounded in Self-Determination Theory and aimed to increase participants’ awareness of their lifestyle, primarily focusing on PA and its relationship with depression. Activities included lectures, group discussions, interactive activities with family and friends, and PA practices in different contexts. Intensity-specific PA was assessed using wrist-worn accelerometers, and contextual PA (by type and domain) was self-reported. Generalized estimating equations were used to assess intervention effects. Potential moderators (sex and age) were examined in exploratory analyses using three-way interaction terms. Results A total of 78 individuals (76.9% women, mean age 37.5 ± 10.2) were equally randomized into control (CG) and intervention (IG) groups. No significant group-by-time interactions were identified in the intention-to-treat analyses. However, per-protocol analysis suggested that the intervention increased leisure-time PA compared to controls (p = 0.004), with short-term increases (between-group changes of 119.6 min/week) and maintenance at follow-up (83.6 min/week). Exploratory moderator analyses indicated potential differences in intervention effects according to sex and age. Conclusion Although no significant effects were identified in the intention-to-treat analyses, per-protocol findings suggested potential increases in leisure-time PA among participants with higher adherence. Exploratory findings indicate possible variation according to sex and age, but these results should be interpreted with caution and considered hypothesis-generating. Overall, the findings highlight the importance of strategies to improve adherence in PA interventions targeting adults with depressive symptoms. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR7466htj, April, 17 2023. Retrospectively registered.