Background: Embryo implantation is a complex biological process which requires synchronized dialogue between the receptive endometrium and the blastocyst. The endometrium, however, is only receptive to embryo implantation for a very short period. Recurrent implantation failure (RIF) is a major challenge in assisted reproductive techniques mainly due to impaired receptivity, but there is still a need for a reliable and valid clinical test to assess endometrial receptiveness, especially at embryo transfer time. The aim of this review is to investigate what is currently known about the contribution of endometrial fluid (EF) to endometrial receptivity by identifying its potential biomarkers. Methods: This study involved an extensive search of the electronic databases PubMed and Cochrane, covering the period from 2011 to 2022. A combination of Medical Subject Headings with the terms 'endometrial fluid' and ‘embryo implantation’ was used. Results: Several different proteins presented in the endometrial cavity fluid have been described but the most consistent as potential biomarkers were Proprotein Convertase 6 (PC6), Vascular Endothelial Growth Factor (VEGF), PIGF (Placental growth factor), β3 integrin, Colony Stimulating Factor-3 (CSF-3), Leukaemia inhibitory factor (LIF), glycodelin and extracellular vesicles (EVs). Conclusions: Strong indicators support the use of uterine fluid collection as a non-invasive tool for receptivity assessment. Therefore, it could improve outcomes of assisted reproductive techniques.

To determine the diagnostic value of transvaginal ultrasonography and hysteroscopy in patients with postmenopausal bleeding.

Background/Objectives: Adverse pregnancy outcomes (APOs), which include hypertensive disorders of pregnancy (gestational hypertension, preeclampsia, and related disorders), gestational diabetes, preterm birth, fetal growth restriction, low birth weight, small-for-gestational-age newborn, placental abruption, and stillbirth, are health risks for pregnant women that can have fatal outcomes. This study’s aim is to investigate the usefulness of artificial intelligence (AI) in improving these outcomes and includes changes in the utilization of ultrasound, continuous monitoring, and an earlier prediction of complications, as well as being able to individualize processes and support clinical decision-making. This study evaluates the use of AI in improving at least one APO. Methods: PubMed, Web of Science, and Scopus databases were searched and limited to the English language, humans, and between 2020 and 2024. This scoping review included peer-reviewed articles across any study design. However, systematic reviews, meta-analyses, unpublished studies, and grey literature sources (e.g., reports and conference abstracts) were excluded. Studies were eligible for inclusion if they described the use of AI in improving APOs and the associated ethical issues. Results: Five studies met the inclusion criteria and were included in this scoping review. Although this review initially aimed to evaluate AI’s role across a wide range of APOs, including placental abruption and stillbirth, the five selected studies focused primarily on preterm birth, hypertensive disorders of pregnancy, and gestational diabetes. None of the included studies addressed placental abruption or stillbirth directly. The studies primarily utilized machine-learning models, including extreme gradient boosting (XGBoost) and random forest (RF), showing promising results in enhancing prenatal care and supporting clinical decision-making. Ethical considerations, including algorithmic bias, transparency, and the need for regulatory oversight, were highlighted as critical challenges. Conclusions: The application of these tools can improve prenatal care by predicting obstetric complications, but ethics and transparency are pivotal. Empathy and humanization in healthcare must remain fundamental, and flexible training mechanisms are needed to keep up with rapid innovation. AI offers an opportunity to support, not replace, the doctor–patient relationship and must be subject to strict legislation if it is to be used safely and fairly.

Background: Compulsory treatments represent a legal means of imposing treatment on an individual, usually with a mental illness, who refuses therapeutic intervention and poses a risk of self-harm or harm to others. Compulsory outpatient treatment (COT) in psychiatry, also known as community treatment order, is a modality of involuntary treatment that broadens the therapeutic imposition beyond hospitalization and into the community. Despite its existence in over 75 jurisdictions worldwide, COT is currently one of the most controversial topics in psychiatry, and it presents significant ethical challenges. Nonetheless, the ethical debate regarding compulsory treatment almost always stops at a preclinical level, with the different ethical positions arguing for or against its use, and there is little guidance to support for the individual clinicians to act ethically when making the decision to implement COT. Main body: The current body of evidence is not clear about the efficacy of COT. Therefore, despite its application in several countries, evidence favouring the use of COT is controversial and mixed at best. In these unclear circumstances, ethical guidance becomes paramount. This paper provides an ethical analysis of use of COT, considering the principlist framework established by Ross Upshur in 2002 to justify public health interventions during the 2002–2004 severe acute respiratory syndrome outbreak. This paper thoroughly examines the pertinence of using the principles of harm, proportionality, reciprocity, and transparency when considering the initiation of COT. Conclusion: Ross Upshur’s principlist model provides a useful reflection tool for justifying the application of COT. This framework may help to inform sounder ethical decisions in clinical psychiatric practice.

Resource Allocation During the COVID-19 Pandemic: Contributions to an Ethical Approach