Objective: To map and synthesize the published literature on the epidemiological burden of urinary tract infections (UTIs) in adults with spinal cord injury (SCI) or multiple sclerosis (MS) using intermittent catheterization (IC). Methods: We conducted a comprehensive literature review following PRISMA guidelines, searching PubMed, Scopus, and Web of Science for studies published since 2014. A total of 30 studies met the inclusion criteria. Results: Reported UTI incidence varied widely from 24% to 93.1%, highlighting significant heterogeneity across the evidence base. Annually, 15–17% of patients experienced 4–6 UTIs, and up to 16.4% required hospitalization for UTI-related complications. A critical evidence gap was exposed, with only one study focusing specifically on the MS population. Conclusions: Despite its clinical benefits, IC remains underutilized and inconsistently supported. Addressing systemic delivery gaps is essential. UTIs in neurogenic bladder care should be recognized as a modifiable public health issue requiring equity-driven interventions and strengthened implementation frameworks. This review underscores the urgent need for methodologically rigorous research to establish clear best practices.

Background Psychiatric medicine presents unique diagnostic and therapeutic challenges, often involving multimorbidity, polypharmacy, and atypical presentations requiring complex reasoning. Artificial Intelligence, particularly Large Language Models (LLMs), is emerging as a support tool in these settings. However, the clinical validity, interpretability, and reliability of LLMs in psychiatry remain largely unexplored, particularly their ability to generate transparent, guideline-consistent reasoning. Aims This study evaluates the clinical reasoning capabilities of LLMs in complex psychiatric scenarios. The primary aim is to assess the validity of their long chain-of-thought (CoT) reasoning. A secondary aim is to determine whether LLM assistance improves clinicians’ diagnostic accuracy. Method Three LLMs, Gemini 2.5, Grok, and DeepSeek R1, will be assessed using ten complex psychiatric cases sourced from a non-public clinical manual and rated with the Amsterdam Clinical Challenge Scale. Each model's CoT response will be evaluated by blinded panels of psychiatrists, residents, and general practitioners using standardized metrics for factual accuracy, coherence, and medical plausibility. In a second phase, clinicians will answer thirty diagnostic questions with and without support from the best-performing LLM. The study uses step-by-step reasoning prompts and few-shot examples to elicit detailed responses and includes bias mitigation strategies such as randomization, blinding, and statistical controls. Results Analyses will assess inter-rater reliability, metric redundancy, and reasoning quality. Closed-source models are expected to outperform open-source ones. LLM assistance is anticipated to improve diagnostic accuracy, especially among non-specialists. Conclusions This study provides a framework for evaluating LLMs in psychiatry and supporting their safe, evidence-based integration into mental health practice.

Polygenic Risk Scores (PRS) represent a promising adjunct to established breast cancer risk prediction models, including the multifactorial CanRisk model. Despite growing evidence, data on the feasibility of integrating PRS into routine hereditary breast cancer assessment remain scarce, particularly within European clinical pathways. Systematic evaluation of operational requirements, patient and provider acceptability, and organizational impact is essential prior to any broader implementation. This single-arm feasibility study will be conducted at Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Rome, Italy) and is expected to enrol approximately 700 women attending the Medical Genetics Clinic. Eligible participants comprise: unaffected women with a documented family history of breast cancer or known pathogenic variants associated with hereditary breast cancer predisposition; women with unilateral breast cancer undergoing oncogenetic counseling for contralateral risk assessment. All participants will be offered testing for pathogenic variants in breast cancer predisposition genes and PRS, and integrated risk estimates will be generated using the CanRisk model. The primary outcome is the feasibility of implementing PRS within the clinical workflow, assessed through a validated questionnaire administered to participants and healthcare professionals. Secondary outcomes include PRS uptake, perceptions of the integrated pathway, impact on risk category reclassification, and qualitative insights into risk communication processes. This study will generate empirical evidence on the operational, organizational, and perceptual considerations associated with incorporating PRS-enhanced risk assessment into hereditary breast cancer services in Italy. By characterizing feasibility and acceptability, the findings will support the refinement of clinical pathways and inform the sustainable integration of PRS into routine preventive care.