Influenza is a respiratory disease caused by the influenza virus, which is highly transmissible in humans. This paper presents a systematic review and meta-analysis of randomized controlled trials (RCTs) and test-negative designs (TNDs) to assess the vaccine effectiveness (VE) of seasonal influenza vaccines (SIVs) in humans aged 15 to 64 years. An electronic search to identify all relevant studies was performed. The outcome measure of interest was VE on laboratory-confirmed influenza (any strain). Quality assessment was performed using the Cochrane risk-of-bias tool for RCTs and the ROBINS-I tool for TNDs. The search identified a total of 2993 records, but only 123 studies from 73 papers were included in the meta-analysis. Of these studies, 9 were RCTs and 116 were TNDs. The pooled VE was 48% (95% CI: 42–54) for RCTs, 55.4% (95% CI: 43.2–64.9) when there was a match between the vaccine and most prevalent circulating strains and 39.3% (95% CI: 23.5–51.9) otherwise. The TNDs’ adjusted VE was equal to 39.9% (95% CI: 31–48), 45.1 (95% CI: 38.7–50.8) when there was a match and 35.1 (95% CI: 29.0–40.7) otherwise. The match between strains included in the vaccine and strains in circulation is the most important factor in the VE. It increases by more than 25% when there is a match with the most prevalent circulating strains. The laboratorial method for confirmation of influenza is a possible source of bias when estimating VE.

To evaluate the association between the endometriosis staging and the type and intensity of pain reported by patients, describing the pain intensity across different pain types. On January 27, 2025, a systematic search was conducted in PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. The search terms included endometriosis, pain, dysmenorrhea, dyspareunia, pelvic pain, dyschezia, dysuria, and classification. Eligible studies examined women with endometriosis, assessing how endometriosis staging (rASRM or ENZIAN classification) correlated with pain symptoms (dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain) measured with validated tools. Two reviewers extracted data independently, with a third verifying results. Pain scores were log-transformed to stabilize variance, and proportions of women with advanced endometriosis were analyzed on the logit scale. Given high heterogeneity, random-effects models with restricted maximum likelihood were used. Of 2527 records, 112 studies were reviewed and eight met inclusion criteria (seven using rASRM, one using ENZIAN). Dysmenorrhea showed the highest mean intensity (6.61, 95% CI: 4.43-10.10), while dysuria was lowest (1.08, 95% CI: 0.62-1.89). Pain intensity did not differ significantly between rASRM stages I/II and III/IV (p > 0.05), though chronic pelvic pain was more frequent in advanced disease (p < 0.05). Dysmenorrhea is linked to higher pain intensity in women with endometriosis, while dysuria is linked to lower intensity. Pain intensity is not associated with the rASRM stage; however, chronic pelvic pain seems more prevalent in advanced stages of the disease.

Background: Non-communicable diseases are a global health problem. The metric Disability-Adjusted Life Years was developed to measure its impact on health systems. This metric makes it possible to understand a disease’s burden, towards defining healthcare policies. This research analysed the effect of healthcare expenditures in the evolution of disability-adjusted life years for non-communicable diseases in the European Union between 2000 and 2019.Methods: Data were collected for all 27 European Union countries from Global Burden of Disease 2019, Global Health Expenditure, and EUROSTAT databases. Econometric panel data models were used to assess the impact of healthcare expenses on the disability-adjusted life years. Only models with a coefficient of determination equal to or higher than 10% were analysed.Results: There was a decrease in the non-communicable diseases with the highest disability-adjusted life years: cardiovascular diseases (−2,952 years/10⁵ inhabitants) and neoplasms (−618 years/10⁵ inhabitants). Health expenditure significantly decreased disability-adjusted life years for all analysed diseases (p < 0.01) unless for musculoskeletal disorders. Private health expenditure did not show a significant effect on neurological and musculoskeletal disorders (p > 0.05) whereas public health expenditure did not significantly influence skin and subcutaneous diseases (p > 0.05).Conclusion: Health expenditure have proved to be effective in the reduction of several diseases. However, some categories such as musculoskeletal and mental disorders must be a priority for health policies in the future since, despite their low mortality, they can present high morbidity and disability.

Beer is considered one of the most consumed beverages worldwide and a potential vehicle for probiotics. However, there are several technical challenges to overcome during the production and storage of beers, as probiotics must remain viable until the moment of consumption. Therefore, this work aims to discuss how the incorporation of probiotics improves or adds value to beer and which variables influence the viability of the process. This is a narrative review of the literature with research in the PubMed, Web of Science, and b-on databases for articles related to the incorporation of probiotics in beer and the variables that influence the process. The results demonstrated that the incorporation of probiotics into beer faces technical challenges such as probiotic selection, pH, the presence of alcohol, and beer’s production and storage temperatures. However, strategies such as immobilizing probiotics in alginate, alginate–silica, and durian husk powder, fermentation with the yeast Saccharomyces cerevisiae var. boulardii, and co-fermentation with probiotics permit us to overcome these barriers. Thus, incorporating probiotics into beer brings added value, potentially increasing antioxidant activity and phenolic compound content and providing unique flavors and aromas. Nevertheless, strict control of the technical conditions involved is necessary to ensure probiotic viability and the health benefits they confer.

We investigate Gaussian mixtures with independent components, whose parameters are numerically estimated. A decomposition of a Gaussian mixture is presented when the components have a common variance. We introduce a shifted and scaled t-Student distribution as an approximation for the distribution of Gaussian mixtures when their components have a common mean and develop a hypothesis test for testing the equality of the components means. Finally, we analyse the fitness of the approximate model to the logarithmic daily returns of the Portuguese stock index PSI-20.

Aims: This study evaluated the 10‐year consumption and economic patterns of classical analgesics, adjuvants and opioids in Portugal (2012‐2022), and conducted a comparative analysis between Portugal, Spain and Denmark to explore the consumption patterns among these countries for 2022.Methods: Data on sales and national health service (NHS) costs were obtained from the Portuguese National Authority of Medicines and Health Products. Sales data were converted to defined daily dose (DDD) per 1000 inhabitants per day according to the Anatomical Therapeutic Chemical (ATC) classification/DDD methodology, while comparisons between Spain and Denmark were evaluated with the chi‐square test, when appropriate.Results: The findings reveal that classical analgesics use in Portugal remained stable during the period 2012‐2022, with ibuprofen being the most consumed. Adjuvants, specifically gabapentinoids, experienced an 84% increase in use, primarily attributed to pregabalin. Weak opioids, led by tramadol, witnessed a 117% rise in use, while strong opioid use, led by tapentadol, increased by 618%. Portugal presented the lowest overall opioid consumption when compared to Denmark and Spain in 2022. Economic trends indicated a heightened NHS expenditure on analgesics, primarily driven by increased opioid use. Notwithstanding, there was no significant burden on relative expenditure over the 10‐year period.Conclusions: Portugal presented a major increase in both weak and strong opioid prescriptions, aligning with the trends for Spain and Denmark. The development and approval of generic medicines and vigilant market monitoring are imperative strategies for managing the escalated costs resulting from heightened consumption, particularly concerning opioids.