Intensive epigenome and transcriptome analyses have unveiled numerous biological mechanisms, including the regulation of cell differentiation, proliferation, and induced apoptosis in neoplastic cells, as well as the modulation of the antineoplastic action of the immune system, which plausibly explains the observed population-based relationship between low vitamin D status and increased cancer risk. However, large randomized clinical trials involving cholecalciferol supplementation have so far failed to show the potential of such interventions in cancer prevention. In this article, we attempt to reconcile the supposed contradiction of these findings by undertaking a thorough review of the literature, including an assessment of the limitations in the design, conduct, and analysis of the studies conducted thus far. We examine the long-standing dilemma of whether the beneficial effects of vitamin D levels increase significantly above a critical threshold or if the conjecture is valid that an increase in available cholecalciferol translates directly into an increase in calcitriol activity. In addition, we try to shed light on the high interindividual epigenetic and transcriptomic variability in response to cholecalciferol supplementation. Moreover, we critically review the standards of interpretation of the available study results and propose criteria that could allow us to reach sound conclusions in this field. Finally, we advocate for options tailored to individual vitamin D needs, combined with a comprehensive intervention that favors prevention through a healthy environment and responsible health behaviors.

Background: Forecasting the behavior of epidemic outbreaks is vital in public health. This makes it possible to anticipate the planning and organization of the health system, as well as possible restrictive or preventive measures. During the COVID-19 pandemic, this need for prediction has been crucial. This paper attempts to characterize the alternative models that were applied in the first wave of this pandemic context, trying to shed light that could help to understand them for future practical applications. Methods: A systematic literature search was performed in standardized bibliographic repertoires, using keywords and Boolean operators to refine the findings, and selecting articles according to the main PRISMA 2020 statement recommendations. Results: After identifying models used throughout the first wave of this pandemic (between March and June 2020), we begin by examining standard data-driven epidemiological models, including studies applying models such as SIR (Susceptible-Infected-Recovered), SQUIDER, SEIR, time-dependent SIR, and other alternatives. For data-driven methods, we identify experiences using autoregressive integrated moving average (ARIMA), evolutionary genetic programming machine learning, short-term memory (LSTM), and global epidemic and mobility models. Conclusions: The COVID-19 pandemic has led to intensive and evolving use of alternative infectious disease prediction models. At this point it is not easy to decide which prediction method is the best in a generic way. Moreover, although models such as the LSTM emerge as remarkably versatile and useful, the practical applicability of the alternatives depends on the specific context of the underlying variable and on the information of the target to be prioritized. In addition, the robustness of the assessment is conditioned by heterogeneity in the quality of information sources and differences in the characteristics of disease control interventions. Further comprehensive comparison of the performance of models in comparable situations, assessing their predictive validity, is needed. This will help determine the most reliable and practical methods for application in future outbreaks and eventual pandemics.

Study Design.: Randomized clinical trial. Objective.: To compare the effect on quality of life of night-time (NT) and full-time (FT) brace treatment for adolescent idiopathic scoliosis (AIS). Summary of Background Data.: Conservative treatment of adolescent idiopathic scoliosis (AIS) with full-time (FT) braces has proven to prevent the risk of progression and the need for surgery, with an inversely proportional relationship to the number of hours worn. However, therapeutic adherence and its effect on quality of life continue to pose a clinical challenge. Materials and Methods.: Open-label clinical trial including AIS patients with curves between 25-45 degrees randomized to either NT or FT brace group. Follow-up occurred over two years, assessing treatment efficacy through radiographs and quality of life using SRS-22 and visual analog scale (VAS) questionnaires scores at baseline, 6 months, and 12 months. Compliance was monitored with thermal sensors every three months. Statistical analyses were conducted, with significance set at P < 0.05. Results.: 78 AIS patients, predominantly females (85.9%), were recruited, including 35 (44.87%) in FT group and 43 (55.13%) in NT. Initial Cobb angles were comparable between groups. Nine patients were excluded, and eight required surgery (NT 12.82%, FT 10%). After two years, both braces showed similar effectiveness in preventing curve progression. No differences on SRS-22 nor VAS scores were found before treatment. At six-month follow-up, NT group reported significantly better outcomes in “Self-image” compared to FT (P=0.047). After one year, NT patients reported less pain compared to baseline (P=0.048) Conclusions.: According to our results, both braces are equally effective in avoiding the progression of the deformity and need for surgery. However, FT brace has a higher impact on self-image and pain compared to NT brace.

Müller-Weiss disease (MWD) is a rare anomaly of the tarsal scaphoid. Maceira and Rochera proposed the most commonly accepted etiopathogenic theory, in which dysplastic, mechanical, and socioeconomic environmental factors would be involved. The aim is to describe the clinical and sociodemographic characteristics of patients with MWD in our setting, corroborate their association with the socioeconomic factors previously described, estimate the influence of other factors involved in the development of MWD, and describe the treatment carried out. Retrospective study of 60 patients diagnosed with MWD in 2 tertiary hospitals of Valencia (Spain) between 2010 and 2021. Sixty patients were included, 21 (35.0%) men and 39 (65.0%) women. In 29 (47.5%) cases, the disease was bilateral. The mean age of onset of symptomatology was 41.9±20.3 years. During childhood, 36 (60.0%) patients suffered migratory movements, and 26 (43.3%) had dental problems. The mean age of onset was 14.6±4.5 years. Thirty-five (58.3%) cases were treated orthopedically versus 25 (41.7%) treated surgically, 11 (18.3%) by calcaneal osteotomy, and 14 (23.3%) with arthrodesis. As in the series of Maceira and Rochera, we found a higher prevalence of MWD among those born around the Spanish Civil War and the period of massive migratory movements that occurred in the fifth decade of the 20th century. Treatment is still not well established.

Introduction and aim: Minimally invasive surgery (MIS) of the spine prevents the collapse of osteoporotic vertebral fractures (OVF) with lower complication and bleeding rates than open surgery. However, the possibility of hidden blood loss (HBL) has been recently described, referring to the loss of blood diffused into tissues and lost through hemolysis. This study aimed to estimate the postoperative impact of HBL in patients undergoing MIS for OVF. Materials and methods: This was a retrospective study of a series of patients who had MIS for OVF. A descriptive analysis of recorded variables was performed, and total blood volume (TBV), total bleeding (TB), HBL, and Hb drop were calculated. This was followed by a comparative analysis between HBL (<500 mL vs. ≥500 mL) and the variables of hospital stay and postoperative evolution. Binary logistic regression models were performed to rule out confounding factors. Results: A total of 40 patients were included, 8 men and 32 women, with a mean age of 76.6 years. The mean HBL was 682.5 mL. An HBL greater than 500 mL is found to be an independent risk factor for torpid postoperative evolution (p = 0.035), while it does not predict a longer hospital stay (p = 0,116). In addition, a higher HBL was observed in surgeries of greater technical complexity and longer surgical time. Conclusions: Although MIS techniques have shown less intraoperative bleeding than open surgery, HBL should be diagnosed because it is associated with a torpid evolution. The use of a diagnostic and therapeutic algorithm may help minimize its impact. Antecedentes y objetivo: La cirugía mínimamente invasiva (MIS) de columna previene el colapso de las fracturas vertebrales osteoporóticas (FVO) con menores tasas de complicaciones y sangrado que la cirugía abierta. Sin embargo, recientemente se ha descrito la posibilidad de sangrado oculto (SO) intraoperatorio, que hace referencia a la pérdida de sangre difundida en los tejidos, y que se pierde por hemólisis. Se pretende estimar el impacto del SO en pacientes sometidos a cirugía MIS por FVO. Material y métodos: Estudio retrospectivo de una serie de pacientes intervenidos mediante cirugía MIS por FVO. Se realizó un análisis descriptivo de las variables recogidas y se calcularon el volumen sanguíneo total (VST), el sangrado total (ST), el SO y la caída de Hb. A continuación, se realizó un análisis comparativo entre el SO (<500 mL frente a ≥500 mL) y las variables de estancia hospitalaria y evolución postoperatoria. Se realizaron modelos de regresión logística binaria para descartar factores de confusión. Resultados: Se incluyeron 40 pacientes, 8 hombres y 32 mujeres, con una edad media de 76,6 años. El SO medio fue de 682,5 ml. Se observó que un SO superior a 500 mL es un factor de riesgo independiente de padecer una evolución postoperatoria tórpida (p = 0,035), mientras que no predice una mayor estancia hospitalaria (p = 0,116). Se calculó un mayor SO en cirugías de mayor complejidad técnica y mayor tiempo quirúrgico. Conclusiones: Aunque las técnicas MIS han demostrado menor sangrado intraoperatorio, el SO debe ser diagnosticado porque se asocia a una evolución tórpida. El uso de un algoritmo diagnóstico y terapéutico puede ayudar a minimizar su impacto.