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Sleep disturbances and sexual dysfunction are highly prevalent during the menopausal transition. Although traditionally both conditions are linked to hormonal decline and vasomotor symptoms, growing evidence highlights the central role of pre sleep cognitive activity (PSCA) in sleep disturbances, including rumination, worry and intrusive thoughts. Disruption of circadian rhythms further intensifies sleep fragmentation, with consequences for cognition, mood and sexual function. This review synthesizes current evidence on cognitive hyperarousal in menopausal women by integrating hormonal, circadian and psychosocial mechanisms, and examines implications for sleep and sexual health. A narrative synthesis across cognitive science, sleep medicine, neuroendocrinology and chronobiology suggests that PSCA, contributes meaningfully to insomnia during menopause. Evidence indicates that PSCA may interact with vasomotor symptoms and circadian irregularities, amplifying vulnerability to persistent sleep disruption. These sleep related mechanisms can influence sexual health through pathways involving hormonal fluctuation, fatigue and cognitive intrusiveness. Cognitive based interventions, including CBT I, mindfulness and selected cognitive techniques, such as imagery distraction, paradoxical intention and the cognitive shuffle, have shown efficacy in reducing PSCA and improving sleep continuity. Although these approaches hold promise, menopause specific adaptations and targeted evaluations remain limited in the current literature in respect of sexual health. Addressing cognitive hyperarousal and circadian disruption offers an opportunity to complement traditional pharmacological approaches for menopausal insomnia. Integrated non-pharmacological strategies may improve sleep quality, circadian alignment and sexual health in midlife women. Future research should prioritize the development of menopause specific cognitive circadian models, objective assessments of PSCA and scalable digital interventions tailored to this population.

Abstract Background According to the Clinical & Laboratory Standards Institute (CLSI) guideline, Point of Care technology (POCT) refers to devices used to provide clinical parameters at the site of a patient care or its proximity, allowing faster test results and improving medical response. However, the improvement in clinical outcomes depends on how healthcare professionals utilize this advantage and the performance of the chosen system. With a vast and growing scope, POCT devices enable the analysis of a wide range of analytes, including cardiac markers, coagulation markers, glucose, blood gases, chemical and metabolic parameters, among others. The Stat Profile Prime® analyzer, which exhibits POCT characteristics, offers benefits to patient care, especially during emergency periods and in restricted situations related to patient movement for conducting tests. In this context, the analytical verification of the device is important to clarify the process, the risks associated with the use of the equipment as well as suitability for the intended use. Moreover, performance evaluation ensures the quality and safety of the results obtained from the tests carried out. This study aimed to evaluate the performance of the POCT Stat Profile Prime equipment to measure blood gases and metabolic parameters. Methods Verification tests were conducted between October and December 2024 based on the CLSI-POCT09-A protocol. Precision study was assayed using three commercial control levels, used to monitor the performance of the Stat Profile Prime (Prime Auto QC Cartridge CCS), in quintuplicate over 5 days, for the quantitative determination of the parameters pH, PCO2, PO2, Htc, Na+, K+, Cl-, iCa, Gli (glucose), and Lac (lactate). The acceptance criteria for this analysis included the coefficient of variation (CV) or standard deviation (SD) according to the manufacturer*s specifications. For the comparative study, two sample groups were used: 42 heparinized whole blood samples and 34 serum samples for iCa. Both sample groups were tested on the Gem 3500 (Werfen) and Stat Profile Prime (Nova Biomedical) instruments. The allowable total error and correlation (r = 0.95) were considered approval criteria for the major of tested analytes and Kappa index (= 75%) for Htc. The linearity study was determined using four levels of the linearity standards (Nova Linearity Levels set), which were processed in three replicates, with the expected correlation of r = 0.99. Results The precision tests performed with 3 control levels showed a confidence interval greater than 95% and SD and CV close to the values specified by the manufacturer, indicating satisfactory performance for all evaluated parameters. In the comparative study, the tested parameters showed a correlation = 0.95, displaying 95% of the results within the total allowable error (TEa), and a Kappa index of 79.3% for Htc. According to quality specifications, the parameters from linearity study demonstrated a correlation = 0.99. Conclusion The Stat Profile Prime device demonstrated reliable performance and verification data in accordance with quality standards, ensuring safety and efficiency for clinical use. Furthermore, as a POCT, the equipment provides prompt and accurate results, which is crucial in a hospital environment, improving patient care.

Abstract Background Gestational trophoblastic disease (GTD) encompasses a group of diseases diagnosed during pregnancy. Hydatidiform mole (HM) refers to premalignant disorders where villi contain excess paternal genetic material, either due to complete absence of maternal material (complete molar pregnancy) or excess paternal material combined with maternal material (partial molar pregnancy). Complete mole (CHM) has a higher malignant potential than partial mole (PHM). Gestational trophoblastic neoplasia includes invasive mole, choriocarcinoma, placental site trophoblastic tumor (PSTT), and epithelioid trophoblastic tumor. Diagnosing GTD can be difficult with curettage material, requiring correlation with serum beta-hCG levels and radiological findings. CHM typically shows severe villous swelling resembling a bunch of grapes and usually lacks an embryo, while PHM has less swelling and usually contains an embryo. If CHM or PHM invades the myometrium, it is classified as invasive mole. After HM, full-term pregnancy, miscarriage, or ectopic pregnancy may follow. Choriocarcinoma may arise after a miscarriage or full-term pregnancy and appear years later with metastases, elevated beta-hCG levels, and normal pelvic ultrasound. Pathological diagnosis may not always distinguish PHM from CHM, with reports often stating HM without specifying whether it is complete or partial. This study aims to analyze cases identified by pathological anatomy (PA), types of CHM, PHM, (histologically undefined hydatidiform mole) HUHM, and beta-hCG levels before and 30 days after PA. Methods The authors analyzed of 2019 to 2024, 316 cases of women who had undergone pathological examination (PA) of HM and beta-hCG levels before and after 30 days of the procedure. The ages ranged from 19 to 34 years. Our sample belongs to the database of a large laboratory headquartered in São Paulo, Brazil. Statistics: The chi-square test of independence was used to compare the frequency of each type of mole between years. Pearson*s residuals were used, and the nonparametric Kruskal-Wallis test was used to compare beta-hCG values, ages, and mole volume between the different types of moles. Results When comparing the types of HM that were characterized, the authors found a statistically significant difference (p=0.001) between them. In 2019 was found: the highest frequency in CHM (33%) ( n= 85) and in the other years (2020 – 2024) the highest percentages were in HUHM,n=146,(37%) except in 2024, when PHM, n= 85, presented the highest frequency (30%). The mean levels of beta-hCG before the procedure ranged from 149.0 to 186.0 mIU / mL (p = 0.33) among the three types of HM and after 30 days from 16.47 to 18.07 mIU / mL (p = 0.84) there were not statistical difference between the types and neither in the two phases. Conclusion According to this data, the most frequent HM type was HUHM during these 6 years. Fact suggests research into molecular genetic testing. The importance of diagnosing GTD diseases, including the diagnosis of HM, is fundamental for treatment. The use of chemotherapy has dramatically improved the prognosis of these lesions. All patients with this rare disease need to be registered with the national gestational trophoblastic disease service.