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Immigrant populations, particularly undocumented immigrants, are often considered ‘hidden’ or ‘hard to reach’ in research. This invisibilisation—under-representation or exclusion in data collection—leads to data inequities and biased findings that fail to capture their unique experiences. Starfish sampling mitigates selection bias and improves access to invisibilised populations by recruiting ‘seed’ participants at randomly selected times and locations and leveraging their social networks to recruit the next wave of participants. In this protocol paper, we outline the sampling strategy for the BRAVE (Building community, Raising All immigrant Voices for health Equity) study, a multi-site, cross-sectional survey examining the relationship between immigration history and sexual and reproductive health (SRH) service utilisation among Asian immigrant women in the USA. This protocol is an adaptation of novel starfish sampling in combination with various data tools and a community-based participatory research approach.
Using data from the American Community Survey and insights from community partners, we will conduct community mapping across four study sites (Atlanta, Houston, Los Angeles County and New York City). We will select census tracts that reflect the primary ethnic groups of interest and diverse socioeconomic backgrounds. From these selected census tracts, we will construct a venue universe by identifying key activity areas for Asian immigrant women through data scraping from online sources. We will then randomly select venue-date-time combinations and deliberately choose various community engagement events for recruitment. Culturally competent field officers who are fluent in Asian languages will recruit participants at these events. Participants can refer up to three peers from their social networks to take part in the survey. Results will be presented as descriptive statistics and logistic regression models to test the association between immigration history and SRH service utilisation.
The overarching BRAVE study protocol was approved by the University of California Los Angeles Institutional Review Board (IRB) (IRB-22–0493-AM-016). The results will be disseminated through academic journal publications and relevant data will be shared with our community partners.
Limited literature has focused on people with cancers' preference for care providers in scenarios where trade-offs may have to be made.
To report the results of a comprehensive search and synthesis of discrete choice experiments or best-worst scaling studies (± willingness to pay estimates) in scenarios involving cancer nurses, with a focus on: (1) preferred care provider; and (2) relative importance of attributes of care provision for people with cancer.
A search was conducted across: CINAHL, Cochrane Central Register of Controlled Trials, EconLit, Medline, PsycINFO, Scopus, Web of Science Core Collection, and Google Scholar for discrete choice experiments published between January and July 2025. Data were extracted and appraised by two authors. Results were narratively synthesised.
Of 461 studies screened, 11 were included, published in Australia (n = 3), UK (n = 3), and China (n = 5) including people with breast (n = 4), gastric (n = 4), prostate (n = 1), or mixed cancers (n = 2). In six studies exploring scenarios of follow-up care (i.e., survivorship/surveillance), cancer medical specialists were the preferred care provider, followed by cancer nurses, and then general practitioners. In four of the five studies of supportive care scenarios (i.e., diet and exercise advice, anxiety and depression screening), cancer nurses were the preferred care provider, followed by allied health professionals, then cancer medical specialists. The highest WTP estimate was $US226.15 for a medical specialist to provide follow-up care. For supportive care, the highest WTP was $US137.52 for a cancer nurse to provide diet-based lifestyle advice post-treatment for breast cancer.
Cancer nurses are highly valued by people with cancer, particularly for supportive care provision. Opportunities exist for an increase in cancer nurse specialists with expanded scope of practice, to support the preference of people with cancer to have cancer medical specialists, or cancer nurse specialists provide expert cancer follow-up care.
Employees of a cancer patient advocacy group were involved in the design of the study, interpretation of the data, and the preparation of the manuscript. No patients were involved in this work. However, this systematic review prioritized patient voices by including studies that reported on the preferences of people with cancer.
by Claude Emmanuel Koutouan, Marie Louisa Ramaroson, Angelina El Ghaziri, Laurent Ogé, Abdelhamid Kebieche, Raymonde Baltenweck, Patricia Claudel, Philippe Hugueney, Anita Suel, Sébastien Huet, Linda Voisine, Mathilde Briard, Jean Jacques Helesbeux, Latifa Hamama, Valérie Le Clerc, Emmanuel Geoffriau
Resistance of carrot to Alternaria leaf blight (ALB) caused by Alternaria dauci is a complex and quantitative trait. Numerous QTL for resistance (rQTLs) to ALB have been identified but the underlying mechanisms remain largely unknown. Some rQTLs have been recently proposed to be linked to the flavonoid content of carrot leaves. In this study, we performed a metabolic QTL analysis and shed light on the potential mechanisms underlying the most significant rQTL, located on carrot chromosome 6 and accounting for a large proportion of the resistance variation. The flavonoids apigenin 7-O-rutinoside, chrysoeriol 7-O-rutinoside and luteolin 7-O-rutinoside were identified as strongly correlated with resistance. The combination of genetic, metabolomic and transcriptomic approaches led to the identification of a gene encoding a bHLH162-like transcription factor, which may be responsible for the accumulation of these rutinosylated flavonoids. Transgenic expression of this bHLH transcription factor led to an over-accumulation of flavonoids in carrot calli, together with significant increase in the antifungal properties of the corresponding calli extracts. Altogether, the bHLH162-like transcription factor identified in this work is a strong candidate for explaining the flavonoid-based resistance to ALB in carrot.
The study focused on nurses' familiarity with, beliefs about, and attitudes towards artificial intelligence, aiming to identify configurations of necessary and sufficient conditions associated with strong intentions to use artificial intelligence-based health technologies in their clinical practice.
Cross-sectional survey conducted online from mid-October 2023 through early February 2024.
The fuzzy set qualitative comparative analysis method was employed to analyse the survey data.
307 members of the professional order of nurses in Québec province, Canada.
Findings from the qualitative comparative analysis show that strong intentions to use artificial intelligence are only observed when nurses perceive artificial intelligence to have a high impactfulness on their future clinical practice (necessary condition). Moreover, we observe three configurations of sufficient conditions, that is, three combinations (artificial intelligence profiles) of familiarity with, belief about, trust in, and perceived impactfulness of artificial intelligence.
Current curriculum efforts have centred on defining artificial intelligence competencies, yet competency alone does not guarantee a willingness to adopt artificial intelligence tools. Our findings indicate that a positive attitude towards artificial intelligence's potential impact is crucial, with various profiles supporting intentions to adopt artificial intelligence.
These findings suggest that nurses' preparation should go beyond developing artificial intelligence competencies and that nursing educators and trainers need to account for the different profiles associated with strong intentions to use artificial intelligence technologies. Training programmes and nursing curricula should prioritise shaping nurses' beliefs and attitudes about artificial intelligence rather than focusing solely on technical skills.
We contribute to nursing research by showing that a positive attitude towards artificial intelligence's impactfulness on nurses' future clinical practice is a necessary condition for having high intentions to use artificial intelligence technologies.
Relevant guidelines have been adhered to by employing recommended qualitative comparative analysis reporting methods.
No patient or public contribution.
by Connie Nait, Simple Ouma, Saadick Mugerwa Ssentongo, Boniface Oryokot, Abraham Ignatius Oluka, Raymond Kusiima, Victoria Nankabirwa, John Bosco Isunju
BackgroundDespite advances in HIV care, viral load suppression (VLS) among adolescents living with HIV (ALHIV) in Uganda continue to lag behind that of adults, even with the introduction of dolutegravir (DTG)-based regimens, the Youth and Adolescent Peer Supporter (YAPS) model, and community-based approaches. Understanding factors associated with HIV viral load non-suppression in this population is critical to inform HIV treatment policy. This study assessed the prevalence and predictors of viral load non-suppression among ALHIV aged 10–19 years on DTG-based ART in Soroti City, Uganda.
MethodsWe conducted a cross-sectional study among 447 ALHIV attending three urban HIV clinics in Soroti City. Data were abstracted using a structured questionnaire and analyzed in STATA 15.0. Modified Poisson regression with robust error variance was used to identify predictors of viral load non-suppression. Adjusted relative risks (aRR) and 95% confidence intervals (CIs) were reported, with statistical significance set at p ≤ 0.05.
ResultsOf the 447 participants, 53.5% were female, with a median age of 16 years (IQR: 14.0–17.6). The majority (72.9%) were from Soroti district and had been on DTG-based ART for a median of 42.5 months (IQR: 37.0–48.0). Most were receiving multi-month dispensing (MMD) (75.2%) and were active in care (98%). The prevalence of viral load non-suppression was 19.2% (86/447). Independent predictors of non-suppression included older age (15–19 vs. 10–14 years) (aRR: 1.69; 95% CI: 1.08–2.67), male sex (aRR: 1.48; 95% CI: 1.05–2.11), prior non-suppression before switching to DTG (aRR: 1.76; 95% CI: 1.19–2.59), use of non-fixed dose DTG regimens (aRR: 2.03; 95% CI: 1.23–3.33), history of poor adherence (aRR: 4.36; 95% CI: 2.05–9.26), and not receiving MMD (aRR: 2.83; 95% CI: 1.93–4.15).
ConclusionNearly one in five adolescents on DTG-based ART in Soroti City had viral non-suppression, despite optimized treatment regimens. Targeted interventions−particularly enhanced adherence counseling for older and male adolescents, expanding MMD coverage, and provision of fixed-dose regimens−are urgently needed to improve VLS among ALHIV. These findings underscore the need for adolescent-centered HIV care strategies to close the viral suppression gap and advance progress towards epidemic control.
by Alessandro Roman, Charlotte Linthout, Ben Raymond, Constantianus J. M. Koenraadt
Various vector control strategies are in place to reduce the spread of arthropod-borne viruses. Some of these, such as application of insecticides, are encountering operational challenges and a reduced overall effectiveness due to evolution of resistance. Alternative approaches for mosquito population control, such as the sterile insect technique, depend on efficient mass-rearing of healthy mosquitoes prior to mass-release in the field. Therefore, improving efficiency and quality of mass-rearing techniques is crucial to obtain fit mosquitoes. Previous studies have shown that Acetic Acid Bacteria of the genus Asaia can have a mutualistic effect on larval development in different mosquito species and can thus contribute to improved rearing output. However, whether improved performance in the larval stages may have knock-on effects in the adult stage, for example by increasing their capability to transmit arbovirus, remains unclear. Such effects may jeopardize future control efforts. We tested the effects of two Asaia species, Asaia krungthepensis and Asaia bogorensis, on development time and adult size under two rearing conditions: individual rearing and group rearing of Culex pipiens larvae. Besides investigating development and size, we also investigated whether Asaia spp. exposure during the larval stage can influence the vector competence of Culex pipiens pipiens for West Nile virus (WNV). Our work shows the potential of improving mass-rearing efficiency by employing Asaia krungthepensis as a mutualist for Culex pipiens pipiens. Importantly, this study reveals no significant increase in dissemination and transmission rate of WNV by Culex pipiens pipiens when inoculated with Asaia spp., although an increase in viral titer in the legs and the saliva was observed when the mosquitoes were inoculated with the two Asaia species. Interestingly, we confirmed that Asaia spp. bacteria did not establish as a permanent member of the microbiota of Culex pipiens pipiens. As Asaia spp. did not establish in adult mosquitoes, the observed change in WNV titers can be a result of indirect interactions of Asaia with the native Culex pipiens pipiens microbiome. Our results stress the importance of carefully evaluating host-symbiont interactions to avoid the potential of releasing mosquitoes with enhanced vector competence.
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