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Endometriosis is a common, benign, chronic inflammatory disease with multiple consequences, from chronic pain to systemic comorbidities and poor quality of life. As it usually affects people of reproductive age, one of the most distressing consequences is infertility, which can be only partly overcome by medically assisted reproduction. Poor outcomes are, in fact, frequent adverse events. As no definitive therapy exists for endometriosis-related infertility, affected women often tend to try either complementary and alternative medicine or self-management strategies to improve their quality of life, with the hope of also enhancing their fertility. Among available options, dietary interventions are commonly explored, even if no robust evidence is available on the optimal type of diet and its effects on reproductive outcomes. This trial will investigate whether an anti-inflammatory dietary intervention can improve fertility outcomes in women affected by endometriosis undergoing in vitro fertilisation (IVF).
The DietAry interveNtion in ameliorating fertiliTy parameters in women with Endometriosis undergoing IVF (DANTE) study is a single-centre, randomised, controlled, non-pharmacological interventional trial in patients living with endometriosis who are infertile and require IVF. Participants will be allocated to either a 12-week intervention based on an anti-inflammatory diet or no diet before the beginning of controlled ovarian stimulation. Following baseline assessment, 438 participants aged
The study has received ethics approval from Comitato Etico Territoriale Lombardia 3 (#5587_18.12.2024). Results will be presented in peer-reviewed journals and at international conferences.
by Laura de la Roche, Carlos G. Fuentes, Ailiya Z. Jafry, Omolola E. Adepoju
IntroductionReports indicate increasing prevalence rates of successive natural disasters, and the negative impact on existing infrastructures are well documented. However, factors impacting outcomes on both communities and individuals remain unclear. For historically underserved communities, the effects of disasters are exacerbated by pre-existing barriers that make efforts to recovery difficult. Thus, understanding the nuance of their circumstances and experience is crucial to helping build resilience in these communities and inform preparedness and response efforts.
ObjectiveThrough this study, we sought to qualitatively understand the lived experience of historically underserved communities in the context of natural disasters to support the development and/or adoption of resources.
MethodsPhotovoice was used to guide semi-structured interviews with participants recruited from three communities (Kashmere Gardens, Greater Third Ward, Greater Fifth Ward) in Houston, TX. Reflexive thematic analysis was employed to generate themes accurately depicting participant experiences. Reflexivity, persistent observation, and triangulation were employed to increase trustworthiness in analysis.
ResultsFive key themes emerged from analysis: 1) Acute and long-term damage from natural disasters requires sustained recovery efforts; 2) Gaps and opportunities exist in city, state, and federal support mechanisms; 3) Strengthening and expanding support networks and community resources after extreme weather events is critical; 4) Need to address structural barriers to disaster preparedness and coping; and 5) Recognizing and mitigating the broad mental health impacts of natural disasters.
ConclusionThe lived experiences of individuals from historically underserved communities in Houston highlight a complex interaction of psychosocial, structural, and cultural factors that influence both community resilience and vulnerability. Understanding this interplay is crucial to informing policy efforts that prioritize resilience building in these communities. Implications from these findings are discussed.
Heart failure with reduced ejection fraction (HFrEF) remains a significant cause of morbidity and mortality worldwide, particularly in patients who remain symptomatic despite guideline-directed medical therapy (GDMT). Preliminary data suggest that a single fraction low-dose whole-heart external beam radiotherapy (EBRT) may improve cardiac function by modulating inflammatory and fibrotic processes. This trial aims to evaluate the preliminary efficacy of a single fraction 5 Gy whole-heart EBRT to improve left ventricular ejection fraction (LVEF) in patients with HFrEF on GDMT. Secondary objectives will assess safety, cardiac biomarkers and patient-reported outcomes.
Single-centre, single-arm, prospective interventional trial aiming to enrol 40 patients with HFrEF (LVEF≤35%) on maximal GDMT, New York Heart Association (NYHA) classes II–IV, and stable for ≥6 months prior to enrolment, without recent heart failure admissions or GDMT changes. All participants are required to have cardiac implantable electronic devices. Recruitment will be balanced with 20 patients with ischaemic and 20 with non-ischaemic aetiology. Eligible patients will receive a single fraction of 5 Gy whole-heart EBRT guided by a non-contrast enhanced primary planning CT. Follow-up assessments will be conducted at baseline, 6 weeks, 12 weeks and 6 months. The primary outcome is an improvement in LVEF of ≥5% at 6 months, assessed by transthoracic echocardiography. This is an open-label trial with blinded ascertainment of the primary outcome. Secondary outcomes include acute and late toxicity, overall survival, hospital admission for heart failure, patient-reported quality of life, cardiac biomarkers and device-reported arrhythmia burden.
The trial has been approved by the Ethics Committee Research UZ/KU Leuven, Belgium (S69569). The study results will be shared through peer-reviewed journals and presentations at academic conferences.
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