Conectar
Colorectal cancer patients with peritoneal metastases have a very poor prognosis. A minority of these patients is eligible for curative cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The peritoneal cancer index (PCI) is an important criterion to select patients for CRS-HIPEC. Due to challenges in peritoneal metastasis detection by imaging, the PCI is currently routinely assessed by invasive diagnostic laparoscopy in addition to CT and/or MRI. Yet, open-close procedures and early disease recurrence following CRS-HIPEC are common, indicating the need for better patient selection tools. Fibroblast activation protein (FAP)-targeted imaging has recently emerged as a promising strategy for visualising peritoneal disease. The aim of this study is to assess the potential value of FAP inhibitor positron emission tomography/CT (FAPI-PET/CT) as an alternative non-invasive tool for quantitative PCI assessment.
TROMPET is a prospective observational proof-of-concept study. A total of 25 colorectal cancer patients with suspected or verified peritoneal metastases who are eligible for CRS-HIPEC based on MRI will be included in this study. Patients younger than 18, pregnant and/or breastfeeding, with any contraindication(s) for MRI, PET, CT and/or CRS-HIPEC, and/or with a known additional malignancy within the past five years are excluded. Participants will receive [18F]AlF-FAPI-74 PET/CT prior to surgery. The primary objective is to determine the correlation between PCI scores determined by FAPI-PET/CT and ‘true’ PCI scores determined by histopathological analysis of all resected lesions. The secondary objectives include the correlations between PCI scores determined by FAPI-PET/CT, by MRI and during surgery, the potential of FAPI-PET/CT to detect extraperitoneal metastases, and molecular and immunohistochemical analysis of resected tissue to provide insight into the nature of FAPI-PET-positive lesions. The primary endpoint is all PCI scores determined by FAPI-PET and histopathology and their correlation on patient level. If this study shows that the PCI score can be accurately determined preoperatively by FAPI-PET/CT, it will form the basis for further developing FAPI-PET/CT as a quantitative, standardised, non-invasive diagnostic tool for selecting patients for CRS-HIPEC. Moreover, the ‘radiology-pathology’ setup of the study will allow us to characterise FAPI-PET-positive and PET-negative lesions in detail, providing further insight into the strengths and potential pitfalls of FAPI-PET/CT in the detection of peritoneal metastases from colorectal cancer.
This study is approved by the assigned Medical-Research-Ethics-Committee (METC NedMec) on 19-08-2024. All participants will provide written informed consent. Study results will be disseminated through (inter)national meetings and peer-reviewed publications.
2024-512301-16-01
Female genital mutilation (FGM)/cutting remains highly prevalent in Somalia and is associated with a range of long-term gynaecological and urological complications. However, data on lower urinary tract symptoms (LUTS) and their severity across different FGM types are limited. The aim of this study was to examine the association between FGM type and LUTS among symptomatic care-seeking women with FGM and to evaluate whether symptom severity differed according to FGM type.
This cross-sectional study included 122 symptomatic women with a history of FGM who presented with LUTS between January and April 2024.
Sociodemographic characteristics, FGM type, clinical symptoms, and vaginal and urine culture results were recorded. LUTS severity and associated bother were assessed using the International Consultation on Incontinence Questionnaire–Female Lower Urinary Tract Symptoms Long Form (ICIQ-FLUTS-LF). Comparisons were made between women with FGM types I–II and those with type III.
The mean age of participants was 31.7±7.6 years. Women with FGM type III had a significantly higher prevalence of positive urine culture growth, history of urinary tract infection (UTI) and prior antibiotic use, and abdominal pain compared with those with types I–II (p<0.05). Median scores for all LUTS domains and corresponding bother scores were significantly higher in women with FGM type III compared with types I–II (all p<0.001), and similar findings were confirmed in regression analyses.
Among symptomatic care-seeking women with FGM, type III was associated with greater LUTS burden, higher reported history of UTI and greater symptom-related distress compared with types I and II.
Rare diseases (RDs) affect millions of people worldwide and present major challenges for research due to small patient populations, limited longitudinal data and the difficulty of capturing real-world disease manifestations. Digital technologies provide new opportunities to collect multimodal data directly from patients and their environments. In particular, video recordings, wearable-based physical activity monitoring and digital questionnaires can generate detailed, longitudinal information on symptoms, functional abilities and daily-life impact. The digital tools for rare disorders (DT4RD) protocol aims to develop and evaluate a digital framework that integrates these technologies to support data collection and analysis in RD research.
DT4RD will implement a technology-driven platform designed to collect and analyse multimodal patient-generated data. The protocol includes three main components: (1) structured video capture to document clinical signs and functional performance, enabling remote assessment and computational analysis; (2) continuous physical activity monitoring using wearable sensors to quantify mobility and daily activity patterns and (3) digital questionnaires to capture patient-reported outcomes and contextual information. These data streams will be integrated within a dedicated digital infrastructure supporting secure data collection, storage and analysis. This pilot study will be conducted with participants affected by rare neuromuscular diseases to evaluate the feasibility, usability and analytical potential of the platform as well as its ability to generate clinically relevant insights from multimodal digital data anchored to regular hospital visits.
The study was approved in France by the Comité de Protection des Personnes Sud-Est III on 21 February 2023 (National Number ID-RCB 2022-A02749-34). UK approval was granted by the Health Research Authority and Health and Care Research Wales on 4 March 2024 (IRAS project ID 331474). The protocol has been registered on ClinicalTrials.gov under the number NCT05798325. All participants will be provided with verbal and written information about the study and its procedures before providing written informed consent. Data will be anonymised and handled in accordance with GDPR, French CNIL regulations (MR-001) and applicable national data-protection requirements. Results will be communicated through peer-reviewed publications, conference presentations and lay reports.
Evidence of an association between carbohydrate intake and atrial fibrillation (AF) incidence remains limited. We investigated the association between carbohydrate and staple food consumption and AF risk in a Japanese urban population.
Our population-based prospective cohort study included 5229 adult participants (mean age 56.9 years; 46.5% men) who completed a Food Frequency Questionnaire. Multivariable-adjusted Cox regression models were used to assess the association between carbohydrate intake (g/day) and staple food consumption (rice, noodles and bread) and AF incidence after adjusting for confounding factors. During 68 668 person-years of follow-up (mean, 13.1 years), 226 individuals developed AF. Total and simple carbohydrate intakes were associated with an increased AF risk in men (HR and 95% CI for Q4 vs Q1 were 2.51 (1.06 to 5.96) and 3.29 (1.33 to 8.13), respectively). In contrast, there were no significant associations between total carbohydrate, simple or complex carbohydrate intake and AF risk in women (HR and 95% CI for Q4 vs Q1 were 1.33 (0.27 to 6.65), 2.75 (0.74–10.26) and 1.04 (0.38-2.83), respectively). We found no association between staple foods and AF risk in men or women.
Our findings imply that the association between carbohydrate intake and AF risk is influenced by the type of carbohydrates. We found a positive association between high intake of simple carbohydrates and AF risk in men whereas the association was negative for complex carbohydrate intakes. Meanwhile, the results in the women’s group were inconclusive.
by Koki Nambu, Naoki Kaneko, Shiho Yokomizo, Hu Chen, Lijing Yan, Wang Shiyao, Ryusei Shizuma, Eiji Iwata, Yukiko Ohyama, Shohei Akagawa, Soichiro Ibaragi, Shintaro Kawano, Masafumi Moriyama
Oral lichen planus is a chronic inflammatory disease of the oral mucosa characterised by immune dysregulation, but its pathogenesis remains incompletely understood and no curative treatment has been established. Our previous work showed that patients with oral lichen planus exhibit gut dysbiosis, including reduced microbial diversity and depletion of butyrate-producing bacteria. Because butyrate promotes regulatory T-cell differentiation and supports immune homeostasis, targeting this dysbiosis may represent a microbiota-directed approach for immune modulation in oral lichen planus. This study aims to investigate the effects of inulin supplementation on the gut microbiota and related immune markers in patients with oral lichen planus. This multicentre, double-blind, randomised, placebo-controlled parallel-group trial will enrol 80 patients with oral lichen planus. Participants will be randomly assigned in a 1:1 ratio to receive either inulin (8 g/day) or a maltose placebo for 4 weeks, in addition to standard care. The primary outcome is the change in the relative abundance of prespecified butyrate-producing gut bacteria from baseline to the end of intervention at Week 6. Secondary outcomes include changes in gut microbiota diversity, salivary microbiota composition, faecal short-chain fatty acid concentrations, peripheral blood regulatory T-cell counts, blood test parameters, and clinical symptoms of oral lichen planus. Analyses will follow the intention-to-treat principle, and between-group differences will be assessed using appropriate statistical methods. This trial is designed to evaluate, in a randomised placebo-controlled setting, whether a microbiota-directed intervention can modify gut microbial profiles and related immune markers in patients with oral lichen planus. The findings are expected to clarify whether inulin supplementation can modify gut microbial profiles and related immunological markers in patients with oral lichen planus. Trial registration: UMIN Clinical Trials Registry (UMIN-CTR), UMIN000060840, registered on 1 April 2026 (https://rctportal.mhlw.go.jp/detail/um?trial_id=UMIN000060840#).This study aimed to evaluate the effects of nonpharmacological interventions used during intrauterine device (IUD) insertion on pain and patient satisfaction.
This study is a systematic review and meta-analysis.
PubMed, Web of Science, EBSCOhost, Google Scholar and the National Thesis Center of the Council of Higher Education databases were searched between January 2026 and February 2026, without publication year restriction. Experimental and quasi-experimental studies evaluating nonpharmacological interventions during IUD insertion were included. Methodological quality was assessed using the Joanna Briggs Institute critical appraisal tools. Risk of bias was evaluated using the Cochrane Risk of Bias tool (RoB 2) for randomized controlled trials and ROBINS-I for quasi-experimental studies. The certainty of evidence was assessed using the GRADE approach. Publication bias was evaluated using funnel plots, Egger's test and Duval and Tweedie's trim-and-fill method. Data were synthesized using meta-analysis and narrative synthesis.
Twelve studies involving 1241 women were included. The interventions examined included virtual reality, distraction techniques, EFT, music, video-assisted information, ultrasound-guided IUD insertion, acupuncture, cold application and the full bladder method. Some interventions, particularly virtual reality, distraction cards, EFT, music and acupuncture, showed positive effects. Overall, nonpharmacological interventions significantly reduced pain during IUD insertion (SMD: 0.803; 95% CI: 0.427 to 1.179; Z = 4.182; p < 0.001; I 2 = 90.687). They also significantly increased procedural satisfaction (SMD: −1.046; 95% CI: −1.516 to −0.577; Z = −4.368; p < 0.001; I 2 = 85.677).
Nonpharmacological interventions may reduce perceived pain and improve patient satisfaction during IUD insertion.
These interventions may enhance patient comfort and procedural satisfaction in clinical practice.
PRISMA guidelines were followed.
This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (Registration No: CRD420261307366)
Common mental disorders (CMDs) are endemic globally. The availability of evidence-based mental health interventions has grown rapidly, with many services focused on psychotherapy. Most psychotherapies require multiple sessions, resulting in lengthy waiting times due to limited provider availability. These delays can lead to higher morbidity, poorer adherence and less favourable outcomes.
Recent research indicates that single-session therapy (SST) can be as effective as multi-session approaches and offers cost savings. This pragmatic, prospective mixed-methods pilot cohort study assesses the uptake, feasibility, acceptability, appropriateness and preliminary clinical effectiveness of SST in individuals receiving the Friendship Bench intervention. The Friendship Bench is a task-shifting mental health intervention for individuals with low to moderate symptoms of CMDs.
We will conduct a pragmatic, prospective, mixed-methods pilot interventional cohort study involving 350 first-time clients of the Friendship Bench intervention in Harare and surrounding periurban areas. We will primarily explore the intervention’s feasibility, uptake, appropriateness and acceptability including the feasibility of a larger follow-up clinical trial. Secondary outcomes include changes in CMDs severity, depression and anxiety symptoms, social connectedness, functional status, hope, resilience, health-related quality of life and therapeutic alliance. Participants will be followed for 6 weeks, with data collected at baseline and at 2, 4 and 6 weeks postintervention time points. A qualitative component will explore participants’ perspectives and experiences with SST. Quantitative data will be analysed using descriptive statistics, bivariate analysis, Cox proportional hazards models and generalised mixed models with maximum likelihood estimation. Qualitative data will be analysed thematically.
Ethical approval was granted by the Medical Research Council of Zimbabwe. Findings from this study will contribute to the evidence base for SST in the management of CMDs and may inform mental health service delivery in low-resource settings. Results will be disseminated through peer-reviewed publications, conference presentations, social media platforms and policy briefs.
PACTR202605687485459
by Yang Guo, Shuai Jiang, Wei Zhu, Longwang Tan, Chuang Liu, Yongjun Jia, Chi Zhang, Kok-Yong Chin
BackgroundMachine learning (ML) shows promise in using clinical data to predict chronic diseases. However, its application in PMOP risk assessment using readily available clinical and biochemical parameters is underexplored.
ObjectiveThis study aimed to develop and validate an interpretable ML-based model for assessing PMOP using clinical features and laboratory biomarkers, and to identify factors associated with PMOP using SHapley Additive exPlanations (SHAP).
MethodsA retrospective cross-sectional study included 1,717 postmenopausal women from two hospitals in Northwest China. PMOP was diagnosed with dual-energy X-ray absorptiometry (DXA T-score ≤−2.5). Data collected included demographics, clinical details, and various laboratory parameters, such as bone metabolism markers, 25-hydroxyvitamin D [25-(OH)D], electrolytes, and routine blood counts. Ten ML algorithms were employed for feature selection and model construction on a dataset split into training (n = 1201) and testing (n = 516) sets. Performance was evaluated using the Area Under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and calibration.
ResultsThe Extra Trees (ET) model achieved the best test-set performance, with an AUC of 0.717 (95% CI: 0.682–0.752). SHAP analysis revealed that age was the most significant associated factor (SHAP value: 0.0648), followed by body mass index (BMI) (0.0243) and chloride ion levels (0.0209). Other top predictors included the use of antihypertensive drugs and years since menopause.
ConclusionThe ET ML algorithm showed the best performance in assessing PMOP, with age, BMI, and circulating chloride levels as significant associated factors.
by Juliana Ju Yun Hoo, Shumetha Sidhu, Kok Wei Tan
Rapid urbanization has increased disconnection from nature, especially in cities. While research on restorative environments has largely focused on non-tropical regions, little is known about the restorative potential of tropical urban green spaces (UGSs). This study assessed the perceived restorativeness of tropical UGSs in Malaysia using 120 environmental stimuli from nature, urban, and mixed urban-nature settings. 87 participants were randomly assigned to one of the three modalities: audio-only, visual-only, or bimodal. Each participant rated a subset of 30 stimuli on perceived restorativeness. Results showed that nature and mixed urban-nature scenes were in general rated as more restorative than urban scenes. An interaction effect indicated that, in the visual-only modality, mixed urban-nature scenes were perceived as more restorative than nature scenes, while no significant differences were observed in the audio-only and bimodal modalities. Moreover, perceived restorativeness for nature scenes was comparable across bimodal, visual-only, and audio-only presentations. These findings suggest that small pockets of urban nature (e.g., tree-lined streets, rooftop gardens) can offer greater psychological restoration than wild, untamed forests. In addition, high-quality nature sounds (e.g., birdsong, flowing water) can provide restorative benefits comparable to visual exposure when access to green views is limited. Such insights can inform urban planning strategies to design more restorative and liveable cities.Asthma, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) are prevalent chronic respiratory diseases associated with increased comorbidity, mortality and healthcare costs. Physical activity and exercise are widely recommended as part of treatment for these conditions, yet the specific effects of Nordic walking (NW) remain underexplored. The aims of this randomised controlled trial (RCT) are to improve physical fitness, functional capacity and respiratory health and increase regular physical activity and quality of life of older adults with asthma and/or COPD and/or OSA through a supervised 3-month group-based NW intervention combined with resistance, balance and mobility training.
This single-blinded, parallel-group RCT will recruit 100 adults aged 55–80 years diagnosed with asthma and/or COPD and/or OSA in the Northern Savo region of Finland. Participants will be randomly allocated to either an intervention group or a control group.
The intervention group will participate in a 12-week supervised exercise programme consisting of progressive NW sessions twice per week and resistance, balance and mobility training once per week. The primary outcome is a change in cardiorespiratory endurance. Secondary outcomes include functional capacity, physical activity level, spirometry parameters and quality of life. The control group will continue their usual physical activity and receive physical activity guidance after 12 weeks. Measurements were conducted at baseline, three and 9 months. Data will be analysed according to the intention-to-treat principle. Group differences over time will be examined using appropriate parametric or non-parametric methods depending on data distribution.
Ethical approval was obtained from the Regional Medical Research Ethics Committee of Eastern Finland Collaborative Area (892/13.00/2023). Findings will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences.
The trial is registered at ISRCTN12097135, registration date: 7 June 2024.
The survival rate of patients with life-threatening diseases primarily depends on the speed of diagnosis. Too often, diseases are detected only after symptoms appear, which usually occurs at later stages of a disease when available treatments may be less effective. Current detection techniques primarily depend on identifying metabolites in biofluids such as blood and urine. The analysis of these fluids is typically performed in laboratories, resulting in lengthy waiting times for patients to receive their results. In severe cases, invasive biopsies and radiative methods are used to diagnose conditions such as cancer. These biopsies can cause distress for patients who are already experiencing significant emotional or physical stress, while imaging techniques involving ionising radiation may pose additional health risks. Additionally, these methods can be costly. In recent years, exhaled breath has become a biofluid matrix of interest for disease detection, allowing for the identification of volatile organic compounds (VOCs) or VOC profiles associated with specific conditions. To improve early disease detection through breath analysis, the VOCORDER project aims to develop a device that provides a fast, simple, user-friendly and cost-effective method for continuous health monitoring to identify diseases in their early stages before symptoms appear.
A literature review was initially conducted to identify five reference diseases of interest (lung cancer, stomach/colon cancer, breast cancer and kidney insufficiency) and previously reported VOC profiles associated with these diseases. In this trial, the project team from the MITERA Hospital will select patients, and the hospital staff will conduct personal interviews with these subjects. Each participant will also complete a questionnaire for the acquisition of demographic and medical history data, after being informed in detail about the purposes of the questionnaire and signing a consent form. The study protocol consists of two phases. Phase 1 is a baseline study designed to detect and identify breath biomarkers for the early diagnosis of the diseases mentioned above using gas chromatography-mass spectrometry (GC-MS) and secondary electrospray ionisation high-resolution mass spectrometry (SESI-HR-MS). Prescreening will select 120 healthy controls and 175 patients for the baseline phase of the clinical trial, for which breath samples will be collected in 1 L Supel-Inert Multi-Layer Foil gas sampling bags. New biomarkers and VOC profiles will be extracted from these data, and further statistical analysis will allow for artificial intelligence (AI) models to be produced and tested. For phase 2 (validation phase), 120 healthy controls and 100 patients will be selected. Breath samples will again be collected in 1 L gas sampling bags for analyses with GC-MS and SESI-HR-MS. The VOCORDER device will also be used, and its functioning with the newly developed AI models will be evaluated.
This clinical study has been approved by the scientific council at the MITERA hospital in Athens, Greece (#513/2024). The outcomes will be disseminated through peer-reviewed journal publications and presentations at scientific conferences.
Acute kidney injury is a global health concern with significant implications for morbidity and mortality when it comes to children. High morbidity and mortality result from consequences such as metabolic acidosis, hyperkalaemia, fluid overload and cardiovascular issues. Good clinical outcomes among children with acute kidney injury can be achieved through early recognition and initiation of management to prevent disease progression. However, evidence on early recognition and management of acute kidney injury in children is lacking, especially in low-resource settings such as Tanzania. This study explores healthcare providers’ experiences with early recognition and management of acute kidney injury among children attending primary healthcare facilities.
This exploratory qualitative case study aims to capture contextual experiences using semi-structured interviews to gain thematic insights. The estimated sample size for this study is 20 informants and will be selected purposively. Data will be collected through individual interviews using an interview guide with predetermined questions followed by probing questions. Each interview session will last for about 30–60 min. Data analysis will begin during the data collection period using the six-phase thematic analysis approach by Braun and Clarke.
Ethical approval has been provided by the Muhimbili University of Health and Allied Sciences Senate of Research and Ethical Committees with reference number DA.282/298/01.C/2630. In accordance with the Declaration of Helsinki (1964) and its later amendments, all respondents will provide verbal and written informed consent and will be free to participate voluntarily with no incentives. The findings will be shared with participating healthcare facilities, district and regional health authorities and relevant stakeholders through presentations and summary reports. Findings will also be presented at national and international scientific conferences and submitted for publication in peer-reviewed journals.
Diabetes mellitus represents a major global health challenge, with over 537 million adults currently affected worldwide. Among its complications, diabetic foot ulcers remain a leading cause of morbidity, hospitalization and amputation, imposing a significant socioeconomic burden. Effective management requires a multidisciplinary approach integrating surgical, medical and rehabilitative expertise. Negative pressure wound therapy has demonstrated clinical efficacy in promoting granulation tissue formation, accelerating wound healing, and reducing infection rates compared with conventional dressings. This case series presents the management of four frail, septic patients with severe diabetic foot ulcers treated between 2023 and 2025 in an academic surgical department. All patients required surgical intervention, including debridement or partial amputation, combined with negative pressure wound therapy and, in selected cases, revascularization or skin grafting. One case utilized an electrospun nanofiber dressing which enhanced wound granulation and shortened healing time. Outcomes varied according to systemic comorbidities, vascular status and glycemic control; however, NPWT consistently supported wound stabilization and preparation for definitive closure. These findings reinforce the essential role of interdisciplinary collaboration and advanced wound technologies in the treatment of complex diabetic foot infections, particularly in frail or septic patients, and highlight the potential of nanofiber-based dressings as adjunctive therapies in comprehensive diabetic foot care.
by Verner N. Orish, Renosten E. Tetteh, David Adzah, Chinecherem A. Ndiokwelu, Emmanuel A. Allotey, Evans A. Yeboah, Sylvester Y. Lokpo, Kenneth Ablordey, Duneeh R. Vikpebah, Ekene K. Nwaefuna, Precious K. Kwadzokpui, Noble D. Dika, Elom Y. Dzefi, Kokou H. Amegan-Aho, Aninagyei Enoch, Senyo Tagboto
BackgroundToxoplasma gondii (T. gondii) is a successful protozoan parasite infecting up to a third of the human population. It has varied transmission routes including ingestion of food and water contaminated by cat feces containing oocysts of the parasite and ingestion of bradyzoites in poorly cooked meat. Blood transfusion is another possible route of transmission especially among people with medical conditions requiring blood transfusion, such as those with sickle cell disease (SCD). This study aimed at finding out the prevalence of T. gondii infection and the association of blood transfusion among patients with SCD.
MethodThis study was a cross-sectional study involving SCD patients attending the SCD clinic at the Ho Teaching Hospital in the Volta Region of Ghana. Questionnaire administration was employed to obtain sociodemographic information, cat ownership, consumption of poorly cooked meat, as well as blood transfusion history. A blood sample was collected and anti-T. gondii IgG and IgM were detected using Rapid Diagnostic Test (RDT), while Enzyme-linked Immunosorbent Assay (ELISA) was used as the gold standard and reference. Seropositivity was defined as either positive for IgG, IgM or both. Data was analyzed using SPSS version 23, with frequency distribution done for the sociodemographic variables and the prevalence of RDT and ELISA anti-T. gondii IgG and IgM. Pearson Chi-square analysis was performed to find any significant association between diagnosis of T. gondii infection with sociodemographic variables and blood transfusion. Logistic regression analysis was performed to investigate the odds of seropositivity (ELISA) with sociodemographic variables and blood transfusion.
ResultsA total of 156 SCD patients participated in this study of which 124 (79.5%) and 32(20.5%) were HbSS and HbSC respectively. Among the study participants, 105 (67.3%) had a history of blood transfusion. A total of 60 (38.5%) and 83 (53.2%) patients were positive for RDT and ELISA respectively. No significant association was seen between T. gondii diagnosis and cat ownership (RDT,20[37.7%], p = 0.891; ELISA, 27[50.9%], p = 0.673) and consumption of poorly cooked meat (RDT,37[41.6%],p = 0.370;ELISA,53[59.6%], p = 0.211). However there was a significant association between T. gondii diagnosis and age, with seropositive results predominantly seen among older patients (≥20 years) (RDT, 38[52.1%], p = 0.002; ELISA 49 [67.1%, p = 0.002]. Blood transfusion had a significant association with T.gondii diagnosis (RDT, p = 0.003; ELISA, p = 0.001). A total of 66 (62.9%) of SCD patients who had history of blood transfusion tested positive for ELISA and they had 3 times the odds of testing positive for ELISA (adjusted OR 3.14[95% CI 1.50–6.58]; p = 0.002).
ConclusionThe prevalence of T. gondii infection was higher by ELISA (53.0%) than by rapid diagnostic testing (RDT) (38.5%), and sickle cell disease patients with a transfusion history had higher odds of seropositivity. These findings highlight the need to strengthen transfusion safety protocols and consider screening strategies for T. gondii among high-risk populations such as patients with sickle cell disease. Also, there is the need for longitudinal research to help elucidate the true contribution of blood transfusion transmission of T. gondii since a cross-sectional study, causality could not be established.
by Caitlin D. October, Dzunisani P. Baloyi, Lario Viljoen, Rene Raad, Dillon T. Wademan, Megan Palmer, Juli Switala, Michaile G. Anthony, Karen Du Preez, Petra De Koker, Anneke C. Hesseling, Bronwyne Coetzee, Graeme Hoddinott
Children who are hospitalised for tuberculosis (TB) experience challenges that put them at risk of developing emotional, behavioural, and social difficulties. In this methodological paper, we showcase the development of a narrative intervention toolkit with key components of the resulting version 1.0 tool. The study design was participatory and pragmatic, with researchers working with the routine staff of TB hospital wards, children admitted and their caregivers, to iteratively understand and improve children’s experiences of hospitalisation. The project included three phases: (1) a situational analysis to map children and healthcare providers’ perspectives on priorities and potential intervention components, (2) co-development of a beta-version of the intervention, and (3) piloting and incremental refinement toward a version 1.0 of the intervention. The intervention toolkit combined a series of activities alongside the story of ‘Courageous Curly’ to facilitate children’s engagement with their own experiences of hospitalisation, including psychosocial and treatment challenges, captured, and described throughout data collection. We found that dividing the story into short chapters facilitated children’s engagement with the section of story that is being told on a specific day. Each chapter of the story follows/mimics a different stage children can expect during their treatment journey while hospitalised for TB care. Implementation and evaluation of such interventions can mitigate the psychosocial impact of TB in children and inform policies to improve their overall TB care.by Azusa Kubota, Kentaro Kojima, Shinnosuke Koketsu, Takayuki Kannon, Takehiro Sato, Kazuyoshi Hosomichi, Yoshiaki Shinohara, Atsushi Tajima
Brain asymmetry is a fundamental feature of neural organization. However, the molecular basis of hippocampal lateralization in response to environmental stimuli remains poorly understood. Here, we examined the transcriptomic profiles of the left and right hippocampal CA1 regions in rats reared under isolated or enriched housing conditions to elucidate hemisphere-specific responses and shared molecular adaptations. RNA-sequencing analysis revealed lateralized differences in the number and identity of differentially expressed genes, accompanied by distinct biological themes, as indicated by overrepresentation and gene set enrichment analysis. The left CA1 region was prominently engaged in pathways related to synaptic organization and mitochondrial function, whereas the right CA1 region exhibited enrichment in transcriptional regulation and RNA metabolic processes. Despite these asymmetries, co-expression and protein–protein interaction network analyses revealed shared molecular architectures. Immediate early genes formed consistent central hubs across both hemispheres, and a common Mecp2–Grin2b–Cdkl5–Tet3 protein interaction cluster was identified as a potential integrative regulatory module. Additional enrichment analysis of differentially expressed genes shared between hemispheres further highlighted conserved responses, particularly in synaptic plasticity and cell–cell communication. Together, these findings demonstrate that the left and right CA1 regions employ distinct yet partially convergent transcriptional programs to adapt to environmental stimuli. This coordinated molecular asymmetry provides novel insights into hippocampal lateralization and its role in experience-dependent brain plasticity.by Oumarou I. Wone Adama, Iman Frédéric Youa, Alexandra Bitty-Anderson, Arnold Junior Sadio, Rogatien Comlan Atoun, Yao Rodion Konu, Hezouwe Tchade, Martin Kouame Tchankoni, Kokou Herbert Gounon, Kparakate Bouboune Kota-Mamah, Abissouwessim Egbare Tchade, Godonou Amivi Mawussi, Fiali Ayawa Lack, Fifonsi Adjidossi Gbeasor-Komlavi, Anoumou Claver Dagnra, Didier Koumavi Ekouevi
IntroductionIn Togo, the syndromic approach is used for the diagnosis and management of sexually transmitted infections (STIs). The aim of this study was to evaluate the syndromic approach for diagnosis of STIs among female sex workers (FSW) in Lomé, Togo.
MethodsA cross-sectional study was carried out from September to October 2023 among FSW in Lomé (Togo). FSW aged 18 years and above were included. A gynecological examination was performed for syndromic diagnosis, and the Xpert® CT/NG were used to screen vaginal swabs for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). The performance (predictive values) of the syndromic approach to STI diagnosis was evaluated using the Xpert® CT/NG test as the gold standard.
ResultsA total of 357 FSW were recruited. The median age of FSW was 32 years (IQR: [26–40 years]) and 8.2% had attained a higher level of education. The prevalence of syndromic STI among FSW was 33.3%. Vaginal swabs were positive for CT (8.4%) and NG (8.7%), with a prevalence of bacterial STIs (CT and/or NG) of 14.3%. The syndromic approach to STI diagnosis demonstrated a positive predictive value of 24.3%.
ConclusionThe prevalence of STIs is relatively high among FSW in Lomé. According to this study, the diagnosis of STIs using the syndromic approach has limited relevance. National STI screening and management policies urgently need to be rethought, incorporating recent technological advances.
FreshRSS 