The Tigray War (November 2020-November 2022) caused catastrophic health system collapse in northern Ethiopia, with substantial excess mortality and near-total destruction of health infrastructure. The impact on HIV care services remains poorly documented. We comprehensively assessed HIV care continuum recovery across prevention of mother-to-child transmission (PMTCT), HIV-exposed infant care and cervical cancer screening among women living with HIV during the postconflict period.

We conducted a retrospective multidomain cohort study across seven health facilities in Mekelle City, Tigray, from November 2022 to May 2025. We assessed: (1) mother-to-child transmission (MTCT) rates among 405 HIV-exposed infants using Firth's penalised logistic regression; (2) feeding practices, growth outcomes, cotrimoxazole prophylaxis coverage and retention among 2482 follow-up visits using generalised estimating equations and (3) cervical cancer screening cascade completion among 2515 women living with HIV using mixed-effects logistic regression.

Among 405 HIV-exposed infants, 11 were diagnosed HIV-positive, an MTCT rate of 2.72% (95% CI 1.36% to 4.81%). MTCT declined significantly from 5.56% in 2022 to 0% by early 2025 (p=0.0015). All transmissions occurred in primary-level facilities (8.27%), with none in secondary-level facilities (0%). Exclusive breastfeeding occurred in 90.9% of visits (95% CI 89.3 to 92.4%). Growth failure was rare among exclusively breastfed infants (0.48%) but markedly higher among replacement-fed infants (26.2%). Programme retention was 99.8%, mortality 0.2%, and no infants were lost to follow-up. Cervical cancer screening coverage was high (98.6% offered, 98.3% accepted), though only 76.9% completed screening.

Despite catastrophic health system disruption, facility-based HIV services in post-war Tigray achieved near-elimination of MTCT by 2025, with exceptional retention, prophylaxis coverage and breastfeeding outcomes. Concentration of PMTCT services at secondary-level facilities was strongly associated with reduced transmission. However, these findings represent a selected population successfully accessing services; true population-level outcomes are likely substantially worse. Sustained investment in facility-based services and community outreach is essential for comprehensive HIV care recovery.

Infections are a leading cause of non-relapse mortality following chimeric antigen receptor T-cell therapy (CAR-T) and bispecific antibody (BsAb) therapies. However, infection data from clinical trials are often incomplete, lack pathogen-level detail and rarely capture late infectious complications. This CAR-T treatment in Lymphoma: Analysis of Risk of Infection following Therapy (CLARITY) study aims to generate real-world, longitudinal infection data with extended follow-up to characterise infection timing, including late events and inform risk prediction in patients with lymphoma and myeloma receiving novel immunotherapies.

CLARITY is a multicentre observational cohort study across six Australian centres enrolling adults treated with CAR-T or BsAb therapies. A co-designed REDCap (Research Electronic Data Capture) instrument captures infections classified as microbiologically defined, clinically defined or fever of unknown origin, using internationally standardised definitions. Patients were enrolled between 2019 and 2023, with at least 2 years follow-up per patient, allowing time-updated data on immunosuppressive exposures, haematological recovery and prophylaxis. Multivariable regression and landmark analyses will estimate infection incidence and identify dynamic risk factors over time. Incidence rate ratios will assess prophylaxis effectiveness. Data integrity is supported by central adjudication and site-level audits.

The study has received a waiver of consent (HREC/PMCC/89002) and was co-designed by haematology and infectious diseases investigators. Findings will be disseminated through peer-reviewed publications, scientific meetings and national guideline committees to inform infection prevention and late effects surveillance in immunotherapy-treated populations.

While exercise adherence is known to vary during cancer treatment, little is known about what predicts these changes during chemotherapy or within individual treatment cycles for breast cancer. We examined changes in adherence and its predictors (1) across chemotherapy treatment and (2) within treatment cycles in women undergoing (neo-)adjuvant chemotherapy for breast cancer.

This study is based on data from the Phys-Can multicentre parallel randomised trial.

The exercise intervention was conducted at public gyms in three Swedish university cities.

178 women undergoing (neo-)adjuvant chemotherapy without any chemotherapy treatment delays and had any adherence data were included in the analysis.

Participants in the Phys-Can trial were randomised to either high or low-to-moderate intensity combined endurance and resistance training.

The primary outcome variable for this secondary analysis of Phys-Can trial data was adherence to endurance and resistance training. Bayesian multilevel growth curve models were used to examine adherence to resistance and endurance training throughout the chemotherapy treatment period and within chemotherapy cycles. Potential predictors of adherence included exercise intensity, chemotherapy dose, muscle strength, body mass index, cardiorespiratory fitness, fatigue and age. Results are reported with 95% credibility intervals (CrIs).

Adherence to endurance and resistance training declined on average across the chemotherapy treatment by 1% (95% CrI -1.5, -0.5) and 5.2% (95% CrI -6.8, -3.6), respectively, per week. Adherence decreased within the chemotherapy treatment cycle by 2.4% for endurance (95% CrI -4.2, -0.7) and 6.1% (95% CrI -8.2, -4.1) for resistance training, respectively. Higher baseline fitness predicted better adherence to endurance exercise (β=1.2, 95% CrI 0.1, 2.3), while high-intensity training predicted a steeper decline (β=-1.2, 95% CrI -2.2, 0.2). No significant predictors were found for adherence to resistance training over time.

Women with breast cancer may require additional support to maintain exercise adherence during the later stages of chemotherapy and during the second and third weeks of their chemotherapy cycles. Those with lower pretreatment fitness levels may benefit from more intensive support to sustain engagement in exercise.The Phys-Can trial was registered in Clinical trials: ClinicalTrials.gov NCT02473003.

Body mass index (BMI) confers a higher risk of colorectal cancer (CRC) and may influence cancer diagnostic pathways. We investigated variations in diagnostic pathways by BMI category among patients with symptomatic CRC.

Retrospective cohort study using linked cancer registry, primary, and secondary care data.

England PARTICIPANTS: 5571 patients with symptomatic CRC diagnosed in England between 2011 and 2015.

Route to CRC diagnosis (emergency presentation and fast-track referrals among patients with new-onset red flag symptoms), presenting symptoms and pre-diagnostic endoscopy use.

Red-flag symptoms (change in bowel habit, rectal bleeding) were more frequently recorded among patients with rectal cancer with obesity and overweight versus normal weight (65.2% and 65.5% vs 56.8%, respectively). Among colon cancer patients endoscopy during the year pre-diagnosis was used in a greater proportion of patients with obesity versus normal weight (72.8% vs 64.4%, p<0.001). Among patients with colon cancer with red-flag symptoms, being overweight versus normal weight was associated with higher odds of fast-track referral compared with diagnosis through other routes (OR: 1.48, 95% CI 1.16 to 1.88). Obesity was associated with lower odds of emergency presentation, compared with normal weight (colon 23.6% vs 32.1%; adjusted OR: 0.72, 95% CI 0.57 to 0.90; rectum 8.3% vs 14.8%; OR: 0.57, 95% CI 0.35 to 0.92).

Patients with CRC with higher BMI are more likely to be referred urgently and less likely to experience emergency cancer diagnosis than normal weight patients.

Stereotactic body radiotherapy (SBRT) delivered on an MRI-guided linear accelerator (MR-linac) enables highly conformal prostate cancer irradiation. The DESTINATION 2 trial is a federated, randomised phase II/R-IDEAL 2b study evaluating whether de-escalating the dose to prostate tissue, while maintaining a high dose to MRI-visible tumour(s) in two fractions, reduces genitourinary (GU) treatment-related adverse events (AE) without compromising disease control in men with localised prostate cancer.

200 men worldwide with localised, MRI-visible prostate cancer will be randomised 1:1 to receive either (1) prescribed uniform dose MR-linac SBRT (27 Gy in two fractions to the whole prostate and seminal vesicles with 0 mm CTV-PTV margin) or (2) de-escalated SBRT (20 Gy in two fractions to whole prostate with 0 mm CTV-PTV margin and 27 Gy in two fractions to MRI-visible tumour(s) with a 4 mm intraprostatic margin applied to the GTV. All treatments are delivered using MRI-guided adaptive Radiotherapy (MRIgRT). The primary endpoint is the absolute and relative risk reduction in acute grade 2+GU AE (CTCAE v5) within 12 weeks of completing radiotherapy. Secondary endpoints include late GU AE, acute and late gastrointestinal (GI) AE, sexual AE, patient-reported outcomes, dosimetry, technical feasibility and 2-year biochemical relapse-free survival.

This is a federated trial design in which each centre operates independently with its own sponsor, ethics committee approval and regulatory oversight. Each centre is responsible for obtaining and maintaining local ethics approval in accordance with their national and institutional requirements. The UK centre (The Royal Marsden NHS Foundation Trust) has received ethical approval from the East of England-Cambridge South Research Ethics Committee (REC reference: 24/EE/0163; IRAS: 338368). Results will be disseminated via peer-reviewed publications and conference presentations.

NCT06638541.

Breast cancer is the most commonly diagnosed cancer among women and is the leading cause of cancer death among Latina individuals. Breast cancer survivors are at increased risk of obesity. Mobile health interventions have been shown to be an effective way of reducing the risk of weight gain. Less studied but also important is the extent to which social networks play a role in supporting or undermining weight loss efforts.

We examined the association between 4 kinds of social network interactions and change in BMI among Latina and non-Hispanic White breast cancer survivors engaging in a mobile health app pilot study.

Latina and non-Hispanic White breast cancer survivors were randomized to engage in either the Mi Salud or Mi Vida, Mi Salud app. Mi Salud allowed participants to engage in self-monitoring by recording their behaviors and symptoms. Mi Vida, Mi Salud used these same features in addition to a self-discovery feature that would summarize and report back this information to participants. We collected information on BMI and health-related social support; positive and negative health-related social control (which included persuasion and pressure, respectively); and undermining at baseline and after 12 weeks of the intervention.

While participants (non-Hispanic White n=22 and Latina n=22) in both study arms experienced decreased BMI over the 12-week period, this change in BMI did not differ according to ethnicity. Furthermore, change in social support was not associated with decreased BMI (B=-0.19, P=.12). However, the interaction between change in social support and ethnicity was significant, such that predicted margins were significant for non-Hispanic White individuals (B=-0.57, P=.02) but not for Latina individuals (B=-0.54, P=.72). Change in persuasion was not associated with change in BMI (B=0.072, P=.61); however, increased pressure was associated with increased BMI (B=0.66, P=.02). Finally, change in undermining was not associated with change in BMI (B=0.32, P=.11).

Latina and non-Hispanic White participants did not differ in weight loss. However, our findings regarding social network involvement and change in BMI show the importance of considering social network processes in weight loss among breast cancer survivors. These findings buttress existing research suggesting the benefits of social support, particularly within specific cultural frameworks, while attempts to increase participants' healthy behaviors that involve criticism can be detrimental to change efforts. Future research that builds on these findings is needed to elucidate the specific social network processes that may drive health behavior among diverse breast cancer survivors.

Gastric cancer (stomach cancer) is an important contributor to morbidity and mortality in Aotearoa New Zealand, with marked ethnic inequities. Although national incidence rates are declining, Māori and Pacific peoples continue to experience higher rates than other groups. Demographic change and regional population growth are expected to influence future burden, yet no published projections provide estimates disaggregated by ethnicity and region.

Gastric cancer registrations from 2001 to 2022 from the New Zealand Cancer Registry were linked to population estimates and projections stratified by age, sex, prioritised ethnicity and Health New Zealand - Te Whatu Ora region. Incidence was modelled using an age-period-cohort approach with time-based weighting to emphasise recent trends. Projections to 2045 were generated, and uncertainty was quantified using 1,000 non-parametric bootstrap iterations incorporating perturbation of population denominators.

Gastric cancer cases are projected to increase by 47.7% to approximately 725 per year by 2045, despite a decline in the age-standardised rate from 5.9 to 5.3 per 100,000. All regions show increasing absolute numbers, with the Northern Region experiencing the largest rise. Māori and Pacific peoples have the highest current incidence and a large proportional increase in projected cases, although incidence rates decline modestly for all ethnic groups. Future case growth is driven mainly by demographic expansion and an ageing population.

Absolute gastric cancer cases are projected to increase, particularly among Māori and Pacific populations and in regions experiencing rapid population growth. This has implications for early diagnosis and specialist service delivery. These projections support equity-focussed prevention and service planning, including Helicobacter pylori control, timely diagnostic pathways, and regional planning for specialist cancer services.

Chronic myeloid leukemia (CML) has evolved into a chronic condition as a consequence of effective tyrosine kinase inhibitor (TKI) therapy, leading to an expanding demographic of patients necessitating lifelong monitoring. The use of eHealth solutions has the potential to facilitate sustainable and patient-centered care by enabling remote monitoring and enhancing guideline adherence. The Dutch CMyLife digital care platform incorporates a CML Dashboard intended for health care professionals (HCPs). This dashboard is designed to provide insight into real-world CML care and enable remote monitoring.

This study aimed to evaluate the feasibility of the CML Dashboard for remote monitoring of CML care, to assess the usefulness of dashboard-derived data, and to identify barriers and facilitators for its implementation in routine clinical practice.

We conducted a multimethods early-stage evaluation, determining the feasibility of the CML Dashboard and its barriers and facilitators. Quantitative data were generated through the CMyLife app and displayed in the CML Dashboard. These data were collected over a 2.5-year period and analyzed descriptively. Concurrently, semistructured interviews were conducted with HCPs treating patients with CML to explore barriers and facilitators for implementation. The analysis of interview transcripts was conducted using framework analysis, using established implementation models.

Of the 199 patients who were registered, 177 provided data to the dashboard. The dashboard provided insight into patient characteristics, TKI treatment, BCR::ABL1 values, and monitoring intervals. However, the completeness and reliability of the data were limited, as the majority of the data were manually entered by the patients. The absence of complete data and the presence of inconsistencies in monitoring time points reduced the immediate usability of the dashboard for clinical decision-making and quality monitoring. A total of 8 HCPs participated in the interviews. The facilitators included an enhanced overview of patient data, support for consultation preparation, and the potential for remote monitoring and quality improvement. Key barriers identified were the lack of integration with electronic medical records, the necessity for additional log-in procedures, the limited adoption of the app by patients, and the perception of its added value as being inferior to existing systems.

The prospect of implementing a remote monitoring system for CML care holds promise. Such a system, using a digital dashboard, has the potential to enhance oversight and contribute to the enhancement of quality assurance. Nonetheless, the implementation of automated data exchange with electronic medical records, enhanced data completeness, and the augmentation of integration into clinical workflows are imperative prior to the large-scale implementation and the transition toward home-based CML care.

To identify and map prehabilitation services for patients preparing for cancer surgery in the UK National Health Service (NHS) and understand how issues of accessibility and inequality are being addressed.

A survey based on the Template for Intervention Description and Replication and criteria for high-quality, equitable prehabilitation developed as part of our broader study.

National Health Service organisations in the UK.

Representatives of prehabilitation services, who were mainly healthcare professionals. To be eligible for inclusion, services had to be part of the funded usual care pathway for patients in the NHS trust or health board and offered, referred to, or signposted by the NHS cancer care team.

The primary outcome was the availability of a prehabilitation service to patients who were preparing for cancer surgery at a given NHS organisation. Where prehabilitation services existed, we collected data on service characteristics, the size and workload of the service, screening and individualised assessment for prehabilitation, interventions, addressing inequalities, and evaluation of the service.

Of 152 NHS organisations which provided cancer surgery services, we received a response from 112 (74%). Of these, 73 (65%) stated that they had an eligible prehabilitation service, and 39 (35%) stated that they did not. We received detailed survey responses from 51/73 prehabilitation services (70%). These demonstrated variability across all survey domains. Most services involved physiotherapists (43; 84%) and dietitians (37; 73%), with a variety of other professions represented. Twenty-four prehabilitation services (47%) reported that they tailor initial assessments to account for patient characteristics, and most services reported that they take steps to address inequities of access, the most common being support for people who have barriers to accessing the internet (46; 90%). Only 19 prehabilitation services (37%) were in receipt of permanent funding.

Prehabilitation provision for people preparing for cancer surgery varies widely across the UK, and this creates inequities in services. Nevertheless, prehabilitation services appear to be aware of the risk of unequal access, and are taking steps to address this. There is an opportunity to address inequalities as prehabilitation services are commissioned, developed and implemented.

Central nervous system (CNS)-type tumors may occur in the ovary, often associated with a mature teratomatous component. Because of their rarity, little is known about the tumor types historically designated within the primitive neuroectodermal tumors (PNET) terminology and whether they share histopathological and molecular features akin to those of their CNS counterparts. Herein, we retrospectively investigated data from 13 ovarian tumors, initially diagnosed as either "PNETs" or CNS-type neoplasms. For each tumor we performed comprehensive histopathologic, genetic and epigenetic analyses and retrieved clinical data when available. Integrated diagnoses were established after a central review of histopathological and molecular data, the following entities were identified: four embryonal tumors with multilayered rosettes (non C19MC-altered), three medulloblastomas, SHH-activated, three ependymomas not elsewhere classified, one Ewing sarcoma, one sarcoma, DICER1-mutant, and one peripheral neuroblastoma. Interestingly, none of the ETMRs harbored a C19MC amplification or DICER1 mutation. The three medulloblastomas, SHH-activated were histopathologically and molecularly similar to their CNS counterparts. Ependymomas did not show any classifying molecular alteration and presented a distinct epigenetic profile when compared with CNS ependymomas. These results indicate that ovarian "PNETs" comprise a heterogeneous spectrum of CNS and extra-CNS embryonal or non-embryonal tumor types, and that brain tumor methylation classifiers may be used to classify these tumors. Moreover, these components are characterized by distinct molecular alterations from primary CNS tumors, without C19MC alterations for ETMRs, with an overrepresented SHH-subgroup for medulloblastomas, and with an epigenetic profile distinct from CNS counterparts in ovarian ependymomas. These data need to be confirmed before they can be incorporated into future patient personalized treatment.