Sexual and gender minority people (SGM) experience multiple cancer-related disparities, including higher rates of cancer risk factors, lower rates of cancer screening, higher lifetime risk of cancer, and unmet needs throughout cancer survivorship. Although many national organizations, including the National Cancer Institute (NCI) and the American Cancer Society (ACS), have emphasized the need for more cancer research among SGM communities, currently no consensus exists about the highest research priorities, promising research models, or mechanisms to support collaboration between geographically dispersed scientific teams. To address this gap, we convened a three-day conference to focus on the "Science of Cancer Health Equity for SGM Communities." Held at the New York University (NYU) Langone Medical Center Campus in New York City from October 5-7, 2023, this conference brought together researchers, trainees, early-stage investigators, and community members. The conference aimed to: 1) examine the current span of evidence-based research on SGM cancer across the cancer control continuum; 2) establish SGM cancer research priorities; 3) promote the careers and research of trainees and early stage investigators, especially those from minoritized backgrounds; 4) develop a transdisciplinary network of professionals with a focus on mentorship and shared research methods; and 5) disseminate findings from this conference, including priorities for SGM cancer health equity research. Response to the conference was overwhelmingly positive. The success of this inaugural conference indicated the need for additional efforts to advance SGM cancer research and expand on scientific priorities.
The development of Artificial Intelligence (AI) is rapidly advancing, and AI tools are being integrated into many aspects of daily life, including medical care and public health. The full extent to which AI related tools can be implemented in order to strengthen health systems are a matter of continued debate. The Center for International Health at Ludwig-Maximilians-Universität's (CIHLMU) 2025 student-led symposium on "The Role of Artificial Intelligence in Health Systems Strengthening to Achieve One Health" deliberated on the transformative potential of AI in global health. The primary focus of the symposium was to explore how AI can be leveraged to strengthen health systems. Presentations were delivered by health experts on AI from Africa and Europe. The event provided a platform for experts and students to discuss how AI can be harnessed to improve healthcare delivery, disease surveillance, and research. Discussions resonated around AI health-related research, responsible AI integration, advocacy for AI-related policies, and challenges associated with AI integration in health, such as data privacy and the need for robust governance frameworks. Emphasis was placed on the importance of context-specific implementation, interdisciplinary collaboration, and robust governance to ensure AI's responsible integration into One Health approaches. The symposium concluded that AI holds immense promise to strengthen health systems by improving efficiency, equity, and responsiveness. However, ethical, infrastructural, and regulatory challenges must be addressed, particularly in low- and middle-income countries (LMICs).
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Inadequate medicolegal training contributes to physician anxiety and defensive medicine practices. To address this issue, we implemented a novel pedagogical approach incorporating simulated mediation and mock court proceedings into a medical course to enhance medicolegal competency among medical students. This study was conducted in August 2022 that recruited medical students preparing for clinical rotations. Students completed a 4-part 150-minute workshop that covered simulated mediation, mock court, debriefing, and reflection sessions. During the simulated mediation session, the participants watched expert-recorded videos of different medical mediation perspectives, followed by small-group discussions with real-time feedback. During the mock court session, a judge-led multidisciplinary expert group demonstrated actual litigation process. Data were collected by using an online questionnaire, including structured and semi-structured items. For quantitative analysis, 157 valid responses were analyzed and the questionnaire had satisfactory internal consistency. Quantitative analysis revealed significant improvements in medicolegal knowledge, empathy, and physician-patient communication, with postworkshop mean scores being significantly higher than preworkshop scores. Participant feedback indicated high satisfaction levels, with 66.9% of participants endorsing the effectiveness of simulations for learning. Qualitative analysis of 113 student reflections identified 3 themes: medicolegal competencies, mutual engagement in communication, and legal and professional reflections. This brief conflict management workshop using simulated mediation and mock court proceedings effectively enhanced medical students' perceived medicolegal knowledge, empathy, and dispute resolution skills. However, students' unfamiliarity with legal terminology highlighted learning barriers that require interdisciplinary collaboration with legal professionals. Integrating such simulations with legal expert involvement in future medicolegal education is recommended.
Despite global progress in developing integrated mental healthcare on primary healthcare level, particularly in low-and-middle income countries, descriptions of scaling-up efforts remain scarce. The aim of this study was two-fold. First, to describe a collaborative approach to embed a common mental health conditions screening tool and process within district primary health care systems in KwaZulu-Natal, South Africa. Second, to explore perceptions of participating frontline workers and policy makers of the barriers and facilitators to embedding the tool using this collaborative approach as part of a scale-up process. Following a participatory action research approach, a learning collaborative was established that involved (1) mental health service coordinators from each district of the province of KwaZulu-Natal (n = 11), (2) provincial managers and policymakers (n = 4), and (3) members of the local research team. The capacity building programme was co-developed during a series of participatory workshops, and the common mental health conditions screening tool and associated processes were implemented and workshopped iteratively. The development and implementation of this programme as part of scaling up the screening intervention was assessed drawing from workshop proceedings, individual interviews with district coordinators (n = 11), and a focus group discussion (n = 8). Data were transcribed verbatim and thematically analysed guided by the Consolidated Framework for advancing Implementation Research. The participatory development and implementation process resulted in consensus building, curriculum development, situational analyses, training, and continuous quality improvement. The collaborative and co-development approach to the capacity building curriculum was broadly favoured. Outer Settings emerged in terms of a lack of formal guidance documents for district mental health services, limited intersectoral collaboration, and limited community mental health literacy. In terms of Inner Settings, mental health continued to be under-prioritised in district services, with a lack of ring-fenced funding and data monitoring systems. Regarding Individuals, PHC staff were less well-trained and did not always want to engage in mental healthcare, with limited opportunity for capacity development. In terms of Implementation Processes, the flexibility of programme was particularly well illustrated during the disruptions of COVID-19, and adaptations were added to the programme to help address mental health and containing leadership among primary healthcare workers. While this period resulted in virtual workshops, face-to-face meetings were favoured. The scaling-up of an integrated primary mental health screening innovation requires capacity building among mid-level management, and a co-developed, collaborative programme built on continuous quality improvement provides promise in providing flexibility and communal problem-solving for more sustained implementation.
International scientific conferences expose nursing students to current evidence, professional identity formation, and global networks, yet participation remains low. We aimed to identify evaluated interventions designed to increase nursing students’ participation in international scientific conferences. Following PRISMA 2020, we searched PubMed, CINAHL, Scopus, and Web of Science for English/Japanese records from January 2005 to 31 May 2025. We also examined three International Council of Nurses (ICN) Congress proceedings items authored by the research team as contextual sources. Two reviewers independently screened titles/abstracts. Eligible studies targeted pre-licensure undergraduate nursing students and evaluated strategies intended to increase participation, reporting objective participation outcomes (e.g., abstract submission, registration, attendance, presentation). Database searches identified 173 records. After removing 58 duplicates, 115 records were screened by title and abstract. All 115 records were excluded at the title/abstract stage; therefore, no eligible evaluative studies were identified (n = 0). No evaluated interventions were identified. This empty review highlights an actionable evaluation gap. Informed by implementation and behavior-change theory and adjacent evidence, we outline implementation implications that can be adopted and monitored using routine indicators (key performance indicators) and iterative improvement cycles (Plan–Do–Study–Act). The online version contains supplementary material available at 10.1186/s12909-026-08859-8.
We aimed to begin studying, more empirically, within our ethics department,scientific integrity itself, considering scientific integrity as an integral part of morality. We therefore decided to start with a preliminary meta-ethics study, based on a small sample of chapters from two conference proceedings, published exclusively in French in 2016 and 2021, to which two of us have actively contributed . A thematic analysis of secondary information extracted from this sample enabled us to identify three principal themes in scientific integrity: its institutionalization, definition and applicability. And these themes, with their subthemes, highlighted two trends. On the one hand, scientific morality tends towards moral absolutism, whereas, on the other, it tends towards moral relativism. In other words, context does not, morally, justify anything in the first case, but can, ethically, justify certain things in the second. We think that it would be questionable to formalize scientific integrity as a moral absolutism, but this does not necessarily tip the balance in favor of radical moral relativism either. Scientific integrity should allow a contextualization of certain scientific practices within the framework of the activities of research ethics committees applying pragmatist ethical theories.
Preconception health status, especially of women, but also of men, is known to influence pregnancy outcomes. Despite knowledge of the growing importance of preconception health, numerous challenges remain for conducting research in this population and delivering appropriate clinical care. The 2023 Global Pregnancy Collaboration annual workshop focused on exploring preconception health as it relates to adverse pregnancy outcomes. Here we summarize the proceedings and the current state of the science. We particularly focus on quantifying the exposome as a rich target for investigation of factors that increase the risk for and/ or contribute to preeclampsia and other adverse pregnancy outcomes. We conclude with recommendations for the scientific and clinical community to address knowledge gaps regarding the links between preconception health and adverse pregnancy outcomes.
Immune checkpoint inhibitors (ICIs) combined with other agents have emerged as the standard first-line treatment for metastatic hepatocellular carcinoma (HCC), replacing tyrosine kinase inhibitors (TKIs). However, the comparative efficacy and safety of different ICI-based combinations remains unclear. To evaluate the efficacy and safety of ICI-based combinations versus TKIs across different regimens through a systematic review and network meta-analysis (NMA) of phase III randomized controlled trials (RCTs). A comprehensive literature search was conducted across major databases and conference proceedings between 2019 and 2024. Eligible studies included phase III RCTs that evaluated ICI combinations in the first-line setting for metastatic HCC. Pairwise meta-analysis and Bayesian NMA were performed to assess overall survival (OS), progression-free survival (PFS), overall response rate (ORR), treatment-related adverse events (TRAEs), grade 3–4 TRAEs, and therapy discontinuation owing to toxicity. Six RCTs comprising 3937 patients were included in the study. Compared with TKIs, ICI-based combinations improved OS (OR, 0.72; 95% CI: 0.58–0.91) and ORR (OR: 3.13; 95% CI: 2.07–4.47), without significantly increasing TRAEs. No significant benefit was observed in PFS (OR, 0.81; 95% CI: 0.56–1.19). The NMA rankings suggested camrelizumab plus rivaroceranib (CAM+ RIVO), nivolumab plus ipilimumab (NIVO + IPI), and durvalumab plus remelimumab (DURVA + TREME) as the most effective regimens for OS, PFS, and ORR, respectively. DURVA + TREME appeared to have the best safety profile, and CAM + RIVO was associated with higher rates of treatment discontinuation due to toxicity. ICI-based combinations are more effective than TKIs in improving the OS and ORR in patients with metastatic HCC, with an acceptable safety profile. CAM + RIVO, NIVO + IPI, and DURVA + TREME have emerged as promising first-line options, although direct comparisons in future trials are warranted to confirm these findings. The online version contains supplementary material available at 10.1186/s12885-026-15893-8.
In 2021, an ad hoc committee of the United States (U.S.) National Academies of Science, Engineering, and Medicine (NASEM) affirmed that robust, relationship-centered primary care is the foundation of efficient, effective health care. Yet the ad hoc committee also noted primary care was "slowly dying," due to chronic under-investment, ill-suited payment models, and inadequate workforce planning and development. Encouragingly, efforts to revitalize primary care are underway. To accelerate this movement by generating expert consensus recommendations on the highest priority actions to take in repairing the frayed U.S. primary care base, clinical scientists at the University of California Davis (UCD) School of Medicine convened the Summit to Revitalize Primary Care (Rev PC). Summit recommendations were generated in four closed working sessions of a national Expert Committee. Committee members were selected to ensure a breadth of perspectives (e.g., health plans, purchasers of insurance, regulatory agencies, health systems, clinicians, educators, researchers, economists) from the public and private sectors. Seven high priority recommendations emerged: (1) Increase the proportion of spending on primary care, coupled with initiatives to slow the growth in total health care spending; (2) Pay for primary care using models that support high quality, team-based, relationship-centered, equitable care; (3) Assist practices in transformation to advanced primary care models and assess the impacts on clinical teams, patients, and communities; (4) Maximize primary care's potential to equitably advance health; (5) Advocate for training an appropriately large and diverse primary care physician workforce; (6) Expand research to address the most pressing issues in primary care; (7) Collaborate with a broad array of societal stakeholders in messaging the importance of robust primary care. These recommendations both overlap with and expand on those of the NASEM ad hoc committee and subsequent Standing Committee on Primary Care. Broad pursuit of the recommendations would catalyze sustained momentum toward appropriate primary care investment and workforce planning and development, enabling U.S. primary care to realize its yet-unfulfilled potential to improve population health and advance health equity while helping to control growth in total health care costs.
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Negative perceptions of insulin therapy are common in diabetes mellitus (DM) patients and may delay treatment. Insulin perception has been studied in type 2 diabetics but not type 1 or prediabetics. The aim of this study was to determine the differences in perceptions of insulin use between diabetes types. This cross-sectional study was conducted at a tertiary care hospital between December 2023 and April 2024. Participants were adult diabetes outpatient clinic patients with T1DM, T2DM, or prediabetes. The validated Insulin Therapy Appraisal Scale (ITAS) quantified patients' insulin therapy perceptions. Patients who did not use insulin and were in the prediabetes category answered the questions based on their current knowledge about insulin treatment. Higher scores on the positive sub-dimension indicate more favorable perceptions of insulin therapy, whereas higher scores on the negative sub-dimension and total ITAS reflect more negative perceptions. p-value < 0.05 was considered statistically significant. A total of 160 adult patients were included in the study. Patients with T1DM demonstrated significantly higher ITAS positive sub-dimension scores and lower negative sub-dimension and total ITAS scores compared with patients with T2DM and prediabetes (p < 0.05). No significant differences in ITAS scores were observed between the T2DM and prediabetes groups. Correlation analyses showed that the ITAS positive sub-dimension score was inversely associated with age and C-peptide levels. In contrast, negative sub-dimension and total ITAS scores were positively correlated with age and C-peptide levels but negatively correlated with diabetes duration. Marital status, highest education level, and regular blood glucose monitoring were found to significantly influence insulin perception (p < 0.05). Female patients exhibited more positive perceptions, whereas insulin users, patients without diabetes-related complications, and those who exercised regularly demonstrated less negative attitudes toward insulin therapy. Patients with T1DM have significantly more positive perceptions of insulin therapy compared with patients with T2DM and prediabetes. Identifying factors influencing insulin-related perceptions may help improve acceptance of insulin therapy and enhance treatment adherence in patients with diabetes. N/A.
This paper reports on insights from the OPTIMA (Optimal Treatment for Patients with Solid Tumours in Europe Through Artificial Intelligence) prototyping workshop held in Berlin from November 6 to November 8, 2024. Through integrated analysis of clinical, genomic, imaging and pathology data, we addressed the following key challenges in breast and lung cancer management: utility of comprehensive genomic profiling in metastatic breast cancer settings; relevance of tumor heterogeneity for predicting treatment response; development of less invasive technologies for assessing tumor biology; and treatment outcomes in early stages of small cell lung cancer. Our findings demonstrate the potential of computational analysis using multiple data modalities to identify cancer molecular subtypes and enhance treatment selection and monitoring while highlighting important areas for future development to achieve the research objectives of the OPTIMA consortium.
Respiratory pathogen surveillance dashboards surged during the COVID-19 pandemic and have remained widely used tools for real-time data visualization in public health. While these dashboards offer timely, actionable insights for monitoring trends and decision-making, their rapid expansion has also highlighted persistent challenges related to governance, data accessibility, standardization, and sustainability. To explore these issues in depth, the Center of Excellence for Respiratory Pathogens (CERP) hosted a two-day workshop in Lyon, France. Experts representing a range of respiratory pathogen surveillance initiatives convened to share experiences, highlight successes, and discuss ongoing challenges. Key themes included the need for improved data quality, transparency, and standardization; sustainable IT infrastructure and staffing; greater access to underlying data; and alignment between dashboard objectives and user needs. Participants emphasized that broader governance and collaboration challenges strongly impact dashboard performance and interoperability. This report summarizes the valuable insights and subsequent actionable recommendations that emerged from the workshop, offering guidance to both developers and users of respiratory pathogen (or disease burden) dashboards. It aims to support the development of a more integrated, effective, and sustainable global respiratory surveillance ecosystem.