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Abstract Background The EU Patient-cEntric clinicAl tRial pLatforms (EU-PEARL) project (IMI2-853966) aimed to develop tools to establish integrated research platforms (IRP) for conducting adaptive-design trials in various diseases, including metabolic-dysfunction associated steatohepatitis (MASH). One essential component of a successful MASH IRP is a robust and reliable Clinical Research Network (CRN). Herein, we outline the required elements and anticipated steps to set-up such a CRN. Methods We identified European clinical research sites that could potentially serve as the foundation for MASH IRP and a CRN. A survey was sent to sites to assess their interest in joining a CRN, their familiarity with platform trials, and their capacity to participate in a future MASH IRP. Results A total of 141 investigators were invited to participate in the survey, and 40% responded. More than half of the answers (52%) identify MASH with advanced fibrosis (F3-4) as the subpopulation with the greatest unmet need. Regarding the difficulty in identifying candidates for trials, 65% find it is moderately difficult and 30% very difficult. Most respondents (94%) believe that a platform trial could offer substantial benefits to patients. Nearly all researchers express interest in participating in a platform trial (78%), with 22% indicating their interest would be contingent on initial industry funding. Conclusion While preliminary, our findings on responding sites are encouraging for the potential establishment of a CRN for a MASH IRP. However, funding schemes and sustainability strategies to provide proof-of-platform in MASH seem key in the short-term scenario.

Objective: To compare, from an empirical point of view, the use of focus group and photovoice as we conducted two studies on food environment in neighbourhoods with different socio-economic profiles. Method: The European project Heart Healthy Hoods studied the association between the physical and social environment of Madrid (Spain) and the cardiovascular health of its residents. Two ancillary studies were developed to further expand the study of urban health inequalities using focus group and photovoice. Both studies, similar in their objectives and study populations, are the basis for comparing both techniques. The comparison considered the following methodological aspects: study design, logistic aspects, commitment and involvement, ethical issues, and data analysis. Results: We identified differences, similarities, potentialities, and limitations of each technique with their corresponding results. We found that depending on the research objectives, one technique was more beneficial than the other. If the objective is producing new knowledge, using focus group would be the most appropriate technique, whereas if the objective includes generating social change, photovoice would be more suitable. We found that photovoice is a powerful technique in public health, especially studying social processes related to population health, requiring extra effort from researchers and a special care with the related ethical considerations. Conclusions: Increasing participants’ awareness, involving decision makers to channel proposals, the atypical role of researchers and ethical implications of photography are aspects to be considered when choosing photovoice instead of focus group. Resumen: Objetivo: Comparar empíricamente el uso del grupo focal y el fotovoz en investigación sobre el entorno alimentario en barrios con diferente perfil socioeconómico. Método: El proyecto europeo Heart Healthy Hoods estudió la asociación entre el entorno físico y social de Madrid y la salud cardiovascular de sus residentes. Dentro de él se desarrollaron dos estudios para analizar las desigualdades en salud utilizando las técnicas del grupo focal y el fotovoz. Ambos estudios, similares en sus objetivos y población diana, fueron la base para comparar las dos técnicas. Consideramos los siguientes aspectos metodológicos: diseño, aspectos logísticos, compromiso e implicación del equipo investigador y de las personas participantes, cuestiones éticas y análisis de los datos. Resultados: Identificamos diferencias, similitudes, potencialidades y limitaciones de cada técnica utilizada con sus correspondientes resultados. Dependiendo de los objetivos, una técnica sería más beneficiosa que la otra. Si el objetivo es producir nuevo conocimiento, el grupo focal sería la técnica más adecuada, mientras que, si el objetivo incluye generar cambio social, el fotovoz sería más apropiado. Consideramos el fotovoz una técnica muy provechosa para la investigación en salud pública, especialmente para estudiar procesos sociales en relación con la salud de la población, aunque requiere un esfuerzo adicional por parte del equipo investigador y de los participantes, y un cuidado especial con las consideraciones éticas. Conclusiones: Aumentar la conciencia de las personas participantes, involucrar a decisores políticos para canalizar las propuestas resultantes, el papel atípico del equipo investigador y las implicaciones éticas de la fotografía son aspectos a considerar si elegimos el fotovoz frente al grupo focal.

La formación del profesorado sobre la especificidad de las escuelas situadas en territorios rurales se torna necesaria y clave para hacer frente a la imagen sesgada, victimizada y desvirtuada que se difunde en los medios de comunicación, en las políticas educativas neoconservadoras y en los manuales didácticos. Parte del cambio está en la inclusión de la realidad de estas escuelas en los planes formativos de los Grados de Educación Infantil y Educación Primaria, con la finalidad de dotar al futuro profesorado de conocimientos, habilidades y actitudes que les permita desarrollar prácticas educativas conectadas y coherentes a la casuística de cada territorio rural. Esto debe ser enfocado desde una triple vertiente: organizativo, didáctico-curricular y sociocultural. La sostenibilidad de los territorios rurales depende en parte del ejercicio profesional del profesorado que puede contribuir al arraigo y a la fijación de la población para prevenir el fenómeno de la España vaciada.

Summary: Platform trials bring the promise of making clinical research more efficient and more patient centric. While their use has become more widespread, including their prominent role during the COVID-19 pandemic response, broader adoption of platform trials has been limited by the lack of experience and tools to navigate the critical upfront planning required to launch such collaborative studies. The European Union-Patient-cEntric clinicAl tRial pLatform (EU-PEARL) initiative has produced new methodologies to expand the use of platform trials with an overarching infrastructure and services embedded into Integrated Research Platforms (IRPs), in collaboration with patient representatives and through consultation with U.S. Food and Drug Administration and European Medicines Agency stakeholders. In this narrative review, we discuss the outlook for platform trials in Europe, including challenges related to infrastructure, design, adaptations, data sharing and regulation. Documents derived from the EU-PEARL project, alongside a literature search including PubMed and relevant grey literature (e.g., guidance from regulatory agencies and health technology agencies) were used as sources for a multi-stage collaborative process through which the 10 more important points based on lessons drawn from the EU-PEARL project were developed and summarised as guidance for the setup of platform trials. We conclude that early involvement of critical stakeholder such as regulatory agencies or patients are critical steps in the implementation and later acceptance of platform trials. Addressing these gaps will be critical for attaining the full potential of platform trials for patients. Funding: Innovative Medicines Initiative 2 Joint Undertaking with support from the European Union’s Horizon 2020 research and innovation programme and EFPIA.

We report new radio observations of SDSS J090122.37+181432.3, a strongly lensed star-forming galaxy at z = 2.26. We image 1.4 GHz ( L -band) and 3 GHz ( S -band) continuum using the Very Large Array (VLA) and 1.2 mm (band 6) continuum with Atacama Large Millimeter/submillimeter Array, in addition to the CO(7–6) and C i ( ^3 P _2 → ^3 P _1 ) lines, all at ≲1.″7 resolution. Based on the VLA integrated flux densities, we decompose the radio spectrum into its free–free (FF) and nonthermal components. The infrared–radio correlation parameter ${q}_{\mathrm{TIR}}={2.65}_{-0.31}^{+0.24}$ is consistent with expectations for star-forming galaxies. We obtain radio continuum-derived star formation rates (SFRs) that are free of dust extinction, finding ${620}_{-220}^{+280}\,{M}_{\odot }\,{\mathrm{yr}}^{-1}$ , ${230}_{-160}^{+570}\,{M}_{\odot }\,{\mathrm{yr}}^{-1}$ , and ${280}_{-120}^{+460}\,{M}_{\odot }\,{\mathrm{yr}}^{-1}$ from the FF emission, nonthermal emission, and when accounting for both emission processes, respectively, in agreement with previous results. We estimate the gas mass from the C i ( ^3 P _2 → ^3 P _1 ) line as M _gas = (1.2 ± 0.2) × 10 ^11 M _☉ , which is consistent with prior CO(1–0)-derived gas masses. Using our new IR and radio continuum data to map the SFR, we assess the dependence of the Schmidt–Kennicutt relation on choices of SFR and gas tracer for ∼kpc scales. The different SFR tracers yield different slopes, with the IR being the steepest, potentially due to highly obscured star formation in J0901. The radio continuum maps have the lowest slopes and overall fidelity for mapping the SFR, despite producing consistent total SFRs. We also find that the Schmidt–Kennicutt relation slope is flattest when using CO(7–6) or C i ( ^3 P _2 → ^3 P _1 ) to trace gas mass, suggesting that those transitions are not suitable for tracing the bulk molecular gas in galaxies like J0901.

“En cinco años me veo con mi propio negocio, mis propias ganancias para que yo pueda decidir y hacer más cosas”, fue lo que comentó Noemi, una mujer desempleada de 56 años durante nuestra entrevista (N. Casillas, comunicación personal, noviembre de 2022), quien al mencionar su plan a corto plazo demuestra una clara consciencia de su situación actual y determinación por cambiarla para tomar el control de su futuro. En los siguientes apartados explicaré las adversidades y circunstancias sociales que han llevado a Noemí y a miles de mujeres más en México a enfrentar una combinación de desempleo, pobreza laboral, trabajo no remunerado y vulnerabilidad social entre otras fricciones. Finalmente, se plantea un modelo que espera responder a esta problemática a través de la preparación de comida casera como una opción para recuperar su autonomía financiera: el de las dark fondas.

Background: The International Society of Paediatric Oncology Society Global Mapping Program aims to describe the local pediatric oncology capacities. Here, we report the data from Latin America., Methods: A 10-question survey was distributed among chairs of pediatric oncology services. Centers were classified according to patient volume into high- (HVC; 100 or more new cases per year), medium- (MVC; 31-99 cases), and low-volume centers (LVC; 30 cases or less), respectively. National referral centers (NRC) were identified., Results: Total 307 centers in 20 countries were identified (271 responded), and 264 responses were evaluable, accounting for 78% of the expected cases (21,359 cases per year). Seventy-seven percent of patients are treated in public centers, including additional support by civil society organizations. We found that 66% of the patients are treated in 70 centers of excellence, including 21 NRC. There was a median of one pediatric oncologist every 21 newly diagnosed patients (44 for NRC), and in 84% of the centers, nurses rotated to other services. A palliative care team was lacking in 25% of the centers. LVC with public funding have significantly lower probability of having a palliative care team or trained pediatric oncology surgeons. Psychosocial, pharmacy, and nutrition services were available in more than 93% of the centers. No radiotherapy facility was available on campus in nine of 21 NRC., Conclusions: Most children with cancer in Latin America are treated in public HVC. There is a scarcity of pediatric oncologists, specialized nurses and surgeons, and palliative care teams, especially in centers with public funding., (© 2024 Wiley Periodicals LLC.)

Background: Primary central nervous system germ cell tumors (GCT) are rare neoplasms in pediatrics. Treatment depends on the histological subtype and extent of the disease. Overall survival (OS) is above 90% for germinomas and 70%-80% for nongerminomatous GCT (NGGCT) in high-income countries (HIC) while data are usually lacking for patients in Low-Middle Income country (LMIC)., Objective: This study aims to describe the experience of treating patients with CNS GCT in four of eight countries, members of the Asociación de Hemato-Oncología Pediátrica de Centro América (AHOPCA), and determine their 5-year OS., Design/methods: We conducted a retrospective chart review of patients treated for CNS GCT. Epidemiological and clinical characteristics, histology, treatment modalities, and outcomes were analyzed., Results: From 2001 to 2021, 48 patients were included: 22 from Guatemala, 18 from Nicaragua, three from the Dominican Republic, and five from El Salvador. Thirty-one (64.6%) were boys; the median age at diagnosis was 10.2 years (range: 1 to 17 years). Presenting symptoms were headaches ( n = 24, 50%), visual disturbances ( n = 17, 35.4%), vomiting ( n = 12, 25%), nausea ( n = 8, 16.7%), and diabetes insipidus ( n = 7, 14.6%). Two patients with NGGCT presented with precocious puberty. Biopsy or tumor resection was performed in 38 cases (79.2%): 23 (88.4%) germinomas, 11 (78.6%) NGGCT, and four (50%) CNS GCT. Eight patients were diagnosed and treated based on CSF tumor marker elevation; four germinomas (BHCG 11.32-29.41 mUI/mL) and four NGGCT (BHCG 84.43-201.97 mUI/mL or positive AFP > 10 UI/mL). Tumor locations included suprasellar ( n = 17, 35.4%), pineal ( n = 13, 27.1%), thalamus/basal ganglia ( n = 5, 10.4%), other ( n = 12, 25%), and one bifocal. Four (8.3%) had metastatic disease, and six had positive CSF; staging data were incomplete in 25 patients (52%). Patients were treated with varied chemotherapy and radiotherapy modalities. Nine patients had incomplete data regarding treatment. Five-year OS was 65% (68% for germinoma, 50.6% for NGGCT, and 85.7% for unclassified GCT)., Conclusions: Germinoma was the most common histology, and there was a male predominance. More than half of patients had incomplete staging data and treatment was variable across the region. OS is lower compared to HIC. Standardized treatment protocols will aid in adequate staging and treatment planning, prevent complications, and improve survival., Competing Interests: DO was employed by the company ICON PLC, a clinical research organization. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Girón, Blanco-Lopez, Calderon, Jiron, Pineda, Montero, Lizardo, Bartels and Osorio.)

Background: Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level., Methods: As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment., Results: Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology., Conclusion: Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results., (© 2024 Wiley‐Liss, Inc., A Wiley Company.)

Background/objectives: High-risk Hodgkin lymphoma (HRHL) in children is curable with combined modality therapy. The Association of Pediatric Hematology-Oncology of Central America (AHOPCA) is a consortium of cancer centers from Central America. In 2004, AHOPCA implemented a guideline with a short course of chemotherapy (mStanfordV), strict diagnostics, and radiation guidelines, aimed at reducing abandonment and improving outcomes., Methods: Newly diagnosed children less than 18 years of age with high-risk HL (Ann Arbor stages: IIB, IIIB, IV) from AHOPCA centers were staged with chest radiography and ultrasound or computed tomography. Therapy was a modified Stanford V (mStanfordV), substituting cyclophosphamide for mechlorethamine and involved field radiation., Results: Of 219 patients with HRHL, 181 patients were eligible and evaluable; 146 (81%) were boys, 22% being less than 6 years; 43 were stage IIB, 84 IIIB, and 54 IV. Thirty-one (17%) abandoned therapy, 28 (15%) progressed, 30 (17%) relapsed, and eight (4%) died of toxicity. Radiation guidelines were not followed. Five-year abandonment-sensitive event-free survival and overall survival (AS-EFS, AS-OS ± SE) for the cohort were 46% ± 4% and 56% ± 4%; 5-year AS-OS for stages IIB, IIIB, and IV was 76% ± 7%, 59% ± 7%, and 35% ± 7% (p = .0006)., Conclusion: Despite instituting a short treatment guideline, it did not improve the abandonment rate (17%) and did not achieve the reported outcomes of Stanford V. The cyclophosphamide dose used to replace merchlorethamine was inadequate. Despite strict guidelines, the radiation therapy application was inaccurate. Weekly chemotherapy may have adversely affected abandonment of therapy by increasing the burden of travel time. Based on these results, AHOPCA established a new abandonment strategy and a new guideline., (© 2023 Wiley Periodicals LLC.)