Malacological surveys were conducted in 2021 in the Kimpese region of Central Kongo Province, west of the Democratic Republic of Congo (DRC). Snail specimens were collected following a standardised protocol, identified using morphological and molecular methods, and tested for schistosome infection using a diagnostic PCR assay. Positive snail samples were sequenced to characterise the infecting schistosome species. Partial mitochondrial cytochrome c oxidase subunit 1 (COX1) gene sequences were used in phylogenetic analyses to explore the evolutionary position of these snail species within the broader African context. At least four intermediate snail hosts were identified: Bulinus truncatus, Bulinus forskalii, Biomphalaria pfeifferi, and a Biomphalaria species belonging to the Nilotic species complex (tentatively named Biomphalaria cf sudanica), of which the species identity needs to be confirmed. A total of 37 out of 1,196 snails (3.1%) tested positive for schistosome infection, with an infection prevalence of 7.4% for B. truncatus with Schistosoma haematobium and 1.5% for Biomphalaria spp. with Schistosoma mansoni. The S. mansoni sequence retrieved from these samples formed a basal clade relative to Zambian isolates, whereas S. haematobium grouped with the most frequently characterised haplotype cluster previously identified across mainland Africa. It is important to note that no animal schistosome species were identified in this study. Both the sequences from the snail hosts and the parasites represent novel contributions from the DRC. Additionally, the findings update the current knowledge of schistosomiasis transmission in the Kimpese region by providing insight into the phylogenetic placement, species diversity, and infection status of local snail populations.

Conduct disorder is a psychological condition marked by persistent patterns of rule-breaking, aggression and disregard for societal norms. As pornography consumption becomes increasingly prevalent among young adults, concerns have emerged regarding its potential psychological and social implications. This study explores how pornography consumption may contribute to conduct disorder symptoms among young adults through an in-depth qualitative analysis. Using a case-study approach, four individuals with a history of frequent pornography consumption and behavioural issues linked to conduct disorder were selected. Data were collected through detailed interviews, focusing on their experiences, behavioural patterns and psychological effects. The analysis revealed that prolonged exposure to certain types of pornography was associated with increased impulsivity, aggression and rule-breaking tendencies. Participants also reported social and emotional challenges, further reinforcing conduct disorder symptoms. This study suggests that specific patterns of pornography consumption may play a role in the development or worsening of conduct disorder symptoms. Recognizing these behavioural links is crucial for creating effective prevention and intervention strategies, especially for young adults at risk of engaging in deviant or criminal behaviour.

New Zealand and Australian governments rely heavily on voluntary industry initiatives to improve population nutrition, such as voluntary front-of-pack nutrition labelling (Health Star Rating [HSR]), industry-led food advertising standards, and optional food reformulation programmes. Research in both countries has shown that food companies vary considerably in their policies and practices on nutrition(1). We aimed to determine if a tailored nutrition support programme for food companies improved their nutrition policies and practices compared with control companies who were not offered the programme. REFORM was a 24-month, two-country, cluster-randomised controlled trial. 132 major packaged food/drink manufacturers (n=96) and fast-food companies (n=36) were randomly assigned (2:1 ratio) to receive a 12-month tailored support programme or to the control group (no intervention). The intervention group was offered a programme designed and delivered by public health academics comprising regular meetings, tailored company reports, and recommendations and resources to improve product composition (e.g., reducing nutrients of concern through reformulation), nutrition labelling (e.g., adoption of HSR labels), marketing to children (reducing the exposure of children to unhealthy products and brands) and improved nutrition policy and corporate sustainability reporting. The primary outcome was the nutrient profile (measured using HSR) of company food and drink products at 24 months. Secondary outcomes were the nutrient content (energy, sodium, total sugar, and saturated fat) of company products, display of HSR labels on packaged products, company nutrition-related policies and commitments, and engagement with the intervention. Eighty-eight eligible intervention companies (9,235 products at baseline) were invited to participate, of whom 21 accepted and were enrolled in the REFORM programme (delivered between September 2021 and December 2022). Forty-four companies (3,551 products at baseline) were randomised to the control arm. At 24 months, the model-adjusted mean HSR of intervention company products was 2.58 compared to 2.68 for control companies, with no significant difference between groups (mean difference -0.10, 95% CI -0.40 to 0.21, p-value 0.53). A per protocol analysis of intervention companies who enrolled in the programme compared to control companies with no major protocol violation also found no significant difference (2.93 vs 2.64, mean difference 0.29, 95% CI -0.13 to 0.72, p-value 0.18). We found no significant differences between the intervention and control groups in any secondary outcome, except in total sugar (g/100g) where the sugar content of intervention company products was higher than that of control companies (12.32 vs 6.98, mean difference 5.34, 95% CI 1.73 to 8.96, p-value 0.004). The per-protocol analysis for sugar did not show a significant difference (10.47 vs 7.44, mean difference 3.03, 95% CI -0.48 to 6.53, p-value 0.09).In conclusion, a 12-month tailored nutrition support for food companies did not improve the nutrient profile of company products.

In mammals, pregnancy and lactation are marked by calcium stress and bone resorption, leading to reduced bone mineral density. In humans, these periods may partly explain the higher prevalence of osteoporosis in older women compared with men, but lactation patterns in modern humans may reflect cultural influences rather than natural conditions. The extent to which these findings apply to wild-living mammals remains unknown. We measured urinary C-terminal crosslinking telopeptide of Type I collagen (CTX-I) levels, a bone resorption marker, during pregnancy in wild and zoo-housed bonobos (Pan paniscus) and during lactation in wild bonobos. Studying wild-living primates such as bonobos can provide insights into ancestral reproductive adaptations. We found an increase in CTX-I levels towards the end of pregnancy in zoo-housed and primiparous wild females. Contrary to expectations, CTX-I levels during early lactation are lower than in other reproductive phases. This pattern diverges from the assumption that lactation increases bone resorption. Our findings suggest that wild bonobos may use physiological or behavioral strategies to modulate bone metabolism during lactation. These adaptations, shaped in natural environments, provide insight into evolutionary pressures on skeletal health and may inform strategies to mitigate bone loss in humans.

Systematic reviews (SRs) synthesize evidence through a rigorous, labor-intensive, and costly process. To accelerate the title–abstract screening phase of SRs, several artificial intelligence (AI)-based semi-automated screening tools have been developed to reduce workload by prioritizing relevant records. However, their performance is primarily evaluated for SRs of intervention studies, which generally have well-structured abstracts. Here, we evaluate whether screening tool performance is equally effective for SRs of prognosis studies that have larger heterogeneity between abstracts. We conducted retrospective simulations on prognosis and intervention reviews using a screening tool (ASReview). We also evaluated the effects of review scope (i.e., breadth of the research question), number of (relevant) records, and modeling methods within the tool. Performance was assessed in terms of recall (i.e., sensitivity), precision at 95% recall (i.e., positive predictive value at 95% recall), and workload reduction (work saved over sampling at 95% recall [WSS@95%]). The WSS@95% was slightly worse for prognosis reviews (range: 0.324–0.597) than for intervention reviews (range: 0.613–0.895). The precision was higher for prognosis (range: 0.115–0.400) compared to intervention reviews (range: 0.024–0.057). These differences were primarily due to the larger number of relevant records in the prognosis reviews. The modeling methods and the scope of the prognosis review did not significantly impact tool performance. We conclude that the larger abstract heterogeneity of prognosis studies does not substantially affect the effectiveness of screening tools for SRs of prognosis. Further evaluation studies including a standardized evaluation framework are needed to enable prospective decisions on the reliable use of screening tools.

In individuals with irritable bowel syndrome (IBS), eliminating dietary triggers can alleviate symptoms but may lead to nutrient deficiencies and overall health decline. Although various nutritional supplements show promising results in relieving IBS symptoms due to their potential to alter the microbiome, conclusive scientific evidence remains lacking. This exploratory study aims to assess the bifidogenic properties of four nutritional supplement interventions and their impact on IBS-symptoms, faecal microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, stool pattern, and quality of life (QoL), compared to a placebo control. Seventy subjects with IBS, meeting the ROME IV criteria, participated in this randomised, double-blind, placebo-controlled parallel intervention study. Subjects were assigned to one of the four treatment groups, receiving either resistant starch, pea fibre, chondroitin sulfate, protein hydrolysate, or placebo daily for four weeks. Daily reports on stool pattern and gastrointestinal complaints were collected. Stool samples and questionnaires on dietary intake, symptom severity, QoL, and anxiety and depression were collected at baseline and after the 4-week intervention. The results show no significant increase in Bifidobacterium abundance or faecal SCFA levels after the 4-week intervention with any of the four nutritional supplement interventions. While some improvements in symptom severity and QoL were observed within-groups, these were not significantly different from changes observed with placebo. In conclusion, the tested nutritional supplements did not increase Bifidobacterium abundance in subjects with IBS within four weeks. Furthermore, we conclude that future studies should consider a run-in period and a larger sample size to study improvements in IBS symptoms.

Background: While efgartigimod usage is expected to reduce immunoglobulin (IG) utilization, evidence in clinical practice is limited. Methods: In this retrospective cohort study, patients with gMG treated with efgartigimod for ≥1-year were identified from US medical/pharmacy claims data (April 2016-January 2024) and data from the My VYVGART Path patient support program (PSP). The number of IG courses during 1-year before and after efgartigimod initiation (index date) were evaluated. Patients with ≥6 annual IG courses were considered chronic IG users. Myasthenia Gravis Activities of Daily Living (MG-ADL) scores before and after index were obtained from the PSP where available. Descriptive statistics were used without adjustment for covariates. Results: 167 patients with ≥1 IG claim before index were included. Prior to efgartigimod initiation, the majority of patients (62%) received IG chronically. During the 1-year after index, the number of IG courses fell by 95% (pre: 1531, post: 75). 89% (n=149/167) of patients fully discontinued IG usage. Mean (SD) best-follow up MG-ADL scores were significantly reduced after index (8.0 [4.1] to 2.8 [2.1], P<0.05, n=73/167, 44%). Conclusions: Based on US claims, IG utilization was substantially reduced among patients who continued efgartigimod for ≥1-year, with patients demonstrating a favorable MG-ADL response.

Background: TERT promoter mutation (TPM) is an established biomarker in meningiomas associated with aberrant TERT expression and reduced progression-free survival (PFS). TERT expression, however, has also been observed even in tumours with wildtype TERT promoters (TP-WT). This study aimed to examine TERT expression and clinical outcomes in meningiomas. Methods: TERT expression, TPM status, and TERT promoter methylation of a multi-institutional cohort of meningiomas (n=1241) was assessed through nulk RNA sequencing (n=604), Sanger sequencing of the promoter (n=1095), and methylation profiling (n=1218). 380 Toronto meningiomas were used for discovery, and 861 external institution samples were compiled as a validation cohort. Results: Both TPMs and TERTpromoter methylation were associated with increased TERT expression and may represent independent mechanisms of TERT reactivation. TERT expression was detected in 30.4% of meningiomas that lacked TPMs, was associated with higher WHO grades, and corresponded to shorter PFS, independent of grade and even among TP-WT tumours. TERT expression was associated with a shorter PFS equivalent to those of TERT-negative meningiomas of one higher grade. Conclusions: Our findings highlight the prognostic significance of TERT expression in meningiomas, even in the absence of TPMs. Its presence may identify patients who may progress earlier and should be considered in risk stratification models.

Background: Functional movement disorder (FMD), a subtype of functional neurological disorder, is a complex neuropsychiatric syndrome characterized by inconsistent and incongruent motor symptoms, such as tremor and gait disorder. Despite its prevalence and associated disability, FMD remains understudied. The multidisciplinary FMD Clinic in Calgary, Alberta offers an opportunity to describe characteristics of FMD, focusing on sex and gender differences, neuropsychiatric risk factors, healthcare utilization and motor phenotypes. Methods: This ongoing registry study evaluates adult FMD patients seen in the Calgary FMD Clinic by a movement disorders neurologist and neuropsychiatrist. Patients undergo detailed movement disorders and neuropsychiatric assessments, including identifying motor phenotypes, psychiatric comorbidities, and relevant psychological traits. Standardized scales evaluate symptom severity and impact. Descriptive statistics and measure of variance will be calculated for variables of interest. Results: The Calgary FMD Registry was approved in March 2024, with 53 participants currently enrolled. Data collection for this study is projected to conclude in March 2025. Conclusions: The Calgary FMD Registry is the first of its kind to systematically characterize FMD based on both movement disorders and neuropsychiatric variables. This study aims to improve our understanding of neuropsychiatric factors related to FMD. Future studies from this registry will examine short- and long-term outcomes.

Background: Deep brain stimulation (DBS) in Parkinson’s disease (PD) requires extensive trial-and-error programming, often taking over a year to optimize. An objective, rapid biomarker of stimulation success is needed. Our team developed a functional magnetic resonance imaging (fMRI)-based algorithm to identify optimal DBS settings. This study prospectively compared fMRI-guided programming with standard-of-care (SoC) clinical programming in a double-blind, crossover, non-inferiority trial. Methods: Twenty-two PD-DBS patients were prospectively enrolled for fMRI using a 30-sec DBS-ON/OFF cycling paradigm. Optimal settings were identified using our published classification algorithm. Subjects then underwent >1 year of SoC programming. Clinical improvement was assessed under SoC and fMRI-determined stimulation conditions. Results: fMRI optimization significantly reduced the time required to determine optimal settings (1.6 vs. 5.6 months, p<0.001). Unified Parkinson’s Disease Rating Scale (UPDRSIII) improved comparably with both approaches (23.8 vs. 23.6, p=0.9). Non-inferiority was demonstrated within a predefined margin of 5 points (p=0.0018). SoC led to greater tremor improvement (p=0.019), while fMRI showed greater bradykinesia improvement (p=0.040). Conclusions: This is the first prospective evaluation of an algorithm able to suggest stimulation parameters solely from the fMRI response to stimulation. It suggests that fMRI-based programming may achieve equivalent outcomes in less time than SoC, reducing patient burden while potentially enhancing bradykinesia response.