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Background: Even though it is preventable, cervical cancer contributes significantly to cancer-related mortality among Ethiopian women. Follow-up visits after treatment of precancerous lesions are essential to monitor lesion recurrence. In our previous study, we found a level of adherence to follow-up of 44.7%, but the reasons for low adherence have not been comprehensively explored within the Ethiopian context. This study aimed to identify these reasons by interviewing 167 women who had missed their follow-up appointments as well as 30 health professionals with experience in the field., Methods: The study employed a mixed-methods approach: Quantitative data were collected through a telephone questionnaire conducted with 167 women who had a positive visual inspection with acetic acid (VIA) and had missed their follow-up appointments. Subsequently, in-depth interviews were conducted with 30 healthcare professionals, and an inductive content analysis was carried out., Results: In the patient interviews, the reasons given most often were "lack of information about the follow-up" (35; 21.1%), "forgetting the appointment" (30; 18.1%), and "not seeing the need for follow-up" (24; 14.5%). Healthcare professionals identified various reasons such as lack of knowledge, living in a remote area/changing living area, forgetfulness, fear, poor counseling, a shortage of trained healthcare providers to give counseling and follow-up, and reminder-related barriers., Conclusion: Lack of knowledge, forgetfulness, poor health-seeking behavior, and a lack of reminders were identified as barriers contributing to the low uptake of rescreening. Further interventions should target these by creating community awareness, improving patient counseling, tracing patients in need of follow-up, and making reminder calls or using SMS., (© The Author(s) 2024. Published by Oxford University Press.)

Background: In Ethiopia, both incidence and mortality of cervical cancer are relatively high. Screening services, which were implemented during the past few years, are currently being expanded. The World Health Organization recommends patients with a positive VIA (visual inspection with acetic acid) result should immediately receive treatment followed by rescreening after 1 year as precancerous lesions can reoccur or become residential despite treatment., Materials and Methods: Screening logbooks dating between 2017 and 2020 were retrospectively reviewed in 14 health facilities of Addis Ababa and Oromia region. Data for 741 women with a VIA-positive result were extracted and those women were asked to participate in a questionnaire-based phone interview to gain insights about adherence to treatment and follow-up. Data were analyzed using descriptive methods and then fitted into 2 generalized linear models to test variables for an influence on adherence to follow up., Results: Around 13 800 women had received a VIA screening, of which approximately 820 (5.9%) were VIA positive. While over 90% of women with a positive screen received treatment, only about half of the treated patients returned for a follow-up examination. After treatment, 31 women had a VIA-positive re-screen. We found that educational status, age over 40, no/incorrect follow-up appointment, health facility-related barriers, and use of reminders are important drivers of adherence to follow up., Conclusion: Our results revealed that adherence to treatment after VIA positive screening is relatively high whereas adherence to follow up recommendations still needs improvement. Reminders like appointment cards and phone calls can effectively reduce the loss of follow-up., (© The Author(s) 2024. Published by Oxford University Press.)

Objective: Schizophrenia is a multifaceted disorder associated with structural brain heterogeneity. Despite its relevance for identifying illness subtypes and informative biomarkers, structural brain heterogeneity in schizophrenia remains incompletely understood. Therefore, the objective of this study was to provide a comprehensive insight into the structural brain heterogeneity associated with schizophrenia., Methods: This meta- and mega-analysis investigated the variability of multimodal structural brain measures of white and gray matter in individuals with schizophrenia versus healthy controls. Using the ENIGMA dataset of MRI-based brain measures from 22 international sites with up to 6139 individuals for a given brain measure, we examined variability in cortical thickness, surface area, folding index, subcortical volume and fractional anisotropy., Results: We found that individuals with schizophrenia are distinguished by higher heterogeneity in the frontotemporal network with regard to multimodal structural measures. Moreover, individuals with schizophrenia showed higher homogeneity of the folding index, especially in the left parahippocampal region., Conclusions: Higher multimodal heterogeneity in frontotemporal regions potentially implies different subtypes of schizophrenia that converge on impaired frontotemporal interaction as a core feature of the disorder. Conversely, more homogeneous folding patterns in the left parahippocampal region might signify a consistent characteristic of schizophrenia shared across subtypes. These findings underscore the importance of structural brain variability in advancing our neurobiological understanding of schizophrenia, and aid in identifying illness subtypes as well as informative biomarkers.

It is well established that vibrotactile stimuli are represented in somatotopic maps. However, less is known about whether these somatotopic representations are modulated by task demands and maybe even in the absence of tactile input. Here, we used a vibrotactile discrimination task as a tool to investigate these questions in further detail. Participants were required to actively perceive and process tactile stimuli in comparison to a no-task control condition where identical stimuli were passively perceived (no-memory condition). Importantly, both vibrotactile stimuli were either applied to the right index or little finger, allowing us to investigate whether cognitive task demands shape finger representations in primary somatosensory cortex (S1). Using multivoxel pattern analysis and representational similarity analysis, we found that S1 finger representations were more distinct during the memory than the no-memory condition. Interestingly, this effect was not only observed while tactile stimuli were presented but also during the delay period (i.e., in the absence of tactile stimulation). Our findings imply that when individuals are required to focus on tactile stimuli, retain them in their memory, and engage in active processing of distinctive stimulus features, this exerts a modulatory effect on the finger representations present in S1. NEW & NOTEWORTHY Using multivoxel pattern analysis, we found that discrimination task demands shape finger representations in the contralateral primary somatosensory cortex (S1), and that somatotopic representations are modulated by task demands not only during tactile stimulation but also to a certain extent in the absence of tactile input.

Background: Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death in over 100 countries. In March 2021, the World Health Organization called on the global community to decrease mortality by 2.5% per year. Despite the high burden of the disease, the survival status and the predictors for mortality are not yet fully determined in many countries in Sub-Saharan Africa, including Ethiopia. Here, we report the survival status and predictors of mortality among breast cancer patients in South Ethiopia as crucial baseline data to be used for the design and monitoring of interventions to improve early detection, diagnosis, and treatment capacity., Methods: A hospital-based retrospective cohort study was conducted among 302 female breast cancer patients diagnosed from 2013 to 2018 by reviewing their medical records and telephone interviews. The median survival time was estimated using the Kaplan-Meier survival analysis method. A log-rank test was used to compare the observed differences in survival time among different groups. The Cox proportional hazards regression model was used to identify predictors of mortality. Results are presented using the crude and adjusted as hazard ratios along with their corresponding 95% confidence intervals. Sensitivity analysis was performed with the assumption that loss to follow-up patients might die 3 months after the last hospital visit., Results: The study participants were followed for a total of 4,685.62 person-months. The median survival time was 50.81 months, which declined to 30.57 months in the worst-case analysis. About 83.4% of patients had advanced-stage disease at presentation. The overall survival probability of patients at two and three years was 73.2% and 63.0% respectively. Independent predictors of mortality were: patients residing in rural areas (adjusted hazard ratio = 2.71, 95% CI: 1.44, 5.09), travel time to a health facility ≥7 hours (adjusted hazard ratio = 3.42, 95% CI: 1.05, 11.10), those who presented within 7-23 months after the onset of symptoms (adjusted hazard ratio = 2.63, 95% CI: 1.22, 5.64), those who presented more than 23 months after the onset of symptoms (adjusted hazard ratio = 2.37, 95% CI: 1.00, 5.59), advanced stage at presentation (adjusted hazard ratio = 3.01, 95% CI: 1.05, 8.59), and patients who never received chemotherapy (adjusted hazard ratio = 6.69, 95% CI: 2.20, 20.30)., Conclusion: Beyond three years after diagnosis, patients from southern Ethiopia had a survival rate of less than 60% despite treatment at a tertiary health facility. It is imperative to improve the early detection, diagnosis, and treatment capacities for breast cancer patients to prevent premature death in these women., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Shita et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Ergodicity describes an equivalence between the expectation value and the time average of observables. Applied to human behaviour, ergodic theories of decision-making reveal how individuals should tolerate risk in different environments. To optimize wealth over time, agents should adapt their utility function according to the dynamical setting they face. Linear utility is optimal for additive dynamics, whereas logarithmic utility is optimal for multiplicative dynamics. Whether humans approximate time optimal behavior across different dynamics is unknown. Here we compare the effects of additive versus multiplicative gamble dynamics on risky choice. We show that utility functions are modulated by gamble dynamics in ways not explained by prevailing decision theories. Instead, as predicted by time optimality, risk aversion increases under multiplicative dynamics, distributing close to the values that maximize the time average growth of in-game wealth. We suggest that our findings motivate a need for explicitly grounding theories of decision-making on ergodic considerations., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: HRS has received an honoraria as speaker from Sanofi Genzyme (Denmark) and Novartis (Denmark) and as a consultant from Sanofi Genzyme (Denmark), and as a senior editor (NeuroImage) from Elsevier Publishers (Amsterdam, The Netherlands). HRS has received royalties as a book editor from Springer Publishers (Stuttgart, Germany).

We have established the Ustilago bromivora - Brachypodium spp. interaction as a new model pathosystem for biotrophic fungal plant infections of the head smut type (Rabe et al. , 2016). In this protocol, the methodology used for comparing gene expression between saprophytic and in planta growth of the fungus is described. The experimental and analytical pipeline, how next generation RNA sequencing (Illumina RNA-Seq) analysis can be used to obtain lists of genes significantly up or down regulated in planta in comparison to axenic culture is given. Furthermore, different methods to identify functional categories that are over- or under-represented among specific classes of genes are presented.

Due to their economic relevance, the study of plant pathogen interactions is of importance. However, elucidating these interactions and their underlying molecular mechanisms remains challenging since both host and pathogen need to be fully genetically accessible organisms. Here we present milestones in the establishment of a new biotrophic model pathosystem: Ustilago bromivora and Brachypodium sp. We provide a complete toolset, including an annotated fungal genome and methods for genetic manipulation of the fungus and its host plant. This toolset will enable researchers to easily study biotrophic interactions at the molecular level on both the pathogen and the host side. Moreover, our research on the fungal life cycle revealed a mating type bias phenomenon. U. bromivora harbors a haplo-lethal allele that is linked to one mating type region. As a result, the identified mating type bias strongly promotes inbreeding, which we consider to be a potential speciation driver., Competing Interests: The authors declare that no competing interests exist.

The phenolic compound salicylic acid (SA) is a key signalling molecule regulating local and systemic plant defense responses, mainly against biotrophs. Many microbial organisms, including pathogens, share the ability to degrade SA. However, the mechanism by which they perceive SA is unknown. Here we show that Ustilago maydis, the causal agent of corn smut disease, employs a so far uncharacterized SA sensing mechanism. We identified and characterized the novel SA sensing regulator, Rss1, a binuclear zinc cluster protein with dual functions as putative SA receptor and transcriptional activator regulating genes important for SA and tryptophan degradation. Rss1 represents a major component in the identified SA sensing pathway during the fungus' saprophytic stage. However, Rss1 does not have a detectable impact on virulence. The data presented in this work indicate that alternative or redundant sensing cascades exist that regulate the expression of SA-responsive genes in U. maydis during its pathogenic development., (© 2016 The Authors. Molecular Microbiology Published by John Wiley & Sons Ltd.)

Salicylic acid (SA) is a key plant defence hormone which plays an important role in local and systemic defence responses against biotrophic pathogens like the smut fungus Ustilago maydis. Here we identified Shy1, a cytoplasmic U. maydis salicylate hydroxylase which has orthologues in the closely related smuts Ustilago hordei and Sporisorium reilianum. shy1 is transcriptionally induced during the biotrophic stages of development but not required for virulence during seedling infection. Shy1 activity is needed for growth on plates with SA as a sole carbon source. The trigger for shy1 transcriptional induction is SA, suggesting the possibility of a SA sensing mechanism in this fungus., (© 2013 John Wiley & Sons Ltd.)

Maize smut caused by the fungus Ustilago maydis is a widespread disease characterized by the development of large plant tumours. U. maydis is a biotrophic pathogen that requires living plant tissue for its development and establishes an intimate interaction zone between fungal hyphae and the plant plasma membrane. U. maydis actively suppresses plant defence responses by secreted protein effectors. Its effector repertoire comprises at least 386 genes mostly encoding proteins of unknown function and expressed exclusively during the biotrophic stage. The U. maydis secretome also contains about 150 proteins with probable roles in fungal nutrition, fungal cell wall modification and host penetration as well as proteins unlikely to act in the fungal-host interface like a chorismate mutase. Chorismate mutases are key enzymes of the shikimate pathway and catalyse the conversion of chorismate to prephenate, the precursor for tyrosine and phenylalanine synthesis. Root-knot nematodes inject a secreted chorismate mutase into plant cells likely to affect development. Here we show that the chorismate mutase Cmu1 secreted by U. maydis is a virulence factor. The enzyme is taken up by plant cells, can spread to neighbouring cells and changes the metabolic status of these cells through metabolic priming. Secreted chorismate mutases are found in many plant-associated microbes and might serve as general tools for host manipulation.

Many of the newer X-ray machines are equipped with electronic means to provide dose-area product (DAP) information. For machines without that ability, an alternative method is to record radiation on a film that can handle a large amount of cumulative exposure. The use of GafChromic XR Type R film was investigated for this purpose by placing it at the X-ray tube assembly to record the radiation in interventional radiological procedures. Dose-area product was determined with a reflective densitometer and then with a flatbed scanner. Precisions were demonstrated to be 5% and 2%, respectively. In a comparison with the machine-recorded DAP, a regression analysis showed the validity of both techniques for values less than 1200 Gy-cm2.

The GafChromic XR Type R film is a relatively new product for recording high radiation dose in interventional radiological procedures. Means of measuring the film response were studied in this investigation. Two handheld reflective-type densitometers of different models were compared in the range of 0-8 Gy. They were found to be in excellent agreement. Five reflective flatbed scanners of different models were compared by a simple preliminary test. Their widely differed performances suggest the need of testing a scanner before using it for dosimetry measurement. A selected scanner was further tested for its ability to measure radiation in the range of 0-8 Gy and for the development of a scanning protocol. This experiment suggested the inclusion of a calibration pattern with known exposures and a black reference step in the scanning of a film in RGB mode. Then the red component of this image should be used for dosimetry computation. This method was compared to the use of a red acetate filter. The latter was demonstrated to be a possible alternative for measurement below 5 Gy and when there is no software ability to split an image into color components., ((c) 2003 American College of Medical Physics.)