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Background: In France, approximately 40% of women, including menopausal women, do not participate in cervical cancer screening. Many studies and meta-analyses have shown that self-sampling devices for high-risk human papillomavirus (HR-HPV) testing are valuable tools to increase participation. The success of self-sampling screening strategies depends on several factors, including the manner and circumstances in which the women are invited to participate. The acceptability and effectiveness of these strategies should be evaluated before further implementation. Objectives: The primary objective is to evaluate the uptake of cervical cancer screening in under-screened women, based on a direct offer of a vaginal self-sampling device by a midwife. Design: RIDECA is an interventional research project located in the South of France. Methods and Analysis: Six hundred women aged 50–65 with no cervical smear or HR-HPV test for 3 years or more will be recruited at two sites. The device will be offered to enrolled women to utilize at home and return to the Montpellier Hospital laboratory for HR-HPV testing. Completion of self-sampling by women who have accepted the device and follow-up of those with positive HR-HPV DNA tests will be monitored. During recruitment, participants will complete questionnaires on their socio-economic environment and motivational factors based on the psychosocial I-Change model. Semi-structured interviews will be conducted with a sub-group to identify barriers and levers to participation. Statistical analyses will be conducted for the full research sample and for each recruitment site. Ethics: The project was approved by the Ethical Research Committee Ile de France VI and by the French Data Protection Authority. Discussion: The results will provide useful information on the effectiveness (acceptability, efficiency) of this outreach strategy and identify barriers and levers that facilitate its implementation. Registration: ClinicalTrials.gov (NCT04716127), January 20, 2021. Plain language summary: Can we improve postmenopausal women's adherence to cervical cancer screening by using vaginal self-sampling and a direct approach by a midwife? Why is this study being done? In France, 40% of women, especially postmenopausal women, do not participate in cervical cancer screening. We already know that vaginal self-collection with HPV testing is highly accepted by women and increases their participation in screening. Different strategies have been proposed as the most appropriate approach to utilize when offering the vaginal self-sampling option to women. What are the researchers doing? The study, set up in the Occitania region of France, is still ongoing and is targeting women aged 50–65 who have not been screened for cervical cancer. The aim of the study is to assess whether reaching women in their everyday environment and offering them a vaginal self-collection device during an educational session with a midwife improves their adherence to and participation in cervical cancer screening. To answer these questions, we will recruit six hundred women aged 50–65 who have not been screened for cervical cancer for three years or more at two sites: - In the department of Hérault, where midwives will approach women visiting a mobile breast cancer screening unit, - in the department of Aude, where a midwife can easily arrange appointments for interested women, following an information campaign. Participants who agree to take part will receive a self-sampling kit to use at home and return to the laboratory for HR-HPV testing. During recruitment, we will also use questionnaires and interviews to assess women's socio-economic situation and motivations for participating (or not) in cervical cancer screening. What are the expected results? This study will allow us to assess women's adherence to this "direct" "face-to-face" cervical screening strategy and the potential influence of socio-economic and motivational factors on adherence. Through gaining these vital insights, we hope to identify the barriers and levers that will facilitate its implementation. [ABSTRACT FROM AUTHOR]

In adults, monocytes and neutrophils play important roles in the hyperinflammatory responses characteristic of severe forms of SARS-CoV-2 infection. We assessed leukocyte activation in 55 children attending the emergency department for acute fever between March 2020 and September 2021. The following markers were analyzed by flow cytometry: CD169 and HLA-DR on monocytes, CD64 and CD16 on neutrophils, and CD38 on lymphocytes TCD8. Fifteen of the children had SARS-CoV-2 infection, 15 had bacterial infections, and 15 had inflammatory diseases. We observed overexpression of CD169 on monocytes and CD38 on T lymphocytes in all patients with a diagnosis of SARS-CoV-2, while overexpression of CD64 on neutrophils was observed with bacterial infections and inflammatory diseases. There was a decrease in the expression of HLA-DR on monocytes in the bacterial infection and inflammatory pathology groups. Leukocyte analysis identifies distinct activation patterns in children during SARS-CoV-2 infections, bacterial infections, and inflammatory diseases. [ABSTRACT FROM AUTHOR]

HE4 and CA-125 are used for epithelial ovarian cancer (EOC) screening, diagnosis, and follow-up. Our objective was to study HE4 and CA-125 kinetics in patients treated for recurrent EOC. Serum samples were prospectively collected before the first chemotherapy cycle and every 3 months until disease progression. Data from 89/101 patients could be analyzed. At baseline, the median CA-125 and HE4 concentrations were 210 IU/L (7-10,310) and 184 pM (31-4,836). Among the 12 patients (13%) with normal CA-125 (<35 IU/L) concentration, eight had HE4 concentration ≥75 pM, and among the 16 patients with normal HE4 concentration (18%), 12 had increased CA-125 concentration. The median nadir concentrations were 31 IU/L (3-8,744) for CA-125 and 75 pM (20-4,836) for HE4. The median times to nadir were 14 (0-130) weeks for CA- 125 and 12 (0-52) weeks for HE4. In multivariate analysis, CA-125 and HE4 nadir concentrations (<35 IU/L, HR 0.35, 95% CI: 0.17-0.72 and<75 pM, HR 0.40, 95% CI: 0.20-0.79) and time to CA-125 and HE4 nadir (>14 weeks, HR 0.37, 95% CI: 0.20-0.70 and >12 weeks, HR 0.43, 95% CI: 0.23-0.83) were prognostic factors of progression-free survival. More investigations on HE4 kinetics could help to better monitor patients with CA-125 concentration within normal values. [ABSTRACT FROM AUTHOR]