Treatment with bevacizumab achieves both tumour stabilisation or regression and preservation or improvement of hearing. However, the efficacy of bevacizumab varies between patients and within patients. Side effects due to bevacizumab treatment are also common. It would be of value to predict therapeutic response prior to initiating therapy to prevent unnecessary exposure in patients unlikely to benefit.

We aim to recruit 25 patients with NF2-related schwannomatosis (NF2) with bilateral vestibular schwannomas. Patients will receive an intravenous injection of 37 MBq [⁸⁹Zr]bevacizumab followed by positron emission tomography (PET)/CT imaging 4 days later. After clinical evaluation at baseline, patients undergo bevacizumab treatment and are followed up at 3 and 6 months. The primary objective is to examine associations between pretreatment [⁸⁹Zr]bevacizumab uptake on PET/CT and changes in multiple hearing outcomes and radiological characteristics of the target tumour following treatment. Secondary outcome measures include vestibular functioning, patient reported outcome measures, cranial nerve functionality, peripheral neurology, non-target schwannoma response and renal function. Given the explorative nature of the study, associations between PET-derived metrics and clinical and radiological outcomes will be examined without formal hypothesis testing, using generalised estimating equations to account for within-patient correlation. Pairwise associations will be summarised in an association matrix with multiplicity addressed using an all-resolutions inference approach, and findings will be considered hypothesis generating.

This study was submitted via the Clinical Trials Information System reviewed and approved by the Medical Research Ethics Committee Leiden–The Hague–Delft Delft. The study findings will be disseminated through publication in peer-reviewed scientific journals and by presentation at national and international conferences.

The trial is registered at ClinicalTrials.gov Protocol Registration and Results System under the registration ID: NCT05685836.

Although menstrual cups have a long history and numerous benefits, many women of reproductive age remain unaware. This study assessed the knowledge, attitude and use regarding menstrual cups and its associated factors among females of reproductive age in Siddharthanagar Municipality, Lumbini Province, Nepal.

Cross-sectional study

Siddharthanagar municipality, Rupandehi was taken as the study setting.

A total of 250 women of reproductive age group (15–49 years) residing in Siddharthanagar Municipality.

Knowledge, attitude and use of menstrual cups were assessed by a pretested structured tool. The knowledge scores for each question were given as one mark for a correct response, and the overall scores were categorised using a modified Bloom’s cut-off as follows: good knowledge≥60% and poor knowledge80%), neutral (60%–80%) and unfavourable (2 test and multivariable logistic regression analysis were performed to determine factors associated with knowledge, attitude and use at the 5% level of significance.

This study found that the majority (88.04%) had poor knowledge about the menstrual cup, with 31.2% of participants expressing a favourable attitude. Only 10.6% of participants had used a menstrual cup. The odds of adequate knowledge among the participants with bachelor and higher level of education was 3.470 times (adjusted OR (aOR)=3.470, 95% CI 1.08 to 11.10) as compared with participants with secondary or lower level of education, adjusting for other explanatory variables. The odds of having adequate knowledge among participants who were employed was 1.66 times (aOR=1.66, 95% CI 1.24 to 5.83) compared with those who were unemployed, which was 2.487 times (aOR=2.487, 95% CI 1.24 to 7.95) in case of favourable attitude. Similarly, the odds of using a menstrual cup among the participants with an adequate level of knowledge was 7.960 times (aOR=7.960, 95% CI 2.70 to 23.40) as compared with participants who had an inadequate level of knowledge, adjusting for other explanatory variables.

Our study revealed that, despite their advantages, participants have limited knowledge and usage of menstrual cups. This highlights the need for advocacy and education about menstrual cups to enable informed choices, enhance women’s quality of life and protect the environment by reducing waste from disposable menstrual products.