by Azusa Kubota, Kentaro Kojima, Shinnosuke Koketsu, Takayuki Kannon, Takehiro Sato, Kazuyoshi Hosomichi, Yoshiaki Shinohara, Atsushi Tajima
Brain asymmetry is a fundamental feature of neural organization. However, the molecular basis of hippocampal lateralization in response to environmental stimuli remains poorly understood. Here, we examined the transcriptomic profiles of the left and right hippocampal CA1 regions in rats reared under isolated or enriched housing conditions to elucidate hemisphere-specific responses and shared molecular adaptations. RNA-sequencing analysis revealed lateralized differences in the number and identity of differentially expressed genes, accompanied by distinct biological themes, as indicated by overrepresentation and gene set enrichment analysis. The left CA1 region was prominently engaged in pathways related to synaptic organization and mitochondrial function, whereas the right CA1 region exhibited enrichment in transcriptional regulation and RNA metabolic processes. Despite these asymmetries, co-expression and protein–protein interaction network analyses revealed shared molecular architectures. Immediate early genes formed consistent central hubs across both hemispheres, and a common Mecp2–Grin2b–Cdkl5–Tet3 protein interaction cluster was identified as a potential integrative regulatory module. Additional enrichment analysis of differentially expressed genes shared between hemispheres further highlighted conserved responses, particularly in synaptic plasticity and cell–cell communication. Together, these findings demonstrate that the left and right CA1 regions employ distinct yet partially convergent transcriptional programs to adapt to environmental stimuli. This coordinated molecular asymmetry provides novel insights into hippocampal lateralization and its role in experience-dependent brain plasticity.by Hana Wakasa, Satoshi Sunohara, Takashi Kimura, Takaya Ichikawa, Akiko Tamakoshi
Obesity is a growing global health concern and has been associated with increased mortality from various cancer types, including hematological malignancies. However, evidence for this association in Asian populations, particularly among Japanese adults, remains limited. Thus, this study aimed to examine the association between obesity and mortality due to hematological malignancies. Data from 97,073 participants in the Japan Collaborative Cohort (JACC) Study were analyzed. The participants were followed for a mean duration of 17 years. Body mass index (BMI) was calculated using self-reported height and weight and categorized as underweight (To conduct a child and family health nursing service redesign to improve pathways of access, response and outcomes for all families with children aged 0–5 years.
The study was conducted as an iterative, mixed-method study of the process and impact of the service redesign, informed by a participatory action research paradigm and the NSW Agency for Clinical Innovation process for developing a model of care.
Diagnostic, solution design, implementation and sustainability phases were undertaken. Quantitative analyses were undertaken of administrative data, and child and family health nurse and client surveys. Qualitative analyses were undertaken of design workshops.
The administrative data demonstrated that prior to the redesign service provision was the same for all clients regardless of levels of risk. The design solution, developed through a series of diagnostic and visioning workshops, included multiple new client response pathways. Implementation included development of tools and training. Sustainability of the redistribution of resources to the new pathways was assessed though an evaluation demonstrating a positive impact for families with adversity, with no deleterious effects for families receiving a universal response, and improvements in the emotional labour undertaken by nurses. Despite this, nurse burnout increased post-redesign.
The shift from equal services (everyone receives the same) to equitable proportionate universal provision in response to need can be achieved and has positive impacts for nurses and families.
This study shows the value of undertaking a systematic and participatory approach to service redesign. A proportionate universalism approach can ensure that early childhood nursing services are available to all in relation to needs.
The Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) check-list was used to guide reporting.
No patient or public contribution.
Childhood cancer accounts for a significant proportion of global childhood mortality, especially in low-income and middle-income countries (LMICs). Unlike many adult malignancies, primary prevention of childhood cancers is not possible. Improving survival requires a two-pronged strategy: earlier diagnosis and effective treatment. Our study aims to establish the feasibility, clinical and implementation effectiveness of an adapted early warning signs and symptoms (EWSS) intervention in Cameroon and Kenya. It will equip healthcare workers, Ministry of Health (MOH) representatives and National Cancer Institute leaders with evidence-informed guidance on implementing context-adapted interventions to improve the early detection and referral of childhood cancers in these countries.
The study is a quasi-experimental, hybrid type 2 implementation effectiveness study based on a Ghanaian adaptation of the ‘Saint Siluan’ EWSS campaign. Our protocol proposes context-specific adaptation and evidence-based implementation of the EWSS intervention through iterative engagement with country-level implementation teams to train healthcare workers and improve referral pathways for earlier childhood cancer diagnoses in each study country. Training effectiveness will be measured through pretraining and post-training tests of knowledge and application, as well as training satisfaction surveys. Clinical effectiveness will be assessed by using a REDCap database to track the number of newly diagnosed childhood cancer cases in the study regions and counties, healthcare timelines and paths to diagnosis, and the stage and proportion of metastatic disease at diagnosis. Implementation effectiveness will be evaluated through interviews with senior and mid-level health system partners and clinicians, tracking fidelity to the implementation process as laid out in The Implementation Roadmap Workbook, and analysis of meeting minutes from monthly local implementation team meetings.
This study has received ethical approval from The Hospital for Sick Children (REB # 1000080092) and all participating sites. We have received National Ethical Clearance from the Cameroon Ethical Board (#1699) and Regional Administrative Authorizations from our piloting regions (Centre and West). We have also received ethical clearance from Kenyatta National Hospital (KNH) (ERB# KNH-ERC/RR/955) and our National Commission for Science, Technology and Innovation in Kenya licence from the counties we are piloting in Kenya. As clinical data will be collected from existing health registries and patient charts, patient consent will not be required; however, we will obtain consent from all members of the leadership implementation teams and operational implementation teams for their participation in the implementation meetings and from all individuals participating in the semistructured interviews. We will disseminate findings to build awareness and share findings among various target audiences: (1) key county and regional parties (eg, clinical societies, advocacy groups, country MOHs and regional bodies such as the East African Community, Economic Community of West African States); (2) international bodies such as the WHO; and (3) the academic community.
This study aims to assess the economic feasibility and broader policy implications of the Korea International Cooperation Agency’s (KOICA) official development assistance (ODA) projects for the COVID-19 emergency response in Uzbekistan through a cost–benefit analysis. The primary research question is to evaluate whether the interventions provide sufficient economic returns relative to their costs while informing future pandemic preparedness of response strategies.
A cost–benefit analysis using quantitative methods was performed to assess the financial impact of the COVID-19 ODA projects.
The study was conducted in Uzbekistan, focusing on KOICA’s COVID-19 emergency response projects from January 2020 to December 2021.
The intervention involved the implementation of KOICA’s COVID-19 emergency response activities, including early diagnosis support, establishment of rapid response bases, provision of medical equipment and emergency relief efforts in Uzbekistan.
The primary outcome measure is the net present value (NPV) and benefit/cost ratio of the project. Secondary outcome measures are the project’s effectiveness in terms of death prevention, reduction in medical costs and timely COVID-19 testing.
The analysis revealed a total programme cost of US$11 353 173, with a net benefit ranging from US$21 026 032 to US$34 573 403, and a benefit/cost ratio between 1.85 and 3.05. A detailed examination of costs and benefits highlighted the programme’s positive NPV and benefit/cost ratio, indicating its economic feasibility. The study also underscored the programme’s effectiveness in preventing deaths, reducing medical costs and providing timely COVID-19 testing.
The findings confirm that KOICA’s COVID-19 emergency response projects in Uzbekistan were economically viable and effective. The study highlights the importance of integrating economic evaluations into ODA assessments, particularly for emergency response and infectious disease control. It recommends expanding the use of quantitative analysis to optimise resource allocation and improve decision-making in future global health crises.