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Status and comparison of HIV Knowledge, HIV Testing and other healthy behavior between men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a cross-sectional study in Zhejiang Province, China

BMC Public Health. 2025 Feb 12;25(1):582. doi: 10.1186/s12889-025-21860-y.

ABSTRACT

OBJECTIVE: This study was conducted to explore the human immunodeficiency virus (HIV) status of and compare HIV knowledge, HIV testing, and other healthy behaviors between men who have sex with men and women (MSMW) and men who have sex with men only (MSMO), to provide a scientific basis for targeted HIV interventions for this population.

METHODS: A cross-sectional survey was conducted to collect demographic and behavioral information using questionnaires for statistical analysis.

RESULTS: Among 1,993 participants, 772 (38.7%) reported having sexual intercourse with women. The results of the multivariate logistic regression model analysis indicated that MSMW had a lower probability than MSMO of reporting HIV knowledge 1 (adjusted odds ratio [aOR]:0.556, 95% CI: 0.409-0.756), knowledge 2 (aOR:0.626; 95% CI, 0.515-0.761), knowledge 3 (aOR:0.569; 95% CI: 0.447-0.724), informing their HIV status to the last casual sex partners offline (aOR: 0.515, 95% CI: 0.358-0.743), HIV testing more than once in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931), and HIV testing in a hospital in the past 6 months (aOR: 0.696, 95% CI: 0.521-0.931). In contrast, MSMW had a higher probability of post-exposure prophylaxis (PEP) intake in the past 6 months (aOR: 2.252, 95% CI: 1.570-3.229), pre-exposure prophylaxis (PrEP) intake in the past 6 months (aOR: 1.630, 95% CI: 1.091-2.434), and cumulative HIV testing more than twice (aOR: 1.917, 95% CI: 1.434-2.563).

CONCLUSION: MSMW showed significant differences with MSMO in HIV knowledge and HIV related risky reduction behaviors. It is necessary to enhance awareness and skills on HIV self-testing, PEP, and PrEP among MSM. Encouraging HIV knowledge education and HIV testing service are important for MSMW. PEP and PrEP might be enhanced among MSMO for reducing the risk of HIV transmission.

PMID:39939969 | DOI:10.1186/s12889-025-21860-y

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Prevalence of asymptomatic malaria infection and associated risk factors in Mizan-Aman town, Ethiopia: community-based cross-sectional study

Malar J. 2025 Feb 12;24(1):41. doi: 10.1186/s12936-024-05210-8.

ABSTRACT

BACKGROUND: Asymptomatic malaria parasitemia patients constitute an effective transmission pool for malaria infection in the community. However, less attention has been given to malaria control and elimination strategies. Therefore, to achieve a malaria elimination strategy, investigating the magnitude of asymptomatic malaria in different settings in Ethiopia is crucial. However, there is not enough information on the prevalence of asymptomatic malaria infection and associated risk factors in the Bench Sheko Zone, southwest Ethiopia. This study, therefore, aimed to provide information and help achieve sustainable malaria elimination.

METHODS: A community-based cross-sectional study was conducted from February to April 2019 in Mizan-Aman town, southwest Ethiopia. A semi-structured questionnaire was used to collect sociodemographic information. Plasmodium species were screened using microscopy and rapid diagnostic test (RDT). HemoCue was used to measure haemoglobin levels. Statistical Package for the Social Sciences (SPSS) version 20.0 was used for descriptive and logistic regression statistics to risk factors. A P-value of 0.05 was used as a cutoff-value for significance.

RESULTS: A total of 353 malaria-like symptom free participants were enrolled in this study. 17 seventeen (4.8%, 95% Confidence interval = 2.57, 7.03) asymptomatic malaria cases were revealed; among these, 12 (70.58%) (95% CI = 65.75, 75.25) were due to Plasmodium vivax and 5 (29.41%) (95% CI = 24.74, 34.25) were due to Plasmodium falciparum. Asymptomatic malaria was significantly associated with the presence of mosquito breeding sites [Adjusted odd ratio (AOR) = 6.06 (1.76-20.82)], insecticide-treated nets (ITN) use [AOR = 3.51 (0.97-12.68)], and indoor residual spraying (IRS) [AOR = 3.95 (1.26-12.37)]. Mild anaemia was found in 20% (3/15) of the asymptomatic malaria patients. Additionally, there was a significant association between malaria and anaemia [OR = 5.786 (1.46-22.85)] in this study.

CONCLUSIONS: The population of the current study area will be at risk because asymptomatic malaria is present. Low coverage of the IRS, ITN, and proximity of stagnant water in residences had an impact on asymptomatic malaria. Further studies are needed on the burden of asymptomatic malaria via molecular methods, and the Bench Sheko regional health office is better able to scale-up malaria prevention and control tools.

PMID:39939966 | DOI:10.1186/s12936-024-05210-8

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Material hardship, forced displacement, and negative health outcomes among unhoused people who use drugs in Los Angeles, California and Denver, Colorado: a latent class analysis

BMC Public Health. 2025 Feb 13;25(1):591. doi: 10.1186/s12889-025-21626-6.

ABSTRACT

BACKGROUND: Homelessness is a growing concern in the United States, especially among people who use drugs (PWUD). The degree of material hardship among this population may be linked to worse health outcomes. PWUD experiencing homelessness in urban areas are increasingly subjected to policies and social treatment, such as forced displacement, which may worsen material hardship. It is critical to describe hardship among PWUD and examine if it is linked to health outcomes.

METHODS: Data were collected as part of a prospective cohort study of PWUD in Los Angeles, California and Denver, Colorado (n = 476). Analysis sample size was smaller (N = 395) after selecting for people experiencing homelessness and for whom data were complete. Five indicators assessing hardship (difficulty finding food, clothing, restrooms, places to wash/shower, and shelter) in the past three months were obtained from participants at baseline and were used in latent class analysis (LCA). We chose a base latent class model after examination of global fit statistics. We then built three auxiliary models using the three-step Bolck-Croon-Hagenaars (BCH) method to test the relationship of latent class membership to several hypothesized social and health variables in this same three month time period.

RESULTS: Fit statistics, minimum classification probabilities, and ease of interpretation indicated a three-class solution for level of material difficulty. We termed these classes “High Difficulty” (n = 82), “Mixed Difficulty” (n = 215), and “Low Difficulty” (n = 98). Average classification probabilities indicated good class separability. “High Difficulty” participants had high probabilities of usually having difficulty accessing all five resources. “Mixed Difficulty” participants indicated a range of difficulty accessing all resources, with restrooms and bathing facilities being the most difficult. “Low Difficulty” participants were defined by high probabilities of never having access difficulty. In auxiliary analyses, there were significant (p < 0.05) differences in experiences of displacement, opioid withdrawal symptoms, nonfatal overdose, and violent victimization between classes.

CONCLUSIONS: This LCA indicates that among PWUD experiencing homelessness there exist distinct differences in resource access and material hardship, and that these differences are linked with political, social, substance use, and other health outcomes. We add to the literature on the relationship between poverty and health among PWUD. Policies which increase difficulty accessing necessary material resources may negatively impact health in this population.

PMID:39939965 | DOI:10.1186/s12889-025-21626-6

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Rapid shift of gut microbiome and enrichment of beneficial microbes during arhatic yoga meditation retreat in a single-arm pilot study

BMC Complement Med Ther. 2025 Feb 13;25(1):51. doi: 10.1186/s12906-025-04783-4.

ABSTRACT

BACKGROUND: The human microbiome plays a vital role in human health, mediated by the gut-brain axis, with a large diversity of functions and physiological benefits. The dynamics and mechanisms of meditations on oral and gut microbiome modulations are not well understood. This study investigates the short-term modulations of the gut and oral microbiome during an Arhatic Yoga meditation retreat as well as on the role of microbiome in improving well-being through a possible gut-brain axis.

METHODS: A single-arm pilot clinical trial was conducted in a controlled environment during a 9-day intensive retreat of Arhatic Yoga meditation practices with vegetarian diet. Oral and fecal samples of 24 practitioners were collected at the start (Day0: T1), middle (Day3: T2), and end (Day9:T3) of the retreat. Targeted 16S rRNA gene amplicon sequencing was performed for both oral and gut samples. Functional pathway predictions was identified using phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt2). DESeq2 was used to identify the differential abundant taxa. Various statistical analyses were performed to assess the significant changes in the data.

RESULTS: Our findings revealed that Arhatic Yoga meditation together with a vegetarian diet led to changes in the oral and gut microbiome profiles within the 9-day retreat. Oral microbiome profile showed a significant (p < 0.05) difference in the species richness and evenness at the end of study, while non-metric multidimensional scaling (NMDS) confirmed the shift in the gut microbiome profile of the practitioners by T2 timepoint, which was further supported by PERMANOVA analysis (p < 0.05). Health-benefiting microbes known to improve the gastrointestinal and gut-barrier functions, immune modulation, and gut-brain axis were enriched. Gut microbiome of both beginner and advanced Arhatic Yoga practitioners showed similar trends of convergence by the end of study. This implies a strong selection pressure by Arhatic Yoga meditation together with a vegetarian diet on the beneficial gut microbiome.

CONCLUSION: This pilot study demonstrates that Arhatic Yoga meditation practices combined with a vegetarian diet during a short intensive retreat resulted in enrichment of known health-promoting microbes. Such microbial consortia may be developed for potential health benefits and used as probiotics to improve the gastrointestinal and immune systems, as well as functions mediated by the gut-brain axis.

TRIAL REGISTRATION: Study was submitted in https://clinicaltrials.gov/on28-02-2024 . Retrospective registered.

PMID:39939954 | DOI:10.1186/s12906-025-04783-4

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Ribes nigrum leaf extract downregulates pro-inflammatory gene expression and regulates redox balance in microglial cells

BMC Complement Med Ther. 2025 Feb 12;25(1):49. doi: 10.1186/s12906-025-04780-7.

ABSTRACT

BACKGROUND: This study focuses on the investigation of the antioxidant and anti-inflammatory activities of alcohol extracts from Ribes nigrum leaves on murine BV-2 microglial Wt and Acyl-CoA oxidase 1 deficient (Acox1-/-) cell line models, useful for the investigation of some neurodegenerative disorders.

METHODS: The extract chemical composition was analyzed via LC-Q-Orbitrap HRMS. Various assays, including DPPH, MTT, and H2DCFDA, were used to assess the extract’s antioxidant capacity, cell viability, and reactive oxygen species (ROS) production. Immunoblotting and RT-qPCR techniques were employed to measure protein expression and gene transcription in treated cells. Statistical analysis was conducted using GraphPad Prism, with significance determined at p < 0.05.

RESULTS: Investigations showed the presence of phenolic compounds in this extract, among which flavan-3-ols, flavonols, furanocoumarins, hydroxycinnamates were major components, which are known for their biological activity in various test systems. The MTT test revealed a concentration of 0.125 mg/mL of R. nigrum extract as the highest non-toxic. The investigated extract showed high antioxidant activity in chemical-based tests. The antioxidant potential of the R. nigrum leaf extract was furtherly explored using the BV-2 microglial cell line models. Moreover, the extract was found to alter the activity of the main antioxidant enzyme, catalase and fatty acid oxidation enzyme, Acyl-CoA oxidase 1 (ACOX1) as well as the expression of appropriate genes in Wt and Acox1-/- BV-2 microglial cells such as Cat, iNos, Il-1β, Tnf-α, and Abcd1. In Wt cells, after the 24-hour treatment with R. nigrum leaf extract, ACOX1 activity was downregulated, meanwhile the catalase activity remains unchanged. Further treatment led to the downregulation of catalase and the upregulation of ACOX1 activity. However, in Acox1-/- cells, which represent a model of oxidative stress, an increase in catalase activity was observed only after 48 h of treatment. It was also observed the reduced ROS and NO formation in cells, showing the pronounced antioxidant capacity of R. nigrum extract in the investigated cell-models.

CONCLUSION: Our study demonstrated the protective effects of R. nigrum leaf extracts on BV-2 microglial cells by reducing oxidative and nitrosative stress, decreasing pro-inflammatory gene expression, and normalizing peroxisomal function, highlighting the potential of these extracts as therapeutic agents for managing oxidative stress and inflammation.

PMID:39939952 | DOI:10.1186/s12906-025-04780-7

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Prevalence of hepatitis B virus infection and associated factors among adults intrafamilial household contacts attending antenatal care clinics in the Central Ethiopian region: from pregnant women index cases

Virol J. 2025 Feb 13;22(1):34. doi: 10.1186/s12985-025-02633-w.

ABSTRACT

BACKGROUND: In Ethiopia, hepatitis B virus infections are prevalent and highly endemic. Additionally, there has been a significant increase in hospital admissions, morbidity, and mortality associated with hepatitis B virus infections. This study aimed to assess the prevalence of hepatitis B virus infection and associated factors among adult intrafamilial household contacts of pregnant women index cases attending antenatal care clinics in the central Ethiopian region.

METHODS: A community-based cross-sectional study was conducted between October 1, 2023, and March 1, 2024. Three hundred eighty-five adult intrafamilial household contacts were randomly selected via lottery methods. A 3 ml venous blood sample was taken from adult intrafamilial household contacts and checked for hepatitis B virus infection through hepatitis B surface antigen. An interviewer-administered questionnaire was used to collect the data. A logistic regression model predicted the relationship between predictor and outcome variables. A p-value of < 0.05 indicated statistical significance.

RESULTS: The overall response rate was 96.1%. Two-thirds of the adults of intrafamilial household contacts (n = 229; 61.9%) were aged between 18 and 28 years, with a mean age of 28 years. The prevalence rate of hepatitis B virus infection among adults of intrafamilial household contacts with pregnant women as the index case was 11.6% (95% CI, 8.6 to 15.1). Being male (AOR: 0.09; 95% CI: 0.03, 0.37) and a duration of stay with the index case of less than six months (AOR: 0.30; 95% CI: 0.11, 0.81) were associated with a reduced risk of hepatitis B virus infection. Meanwhile, large family sizes (≥ 7) (AOR: 4.32; 95% CI: 1.34, 13.98), genital discharge (AOR: 3.14; 95% CI: 1.60, 6.15), engagement in unsafe sex (AOR: 2.37; 95% CI: 1.13, 4.97), and a history of mortality due to hepatitis in the family (AOR: 3.03; 95% CI: 1.09, 8.42) were associated with an increased risk of hepatitis B virus infection.

CONCLUSION: This study found that hepatitis B surface antigen seropositivity among adult intrafamilial household contacts with pregnant women index cases in the central Ethiopia region was high at 11.6%. These findings suggest that interventions to prevent HBV infection should prioritize educational campaigns targeting adult intrafamilial household contacts of HBV-positive index cases, focusing on risk factors associated with HBV transmission, prevention, counselling, testing, and vaccination.

PMID:39939946 | DOI:10.1186/s12985-025-02633-w

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The effectiveness of a transition programme based on the integrated theory of health behavior change in adolescents with chronic kidney disease: a quasi-experimental study

BMC Pediatr. 2025 Feb 12;25(1):111. doi: 10.1186/s12887-025-05467-1.

ABSTRACT

BACKGROUND: To validate the effectiveness of the application of a transition programme for adolescents with chronic kidney disease based on the Integrated Theory of Health Behavior Change.

METHODS: This study was a quasi-experiment study. We included 76 adolescents with chronic kidney disease, and based on their willingness to undergo transition intervention, participants were assigned to either the intervention group or the control group. The intervention group received the transition intervention guided by the Integrated Theory of Health Behavior Change, while the control group received standard care and education, remaining unaware of the intervention group’s existence. The data of the intervention group were collected before and after the intervention. Because the total intervention lasted approximately 4 weeks, the data of the control group were collected at baseline (T0) and 1 month (T1). We chose transition readiness as the primary outcome. The secondary outcomes included medication adherence and self-efficacy.

RESULTS: At the final assessment (T1), the scores related to transition readiness, medication adherence, self-care self-efficacy, and adolescent exercise and eating behavior self-efficacy in the intervention group were significantly higher than those in the control group (P < 0.05). Compared with those at T0, the scores of all the constructs in the intervention group increased at T1, and these differences were statistically significant. There was a weak positive correlation between participants’ transition readiness and their medication adherence (r = 0.389, P < 0.01), self-care self-efficacy (r = 0.501, P < 0.01), exercise behavior self-efficacy (r = 0.237, P < 0.05), and eating behavior self-efficacy (r = 0.481, P < 0.01).

CONCLUSIONS: Based on the Integrated Theory of Health Behavior Change, the transition program for adolescents with chronic kidney disease significantly improved participants’ transition readiness, self-care self-efficacy, and exercise and eating behavior self-efficacy. While the study’s design limits definitive conclusions on the program’s impact on medication adherence, the observed improvements suggest that potential benefits warrant further investigation.

TRIAL REGISTRATION: The study obtained approval from the local institutional review board and was registered on https://www.chictr.org.cn (Clinical Trial Number: ChiCTR2300077149) prior to the enrollment of the first subject on October 31, 2023.

PMID:39939945 | DOI:10.1186/s12887-025-05467-1

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Retention of gross and clinical anatomy knowledge among medical graduates in Sudan: a comparative study

BMC Med Educ. 2025 Feb 12;25(1):227. doi: 10.1186/s12909-025-06832-5.

ABSTRACT

BACKGROUND: Retaining anatomical knowledge is crucial for safe and effective medical practice, yet many medical graduates struggle to apply this knowledge in clinical settings over time. This study aimed to evaluate and compare the retention of gross anatomy and clinical anatomy knowledge among medical graduates in Sudan.

METHODS: A cross-sectional study was conducted in a sample of 385 medical graduates from various Sudanese universities, estimated using the Cochrane formula. The participants completed a self-administered questionnaire assessing their knowledge of gross and clinical anatomy, as well as demographic and educational factors. The data were analyzed via descriptive statistics, paired t-tests, and ANOVA.

RESULTS: Clinical anatomy knowledge was significantly better retained (mean score: 68.39%) than gross anatomy knowledge was (mean score: 45.35%). The retention of gross anatomy is influenced by academic background, with integrated and hybrid learning approaches showing better outcomes than traditional methods do. In contrast, clinical anatomy retention was more consistent across demographic factors but varied by speciality, with emergency medicine, general practice, surgery and radiology showing the highest retention levels.

CONCLUSION: Clinical anatomy is retained more effectively due to its frequent application in practice, whereas gross anatomy requires greater integration with clinical relevance to enhance retention. The study recommends medical curricula that merge gross and clinical anatomy through active learning strategies and continuous education to improve long-term retention and clinical competency.

PMID:39939944 | DOI:10.1186/s12909-025-06832-5

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Exploring the impact of angiotensin-converting enzyme (ACE) gene polymorphism on early diastolic function in hypertension using four-dimensional echocardiography

BMC Cardiovasc Disord. 2025 Feb 12;25(1):95. doi: 10.1186/s12872-025-04498-x.

ABSTRACT

BACKGROUND: This study explores the relationship between angiotensin-converting enzyme (ACE) gene polymorphisms and early diastolic dysfunction in patients with hypertension utilizing four-dimensional echocardiography and assesses the prognosis.

METHODS: This study consecutively selected 470 patients with hypertension who visited the Fourth Affiliated Hospital of Soochow University between September 2021 and August 2022, with 274 meeting the inclusion criteria. Hypertension gene testing was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques, and the Hardy-Weinberg equilibrium test was used to confirm genetic equilibrium. Patients were categorized into the D allele group (n = 163) and the non-D allele group (n = 111). Diastolic function was assessed using four-dimensional echocardiography, which included averaging the E/e’ ratio over three cardiac cycles, measuring the left atrial (LA) maximum volume index (LA volume), tricuspid regurgitation velocity (TR velocity), LA strain, and left ventricular isovolumic relaxation time (IVRT). Patients were subsequently classified into the diastolic dysfunction group (n = 133) and the normal diastolic function group (n = 141). Chi-square tests were used to analyze differences in diastolic function indicators between the groups, Logistic regression was applied to control for potential confounding factors, and receiver operating characteristic (ROC) curves were plotted to assess the predictive value of different ACE alleles for diastolic dysfunction in patients with hypertension.

RESULTS: The genotype distribution in both the D allele group and the non-D allele group was consistent with Hardy-Weinberg equilibrium (P > 0.05). Compared to the non-D allele group, echocardiographic indicators in the D allele group showed a decline in diastolic function: the average E/e’ ratio over three cardiac cycles (14.67 [13.82, 15.80] vs. 9.30 [8.12, 12.00]), LA volume (32.76 [29.34, 34.61] vs. 25.61 [22.63, 29.64] ml/m2), TR velocity (2.90 [2.40, 2.90] vs. 1.40 [1.10, 2.40] cm/s), LA strain (18.00 [14.00, 25.00] vs. 37.00 [24.00, 40.00] %), and IVRT (104.25 [95.87, 106.25] vs. 88.09 [80.99, 96.56] ms). Differences between each group were statistically significant (all P < 0.05). The number of patients with diastolic dysfunction was higher in the D allele group (n = 102; 62.6%) compared to the non-D allele group (n = 31; 27.9%). In the logistic regression model, the D allele was associated with an increased risk of early diastolic dysfunction in hypertension (OR = 4.32, 95% CI = 2.56-7.27, P < 0.01). In the adjusted model, the D allele remained associated with an elevated risk of early diastolic dysfunction in hypertension (OR = 3.83, 95% CI = 2.24-6.54, P < 0.01). ROC curve analysis indicated that the D allele has predictive value for early diastolic dysfunction in patients with hypertension (area under the curve [AUC], 0.667; 95% confidence interval [CI], 0.608-0.723; sensitivity, 76.7%; and specificity, 56.7%; P < 0.05).

CONCLUSIONS: The ACE-D allele is associated with early diastolic dysfunction in hypertension. ACE gene testing can enhance the predictive value for diastolic dysfunction in patients with hypertension.

PMID:39939942 | DOI:10.1186/s12872-025-04498-x

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Disease-free survival as surrogate for overall survival in esophageal cancer: An individual patient data meta-analysis of neoadjuvant chemotherapy and chemoradiotherapy

Eur J Cancer. 2025 Feb 7;218:115292. doi: 10.1016/j.ejca.2025.115292. Online ahead of print.

ABSTRACT

BACKGROUND: The use of surrogate endpoints may expedite the reporting of study outcomes of clinical trials. The validity of disease-free survival (DFS) as a surrogate for overall survival (OS) in the neoadjuvant treatment of esophageal (E) or gastroesophageal junctional (GEJ) carcinomas remains uncertain.

OBJECTIVE: To evaluate DFS as a surrogate end-point for OS in E/GEJ using the meta-analytical approach DESIGN, SETTING, AND PARTICIPANTS: individual patient data from an international meta-analysis on operable locally advanced E/GEJ, which including randomized trials comparing at least two of the neo-adjuvant treatment strategies: upfront surgery (S), chemotherapy followed by surgery (CS), and/or chemoradiotherapy followed by surgery (CRS).

MAIN OUTCOMES AND MEASURES: Individual (Kendall’s tau) and trial-level (R2) correlations between DFS and OS were estimated using a Clayton copula.

RESULTS: DFS and OS data were available for a total of 4518 pts: 2222 pts included in CS vs S, 1908 pts in CRS vs S, and 388 in CS vs CRS comparisons. 3440 patients had a DFS event and 3303 patients died. Kendall’s tau was 0.73 [95 % CI 0.71 – 0.75] and R2 trial-level correlation was 0.95 [0.84 – 0.99] for CS vs S, Kendall’s tau was 0.76 [0.74 – 0.77] and R2 was 0.96 [0.87 – 0.99] for CRS vs S, Kendall’s tau was 0.87 [0.78 – 0.92] and R2 was 0.93 [0.43 – 1] for CRS vs CS. In a multistate model, the median time in the recurrence state was shorter in older vs more recent trials: mean time of 10.8 [10.2 – 11.4] vs 16.5 months [15.4-17.6].

CONCLUSIONS AND RELEVANCE: DFS is a validated surrogate endpoint for OS in trials evaluating neoadjuvant chemotherapy or chemoradiotherapy in E/GEJ. DFS may be more useful as an endpoint when delays between recurrences and death become larger.

PMID:39938127 | DOI:10.1016/j.ejca.2025.115292