Objective: The Rehabilitation Strategies in Esophagogastric cancer (RESTORE) randomized controlled trial evaluated the efficacy of a 12-week multidisciplinary program to increase the cardiorespiratory fitness and health-related quality of life (HRQOL) of esophagogastric cancer survivors. Background: Patients following treatment for esophagogastric cancer are at risk of physical deconditioning, nutritional compromise, and sarcopenia. Accordingly, compelling rationale exists to target these impairments in recovery. Methods: Disease-free patients treated for esophagogastric cancer were randomized to either usual care or the 12-week RESTORE program (exercise training, dietary counseling, and multidisciplinary education). The primary outcome was cardiopulmonary exercise testing (VO2peak). Secondary outcomes included body composition (bioimpedance analysis), and HRQOL (EORTC-QLQ-C30). Outcomes were assessed at baseline (T0), postintervention (T1), and at 3-month follow-up (T2). Results: Twenty-two participants were randomized to the control group [mean (standard deviation) age 64.14 (10.46) yr, body mass index 25.67 (4.83) kg/m2, time postsurgery 33.68 (19.56) mo], and 21 to the intervention group [age 67.19(7.49) yr, body mass index 25.69(4.02) kg/m2, time postsurgery 23.52(15.23) mo]. Mean adherence to prescribed exercise sessions were 94(12)% (supervised) and 78(27)% (unsupervised). Correcting for baseline VO2peak, the intervention arm had significantly higher VO2peak at both T1, 22.20 (4.35) versus 21.41 (4.49) mL · min−1 · kg−1, P < 0.001, and T2, 21.75 (4.27) versus 20.74 (4.65) mL · min−1 · kg−1, P = 0.001, compared with the control group. Correcting for baseline values, no changes in body composition or HRQOL were observed. Conclusions: The RESTORE program significantly improved cardiorespiratory fitness of disease-free patients after esophagogastric cancer surgery, without compromise to body composition. This randomized controlled trial provides proof of principle for rehabilitation programs in esophagogastric cancer. Clinical Trial Registration Number: NCT03314311.
Abstract Differentiating benign Spitz naevi (BSN), atypical Spitz tumours (AST) and spitzoid melanomas (SM) can be challenging. While the exact aetiology of these tumours is unknown, gene fusions are thought to play a role in their pathogenesis. Modern molecular based techniques such as IdyllaTM can rapidly identify gene fusions to better define management. We aimed to identify gene fusions and correlate them with clinical findings. We retrospectively examined 20 spitzoid lesions from 2021 to 2025 with traditional immunohistochemistry (IHC) for anaplastic lymphoma kinase (ALK) (D5F3), ROS1 and pan-TRK and with Idylla. Most lesions displayed benign clinical features and 12 were subsequently confirmed on histopathology as BSN. Among these, 10 were from women, whose mean age was 32 years. Seven cases showed positive staining by IHC and Idylla identified five fusions. Only two cases showed unequivocal positivity in both modalities. The remaining eight cases were composed of ASTs and SMs. Clinically, three of these presented similarly as pink papules with atypical vessels. Most (n = 5) were in women and their mean age was 34 years. IHC showed positivity in all cases and only one was positive on Idylla testing. Within this cohort, two patients in their 20s had SMs on the lower extremities with a history of sunbed use. Both cases displayed some positive staining with ALK by IHC. Overall, only three gene fusions showed unequivocal correlation on both IHC and molecular testing. Idylla identified three fusions not found on IHC. Six positive cases were found on IHC that were not identified on Idylla. The clinical and pathological diagnosis of spitzoid-spectrum lesions continues to pose a challenge for clinicians. Our data show both similarities and variation among gene fusions identified using IHC and Idylla. We are currently undertaking a prospective analysis of spitzoid lesions with additional molecular testing to further evaluate how molecular properties might inform future diagnosis and management.
Women's empowerment is critical for achieving gender equality and sustainable development in low-and-middle-income countries (LMICs). Capacity-building interventions, such as vocational training, microfinance, and digital literacy programmes, are frequently employed to foster empowerment. However, wide variation exists in how empowerment is defined, theorised, and measured, limiting comparability across studies. This scoping review mapped the conceptual foundations, theoretical frameworks, and measurement approaches used in capacity-building interventions for women entrepreneurs in LMICs. The review followed Arksey and O'Malley's framework and was reported in line with PRISMA-ScR guidelines. Searches were conducted in PubMed, Scopus, Web of Science, and JSTOR, complemented by grey literature from major development agencies (2010-2024). Eligible studies focused on capacity-building interventions targeting women entrepreneurs in LMICs. Two reviewers independently screened and extracted data, which were synthesised thematically. Of 11,109 records identified, 25 met inclusion criteria. Most studies were cross-sectional, conducted in sub-Saharan Africa (48%) and South Asia (32%). While 76% defined empowerment, 60% did not employ any explicit theoretical or conceptual framework. Among those that did, frameworks, such as Kabeer's, Longwe's, and Malhotra et al.'s were used inconsistently. Economic empowerment was the most frequently assessed domain, often measured through income or business performance, while social, political, and psychological dimensions were seldom examined. Indicators were heterogeneous and largely self-reported. Conceptual ambiguity and inconsistent measurement hinder progress in women's empowerment research in LMICs. Future studies should adopt theoretically grounded, multidimensional, and context-sensitive frameworks to capture empowerment as a dynamic process beyond economic gains.
Background A pilot eyecare programme aimed to address the urgent eye health needs of older Zanzibari craftswomen. We investigated the impact of correcting presbyopia on their subjective well-being (SWB) 6 months post-correction and assessed the cost-effectiveness of a women-targeted presbyopia correction programme. Methods This study involved Zanzibari craftswomen aged 40 and older with presenting and corrected distance visual acuity better than 6/12 in both eyes and were presbyopic. Using a before–after method, we assessed SWB on a 10-point scale before and after providing free spectacles. Mean SWB scores and differences pre-correction and post-correction were calculated. Programme costs were analysed to determine the cost per SWB score gained and the monthly cost for each SWB score improvement. Additionally, scenario analysis estimated costs for 12 approaches. Results Of 282 craftswomen, 209 met the eligibility criteria. SWB scores significantly increased from 3.34 to 8.14 post correction (p<0.001). Screening costs totalled US$12 885.84, with an average cost of US$45.69 per craftswoman screened and US$61.66 per presbyopia identification. The total programme cost was US$14,574.69. One hundred fifty-four craftswomen experienced increased SWB, with a total of 747 score gains. Achieving one SWB score improvement cost an average of US$19.50, with a monthly average cost of US$3.40 per improvement. Utilising woman screeners, organised transport and ready-made spectacles appeared to be the most cost-effective approach. Conclusion Correcting presbyopia through a targeted eyecare programme significantly enhanced SWB among craftswomen. While the programme seems cost-effective, further research is warranted to explore long-term economic benefits and definitively assess cost-effectiveness in larger studies.
Objective To present older presbyopic Zanzibari craftswomen’s firsthand experiences with the eyeglasses, the challenges they face in advancing their businesses and proposed solutions to these challenges.Design This participatory action research used solicited diaries, where 10 craftswomen documented their experiences with presbyopia correction for 6 months. The diaries were translated into English for qualitative content analysis. Researchers then held a 2-day listening workshop with 20 craftswomen to discuss the diary findings and gather their perspectives on challenges and solutions. These workshops included group discussions and debates to encourage open communication. Narrative analysis was conducted to identify the key narratives.Setting Zanzibar, Unguja and Pemba Islands.Participants Zanzibari craftswomen entrepreneurs with corrected presbyopia, 40 years and older.Intervention Presbyopia near vision eyeglasses for 6 months.Results The study found that improved vision with eyeglasses significantly benefits craftswomen in Zanzibar. They experience increased work efficiency, quality and income. Craftswomen also reported greater independence, confidence and participation in daily activities. However, limited market access and competition restrict their income growth. Business skills training in areas like marketing and finance is seen as a solution for sustainable success.Conclusions Improved near vision was associated with enhanced productivity, financial confidence and well-being among craftswomen. However, persistent barriers—including limited market access, competition and lack of business skills—highlight that a vision-only approach may not address the intersectional challenges faced by older women entrepreneurs in Zanzibar. These findings suggest that integrated strategies combining vision care with business mentoring may offer more sustainable support.
