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Recruitment, Retention Approaches and Community Engagement in the THRIVE pilot Trial: Lessons Learned from a Food is Medicine Trial

Background: Recruitment of underrepresented populations, including Black and Hispanic populations, for Food is Medicine (FIM) and cardiovascular trials, may pose significant challenges. Methods: We implemented a multi-component recruitment approach for the THRIVE (AdapTive personalized dietitian coacHing and messaging with pRoduce prescrIptions to improVE healthy dietary behaviors) pilot trial to engage primarily Black and Hispanic adults in a Food is Medicine for hypertension intervention. The recruitment approaches included community engagement at approximately 40 community events (cultural festivals and neighborhood gatherings); partnerships with 8 community and faith-based service hubs and food distribution sites; recruitment through safety net primary care clinics, digital outreach via the study website, and social media campaigns; and direct recruitment at places of worship. We report lessons learned from the community engagement process, recruitment efficiency, representativeness, and retention outcomes. Results: Within 6 months, the enrollment target was exceeded by 40%, with an accrual index of 1.04. Over 1,000 individuals were reached through the direct-to-community engagement process, while faith-based partnerships engaged about 900 adults. There were 2,673 visits to the study webpage, and social media achieved 12,259 impressions with 399 clicks. About 95% of participants resided within 10 miles of the faith-based recruitment sites. Face-to-face engagement at the food distribution sites within faith-based organizations or community service hubs outperformed digital methods. Faith leader endorsements and follow-up in-person meetings (following unsuccessful email outreach) dramatically increased recruitment. Regarding retention, pre-randomization attrition was 6%, and 82% of participants completed the study. Conclusion: Culturally tailored, community-engaged recruitment grounded in faith-based and local community partnerships, was highly effective in engaging Black and Hispanic populations in this FIM cardiovascular trial. This provides a replicable model for implementing equitable and sustainable cardiovascular health interventions.

A MULTICENTER SWEDISH HISTOPATHOLOGY IMAGE DATASET OF PEDIATRIC CENTRAL NERVOUS SYSTEM TUMORS

Refined detection methods, more detailed tumor characterization, and adequate distinction between different pediatric tumor subtypes are necessary to improve diagnosis and treatment, enable precision medicine, and advance patient prognosis. However, the application of computational approaches to pediatric brain tumors remains limited, largely due to the lack of accessible datasets. To address part of this gap, we provide whole slide images (WSIs) of hematoxylin and eosin (H&E)-stained tissue sections from all pediatric central nervous system (CNS) samples collected in Sweden between 2013 and 2023. These data represent a population-based national cohort encompassing all six pediatric oncology centers in Sweden and are available through the Swedish Childhood Tumor Biobank (BTB). The dataset includes 1,446 WSIs of sufficient image quality with confirmed CNS tumor diagnoses, derived from 537 unique subjects (562 cases). In addition, diagnosticrelevant clinical information is included. Corresponding whole-genome sequencing (WGS), wholetranscriptome sequencing (WTS), and methylation array data are available for most tumor samples through separate resources. This H&E dataset has been specifically curated to support artificial intelligence-based analyses, while also serving broader applications in medical research and education. When combined with matched molecular data, it provides a valuable resource for advancing multimodal and precision diagnostic approaches in the pediatric population. Refined detection methods, more detailed tumor mapping and adequate distinction between different subtypes of pediatric tumors are necessary to improve treatment, enable precision medicine and improve patient prognosis. Application of computational algorithms for pediatric brain tumors is very limited mainly due to the unavailability of pediatric histology brain tumor data sets. To enable the development of AI models comprehensive datasets covering a wide range of pediatric brain tumors are needed.

Characterisation of disease progression in hantavirus haemorrhagic fever with renal syndrome

Hantaviruses can cause haemorrhagic fever with renal syndrome (HFRS). This is a clinically variable disease in which severe outcomes are hypothesized to arise from dysregulated host responses. To characterise this, longitudinal, label-free plasma proteomics was used to compare disease progression in a unique well-defined cohort of patients infected with either Dobrava virus (DOBV) or Puumala virus (PUUV) hantaviruses. Patients were stratified by clinical severity. The average viral load in the first available sample from hospitalized patients was higher in those who went on to have severe infection, and higher in patients infected with DOBV. There was marked separation of infected patients from controls across early, mid and late disease, including after viral RNA clearance, suggesting a sustained systemic host-response signature. Proteomic signatures were consistent with a strong acute-phase response in both mild and severe disease. There was evidence of activation of the adaptive humoral response at later stages. Hierarchical clustering identified severity-associated pathways linked to endothelial dysfunction, thrombocytopenia, vascular leakage and renal injury. These findings define a durable plasma proteomic signature of hantavirus disease and support a model in which severe HFRS is driven by persistent inflammatory, complement and platelet/coagulation pathway activation rather than viral burden alone.