Treatment Strategies Research Articles

Effect of body mass index on post-treatment oral function in patients with oral cancer: a cross-sectional study

This single-center cross-sectional study used sequential sampling to examine the influence of body mass index (BMI) on oral function after oral cancer treatment. Patients who completed primary oral cancer treatment between September 2019 and March 2023 (102 patients, 74 male [72.5%] and 28 female [27.5%]; mean age, 69.6 years) were analyzed. Patient background data were collected from electronic medical records. Post-treatment oral function measurements were conducted on all patients using six assessment tools. Statistical analysis was conducted using Pearson’s correlation coefficient, one-way analysis of variance, the Jonckheere–Terpstra test, and multiple linear regression. Pre-treatment BMI showed a statistically significant relationship with postoperative oral function, particularly tongue pressure (P = 0.01). While the mean values of the groups showed no significant differences, the Jonckheere–Terpstra test revealed a statistically significant trend toward a stepwise increase in tongue pressure for each BMI group (P = 0.03). Multiple linear regression analysis revealed a statistically significant correlation between tongue pressure and pre-treatment BMI (P < 0.05). Pre-treatment BMI was significantly associated with tongue pressure. Since BMI is a variable factor that can be controlled by nutritional therapy even before treatment, nutritional intervention, weight control, and treatment strategies including reconstructive interventions to maintain tongue pressure may be important in oral cancer treatment.

Management of Extra-Articular and Intra-Articular Distal Radius Malunion

This article presents a comprehensive overview of managing extra-articular and intra-articular distal radius malunions (DRM), discussing the pathoanatomy, clinical, and radiologic evaluation, conservative treatment, and surgical strategies. Corrective osteotomy remains the primary surgical intervention for symptomatic DRM. Surgical planning should consider factors such as timing, approach, correction technique, implant, graft, and associated injuries. The correction of extra-articular malunion necessitates brachioradialis tenotomy, circumferential periosteum release, and intrafocal elevation with grafting to facilitate distal radius realignment following osteotomy. Computer-assisted planning with 3D-printed patient-specific instrumentation (PSI) could help execute extra-articular osteotomy with high precision. As for the management of intra-articular malunion, it may require wrist arthrotomy, arthroscopy, or PSI assistance for precise articular osteotomy and reduction of the joint surface. This review highlights the importance of early intervention, thorough preoperative planning, and appropriate surgical techniques to optimize outcomes and minimize complications. Future research should focus on large-scale randomized controlled trials to compare different surgical methods, particularly for intra-articular DRM.

Exploring the pathogenesis of insomnia and acupuncture intervention strategies based on the microbiota-gut-brain axis

Insomnia is a common sleep disorder observed in clinical settings, with a globally rising prevalence rate. It not only impairs sleep quality and daytime functioning but also contributes to a range of physiological and psychological conditions, often co-occurring with somatic and mental disorders. Currently, the pathophysiology of this condition is not fully understood. Treatment primarily involves symptomatic management with benzodiazepine receptor agonists, melatonin and its receptor agonists, sedative antidepressants, atypical antipsychotics, and orexin receptor antagonists. However, due to the adverse side effects of these drugs, including dependency, addiction, and tolerance, there is an urgent need for safer, more effective, and environmentally friendly treatment methods. In recent years, research on the microbiota-gut-brain axis has received significant attention and is expected to be key in uncovering the pathogenesis of insomnia. Acupuncture stimulates acupoints, activating the body’s intrinsic regulatory abilities and exerting multi-pathway, multi-target regulatory effects. A substantial body of evidence-based research indicates that acupuncture is effective in treating insomnia. However, the unclear mechanisms of its action have limited its further clinical application in insomnia treatment. Therefore, this study aims to elucidate the pathogenesis of insomnia from the perspective of the microbiota-gut-brain axis by examining metabolic, neuro-endocrine, autonomic nervous, and immune pathways. Additionally, this study discusses the comprehensive application of acupuncture in treating insomnia, aiming to provide new strategies for its treatment.

Are HPV Vaccines Well Accepted among Parents of Adolescent Girls in China? Trends, Obstacles, and Practical Implications for Further Interventions: A Five-Year Follow-Up Study

Background: In 2020, the WHO proposed the global strategic goal of accelerating the elimination of cervical cancer (CC). One of the key strategies is that, by 2030, 90% of girls will complete HPV vaccination by age 15. In 2017, HPV vaccines were first marketed in China. Objectives: This study aimed to explore the changes in parents’ knowledge about CC, HPV, HPV vaccines, and acceptance of HPV vaccination 5 years after the introduction of HPV vaccines into China. Associated factors and reasons for refusal by parents were also explored. Methods: A school-based follow-up study was conducted among parents in China from May 2018 to May 2023. Comparison using Chi-square tests was performed to measure the changes. Univariate and multivariate analyses were used to explore factors associated with HPV vaccination among teenage girls. Results: The overall cognitive level in terms of CC- and HPV-related knowledge among parents increased, and they expressed more willingness to vaccinate their daughter (35.4% in 2018 vs. 56.6% in 2023). The HPV vaccination rate among teenage girls remained at a low level (4.4% in 2018, 9.8% in 2023). The main obstacles reported by parents were limited knowledge (42.0%), scarcity of the HPV vaccine (29.2%), waiting until their daughter was older (27.5%), safety concerns (14.7%), high cost (9.0%), and effectiveness concerns (4.6%). Parents who are elderly, local residents, have received HPV vaccines themselves, have had experience of vaccinating their children with influenza vaccines, and have a higher knowledge level of CC, HPV and HPV vaccines are more likely to vaccinate their children with HPV vaccines. Conclusions: Although we observed an increment in parents’ knowledge level in terms of CC, HPV, HPV vaccines, and HPV vaccine uptake over the past 5 years, the HPV vaccine coverage among girls still falls short of the WHO’s 2030 target. Comprehensive intervention strategies, including tailored health education among adolescents and their parents, doctor recommendations, and providing financial subsidies or free HPV vaccines are needed in China.

Clinical Features, Genetic Landscape and Management of Behçet's Syndrome: A Comprehensive Review

Behçet's syndrome is a systemic inflammatory disorder of unknown origin, presenting with diverse symptoms such as recurrent oral and genital ulcers, skin lesions, and uveitis, and can impact multiple organ systems. Diagnosis relies primarily on clinical evaluation due to the lack of specific diagnostic tests. Management requires a multidisciplinary approach to control inflammation and alleviate symptoms, utilizing treatments like corticosteroids, immunosuppressive agents, and biological therapies. The higher prevalence of Behçet's syndrome along the Silk Road points to significant environmental and genetic influences. Despite progress in understanding its clinical manifestations and treatment options, the underlying mechanisms of the disease remain unclear. Future research is crucial to uncover the disease's pathophysiology and refine treatment strategies, aiming to prevent severe complications such as blindness and neurological impairment. This comprehensive review explores the clinical features, genetic background, and management strategies for Behçet's syndrome, highlighting the potential of precision medicine to improve patient care.

Deep learning-based multimodal image analysis predicts bone cement leakage during percutaneous kyphoplasty: protocol for model development, and validation by prospective and external datasets

BackgroundBone cement leakage (BCL) is one of the most prevalent complications of percutaneous kyphoplasty (PKP) for treating osteoporotic vertebral compression fracture (OVCF), which may result in severe secondary complications and poor outcomes. Previous studies employed several traditional machine learning (ML) models to predict BCL preoperatively, but effective and intelligent methods to bridge the distance between current models and real-life clinical applications remain lacking.MethodsWe will develop a deep learning (DL)-based prediction model that directly analyzes preoperative computed tomography (CT) and magnetic resonance imaging (MRI) of patients with OVCF to accurately predict BCL occurrence and classification during PKP. This retrospective study includes a retrospective internal dataset for DL model training and validation, a prospective internal dataset, and a cross-center external dataset for model testing. We will evaluate not only model’s predictive performance, but also its reliability by calculating its consistency with reference standards and comparing it with that of clinician prediction.DiscussionThe model holds an imperative clinical significance. Clinicians can formulate more targeted treatment strategies to minimize the incidence of BCL, thereby improving clinical outcomes by preoperatively identifying patients at high risk for each BCL subtype. In particular, the model holds great potential to be extended and applied in remote areas where medical resources are relatively scarce so that more patients can benefit from quality perioperative evaluation and management strategies. Moreover, the model will efficiently promote information sharing and decision-making between clinicians and patients, thereby increasing the overall quality of healthcare services.

Isolation and Pharmacological Characterisation of Pre-Synaptic Neurotoxins from Thai and Javanese Russell’s Viper (Daboia siamensis) Venoms

The widespread geographical distribution of Russell’s vipers (Daboia spp.) is associated with marked variations in the clinical outcomes of envenoming by species from different countries. This is likely to be due to differences in the quantity and potency of key toxins and, potentially, the presence or absence of some toxins in venoms across the geographical spectrum. In this study, we aimed to isolate and pharmacologically characterise the major neurotoxic components of D. siamensis venoms from Thailand and Java (Indonesia) and explore the efficacy of antivenom and a PLA2 inhibitor, Varespladib, against the neuromuscular activity. These data will provide insights into the link between venom components and likely clinical outcomes, as well as potential treatment strategies. Venoms were fractionated using RP-HPLC and the in vitro activity of isolated toxins assessed using the chick biventer cervicis nerve-muscle preparation. Two major PLA2 fractions (i.e., fractions 8 and 10) were isolated from each venom. Fraction 8 from both venoms produced pre-synaptic neurotoxicity and myotoxicity, whereas fraction 10 from both venoms was weakly neurotoxic. The removal of the two fractions from each venom abolished the in vitro neurotoxicity, and partially abolished myotoxicity, of the whole venom. A combination of the two fractions from each venom produced neurotoxic activity that was equivalent to the respective whole venom (10 µg/mL), but the myotoxic effects were not additive. The in vitro neurotoxicity of fraction 8 (100 nM) from each venom was prevented by the pre-administration of Thai Russell’s viper monovalent antivenom (2× recommended concentration) or preincubation with Varespladib (100 nM). Additionally, the neurotoxicity produced by a combination of the two fractions was partially reversed by the addition of Varespladib (100–300 nM) 60 min after the fractions. The present study demonstrates that the in vitro skeletal muscle effects of Thai and Javanese D. siamensis venoms are primarily due to key PLA2 toxins in each venom.

Assessing The Thermal Damage Induced By Radiofrequency Ablation for Localized Liver Cancer

Abstract Clinical trials are already established for high-temperature treatment of localized cancer, i.e., rise of tissue temperature to more than 550 C as an effective non-invasive method for the treatment of localized cancer. However, as the computational techniques and capacity have enhanced considerably personalized treatment planning has become a manured tool. In the present investigation, a novel treatment planning framework is being proposed for radiofrequency ablation of cancer tissue based on the tomographic image-based actual model. In patient-specific modelling, different thermal parameters like temperature history during ablation, and thermal damage profile have been virtually determined based on Penne's bioheat transfer model with appropriate boundary conditions. This advancement promises to significantly enhance the capabilities of healthcare practitioners in tailoring personalized treatment strategies for their clinical cases. By leveraging simulation outcomes, clinicians can precisely determine the most effective parameters, such as ablation power and frequency. Unfortunately, the current landscape in India presents a scarcity of specialized medical experts in the field of ablation oncology. Moreover, those who practice in this niche often rely on empirical charts rather than data-driven approaches, highlighting a critical need for increased expertise and the integration of advanced simulation technology to optimize cancer tissue ablation procedures. Last but not least optimizing different operating parameters of RF in this patient-centric approach for accurate treatment has also been discussed.

Key regulators of vascular calcification in chronic kidney disease: Hyperphosphatemia, BMP2, and RUNX2

Vascular calcification is quite common in patients with end-stage chronic kidney disease and is a major trigger for cardiovascular complications in these patients. These complications significantly impact the survival rate and long-term prognosis of individuals with chronic kidney disease. Numerous studies have demonstrated that the development of vascular calcification involves various pathophysiological mechanisms, with the osteogenic transdifferentiation of vascular smooth muscle cells (VSMCs) being of utmost importance. High phosphate levels, bone morphogenetic protein 2 (BMP2), and runt-related transcription factor 2 (RUNX2) play crucial roles in the osteogenic transdifferentiation process of VSMCs. This article primarily reviews the molecular mechanisms by which high phosphate, BMP2, and RUNX2 regulate vascular calcification secondary to chronic kidney disease, and discusses the complex interactions among these factors and their impact on the progression of vascular calcification. The insights provided here aim to offer new perspectives for future research on the phenotypic switching and osteogenic transdifferentiation of VSMCs, as well as to aid in optimizing clinical treatment strategies for this condition, bearing significant clinical and scientific implications.

Evaluating Treatment Modalities for Reducing Recurrence in Central Giant Cell Granuloma: A Narrative Review

Treating central giant cell granuloma (CGCG) is challenging due to high recurrence rates and variable therapy responses. This study examines the efficacy of various treatments in reducing CGCG recurrence. A literature review explored outcomes of surgical excision, curettage, intralesional corticosteroid injection, and adjuvant therapy, considering factors like lesion location, size, and histological features. Aggressive surgical techniques such as en bloc resection were found to potentially lower recurrence rates compared to conservative approaches. However, treatment should be tailored to individual patient needs. Further research is needed to confirm these findings and improve treatment strategies. A concise literature review was conducted using PubMed, MEDLINE, and Google Scholar, focusing on papers published from 1986 to 2024. Search terms included “central giant cell granuloma”, “recurrence”, “treatment modalities”, and “surgical excision”. Studies reporting recurrence rates and treatment outcomes for CGCG were analyzed. Twenty-nine studies were reviewed, including six studies on surgical excision and curettage, eight studies on intralesional corticosteroid injections, six studies on calcitonin therapy, five studies on interferon-alpha therapy, and four studies on the therapy with denosumab. Analysis indicated that aggressive surgical treatments like en bloc resection were associated with lower recurrence rates compared to conservative methods. Predictors of recurrence included lesion size (&gt;3 cm), location (mandible), and aggressive histopathological features. Aggressive surgical excision combined with nonsurgical methods may lower recurrence rates, while conservative techniques remain viable in some cases. Further prospective research is needed to validate these findings and enhance CGCG treatment options.

The p-MYH9/USP22/HIF-1α axis promotes lenvatinib resistance and cancer stemness in hepatocellular carcinoma

Lenvatinib is a targeted drug used for first-line treatment of hepatocellular carcinoma (HCC). A deeper insight into the resistance mechanism of HCC against lenvatinib is urgently needed. In this study, we aimed to dissect the underlying mechanism of lenvatinib resistance (LR) and provide effective treatment strategies. We established an HCC model of acquired LR. Cell counting, migration, self-renewal ability, chemoresistance and expression of stemness genes were used to detect the stemness of HCC cells. Molecular and biochemical strategies such as RNA-sequencing, immunoprecipitation, mass spectrometry and ubiquitination assays were used to explore the underlying mechanisms. Patient-derived HCC models and HCC samples from patients were used to demonstrate clinical significance. We identified that increased cancer stemness driven by the hypoxia-inducible factor-1α (HIF-1α) pathway activation is responsible for acquired LR in HCC. Phosphorylated non-muscle myosin heavy chain 9 (MYH9) at Ser1943, p-MYH9 (Ser1943), could recruit ubiquitin-specific protease 22 (USP22) to deubiquitinate and stabilize HIF-1α in lenvatinib-resistant HCC. Clinically, p-MYH9 (Ser1943) expression was upregulated in HCC samples, which predicted poor prognosis and LR. A casein kinase-2 (CK2) inhibitor and a USP22 inhibitor effectively reversed LR in vivo and in vitro. Therefore, the p-MYH9 (Ser1943)/USP22/HIF-1α axis is critical for LR and cancer stemness. For the diagnosis and treatment of LR in HCC, p-MYH9 (Ser1943), USP22, and HIF-1α might be valuable as novel biomarkers and targets.

Natural Therapeutic Agents’ Efficacy in Preventive Strategies against the Periodontal Pathogen Aggregatibacter actinomycetemcomitans: An In Vitro Study

Adolescent carriers of the Aggregatibacter actinomycetemcomitans JP2 genotype have an increased risk of developing periodontitis, due to the bacterium’s high leukotoxin (LtxA) production. LtxA contributes to marginal bone loss by killing immunity cells, thus activating the proinflammatory interleukin-1β (IL-1β), which, in turn, activates the osteoclasts. A possible strategy to prevent periodontitis might be to neutralize LtxA in JP2-infected individuals. The aim of this study was to investigate whether extracts from Matcha or Guava leaves can prolong the viability of macrophages in cell cultures by neutralizing the highly leukotoxic JP2 genotype bacteria. The A. actinomycetemcomitans JP2 genotype was pretreated with extracts from either Matcha or Guava leaves. Later, the extracts were rinsed off, before JP2 bacteria were exposed to macrophage cell cultures. The experiment was repeated, where JP2 bacteria were persistently treated with the extracts instead, i.e., the extracts were not rinsed off. The macrophage viability after bacterial exposure was analyzed and compared with that of macrophages exposed to untreated JP2 bacteria. IL-1β secretion in the cell culture medium was quantified in all group samples. Pretreatment of the A. actinomycetemcomitans JP2 genotype with Matcha or Guava leaf extracts moderately neutralized LtxA activity, which resulted in prolonged macrophage viability and decreased IL-1β secretion. These effects of prolonged macrophage viability were enhanced when extracts were persistently present during the exposure period. The results indicate that Matcha and Guava leaf extracts have effects on the virulence of the A. actinomycetemcomitans JP2 genotype that may be useful in future treatment strategies to prevent periodontitis in JP2 bacterium carriers.

Retrospective evaluation of rapid genotypic ID and phenotypic AST systems on positive blood culture turnaround time and simulated potential impacts on bloodstream infection management

Abstract Background Bloodstream infections are linked to heightened morbidity and mortality rates. The consequences of delayed antibiotic treatment can be detrimental. Effective management of bacteraemia hinges on rapid antimicrobial susceptibility testing. Objectives This retrospective study examined the influence of the VITEK® REVEAL™ Rapid AST system on positive blood culture (PBC) management in a French tertiary hospital. Materials and methods Between November 2021 and March 2022, 79 Gram-negative monomicrobial PBC cases underwent testing with both VITEK®REVEAL™ and VITEK®2 systems. Results The study found that VITEK®REVEAL™ yielded better results than the standard of care, significantly shortening the time to result (7.0 h compared to 9.6 h) as well as the turnaround time (15 h compared to 31.1 h) when applied for all isolates. Conclusions This study implies that the use of VITEK®REVEAL™ enables swift adaptations of antibiotic treatment strategies. By considerably minimizing the turnaround time, healthcare professionals can promptly make necessary adjustments to therapeutic regimens. Notably, these findings underscore the potential of VITEK®REVEAL™ in expediting appropriate antibiotic interventions, even in less ideal conditions. Further studies in varied laboratory contexts are required to validate these encouraging outcomes.

Identification of potential biomarkers for lung adenocarcinoma: a study based on bioinformatics analysis combined with validation experiments

BackgroundThe prognosis for lung adenocarcinoma (LUAD) remains dismal, with a 5-year survival rate of &amp;lt;20%. Therefore, the purpose of this study was to identify potentially reliable biomarkers in LUAD by machine learning combination with Mendelian randomization (MR).MethodsTCGA-LUAD, GSE40791, and GSE31210 were employed this study. Key module differential genes were identified through differentially expressed analysis and weighted gene co-expression network analysis (WGCNA). Furthermore, candidate biomarkers were derived from protein–protein interaction network (PPI) and machine learning. Ultimately, biomarkers were confirmed using MR analysis. In addition, immunohistochemistry was used to detect the expression levels of genes that have a causal relationship to LUAD in the LUAD group and the control group. Cell experiments were conducted to validate the effect of screening genes on proliferation, migration, and apoptosis of LUAD cells. The correlation between the screened genes and immune infiltration was determined by CIBERSORT algorithm. In the end, the gene-related drugs were predicted through the Drug–Gene Interaction database.ResultsIn total, 401 key module differential genes were obtained by intersecting of 5,702 differentially expressed genes (DEGs) and 406 key module genes. Thereafter, GIMAP6, CAV1, PECAM1, and TGFBR2 were identified. Among them, only TGFBR2 had a significant causal relationship with LUAD (p=0.04, b=−0.06), and it is a protective factor for LUAD. Subsequently, sensitivity analyses showed that there were no heterogeneity and horizontal pleiotropy in the univariate MR results, and the results were not overly sensitive to individual SNP loci, further validating the reliability of univariate Mendelian randomization (UVMR) results. However, no causal relationship was found between them by reverse MR analysis. Meanwhile, TGFBR2 expression was decreased in LUAD group through immunohistochemistry. TGFBR2 can inhibit proliferation and migration of lung adenocarcinoma cell line A549 and promote apoptosis of A549 cells. Immune infiltration analysis suggested a potential link between TGFBR2 expression and immune infiltration. Finally, Irinotecan and Hesperetin were predicted through DGIDB database.ConclusionIn this study, TGFBR2 was identified as a biomarker of LUAD, which provided a new idea for the treatment strategy of LUAD and may aid in the development of personalized immunotherapy strategies.

Multi-omics profiling and experimental verification of tertiary lymphoid structure-related genes: molecular subgroups, immune infiltration, and prognostic implications in lung adenocarcinoma

Lung adenocarcinoma (LUAD), characterized by a low 5-year survival rate, is the most common and aggressive type of lung cancer. Recent studies have shown that tertiary lymphoid structures (TLS), which resemble lymphoid structures, are closely linked to the immune response and tumor prognosis. The functions of the tertiary lymphoid structure-related genes (TLS-RGs) in the tumor microenvironment (TME) are poorly understood. Based on publicly available data, we conducted a comprehensive study of the function of TLS-RGs in LUAD. Initially, we categorized LUAD patients into two TLS and two gene subtypes. Subsequently, risk scores were calculated, and prognostic models were constructed using seven genes (CIITA, FCRL2, GBP1, BIRC3, SCGB1A1, CLDN18, and S100P). To enhance the clinical application of TLS scores, we have developed a precise nomogram. Furthermore, drug sensitivity, tumor mutational burden (TMB), and the cancer stem cell (CSC) index were found to be substantially correlated with the TLS scores. Single-cell sequencing results reflected the distribution of TLS-RGs in cells. Finally, we took the intersection of overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI) prognosis-related genes and then further validated the expression of these genes by qRT-PCR. Our in-depth investigation of TLS-RGs in LUAD revealed their possible contributions to the clinicopathological features, prognosis, and characteristics of TME. These findings underscore the potential of TLS-RGs as prognostic biomarkers and therapeutic targets for LUAD, thereby paving the way for personalized treatment strategies.

Deep Learning and MRI Biomarkers for Precise Lung Cancer Cell Detection and Diagnosis

Aim This research work aimed to combine different AI methods to create a modular diagnosis system for lung cancer, including Convolutional Neural Network (CNN), K-Nearest Neighbors (KNN), VGG16, and Recurrent Neural Network (RNN) on MRI biomarkers. Models have then been evaluated and compared in their effectiveness in detecting cancer, using a meticulously selected dataset containing 2045 MRI images, with emphasis being put on documenting the benefits of the multimodal approach for attacking the complexities of the disease. Background Lung cancer remains the most common cause of cancer death in the world, partly because of the challenges in diagnosis and the late stage of presentation. Although Magnetic Resonance Imaging (MRI) has become a critical modality in the identification and staging of lung cancer, too often, its effectiveness is curtailed by the interpretative variance among radiologists. Recent advances in machine learning hold great promise for augmenting the analysis of MRI and perhaps even increasing diagnostic accuracy with the start of timely treatment. In this work, the integration of advanced machine learning models with MRI biomarkers to solve these problems has been investigated. Objective The purpose of the present paper was to assess the effectiveness of integrating various machine-learning models with MRI biomarkers for lung cancer diagnostics, such as CNN, KNN, VGG16, and RNN. The dataset involved 2,045 MRI images, and the performances of the models were investigated by comparing their performance metrics to determine the best configuration of interconnection while underpinning the necessity of this multimodal approach for accurate diagnoses and, consequently, better patient outcomes. Methods For this study, we used 2045 MRI images, with 70% for training and 30% for validation. We used four machine-learning models to work on the photos: CNN, KNN, VGG16, and RNN. Systematic performance measures were included in the study: accuracy, recall, precision, and F1 score. The confusion matrices of this study compared the diagnostic power of every model to comprehend the pragmatic use of the models in a real-world predictive capability. Results The scores for the model were found to be better with the convolutional neural network in terms of recall, accuracy in measures tested, precision, and F1. The rest of the models, KNN, VGG16, and RNN, performed decently but were slightly lower in performance than CNN. The in-depth analysis through confusion matrices thus established the predictive reliability of the models in revealing immense insight into the capability of identifying true positives and minimizing false negatives in enhancing the diagnostic accuracy of lung cancer detection. Conclusion The findings obtained have shown further support and great potential for integrating advanced machine learning models with MRI biomarkers to improve lung cancer diagnosis. The high performance of CNN, high sensitivity and specificity of the KNN model, and robustness of results obtained from VGG16 and RNN models have pointed to the potential feasibility of AI in the accurate detection of cancer. Our work has shown strong support for this multimodal diagnostic approach, which might impact future practice in oncology through the integration of AI to improve treatment strategies and patient outcomes in medical imaging.

Glioma stem cells remodel immunotolerant microenvironment in GBM and are associated with therapeutic advancements

Glioma is the most common primary tumor of the central nervous system (CNS). Glioblastoma (GBM) is incurable with current treatment strategies. Additionally, the treatment of recurrent GBM (rGBM) is often referred to as terminal treatment, necessitating hospice-level care and management. The presence of the blood-brain barrier (BBB) gives GBM a more challenging or “cold” tumor microenvironment (TME) than that of other cancers and gloma stem cells (GSCs) play an important role in the TME remodeling, occurrence, development and recurrence of giloma. In this review, our primary focus will be on discussing the following topics: niche-associated GSCs and macrophages, new theories regarding GSC and TME involving pyroptosis and ferroptosis in GBM, metabolic adaptations of GSCs, the influence of the cold environment in GBM on immunotherapy, potential strategies to transform the cold GBM TME into a hot one, and the advancement of GBM immunotherapy and GBM models.

Impaired somatosensory habituation in older adults with chronic pain during an affective oddball task.

Chronic pain is one of the most common health conditions among older adults, triggering various disruptions in information processing across attentional, emotional, and somatosensory domains. However, there is insufficient information about how these aspects interact and their potential contribution to the vulnerability of older adults to chronic pain. This study aimed to investigate potential alterations induced by chronic pain during aging in attentional aspects of tactile stimulation and to observe the influence of affective context. Twenty-six older adults with chronic pain (70.00 ± 5.07 years; 11 males), 28 pain-free older adults (69.57 ± 3.96 years; 13 males) and 27 healthy younger adults (21.48 ± 1.80 years; 14 males) participated in the study. We compared the somatosensory evoked potentials elicited by frequent and deviant stimulation (probability 14%) applied when participants were viewing blocks of pleasant, unpleasant, and neutral images from the International Affective Picture System. During frequent stimulation, older adults with chronic pain showed higher P50 and N100 amplitudes compared to pain-free older adults and younger individuals. Furthermore, the older group with pain exhibited higher P300 amplitude during emotional contexts compared to neutral scenarios. During deviant stimulation, older adults with chronic pain exhibited higher P50 and N100 amplitudes compared to pain-free older adults but displayed typical age-related flattening during P300. These findings indicate that chronic pain leads to a decline in the ability to habituate to non-painful irrelevant somatosensory stimuli, especially when it is presented in an emotional context. In the present study, we have observed how older individuals suffering from chronic pain exhibit a decline in the habituation capacity of irrelevant somatosensory information. Furthermore, we have observed how the affective context in which these individuals are situated leads to an exacerbation of this deficit. Enhancing our comprehension of how aging and chronic pain interact to impact somatosensory processing could facilitate the tailoring of novel intervention strategies.

Cytotoxicity in Tobacco Chewers: Insights from Buccal Cytome Analysis in Botad, Gujarat: A Cross-Sectional Study

Introduction: Oral submucous fibrosis (OSMF) is a significant public health concern linked to tobacco consumption, particularly affecting rural populations in Gujarat. This condition, which can lead to serious health complications, underscores the urgent need for awareness and intervention strategies in these areas. The primary aim of this study was to investigate the prevalence of OSMF among tobacco chewers in rural Botad, focusing on identifying cellular abnormalities through buccal cytome analysis. Materials and Methods: A proforma-based approach was employed to collect data from OSMF patients. The study included buccal cytome analysis to assess cellular abnormalities among tobacco chewers, with a particular focus on those consuming mava and pan masala. Additionally, physical observations were made to correlate perinatal health with pre-cancerous lesions. Results: The findings revealed a predominance of OSMF in male patients from rural areas, highlighting a significant lack of awareness regarding the risks associated with tobacco use. Buccal cytome analysis indicated notable cellular abnormalities, especially among mava and pan masala consumers, suggesting heightened cytotoxicity. The study also found major abnormalities in tobacco chewers using lime. Conclusion: This study underscores the critical need for early detection, intervention, and public health initiatives to combat the prevalence and adverse effects of OSMF among tobacco chewers in rural Botad. Addressing this preventable condition is essential for improving community well-being and reducing the burden of tobacco-related health issues..

Global burden of benign prostatic hyperplasia, urinary tract infections, urolithiasis, bladder cancer, kidney cancer, and prostate cancer from 1990 to 2021

BackgroundThe burden of common urologic diseases, including benign prostatic hyperplasia (BPH), urinary tract infections (UTI), urolithiasis, bladder cancer, kidney cancer, and prostate cancer, varies both geographically and within specific regions. It is essential to conduct a comprehensive and precise assessment of the global burden of urologic diseases.MethodsWe obtained data on incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) for the aforementioned urologic diseases by age, sex, location, and year from the Global Burden of Disease (GBD) 2021. We analyzed the burden associated with urologic diseases based on socio-demographic index (SDI) and attributable risk factors. The trends in burden over time were assessed using estimated annual percentage changes (EAPC) along with a 95% confidence interval (CI).ResultsIn 2021, BPH and UTI were the leading causes of age-standardized incidence rate (ASIR) and age-standardized prevalence rate (ASPR), with rates of 5531.88 and 2782.59 per 100,000 persons, respectively. Prostate cancer was the leading cause of both age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR), with rates of 12.63 and 217.83 per 100,000 persons, respectively. From 1990 to 2021, there was an upward trend in ASIR, ASPR, ASMR, and ASDR for UTI, while urolithiasis showed a downward trend. The middle and low-middle SDI quintile levels exhibited higher incidence, prevalence, mortality, and DALYs related to UTI, urolithiasis, and BPH, while the high and high-middle SDI quintile levels showed higher rates for the three cancers. The burden of these six urologic diseases displayed diverse age and sex distribution patterns. In 2021, a high body mass index (BMI) contributed to 20.07% of kidney cancer deaths worldwide, while smoking accounted for 26.48% of bladder cancer deaths and 3.00% of prostate cancer deaths.ConclusionsThe global burden of 6 urologic diseases presents a significant public health challenge. Urgent international collaboration is essential to advance the improvement of urologic disease management, encompassing the development of effective diagnostic screening tools and the implementation of high-quality prevention and treatment strategies.