Incidence and Impact of ctDNA Positivity in Cutaneous Squamous Cell Carcinoma

Objective: To explore the impact and establish biochemical response criteria for optimized risk stratification for anti-glycoprotein (gp) 210 and anti-centromeric antibodies (ACA) dual positivity on the prognosis of patients with primary biliary cholangitis (PBC). Methods: A retrospective cohort study was conducted, including 1 286 PBC patients who visited the Department of Gastroenterology, First Affiliated Hospital of Air Force Medical University, from June 2006 to March 2025. Patients were grouped according to their serum autoantibody status. Clinical data such as baseline demographic characteristics, laboratory indicators, and histological staging were collected. The endpoint events were complications of cirrhosis (ascites, hepatic encephalopathy, variceal bleeding, etc.), hepatocellular carcinoma, liver transplantation, or death. Statistical analysis was performed using SPSS 26.0 software. Survival curves were plotted using the Kaplan-Meier method. The log-rank test was used to compare differences between groups. ROC curves were plotted to compare the predictive performance of different biochemical response criteria. Continuous data were compared using the independent samples t-test or the Mann-Whitney U rank-sum test between the groups. Categorical data were compared using the χ2 test or Fisher's exact test between the groups. Results: Patients with dual positivity for anti-gp210 antibody and ACA had significantly shorter event-free survival (P<0.05). Early-stage patients with dual positivity had a significantly higher incidence of adverse events than other groups (46.05%, P<0.05), along with lower serum albumin (ALB) and platelet count (PLT) levels (P<0.05). The area under the curve (AUC) was 0.873 (95%CI: 0.771-0.975) for the biochemical response criteria based on ALB ≥1×lower limit of normal (LLN) and PLT ≥1×LLN after one year of ursodeoxycholic acid (UDCA) treatment. The incidence rate of adverse events in biochemical respondents was 4.3%, which was superior to other biochemical response criteria in predicting adverse events in early-stage dual-positive patients (P<0.05). However, there was no statistically significant difference in the incidence of endpoint events among the different biochemical response criteria groups in late dual-positive patients (P>0.05). Conclusion: PBC patients with dual positivity for anti-gp210 antibody and ACA have a poorer prognosis and exhibit a high risk of decompensation in the early stages of disease. Biochemical response criteria based on ALB and PLT can accurately identify high-risk patients with dual positivity at an early stage, providing an objective basis for implementing early intensive intervention strategies for high-risk patients in clinical practice.

Background and Objectives: Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers and remains a leading cause of cancer-related mortality worldwide. EGFR-targeted tyrosine kinase inhibitors (TKIs) have substantially improved outcomes in EGFR-mutant NSCLC; however, primary and acquired resistance continues to limit their long-term efficacy. HER3 (receptor tyrosine-protein kinase ErbB3), a member of the ErbB receptor family, has been implicated in TKI resistance through heterodimerization with EGFR and HER2, leading to downstream PI3K/AKT pathway activation. Despite its biological plausibility as a resistance mediator, the clinical significance of HER3 expression as a prognostic and predictive biomarker in EGFR-mutant NSCLC has not been thoroughly characterized in real-world cohorts. Materials and Methods: This retrospective, single-center study included 52 patients diagnosed with EGFR-mutant NSCLC who received TKI therapy at Afyonkarahisar Health Sciences University between January 2011 and September 2023. HER3 protein expression was evaluated by immunohistochemistry (IHC) on formalin-fixed, paraffin-embedded tumor tissue sections using the Huabio anti-HER3 antibody (clone PD00-44, 1:2000 dilution). Staining in more than 30% of tumor cells was considered HER3-positive; membranous staining intensity was scored on a 1-3 scale. Progression-free survival (PFS1, PFS2) and overall survival (OS) were analyzed using the Kaplan-Meier method and log-rank test. Statistical significance was set at p < 0.05. Results: Of 52 patients (55.8% female; mean age 64.5 years), 59.6% received chemotherapy and 40.4% received an EGFR TKI as first-line treatment; erlotinib constituted 71.2% of targeted therapies. In the first-line TKI group, HER3-negative patients had a numerically longer median PFS1 compared with HER3-positive patients (14.0 vs. 7.1 months; p = 0.285); however, this difference did not reach statistical significance and should be interpreted with caution given the small sample size. In contrast, among patients receiving first-line chemotherapy, HER3 staining status did not meaningfully affect PFS1 (4.1 vs. 2.5 months; p = 0.063). In second-line treatment, HER3-positive patients who received TKI after prior chemotherapy demonstrated a PFS2 comparable to or slightly exceeding that of HER3-negative patients (21.8 vs. 19.8 months; p = 0.49), suggesting that the sequencing of chemotherapy before TKI may attenuate the adverse effect of HER3 positivity. Median OS was 15.1 months in HER3-negative patients and 12.7 months in HER3-positive patients (p = 0.824); this numerical difference of approximately 3 months did not reach statistical significance and should therefore be interpreted cautiously. Among patients receiving TKI in the first line, HER3-positive patients had a shorter median OS than HER3-negative patients (9.6 vs. 14.2 months), whereas those receiving TKI in the second line showed a trend toward longer OS in HER3-positive patients (20.5 vs. 17.2 months). Conclusions: HER3 expression was associated with reduced first-line TKI efficacy in EGFR-mutant NSCLC, suggesting a possible role for HER3 in primary TKI resistance; however, these findings are exploratory and did not reach statistical significance. The observation that HER3-positive patients who received chemotherapy before TKI demonstrated outcomes comparable to HER3-negative patients raises the hypothesis that treatment sequencing may potentially influence the impact of HER3 positivity, though this requires prospective validation before any clinical conclusions can be drawn. These results suggest that HER3 expression may warrant further investigation as a candidate biomarker for treatment sequencing decisions and as a potential therapeutic target in EGFR-mutant NSCLC. Prospective studies evaluating chemotherapy-TKI sequencing and HER3-directed agents such as patritumab deruxtecan (HER3-DXd) in HER3-positive patients are needed to confirm these preliminary observations.

The incidence of positive microscopic margins after gastrectomy for gastric cancer (GC) has been reported between 1% to 5%. The aim of the present study was to identify risk factors associated with positive microscopic resection margin in GC patients undergoing gastrectomy, and to assess the survival outcomes and prognostic factors in these patients. The patients were selected from the consecutive database of Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Department of Gastric Surgery, according to the following criteria: (i) histologically proven gastric adenocarcinoma (ii) patients who underwent curative gastrectomy for gastric cancer as a primary treatment and archived R0 or R1 resection between 2005 and 2025. Positive microscopic resection margin was defined as disease present at the line of luminal transaction in mucosa, submucosa, or serosa on final pathology. Univariate and multivariate logistic regression analyses were performed to identify risk factors for resection margin positivity. A total of 1,996 patients were eligible for the present study. Among these patients, 35 patients (1.8%) had positive microscopic resection margin. Pathological type, macroscopic tumor type, and tumor size were identified as independent risk factors for positive resection margin in multivariate analysis. Moreover, positive peritoneal lavage cytology was identified as an independent predictor of poor overall survival prognostic factor in margin-positive GC patients. Microscopic resection margin positivity after gastrectomy for GC was linked to specific tumor characteristics, while positive peritoneal lavage cytology independently predicted poorer survival. To minimize the occurrence of resection margin-positive GC after gastrectomy, it is essential to identify risk factors during perioperative evaluation. Furthermore, treatment strategies based on lavage cytology status could improve prognosis in high-risk patients.

To explore the characteristics of voluntary blood donors with direct antiglobulin test (DAT) positivity and the impact of DAT positivity on blood quality, and to propose a management strategy for these donors. A retrospective analysis was performed on the relevant data of 80 DAT-positive blood donors from 2020 to 2023, including sex, age, ABO blood group, and blood quality sampling results. Additionally, antibody typing, agglutination strength, and DAT follow-up results from subsequent blood donations were analyzed. Among DAT-positive blood donors, age was positively correlated with the DAT positivity rate (r =0.8545), while there were no statistically significant differences in DAT positivity rates among donors of different sex and blood groups. IgG antibody was predominant (67.50%), with agglutination strength primarily between 1+ and 2+. There were no statistically significant differences in some blood quality sampling items between DAT-positive and DAT-negative donors (P >0.05). Follow-up results showed that 93.02% of DAT-positive donors had negative DAT results during subsequent donations. The positivity rate of DAT among blood donors is positively correlated with age. It is recommended to conduct follow-up testing on DAT-positive donors. For rejected DAT-positive blood units, quality sampling tests can be performed to conserve blood resources.

To explore the clinical features and prognosis of patients with Epstein-Barr virus (EBV)-positive diffuse large B-cell lymphoma (DLBCL). The clinical data of 152 patients with DLBCL in Jixi Road Hospital District, Gaoxin Hospital District, North District of the First Affiliated Hospital and the Second Affiliated Hospital of Anhui Medical University from January 2017 to March 2024 were collected and retrospectively analyzed to determine the clinical characteristics and the impact of EBV positivity on prognosis. Among 152 DLBCL cases, there were only 15 cases of EBV-positive DLBCL, with a positivity rate of about 9.87% (15/152). Among the patients with EBV-positive DLBCL, the median age at onset was 75 years old, there were 8 males and 7 females, all of them were immunophenotyped as ABC (15/15), all of the 15 EBV-positive patients were treated with R-CHOP, the recent efficacy assessment was progressive disease in all of them (15/15). Ann Arbor staging, ECOG score, lactate dehydrogenase (LDH), IPI score, immunophenotyping, and MYC expression were correlated with the expression of EBER (P< 0.05). The prognosis of patients with EBV-positive DLBCL was significantly worse than that of patients with EBV-negative DLBCL, and the ECOG score and EBER positivity were independent prognostic factors in patients with DLBCL. EBV-positive DLBCL is a rare group of highly aggressive lymphomas with predominantly ABC subtypes, with a high overall morbidity and mortality. The expression of EBER and the ECOG score were associated with DLBCL prognosis.

AimsThis study aimed to investigate whether the efficacy of neoadjuvant chemotherapy differs between HER2-low and HER2-zero subgroups in hormone receptor-positive, HER2-negative breast cancer.Materials and MethodsA total of 61 patients who received neoadjuvant chemotherapy between 2015 and 2025 were retrospectively analyzed. HER2 status was determined from pre-treatment core biopsy specimens and classified as HER2-low (IHC 1 + or 2 + and FISH-negative) or HER2-zero (IHC 0). The pathological complete response (pCR) rates were compared between the two groups.ResultsAmong 61 patients, 28 had HER2-low and 33 had HER2-zero tumors. The pCR rate was 7.1% in the HER2-low group and 27.3% in the HER2-zero group (p = 0.042). A post-hoc power analysis based on these results showed a moderate power (0.59) to detect the observed difference.ConclusionsHER2-low expression may negatively influence chemosensitivity in hormone receptor-positive breast cancer treated with neoadjuvant chemotherapy. Further studies are warranted to evaluate the potential role of trastuzumab deruxtecan (T-DXd) and other antibody-drug conjugates in this newly defined subgroup.

Impact of anticyclic citrullinated peptide antibody positivity on subclinical cardiovascular profile of patients with established rheumatoid arthritis

BackgroundInfective endocarditis (IE) carries high in-hospital mortality, particularly among intensive care unit (ICU) patients. The predictive role of blood culture positivity in these patients remains unclear.MethodsWe analyzed 484 adult IE patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database, divided into training (n = 339) and testing (n = 145) cohorts. A suite of demographic, clinical, laboratory, and blood culture variables was used to develop tree-based machine learning models. Random Forest (RF) and Extreme Gradient Boosting (XGB) emerged as top performers and were combined into an ensemble model. SHapley Additive exPlanations (SHAP) quantified variable importance, while the Generative Adversarial Nets for Inference of Individualized Treatment Effects (GANITE) model assessed the average treatment effect (ATE) and conditional treatment effects (CATE) of blood culture positivity on in-hospital mortality across various clinical subgroups.ResultsThe ensemble model demonstrated robust performance with an area under the receiver operating characteristic curve (AUROC) of 0.826 and an accuracy of 0.821 on the test set. Blood culture positivity consistently ranked among the top predictors of mortality. SHAP analysis revealed that the presence of bacteremia increased the predicted probability of in-hospital mortality. Specifically, the GANITE model estimated that blood culture positivity raised mortality by 0.9% (95% confidence interval [CI]: −0.9% to 2.6%) in the training set, 7.4% (95% CI: 4.3% to 10.4%) in the test set, and 2.8% (95% CI: 1.2% to 4.4%) overall. Furthermore, CATE analysis highlighted that the adverse impact of blood culture positivity was significantly more pronounced in patients aged 60 years and older, those with systolic blood pressure below 100 mmHg, and in certain endocarditis subtypes.ConclusionsBlood culture positivity at ICU admission is associated with a modest yet clinically significant increase in in-hospital mortality among IE patients. The application of advanced machine learning and causal inference models enhances risk stratification and may inform more targeted clinical interventions in this high-risk group.

Validation of measurable residual disease as a surrogate endpoint in acute myeloid leukemia: A HARMONY Alliance study of European randomized trials

Impact of inhibitors positivity on treatment patterns and disease burden in Chinese patients with hemophilia: A cross-sectional real-world study

One of the recurring economic issues is the challenge of poverty faced by various countries worldwide, including Indonesia. Poverty is evident through a high number of unemployed individuals. Those living in poverty and those facing unemployment generally encounter difficulties in accessing job opportunities, limited business development, income disparities, and lack of workplace protections, especially for women. These issues also affect economically disadvantaged groups in society. This study aims to analyze the impact of job opportunities and minimum wage on unemployment and poverty rates in the Regencies/Cities of Bali Province. The research utilizes secondary data from the period 2012-2021. The study covers 9 Regencies/Cities within Bali Province. Path Analysis is the employed analytical technique. The findings of this research indicate that: 1) Job opportunities have a significant negative impact on unemployment, while minimum wage has a significant positive impact on unemployment. 2) Job opportunities have a positive but insignificant impact on the poverty rate, while minimum wage has a significant negative impact on the poverty rate. Unemployment, on the other hand, has a positive but insignificant impact on the poverty rate. 3) Job opportunities do not have a direct impact on the poverty rate through unemployment, whereas minimum wage directly affects the poverty rate through unemployment. Keyword: Employment Opportunity, Minimum Wage, Unemployment, Poverty Rate.

This study aims to simultaneously or partially analyze multiple factors that affect the informal sector income of Angklingan enterprises in Denpasar city: working capital, working hours and business duration. All data for this study used primary data obtained by distributing questionnaires to 71 interviewees. Samples are determined by random sampling techniques. The analytical technique used is multiple regression analysis. As a result, it was found that working capital, working hours and operating period simultaneously had a significant impact on the informal sector income of Angklingan companies in Denpasar city. Variables such as working capital, working hours and length of operation have had some positive impact on the income of the informal business sector in Denpasar city.. keyword: Angkringan Business, Income, Working Capital, Working Hours, Length of Business

Poverty is a problem faced by every country, especially in developing countries like Indonesia. Efforts are always made to minimize poverty, and even eliminate it if possible. However, in reality, poverty continues to remain an integral part of various aspects of human life. The complexity of the poverty issue continues to be a recurring focus in every developmental phase across different regions. It's worth noting that Bali Province has experienced rapid economic growth, but the unemployment rate and the number of people living in poverty remain high. Addressing the issue of poverty remains a primary focus that requires additional attention. Therefore, government policies are needed to address this problem, particularly in the districts and cities of Bali Province. This study aims to analyze the per capita Gross Regional Domestic Product (GRDP), unemployment, health complaints, and population numbers in relation to poverty in the districts and cities of Bali Province. The research employs secondary data spanning a period of 10 years, from 2012 to 2021. The study is conducted in Bali Province, encompassing 9 districts and cities. The analytical technique used is multiple linear regression analysis. The results of this study indicate that per capita GRDP does not have a negative impact on poverty in the districts and cities of Bali Province. Meanwhile, unemployment, health complaints, and population growth have a positive impact on poverty in the districts and cities of Bali Province. Keywords: Poverty, GRDP Per Capita, Unemployment, Health Complaints, Population Growth

The problem of poverty has a very urgent nature and has no clear boundaries. This is due not only to its continued upward trend, but also to its impact that transcends the economic sphere, encompasses social aspects and even threatens political stability within the country. Most countries with large populations also tend to have higher poverty rates compared to countries with smaller populations. Likewise, with the level of education and TPAK where inmany communities with low economies, opportunities to get adequate education, ranging from elementary to higher, are often limited, furthermore, if TPAK increases this can have a positive impact on economic growth. This study uses time series data with variables of population growth, education level, , TPAK, and poverty rate in the last 26 years, namely 1996-2021 until the number of observations is 26 observation points. Based on the results of data processing and testing simultaneously shows that population growth, education rate, and labor force participation rate (TPAK) affect simultaneously in Papua Province. Population growth has a negative and significant effect on poverty. The level of education, that is, the average length of schooling, has a negative and insignificant effect on poverty. The labor force participation rate (TPAK) has a negative and significant effect on poverty. keyword: Population Growth, Education Level, TPAK, Poverty

The purpose of this study is to (1) analyze the joint effects of economic growth, investment, technology and minimum wage on employment opportunities in districts/cities in Bali; (2) Analysis of partial effects of economic growth, investment, technology and minimum wage on employment opportunities in districts/cities in Bali. (3) Analyze the order of impact of economic growth, investment, technology and minimum wage on employment opportunities in districts/cities of Bali. This study is an associative quantitative study using panel data of up to 72 observations. Data sources for this study are secondary data from the Bali Provincial Central Bureau of Statistics and primary data obtained from informants through in-depth interviews. The collected data were then analyzed using several linear regression analysis techniques. Based on the analysis results, it is shown that (1) economic growth, investment, technology and minimum wage simultaneously have a great impact on employment opportunities in provinces/cities in Bali. (2) Economic growth and minimum wages can have a significant positive impact on employment opportunities in provinces/cities of Bali Province. Investments and technology may not affect employment opportunities in districts and cities in Bali. (3) Minimum wage has the greatest impact, followed by economic growth, investment and technology

This study aimed to investigate the relationship between human papillomavirus (HPV) positivity, genotype, and female sexual dysfunction, particularly anorgasmia and psychosexual stress, among women participating in a cervical cancer screening program. It also examined whether HPV infection or genotype independently contributes to sexual dysfunction after adjusting for sociodemographic and reproductive factors. This prospective, cross-sectional study included 1,353 sexually active women aged 25-65 years who underwent HPV testing at Antalya City Hospital between May and September 2025. Participants completed validated questionnaires including the Female Sexual Function Index, Arizona Sexual Experiences Scale, Beck Depression Inventory, and Beck Anxiety Inventory. Sociodemographic, reproductive, and clinical characteristics were recorded, and HPV genotyping was performed using polymerase chain reaction-based assays. Anorgasmia was identified in 31.5% of participants (n=427). It was significantly more common among unemployed women (84.1% vs. 71.6%; odds ratio =2.09, 95% confidence interval: 1.56-2.82; p=0.0001). Higher gravidity, parity, number of living children, and elevated vaginal pH were all associated with anorgasmia (p<0.05). No significant association was found between HPV positivity or genotype and anorgasmia (p>0.05). Anorgasmia is primarily influenced by sociodemographic and reproductive factors, such as occupation, education level, parity, and vaginal environment, rather than HPV infection or genotype. These findings emphasize the importance of biopsychosocial and culturally sensitive approaches in evaluating and managing women's sexual health.

Tourist satisfaction is an emotion that is felt by visitors when they there are in a place, in this case a tourism place. The satisfaction felt by visitors makes certain behaviours, which in this case share information using social media. This study examines and analyzes the predictors of tourist satisfaction and tourist engagement on the behaviour of sharing tourism experience on social. This study had 115 respondents, using the SEM-PLS analysis technique the results showed that all influence tests were acceptable. Novelty in this study is the existence of tourist engagement that is able to make something unique because both the visitor and the place visited have an emotional engagement

Association of Plasma Septin9 Methylation Status With Therapeutic Response to Antitumor Agents in Colorectal Cancer Patients.

Objective: To Investigate Urogenital Infections In Patients Diagnosed With Preterm Premature Rupture Of The Membranes (PPROM) And Their Impact On Perinatal Outcomes. Material and Method: This retrospective study was conducted at the Perinatology Clinic of Ankara Bilkent City Hospital between June 2020 and December 2023 and included 250 patients diagnosed with PPROM who were followed up and treated in the high-risk pregnancy Vaginal and urine cultures were obtained from each patient, and the impact of culture positivity on perinatal outcomes was assessed. Results: Among these, 72 patients tested positive on culture, while 178 tested negative. Of the obtained vaginal cultures, 46 patients were identified as culture-positive. Among these culture-positive cases, Candida was detected in 36 patients(78%).Additionally, 32 patients had positive results on urine culture. The distribution of microorganisms in urine cultures revealed that 21 patients (65%) had results indicating diverse species. Membrane rupture was found to occur at significantly earlier weeks in those with a positive culture test (p