Introduction: Cancer and its treatment can significantly affect self-perception and body image in women. Physical and psychological changes resulting from cancer treatment can lead to lower self-esteem and negative perceptions of body image.Objectives: The purpose of this study was to assess self-esteem and perceptions of self-image among women following oncological treatment for gynecological and breast cancers, compared to a group of healthy women.Material and Methods: The survey was conducted by CAWI and included a total of 380 women. The study group consisted of 177 women aged 20-73 who had undergone treatment for breast cancer or gynecological cancers. The control group consisted of 203 healthy women aged 18-65. The participants completed the Body Image Scale for Adolescents and Adults (BESAA) and the Rosenberg Self-Esteem Scale (SES).Results: Women after cancer treatment had significantly lower body image and self-esteem scores compared to the control group (p < 0.001). The highest scores were observed in women after breast cancer treatment, while the lowest scores were observed in patients treated for endometrial cancer. Type of cancer proved to be a key determinant of self-perception, while treatment status had no significant effect on the results.Conclusions: The type of cancer significantly affects self-esteem and body image in women after cancer treatment. The results underscore the need to include aspects of self-esteem in the care of cancer patients.

Current international guidelines recommend blood pressure (BP) thresholds for patients eligible for endovascular thrombectomy (EVT). Previous studies have suggested that both low and high admission BPs are associated with poor functional outcome after EVT. However, the association between admission BP and outcomes after EVT remains poorly understood.The aim of this study was to investigate the relationship between admission systolic BP (SBP) and outcomes in patients treated with EVT and to assess whether this association is modified by IV thrombolysis (IVT) treatment and recanalization status. In this observational, international, multicenter cohort study, we used data from the EVA-TRISP registry. Consecutive patients treated with EVT with available admission SBP were included. The primary outcome was 90-day functional outcome. Secondary outcomes included 90-day mortality, 24-hour NIH Stroke Scale (NIHSS), successful recanalization, and symptomatic intracranial hemorrhage (sICH). We used multivariable regression to study the relation between admission SBP and outcomes and to assess effect modification by IVT treatment and recanalization status. We included 10.963 EVT patients. At baseline, the mean age was 72.8 years (SD 13.5), 50.2% were female and the median NIHSS at presentation was 15 (interquartile range 9-19). The association between admission SBP and functional outcome, mortality, and 24-hour NIHSS score was U-shaped, and the nadir was around 150 mm Hg. Below 150 mm Hg, every 10 mm Hg decrease in SBP was associated with higher odds of poor functional outcome (adjusted odds ratio (aOR) 1.07 [95% CI 1.02-1.11]) and mortality (aOR 1.17 [1.12-1.23]). Above 150 mm Hg, every 10 mm Hg increase in SBP was associated with higher odds of poor functional outcome (aOR 1.05 [1.01-1.08]), mortality (aOR 1.04 [1.01-1.09]), and higher 24-hour NIHSS score (β-coefficient 0.28 [0.17-0.40]). We found a positive linear relationship between admission SBP and sICH (1.04 [1.01-1.08]). IVT treatment modified the association between admission SBP and outcomes after EVT. In 5544 EVT-only treated patients, there was no longer a clear association between higher admission SBP values and worse outcome. Lower and higher admission SBP was associated with worse outcomes in the complete cohort. In EVT-only patients, this association was less evident, suggesting that high admission BP alone should not always delay or preclude treatment with EVT in otherwise eligible patients.

Background and Objectives: IgG4-related disease is a chronic fibro-inflammatory condition. Despite the development of classification and responder indexes, reliable biomarkers for disease activity and therapeutic monitoring remain limited. We evaluate the performance of a panel of biomarkers, including cytokine profiles, plasmablasts and conventional markers. Materials and Methods: We conducted a cross-sectional, single-center study, involving 35 patients diagnosed with IgG4-RD. Disease activity was evaluated using the IgG4-RD Responder Index (RI), Damage Index (DI) and clinical assessment. Laboratory evaluation included serum IgG4, total IgG, CRP, ESR, eosinophils, IgE, complement levels, and cytokine profiling via multiplex immunoassay. B cell subpopulations were analyzed by flow cytometry. Statistical analyses were performed using STATA/BE 17.0. Results: Patients with active disease (RI > 4 or clinical judgment) exhibited significantly higher levels of total IgG (p = 0.02), IgG4 (p = 0.01), and IL-5 (p = 0.03). PET-positive patients showed a Th1-skewed immune profile, with elevated IFN-γ/IL-4 (p < 0.001), reduced IL-21/IFN-γ (p = 0.03), and increased eosinophils (p = 0.03). Clinician-assessed active disease was associated with higher total IgG levels (p = 0.01). Treatment-specific effects were observed: prednisone was associated with lower IgG4 and C3 levels. Notably, plasmablasts did not consistently correlate with clinical or imaging activity scores, possibly reflecting treatment status or B cell dynamics. Conclusions: This study demonstrates that cytokine ratios, particularly those involving IL-5, IL-13, IL-21, and IFN-γ, offer complementary information to traditional serological markers for IgG4-RD activity. While PET/CT-defined activity was best reflected by biomarkers of an IFN-γ-mediated pathway, the IgG4-RD RI demonstrated a stronger association with conventional humoral markers like serum IgG4 and total IgG. None of these biomarkers correlated with organ damage.

Background: Since endovascular thrombectomy (EVT) became standard of care in 2015, stroke systems-of-care have adapted to increase the number of acute ischemic stroke (AIS) patients who can access EVT. Our objective was to characterize how California hospitals have changed their EVT capabilities over time based on the provision of EVT procedures (high or low volume) and the transfer of patients to EVT-capable hospitals from non-EVT-capable hospitals. Methods: We identified all AIS encounters in statewide all-payer data from the California Department of Health Care Access and Information from 2016-2021. EVT treatment status of each encounter was determined based on ICD-10 PCS and MS-DRG codes. Hospitals were categorized into 4 mutually exclusive groups annually based on how they provided EVT care: 1) high-volume EVT hospital (meeting The Joint Commission standard of conducting 15 EVT procedures in the past year ), 2) low-volume EVT-capable hospital (conducting 2-14 EVT procedures in the past year), 3) gateway hospital (no EVT capability but transferred at least one AIS patient to an EVT-capable hospital) and 4) gap hospital (no EVT capability and no AIS patient transferred to an EVT-capable hospital). Stroke encounters were attributed to the initial hospital of presentation. We used linear regression models to examine trends over time. Results: There were 264,661 AIS encounters in California from 2016-2021. The number of hospitals caring for AIS patients each year ranged from 298 (in 2020) to 316 (in 2016). The number of low-volume EVT hospitals decreased modestly from 28 (8.9%) in 2016 to 23 (7.6%) in 2021 as the number of high-volume EVT hospitals increased from 42 (13.3%) in 2016 to 62 (20.4%) in 2021 (Figure 1). The number of gateway hospitals decreased over the study period as more hospitals expanded EVT capability and high-volume EVT status, while the number of gap hospitals remained relatively stable over time (Table 1). At the encounter level, an increasing proportion of patients presented to high-volume EVT centers over the study period while the number of patients presenting to gateway hospitals declined as EVT capability grew (Tables 1 and 2). Conclusions: Most patients with stroke in California present to hospitals with capabilities to provide EVT directly or are transferred to them. While an increasing number of hospitals are performing EVT for stroke patients, many do not meet the TJC-recommended volume threshold.

This letter contextualizes recent findings linking tumour necrosis factor-like weak inducer of apoptosis (TWEAK) to inflammation and disease severity in pemphigus, highlighting the potential relevance of the TWEAK–Fn14 axis to keratinocyte injury and downstream cytokine/chemokine signalling. We outline key considerations for clinical interpretability—including treatment status in “new-onset” cohorts, incremental value beyond established serology and routine inflammatory indices, and appropriate handling of multiplicity—and propose priorities for prospective validation of TWEAK as a biomarker and therapeutic target.

Background/Objectives: Male breast cancer (MBC) is rare, accounting for less than 1% of all breast cancers. Given its low incidence, male breast cancer (MBC) remains understudied; this 33-year Serbian cohort was assessed for clinicopathological features, therapeutic approaches, genetic alterations, and survival. Methods: We retrospectively analyzed MBC patients diagnosed between 1991 and 2024 at the Institute for Oncology and Radiology of Serbia. Data included demographics, tumor characteristics, and stage, treatment, hormone receptor and HER2 status, Ki-67 index, genetic testing, and survival. Results: A total of 191 patients were identified (median age 66). Family history was negative in 91% and positive in 5.8%. T2 tumors were most frequent (36%), and 96% presented without metastasis. Mastectomy with axillary or sentinel lymph node dissection was performed in 78.5%. Neoadjuvant chemotherapy and radiotherapy were administered in 5.8% and 8.4%. Estrogen receptor positivity was 72%, progesterone receptor 88%, HER2 overexpression 11.0%, and triple-negative tumors 2.6% (40% with axillary involvement). High Ki-67 (≥15%) was recorded in 28.8%. Adjuvant chemotherapy, radiotherapy, and hormone therapy were given in 36%, 58%, and 68%. Among 37 genetically tested patients, seven had pathogenic variants (BRCA1, BRCA2, CHEK2, PALB2). Disease recurrence occurred in 30%. Median follow-up was 53 months. Median disease-free survival (DFS) was 82 months (1-, 2-, 5-, 10-year DFS: 87%, 73%, 57%, 39%). Median overall survival (OS) 131 months (1-, 2-, 5-, 10-year OS: 95%, 93%, 73%, 53%). Conclusions: This long-term cohort highlights the predominance of hormone-receptor positivity, the infrequency of germline mutations, and moderate survival rates, informing patient management and guiding future studies.

Oxidative stress (OS) is a major cause of defective sperm function. During laboratory handling, gametes are exposed to OS, potentially mitigated by in vitro antioxidant supplementation. This study evaluates the protective role of caffeic acid (CAF) on basal human semen and under induced OS. First, six semen samples from normozoospermic donors were incubated with CAF concentrations ranging from 50 to 500 µM at 37 °C for 2 h. Sperm motility and DNA integrity (acridine orange) were evaluated. Then, ten semen samples were divided into four aliquots and incubated, respectively, with CAF at 100 µM, H2O2 at 2 mM, or H2O2 at 2 mM + CAF at 100 µM, or untreated. Motility, DNA integrity, acrosome status (Pisum sativum agglutinin), OS quantified by F2-isoprostanes (ELISA), and expression of Nrf2, Keap1, and HO-1 (qRT-PCR) were assessed. CAF at 100 µM improved progressive motility without damaging DNA and was selected for subsequent experiments. CAF showed protective effects on sperm damage induced by H2O2 treatment, restoring motility, DNA integrity, and acrosome status and reducing F2-isoprostane levels. Nrf2 and HO-1 expression were upregulated by CAF, downregulated by H2O2, and restored by the co-treatment. CAF supplementation may protect human spermatozoa during in vitro handling by reducing OS, improving several sperm parameters, with a possible mechanism of action involving the Nrf2 pathway.

Early neurological deterioration (END) in patients with acute ischemic stroke (AIS) is a common phenomenon strongly associated with unfavorable outcomes. The TREND trial (NCT04491695) demonstrates the efficacy of intravenous tirofiban compared to oral aspirin in preventing END. The purpose of this study was to explore whether prior antiplatelet therapy (APT) affected the therapeutic effects of tirofiban. This prespecified post hoc analysis of the TREND trial stratified patients by prior antiplatelet use. The primary outcome was END4 (≥ 4 points increase in National Institutes of Health Stroke Scale [NIHSS] within 72 h). Secondary outcomes included END2 (≥ 2 points increase in NIHSS), early neurological improvement, 90-day functional outcomes, and safety events. Overall, 425 patients with AIS were analyzed, including 143 (33.6%) and 282 (66.4%) with and without prior APT, respectively. In patients without prior APT, tirofiban significantly reduced the risk of END4 compared with aspirin (5.0% versus 14.2%; adjusted OR, 0.38; 95% CI 0.15-0.96; P = 0.040). Tirofiban was beneficial in reducing the risk of END₂ in both patients with (8.3% versus 22.5%, P = 0.020) or without prior APT (13.5% versus 24.1%; P = 0.032). There was no significant interaction between treatment and prior APT status (P for interaction > 0.05). Further, no significant differences in 90-day functional outcomes or safety events were observed between the treatment groups for either antiplatelet status after adjustment. Intravenous tirofiban significantly reduced the risk of END compared with aspirin in patients with AIS who were not on prestroke APT. Although this benefit was attenuated in pretreated patients, tirofiban might maintain a consistent efficacy and safety profile irrespective of prior antiplatelet use.

Association of supine versus seated hypertension with cardiovascular events in older adults.

Single nucleotide polymorphisms in the bepirovirsen binding site have limited impact on treatment response in chronic hepatitis B.

Gastric mucinous adenocarcinoma (GMC) is a rare subtype of gastric cancer characterized by excessive mucus production, aggressive biological behavior, and poor prognosis, with most patients presenting with metastatic disease at initial diagnosis and losing the opportunity for curative resection. Currently, there are no standardized diagnostic and treatment guidelines for metastatic GMC in the conversion therapy setting, and the therapeutic effect of conventional chemotherapy remains unsatisfactory. Herein, we present a 69-year-old male patient diagnosed with HER2-negative, TMB-H advanced GMC, with intraperitoneal and retroperitoneal lymph node metastases. The patient was initially deemed unresectable by the multidisciplinary team (MDT) but opted for conversion therapy due to a strong willingness for treatment and good performance status (ECOG-PS=0). He received 6 cycles of FLOT chemotherapy combined with nivolumab, achieving partial response (PR) per RECIST 1.1. Subsequent laparoscopic distal gastric subtotal resection (D2+ lymphadenectomy) was performed, and postoperative pathology revealed a near pathological complete response (Mandard-TRG1) with no lymph node metastases (0/21), pathologically staged as ypTisN0. Postoperatively, the patient received 4 cycles of XELOX chemotherapy plus nivolumab, followed by consolidative radiotherapy synchronized with capecitabine and nivolumab, and subsequent maintenance therapy with capecitabine and nivolumab until sustained no evidence of disease (NED) was confirmed in January 2023. Regular surveillance, including the latest contrast-enhanced CT in May 2025, showed no recurrence or metastasis, with progression-free survival (PFS) exceeding 5 years. This exceptional and sustained response may be attributed to the synergistic effect of TMB-H and POLD1 mutation, which enhance neoantigen generation and sensitize tumors to immunotherapy. This case highlights the potential of biomarker-driven chemo-immunotherapy combined with MDT-guided multimodal treatment (surgery + adjuvant therapy + consolidative radiotherapy) to achieve curative intent in patients with metastatic GMC, providing valuable insights for personalized treatment strategies in this poor-prognosis population.

Early-onset colorectal cancer (EOCRC; diagnosed before age 50) is rising at an accelerated rate, with a disproportionate impact on underserved populations. While alterations in the receptor tyrosine kinase-RAS (RTK-RAS) signaling pathway play a fundamental role in colorectal cancer (CRC) biology, their prognostic significance in the setting of FOLFOX chemotherapy-particularly across different age groups and ancestral backgrounds-remains insufficiently characterized. We sought to characterize age-, ancestry-, and treatment-specific associations between RTK-RAS alterations and clinical outcomes using an AI-enabled precision oncology framework. We analyzed 2515 CRC cases, including 266 Hispanic/Latino (H/L) and 2249 non-Hispanic White (NHW) patients, stratified by age at onset, ancestry, and FOLFOX treatment status. Mutation frequencies were assessed using Fisher's exact and chi-square tests, while overall survival was analyzed with Kaplan-Meier methods. The AI-HOPE and AI-HOPE-RTK-RAS conversational artificial intelligence platforms were used to integrate clinical, genomic, and treatment data via multi-parameter, natural language-based queries. In early-onset Hispanic/Latino patients, ERBB2 and NF1 mutations occurred at significantly lower frequencies in FOLFOX-treated cases compared with untreated cases (p = 0.01 for both). In late-onset H/L patients, NTRK2 mutations were depleted in FOLFOX-treated tumors (p = 0.04). In untreated early-onset H/L patients, MAPK3 and NF1 mutations were enriched relative to NHW counterparts. Among early-onset NHW patients, IGF1R and ERRFI1 mutations were less frequent with FOLFOX exposure, while multiple RTK-RAS genes were reduced in FOLFOX-treated late-onset NHW patients. Survival analyses revealed worse overall survival in FOLFOX-untreated early-onset NHW patients with RTK-RAS alterations (p = 0.029), but improved survival in FOLFOX-treated late-onset NHW patients (p = 0.048). RTK-RAS pathway alterations demonstrate strong age-, ancestry-, and treatment-specific prognostic effects and may serve as precision biomarkers of differential chemotherapy response. AI-enabled analytics substantially accelerated integrative biomarker discovery, supporting their utility for advancing precision oncology in EOCRC.

Intelligence quotient in adults with idiopathic hypersomnia and narcolepsy type 1.

The results of a previous randomized trial showed that mentalization-based treatment for psychotic disorder (MBTp) was associated with greater improvement than treatment as usual (TAU) in social functioning up to 6months after treatment. The purpose of the present study is to examine the effect after 5 years. The researchers tried to find all patients who had participated in the trial (n=84) and to assess, blind to previous treatment status, their social functioning and mentalizing capacity. Social functioning was measured using the Social Functioning Scale, mentalizing using the Social Cognition and Object Relations Scale and the Hinting Task. Twenty-three MBTp patients and 23 TAU patients collaborated. There was no evidence of selective drop-out. A complete case, repeated measure analysis of variance on the basis of intention-to-treat showed that, 5 years post-treatment, MBTp patients still scored better on social functioning compared to baseline [ηp2=.25, p=.01], whereas TAU patients did not [ηp2=.01, p=.67], with a significant difference between the conditions [ηp2=.10, p=.03]. A sensitivity analysis with linear mixed models, however, showed weaker evidence for an additive effect of MBTp over TAU on social functioning 5 years post-treatment, F=3.731, p=.06. MBT patients also showed a greater improvement in one aspect of mentalizing, understanding of social causality [ηp2=0.17, p=.04], but not other aspects of mentalizing. The results suggest a durable effect of MBTp.

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths in the U.S. While racial and ethnic disparities in outcomes are known, long-term trends and the specific contribution of clinical and socioeconomic factors remain unclear. To quantify the long-term racial/ethnic disparities in NSCLC mortality (2000-2020) and assess the relative contribution of modifiable clinical and socioeconomic factors to these inequities. A retrospective population-based cohort study. Data for 548,526 NSCLC patients diagnosed between 2000 and 2020 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Cumulative incidence of death was analyzed using the Fine and Gray model. Multivariable cause-specific hazard regression quantified the contribution of stage, tumor grade, treatment status, and household income to racial/ethnic disparities. The five-year cumulative mortality rate was highest among Black patients (83.5%), followed by American Indian/Alaska Native (AI/AN , 82.0%), White (79.5%), Hispanic (79.5%), and Asian or Pacific Islander (API , 77.1%) patients. Cancer-directed surgery, stage at diagnosis, and household income were significant contributors to disparities, explaining up to 29.04% of Black-White and 19.97% of AI/AN-White disparities in all-cause mortality. Relative disparities decreased over time, but absolute disparities widened, particularly between Black and White patients. Significant racial and ethnic disparities in NSCLC mortality have persisted over the past two decades. Addressing modifiable factors like late-stage diagnosis and ensuring equitable access to high-quality, cancer-directed treatments are essential steps toward promoting health equity.s.

Aims: The aim of this study is to examine Pan-Immune-Inflammation Value (PIV) levels in patients with vestibular neuritis (VN) and to reveal the potential diagnostic and prognostic value of this marker. Methods: One hundred patients diagnosed with VN between October 1, 2023 and October 1, 2025 and 100 healthy individuals compatible with the patient group were included in the study. Patients’ demographic characteristic, complete blood count parameters at the time of presentation, and outpatient treatment or admission status were recorded by means of retrospective scanning of the hospital records. PIV, SII, NLR, and PLR values were calculated from complete blood count parameters. The results were compared among the groups. Results: No significant difference were observed between the two groups in terms of age or gender (p=0.921 and p=0.884 respectively). Comparison of laboratory parameters revealed a significantly higher neutrophil level in the VN group (p

Mechanisms, treatment strategies and predictive biomarkers of drug resistance in acute myeloid leukemia.

Although marital status has been associated with survival in several cancers, evidence regarding its prognostic relevance in follicular lymphoma (FL), an indolent lymphoma characterized by prolonged survival, remains limited. In this population-based study using the SEER database, we identified 23,434 adult patients diagnosed with FL between 2013 and 2022. Propensity score matching was performed to balance baseline characteristics, and survival outcomes were assessed using Kaplan–Meier analysis and Cox proportional hazards models. In the overall cohort, unmarried patients were more likely to be female, older, and present with B symptoms (all P < 0.001), and demonstrated significantly lower 5-year overall survival (OS: 72.8% vs. 81.0%, P < 0.001) and cause-specific survival (CSS: 84.9% vs. 90.6%, P < 0.001) compared with married patients. After 1:1 propensity score matching on age, sex, race/ethnicity, Ann Arbor stage, B symptoms, treatment status, prior cancer history, and diagnosis year (matched cohort, n = 16,384), this survival disparity persisted (5-year OS: 72.5% vs. 81.3%; CSS: 84.7% vs. 90.7%; both P < 0.001). Multivariable Cox regression confirmed that unmarried status was independently associated with increased risks of OS (HR, 1.62; 95% CI, 1.53–1.71, P < 0.001) and CSS (HR, 1.77; 95% CI, 1.63–1.92, P < 0.001). These findings suggest that unmarried status is an independent adverse prognostic factor in patients with FL and highlight additional attention may be warranted for unmarried individuals during long-term disease management.

Cerebrovascular hemodynamics and cardiac biomarkers in multiple sclerosis: A case-control study.

Limited population data exist assessing trends in advanced HIV disease (AHD) in the test-and-treat era. We examined changes in AHD prevalence from 2015 to 2017 (round 1) and 2019 to 2023 (round 2) in 7 African countries. We pooled data from 2 rounds of the Population-Based HIV Impact Assessment (PHIA) surveys from 7 countries among persons with HIV (PWH) aged 15 to 59 years. AHD was defined as having an HIV-positive result and CD4 <200 cells/mm3. Awareness of HIV diagnosis and treatment status were based on self-report and detection of antiretrovirals. Weighted estimates between survey rounds were compared through complex survey methods. Across all countries, 13.2% and 6.8% of PWH met criteria for AHD during rounds 1 and 2, respectively. AHD prevalence among those aware of their HIV status and not on antiretroviral therapy (ART) increased by 31.7% (20.8% to 27.4%) but decreased by 17.7% (17.5% to 14.4%) among those unaware and not on ART and by 53.3% (10.5% to 4.9%) among those aware and on ART. The adjusted odds ratio for AHD comparing rounds 1 and 2 among those aware and on ART was 0.46 (95% CI, 0.39-0.53). Those who were aware and on ART accounted for the majority of PWH with AHD in both rounds (51.6%, round 1; 58.8%, round 2). These findings indicate substantial reductions in AHD prevalence among those on ART between 2015-2017 and 2019-2023. Continued efforts are warranted to ensure timely diagnoses and treatment adherence and reduce barriers to care reengagement, which represent an increasingly important driver of AHD.