BACKGROUND: Lymphedema is a common complication after breast cancer surgery that significantly affects quality of life. This study aimed to synthesize current evidence on effective interventions for lymphedema care postsurgery. METHODS: A systematic literature search was conducted in PubMed, Cochrane Library, and Scopus to identify randomized controlled trials and observational studies published until September 2024. Included studies evaluated interventions for preventing and managing lymphedema, such as physical therapy [manual lymphatic drainage (MLD), exercise], compression therapy, and pharmacological treatments, reporting on lymphedema incidence, severity, or quality-of-life outcomes. Data were extracted by two independent reviewers, and a random-effects model estimated pooled effect sizes. Subgroup analyses were based on intervention types and design. RESULTS: Nine studies comprising 1183 patients were included. The pooled lymphedema incidence in control groups was 22.5% [95% confidence interval (CI): 19.3%-26.1%]. MLD reduced lymphedema incidence by 38% [risk ratio (RR) = 0.62, 95% CI: 0.52-0.74], whereas compression therapy decreased limb circumference by 15% (standardized mean difference = -0.33, 95% CI: -0.46 to -0.19). Exercise programs offered a 12% risk reduction (RR = 0.88, 95% CI: 0.76-1.03). Combined interventions, such as MLD with compression garments, yielded a 44% reduction in incidence (RR = 0.56, 95% CI: 0.47-0.67) and significantly improved quality of life (mean Functional Assessment of Cancer Therapy-Breast difference = 7.4, 95% CI: 5.1-9.7). Early and integrated care approaches showed the greatest benefit. CONCLUSIONS: This meta-analysis confirms MLD and compression therapy's effectiveness in managing postsurgical lymphedema. A multimodal approach provides optimal outcomes for reducing lymphedema burden and improving quality of life.

Over several decades, therapeutic advances have transformed oncology, yet for many tumour types, survival improvements have been incremental, with substantial treatment-related morbidity. A decisive pivot in oncology, from treating established malignancy to intercepting and preventing carcinogenesis, could deliver far greater population impact. Delivering this shift requires further mechanistic understanding of tumour initiation, validated biomarkers of premalignant progression and redesigned prevention trials in at-risk populations. Regulatory and commercial frameworks must evolve to enable scalable molecular prevention. Such trials must deliver tolerable side effect profiles and rely on biologically validated surrogate endpoints rather than traditional survival outcomes. Cancer interception should be established as a core pillar of oncological management, alongside early detection and the therapeutic management of established disease, together creating an opportunity to reduce global disease burden at a scale that decades of therapeutic progress in advanced cancer have yet to achieve.

BACKGROUND/PURPOSE: Oral mucositis is one of the most frequent and debilitating adverse effects of antineoplastic therapy, significantly impairing treatment adherence and patients' quality of life. This study aimed to evaluate the effectiveness of Intravenous Laser Irradiation of Blood (ILIB), applied alone or combined with low-level laser therapy, in reducing oral mucositis and improving the quality of life of oncology patients. METHODS: This quasi-experimental prospective study with parallel groups was conducted between 2023 and 2024 at the Memorial Hospital of Arcoverde (PE), involving 76 patients equally allocated into four groups (n = 19): ILIB alone (A and C) and ILIB combined with laser therapy (B and D), applied therapeutically or preventively over weeks. Oral mucositis grade (WHO scale) and quality of life (OHIP-14) were assessed before and after the interventions. RESULTS: No baseline differences were observed between groups (p > 0.05). After the intervention, the combined therapy groups showed greater reductions in mucositis (B: -1.60; -55.2% and D: -1.70; -60.7%) compared with ILIB alone (A: -0.70; -25.0% and C: -0.70; -25.9%) (p < 0.05). Improvements in quality of life were also more pronounced in the combined groups (B: -9.00; -31.0% and D: -10.40; -36.0%) compared with ILIB alone (A: -4.50; -15.8% and C: -4.30; -15.5%) (p < 0.05). CONCLUSION: The ILIB + laser therapy association was more effective than ILIB alone in reducing oral mucositis and improving quality of life, both in prevention and treatment contexts.

Phosphorescent metal complexes have the potential to be used for photodynamic detection of tumor margins in surgery and photodynamic therapy (PDT). In this work, iridium(III) complexes are prepared with two cyclometalating ligands, either phenylpyridine (ppy) or phenylisoquinoline (piq), and one 6-hydrazinonicotinic acid (HYNIC) ancillary ligand to give [Ir(ppy)(HYNIC)] and [Ir(piq)(HYNIC)]. The extended conjugation in [Ir(piq)(HYNIC)] results in a significant redshift in the absorption and emission properties. Both [Ir(ppy)(HYNIC)] and [Ir(piq)(HYNIC)] generate singlet oxygen upon irradiation with light in the presence of oxygen. Irradiation of [Ir(piq)(HYNIC)] (λ = 420 nm) results in the production of hydroxyl and superoxide radicals. The carboxylic acid functional group in HYNIC has been used to attach a lysine-ureido-glutamatic acid pharmacophore that selectively binds to prostate specific membrane antigen (PSMA) to give HYNIC-PSMA. PSMA is an enzyme that is overexpressed in prostate cancer. HYNIC-PSMA was used to prepare [Ir(ppy)(HYNIC-PSMA)] and [Ir(piq)(HYNIC-PSMA)]. Both complexes bind to cells that overexpress the PSMA enzyme. [Ir(piq)(HYNIC-PSMA)] is nontoxic to cells in the dark, but irradiation with visible light results in a dose-dependent cytotoxicity. These complexes have the potential to be of use to identify tumor margins, to guide robot-assisted surgical resection of tumors, as well as for molecularly targeted PDT.

BACKGROUND: Erythrodermic psoriasis (EP) is a rare but severe condition. Because of its low prevalence, there are no standardized treatment recommendations for EP. Specific EP guidelines are outdated, prioritizing conventional disease-modifying antirheumatic drugs (cDMARDs) and tumor necrosis factor-alpha (TNF-α) inhibitors. METHODS: We conducted a multicenter retrospective chart analysis in five academic centers in Bavaria, Germany (Augsburg, Erlangen, LMU Munich, TU Munich, Regensburg). Patients diagnosed with EP between 2019 and 2024 who received systemic treatment were included in the study. RESULTS: A total of 29 patients were included. cDMARDs were initiated in 8 patients (27.6%). Biologics were used in 21 patients (72.4%). Psoriasis Area and Severity Index (PASI) decreased from 31.9 to 10.8 across all therapies (p < 0.001). PASI 75 was achieved with methotrexate (1), cyclosporine (1), fumarates (1), infliximab (1), ustekinumab (2), ixekizumab (1), secukinumab (2), risankizumab (4), and guselkumab (1). PASI 100 was achieved with infliximab (1), ustekinumab (1), and risankizumab (2). Adverse events occurred most frequently in the cDMARDs group. CONCLUSION: There is a wide variety of treatment approaches. Standardized guidelines are needed. Biologic therapies, especially interleukin (IL)17 and IL23-inhibitors, showed favorable outcomes in this cohort and warrant prospective evaluation.

BACKGROUND Renal cysts and diabetes syndrome (RCAD), caused by heterozygous variants or whole-gene deletions in the HNF1B gene, is a rare, multisystem disorder often detected prenatally by ultrasound findings of bilateral cystic or hyperechogenic kidneys. CASE REPORT We present the case of a 21-year-old woman (G3P2) at 19 weeks of gestation referred for detailed fetal evaluation due to bilateral hyperechogenic, polycystic kidneys and severe oligohydramnios. After counselling, an amnioinfusion was performed to enable amniocentesis and cytogenetic testing. Chromosomal microarray analysis identified a 1.4 Mb interstitial deletion at 17q12 (arr 17q12(34,850,785_36,248,926)x1), encompassing the HNF1B gene and consistent with RCAD syndrome. Family history revealed maternal renal cysts and paternal early-onset diabetes. Despite conservative management and monitoring, the pregnancy was complicated by intrauterine infection, leading to fetal death. CONCLUSIONS This case report expands the spectrum of prenatal findings associated with RCAD and emphasizes the importance of integrating ultrasonographic, genetic, and familial data in the diagnostic pathway. Chromosomal microarray analysis remains a pivotal tool for prenatal detection of HNF1B deletions and for differentiating RCAD from other cystic kidney diseases, such as autosomal recessive polycystic kidney disease (ARPKD) and autosomal dominant polycystic kidney disease (ADPKD), which require targeted gene sequencing. Recognition of RCAD in the prenatal setting enables precise counselling, recurrence risk assessment, and postnatal follow-up planning for affected families.

BACKGROUND: Relationship between timing of initiating adjuvant chemotherapy (AC) and clinical outcomes after surgery for pancreatic cancer remains controversial. METHODS: In this ancillary analysis of the JASPAC 01 trial, 187 patients were classified according to the interval between surgery and chemotherapy initiation to Early (< 6 weeks, n = 45), Standard (6-8 weeks, n = 70), and Delayed (> 8 weeks, n = 72). Overall survival (OS) and relapse-free survival (RFS) were analyzed. RESULTS: Baseline characteristics were comparable among three groups. The Standard group showed significantly longer OS than the Early group (median, 66 vs. 37 months; HR 0.61, 95% CI 0.38-0.99; p = 0.041), and relatively longer OS compared with the Delayed group (median, 45 months; HR 0.68, 95% CI 0.44-1.05; p = 0.077). RFS was longer in the Standard group (median, 46 months) compared with the Early group (20 months; HR 0.61, 95% CI 0.38-0.99; p = 0.040) and the Delayed group (20 months; HR 0.59, 95% CI 0.39-0.89; p = 0.011). Multivariate analysis identified operative procedure, R1 resection, lymph node metastasis, and nonstandard initiation (< 6 or > 8 weeks) as independent adverse prognostic factors. CONCLUSIONS: Initiation of S-1 AC at 6-8 weeks after pancreatectomy was associated with favorable survival outcomes.

Osteosarcoma is the most common malignant bone tumor, primarily affecting adolescents and young adults. Patients with metastases have a low survival rate, making the identification of prognostic markers crucial. The adaptor protein CIN85 is involved in various signaling pathways that regulate cell differentiation, adhesion, and motility. Its overexpression is associated with poor prognosis in multiple cancers. However, the role of CIN85 in osteosarcoma progression has not yet been explored. This study shows that CIN85 expression is higher in osteosarcoma than in normal bone tissue and further increased in metastatic lesions relative to primary tumors. CIN85 overexpression increases cell migration and Matrigel invasion, whereas silencing CIN85 suppresses these behaviors. Functional annotation and enrichment analyses of the CIN85-driven transcriptome suggest that CIN85 regulates migration, adhesion, and extracellular matrix organization in osteosarcoma. CIN85 affects MMP2 and COL3A1 gene expression and activates Akt/mTOR signaling. Knockdown of MMP2 and COL3A1 or pharmacological inhibion of Akt/mTOR signaling abrogates CIN85-induced motility. This study demonstrates that elevated CIN85 expression contributes to osteosarcoma migration and metastasis, highlighting its potential as a therapeutic target.

BACKGROUND: Reference intervals for calculated free testosterone (cFT) in healthy, nonobese men have been released, but have not been validated in men with erectile dysfunction (ED). OBJECTIVES: To assess the clinical impact of new cFT reference intervals in men with new-onset ED. METHODS: Data from 410 healthy, nonobese men were analyzed (2015-2023). cFT was assessed using Vermeulen's formula and compared to Jasuja et al.'s (2022) reference values, using the 2.5th percentile as a pathological threshold. At baseline, all patients completed the International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). Descriptive statistics and linear regression analyses were applied. RESULTS: Median (IQR) age and total testosterone at presentation were 48 (38-59) years and 4.7 (3.3-6.1) ng/mL. Median IIEF-EF score was 18 (8-23), with 134 patients (32.8%) reporting severe ED. Percentiles of cFT in ED men were: 2.5th = 10, 10th = 50, 50th = 90, 90th = 150, and 97.5th = 227.5 pg/mL, compared to 66, 91, 141, 240, and 309 pg/mL in healthy controls. Seventy-four had cFT between 10 and 66 pg/mL, normal for ED distribution but pathological by healthy reference. This group was older (p<0.01), had lower IIEF-EF (p<0.001), and higher BDI (p<0.01) versus those with cFT >66 pg/mL, though other parameters were similar. Severe ED rates were 72.7%, 44.6%, and 28.7% in men with cFT <10, 10-66, and >66 pg/mL (p<0.01). At multivariable regression, cFT >66 pg/mL was linked to higher IIEF-EF (p = 0.02), while cFT >66 pg/mL (p = 0.03) and younger age (p = 0.01) were associated with lower BDI scores. CONCLUSIONS: Reference thresholds for cFT derived from healthy men identify, among men with ED, a subgroup showing a less favorable erectile and psychometric profile. These findings suggest that healthy-derived cFT reference values may provide clinically useful information in the assessment of men presenting with ED.

Pirtobrutinib (PBN), a non-covalent BTK inhibitor, has been approved by the FDA for relapsed/refractory mantle cell lymphoma (MCL); however, resistance to PBN has been observed. To dissect the molecular dynamics driving PBN resistance, we performed integrative single-cell multi-omic profiling (scRNA-seq, scATAC-seq, and scDNA-seq) on longitudinal MCL patient samples. Our analyses revealed both genetic and non-genetic routes of resistance: In some patients, resistance involves sequential copy number gains (e.g., 1q, 2p, and 8q) accompanied by transcriptomic reprogramming and epigenetic alterations, whereas in others, resistance occurs through non-genetic mechanisms driven by transcriptional and epigenetic remodeling. Integration of scATAC-seq and scRNA-seq enabled gene regulatory network inference and in silico perturbation analysis, highlighting RAD21 and SMC3, core components of the cohesin complex, as chromatin regulators whose downregulation may re-sensitize cells to PBN. A stem-like malignant B cell population enriched in resistant samples exhibited features of metabolic reprogramming and epithelial-mesenchymal transition. Together, our findings highlight heterogeneous, multi-layered mechanisms of PBN resistance and suggest chromatin regulators as potential therapeutic targets to overcome PBN resistance in MCL.

While thyroid cancer generally carries a favorable prognosis, the 5-year survival rate for advanced cases, particularly poorly differentiated and anaplastic subtypes, remains below 20%. The latest guidelines recommend conservative use of chemotherapy in thyroid cancer, primarily due to the absence of reliable efficacy prediction systems. Tumor-derived organoid-based strategies represent a powerful tool for assessing individual-level drug sensitivity and identifying novel treatment regimens. This prospective single-arm cohort study enrolled 25 patients. Thyroid tumor tissue was procured via ultrasound-guided core needle biopsy, and organoids were established using a modified Matrigel-air-liquid interface culture method. Drug sensitivity testing encompassed clinically relevant chemotherapeutic agents, utilizing IC50 values as the primary parameter for formulating individualized regimens. Eventually, the objective response rate (ORR) of 15 patients who received the recommended regimens reached 53.3%, among which the ORR of patients with anaplastic thyroid carcinoma (ATC) was as high as 87.5%. The tumor diameters of the patients were significantly reduced, with a median reduction of 40.32% (IQR: 7.89%-65.22%), and 80% of the patients had a progression-free survival (PFS) exceeding 6 months. This preliminary study confirmed the feasibility of extracting and culturing tumor organoids from patients' tumor lesions, which can serve as an effective tool for chemotherapy drug screening, highlighting the potential of precision medicine in individualized chemotherapy for locally advanced thyroid carcinoma (LATC).

BACKGROUND: In colitis-associated colorectal cancer (CAC), chronic inflammation is the primary driver of tumorigenesis. A critical event in this process is the massive recruitment of neutrophils, which, while part of the host defense, can paradoxically fuel cancer progression. Excessive neutrophil infiltration contributes to sustained mucosal damage through the release of pro-inflammatory mediators and shapes a tumor-promoting microenvironment. Despite their recognized role, therapeutic strategies specifically targeting pathogenic neutrophil recruitment in CAC are limited. Thlaspi arvense (TA), a traditional medicinal plant, possesses purported anti-inflammatory properties, suggesting its potential utility against CAC. Therefore, this study was designed to evaluate the efficacy of TA in preventing CAC and to delineate its mechanism of action, particularly its impact on neutrophil-driven inflammation. METHODS: An azoxymethane/dextran sulfate sodium (AOM/DSS) mouse model of CAC was employed. Mice were administered with TA to evaluate its effects on disease severity, as gauged by body weight change, colon length, tumor burden, and survival rate. Histological and immunofluorescence staining were performed to assess mucosal integrity and the expression of tight junction proteins (ZO-1, Claudin-1). Neutrophil infiltration was quantified by flow cytometry and immunofluorescence. The levels of pro-inflammatory cytokines (IL-6, TNF-α, IL-1β, IFN-γ) and neutrophil chemoattractants (CXCL1/2) were measured using ELISA and qPCR, respectively. To specifically probe the CXCL1/2-CXCR2 axis, a CXCR2 inhibitor was used as an interventional control. Mechanistic insights were gained through RNA sequencing and Western blot analysis. Furthermore, molecular docking was performed to predict the binding affinity of key TA constituents to core proteins within the NOD/NF-κB pathway. RESULTS: The AOM/DSS mouse model successfully recapitulated the hallmark features of CAC. Treatment with TA, especially at higher doses, markedly attenuated the pathological manifestations, including body weight loss, colon shortening, adenoma formation, and severe inflammatory responses. Consistently, the TA administration restored mucosal integrity and significantly upregulated the expression of tight junction proteins ZO-1 and Claudin-1. At a functional level, TA significantly reduced the production of the neutrophil chemoattractants CXCL1 and CXCL2, which and consequently impaired the interaction with CXCR2 on neutrophils and led to a substantial decrease in neutrophil recruitment. Mechanistic investigation further demonstrated that TA exerted its effects by suppressing the activation of key proteins within the NOD/NF-κB signaling pathway. This suppression resulted in diminished CXCL1/2 expression and a consequent attenuation of the neutrophil-driven pro-tumorigenic microenvironment. CONCLUSIONS: We conclude that TA attenuates colitis-associated carcinogenesis by inhibiting the NOD/NF-κB pathway and its downstream CXCL1/2-CXCR2-mediated neutrophil recruitment. This study underscores the value of targeting neutrophil-driven inflammation and positions TA as a viable natural therapeutic for preventing CAC progression.

BACKGROUND: Tendinopathy is a prevalent orthopaedic condition characterized by disrupted tendon homeostasis, with oxidative stress being a key contributing mechanism. Although the natural compound 18-β-Glycyrrhetinic acid (GA) exhibits antioxidant properties and is a therapeutic candidate for tendinopathy, its precise molecular mechanism remains unclear. This study aimed to elucidate how GA alleviates tendinopathy, with a focus on its role in regulating the HMGB1-cGAS-STING axis and NLRP3 inflammasome activation in the context of oxidative stress. METHODS: We employed single-cell RNA sequencing (scRNA-seq) of clinical samples, proteomics of animal tissues, and comprehensive pharmacological assays to investigate the mechanisms of tendinopathy. Furthermore, the rat tendinopathy model and HO-induced oxidative stress model of tendon stem cells (TSCs) were used to validate the protective effects of GA. RESULTS: We found that GA significantly reduced oxidative stress and subsequent inflammation, thereby mitigating collagen disruption in rats with tendinopathy. Notably, scRNA-seq revealed that the proportion of TSCs increased significantly during tendinopathy, which were particularly susceptible to reactive oxygen species (ROS). TSCs from oxidative damage and inhibited activation of the NLRP3 inflammasome by suppressing the cGAS-STING pathway. Mechanistically, GA promoted cGAS degradation by enhancing its interaction with the mitochondrial E3 ubiquitin ligase Mul1. This effect was mediated through high-mobility group box 1 (HMGB1), as GA disrupted the HMGB1-cGAS interaction. Specifically, GA induced methylation of HMGB1 at lysine 43, a modification essential for its activity. This methylation was catalyzed by the methyltransferase DOT1L, which was upregulated and directly bound by GA. Collectively, GA alleviates tendinopathy by targeting the DOT1L-HMGB1-cGAS axis to resolve oxidative stress and inflammation. CONCLUSION: Collectively, our findings provide new insights into how oxidative stress accelerates tendinopathy progression. Moreover, they delineate the mechanism by which GA in mitigates oxidative damage and inflammation in TSCs by inhibiting the co-localization of HMGB1 and cGAS. Overall, this study offers scientific support for further developing GA as a promising therapeutic agent for tendinopathy treatment.

BACKGROUND: Targeted intraoperative radiotherapy (TARGIT-IORT) delivers a single high-dose boost to the tumor bed during breast-conserving surgery (BCS) and is now recommended only within clinical trials or registries. Its acute systemic immunogenic effects relative to BCS-only are not well characterized. METHODS: Women with histologically confirmed breast carcinoma were allocated in an alternating 1:1 sequence to BCS + TARGIT-IORT or BCS-only groups. Peripheral blood was sampled pre-operatively and 24 h post-surgery. ICD and cytokine/DAMP mediators, including HMGB1, PRF1, TRAIL, FASL-NFSF6, CASP-8, GZMB, CRT, TLR4, RAGE, GDF15, and M-CSF, were quantified using ELISA. Perioperative changes were analyzed using the Wilcoxon signed-rank test; between-group Δ differences were assessed using the Mann-Whitney U test. RESULTS: Forty-two patients were enrolled (26 BCS + TARGIT-IORT; 16 BCS-only). TARGIT-IORT induced a distinct early immune shift across ICD markers. HMGB1 showed the most pronounced change (3410.5 → 359.8 pg/ml; p < 0.001), significantly greater than that after BCS-only (1040.7 → 263.6 pg/ml; Δp < 0.001). TRAIL (246.1 → 155.5 pg/ml; p = 0.001) and FASL-NFSF6 (1087.1 → 839.3 pg/ml; p = 0.003) also declined significantly after TARGIT-IORT, whereas changes following BCS alone were modest. TARGIT-IORT increased M-CSF (266.7 → 386.7 pg/ml; p = 0.037) and reduced TLR4 (1456.3 → 1331.3 ng/ml; p = 0.007), with no significant perioperative changes in RAGE, GDF15, CRT, GZMB, or CASP-8. DISCUSSION: Within 24 h, TARGIT-IORT generates a coordinated ICD-related and cytokine/DAMP signature, marked HMGB1 depletion, death ligand modulation, TLR4 engagement, and M-CSF upregulation, consistent with rapid immune priming. These findings are exploratory and should be interpreted within a translational framework. Larger, randomized multicentre studies with extended longitudinal and tissue-level immune profiling are needed to confirm these signals.

BACKGROUND: Retroperitoneal sarcoma (RPS) resection remains challenging, with up to 50% of patients developing local recurrence and a 5-year survival rate of 50%. CEB-01, designed for local and controlled SN-38 delivery postresection, may increase local control and survival rates. MATERIALS AND METHODS: CEB-01 is a first-in-human, multicenter trial following a 3+3 dose escalation design and expansion cohort conducted in six centers in Spain. CEB-01 was implanted at three dose levels of SN-38: 9, 18, and 36 mg. The objectives were to establish the recommended phase 2 dose (RP2D) and evaluate its safety, efficacy, and pharmacokinetics. RESULTS: From July 2020 to November 2023, 14 patients were included: 10 males, with a median age of 63 years (range: 40-76), mostly with dedifferentiated (50%) and well-differentiated liposarcoma (35.7%), and R0 (79%) and R1 (21%) postsurgical margins. No dose-limiting toxicities were observed, and the RP2D was set at 18 mg. With a median follow-up of 9.1 months (range: 1-21), all patients at RP2D were recurrence-free and alive. Grade ≥ 3 adverse events were reported in just one patient treated with RP2D. The pharmacokinetic profile of SN-38 showed substantially lower C (20-70-fold) and longer elimination half-life times than those of intravenous irinotecan at clinically relevant doses. CEB-01 showed prolonged release of SN-38, which was detectable after 28 days in circulating blood. CONCLUSIONS: CEB-01 at 18 mg exhibited a tolerable safety profile and preliminary efficacy against postsurgery recurrence in patients with RPS. These results warrant further clinical investigations of this type of tumor. Clinical trial identification: EU CT: 2024-516971-34-00; clinicaltrials.gov: NCT04619056.

BACKGROUND AND AIMS: The development of breast cancer exhibits a heterogeneous and complex character in both felines and humans, which motivates the search for serum biomarkers for diagnosis, prognosis, and therapeutic monitoring. Although the feline species is recognized as a relevant comparative model for human breast cancer, metabolomic studies in cats are still scarce. This work aimed to investigate altered serum metabolites involved in feline mammary carcinoma (FMC). METHODS: Serum samples from 28 adult female cats (11 healthy and 17 with malignant mammary tumors undergoing mastectomy) were evaluated. The samples were extracted with pure methanol and derivatized (oximation followed by silylation) for GC-MS analysis. RESULTS: Twenty-six metabolites or chemical classes were found significantly altered. The main alteration was related to the metabolism of amino acids, carbohydrates, and the tricarboxylic acid cycle, mostly with reduced serum levels in female cancer patients, suggesting high tumor uptake. Analysis of metabolic pathways revealed alterations in the metabolism of alanine, aspartate, and glutamate; arginine and proline; starch and sucrose; and butanoate metabolism. CONCLUSIONS: These findings provide preliminary evidence supporting the determination of candidate biomarkers and the mapping of disrupted metabolic pathways in FMC. Validation of the study and confirmation of the metabolite's structural identity are critical to enable robust comparative studies and to direct the development of innovative diagnostic and therapeutic strategies.

PURPOSE: The study explored the implementation of integrative nursing (IN) interventions in oncology inpatient care within a dedicated project. As part of an IN consultation service, trained integrative nurses delivered external naturopathic, non-pharmacological interventions. The aim of this study was to characterize patients receiving IN interventions and to describe how these interventions are implemented and applied in oncological inpatient care. METHODS: This retrospective study analyzed routine project-related data collected at Ulm University Hospital between 2021 and 2023. Recorded variables included patient demographics, clinical characteristics, type and frequency of IN interventions, and immediate patient reaction. Quantitative data were analyzed descriptively, and qualitative data were examined using content analysis. RESULTS: Healthcare professionals requested an IN consultation for 381 patients, of whom 361 (94.8%) agreed to participate. The majority were female (62.3%; n = 225) and between 60 and 69 years of age (33.5%; n = 121). In total, 1910 IN interventions were carried out, with a median of four IN interventions per patient (M = 5.3 ± 4.6; r = 1-30). Most IN interventions targeted the lower limbs (38.7%; n = 740), most frequently using rhythmic embrocation (70.9%; n = 1355) and solum oil (39.6%; n = 757). Immediately after the IN intervention, the most commonly observed patient reactions were relaxation (67.5%; n = 726) and deeper breathing (37.5%; n = 403). CONCLUSION: The high level of acceptance and the continuous increase in utilization suggest that IN was well implemented in clinical practice during the project, with positive short-term reactions from patients. Further intervention studies are needed to provide robust evidence of its efficacy and to support its long-term integration into routine hospital care.

ATG14 (ATG14L/Barkor) is the autophagy-specific subunit of class III phosphatidylinositol 3-kinase complex I (PI3KC3-C1) and functions as a pivotal node linking autophagosome formation to autophagosome-lysosome fusion. Functionally, ATG14 regulates cell fate through multiple mechanisms. Under hypoxic or nutrient-deprived conditions, ATG14 maintains tumor cell survival and drug resistance, remodels cellular metabolism via lipophagy and mitophagy, and can either suppress or promote programmed cell death depending on the cellular context. Moreover, ATG14 plays protective roles in maintaining neuronal and hepatic homeostasis and is involved in the development of inflammatory and metabolic disorders. Here, we discuss the multi-layered regulation of ATG14, including post-translational modifications (phosphorylation, ubiquitination, palmitoylation), epitranscriptomic and non-coding RNA regulation, and competitive complex interactions, all of which fine-tune its autophagic output and functional plasticity. We further highlight the central roles of ATG14 during the autophagic process, summarize recent advances in cancer-related ATG14 research, and review ongoing drug development efforts as well as potential therapeutic strategies targeting ATG14. Our goal is to provide a comprehensive understanding of the physiological and pathological functions of ATG14 and to explore its potential as a druggable signaling hub. Given its bidirectional regulatory capacity to either suppress cytoprotective autophagy or enforce lethal autophagy-ATG14-targeted interventions must be strategically designed based on the disease stage and autophagy dependence.

PURPOSE: This study aimed to evaluate the performance of ChatGPT in responding to patient-centered queries related to cancer rehabilitation. It examined the accuracy, completeness, and overall quality of ChatGPT's responses across major domains of cancer rehabilitation from a physical therapy perspective. METHODS: Fifteen representative patient queries covering eight domains of cancer rehabilitation-including general exercise, fatigue, bone metastasis, neuropathy, balance and falls, breast cancer, women's health, and pediatric cancer-were developed by two licensed physical therapists. Each query was input into ChatGPT-4, and responses were independently evaluated for accuracy, completeness, and global quality based on established clinical practice guidelines and expert consensus. RESULTS: ChatGPT demonstrated a mean accuracy score of 3.93 (SD = 1.10) on a 5-point scale, a mean completeness score of 2.13 (SD = 0.83) on a 3-point scale, and a mean global quality score of 3.60 (SD = 1.12) on a 5-point scale. Responses were generally accurate and clinically relevant but often lacked details regarding exercise dosage, safety precautions, and guideline-concordant recommendations. CONCLUSION: ChatGPT shows potential as an accessible tool for general cancer rehabilitation education but requires refinement to ensure accuracy, contextual relevance, and safety. IMPLICATIONS FOR CANCER SURVIVORS: AI-driven conversational models may improve patient access to rehabilitation information and self-management support when used under professional oversight and guided by evidence-based frameworks.

OBJECTIVE: This study was conducted to explore breast cancer survivors' experiences with their adjustment process. METHOD: The study population included women registered at a university hospital who had completed active treatment (surgery, chemotherapy, and/or radiotherapy) between May and July 2025, including those continuing hormone therapy. The study sample included 20 women who agreed to participate. The criterion sampling method was employed. The research data were collected through 'Introductory Information Form', 'Semi-structured Questionnaire', and face-to-face individual interviews. Interviews were recorded with a voice recorder, with the participants' permission. The content analysis method was used to evaluate the qualitative data. In the study, the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist was used to report qualitative research. RESULTS: As a result of the analysis of the data obtained from the interviews on the experiences of breast cancer survivors regarding the adaptation process, five themes, namely "Difficulties in the Adaptation Process", "Emotional Experiences", "Coping Strategies", "Change in Lifestyle and Self-Perception" and "Support Mechanisms in the Adaptation Process", and a total of 34 codes for these themes were created. CONCLUSION: The findings showed that women experienced physical and emotional challenges during the adaptation process, including fatigue, weakness, limited mobility, and emotional confusion. Coping strategies included appearing strong and relying on trust and gratitude. Women also reported changes in lifestyle, self-perception, and life perspective, with a greater focus on living in the moment and self-care. Family members, especially children and spouses, were identified as the main sources of support.

Magnetic resonance imaging (MRI) of the perianal region is frequently performed in the context of fistulizing disease; however, a broad spectrum of non-fistulizing conditions may also affect this region. A wide variety of inflammatory, infectious, vascular, cystic, and neoplastic conditions, as well as anatomical variants and post-surgical changes, may involve the perianal region and often present with overlapping or nonspecific clinical manifestations.MRI, owing to its superior soft tissue contrast and multiplanar capability, plays a central role in the evaluation of perianal pathology. Beyond lesion detection, MRI enables accurate characterization, assessment of disease extent, and differentiation between entities that may be clinically indistinguishable, thereby supporting appropriate therapeutic decision-making. Importantly, perianal abnormalities may also be incidentally detected on pelvic MRI studies performed for unrelated indications. In such cases, unfamiliarity with the full spectrum of perianal findings may represent a source of diagnostic uncertainty, particularly for less experienced radiologists.This review focuses on the MRI appearance of non-fistulizing perianal pathology, emphasizing key imaging features that aid in differential diagnosis across a broad range of benign and malignant conditions. Representative cases from routine clinical practice are presented to illustrate typical and atypical imaging patterns, as well as common diagnostic pitfalls. Selected complementary computed tomography findings are included when relevant.Given the relative infrequency of many perianal conditions, comprehensive knowledge of their MRI features, along with recognition of normal anatomical variants and expected post-treatment appearances, is essential. Such familiarity helps avoid misinterpretation, unnecessary invasive procedures, and delayed diagnosis, ultimately contributing to improved patient management and clinical outcomes.