Search Results (2,293)

Postpartum lactating people are particularly vulnerable to inequities in social determinants of health (SDH), yet no validated tool currently exists to assess these factors comprehensively. This study aimed to co-develop and establish the content validity of an instrument to integratively evaluate SDH in this population. Guided by the Mixed Methods Appraisal Tool, an interdisciplinary e-Delphi panel assessed item sufficiency, clarity, coherence, and relevance. Statistical analyses included the item-level (I-CVI) and scale-level (S-CVI/Ave) content validity indices, average agreement between experts (AABE), Fleiss’ kappa (κ), and Aiken’s V coefficient (V) (p < 0.05). Cognitive interviews were conducted with postpartum lactating participants representing diverse characteristics to assess interpretability. The initial version of the instrument included 135 items across nine sections addressing general demographics, education, employment, home environment, lifestyle, social support, healthcare access, stress, intimate partner violence, insomnia, and nutrition. Based on expert input, it was refined to 131 items through structural and lexical revisions. Content validity indices indicated strong agreement: I-CVI ranged from 0.66–1.00, S-CVI/Ave > 0.95, AABE > 14.26, and κ and V > 0.90. Final adjustments following cognitive interviews led to a 128-item version optimized for clarity and relevance. This instrument offers strong content validity for SDH assessment in postpartum lactating people and supports sustainable use in health research. Full article

The gut microbiota plays a crucial role in early childhood development. Dysbiosis in this community has been linked to risk of disease. The transition from an exclusive milk-based diet to complementary feeding and eventual weaning is crucial for the development and maturation of the gut microbiota. However, the impact of breastfeeding duration during the complementary feeding period (typically 6 to 24 months of age) on microbial development trajectories remains incompletely characterized. Here, we investigated whether prolonged breastfeeding during the complementary feeding window influences gut microbiota succession by comparing children who continued breastfeeding with those who were fully weaned at the same ages. We analyzed 16S rRNA gene sequencing profiles of fecal samples collected from a cohort of Peruvian children at 6, 12, 18, and 24 months of age. Samples were categorized into two groups: a complementary feeding group (BF), which received both complementary foods and breast milk, and a post-weaning group (NBF), which had stopped receiving breast milk for over 7 days. We conducted both alpha and beta diversity to assess within- and between-sample microbial variation. Relative abundances of microbial taxa at the phylum and genus levels were also quantified. The results showed a clear age-related increase in both species richness and species evenness across early childhood, while BF had more gradual changes relative to NBF. Marked differences in community composition were observed between BF and NBF children at 12, 18, and 24 months, respectively. Children who continued breastfeeding maintained a Bifidobacterium-rich, lower-diversity microbiota for a longer period, whereas weaned children at the same age exhibited accelerated microbiota development toward an adult-like profile enriched in Bacteroidota and Bacillota (formerly Firmicutes). These findings suggest that breastfeeding during the complementary feeding period exerts a significant influence on gut microbiota development through the first two years of life, which is most likely independent of complementary food. The study provides potential implications for children’s health and nutrition guidelines from a perspective of gut microbiota succession. Full article

Background/Objectives: Cancer is a major public health burden in Serbia and a factor influencing long-term disaster readiness by straining health system capacity. This study examined spatial and temporal trends in incidence and mortality for eight major cancers among women in Central Serbia (1999–2021) to inform targeted prevention and preparedness strategies. Methods: Standardised rates from national datasets were analysed using the Mann–Kendall trend test and Sen’s slope estimator. Geographic disparities were mapped in ArcGIS Pro 3.2. Mortality trends were assessed only for statistically reliable series. Results: Breast cancer incidence increased in six counties, while cervical cancer declined in several areas, likely reflecting screening success. Colorectal, bladder, pancreatic, and lung and bronchus cancers showed rising incidence; lung and bronchus cancer mortality increased in 16 counties, indicating growing demand for chronic respiratory care. These shifts may reduce surge capacity during disasters by increasing the baseline burden on healthcare infrastructure. Regional disparities highlight uneven system resilience. Conclusions: Aligning cancer control measures—especially for high-burden cancers like lung—with emergency preparedness frameworks is essential to strengthen health system resilience, particularly in resource-limited regions. Full article

Background/Objectives: Routine preventive care, including physical examinations, mammography, and cervical cancer screening, is critical for long-term health maintenance and recurrence surveillance among breast cancer survivors. Community-based organizations (CBOs) may play a key role in supporting adherence to these services through education, navigation, and survivorship care planning. Methods: A secondary analysis was conducted using data from N = 777 breast cancer survivors who contacted a national cancer-focused CBO for resources, including no-cost patient navigation. Preventive care adherence was measured via a composite index based on self-reported receipt of physical exams, mammograms, and Pap smears at guideline-recommended intervals. Patient-reported outcomes were assessed 30 days post-contact, including Survivorship Care Planning (SCP) receipt and quality of life (QoL). Results: Adherence to all three guideline-based screenings was reported by 66% of BCS, 29% adhered to two, and 6% to one or fewer. Physical exams had the highest adherence rate (97%), followed by mammograms (88%) and Pap smears (73%). Bivariate analyses showed higher adherence among younger survivors (t = 4.59, df = 711, p < 0.001), non-white survivors (t = −3.27, df = 267, p < 0.001), those in partnered relationships (t = 1.76, df = 54, p < 0.05), and individuals with better QoL (r = −0.09, p < 0.01). Receipt of SCP components was associated with a trend toward improved adherence: 56% received a care summary, 64% received follow-up instructions, and 45% received written materials (r = 0.05, p < 0.10). In multivariable regression adjusting for partnership status and SCP receipt, younger age (B = 1.13, p < 0.001), non-white race/ethnicity (B = 1.00, p < 0.01), and higher QoL scores (B = 0.09, p < 0.05) were significantly associated with greater adherence. Conclusions: Engagement with a CBO was associated with high levels of adherence to preventive care among breast cancer survivors—especially those who were younger, non-white, and with better QoL. SCP, particularly when delivered in written form with follow-up instructions, may support improved adherence. These findings highlight the value of CBO-led survivorship support in promoting long-term health maintenance for breast cancer survivors. Full article

Breast cancer is the most common malignant tumor among women. It is a significant health and social issue affecting 2.3 million women worldwide. Breast cancer is caused by various factors, including gender, age, race, genetics, hormonal balance, obesity, alcohol and many others. A crucial issue related to breast cancer is the impact of diet on the development of the disease. Dietary fats play a key role. Saturated fatty acids and trans fatty acids increase the risk of breast cancer, while polyunsaturated fatty acids have a protective effect. A high-protein diet reduces the risk of breast cancer and improves prognosis among patients. The role of carbohydrates remains unclear, but women may benefit from reducing their intake of high glycemic index foods. Among the macronutrients influencing the development and progression of breast cancer are calcium and magnesium. Adopting a Mediterranean diet may offer benefits. Among the factors influencing the development of breast cancer, the gastrointestinal microbiota is also noteworthy. Regular physical activity can reduce the risk of developing breast cancer, support treatment, reduce side effects and improve patients’ quality of life. Chronic stress also contributes to the development of breast cancer by affecting the nervous, hormonal and immune systems, disrupting the body’s homeostasis. Full article

Background: Breast cancer remains a critical public health problem worldwide and is a leading cause of cancer-related mortality. Optimizing clinical outcomes is contingent upon the early and precise detection of malignancies. Advances in medical imaging and artificial intelligence (AI), particularly in the fields of radiomics and deep learning (DL), have contributed to improvements in early detection methodologies. Nonetheless, persistent challenges, including limited data availability, model overfitting, and restricted generalization, continue to hinder performance. Methods: This study aims to overcome existing challenges by improving model accuracy and robustness through enhanced data augmentation and the integration of radiomics and deep learning features from the CBIS-DDSM dataset. To mitigate overfitting and improve model generalization, data augmentation techniques were applied. The PyRadiomics library was used to extract radiomics features, while transfer learning models were employed to derive deep learning features from the augmented training dataset. For radiomics feature selection, we compared multiple supervised feature selection methods, including RFE with random forest and logistic regression, ANOVA F-test, LASSO, and mutual information. Embedded methods with XGBoost, LightGBM, and CatBoost for GPUs were also explored. Finally, we integrated radiomics and deep features to build a unified multimodal feature space for improved classification performance. Based on this integrated set of radiomics and deep learning features, 13 pre-trained transfer learning models were trained and evaluated, including various versions of ResNet (50, 50V2, 101, 101V2, 152, 152V2), DenseNet (121, 169, 201), InceptionV3, MobileNet, and VGG (16, 19). Results: Among the evaluated models, ResNet152 achieved the highest classification accuracy of 97%, demonstrating the potential of this approach to enhance diagnostic precision. Other models, including VGG19, ResNet101V2, and ResNet101, achieved 96% accuracy, emphasizing the importance of the selected feature set in achieving robust detection. Conclusions: Future research could build on this work by incorporating Vision Transformer (ViT) architectures and leveraging multimodal data (e.g., clinical data, genomic information, and patient history). This could improve predictive performance and make the model more robust and adaptable to diverse data types. Ultimately, this approach has the potential to transform breast cancer detection, making it more accurate and interpretable. Full article

Gynecological cancer, especially breast, cervical, and ovarian cancer, are significant health issues affecting women worldwide. When screened they are mostly detected at later stages because of non-specific signs and symptoms as well as the unavailability of reliable screening methods. The improvement of early oncologic prediction methods is therefore needed to work out the survival rates, guide individualized treatment, and relieve healthcare pressures. Outcome forecasting and clinical detection are rapidly changing with the use of machine learning (ML), one of the promising technologies used to analyze complex biomedical data. Artificial intelligence (AI)-based ML models are capable of determining low-level trends and making accurate predictions of disease risk and outcomes, because they can combine different datasets (clinical records, genomics, proteomics, medical imaging) and learn to identify subtle patterns. Standard algorithms, including support vector machines, random forests, and deep learning (DL) models, such as convolutional neural networks, have demonstrated high potential in identifying the type of cancer, monitoring disease progression, and designing treatment patterns. This manuscript reviews the recent developments in the use of ML models to advance oncologic prediction tasks in gynecologic oncology. It reports on critical domains, like screening, risk classification, and survival modeling, as well as comments on difficulties, like data inconsistency, inability of interpretation of models, and issues of clinical interpretation. New developments, such as explainable AI, federated learning (FL), and multi-omics fusion, are discussed to develop these models and to make them applicable in practice because of their reliability. Conclusively, this article emphasizes the transformative role of ML in precision oncology to deliver improved, patient-centered outcomes to women who are victims of gynecological cancers. Full article

The breast microbiome remains stable throughout a woman’s life. The breast is not a sterile organ, and its microbiota exhibits a distinct composition compared to other body sites. The breast microbiome is a community characterized by an abundance of Proteobacteria and Firmicutes, which represent the result of host microbial adaptation to the fatty acid environment in the tissue. The breast microbiome demonstrates dynamic adaptability during lactation, responding to maternal physiological changes and infant interactions. This microbial plasticity modulates local immune responses, maintains epithelial integrity, and supports tissue homeostasis, thereby influencing both breast health and milk composition. Disruptions in this balance, the dysbiosis, are closely linked to inflammatory breast conditions such as mastitis. Risk factors for breast cancer (BC) include genetic mutations, late menopause, obesity, estrogen metabolism, and alterations in gut microbial diversity. Gut microbiota can increase estrogen bioavailability by deconjugating estrogen-glucuronide moieties. Perturbations of this set of bacterial genes and metabolites, called the estrobolome, increases circulating estrogens and the risk of BC. Fusobacterium nucleatum has recently been associated with BC. It moves from the oral cavity to other body sites hematogenously. This review deals with the characteristics of the breast microbiome, with a focus on F. nucleatum, highlighting its dual role in promoting tumor growth and modulating immune responses. F. nucleatum acts both on the Wnt/β-catenin pathway by positively regulating MYC expression and on apoptosis by inhibiting caspase 8. Furthermore, F. nucleatum binds to TIGIT and CEACAM1, inhibiting T-cell cytotoxic activity and protecting tumor cells from immune cell attack. F. nucleatum also inhibits T-cell function through the recruitment of myeloid suppressor cells (MDSCs). These cells express PD-L1, which further reduces T-cell activation. A deeper understanding of F. nucleatum biology and its interactions with host cells and co-existing symbiotic microbiota could aid in the development of personalized anticancer therapy. Full article

Breast cancer remains a formidable global health challenge, with triple-negative breast cancer (TNBC) posing unique clinical complexities. Characterized by its aggressive nature and limited number of specific therapeutic targets, this breast cancer subtype disproportionately affects African American women, highlighting critical disparities in care. The tumor immune microenvironment (TIME) plays a critical role in breast cancer development and response to immunotherapy, and it is essential in fostering an immunosuppressive and pro-inflammatory niche. Inflammation, primarily mediated by the NF-κB signaling pathway and chemokine signaling, particularly involving CCL2, plays a pivotal role in TNBC progression and therapy resistance. This review describes some of the molecular mechanisms of polyphenols, which are naturally occurring compounds abundant in various dietary sources, and their potential use as therapeutic agents in the management of TNBC. Polyphenolic compounds have been described as modulating the TIME through the inhibition of tumor progression, immune evasion, and therapy resistance, due to their diverse bioactivities, including anti-inflammatory, antioxidant, and anticancer properties, making them attractive candidates for combating the aggressiveness of TNBC and addressing treatment disparities. Polyphenols, such as curcumin, gossypol, butein, epigallocatechin gallate, cardamonin, and resveratrol, have demonstrated efficacy in modulating several signaling pathways within the TIME, which are implicated in the progression of TNBC. This review highlights the potential effects of polyphenols on inflammatory cytokine release, programmed cell death ligand 1 (PD-L1) expression, which is associated with immune evasion by the host cell, and various intracellular signaling cascades, demonstrating their potential use in personalized therapeutic interventions for TNBC. This study also describes differential responses of TNBC cell lines to polyphenol treatment, highlighting the importance of considering genetic variability in therapeutic strategies, as well as the importance of the interaction of polyphenols with the gut microbiome, which may establish the bioavailability and effectiveness of these compounds toward therapeutic outcomes. Further preclinical and clinical studies are warranted to fully elucidate the therapeutic potential of polyphenols and translate these findings into clinical practice, thereby improving outcomes for patients with TNBC worldwide. Full article

Substance use during pregnancy is an increasingly important yet under-recognized threat to maternal and child health. This narrative review synthesizes the current evidence available on the epidemiology, pathophysiology, clinical management, and policy landscape of prenatal exposure to alcohol, tobacco, opioids, benzodiazepines, cocaine, cannabis, methamphetamines, and other synthetic drugs. All major psychoactive substances readily cross the placenta and can remain detectable in breast milk, leading to a shared cascade of obstetric complications (hypertensive disorders, placental abruption, pre-term labor), fetal consequences (growth restriction, structural malformations), and neonatal morbidities such as neonatal abstinence syndrome and sudden infant death. Mechanistically, trans-placental diffusion, oxidative stress, inflammatory signaling, and placental vascular dysfunction converge to disrupt critical neuro- and cardiovascular developmental windows. Early identification hinges on the combined use of validated screening questionnaires (4 P’s Plus, CRAFFT, T-ACE, AUDIT-C, TWEAK) and matrix-specific biomarkers (PEth, EtG, FAEE, CDT), while effective treatment requires integrated obstetric, addiction, and mental health services. Medication for opioid use disorders, particularly buprenorphine, alone or with naloxone, confers superior neonatal outcomes compared to methadone and underscores the value of harm-reducing non-punitive care models. Public-health strategies, such as Mexico’s “first 1 000 days” framework, wrap-around clinics, and home-visiting programs, demonstrate the potential of multisectoral interventions, but are hampered by structural inequities and punitive legislation that deter care-seeking. Research gaps persist in polysubstance exposure, culturally tailored therapies, and long-term neurodevelopmental trajectories. Multigenerational, omics-enabled cohorts, and digital longitudinal-care platforms represent promising avenues for closing these gaps and informing truly preventive perinatal health policies. Full article

Background/Objectives: Cancer ranks as the second most prevalent cause of death worldwide, according to the World Health Organization. Approximately one in six global deaths is attributed to cancer. Among females, breast cancer stands out as the most frequent type of tumor. Raloxifene (RLX), recognized as a selective estrogen receptor modulator, has been employed as a therapeutic option in treating breast cancer among postmenopausal women. The objective of this study was to investigate the anticancer potential of raloxifene-loaded hexosomes, nanoliposomes, and nanoniosomes to identify the most effective formulation. Methods: The particle size, zeta potential, entrapment efficiency, and structural elucidation of the various nanovesicle formulations was validated; Results: Each nanocarrier exhibited a negative surface charge, nanometric size, and a reasonable encapsulation efficiency. Cytotoxicity of the different raloxifene-loaded nanovesicles on MCF-7 breast cancer cell lines and MCF10 non tumorigenic cells revealed the substantial cytotoxic activity of the hexosomal nanocarrier compared to the other nanovesicles, exhibiting the lowest IC50 = 45.3 ± 1.10 µM. Conclusions: The RLX-loaded hexosomal formulation showed superior cytotoxic activity, indicating its potential as a highly effective therapeutic agent. To fully understand its capabilities and mechanisms, further in vitro characterization studies are necessary. Full article

The purpose of this study was to investigate the effects of duck-derived probiotics added to drinking water on the production and immune performance of Pekin ducks. Two strains with good biological characteristics were isolated from the cecum of Pekin duck and identified as Lactiplantibacillus plantarum (L. plantarum) and Enterococcus faecalis (E. faecalis) by species identification. Then, a total of 90 uniformly sized and healthy 7-day-old Pekin ducks were randomly divided into three groups (six replicates per group, five ducks per replicate). Ducks in the control group were fed the basal diet (control group), and those in the experimental groups were fed the basal diet and supplemented with 1 × 10⁷ CFU/mL L. plantarum (LP group) and E. faecalis (EF group) in drinking water, respectively. The supplementation of L. plantarum and E. faecalis in drinking water could significantly improve the average daily feed intake (ADFI) and average daily gain (ADG) of Pekin ducks, as well as the live weight, eviscerated weight, half-eviscerated weight, breast muscle weight, and leg muscle weight (p < 0.05). Compared with the control group, the duodenal villus height, duodenal V/C (villus height and crypt depth ratio), and ileal villus height were significantly increased in LP and EF groups (p < 0.05). Moreover, supplementing the L. plantarum and E. faecalis significantly improved the immune organ index and serum immunoglobulin A (IgA) content, and reduced the serum immunoglobulin G (IgG) content (p < 0.05). They also significantly decreased the number of pathogenic bacteria in the cecum of Pekin ducks and increased the number of Lactobacillus sp. (p < 0.05). This study indicated that adding duck-derived L. plantarum and E. faecalis can improve the production and immune performance of Pekin ducks, as well as enhance the structure of their gut microbiota and protect intestinal health. These findings deepen our understanding of the functions of duck-derived probiotics and provide a foundation for their use as feed additives. Full article

Background: Breast cancer is a major health concern in Poland, with significant incidence and mortality rates despite national screening programs. This retrospective study aimed to evaluate critical aspects of breast cancer management, focusing on waiting times, treatment coordination, cancer characteristics, diagnostic testing, and staging. Methods: We retrospectively analyzed 587 medical records of breast cancer patients (585 female, 2 male) collected between March 2023 and June 2024 through a data donation model. Data included tumor characteristics (histological type, grade, stage, biological subtype, receptor status, Ki-67), diagnostic and genetic tests, and timelines of key events in the diagnostic and therapeutic pathways. Results: Although referral to first oncology consult (18 days) and MDT referral/admission to treatment (10 days) met NFZ guidelines, diagnosis to surgery (94 days) and diagnosis to drug treatment (109 days) were significantly delayed. No records showed oncology coordinator assignment or educational material provision. Clinically, invasive carcinoma NST (77%) and early-stage (IA/IIA, 61%) were prevalent, with Luminal B (HER2-negative) being the most common biological subtype. BRCA1/2 testing was common, but Oncotype DX was not. For 314 HR+ HER2- patients, stage IA (44%) was most common, with no BRCA1/2 mutations found. Conclusion: Breast cancer care in the Łódź voivodeship falls short of national guidelines due to long waiting times and poor care coordination, a problem worsened by incomplete data. Improving record-keeping and speeding up diagnostic and treatment pathways are crucial for better breast cancer management in Poland. While patient data donation can help analyze real clinical pathways, data completeness, and consistency remain challenges. Full article

This study investigates the psychological and emotional mechanisms underlying women’s reactions to breast cancer awareness advertisements through the dual lens of Protection Motivation Theory (PMT) and neuromarketing methods, addressing a gap in empirical research on the integration of biometric and cognitive approaches in health marketing. Utilizing a lab-based experiment with 78 women aged 40 and older, we integrated Facial Expression Analysis using Noldus FaceReader 9.0 with semi-structured post-exposure interviews. Six manipulated health messages were embedded within a 15 min audiovisual sequence, with each message displayed for 5 s. Quantitative analysis revealed that Ads 2 and 5 elicited the highest mean fear scores (0.45 and 0.42) and surprise scores (0.35 and 0.33), while Ad 4 generated the highest happiness score (0.31) linked to coping appraisal. Emotional expressions—including fear, sadness, surprise, and neutrality—were recorded in real time and analyzed quantitatively. The facial analysis data were triangulated with thematic insights from interviews, targeting perceptions of threat severity, vulnerability, response efficacy, and self-efficacy. The findings confirm that fear-based appeals are only effective when paired with actionable coping strategies, providing empirical support for PMT’s dual-process model. By applying mixed-methods analysis to the evaluation of health messages, this study makes three contributions: (1) it extends PMT by validating the emotional–cognitive integration framework through biometric–qualitative convergence; (2) it offers practical sequencing principles for combining threat and coping cues; and (3) it proposes cross-modal methodology guidelines for future health campaigns. Full article

Aromatase inhibitors (AIs), with or without gonadotropin-releasing hormone analogs, are the cornerstone of adjuvant endocrine therapy for women with hormone receptor-positive early-stage breast cancer, offering significant reductions in recurrence risk and improving long-term survival. Their use is frequently accompanied by treatment-related toxicities that can adversely affect patients’ quality of life (QoL) and adherence to therapy. Commonly reported side effects include vasomotor symptoms, such as hot flashes; musculoskeletal disorders, such as arthralgia and myalgia; mood disorders; and genitourinary discomfort, such as vaginal dryness and dyspareunia. Additionally, AIs are associated with a heightened risk of bone loss, leading to osteoporosis and fractures, and may have implications for cardiovascular health. Effective management of these adverse events is pivotal in maintaining treatment adherence and preserving QoL. Evidence-based strategies to address these toxicities include pharmacological interventions, such as analgesics for joint pain, bisphosphonates or denosumab for bone health, and hormonal or non-hormonal approaches for vasomotor and genitourinary symptoms. Non-pharmacological measures, including physical activity, dietary adjustments, and complementary therapies, can also help mitigate symptoms. This review examines the broad spectrum of AI-associated toxicities, discusses their clinical implications, and provides an overview of evidence-based management strategies. These insights aim to support clinicians in optimizing patient care while minimizing the toxicities of therapy. Full article