Search Results (458)

Background and Objectives: Breast cancer is one of the most common cancers in women and the most common cause of cancer death. Hormone receptors, specifically the estrogen receptor (ER) and progesterone receptor (PR), as well as human epidermal growth factor receptor-2 (Her2), are tumor-specific markers used to guide breast cancer therapy. The purpose of this study is to evaluate the impact of tumor biology, including ER, PR, and Her2 expression, on survival in female breast cancer. Materials and Methods: This retrospective cohort study represents an analysis of 2016 female breast cancer cases using anonymized data. We reviewed cases of female breast cancer diagnosed from 1 January 2010 to 31 December 2021, in the Clinic of Obstetrics and Gynecology, Diakoneo Diak Klinikum Schwäbisch Hall, Germany. Data on clinical, pathology, immunohistochemistry, and follow-up characteristics were retrieved from the clinic’s database. To interpret the data, we used the software IBM SPSS Statistics 20, and, to account for multiple comparisons, we used a Bonferroni-adjusted significance level of 0.004. In the survival analysis, the Kaplan–Meier method and the log-rank test of equality of survival distributions were applied. Results: Among 2016 female breast cancer cases, 84.5% (1703/2016) were hormone receptor (HR)-positive. The 5-year overall survival was 0.873 (95% CI (0.851, 0.895); 99.6% CI (0.841, 0.905)) for HR-positive patients and 0.760 (95% CI (0.713, 0.807); 99.6% CI (0.691, 0.829)) for HR-negative patients (p < 0.001). Statistically significant differences were observed among HR+/HER2+, HR+/HER2−, HR−/HER2+, and triple-negative subtypes (p = 0.003). When comparing survival distributions based solely on HER2 expression (positive vs. negative), no statistically significant difference was observed (p = 0.29). Conclusions: Statistically significant differences in unadjusted overall survival distributions were observed among breast cancer molecular subtypes. HR-positive breast cancers demonstrated better overall survival than HR-negative cancers, while no statistically significant difference in unadjusted survival was observed between HER2-positive and HER2-negative groups. Full article

High temperatures are one of the most important abiotic stressors affecting the survival and growth of American shad (Alosa sapidissima). Building on previous omics sequencing studies of A. sapidissima liver and gills under high temperature stress, this study focused on investigating the regulatory role of miR-1236-3p and its target gene hsp90b1. The results indicate that the full-length cDNA of the hsp90b1 gene is 2023 bp and comprises a 5’ end of 58 bp, a 3’ end of 84 bp, and a coding region of 1881 bp, encoding 626 amino acids. Sequence alignment and phylogenetic tree analysis reveal that the hsp90b1 sequence is highly conserved across species. In situ hybridization showed that hsp90b1 is mainly localized in the cytoplasm. Software prediction identified a potential binding site between miR-1236-3p and hsp90b1. Through the construction of wild-type and mutant 3’UTR hsp90b1 dual luciferase reporter plasmids, the targeted relationship between the two was confirmed. In addition, the spatiotemporal expression levels of the hsp90b1 was found to be highest in the multicellular stage and liver tissue at a cultivation temperature of 27 °C; miR-1236-3P was highly expressed in the hatching stage and heart tissue at 30 °C. These findings provide a theoretical foundation for further investigating the regulatory role of non-coding RNA in A. sapidissima heat stress and offer data for subsequent molecular breeding studies. Full article

Background/Objectives: Patients with pancreatic neuroendocrine tumors (PanNETs) often have a good prognosis with long overall survival. We evaluated quality of life (QoL) after surgery for PanNETs, using the new EORTC-specific questionnaires. Methods: PanNET patients operated on in our unit (1990–2023) received three EORTC questionnaires (QLQ-C30 and the new P.NET15 and P.NET19). We evaluated the following: (1) QLQ-C30 outcomes; (2) mixed domains from QLQ-C30, P.NET15, and P.NET19; and (3) domains from P.NET19 and P.NET15 only. Functional and symptom scales were investigated in relationship with clinical variables. Gamma regression and multivariable analyses were performed with R software. Results: The 100 patients enrolled (median time 133 months after surgery) showed a good QoL (median 83.3/100). Old age was related to worse QoL and physical functioning (p = 0.007 and p < 0.001, respectively). Diabetes negatively influenced QoL (p < 0.001), physical functioning (p = 0.005), and fatigue (p = 0.03). Patients undergoing parenchyma-sparing surgery showed less fatigue (p = 0.046), while non-insulinoma PanNET diagnosis was related to worse QoL (p = 0.039). Multiple comorbidities were negatively associated with physical functioning (p = 0.010), fatigue (p = 0.001), and pain (p = 0.021). According to the new questionnaires, the most affected outcome was muscle energy, depending on age (p = 0.042), diabetes (p = 0.014), type of surgery (p = 0.018), and non-insulinoma diagnosis (p = 0.007). Conclusions: A good QoL evaluated with EORTC questionnaires is reported in PanNET patients after surgery. Elderly and diabetic patients who underwent standard resection for gastrinoma/non-functioning PanNETs showed worse QoL outcomes. Full article

Objective: This study aimed to identify the factors associated with overall survival (OS) in adult patients with primary gliomas, construct a nomogram prediction model, and evaluate its predictive performance. Methods: Clinical data were retrospectively collected from adult patients newly diagnosed with gliomas who underwent surgical treatment in the Department of Neurosurgery of the Fourth Hospital of Hebei Medical University, between January 2019 and December 2023. External validation was conducted using data from the China Glioma Genome Atlas (CGGA) database. Data analysis and visualization were performed using SPSS 26.0 and R software (Version 4.4.1). Results: A total of 257 adult patients were included in this study. Multivariate Cox regression analysis identified age, Karnofsky Performance Status (KPS) score, tumor diameter, WHO grade, and postoperative radiotherapy and chemotherapy, as well as the expression of ATRX, IDH1, and Ki-67, as independent prognostic factors. These factors were incorporated into a nomogram for predicting 1-year, 2-year, and 3-year survival rates. The model demonstrated excellent discrimination, calibration, and clinical utility in both internal and external validations. Conclusions: The nomogram model incorporating clinical factors (age, WHO grade), treatment (radiotherapy, chemotherapy), and tumor markers (ATRX, IDH1, Ki-67) has good predictive efficacy and may serve as a practical and effective alternative to molecular testing for prediction of survival in adult patients with primary glioma. Full article

Background/Objectives: This single-center, randomized controlled clinical trial evaluated the impact of two crown materials—lithium disilicate (LS2) and a polymer-infiltrated hybrid ceramic (HC)—on the marginal bone loss (MBL) and the technical complications in implant-supported single-tooth restorations over a three-year period. Methods: Sixty patients with posterior single-tooth gaps were randomly assigned to receive either LS2 or HC crowns on iSy (Camlog) implants. All of the restorations were fabricated as CAD/CAM-based hybrid abutment crowns bonded to prefabricated titanium bases. Standardized radiographs were taken at the baseline (T0) and at three years (T1) to assess the MBL using ImageJ software. The technical complications were prospectively recorded. The data analysis was descriptive and exploratory. Results: Fifty-eight cases were available for the final evaluation. The three-year implant survival rate was 100%. The mean marginal bone remodeling was minimal (mesial: LS2 0.15 mm, HC 0.08 mm; distal: LS2 0.13 mm, HC 0.12 mm), with no statistically significant intergroup differences. Bone apposition was observed in 74.1% of the cases. The male patients showed a significantly greater mesial bone loss (p = 0.024). Technical complications occurred more frequently in the HC group, including crown fractures (25%), decementation (17.9%), and screw loosening (14.3%). In the LS2 group, only screw loosening (12.5%) was observed. Conclusions: The lithium disilicate-based hybrid abutment crowns demonstrated a high clinical reliability with stable peri-implant bone and fewer technical complications over three years. In contrast, the hybrid ceramic crowns were associated with a higher rate of mechanical failure. Material selection should therefore be a key consideration in planning implant-supported single-tooth restorations. Full article

Yin Yang 1 (YY1) is a multifunctional transcription factor implicated in gene regulation, cell proliferation, and survival. While its role in breast cancer (BC) has been explored, its prognostic significance remains controversial. In this study, we evaluated nuclear YY1 expression in 276 BC tissue samples using immunohistochemistry (IHC), tissue microarrays (TMAs), and digital pathology (DP). Nuclear staining was quantified using Aperio ImageScope software, focusing on tumor regions to avoid confounding from stromal or non-tumor tissues. This selective and standardized approach enabled precise quantification of YY1 expression. Our results show elevated median YY1 expression in tumor vs. normal matched tissues (p < 0.001). The optimal cutoff for medium-intensity nuclear YY1 expression in tumor areas for overall survival (OS) was established by a receiver operating characteristic (ROC) curve (AUC = 0.718, 95% CI: 0.587–0.849, p = 0.008). In contrast, ROC curves showed no prognostic impact (AUC and p-value) for YY1 quantification in whole spots (tumor + normal). As a categorical variable, high YY1 expression was correlated with more aggressive BC features, including tumor size > 3 cm (57.7% vs. 44.2% p = 0.037), the triple-negative breast cancer (TNBC) molecular subtype (27.3% vs. 13.9% p = 0.026), and advanced prognostic stage (III) (31.8% vs. 16.7% p = 0.003), while as a continuous variable, YY1 was associated with higher histological (p = 0.003) and nuclear grades (p = 0.022). High YY1 expression was significantly associated with a reduced OS of BC patients, as shown by Kaplan–Meier curves (HR = 2.227, p = 0.002). Since YY1 was significantly enriched in TNBC, we evaluated its prognostic resolution in this subgroup. But, probably due to the small number of patients within this subset, our results were not statistically significant (HR = 1.317, 95% CI: 0.510–3.405, p = 0.566). Next, we performed multivariate Cox regression, confirming YY1 as an independent prognostic factor for overall survival (HR = 1.927, 95% CI: 1.144–3.247, p = 0.014). In order to improve prognostic value, we constructed a mathematical model derived from the multivariate Cox regression results, including YYI, AJCC prognostic stage (STA), and axillary lymph node dissection (ALN), with the following equation: h(t) = h₀(t) × exp (0.695 × YY1 + 1.103 × STA − 0.503 × ALN). ROC analysis of this model showed a better AUC of 0.915, similar sensitivity (83.3%), and much higher specificity (92%). Bioinformatic analysis of public datasets supported these findings in BC, showing YY1 overexpression in multiple cancer types and its association with poor outcomes in BC. These results suggest that YY1 may play a role in tumor progression and serve as a valuable prognostic biomarker in BC. DP combined with molecular data enhanced biomarker accuracy, supporting clinical applications of YY1 in routine diagnostics and personalized therapy. Additionally, developing a combined score based on the modeling of multiple prognostic factors significantly enhanced survival predictions, representing a practical tool for risk stratification and the guidance of therapeutic decisions. Full article

Objectives: Cervical cancer remains a significant global health burden for women. While neoadjuvant chemotherapy (NACT) has emerged as a potential treatment option, the prognostic implications of early non-response to NACT remain inadequately characterized. This systematic review aims to elucidate the association between early non-response to NACT and long-term disease-free survival (DFS) in cervical cancer patients. Methods: A comprehensive systematic review was conducted following PRISMA guidelines. PubMed, Embase, Elsevier, Springer, EBSCO, and Cochrane Library were systematically searched to identify eligible studies. Pooled hazard ratios (HRs) for DFS with 95% confidence intervals (CIs) were calculated using R software (version 4.5.1). Heterogeneity was assessed via Cochran’s Q test and I² statistics. Publication bias was evaluated using funnel plots, Begg’s test, Egger’s test, and trim-and-fill methods. Sensitivity analyses further validated result robustness. Results: Eleven studies (n = 2064 patients; 1546 responders, 518 non-responders) met inclusion criteria. The pooled early non-response rate ranged from 13% to 39%. Early non-response significantly correlated with poorer DFS (HR = 3.29, 95% CI 2.35–4.62). Subgroup analyses by response criteria showed HRs of 2.94 (95% CI 1.72–5.03) for WHO criteria and 4.00 (95% CI 2.52–6.34) for RECIST criteria. No significant publication bias was detected (Begg’s p = 0.35; Egger’s p = 0.28). Sensitivity analyses and trim-and-fill adjustments confirmed result stability. Conclusions: Early non-response to NACT predicts worse DFS in women with cervical cancer. These findings proposed the need for large-scale or prospective studies to validate the prognostic value of early non-response and optimize treatment strategies for non-responders. Future prospective trials with standardized protocols are essential to validate these findings and establish criteria for optimizing patient selection for NACT-based therapeutic strategies. Full article

Background/Objectives: Catheter ablation is an established therapy for ventricular tachycardia (VT), though outcomes remain limited in patients with non-ischemic dilated cardiomyopathy (NIDCM) due to complex arrhythmogenic substrates. Late iodine enhancement computed tomography (LIE-CT) offers a promising alternative to cardiac MRI for preprocedural substrate visualization. This study evaluated procedural characteristics and outcomes of LIE-CT-supported VT ablation versus conventional mapping (CM) in NIDCM patients. Methods: NIDCM patients undergoing VT ablation between January 2022 and August 2024 were retrospectively analyzed. LIE-CT data were processed using inHEART software. Patients were matched 1:1 by propensity score based on baseline characteristics, electrical storm, and prior ablations. Results: A total of 46 patients (mean age 59 ± 16.4 years, 74% male) were included (23 LIE-CT, 23 CM). Procedure durations were comparable (231.5 ± 74.2 vs. 220.2 ± 70.2 min, p = 0.5), but mapping time (35.9 ± 15.3 vs. 54 ± 5 min, p < 0.001) and fluoroscopy time (14.7 ± 5.1 vs. 21.3 ± 10.6 min, p = 0.02) were significantly shorter with LIE-CT. Epicardial access was more frequent (52% vs. 26%, p < 0.001), and bipolar ablation for intramural scar was performed in 17% of LIE-CT cases. There were no significant differences in acute kidney injury or 30-day mortality. At a median follow-up of 367 days, VT-free survival was 57% with LIE-CT and 52% with CM (p = 0.8). Conclusions: LIE-CT-supported VT ablation and substrate visualization was safe, without additional risk of acute kidney injury, and enabled more efficient and targeted VT ablation. Prospective studies are warranted to assess its impact on long-term outcomes in NIDCM patients. Full article

Objective: To evaluate the impact of body composition parameters, including specifically sarcopenic obesity (SO), on postoperative and oncological outcomes in patients undergoing radical cystectomy (RC) for bladder cancer, thereby addressing a paucity of data in this setting. Methods: A retrospective observational study was conducted in patients who underwent RC. Preoperative CT scans were analyzed using semi-automatic segmentation software to assess body composition parameters, with measurements of adipose and muscle tissue obtained at the level of the L3 vertebra. Results: A total of 249 patients were included, of whom 127 (52.5%) met the criteria for sarcopenia, 53 (21.3%) for obesity, and 14 (5.6%) for SO. Multivariate analysis identified previous abdominal surgery (OR 2.56, 95% CI 1.24–5.23, p = 0.011), total serum protein level (OR 0.57, 95% CI 0.36–0.88, p = 0.013), and SO (OR 7.01, 95% CI 1.06–37.05, p = 0.045) as independent predictors of 90-day postoperative complications. Patients with SO experienced significantly higher rates of abdominal wall complications (p = 0.03). However, in multivariate analyses, SO was not associated with overall survival (despite a p value of 0.04 at univariate analysis), cancer-specific survival, or progression-free survival. Conclusions: Preoperative CT-based assessment of body composition is a valuable tool in the surgical evaluation of patients undergoing RC. SO appears to be an independent predictor of short-term postoperative complications and should be considered when planning prehabilitation strategies. Full article

Background: Seminoma is the most common subtype of testicular germ cell tumors in young men; however, the contribution of tumor-associated macrophages (TAMs) to disease progression remains insufficiently understood. This study aimed to quantitatively and phenotypically characterize CD68⁺ and CD163⁺ TAMs in non-metastatic seminomas (pT1N0M0 and pT2N0M0). Methods: This retrospective, multicenter, cohort, observational, analytical study was conducted from 1 January 2015 to 1 January 2025 at two branches of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation: the A. Tsyb Medical Radiological Research Center and the P. Hertsen Moscow Oncology Research Institute. Archived paraffin-embedded tumor samples from 96 patients and 21 samples of normal testicular tissue were analyzed using immunohistochemistry and digital morphometric analysis with QuPath software to assess macrophage density and spatial distribution. Results: Compared to normal testicular tissue, seminomas demonstrated more than a 10-fold increase in CD68⁺ TAMs and over a 100-fold increase in CD163⁺ TAMs. CD68⁺ cells predominantly localized to peripheral tumor regions, while CD163⁺ cells formed diffuse clusters in central tumor zones and around peripheral vessels. No statistically significant differences in CD68⁺ cell density were found between pT1 and pT2 stages. However, pT2 tumors showed a trend toward higher CD163⁺ TAMs density, suggesting increased M2 polarization with advancing tumor stage. Conclusions: These findings highlight the spatial and phenotypic heterogeneity of TAMs in seminoma and indicate a shift toward an immunosuppressive tumor microenvironment during local progression. Future studies should assess macrophage polarization and progression-free survival to evaluate their potential as prognostic biomarkers and therapeutic targets in seminoma. Full article

Simulating scenarios under climate change is essential to understanding vegetation dynamics, ensuring the survival of forage species, and minimizing uncertainties in project costs and timelines. This study aimed to simulate historical probabilities and develop a biomass production model using PHYGROW software (Texas A&M University, College Station, TX, USA), combined with Monte Carlo Simulation (MCS) in the @RISK program (Ithaca, NY, USA), to evaluate long-term biomass production in a native pasture area of the Caatinga biome. The results show strong agreement between software estimates and field data. For 2016, PHYGROW estimated 883 kg/ha, while field measurements reached 836.8 kg/ha; for 2017, 1117 kg/ha was estimated, while 992.15 kg/ha was observed. For 2018, the model estimated 1200 kg/ha compared with 1763.5 kg/ha in the field, and for 2019, 1230 kg/ha was estimated versus the 1294.3 kg/ha observed. The Monte Carlo simulations indicated that the Weibull distribution best fitted the synthetic series, with 90% adherence. Biomass production values ranged from 618 to 1427 kg/ha with a 90% probability. Only 5% of the simulations projected values below 600 kg/ha or above 1400 kg/ha. Moreover, there was a 95% risk of production issues if planning was based on biomass values above 1000 kg/ha. These findings highlight PHYGROW’s potential for pasture management under semi-arid conditions for predicting and avoiding degradation scenarios that could even lead to areas of desertification. Full article

Background: This study evaluated the prognostic significance of quantitatively assessed interstitial lung abnormalities (ILAs) after lung cancer surgery. Methods: We included patients with pathologic stage I non-small-cell lung cancer (NSCLC) who underwent segmentectomy or lobectomy. ILAs were quantified using deep learning texture analysis software. Five-year overall survival (OS) was compared before and after propensity score matching. Competing risks for lung cancer and non-cancer mortality were also analyzed. Results: Among the 1711 patients, 263 (15.4%) comprised the ILA group. The ILA group was older and had a higher proportion of smokers and pathologic stage IB cases (all p < 0.001). The median follow-up period was 48.0 months. Before matching, 5-year OS was significantly worse in the ILA group than in the non-ILA group (82.5% vs. 93.4%, p < 0.001). After 2:1 matching (N = 697), 5-year OS remained lower in the ILA group (85.8% vs. 91.1%, p = 0.025). Multivariable Cox regression analysis showed that the presence of ILAs was associated with increased risk of all-cause mortality (HR 1.52, 95% CI 1.05–2.18, p = 0.025). Restricted cubic spline analysis revealed a nonlinear increase in mortality risk with greater fibrotic ILA burden. In competing risk analysis, death from lung cancer was similar between groups (2.9% vs. 4.2%, p = 0.3), whereas death from other causes was significantly higher in the ILA group (13.0% vs. 3.7%, p < 0.001). Conclusions: Quantitative assessment of ILAs may provide prognostic value in resected stage I NSCLC, particularly in patients with fibrotic changes. Full article

Spain is among the European countries with the greatest number of preserved castles and defensive structures—some estimates place the total at around 10,000, the majority of which date back to the medieval period. Yet, surprisingly, many of these fortifications remain uncatalogued and in an advanced state of ruin. This study focuses on a small fortress that has been overlooked by historiography and neglected by public authorities, yet which still stands after seven centuries: the Tower of Lopera, a castle belonging to the so-called Banda Morisca (the frontier of Al-Andalus in the 14th century). Using a combination of digital documentation techniques—namely, portable laser scanning, photogrammetry (via drone and camera), and digital image processing software—we have been able to digitize, geometrize, and document both the surviving architectural remains and their immediate physical environment. Rather than pursuing the latest technological innovations, this methodology prioritizes practical and realistic solutions based on the resources typically available to cultural heritage administrations. Our work serves two main objectives: to demonstrate the viability of applying such tools to this typology of architectural heritage and to conduct a detailed graphic and geometric analysis of the structure. Given the abundance of similar abandoned fortresses in Spain, the findings presented here could inform future heritage documentation strategies on a broader, potentially national, scale. Full article

Improving curriculum structure is critical for enhancing student success and on-time graduation, yet few methods exist to evaluate how prerequisite paths shape student progression and graduation outcomes. This study proposes a data-driven, graph-based framework that integrates course prerequisite networks with student performance data to systematically analyze curricular structure and student outcomes. We identify high-risk courses by jointly modeling their structural importance and pass rates, and quantify the time and survivability of different prerequisite paths using probabilistic models. Additionally, we introduced grade transition patterns to capture more nuanced transitions in student performance and pinpoint bottlenecks along prerequisite paths. Applying the model on four science and engineering majors from a public institution, the results not only identify high-risk courses often missed in conventional analyses, but also reveal path-level disparities and structural bottlenecks that affect student progression and time to graduation. For example, in the Computer Science major, we identified that the architecture and operating systems pathway is more challenging than the software engineering pathway. A closer examination of the course pairs along this trajectory revealed that the difficulty stems from a significant drop in student performance between a prerequisite–successor course pairs.This type of analysis fills a gap in conventional curriculum studies, which often overlook path-level dynamics, and offers actionable insights for educators a to identify high risk curricular components. Full article

Background: Intracerebral hemorrhage management presents clinicians with a significant therapeutic challenge. Maintaining antiplatelet therapy potentially increases the risk of recurrent bleeding, while discontinuation heightens susceptibility to ischemic stroke, particularly during the critical first month after hemorrhage. In contemporary practice, physicians demonstrate considerable hesitancy regarding early antiplatelet reinitiation, complicated by the absence of clear evidence-based treatment guidelines. Aim: This meta-analysis assesses the safety of early antiplatelet resumption following ICH. Methods: We conducted a systematic review by searching Web of Science, Scopus, PubMed, and Cochrane Library from inception to April 2025. Articles were independently screened and data extracted by two reviewers who also assessed study quality. The inclusion criteria are enrollment of adults (≥18 years) with imaging-confirmed intracerebral hemorrhage surviving >24 h, comparing early vs. delayed or withheld antiplatelet therapy. Randomized trials underwent separate evaluation using Cochrane’s Risk of Bias. Statistical analysis was performed using R software (version 4.4.2), with categorical outcomes pooled as risk ratios (RRs) with 95% confidence intervals. Statistical significance was established at p < 0.05. The evidence is limited by the availability of few RCTs, variable antiplatelet regiments, male predominance, and other confounding factors. The review was registered in SFO. Results: Our meta-analysis included 10 studies (8 observational, 2 RCTs) with 5554 patients. Early antiplatelet therapy significantly reduced recurrent intracerebral hemorrhage by 46% (RR 0.54, 95% CI 0.37–0.78, p = 0.001). All-cause mortality showed a non-significant difference (RR 0.81, 95% CI 0.65–1.01, p = 0.06). No significant differences were found for ischemic stroke (RR 0.99, 95% CI 0.60–1.63, p = 0.96), major hemorrhagic events (RR 0.75, 95% CI 0.49–1.13, p = 0.17), or ischemic vascular outcomes (RR 0.71, 95% CI 0.49–1.02, p = 0.60). Conclusions: Our meta-analysis reveals that early antiplatelet therapy following intracerebral hemorrhage significantly reduces recurrent hemorrhagic events (46% reduction) without increasing major ischemic or hemorrhagic complications. Full article