Pancreatic enucleation is a parenchymal-sparing procedure used for highly select patients with pancreatic neoplasms. We aim to utilize a multi-institutional health research network platform (TriNetX) and a single, high-volume center to assess complications and identify risk factors associated with post-operative pancreatic fistulas (POPF) after pancreatic enucleation.

A two-tiered retrospective study was conducted. We identified 423 patients from TriNetX, and 34 patients from a single-institution IRB-approved database who underwent pancreatic enucleation between 2004-2025 and 2012-2023, respectively. Univariate and multivariate analyses were performed to determine risk factors associated with post-operative complications and occurrence of POPFs.

In the TriNetX cohort, 128 (30.3%) experienced postoperative complications after pancreatic enucleation. On univariate analysis, hyperlipidemia (HLD) (OR = 2.37), gastroesophageal reflux disease (GERD) (OR = 3.87), acute pancreatitis (OR = 8.28), chronic pancreatitis (OR = 4.76), nicotine dependence (OR = 2.36), ascites (OR = 6.49), deep vein thrombosis (DVT), pulmonary embolism (PE), and thrombophlebitis (OR = 2.95), and body mass index (BMI) ≥ 25 (OR = 1.56) were identified as significant risk factors. On multivariate analysis, acute pancreatitis (HR = 1.64), chronic pancreatitis (HR = 1.78), ascites (HR = 2.96), DVT, PE and thrombophlebitis (HR = 1.74) remained significant. In our single-institution enucleation cohort, 8 patients had a POPF (23.5%). The measured distance from the neoplasm to the main pancreatic duct (MPD) was significantly shorter in patients who developed POPF (2.8 vs 6.5 mm, P < 0.05). ROC analysis determined that shorter distance from the MPD was predictive of POPF occurrence (AUC = 0.79, p < 0.005). Increased estimated blood loss was also associated with POPF (p < 0.01).

Our study identifies clinicopathologic risk factors associated with post-operative complications and POPF after pancreatic enucleation. The distance from the neoplasm to the MPD appears to be a key component of decision-making in the development of POPF.

Single-port endoscopic nipple-sparing mastectomy (E-NSM) with implant-based breast reconstruction (IBBR) represents a promising surgical technique. However, the surgical procedures are complex and lack standardized and systematic surgical protocols. The seven-step method was introduced as a means of simplifying the complex surgical procedures, with detailed descriptions provided of the key points and critical aspects of the surgery.

The medical records of patients who received single-port E-NSM with IBBR guided by the seven-step method from January 2022 to March 2024 were analyzed. The preliminary results were presented.

A total of 65 patients were enrolled in the study, who received 93 procedures of single-port E-NSM with IBBR following the seven-step method. The mean age was 41.7 ± 8.2 years, and the mean body mass index (BMI) was 22.81 ± 3.5 kg/m². All patients had breasts of C cup size or smaller. One case required nipple-areola complex (NAC) removal due to tumor involvement, while no involvement of the surgical margins was detected. The mean operative time was 258.6 ± 71.2 min, and the mean intraoperative blood loss was 27.7 ± 20.5 ml. The overall complication rate was 8.6%, with six cases (6.5%) of nipple partial ischemia observed. No case experienced nipple necrosis. All reported complications were classified as minor. In Breast-Q "Satisfaction with Breasts" module, the mean score was 65.7 ± 18.0. The "physical well-being of chest" score was 73.9 ± 13.6. All four sensory types of the nipple-light touch, temperature, pressure, and pain-as well as erectile function, were preserved at favorable rates following the procedure. As of the last follow-up, no patients experienced local recurrence, distant metastasis, or mortality.

Single-port E-NSM with IBBR, guided by the seven-step method, is a safe and feasibility surgical approach. It is associated with a low complication rate, good cosmetic outcomes, and reasonable preservation of nipple sensation and erectile function. This technique appears particularly suitable for patients with breast sizes of C cup or smaller. The proposed seven-step method may provide a valuable framework for clinical practice and serve as a practical reference for peers, thereby contributing to the establishment of standardized and systematic surgical protocols.

Screening is effective in reducing the disease burden of colorectal cancer, with participation and coverage rates being key determinants of its effectiveness. This systematic review aims to provide a comprehensive assessment of colorectal cancer screening program characteristics and global screening coverage rates. We conducted a systematic literature search in the PubMed and Embase databases from inception to March 2025. Grey literature was obtained from screening program websites and relevant reports. Studies reporting nationwide colorectal cancer screening coverage were eligible for our analysis. A comprehensive overview of essential information and the most recent coverage rates for global screening programs were reported. Temporal trend analyses of coverage rates and subgroup analyses by sex and age were performed. Our results encompassed 45 countries with established national screening programs, among which 33 of them having retrieved coverage rates. Population-based screening programs were predominantly conducted in Europe (25/39), with fecal occult blood testing being the most commonly used modality (38/39). The reported latest screening coverage rates varied greatly across countries, ranging from 1.0% (China, 2020) to 79.4% (Finland, 2021). The coverage of screening program differed slightly between men and women in most countries (men: IQR, 25.3-52.7%; women: IQR, 23.0-65.1%), and coverage increased with age. Temporal trend analysis in 14 countries showed that the majority exhibited increasing or stable screening coverage rates. These findings highlight significant disparities in CRC screening implementation worldwide. Targeted efforts to improve participation and expand coverage are essential, particularly in countries with a high disease burden.

Lipoxygenase family proteins (LOXs) are involved in various stages of tumor development, however, their specific roles in tumor-infiltrating lymphocytes (TILs) within colon adenocarcinoma (COAD) remain poorly defined. This study aims to comprehensively examine LOXs expression in COAD and evaluate their potential associations with immune cell infiltration and clinical outcomes.

We analyzed transcriptomic and clinical data from 477 tumor and 41 adjacent normal tissue samples in the TCGA-COAD dataset to evaluate the expression levels of LOX family genes and their associations with overall survival. To validate ALOXE3 expression, we performed RT-qPCR on fresh tumor and the corresponding matched adjacent tissues from six human colon carcinoma patients. Additionally, immune cell infiltration associated with LOX expression was explored using the TIMER and TISIDB databases. For functional validation, ALOXE3 was either overexpressed or silenced via shRNA in colon cancer cell lines, and its effects on tumor progression were assessed through in vitro proliferation assays and in vivo xenograft models.

Among all LOX family members, only ALOXE3 expression was significantly associated with survival outcomes in COAD patients (overall survival: HR = 1.56, p < 0.05; disease-specific survival: HR = 2.12, p < 0.01; progression-free interval: HR = 1.55, p < 0.05). Functional assays showed that ALOXE3 overexpression significantly promoted tumor cell proliferation in vitro and enhanced tumor growth in vivo, whereas shRNA-mediated knockdown of ALOXE3 markedly suppressed cell proliferation. KEGG pathway analysis of genes co-expressed with ALOXE3 revealed a remarkable enrichment in mitogen-activated protein kinase (MAPK) signlaing pathway. Consistently, ALOXE3 overexpression resulted in activation of the ERK1/2 signaling pathway, as confirmed by Western blot analysis (p < 0.05). Furthermore, treatment with the ERK inhibitor SCH772984 effectively suppressed ALOXE3-induced tumor cell proliferation, suggesting that ALOXE3 may drive tumor growth via activation of the ERK1/2 signaling pathway.

ALOXE3 promotes tumor progression in COAD through activation of the ERK1/2 signaling pathway and exhibits a strong association with the immune cell infiltration of the tumor microenvironment. It may serve as a prognostic biomarker and a potential therapeutic target in COAD. Further studies are warranted to validate its clinical applicability and explore its role in immunotherapeutic approaches.

Bladder cancer (BCa) is a prevalent and lethal malignancy of the urinary system. Recent evidence suggests a strong association between the urinary microbiota and the pathogenesis, progression, and prognosis of BCa. This study investigated the role of the urinary microbiota in BCa, aiming to develop a non-invasive diagnostic model based on microbial biomarkers. Additionally, we proposed a novel urine-based microbiota classification method to enhance diagnostic accuracy and guide treatment strategies.

The study included a discovery cohort (104 BCa patients, 56 with Other Malignant Urological Cancer, 98 with benign urinary diseases, and 42 healthy controls) and a validation cohort (66 BCa patients, 5 with Other Malignant Urological Cancer, 51 with benign urinary diseases, and 22 healthy controls). The urinary microbiota composition was analyzed using 16 S rRNA gene sequencing to assess diversity, identify biomarkers, and construct a diagnostic model for BCa. Finally, clustering analysis was used to establish "Urinetypes".

BCa patients exhibited greater richness and diversity in their urinary microbiota, with significant differences in beta diversity observed across the groups. Genera such as Sphingomonas, Anaerococcus, Acinetobacter, Stenotrophomonas, Aeromonas, and Novosphingobium were more abundant in BCa patients, while Lactobacillus and Gardnerella were less abundant, suggesting their potential as biomarkers. PICRUSt analysis revealed significant enrichment in carbohydrate and nucleotide metabolism in BCa patients, reflecting the increased metabolic demands of cancer cells. A biomarker prediction model employing random forest analysis based on 12 microbial genera achieved high accuracy in the discovery cohort (AUC = 89.08%) and demonstrated robust performance in the validation cohort (AUC = 70.8%). To facilitate potential clinical application, we developed a "Patient Differentiation Index" (PDI), which maintained predictive efficiency in both the discovery cohort (AUC = 86.17%) and the validation cohort (AUC = 78%). Additionally, we identified distinct "Urinetypes", including those dominated by Prevotella and Corynebacterium, which were more prevalent in BCa patients and might represent high-risk subtypes.

This study characterizes the urinary microbiota of BCa patients and, for the first time, provides a reliable non-invasive diagnostic method based on urinary microbiota. The introduction of the innovative concept of "Urinetypes" and the identification of high-risk subtypes associated with BCa offer the potential for improved diagnostic and therapeutic strategies.

This trial was registered on the Chinese Clinical Trial Registry (ChiCTR) with the registration number ChiCTR2300070969, registered on 27 April 2023, https://www.chictr.org.cn/ ChiCTR2300070969. The registration details are publicly accessible on ChiCTR for verification and reference.

The false-negative rate (FNR) of fine needle aspiration (FNA) for clinically positive (suspicious) lymph nodes (LNs) remains excessively high.

We compared the feasibility and diagnostic efficiency of using a novel procedure to FNA for the assessment of clinically positive nodes in patients with early breast cancer. Between 1 January 2015 and 30 September 2023, 198 consecutive patients who consented to undergo axillary biopsy were referred to either the intraoperative ultrasound-guided wire localization group (IOUS-wire) or the ultrasound-guided fine needle aspiration group (US-FNAC). The primary endpoint was the false-negative rate (FNR) and accuracy rates of the two methods. One hundred patients were in the IOUS-wire group, whereas the other 98 patients were in the US-FNAC group.

The FNR of clinically positive lymph node biopsies was lower in the IOUS-wire localization group than in the US-FNAC group (16.1% versus 87.5%, p < 0.001). Among the 32 successfully identified metastatic lymph nodes, 26 (81.3%) were detected in the IOUS-wire group. In the US-FNAC group, 42 additional lymph node metastases were identified via SLNB among patients initially classified as FNAC-negative. The accuracy rates for IOUS-wire and US-FNAC were 95% and 57.1%, respectively (p < 0.001). No significant differences were observed in complications or median SLNs harvested between groups.

IOUS-wire localization with frozen sections demonstrated superior diagnostic performance compared to preoperative US-FNAC in patients with clinically node-positive early breast cancer. This novel method should be further pursued as a potential biopsy method for evaluating axillary node status, particularly in settings where rapid intraoperative decision-making is prioritized.

Not all beverage items are necessarily beneficial for health, but the potential impact of an overall beverage pattern on health remains unknown. We aimed to examine associations of adherence to an overall healthy beverage pattern with all-cause and cause-specific mortality in a prospective cohort of US populations.

We included 8,894 adults from the National Health and Nutrition Examination Survey (2001-2019), a nationally representative cohort of US populations. Dietary data were collected at baseline based on the 24-h recall dietary interview. Using the data, we calculated a healthy beverage score (HBS), where coffee, tea, and low-fat milk received positive scores, while alcohol, fruit juice, artificially sweetened beverages, sugar-sweetened beverages, and whole-fat milk received reverse scores. A higher HBS reflected a healthier beverage pattern. We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of HBS with mortality, adjusting for demographics, dietary and lifestyle factors, and medical history.

During a mean follow-up of 15.5 years, we recorded 2,363 all-cause deaths, including 761 cardiovascular disease (CVD) deaths, 511 cancer deaths, and 1,091 other deaths. Compared with the lowest quartile of HBS, the HRs and 95%CIs of the highest quartile of HBS were 0.79 (0.68, 0.92) for all-cause mortality, 0.75 (0.60, 0.95) for CVD mortality, 0.92 (0.70, 1.22) for cancer mortality, and 0.75 (0.58, 0.98) for other mortality. Inverse linear relationships of HBS with all-cause, and CVD mortality were observed using restricted cubic splines (P_{non-linearity} >0.05). These results were consistent across subgroups predefined by age, sex, smoking status, dietary fiber consumption, hypertension, hyperlipidemia, daily energy intake, and Healthy Eating Index-2015. Results were robust in several sensitivity analyses.

Greater adherence to HBS was associated with a substantially lower risk of all-cause, CVD and other mortality. These findings suggest that greater adherence to a healthy beverage pattern could benefit prevention of premature mortality.

Family relationships play a crucial role in the care and support of patients with terminal cancer, impacting their physical and emotional well-being. This study investigates whether family relationships are associated with caregiver responses in end-of-life (EOL) care for patients with terminal cancer.

This cross-sectional study analyzed data from 172 family caregivers of patients with terminal cancer, collected from nine hospice and palliative care centers in South Korea between June 2021 and May 2023. Standardized tools, including the Caregiver Reaction Assessment (CRA) and the Korean Family Relationship Assessment Scale (FRAS), assessed caregiver burden and family relationships. Analyses were adjusted for variables such as age, gender, marital status, employment status, presence of a spouse, religion, caregiving environment, social support, psychological resilience, and emotional distress. Multivariate regression and subgroup analyses were performed to examine these associations.

The overall FRAS score was significantly correlated with all five domains of caregiver burden, adjusting for various factors (p < 0.01). The financial problems domain of the CRA was positively correlated with family conflict (p < 0.01); however, no correlation was observed with family support and togetherness. In the self-esteem domain of the CRA, positive correlations were observed among caregivers who were older adults, females, spouses, those with lower education levels, married, and those experiencing high emotional distress (p < 0.01). Subgroup analyses revealed variations based on age, gender, caregiver relationship, social support level, resilience, and emotional distress.

These findings emphasize the integral role of family relationships in shaping caregiver experiences for patients with terminal cancer during EOL care.

Breast reconstruction with implants immediately after mastectomy has attracted great attention in recent years. Acellular dermal matrices (ADM) are commonly used for breast reconstruction. However, it has drawbacks such as high cost, infection, and seroma formation. Herein, we present a method for implant-based breast reconstruction using hand-meshed free dermal autograft in pre-pectoral (harvested corium-covered implant (HACCIM)) and partial subpectoral implant-based breast reconstruction procedures.

A total of 22 patients, including 17 patients with unilateral and 5 patients with bilateral breast reconstruction were included in this study. Twenty-seven breasts underwent one-stage pre-pectoral (n = 11) and partial subpectoral (n = 16) implant-based breast reconstructive surgery using patients-derived hand-meshed free dermal autograft. Patients' characteristics, clinical and operative data, and outcomes of interest were examined and recorded.

The median age and BMI of patients who underwent breast reconstruction were 44.5 years (ranging from 34 to 65 years) and 24.97 kg/m² (ranging from 20.57 to 32.87 kg/m²) respectively. The follow-up duration ranged from 2 to 13 months (Median: 8 months). The mean time of free dermal autograft harvest and preparation was 30.26 ± 6.22 min. Superficial skin flap necrosis was observed in 8 breasts (29.63%) with 4 breasts in the partial subpectoral group and 4 in the pre-pectoral group. All minor skin flap necroses were managed successfully by outpatient care. Implant failure occurred in 4 breasts (14.81%), comprising 3 breasts in the partial subpectoral group and one in the pre-pectoral group. Three of the patients who showed implant failure had a history of radiation therapy, and the last one had full-thickness skin flap necrosis related to skin-sparing mastectomy.

Our study indicated that free dermal autograft can be utilized safely in one-stage pre-pectoral and subpectoral implant-based breast reconstruction. Further interventional studies are required to affirm our findings.

The patients may attribute different meanings to diseases and develop various coping mechanisms to cope with them depending on the geography and cultures. In this respect, spirituality is an important dimension that patients frequently refer to in chronic and life-threatening diseases such as cancer. In the Turkiye, the availability of measurement tools designed to assess patients' spiritual needs remains limited. This study aimed to adapt the The Spiritual Needs Assessment for Patients scale into Turkish and examine its psychometric properties.

The scale adaptation process involved the following steps: (1) translation and cross-cultural adaptation and (2) psychometric evaluation, including factor analysis, reliability analysis, and inter-item correlation assessment. 453 patients with cancer were included in the study. The data were collected in 2023. The participants were patients with cancer who were receiving outpatient and inpatient treatment in the medical oncology and hematology clinics of three university hospitals in Turkiye. Data collection tools included the Patient Information Form and the Spiritual Needs Assessment for Patients scale. Validity was examined through content and structural validity assessments, while reliability was measured using Cronbach's alpha coefficient and test-retest reliability.

The content validity index of the T-SNAP was calculated as 80.54%. The exploratory factor analysis indicated 3 factors (psychosocial needs, spiritual needs, religious needs) with 23 items. The combined three factors accounted for 66.92% of the total variance. The factor loadings ranged from 0.43 to 0.96. The Cronbach's alpha coefficient was found to be 0.95, and the test-retest reliability score was 0.96.

The findings suggest that the T-SNAP scale is a reliable and valid tool for assessing the spiritual needs of patients in Turkiye.