Microvascular invasion (MVI) critically impacts hepatocellular carcinoma (HCC) management. We aimed to develop and validate a deep learning model integrating contrast-enhanced ultrasound (CEUS) and clinical features for assessing MVI risk preoperatively, and to explore its prognostic associations in the thermal ablation (TA) cohort.

We enrolled 688 patients with solitary HCC ≤ 5 cm undergoing CEUS before surgical resection (SR) or TA. CEUS features were extracted via a vision transformer and integrated with clinical features to build an MVI classifier for SR patients. SHAP plots visualized key variables. Recurrence-free survival (RFS) was then compared between model-stratified risk groups in the TA cohort. Cox regression analysis identified risk factors for RFS.

The model achieved AUCs of 0.89 (internal validation) and 0.81 (external validation) for MVI prediction. The decision curve analysis further confirmed the clinical utility. SHAP plots identified AFP-L3%, PIVKA-II, and tumour size as the most influential clinical features. Among the CEUS features, the most significant feature was the arterial-phase dynamic sequence. In the TA cohort, patients with model-predicted high-risk MVI had significantly lower 1-, 2- and 3-year RFS rates (75.5%, 54.9%, 39.4%) compared to those with low-risk (83.8%, 80.0%, 78.0%) (p < 0.001). High MVI risk predicted by the model (HR = 2.90; 95% CI: 1.69-4.96) and AFP-L3% (HR = 1.34; 95% CI: 1.06-1.69) were independently associated with RFS in TA patients.

The model accurately predicted MVI in surgical candidates and showed exploratory prognostic value in TA patients. As a retrospective single-centre study, it warrants prospective validation.

Penile cancer is a rare but preventable malignancy with disproportionately high burden in low- and middle-income countries. In Ghana, data on knowledge of penile cancer among university students, where health information dissemination can have a broader public health impact, are limited. This study assessed penile cancer awareness among university students in Ghana, focusing on knowledge of risk factors, symptoms, and prevention, and identifying misconceptions and perceived barriers to care. A descriptive cross-sectional study was conducted among 781 tertiary students at Kwame Nkrumah University of Science and Technology (KNUST) and Presbyterian University, Ghana (PUG) between April and July 2025. Data were collected using a web-based, self-administered questionnaire administered via Google Forms, and analyzed using Stata version 14, with a focus on descriptive analysis only. Results were summarized using descriptive statistics, including frequencies and percentages for categorical variables and means with standard deviations for continuous variables. Overall awareness of penile cancer was relatively high (613, 78.5%); however, detailed knowledge was limited. Only 299 (38.3%) of the respondents were aware of its causes, 371 (47.5%) recognized symptoms, and 282 (36.1%) knew prevention methods, while 625 (80.0%) reported never having received formal education on the topic. Human papillomavirus infection (508, 65.0%) and poor genital hygiene (471, 60.0%) were the most commonly identified risk factors. Misconceptions were widespread, and 365 (60.3%) of respondents perceived stigma as a barrier to seeking information or care, despite 689 (93.0%) expressing a desire for further education. Penile cancer awareness among tertiary students in Ghana remains suboptimal, with misconceptions and stigma posing barriers to timely care. Targeted, youth-friendly educational interventions within tertiary institutions are needed to improve knowledge, reduce stigma, and promote early presentation, thereby reducing the disease burden in Ghana and similar settings.

Microvascular invasion (MVI) has been identified as a risk factor for the prognosis of patients with hepatocellular carcinoma (HCC). However, it can only be diagnosed pathologically, and thus no widely applicable preoperative MVI risk prediction model has been established. The aim of this study was to develop a preoperative predictive model for MVI.

The model derivation set was derived from a global meta-analysis involving 39,253 patients. Model validation was performed at the First Affiliated Hospital of Nanjing Medical University (Nanjing set), which included 538 participants, and the First Affiliated Hospital of Sun Yat-sen University (Guangzhou set), which included 111 participants. The model's discriminative ability, assessed by the concordance index (C-statistic), and calibration curves for MVI probability were evaluated.

Through meta-analysis, we identified 40 MVI risk factors and utilized the three most widely used preoperative indicators (alpha-fetoprotein [AFP], tumor size, and tumor margin) to establish an MVI risk prediction model. The C-statistics of the scoring model were 0.805 (95% CI 0.765-0.844) in the Nanjing set and 0.808 (95% CI 0.729-0.887) in the Guangzhou set. Calibration of the established preoperative MVI risk prediction model was adequate (all χ² values < 20).

The preoperative MVI risk prediction model developed via global meta-analysis exhibits good discriminative ability in different Chinese validation cohorts. Preoperative assessment of MVI status can guide the selection of hepatectomy type, surgical margin width, and neoadjuvant therapy administration, thereby ultimately improving patient prognosis.

Copyright: &copy; 2026 Kahlon et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Multiple myeloma (MM), the second most common hematologic malignancy in the United States, has undergone transformative therapeutic innovation over the past five decades. Using SEER data from 1975 to 2023, we conducted a retrospective cross-sectional analysis to evaluate MM-specific mortality trends in relation to major treatment milestones. Age-adjusted mortality rates and Annual Percent Change (APC) were estimated using Joinpoint regression. Mortality increased from 1975 to 1994 (APC: 1.43%; P &lt; .01), declined modestly from 1994 to 2002 (&#x2013;0.70%; P = .02), dropped steeply from 2002 to 2009 (&#x2013;1.85%; P &lt; .01), plateaued between 2009 and 2014 (0.52%; P = .10), resumed decline from 2014 to 2021 (&#x2013;1.73%; P &lt; .01), and sharply decreased from 2021 to 2023 (&#x2013;5.64%; P &lt; .01). These inflection points align with the introduction of stem cell transplantation, proteasome inhibitors, immunomodulatory drugs, and next-generation immunotherapies including CAR T-cell therapy and bispecific antibodies. While these advances have improved survival, they also introduced chronic treatment burdens and rising costs. Our findings highlight the real-world impact of targeted therapies on population-level outcomes and underscore the urgent need for care models that ensure accessibility, affordability, and long-term sustainability in the era of precision oncology.

The incorporation of immune checkpoint blockade into preoperative regimens has significantly advanced the clinical management of locally advanced non-small cell lung cancer (NSCLC). Standard imaging modalities frequently fall short in assessing actual pathological regression. Our research sought to evaluate circulating tumor cells (CTCs) as an adjunct predictive tool, while uncovering the transcriptomic shifts within the tumor microenvironment that facilitate cellular shedding.

A prospective cohort of 39 patients with NSCLC received neoadjuvant programmed cell death protein 1 (PD-1) inhibitors combined with platinum-doublet chemotherapy. Preoperative radiographic evaluations using RECIST 1.1 were cross-referenced with final pathological outcomes. Peripheral blood CTCs were enriched and phenotypically characterized via multiparametric immunofluorescence (CK, PD-L1). Bulk RNA-sequencing of residual tissue specimens was performed to identify gene signatures associated with CTC dissemination.

The cohort achieved a major pathologic response (MPR) rate of 38.5%, including a pathological complete response (pCR) rate of 23.1%. Preoperative cytokeratin-positive (CK+) CTC burden emerged as a potential independent predictor of pathological non-response (AUC = 0.757), outperforming total CTCs and PD-L1+ CTCs. Crucially, integrating CK+ CTC counts with standard radiographic imaging improved predictive accuracy for pathological outcomes (AUC = 0.79) compared to imaging alone (AUC = 0.54, p = 0.022). Transcriptomic profiling of the residual tumor microenvironment suggested that CTC dissemination may be associated with enhanced proliferative activity, severe local hypoxia and a broad immunological suppression within local microenvironments.

Preoperative CTC monitoring may serve as a promising complementary biomarker to conventional radiographic imaging, with the potential to help resolve predictive ambiguities in neoadjuvant chemoimmunotherapy for NSCLC.

Upper-third esophageal cancer (EC) is a rare malignancy with limited high-quality evidence to guide treatment. Concurrent chemoradiotherapy (CCRT) remains the mainstay approach. This study aimed to evaluate the efficacy and safety of VMAT/IMRT-based CCRT with a simultaneous integrated boost (SIB) in patients with upper-third esophageal squamous cell carcinoma.

We retrospectively reviewed 59 patients treated with definitive SIB-based CCRT at Vietnam National Cancer Hospital between April 2022 and April 2025. All patients received 59.4-61.6 Gy to the gross tumor and involved nodes using VMAT or IMRT. Outcomes included treatment response, failure patterns, survival rates, and toxicities. Progression-free survival (PFS) and prognostic factors were analyzed using Kaplan-Meier and Cox regression methods.

The complete response rate was 47.5%. One- and two-year PFS rates were 62.4% and 37.2%, respectively; OS rates were 85.0% and 73.1%. Local control at 1 and 2 years was 82.9% and 61.1%. Distant metastasis was the most common failure pattern (59.3%), followed by recurrence at the primary site (48.1%) and regional nodes (40.7%). Grade ≥3 toxicities were infrequent. Pretreatment BMI ≥18.5 kg/m² (p = 0.007) and complete response (p = 0.027) were independently associated with better PFS.

This study provides the first real-world Vietnamese data on SIB-based CCRT for upper-third esophageal cancer, demonstrating feasibility, tolerability, and promising local control with shorter treatment duration. Distant metastasis remains a major challenge, highlighting the need for improved systemic strategies. Future research should focus on combining SIB with modern systemic therapies and refining boost volume definition using advanced imaging to enhance outcomes and support personalized treatment approaches.

Adrenaline is commonly added to local anesthetic solutions to reduce bleeding and prolong analgesia. However, its clinical impact during ultrasound-guided interfascial plane blocks in superficial soft tissue surgery remains insufficiently evaluated. This randomized controlled trial assessed the effect of adding adrenaline (1:200,000) to bupivacaine during ultrasound-guided lipoma plane block.

In this prospective randomized controlled study, 40 adult patients undergoing elective superficial lipoma excision were randomly assigned to two groups (20 patients each). Group A received 0.25% bupivacaine with adrenaline (1:200,000), and Group B received 0.25% bupivacaine alone. Primary outcomes were intraoperative blood loss, operative time, and postoperative pain scores at 2, 6, and 24 hours. Secondary outcomes included need for rescue analgesia, supplemental anesthesia, ease of dissection, capsule integrity, and postoperative complications. Statistical significance was defined as p < 0.05.

Baseline characteristics were comparable between groups. Intraoperative blood loss was significantly lower in Group A (6.2 ± 1.5 mL) compared with Group B (12.7 ± 2.8 mL; p < 0.001). Operative time was shorter in the adrenaline group (12.4 ± 3.1 min vs. 17.8 ± 3.9 min; p = 0.002). Postoperative pain scores were significantly lower in Group A at 2 hours (p = 0.004), 6 hours (p = 0.006), and 24 hours (p = 0.009). Rescue analgesia was required less frequently in Group A (15% vs. 40%; p = 0.038). Ease of dissection and capsule integrity preservation were significantly improved with adrenaline. Minor hematoma occurred less frequently in Group A (5% vs. 20%; p = 0.041). No serious adverse events were observed.

The addition of adrenaline (1:200,000) to bupivacaine in ultrasound-guided lipoma plane block significantly reduces intraoperative blood loss, shortens operative time, and improves postoperative analgesia. Adrenaline appears to be a safe and effective adjunct in superficial lipoma excision.

To assess the level of knowledge about risk factors and prevention of lung cancer among medical students, and to identify differences in knowledge based on the year of study and previous secondary education background.

The study was conducted among 223 students of the School of Medicine, University of Zenica, and the School of Medicine, University Clinical Center Tuzla using an anonymous online survey via the Google Forms platform. The collected data were analyzed using descriptive statistics and the &chi;2 test to assess statistical significance.

The majority of students identified smoking as the main risk factor for lung cancer, while air pollution was rated as the most overlooked risk factor. There were significant differences in the perception of neglected risk factors between years of study (p&lt;0.05). Most students from Zenica acquire their knowledge through formal education, while students from Tuzla more often rely on the internet and media (p&lt;0.05). Additionally, 82.5% of students believe that passive smoking is equally harmful as active smoking, with no significant differences between groups.

Medical students demonstrate a good level of awareness regarding risk factors and prevention of lung cancer; however, there is a need for greater emphasis on environmental risks and passive smoking in their education. The results highlight the importance of continuous education to ensure that future healthcare professionals are equipped to effectively promote health and prevent this disease.

For evaluation of predictive factors of sponataneous conception after saline infused sonosalpingography (SIS).

A prospective study was conducted from August 2023 to December 2024 at reproductive medial unit&nbsp; at Mosul/Iraq. &nbsp;100 women were recruited and categorized in to &nbsp;two groups: pregnant after SIS &nbsp;&nbsp;and non pregnant after SIS , for achievement of&nbsp; conception, the two groups were followed for 6 months duration and their clinical characteristics were compared .

The group where &nbsp;polycystic ovary syndrome (PCOS) positive ladies were included show the duration of infertility for &nbsp;positive pregnancy test &nbsp;ladies was&nbsp; &le; 2 years in 58% versus&nbsp; 42% &gt; 2 years (p=0.0001),the history of cesarean section(CS) shows significant difference between pregnant and non pregnant (p=0.11). time to get pregnant after Saline -enhanced sonography &nbsp;shows 79% &le; 2 months versus 21% &gt; 2 months. the PCOS &nbsp;variable shows significant difference between pregnant women and non (p=0.037),the incidence of &nbsp;pregnancy was 24% markedly &nbsp;higher in first 2 months after doing the SIS equal to 79% , anti-mullerian hormone( AMH) didn&rsquo;t show significant difference While in the group where PCOS positive ladies were excluded show the duration of infertility for pregnant ladies was&nbsp; &le; 2 years in 66.7% versus&nbsp; 33.3% &gt; 2 years (p=0.001),the history of CS shows considerable &nbsp;difference between pregnant and non pregnant (p=0.034). time neded to get pregnant after SIS shows 60% &le; 2 months versus 40% &gt; 2 months.,the pregnancy rate was 21.1% and notably higher in first 2 months after excuting &nbsp;hydrosalpingography equall to 60%&nbsp; ,AMH&nbsp; show significant difference in pregnant was 1.5ng/ml versus 1.2 in non Conclusion: The current study declare that SIS has positive effect on spontaneous conception this is must true in first two months after &nbsp;doing the SIS and it encourage considering expectant management for ladies with briefer duration of infertility, good ovarian capacity and less pelvic operation history.

Breast cancer is the most common cancer found in women including in Indonesia. Breast cancer patients are prone to have anxiety and it affects their quality of life. Interleukin-6 (IL-6) is one of the pro-tumorigenic cytokines that increases in breast cancer and is associated with worse prognosis and cancer metastasis. Several studies demonstrated the correlation between inflammatory cytokines and anxiety disorders. Therefore, this study aimed to determine the correlation between IL-6 and quality of life with anxiety syndrome in patients with late-stage breast cancer.

This cross-sectional study involved women with late-stage breast cancer (Stage III and IV) in Haji Adam Malik General Hospital. IL-6 levels were assessed using Sandwich enzyme-linked immunosorbent assay (Sandwich-ELISA). The quality of life and anxiety syndromes were assessed using the European Organization for Research and Treatment of Cancer 30-Item Quality of Life Questionnaire (EORTC QLQ-C30) and Hospital Anxiety and Depression Scale (HADS)-A questionnaire, respectively. Kruskal-Wallis test was used to determine the correlation between variables. A p-value &lt; 0.05 was considered statistically significant.

Fifty-nine women met the inclusion criteria. The analysis demonstrated that higher IL-6 levels (p &lt; 0.001) and poor QoL (p &lt; 0.001) were related to severe anxiety disorders in late-stage breast cancer patients.

IL-6 level and quality of life were potentially used in the risk stratification and early detection of anxiety syndrome in late-stage breast cancer cases.