Sex-based differences influence tumor biology, immune responses, and treatment outcomes in renal cell carcinoma (RCC), yet most computational models do not jointly incorporate sex hormones, immune composition, and tumor genetic evolution. Agent-based models (ABMs) effectively simulate tumor-immune interactions but are rarely extended to include sex-specific modulation or machine learning-based optimization. This study enhanced an agent-based learning model (ALM) to simulate RCC progression and treatment response by integrating hormonal effects, immune interactions, and tumor genetic adaptation with data-driven tuning.

An RCC-specific ALM was developed incorporating immune agents (CD8+, NK, Treg, dendritic cells), hormone-sensitive mechanisms, tumor genetic modules, and effects of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs). Tumor evolution was modeled using a genetic algorithm simulating promoter and gene mutations, with fitness defined by immune evasion and proliferation advantages. Model parameters were optimized using clinical outcomes from the ARON dataset via the Optuna framework, and performance was assessed using concordance index (CI) and mean squared error (MSE).

Simulations reproduced sex-specific treatment responses. Female models showed delayed initial responses but stronger late immune activation and rapid tumor regression, whereas male models exhibited more stable early responses but greater tumor resilience driven by genetic adaptations. Adaptive learning showed capability of reducing prediction error with both fitness functions.

This ALM offers an exploratory framework to provide preliminary insights into how sex hormones, immune dynamics, and tumor genetics may jointly contribute to shaping RCC treatment outcomes. Although the limited sample size constrains validation, the results suggest the potential of combining ABMs with biological data-driven optimization to support patient prediction and call for further investigation in larger cohorts.

Thyroid diseases vary geographically, with iodine deficiency being a major cause in Africa. These conditions range from congenital anomalies to acquired neoplastic and non-neoplastic lesions.

To establish baseline data on the frequency and patterns of thyroid lesions diagnosed in a teaching hospital's histopathology department over an 11-year period (2012-2022).

A retrospective descriptive study was conducted using slides and paraffin-embedded blocks of thyroidectomy specimens from January 2012 to December 2022. Clinical data including age, sex, and histological diagnosis were retrieved and analyzed using SPSS version 23.0.

A total of 111 thyroid lesions (2.4% of all cases) were reviewed, with a female-to-male ratio of 5.5:1 and a mean age of 42.5 years (SD = 12.94). Hyperplastic lesions predominated (76.6%), comprising nodular hyperplasia (45.0%) and diffuse goitre (31.5%). Neoplasms accounted for 18.9%, including papillary carcinoma (7.2%) and follicular carcinoma (4.5%). Congenital and inflammatory lesions were least frequent. Neoplasms peaked in the fourth decade, with significant associations between age, gender, and lesion type (p < 0.001).

Thyroid lesions showed strong female predominance. Non-neoplastic conditions were most common, with peak incidence between the fourth and sixth decades.

Colorectal cancer (CRC) ranks as the third most prevalent malignancy globally, with incidence rates rising steadily in Algeria. Prognostic assessment of CRC increasingly relies on molecular profiling, particularly mutations in the KRAS gene a critical determinant of resistance to anti-EGFR therapies in metastatic disease.

This study investigates the KRAS mutational spectrum and its association with clinicopathological features in CRC patients from Batna, Eastern Algeria.

In a retrospective analysis of 91 cases, KRAS mutations were identified in 46.2% of tumors (wild-type: 58.3%) using RT-PCR and sequencing.

The most frequent alterations localized to codons 12 and 13 (exons 1-2), with p.G12D (c.35G>A) and p.G13D (c.38G>A) predominating. Strikingly, KRAS mutation status showed no significant correlation with age, sex, tumor size, histology, metastatic pattern, or TNM stage suggesting its role as an independent molecular driver rather than a surrogate for conventional prognostic markers.

These findings underscore the high prevalence of KRAS mutations in Algerian CRC patients and highlight their potential utility in refining therapeutic strategies, particularly for anti-EGFR eligibility. The study provides the first regional dataset from Eastern Algeria, addressing a critical gap in North African oncogenomics.

Early-onset (<50 years) and never-smoker lung cancers are increasing global concerns. The emerging trends challenge current screening guidelines, which focus on adults aged >50 years with heavy smoking histories. We applied the US Preventive Services Task Force (USPSTF) 2021 screening criteria as the primary definition of high-risk individuals eligible for lung cancer screening and assessed the potential optimization of these criteria using real-world lung cancer data in China.

In this nationwide, multicenter, hospital-based observational study, we enrolled asymptomatic patients with surgically resected primary lung cancer across 26 tertiary hospitals from January 1, 2014 to December 31, 2021. Screening eligibility was classified using USPSTF 2021 criteria (aged 50-80 years, ≥20 pack-year smoking history, and ≤15 quit-years for former smokers). Temporal trends in eligibility, screening utilization, and mortality risks were assessed through joinpoint regression and Cox proportional hazards models.

A total of 106,266 asymptomatic patients with lung cancer were enrolled. Among the 102,555 patients with complete age and smoking information, only 8.8% (8985/102,555) met the USPSTF 2021 eligibility criteria. The eligibility proportion declined sharply from 21.6% (350/1617) in 2014 to 6.1% (1737/28,582) in 2021, with the annual percentage change being -17.4% [95% confidence interval (CI) -19.1 to -15.9]. Patients with screening utilization, irrespective of eligibility status, demonstrated a higher proportion of stage Ia diagnoses compared with those who were not screened. Screening- ineligible group exhibited 40% lower mortality risk overall [adjusted hazard ratio (HR)=0.60, 95% CI 0.55-0.66], with consistent survival advantages across stage I (adjusted HR=0.63, 95% CI 0.54-0.74) and stage III (adjusted HR=0.76, 95% CI 0.64-0.90) subgroups.

Rigid age- and smoking-based criteria overlook substantial at-risk populations in China. Implementing individualized risk stratification is essential to advance equitable lung cancer screening.

WHO's global target of eliminating cervical cancer is just 5 years away, and women living in low-resource settings like Nigeria may be left behind, because a significant proportion may not be aware of cervical cancer and its preventive measures. Thus, there is an urgent need to review and possibly scale up awareness of cervical cancer prevention among women residing in rural communities in Nigeria through free medical outreach programs. The aim of this study was to assess the level of awareness and perceptions of cervical cancer prevention among participants of a community health outreach program in Ituku, Enugu State, Nigeria.

This mixed-methods study was a quantitative survey of 352 participants and qualitative interviews of 10 purposively selected women attendees at the 2024 free medical outreach at the community of Ituku, Awgu local government area, Enugu State. A pre-tested and validated questionnaire was used to collect data from participants. Quantitative data analysis was done using the Statistical Package for the Social Sciences, while thematic analysis was done for qualitative components.

Out of 525 eligible women who attended the health outreach, 352 (67.0%) were recruited into the study. Awareness of cervical cancer was reported by 27.8% (n=98) of respondents, while 27.3% (n=96) were aware of cervical cancer screening methods. Only 9.1% (n=32) had heard of HPV vaccination as a preventive measure, and 4.5% (n=16) were aware that HPV infection is a causative factor for cervical cancer. Only 4.5% (n=16) of respondents had ever undergone cervical cancer screening. Awareness of screening methods was associated with age of 40 years or less and being Roman Catholic, while willingness to vaccinate children was associated with having formal education.

In a rural community in Enugu State, Nigeria, only 3 out of every 10 women were aware of cervical cancer and its preventive measures. Although 1 in every 10 knew that HPV vaccination prevents against cervical cancer, over 9 of 10 of them were willing to vaccinate their children. To join the global community in eliminating cervical cancer by 2030, there is an urgent need to intensify awareness campaigns through outreach programs targeting rural dwellers in low- and middle-income countries about cervical cancer, its etiology and prevention.

The predictive value of intratumoral microbiota for the efficacy of neoadjuvant immunochemotherapy, as well as the changes in microbiota before and after treatment, has remained largely unexplored.

We employed 2bRAD sequencing for Microbiome (2bRAD-M) to analyze 42 specimens from patients with locally advanced oral squamous cell carcinoma (OSCC), focusing on trends in intratumoral microbiota changes before and after neoadjuvant immunochemotherapy, and predicting responses to the treatment.

(1) There was no significant difference between the MPR_before group and nMPR_before group in terms of α diversity and β diversity at baseline, but Ralstonia_sp.000620465, Methylobacterium_rhodesianum, Methylobacterium_jeotgali, RH_AL1_sp.901457705, Rothia_sp.002418375, and Rothia_mucilaginosa_A, which were enriched in immune-related signaling pathways, were significantly more abundant in the nMPR_before group and could predict the efficacy of neoadjuvant immunotherapy (AUC=0.74) . (2) Importantly, both the α and β diversity of intratumoral microbiota significantly decreased after neoadjuvant immunochemotherapy, regardless of whether we compared the MPR_before group with MPR_after group or the nMPR_before group with nMPR_after group. (3) The abundance of Deinococcus_geothermalis was significantly higher in the nMPR_after group, while Burkholderia_vietnamiensis was enriched in the MPR_after group. These differential microbial populations between the nMPR_after group and MPR_after group were enriched in metabolism-related pathways such as carbon fixation in photosynthetic organisms, taurine and hypotaurine metabolism, and genetic information processing pathways, including homologous recombination and DNA replication.

Neoadjuvant immunochemotherapy markedly alters intratumoral microbiota diversity. Baseline and post-treatment microbiota differences between MPR and nMPR groups implicate specific signaling pathways that may influence treatment efficacy in locally advanced OSCC.

Extragonadal germ cell tumors are rare and have a poorer prognosis compared to testicular germ cell tumors. Although the therapeutic options are similar to those for advanced testicular germ cell tumors, there is uncertainty regarding the efficacy of first-line treatment and effective therapeutic options for second-line treatment or beyond due to the limited cases treated. We retrospectively studied 25 cases of extragonadal germ cell tumorstreated between April 1999 and March 2020. Prognosis was poor in cases that progressed to tertiary treatment, had nonseminomatous tumors, or were categorized as having a poor prognosis according to the International Germ Cell Classification. The findings of this case series indicate that achieving complete remission by up to second-line treatment through multidisciplinary treatment, including surgical resection, is important to avoid cancer mortality.

Breast cancer is a significant public health burden. Despite its critical role in preventing the recurrence of breast cancer, rates of long-term adherence to endocrine therapy (ET) remain low among certain breast cancer survivors. Using embedded sensors in smartphones and wearables, ecological momentary assessment data and health behavior theory may facilitate a richer understanding of the real-world context of medication-taking behaviors, which can aid in the development of personalized interventions.

The objective of this paper is to describe the development of a multiscale modeling intervention (MMI) system to facilitate adherence to daily oral ET for breast cancer survivors. This represents the first phase of a larger project that aims to use machine learning to predict when breast cancer survivors are most likely to miss their ET medications in order to deploy personalized interventions. The purpose of this paper was (1) to determine the acceptability of the proposed MMI system, (2) to identify modifiable predictors of ET medication adherence among breast cancer survivors, and (3) to select surveys or items measuring constructs associated with ET adherence among breast cancer survivors for inclusion in the MMI system.

Study 1 consisted of usability interviews with a cohort of breast cancer survivors (n=25) prescribed ET. For study 1, all qualitative usability interviews were conducted using a semistructured interview guide and assessed whether breast cancer survivors were willing to use various components of the MMI system. Study 2 consisted of (1) a secondary data analysis of ET adherence data from 32 breast cancer survivors using a social cognitive theory framework and (2) a review of research literature of constructs and surveys measuring constructs associated with ET adherence among breast cancer survivors using a social cognitive theory framework. The secondary data analysis included the use of randomized neural network analysis to predict factors strongly associated with medication adherence.

In study 1, usability interview findings suggested that participants were willing to use an ecological momentary assessment smartphone app, a smartwatch and associated smartphone app, a smart pill bottle or smart pill box and associated smartphone app, and the entire MMI system for a 6-month study period. In study 2, the randomized neural network analysis identified 104 survey items with significant contributions to 4-week medication adherence using a threshold of the 70th percentile for feature importance. After a review of peer-reviewed studies, we abstracted modifiable constructs significantly associated with adherence to adjuvant ET and identified 42 surveys used to measure these constructs. When these findings were combined, the final survey for the MMI system consisted of 32 surveys and demographic items.

Our research highlights the use of social cognitive theory, data-driven models, and participant feedback to inform the development of a medication adherence monitoring system. Data from studies 1 and 2 were used to develop a prototype MMI system that will be deployed in a future longitudinal study with 20 breast cancer survivors over 6 months.

The role of infection prevention with fluoroquinolone prophylaxis specifically, during induction chemotherapy in pediatric acute lymphoblastic leukemia (ALL), remains unclear. Therefore, we conducted a systematic review and meta-analysis to assess its efficacy. PubMed, Scopus, and Cochrane databases were systematically searched for randomized controlled trials and observational studies. The main outcome was febrile neutropenia (FN) 26 and secondary outcomes were bloodstream infection (BSI), Clostridioides difficile infection (CDI) and all-cause mortality (ACM). A random-effects meta-analysis was conducted. We included 7 studies with 991 patients; 439 (44.3%) used fluoroquinolone prophylaxis, of whom 255 used levofloxacin and 184 used ciprofloxacin. The B-cell immunophenotype was the most frequent. Fluoroquinolone prophylaxis reduced the risk of FN (46.1% vs 64.9%; OR 0.44; 95% CI 0.33-0.59; I² = 0%). Fluoroquinolone prophylaxis also significantly reduced the risk of BSI (OR 0.50; 95% CI 0.32-0.81; I² = 0%). Risks of CDI (OR 0.43; 95% CI 0.00-42.30; I² = 39.6%) and ACM (OR 1.04; 95% CI 0.20-5.38; I² = 54.3%) were not significantly altered.

Fluoroquinolone prophylaxis during induction chemotherapy for pediatric ALL significantly reduces FN and BSI without increasing C. difficile risk. While overall mortality is unchanged, reducing infectious morbidity may enhance treatment tolerance.

• Febrile neutropenia and bloodstream infections are major causes of treatment-related morbidity and mortality during induction chemotherapy in pediatric acute lymphoblastic leukemia and fluoroquinolone prophylaxis has shown inconsistent results across studies. • Prior evidence suggests potential reduction in infectious complications, but is limited by heterogeneous populations and lack of analyses specific for induction phase.

• This systematic review and meta-analysis focused specifically on the induction phase of pediatric acute lymphoblastic leukemia and demonstrates that fluoroquinolone prophylaxis significantly reduces febrile neutropenia and bloodstream infections with consistent effect across study designs. • The study provides pooled estimate from an specific phase showing no clear increase in Clostridioides difficile infection, demonstrating the risk-benefit profile of fluoroquinolone prophylaxis.

This study aimed to develop and validate a nomogram-based predictive model for acute postoperative pain (APP) in patients undergoing radical resection for colorectal cancer (CRC).

This was a retrospective cohort study designed to develop and validate a nomogram for predicting acute postoperative pain in patients undergoing radical resection for colorectal cancer.

This retrospective analysis included patients who underwent radical CRC resection between January 2021 and December 2022. The study population was divided into a training cohort (n = 126) and a validation cohort (n = 54) using a 7:3 ratio. Risk factors associated with APP were initially screened using least absolute shrinkage and selection operator regression. Subsequently, multivariable logistic regression analysis was conducted to construct the regression model. A nomogram was generated to visualize the predictive model. Model performance was assessed using calibration curves, the Hosmer-Lemeshow goodness-of-fit test, receiver operating characteristic curves with corresponding area under the curve (AUC) values, and decision curve analysis.

The incidence of acute postoperative pain (APP) in the training cohort was 20.63% (26/126). Elevated CA19-9 and AST levels were identified as independent risk factors, while intraoperative nerve blockade, remifentanil administration, and local anesthesia were associated with reduced risk. The nomogram model achieved AUC values of 0.909 and 0.852 in the training and validation cohorts, respectively, demonstrating high sensitivity, specificity, and clinical utility.

Five clinical variables were identified as predictors of APP following radical CRC resection. The validated nomogram offers a practical tool for early risk stratification and may support the implementation of individualized pain management strategies for patients undergoing CRC surgery.