• From vision to action: a framework to assess readiness for the tobacco endgame.
    4 days ago
    Tobacco endgame strategies aim to reduce smoking prevalence to minimal levels (<5%) through measures that expand traditional tobacco control approaches. Although some countries have set endgame targets, most still report prevalence rates >15%, and practical guidance on how to assess readiness for endgame implementation remains limited. This study aims to synthetise the key determinants of jurisdictions' readiness for tobacco endgame and proposes a self-assessment tool to evaluate it.

    A narrative review of peer-reviewed and grey literature published between January 2010 and September 2025 was conducted. Publications were identified through targeted searches of academic databases and relevant organisational websites. A thematic synthesis of evidence on political, social and structural determinants of readiness was undertaken to identify recurring domains, which were later used to inform the development of a self-assessment tool.

    Nine readiness domains were identified: relatively low smoking prevalence; advanced implementation of WHO Framework Convention on Tobacco Control measures; robust enforcement infrastructure; social denormalisation of smoking; broad public understanding and support for ending tobacco use; a positive political climate and strong political will and leadership; a cohesive tobacco control community and civil society; minimal tobacco industry interference with strong protective mechanisms; and sufficient resources to implement tobacco endgame action plan. These domains guided the development of an evidence-informed self-assessment tool to help jurisdictions evaluate readiness, identify gaps and prioritise strategic actions.

    The Assessment of Readiness for Tobacco Endgame tool offers an evidence-informed framework to assess tobacco endgame readiness, helping jurisdictions assess capacities, identify gaps and guide strategic decision-making.
    Mental Health
    Advocacy
  • Attitudes towards people with mental disorders: results of a psychometric evaluation and confirmatory factor analysis of the stigma towards people with mental disorders (SToP-MD) scale.
    5 days ago
    Stigmatizing attitudes toward individuals with mental disorders represent a major barrier to treatment, recovery, and social inclusion. The present research introduces and psychometrically evaluates the German-language Stigma Toward People with Mental Disorders scale (SToP-MD) across three independent studies with distinct samples.In study 1 (N = 266), an initial item pool was developed and refined based on theoretical frameworks and exploratory factor analysis. In study 2 (N = 448), confirmatory factor analysis supported a two-factor structure comprising prejudiced stigmatization (SToP-MD-PS) and assumption of problems (SToP-MD-AP). The model demonstrated adequate fit according to conventional indices (CFI = 0.97, TLI = 0.96, SRMR = 0.07), although robust indices indicated only moderate fit (robust CFI = 0.91, robust RMSEA = 0.13). Internal consistency was good for the PS subscale (ω = 0.83) but limited for the AP subscale (ω = 0.51). In study 3 (N = 266), the scale's sensitivity to short-term change was examined following exposure to differently framed media content.As hypothesized, the SToP-MD subscales were positively associated with depression stigma (DSS) and social distance (SDI), and negatively correlated with openness and agreeableness (NEO-FFI), supporting convergent validity. Discriminant validity was partially confirmed by low or non-significant correlations with attitudes toward physically disabled individuals (ATDP), suicide-related cognitions (CCSS), and socially desirable responding (BIDR).Across all three studies, the SToP-MD demonstrated preliminary yet consistent evidence of structural and construct validity, as well as change sensitivity. It captures both overt prejudices and implicit burden assumptions, offering a nuanced assessment of public stigma toward mental disorders. The scale can serve as a valuable tool in stigma research, public health monitoring, and evaluation of interventions. Future research should extend validation to more diverse samples and test predictive and longitudinal utility.
    Mental Health
    Access
    Care/Management
    Advocacy
  • A Viscous DES-AAV-Foxo1 Delivery System With High Transfection Efficiency for the Treatment of Corneal Endothelial Dysfunction by Restoring Mitochondria-ER Contacts.
    5 days ago
    Corneal endothelial dysfunction is a major cause of global blindness, with an estimated 12.7 million patients awaiting corneal transplantation, and the severe shortage of donor grafts underscores the urgent need for non-surgical therapies. Gene therapy offers a promising alternative, but is hindered by the limitations in existing delivery systems and the scarcity of validated molecular targets capable of reversing core pathophysiology. To address this, we first employed multi-omics analysis and identified FOXO1 as a central and under-explored therapeutic target for corneal endothelial dysfunction. In vivo FOXO1 overexpression effectively improved corneal endothelial function by preserving mitochondria-associated endoplasmic reticulum membrane integrity and mitochondrial Ca2 + homeostasis, yet its therapeutic potential was limited by low transfection efficiency. To overcome this, we engineered an AAV-Foxo1 delivery system using a viscous choline chloride-fructose-based deep eutectic solvent (DES) as the carrier. The DES-AAV-Foxo1 delivery system exhibited good biocompatibility, significantly prolonged anterior chamber retention, and enhanced transfection efficiency in corneal endothelial cells compared to conventional AAV delivery. Animal experiments confirmed that it effectively improved corneal endothelial pump activity and mitigates endothelial dysfunction in type 1 diabetes mellitus and Fuchs endothelial corneal dystrophy mouse models. Our findings demonstrated the therapeutic potential of DES-AAV-Foxo1 delivery system for corneal endothelial disorders.
    Diabetes
    Diabetes type 1
    Care/Management
  • Responsiveness and clinical utility of patient-reported outcome instruments in head and neck cancer: a systematic review.
    5 days ago
    To synthesize and evaluate current evidence on the responsiveness, interpretability (MID/MIC), and clinical utility of validated health-related quality of life (HRQoL) patient-reported outcome (PRO) instruments used in adults with head and neck cancer (HNC).

    A systematic search of PubMed, Scopus, Web of Science, Embase, and Cochrane Library (Central) identified studies published from January 2015 to July 2025. The review was registered in PROSPERO (CRD420251128978) and followed PRISMA 2020 guidelines. Observational and interventional studies assessing HRQoL using validated HNC instruments (EORTC QLQ-C30, QLQ-H&N35/H&N43, UW-QOL, FACT-H&N or MDADI) were included. Eligible studies reported responsiveness (ability to detect meaningful change) or clinical applicability. Methodological quality was evaluated using the COSMIN Risk of Bias checklist, and results were narratively synthesized due to methodological heterogeneity.

    Thirteen studies involving 8,075 patients met the inclusion criteria. The EORTC QLQ-C30 and H&N35/43, UW-QOL, FACT-H&N, and MDADI exhibited consistent responsiveness, capturing expected HRQoL deterioration during treatment and partial recovery within 6-12 months. Reported minimal important difference (MID) and minimal important change (MIC) values typically ranged from 4 to 15 points for improvement and 10-20 points for deterioration, supporting the interpretability of change scores. Several patient-reported outcome measures (PROMs) also demonstrated prognostic relevance, with early HRQoL changes associated with survival or recurrence.

    Validated HRQoL questionnaires in HNC demonstrate robust responsiveness and meaningful clinical applicability, supporting their integration into routine oncology practice. Their use may enhance early detection of complications, guide rehabilitative interventions, and facilitate more individualized, patient-centered care.
    Cancer
    Access
    Care/Management
    Policy
    Advocacy
  • Differential patterns of health-related quality of life among low- and high-income cancer survivors in South Korea: a latent class analysis.
    5 days ago
    This study aimed to identify subgroups of health-related quality of life (HRQoL) and examine predictors of latent class membership among low- and high-income cancer survivors using latent class analysis (LCA).

    We analyzed data from the Korea National Health and Nutrition Examination Survey (2013-2020), including 1075 cancer survivors. HRQoL patterns were identified using LCA based on the EuroQol five-dimension questionnaire. Analyses were conducted separately for low- and high-income groups to examine income-stratified HRQoL patterns. Sociodemographic characteristics and chronic disease status were included as covariates in the latent class models to examine predictors of class membership within each income group.

    Income-stratified LCAs suggested differential HRQoL patterns. Three latent HRQoL classes were identified in the low-income group: Good HRQoL, Pain and Mobility Impairment, and Poor HRQoL. In the high-income group, two classes were identified: Good HRQoL and Pain and Mobility Impairment. While education was a common predictor in both groups, other predictors varied by income level. In the low-income group, older age, unemployment, and multimorbidity were significantly associated with impaired HRQoL classes, whereas female sex predicted membership in the Pain and Mobility Impairment class in the high-income group.

    These findings highlight differences in HRQoL patterns and associated factors across income-stratified groups of cancer survivors, underscoring the limitations of relying solely on average HRQoL scores in survivorship care. Survivorship strategies should be tailored to the differential HRQoL patterns and associated predictors identified within each income group, thereby promoting more targeted and equitable care for cancer survivors.
    Cancer
    Access
    Advocacy
  • Tumor-Immune-On-Chip to Evaluate Pathophysiological Feature of T Lymphocytes Expanded from Patient Tumors and Lymph Node Tissues.
    5 days ago
    The infiltration and cytotoxicity of T lymphocytes are critical for cancer immunotherapy efficacy; however, the behavior of these immune cells has not been thoroughly investigated. Herein, a Tumor-Immune-On-Chip is established using cells acquired from the tissues of a patient with colorectal cancer to monitor T lymphocytes. Through the Tumor-Immune-On-Chip, the interaction between tumor spheroid and either T lymphocytes expanded from tumors (tumor-infiltrating lymphocytes; TILs) or lymph nodes (lymph node-derived lymphocytes; LN T cells) are investigated. Although initial 24-h analysis showed no statistical differences, extended 48-h observation revealed a significant deviation in T cell-mediated cell death signals between TILs and LN T cells. TILs demonstrated more potent cytotoxic effects than LN T cells after 48 h. The number of tumor-infiltrating CD3+ cells and cleaved caspase-3 expression levels were 4- and 2.1-fold higher, respectively, in TIL co-cultures compared to LN T cell co-cultures. Therefore, this proof-of-concept platform allows us to explore the patient-specific tumor-immune microenvironment, focusing on different types of T lymphocytes and establishing methodology for future clinical applications. ClinicalTrial.gov identifier: NCT02589496.
    Cancer
    Access
    Care/Management
  • Trial watch: antibody-drug conjugates in cancer therapy.
    5 days ago
    Antibody-drug conjugates (ADCs) combine the target specificity of monoclonal antibodies with the cytotoxic potency of small-molecule payloads. In recent years ADCs have emerged as a clinically validated component of modern precision oncology. To date, more than a dozen ADCs have received FDA approval for oncologic indications, with additional agents approved regionally and hundreds of ADC-based regimens in clinical development. Collectively, these therapies have demonstrated clinical benefit across hematologic malignancies and solid tumors, including significant overall survival improvements in advanced phase clinical trials. In this Trial Watch, we provide an overview on available ADCs from early preclinical development to current clinical applications. We also summarize design principles underpinning clinically successful ADCs, including epitope targeting, linker chemistry, payload toxicity and drug-to-antibody ratio, and discuss how these features can influence pharmacokinetics, intracellular trafficking, bystander effect and toxicity. Finally, we discuss results from advanced-stage clinical trials and approved agents to define future directions.
    Cancer
    Access
    Care/Management
    Advocacy
  • Psychological Distress Trajectories and Associated Factors in Patients With Breast Cancer: A Cohort Study.
    5 days ago
    Breast cancer patients often experience significant psychological distress. This study examined distress trajectories from diagnosis to 6 months post-treatment and explored differences across demographic, medical, and psychosocial subgroups.

    In this prospective cohort study, 528 patients with breast cancer were recruited between 1 December 2023 and 31 December 2024. Assessments were conducted at baseline (at diagnosis, T0), after the first treatment (T1), mid-treatment (T2), at treatment completion (T3), and at three (T4) and six months (T5) post-treatment. Growth mixture modeling (GMM) was used to identify distinct trajectories of psychological distress. Multinomial logistic regression analysis was performed to examine associations between patient-related factors and trajectory membership.

    Three psychological distress trajectories were identified: a high-distress remission group (17.05%), a moderate-stable distress group (11.93%), and a low-fluctuating distress group (71.02%). Multivariable analyses showed that higher educational attainment, breast-conserving surgery, early disease stage, partial self-management ability, and strong social support were associated with membership in the moderate-stable or low-fluctuating groups (p < 0.05). Employment, health insurance coverage, avoidant medical coping style, and higher baseline anxiety and depression scores were concurrently associated with membership in the high-distress remission group (p < 0.05).

    Although psychological distress generally decreased over time, 71.02% of patients followed a low-fluctuating trajectory, 11.93% maintained moderate distress with potential risk of persistence, and 17.05% showed high initial distress that remitted substantially within 6 months. Continuous monitoring and early psychosocial support are recommended, particularly for patients with moderate- or high-risk trajectories.
    Cancer
    Access
    Care/Management
    Advocacy
  • Molecular mechanisms and clinical impacts of sex differences in urologic cancers.
    5 days ago
    Urological cancers exhibit significant sex differences in incidence, treatment response, and prognosis, with males generally showing higher morbidity and mortality. This review systematically summarizes the underlying molecular and clinical mechanisms of these disparities, focusing on sex hormones, chromosome biology, tumor immune microenvironment, and microbiota. Sex hormones modulate key tumor processes including proliferation, apoptosis, non-apoptotic cell death, and DNA repair. Genetic factors such as X chromosome inactivation escape genes and Y chromosome loss also contribute to sex-biased cancer susceptibility. Furthermore, sex-specific differences in the urinary system and gut microbiota influence local immunity and inflammation, thereby affecting tumor progression and therapeutic response. Lifestyle and environmental factors, including smoking, alcohol consumption, and occupational exposures, further exacerbate these disparities. Clinically, sex differences impact the efficacy of immunotherapy and targeted therapies, underscoring the need for sex-informed treatment strategies. Integrating sex as a biological variable in research, clinical practice, and public health policies is essential for advancing precision oncology in urologic cancers.
    Cancer
    Care/Management
  • Antitumor Activity of Sodium Selenite, Palbociclib, and Disulfiram Against Osteosarcoma and Rhabdomyosarcoma Cell Lines.
    5 days ago
    Osteosarcoma and rhabdomyosarcoma are the most common pediatric sarcomas, yet prognosis remains poor due to high relapse rates. This study investigates the repurposing of palbociclib (PB) and disulfiram (DS), alongside sodium selenite (SS), as potential therapeutic strategies. Using cell lines, we assessed antiproliferative effects via Sulforhodamine B, colony formation, and wound healing assays. Mechanisms of action were explored through protein expression of PARP-1 (apoptosis) and LC3β (autophagy), qPCR for stem cell markers, and ROS quantification. Finally, antitumor and anti-angiogenic efficacy was validated using the in ovo chicken chorioallantoic membrane (CAM) assay. Results demonstrated that all three compounds inhibited proliferation, migration, and spheroid growth while inducing apoptosis and autophagy. Notably, SS and PB elevated ROS levels, triggering parthanatos-mediated cell death via AIF nuclear translocation. SS also exhibited significant anti-angiogenic activity. Xenograft CAM models confirmed the in vivo efficacy of SS, PB, and DS against RD and MG63 cells. These findings suggest that SS, PB, and DS are promising candidates for pediatric sarcoma treatment, particularly as maintenance therapies to prevent relapse following conventional radical treatment.
    Cancer
    Care/Management