Prostate cancer (PCa) is the most common cancer in US men. Nearly half of those diagnosed with PCa present with low-risk disease based on clinical guidelines, for which active surveillance (AS) is increasingly recommended by clinicians to avoid invasive treatment. Obesity is a well-recognized risk factor for poor PCa prognosis. Yet weight loss interventions for PCa patients on AS are limited.

Using the NIH Stage Model for Behavioral Intervention Development as a guide, our Stage 1 study translated and assessed the feasibility, estimated preliminary efficacy signals, and conducted exploratory analyses of two evidence-based behavioral weight loss interventions for PCa patients on AS.

We worked with patients to translate evidence-based continuous energy restriction (CER) and 5:2 (two 600 kcal fast days, eat normally 5 days) intermittent fasting (IF) interventions for PCa patients on AS. Feasibility, estimated preliminary efficacy signals, and exploratory analyses on outcomes from baseline to 3 and 6 months was assessed using a parallel arm randomized controlled trial.

The study met the pre-established benchmarks for feasibility. Twenty patients were randomized (10 CER, 10 IF). All were retained over 6-month follow-up. Participants were predominantly White (95%), with an average age of 65.9 (SD 8.45) years. Each arm produced clinically meaningful weight loss from baseline to 6 months (CER -5.79% [95% confidence interval, CI: -3.48, -8.09; P < .01); IF -7.50% (95% CI: -5.19, -9.80; P < .01). Within IF only, there were favorable exploratory changes in biomarkers related to lipid and glucose metabolism, inflammation and immune function, and signaling pathways critical for PCa progression.

Our study provides evidence for our interventions' feasibility and preliminary efficacy signals for clinically meaningful weight loss in PCa patients on AS. Future studies examining weight loss' impact on PCa progression and related biomarkers are needed.

The Clinical Trials Registration NCT05764330.

Enteral nutrition intolerance can limit achievement of nutrition goals, but its definitions and assessment methods vary widely. This review mapped operational definitions and identified evidence gaps relevant to patients after gastrectomy for gastric cancer.

The Web of Science Core Collection was searched for original clinical studies published from 2015 to 2025 that re-ported explicit operational definitions or ascertainment criteria. Study populations, feeding routes, assessment components, incidence rates, and outcomes were charted and synthesized descriptively.

Forty-seven studies were included. Most involved critically ill populations, whereas only three focused on patients after gastric cancer surgery. Definitions used heterogeneous combinations of gastrointestinal symptoms, gastric residual volume, feeding interruption or rate reduction, failure to meet energy targets, and other indicators, with inconsistent thresholds and observation windows. A preliminary three-domain framework was identified: gastrointestinal and dumping-related symptoms, route-appropriate objective indicators, and treatment response or feeding adjustments.

Existing definitions are heterogeneous and largely derived from intensive care settings. Standardized reporting and disease-specific validation are required before a gastric cancer-specific assessment tool can be developed.

Head and neck myiasis remains an underreported public health concern in endemic regions and may cause extensive tissue destruction and permanent functional sequelae. We aimed to describe its clinical features, associated conditions, management, and sequelae in Venezuelan patients.

This retrospective study included individuals treated between 2024 and 2026 at two referral hospitals in Caracas, Venezuela. Demographic, clinical, etiologic, treatment, and outcome data were analyzed descriptively.

Twenty-one (77.8%) patients were male and six (22.2%) were female; the mean age was 53.0 years. Extraoral involvement was observed in 74.1% of patients and intraoral involvement in 33.3%. Trauma and malignancy were the leading underlying conditions (37.0% each). Basal cell carcinoma (n=5), squamous cell carcinoma (n=4), and melanoma (n=1) were the malignant neoplasms identified. All patients received ivermectin and systemic antibiotics, and mechanical larval removal was performed in 25 (92.6%). Cutaneous defects occurred in 14 (51.9%) patients, and mucosal/labial defects in 13 (48.1%).

Data corroborate the burden documented in low- and middle-income settings and reinforce head and neck myiasis as an underrecognized public health concern associated with potentially preventable morbidity and permanent sequelae. Strengthened surveillance, prevention, and timely access to specialized care are warranted.

Colorectal polyps are a major source of precancerous lesions in colorectal cancer (CRC). In many population-based screening programs, a major challenge is the efficient triage of high-risk individuals for diagnostic colonoscopy amid limited endoscopic resources.

To enrich current screening frameworks, we aimed to develop an accessible, noninvasive risk stratification tool to serve as a digital triage mechanism for colorectal polyps using machine learning (ML) and routinely collected data in China.

We conducted a cross-sectional study in Wenzhou, China. A total of 4108 individuals (aged 50-74 y) who were referred for and accepted colonoscopy following an initial population-based risk assessment (questionnaire and fecal test) between May and November 2021 were included. The dataset was split into training and validation sets, and the synthetic minority oversampling technique (SMOTE) was applied only to the training dataset to address class imbalance. Twenty-one noninvasive predictors (lifestyle, dietary, clinical symptoms, and family history) were selected using the Boruta algorithm and least absolute shrinkage and selection operator (LASSO) regression. Nine ML models were evaluated, with the Shapley Additive Explanations (SHAP) method and local interpretable model-agnostic explanations (LIME) used for model interpretability and feature ranking.

Among the 9 ML algorithms evaluated, XGBoost (Extreme Gradient Boosting) achieved the highest area under the receiver operating characteristic curve of 0.672, while LightGBM (Light Gradient Boosting Machine) was identified as the optimal model for clinical triage due to its superior recall (0.6503), a key metric for minimizing missed lesions in community screenings. SHAP analysis identified current smoking status, sex, and family history of colorectal polyps as the most influential factors. Notably, the model captured significant nonlinear risk thresholds, such as an age of 50 years and a BMI of 25 kg/m², providing a more granular risk profile than traditional linear models.

This study provides a scalable, interpretable triage tool to complement existing 2-step CRC screening protocols. By leveraging only noninvasive variables, the LightGBM model enables prioritized referral for colonoscopy, offering a resource-efficient strategy to optimize CRC prevention in resource-limited settings.

There is tremendous enthusiasm for the use of AI in health care because of the ability to analyze existing data for preventative, diagnostic, and treatment support. Agentic AI can feasibly provide access to large real-world datasets for the generation of real-world evidence for health care and clinical applications to health care providers, researchers, and administrators without access to large analytic programming resources.

The objective of this study was to understand the feasibility of using agentic AI for clinical outcome research and population health management. Specifically, this study used an agentic AI evidence-generation platform to obtain epidemiological estimates of diverse medical conditions, with the results evaluated against existing AI frameworks.

Prevalence estimates of 6 conditions (amyotrophic lateral sclerosis, acute myeloid leukemia, bladder cancer, Huntington disease, elevated lipoprotein (a), and Parkinson disease) were estimated using an agentic AI evidence-generation platform applied to an administrative claims database with representation from every US state. Gender-specific rates were calculated within the following age categories: 0 to 17, 18 to 24, 25 to 34, 35 to 44, 45 to 54, 55 to 64, and 65 to 74 years and 75 years and older. Period prevalence was estimated from January 1, 2020, to June 30, 2025, and annual prevalence rates for each year were estimated from 2020 to 2024. Continuous enrollment for 12 months was required during the study period for inclusion. Source code generated by the platform as part of the analysis was reviewed by an independent programmer for validation of methods and programming, and analyses were replicated using traditional programming methods. Results obtained throughout the process were evaluated against several existing AI application frameworks.

Regarding accuracy, epidemiological estimates obtained using the agentic AI platform were consistent with published estimates for all 6 conditions, as well as with estimates obtained from traditional programming methods. Regarding rigor, the agentic AI platform conducted the analysis with rigor by confirming acceptable methods in published literature for the type of data source used. Code lists used for the analysis were confirmed against existing algorithms when available. Appropriate statistical methods were used to compare differences in prevalence rates by age and gender. Regarding trust (explainability, transparency, replicability, traceability, and validation), the agentic AI platform generated all source code used for the analyses, which was reviewed and validated for accuracy and appropriateness. The analysis included a "human in the loop" to validate the research question, data extraction method, statistical analysis plan, and output plan prior to proceeding with each step.

With specific design considerations to ensure responsible use, agentic AI can be invaluable to increasing the accessibility of large datasets for applied clinical outcome research and population health management analyses.

Left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS) remain recommended for cardiotoxicity surveillance during cancer therapy, yet it changes late and overlooks injury to the other cardiac chambers.

We systematically reviewed echocardiographic and cardiac magnetic resonance (CMR) studies that assessed left atrial (LA), right atrial (RA), and right ventricular (RV) function in patients exposed to potentially cardiotoxic oncological treatment.

PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials were searched for English-language studies published between January 2020 and March 2026, following the PRISMA recommendations. Across tumor types-lymphoma, acute lymphoblastic leukemia, breast, gastrointestinal, and melanoma-and across anthracycline-, trastuzumab-, fluoropyrimidine-, and immune checkpoint inhibitor-based regimens, strain imaging detected subclinical dysfunction that conventional measures missed.

LA reservoir strain declined early and frequently preceded any fall in LVEF, outperforming volumetric LA indices for the detection and prediction of cancer therapy-related cardiac dysfunction (CTRCD). RV deformation parameters, particularly free-wall longitudinal strain and three-dimensional RV ejection fraction, identified RV involvement that was sometimes independent of LV cardiotoxicity and was associated with adverse cardiac events. Data on the RA remain sparse but point in the same direction.

Multichamber strain assessment adds sensitivity to LVEF and GLS-based monitoring; standardization of acquisition, reference values, and reporting is needed before it can enter routine cardio-oncology surveillance.

Pulmonary lesions that newly emerge after chimeric antigen receptor T-cell therapy may raise immediate concern for lymphoma relapse, especially when they occur at sites of prior disease involvement. We report a patient with refractory diffuse large B-cell lymphoma who developed newly apparent or re-enlarged FDG-avid pulmonary opacities four months after axicabtagene ciloleucel infusion. The lesions appeared at or near prior pulmonary lymphoma-suspected sites, strongly suggesting recurrence. However, transbronchial lung biopsy showed organizing pneumonia-like inflammatory changes with Masson bodies, CD3-positive T-cell infiltration, and no evidence of lymphoma involvement by multiple B-cell markers. Because the patient remained clinically stable and relapse was not supported histologically, systemic corticosteroids and salvage chemotherapy were withheld. The biopsied lesion and the remaining pulmonary opacities regressed spontaneously during follow-up, and complete remission was maintained. This case illustrates that organizing pneumonia-like inflammatory lesions may arise at prior lymphoma-suspected pulmonary sites after CAR-T-cell therapy and closely mimic pulmonary relapse on FDG-PET/CT. When new FDG-avid pulmonary lesions arise after CAR-T-cell therapy, particularly at prior lymphoma sites, tissue confirmation is essential to avoid misdiagnosis and unnecessary treatment escalation.

CD20 testing shortly after CD20-directed therapy can be difficult to interpret. We report an 89-year-old woman with multiply relapsed B-cell lymphoma who underwent excisional biopsy of an enlarging right axillary lymph node 17 days after the last dose of mosunetuzumab. A prior lymph node biopsy showed follicular lymphoma grade 3A with preserved CD20 expression. The relapse specimen showed diffuse large B-cell lymphoma of the germinal center B-cell subtype. Immunohistochemistry using the CD20 clone L26 failed to detect CD20 expression, whereas PAX5 and CD79a remained positive. Flow cytometry showed undetectable CD20 with clone L27; the large-cell gate contained CD19-positive B cells and showed kappa light-chain restriction. No morphologic findings of a lineage switch were observed. IGH and IGK rearrangement analyses demonstrated identical monoclonal peaks in the specimens obtained at the follicular lymphoma stage and relapse, supporting clonal continuity. Positron emission tomography/computed tomography revealed a 40-mm right axillary lymph node with a maximum standardized uptake value of 26.7. Epcoritamab was started as the seventh-line treatment despite negativity on routine assays for CD20. During step-up dosing, grade 1 cytokine release syndrome resolved after one dose of tocilizumab. Computed tomography on day 22 revealed a reduction in the size of the right axillary lymph node from 40 to 20 mm. The lesion remained 20 mm on days 41 and 51, with decreases in lactate dehydrogenase and soluble interleukin-2 receptor. Disease progression was documented on day 83. These findings suggest that negative CD20 results by routine assays shortly after mosunetuzumab therapy do not necessarily reflect true target loss. Integrated interpretation of histopathology, flow cytometry, and clonality studies may help guide subsequent CD20-directed treatment decisions.

Liver transplantation (LT) may offer survival or symptomatic benefit for highly selected patients with advanced, well-differentiated small-intestinal or pancreatic neuroendocrine tumours and unresectable liver-dominant metastases. However, its role remains controversial, as LT is rarely curative, recurrence is common, and benefits must be weighed against perioperative risk, lifelong immunosuppression, alternative therapies, and organ allocation ethics. This ENETS position statement summarises current evidence and expert consensus, reframing LT within a transplant-benefit model rather than fixed eligibility criteria. It outlines biologically informed selection principles and multidisciplinary assessment, as well as addressing the need for standardised characterisation, prospective registries, and long-term outcome data to better define the net clinical benefit of LT in this rare patient population.

Glyoxalase I (GLO I) detoxifies the reactive glycolytic byproduct methylglyoxal (MG) and is frequently overexpressed in cancer cells. High GLO I expression is closely associated with resistance to anticancer drugs, including doxorubicin (DOX). However, the functional relationship between GLO I activity and DOX-induced cell death remains unclear. In this study, we investigated whether inhibition of GLO I enhances cellular sensitivity to DOX. Using non-small cell lung cancer cell lines with low (NCI-H460 cells) or high (NCI-H522 cells) GLO I expression, we found that NCI-H522 cells, which we previously reported to be highly sensitive to the GLO I inhibitor TLSC702 and to accumulate MG following GLO I inhibition, were more resistant to DOX than NCI-H460 cells. Cotreatment with exogenous MG significantly potentiated DOX-induced cytotoxicity through multiple cell death pathways, supporting a role for MG-related processes in modulating DOX responses. While simultaneous treatment with TLSC702 and DOX showed limited enhancement, pretreatment with TLSC702 followed by DOX markedly increased cell death in GLO I-high cells, suggesting that prior disruption of MG detoxification may sensitize cells to subsequent DOX exposure. This effect was accompanied by enhanced poly(ADP-ribose) polymerase (PARP) cleavage and was partially suppressed by caspase and autophagy inhibitors, indicating enhanced apoptosis with contributions from additional cell death pathways. Collectively, these results demonstrate that GLO I inhibition primes cancer cells for enhanced DOX-induced apoptosis, providing mechanistic insights into GLO I-associated chemoresistance.