Surgery remains the cornerstone of treatment for colorectal malignancies, with post-operative complications significantly impacting short and long-term outcomes. This study aimed to evaluate 30-day post-operative complications following surgery for colorectal malignancies in a single tertiary care teaching hospital in Navi Mumbai, India.

Thirty patients who underwent surgical resection for colorectal malignancy were followed up for 30 days. Surgical site infection was the most frequent complication, occurring in 36.66% of patients. Emergency surgery was associated with a higher complication burden than elective surgery.

Thirty-day mortality was 10%, predominantly in patients with advanced disease and poor physiological reserve. No significant association was found between tumour location, disease stage, or surgical setting and postoperative complication rates. The median hospital stay was 20 days (IQR 16 20.75).

Emergency surgery carried a higher complication burden, and advanced disease with poor physiological reserve was associated with increased mortality. These findings highlight the burden of post-operative morbidity following colorectal cancer surgery and the poorer outcomes associated with emergency presentation.

Safe surgery is a fundamental quality indicator within the global surgery framework. Postoperative complications remain a leading global cause of disability, mortality, and economic loss, with a disproportionate impact on low- and middle-income countries (LMICs).

This study aims to generate robust epidemiological data on postoperative outcomes of cancer surgery in Ethiopia.

This study employed a 7-day national observational prospective cohort design. The study enrolled adult patients aged 18 years and older who underwent either elective or non-elective cancer surgery in hospitals across Ethiopia. Statistical analysis included descriptive statistics, chi-square tests for categorical variables, and logistic regression models to identify risk factors for postoperative complications. Outcome measures 7th day postoperative mortality and complications. Statistical significance was set at p < 0.05.

A total of 265 cancer surgeries were performed across 46 hospitals (overall surgeries = 4412). The mean patient age was 46.6 years (SD = 14.9). The majority of patients were classified as low-risk America Society of Anesthesiologists (ASA) physical status classification: ASA I (106/265, 40%) and ASA II (133/265, 50.2%) and low Eastern Cooperative Oncology Group (ECOG) performance status: ECOG 0 (112/265, 42.3%) and ECOG 1 (98/265, 37%). Colorectal cancer surgery was the most common type (38/265, 14.5%), while laparoscopic surgery was performed in only 3/265 cases (1.1%). Postoperative complications developed in 84 of 265 patients (31.7%) with leading complication was superficial surgical site infection 47/265(17.8%). Emergency surgery (AOR = 3.1, 95% CI: 1.1-8.4, p = 0.003), comorbidity (AOR = 2.0, 95% CI: 1.1-3.7, p = 0.025), and an ECOG performance status of III (AOR = 9.5, 95% CI: 1.5-61.1, p = 0.02) were statistically significantly associated with 7th day postoperative complications. The overall 7-day mortality rate after cancer surgery was 5/265 (1.9%).

Despite the relatively young age of patients, their low ASA physical status scores, and good ECOG performance, a significant proportion experienced adverse outcomes following cancer surgery: one in three patients developed postoperative complications, one in nine required reoperations, and one in 53 died. These findings suggest a critical need for evidence-based interventions to strengthen the underlying infrastructure and care processes within the surgical system which are essential to achieving safe, effective, and high-quality surgical care for cancer patients in Ethiopia.

Isavuconazole (ISCZ) is an azole antifungal with a low risk of QTc prolongation and no requirement for renal dose adjustment. However, real-world data in Asian patients remain limited.

We retrospectively evaluated 45 patients who received ISCZ between April 2023 and March 2025. Laboratory parameters and QTc values (QTcB/QTcF) were extracted from medical records. Longitudinal changes were assessed using linear mixed-effects models. In patients receiving arsenic trioxide (ATO), QTc trajectories were compared among ATO alone, ATO with ISCZ (ATO-ISCZ), and ATO with other antifungals.

Grade ≥2 elevations in AST and ALT occurred in 11.1% and 13.3% of patients, respectively, and were transient. No significant deterioration in laboratory parameters was observed. In the ATO subgroup, QTc values in the ATO-ISCZ group were lower than those in the ATO group from Day 30, with the largest difference at Day 70 (-45.5 ms for QTcB and -42.3 ms for QTcF; both p < 0.001). The ATO-other antifungals group showed similar trends to the ATO group. No clinically significant cardiac events were observed.

ISCZ showed a favorable safety profile in Japanese patients with hematologic malignancies and may be a safe option during QT-prolonging therapies.

Accurate dose deposition in superficial radiotherapy remains challenging due to the inherent skin-sparing effect of megavoltage photon beams and difficulties in ensuring bolus conformity.

This study aims to comprehensively evaluate the dosimetric characteristics of the room-temperature-malleable high-density bolus, to evaluate the accuracy of dose calculation and to assess clinical outcomes in a clinical cohort of 55 patients.

The dosimetric validation was performed through the use of dose measurements in a solid water phantom on top of which a 1.0 cm thick high-densitybolus was positioned. Absolute depth dose measurements beyond the bolus were obtained by combining an absolute point dose (ion chamber) measurement at 1.0 cm depth beyond the bolus with relative depth dose measurements by using a microDiamond detector. Measurements were performed using 6 megavoltage (MV) flattening-filter-free (FFF) photon beams on an Halcyon and on a TrueBeam treatment unit. Obtained data were compared to dose calculations with both photon dose calculations available in the Eclipse treatment planning system (TPS): Analytical Anisotropic Algorithm (AAA) and Acuros XB (AXB). The impact of non-conforming interfaces was assessed by introducing 0.5 to 2.0 cm thick air cavities between bolus and skin. Skin dose loss due to the air cavities was measured for static open fields and for dynamic sweeping gap fields. Clinical outcomes of 55 patients treated between October 2023 and March 2025 were retrospectively analyzed.

Depth dose measurements confirm that a 1.0 cm high-density bolus was sufficient to effectively overcome the build-up region of the 6FFF photon beam. The AXB dose calculation algorithm provided the best agreement between measurements and calculations. Air gaps between the bolus and the skin resulted in clinically relevant skin dose reductions, ranging from approximately 1% to 20%, depending on field size and gap thickness, especially for clinical target volumes < 5.0 cm, large (> 1.0 cm) air gaps, or the use of large static fields. Among the 55 included patients, acute dermatitis toxicity was predominantly Grade 1 (49%) or Grade 2 (47.0%), with a low incidence of severe adverse events (Grade III: 4 %, Grade IV: 0%).

The high-density bolus demonstrated satisfying dosimetric reliability, particularly when modeled with the Acuros XB algorithm. The bolus addressed the build-up challenge inherent to MV photons, even in the presence of small air gaps, without increased toxicity in a large cohort of patients. This strategy represents a viable and accessible solution for ensuring accurate and conformal dose delivery in superficial tumors.

Canine hemangiosarcoma (HSA) commonly arises in the spleen, heart, and skin, whereas primary peritoneal presentations are rare and poorly characterized. A perivesical peritoneal location without involvement of adjacent organs has not been previously well described.

This study aims to characterize the clinical presentation, diagnostic features, treatment, and outcomes of dogs with primary peritoneal perivesical HSA.

This study included 16 client-owned dogs diagnosed with peritoneal perivesical HSA at 2 referral centres between 2020 and 2024.

Methods consisted of retrospective multicentre case series. Medical records were reviewed for clinical signs, laboratory abnormalities, imaging findings, diagnostic procedures, treatment, metastatic status, and outcome measures, including progression-free survival (PFS) and disease-specific survival time (DSST).

Common presenting signs included lethargy, hyporexia, pale mucous membranes, and abdominal distension. Hemoperitoneum was identified in 50% of the dogs. Frequent laboratory abnormalities included anaemia, thrombocytopenia, neutrophilia, and azotaemia. All dogs had a mass adjacent to the urinary bladder without evidence of origin from surrounding organs. Diagnosis was achieved by cytology or histopathology. Metastatic disease was suspected at diagnosis in 56.25% of the dogs, most commonly affecting the lungs, and the overall metastatic rate was 87.5%. Treatment protocols included chemotherapy alone (n = 8), surgery with adjuvant chemotherapy (n = 7), and neoadjuvant chemotherapy followed by surgery (n = 1). All surgical procedures consisted of debulking surgery. Chemotherapy alone resulted in a 55.55% partial response rate. Mean PFS and DSST were both 125 days. Combination therapy, response to chemotherapy, and rescue treatment were significantly associated with improved DSST.

Primary peritoneal perivesical HSA may represent a distinct anatomical presentation of canine HSA. Multimodal treatment strategies may improve clinical outcomes and survival in affected dogs.

Bovine leukaemia virus (BLV) and Coxiella burnetii are important infectious pathogens of dairy cattle with potential implications for animal health, productivity and zoonotic transmission (in the case of C. burnetii). Because BLV may alter immune function, we hypothesize that infection with the virus could increase cattle susceptibility to C. burnetii.

This cross-sectional study aimed to estimate the seroprevalence of BLV and C. burnetii in dairy cattle herds in the Emirate of Abu Dhabi (EAD) and to assess any association between the positive serostatus of the two pathogens.

Sera from 492 adult Holstein-Friesian cattle were screened by ELISA for antibodies to both pathogens, and associations were evaluated using logistic regression.

The overall seroprevalences of BLV and C. burnetii were 47.0% and 49.4%, respectively, with 24.2% of cattle being dually seropositive. BLV seroprevalences across farms were 27.6%, 56.3% and 50.9%, while C. burnetii seroprevalences were 42.9%, 29.2% and 53.8% for Farms 1, 2 and 3, respectively. Logistic regression showed that BLV-positive cattle had higher odds of C. burnetii seropositivity (OR = 1.25, 95% CI [0.88-1.79]), even though the association was not statistically significant (p = 0.2258).

The relatively high seroprevalences compared with previous reports suggest ongoing intra-herd transmission of both pathogens, likely exacerbated by the absence of targeted control strategies. Although no causal relationship was established, the observed trend may reflect BLV-associated immunosuppression that could enhance susceptibility to C. burnetii. Further large-scale studies are warranted, and livestock health authorities in the UAE are encouraged to implement targeted surveillance and biosecurity measures.

Individuals with opioid use disorder and substance use disorder have lower cervical cancer screening rates than the general population. Human papillomavirus (HPV) self-collection testing provides opportunities to expand screening access to previously unreached patient populations.

To assess the feasibility and uptake of incorporating HPV self-collection testing for cervical cancer screening into routine care for patients with opioid use disorder and substance use disorder, and to track the rates of high-risk HPV and guideline concordant follow-up care in this population.

This prospective cohort study was conducted from June 24, 2024, through December 31, 2025, at We Care Daily Clinics, a federally certified opioid treatment program (OTP) and American Indian Health Facility in Auburn, Washington. Eligible patients were 25 years or older, had a cervix, and were either overdue for cervical cancer screening or unsure of their last screening.

Screening using self-collection kits was offered during the patient's annual wellness visit, and self-collection occurred privately in the clinic restroom. Samples were analyzed for 14 high-risk HPV types at a laboratory. Screened patients with HPV-positive results received education and recommendations for guideline-concordant care. OTP staff facilitated patient referrals to local clinicians for gynecologic services, and follow-up was tracked.

The primary outcomes were the rates of HPV self-collection testing uptake, HPV positivity, and successful linkage to follow-up care.

A total of 194 patients (median [range] age, 41 [25-65] years) were evaluated. Of 174 patients (89.7%) eligible for cervical cancer screening, 158 (90.8%) completed HPV self-collection testing. There were 0 unsatisfactory test results, and 128 patients (81.0%) had HPV-negative results, 7 (4.4%) had HPV-16- or HPV-18-positive results, and 23 (14.6%) had positive results for other high-risk HPV types (non-HPV-16 or HPV-18 types only). Of the 30 patients with HPV-positive test results, 2 (6.7%) were lost to follow-up and 12 (40.0%) completed follow-up to date, which often required multiple coordination attempts by clinicians. The remaining 16 of 30 patients (53.3%) are currently actively engaged in various stages of referral and scheduling.

In this cohort study, incorporation of cervical cancer screening into an OTP using HPV self-collection testing was feasible with high patient eligibility and uptake.

State-level dense breast legislation aims to increase awareness of breast density and promote supplemental imaging, yet the association of specific legislation type with imaging use remains unclear.

To evaluate the differential association of dense breast notification and insurance coverage laws with supplemental imaging use and to assess how specific legislative features are associated with imaging use.

This retrospective, quasi-experimental cohort study used data from the MarketScan database, one of the largest national administrative claims databases in the US, from January 1, 2008, through December 31, 2019. A total of 12.6 million women aged 40 to 64 years undergoing screening mammography with continuous insurance enrollment for at least 6 months after the index screening mammography were followed up for up to 6 months after the screening mammography. Data were analyzed from January to July 2025.

Dense breast legislation, including notification and insurance coverage laws.

Receipt of supplemental ultrasonography or magnetic resonance imaging (MRI) within 6 months of screening mammography. Multivariable logistic regression with an extended difference-in-differences design was used to assess within-state changes over time, leveraging variation in the timing of policy adoption across states.

Of 12 555 082 women (mean [SD] age, 51.3 [6.9] years) undergoing mammography, 9.0% received supplemental ultrasonography and 0.6% received supplemental MRI. Notification mandates were associated with higher use of ultrasonography (odds ratio [OR], 1.09; 95% CI, 1.08-1.10) and MRI (OR, 1.09; 95% CI, 1.06-1.12). Insurance coverage was associated with higher odds of supplemental ultrasonography use (OR, 1.88; 95% CI, 1.86-1.90). Among states with notification mandates, including information on supplemental screening (OR, 2.84; 95% CI, 2.81-2.86) and targeting notification only to women with dense breasts (OR, 1.32; 95% CI, 1.31-1.33) were both associated with higher odds of ultrasonography use.

In this cohort study of women undergoing mammography, both dense breast notification and insurance coverage laws were associated with increased use of supplemental ultrasonography, with greater odds observed for insurance mandates. Specific legislative features, particularly targeted notification and inclusion of supplemental screening information, were also associated with increased use of supplemental ultrasonography. Further studies covering wider populations and integrating claims data with clinical registries, imaging reports, or electronic health records are needed to better delineate the association between dense breast legislation and supplemental screening behavior.

Genomic testing plays a central role in precision oncology by guiding targeted therapies. Medicare established national coverage determinations (NCDs) for next-generation sequencing (NGS) in 2018 and 2020, yet population-level adoption patterns remain underexamined.

To examine trends and variation in uptake of NGS and non-NGS genomic testing among Medicare beneficiaries with common cancers.

This retrospective cohort study used Medicare fee-for-service beneficiaries aged 66 years or older with claims from January 1, 2016, to December 31, 2023. Beneficiaries with incident lung, breast, colorectal, prostate, or endometrial cancer were identified using the Chronic Conditions Data Warehouse. The data analysis was performed from July 1 to December 31, 2025.

Cancer types, time periods defined by implementation of Medicare NCDs for somatic NGS (March 16, 2018) and germline NGS (January 27, 2020), and patient characteristics (age, race and ethnicity, and geographic location).

Outcomes were receipt of NGS testing (primary) and receipt of any genomic testing and shift to NGS testing among tested beneficiaries (secondary), within 180 days after the first cancer diagnosis claim. Testing rates were described by cancer type and over time. Multivariable logistic regression was used to estimate adjusted probabilities of receiving NGS testing.

Of 391 151 Medicare beneficiaries with cancer (50.6% were female; 31.8% were older than 75 years), 7.0% received non-NGS testing only, 1.2% NGS only, 0.5% both, and 91.4% no genomic testing. NGS adoption increased modestly, whereas overall genomic testing nearly tripled from 6.0% in 2016 to 16.7% in 2023. Uptake varied across cancers; beneficiaries with lung cancer had the highest NGS uptake (1.6% in 2016 vs 9.2% in 2023; P < .001), whereas beneficiaries with breast cancer showed the sharpest increase in non-NGS testing without a parallel increase in NGS. Beneficiaries with colorectal or endometrial cancer showed a moderate increase, whereas beneficiaries with prostate cancer had the lowest uptake for any genomic testing. In adjusted analyses, the largest increase was observed among beneficiaries with lung cancer (5.16 percentage points [95% CI, 4.75-5.56 percentage points]; P < .001) during the post-germline NCD phase.

In this cohort study of Medicare beneficiaries with cancer, genomic testing increased after NCD implementation, with increases driven by NGS among beneficiaries with lung cancer and non-NGS among beneficiaries with breast cancer. Overall, NGS uptake remained modest, highlighting persistent gaps in access to precision oncology testing.

Ovarian cancer (OC) remains one of the leading causes of gynecological cancer-related mortality, with limited biomarkers for early detection and prognosis. Changes in DNA methylation-stable and detectable in blood-are potential candidates for clinical application. In our earlier genome-wide methylation study involving monozygotic twins where one had ovarian cancer and the other did not, we identified two genes, RBBP7 and RIBC1, as differentially methylated. These findings laid the groundwork for further targeted investigation.

Peripheral blood methylation of RBBP7 and RIBC1 was evaluated in 387 ovarian cancer patients, 50 benign ovarian disease patients, and 100 healthy controls using a bisulfite-free, methylation-sensitive restriction enzyme (MSRE)-based qPCR assay. In this approach, DNA is divided into digested and undigested reactions, and methylation levels are calculated from Ct differences. Methylation levels differed across groups, with RBBP7 showing a clearer discriminatory pattern (p < 0.001) and associations with disease severity (p < 0.001) and CA125 levels (p = 0.05). RIBC1 also differed between ovarian cancer and healthy controls (p < 0.001) but showed no significant associations with clinicopathological parameters.

RBBP7 methylation appears to be a potential candidate biomarker associated with disease characteristics and progression patterns of ovarian cancer. These findings suggest that RBBP7 methylation may have potential for integration into future multi-marker diagnostic and risk-stratification approaches, pending further validation. While RIBC1 methylation also showed differential patterns, its clinical relevance appears limited and requires further investigation. These findings support the integration of RBBP7 methylation assessment into early-stage diagnostic workflows and risk-stratification strategies for ovarian cancer, enabling more precise clinical decision-making. Future multicenter prospective studies are warranted before clinical implementation.