To evaluate the association between low-dose ionizing radiation from dental imaging (conventional radiography and cone-beam/medical CT) and cancer risk using contemporary epidemiological evidence.

This systematic review and meta-analysis followed PRISMA 2020 guidelines. PubMed, Scopus, and Web of Science were searched up to March 2026 for observational cohort and case-control studies assessing cancer risk after dental radiographic exposure. Risk of bias was assessed using Joanna Briggs Institute tools, causal inference with COSMOS-E guidance, and certainty of evidence with the GRADE framework. Random-effects models pooled adjusted Odds Ratios (ORs) and adjusted Hazard Ratios (HRs) with 95% confidence intervals (CIs).

Among 1,883 records, 24 studies met inclusion criteria, and 19 were included in meta-analysis (415,887 participants). In the 16 case-control studies, thyroid cancer was significantly associated with dental imaging (OR = 2.21; 95% CI: 1.63-2.99), while central nervous system (CNS) tumors showed a non-significant elevation (OR = 1.31; 95% CI: 0.89-1.91). In the three cohort studies, thyroid cancer showed a small but significant association with conventional radiography (HR = 1.13; 95% CI: 1.01-1.26), and CNS tumors risk was moderately associated with CT scan exposure (HR = 1.54; 95% CI: 1.03-2.29). Certainty of evidence was rated low for thyroid cancer, and very low for central nervous system cancers, lymphoid cancer, oral cancer and salivary gland cancer due to risk of bias, inconsistency, and imprecision.

Current evidence is insufficient to confirm an association between low-dose dental radiographic exposure and cancer. A small increased risk was observed, but certainty remains very low, highlighting the need for well-designed prospective research.

Lactylation and liquid-liquid phase separation related genes have been reported to be associated with tumor prognosis and immunity, but their specific influence on the prognosis and immune characteristics of diffuse large B-cell lymphoma (DLBCL) remains unclear.

GSE56315 (33 control samples and 55 DLBCL patient samples) has been used to screen for lactylation and liquid‒liquid phase separation related differentially expressed genes (LLRDEGs). Based on the optimal cutoff, LLRDEGs associated with DLBCL prognosis (overall survival) was further screened through LASSO and univariate Cox regression. Then, based on the GSE10846 dataset (414 DLBCL samples), a prognostic model was constructed based on the LLRDEGs. The Kaplan-Meier curve is used to evaluate the prognostic value (median risk score). And validate the prognostic model on an independent external validation dataset (GSE181063 (1310 DLBCL samples)). Finally, further analysis was conducted on consensus clustering, biological pathways, the immune microenvironment and drug sensitivity.

4 LLRDEGs were ultimately identified as genes associated with the DLBCL' prognosis. A prognostic model was constructed based on the 4 LLRDEGs. An independent external validation dataset confirmed the prognostic model's prognostic value. 4 LLRDEGs were significantly correlated with various immune cells.

This study screened four LLRDEGs significantly associated with prognosis and constructed a prognostic risk stratification model. The Kaplan-Meier curve confirms the prognostic value of the prognostic risk stratification model. This prognostic model is related to the clinical characteristics and immune microenvironment of DLBCL patients.

This study elucidates the role of LLRDEGs in the prognosis and immune features of DLBCL, providing insights into potential therapeutic targets.

Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are rare cutaneous mesenchymal tumours sharing clinical and histopathological features. Compared to AFX, PDS has an increased risk of local recurrence and metastasis. A precise diagnosis is critical to ensure proper clinical management and follow-up. AFX and PDS show a similar genetic background, but also a heterogeneous pattern of different molecular abnormalities still poorly investigated due to the rarity of these tumours. Multiple data from different institutions and geographical areas, facilitate the identification of molecular alteration/s of valuable diagnostic and/or sub-classification power. We investigated the DNA profile of 32 AFX and PDS samples using a custom targeted Next-Generation Sequencing panel including 228 cancer genes. We confirm a common pattern of gene mutations affecting TP53, CDKN2A and NOTCH1. Differences appeared in less frequently detected genes (e.g. TSC2) and in NF2 harbouring novel genetic alterations. Integrating our results with published datasets of AFX and PDS mutation profiles we observed a divergent distribution of alterations in genes signalling through angiogenic pathway (KDR, PDGFRB), DNA damage response (ATR), cellular migration/metastasis (DDR2, CDH1). These differences do not reach statistical significance, and histopathological evaluation remains the diagnostic gold standard, however, they offer valuable insights into the pathogenesis of these tumours.

Serrated lesions of the appendix are rare, often incidental findings in routine appendectomy specimens. Their true frequency, histopathologic spectrum, and anatomic distribution remain incompletely characterized, partly due to variability in sampling practices.

We retrospectively reviewed 2,137 appendectomy specimens (2015-2025) from a single tertiary pathology center. Cases with histologically confirmed serrated lesions were reexamined, classified as hyperplastic polyp (HP) or sessile serrated lesion/polyp (SSL/P), and assessed for clinicopathologic parameters including lesion size, location, and associated pathologies. Nonparametric tests were used, with statistical significance defined as p < .05.

Serrated lesions were identified in 34 cases (1.6%), comprising 17 HPs (0.8%) and 19 SSL/Ps (0.9%). SSL/Ps were significantly larger than HPs (median 10.0 vs. 2.7 mm, p < .001) and were more frequently located in the distal appendix (68.4% vs. 33.3%, p = .045, one-tailed Fisher's exact test). No dysplasia or traditional serrated adenoma was detected. Acute appendicitis was present in 88% of cases, and associated neoplasms in 9%.

Appendiceal serrated lesions are uncommon and often incidental. In this large appendectomy series, SSL/Ps differed from HPs by larger size and distal predilection. These findings primarily support diagnostic awareness and optimized sampling/ grossing practices-particularly careful evaluation of the distal appendix-rather than clinical risk stratification. Further studies incorporating systematic clinical correlation and molecular/immunohistochemistry analyses are warranted.

This UK-based retrospective analysis describes real-world treatment patterns and outcomes in 175 patients with accelerated (AP, n = 69) or blast-phase (BP, n = 106) 'Philadelphia-negative' myeloproliferative neoplasms (MPN-AP/BP) diagnosed between 2013 and 2025. Median age at transformation was 71 years. With a median follow-up of 45.2 months, median overall survival (OS) was 14.9 months, significantly worse for MPN-BP (6.7 months) versus MPN-AP (25.3 months). Treatment selection was heterogeneous across centres. Intensive chemotherapy (IC) improved outcomes only when followed by allogeneic haematopoietic stem cell transplant (allo-HSCT) (median OS 24.7 months). Ruxolitinib-based regimens, particularly combined with azacitidine, showed acceptable activity in AP (median OS 27.2 months). Venetoclax-based regimens achieved a median OS of 14.9 months across the cohort. Multivariable analysis identified IC and venetoclax-based therapy as independently associated with better outcomes, reflecting patient selection, while TP53 mutations predicted inferior survival. IC carried high rates of febrile neutropenia and sepsis; venetoclax was associated with prolonged cytopenias. This study confirms the poor prognosis of MPN-AP/BP, the absence of a unified UK consensus approach and the need for improved therapies and prospective studies to determine optimal treatment approaches for this challenging cohort.

Local recurrence after definitive radiotherapy for prostate cancer (PCa) remains a challenging clinical problem. Salvage irreversible electroporation (sIRE) is a non-thermal focal ablation approach with limited published evidence in the radiorecurrent setting. We report safety and early oncologic outcomes of sIRE for these patients.

We performed a retrospective review of consecutive patients undergoing sIRE at a single institution (December 2023 to June 2025). Inclusion required biopsy-confirmed intraprostatic recurrence and PSMA PET demonstrating no metastatic disease. Outcomes included perioperative morbidity, early PSA response, and post-treatment prostate MRI findings.

Eighteen patients underwent sIRE. Mean age was 73.78 ± 7.0 years. Seventeen patients were discharged on the day of surgery. Postoperative urinary morbidity included urinary tract infection in 3 patients (16.7%), urinary retention requiring limited TURP in 2 (11.1%), and new bothersome storage lower urinary tract symptoms requiring treatment in 2 (11.1%). Mean PSA decreased from 5.37 ± 2.09 ng/mL pre-IRE to 1.61 ± 1.57 ng/mL at approximately 3 months, and 2.17 ± 1.92 ng/mL at approximately 6 months. Twelve patients underwent post-IRE prostate MRI; results included post-treatment change, or ablation defect, or susceptibility artifact in most patients. One patient underwent repeat PSMA PET for a rising PSA and was found to have a PSMA-avid lung lesion consistent with metastatic disease.

Salvage IRE for radiorecurrent prostate cancer has generally manageable short-term urinary morbidity and encouraging early PSA responses, with limited utility of post-treatment MRI. A longer follow-up is needed to define durability and optimal selection.

Alongside the physical burden of cancer and its treatments, women with gynecologic cancer face substantial psychological and social challenges that strongly shape quality of life. Adaptive coping and timely psychosocial support may facilitate adjustment, adherence, and rehabilitation. To summarize coping strategies used by women with gynecologic cancer and their association with quality of life, and to describe the role of the multidisciplinary care team in delivering psychosocial support. We conducted a systematic search of PubMed, ScienceDirect, Google Scholar, BioMed Central, AKJournals, and ResearchGate for studies published between 2018 and 2025 without language restrictions. The search yielded 1419 records; after screening and full-text assessment, 36 studies were included. We extracted data on coping patterns, psychological outcomes, quality of life, and the contribution of psychosocial care and communication. Adaptive coping - particularly problem solving and seeking social support - was associated with better emotional well-being, lower distress, and higher quality of life. Avoidant coping was linked to higher anxiety, depressive symptoms, and poorer quality of life. Structured psychosocial interventions and consistent, empathic clinician-patient communication reduced tension, strengthened trust, and improved adherence. Integrating psychosocial support into oncologic care for women with genital tumors can enhance adaptive coping and improve quality of life. A patient-centered, interdisciplinary approach should include decision-making support, early assessment of coping and psychological burden, timely referral to appropriate professionals, and continuous development of communication and patient management competencies among providers. Orv Hetil. 2026; 167(18): 691-701.

Evidence on sociodemographic disparities in COVID-19 booster vaccine uptake remains limited. We examined disparities in COVID-19 vaccine uptake among the Arab, ultraorthodox Jewish, and general Jewish populations in Israel (January 2021-August 2022), focusing on vaccine dose, community characteristics, and policy analysis.

Publicly available COVID-19 data from 135 cities (≥ 10,000 residents) were analyzed. Cumulative vaccine uptake by dose was assessed by age and population group across 3 periods (period-1: to June 2021, period-2: to December 2021, period-3: to August 2022). Policy analysis was conducted using Walt and Gilson's Policy Triangle framework, drawing on the literature, government reports, official websites, and media coverage.

Data from 76 predominantly non-ultraorthodox Jewish cities, 10 ultraorthodox Jewish cities, and 49 Arab cities were included. Compared to the general Jewish population, dose 1 uptake was lower in ultraorthodox (incidence rate ratio (IRR) = 0.51, 95% CI 0.26-0.99) and Arab cities: IRR = 0.76, 0.53-1.09), with similar gaps for dose 2. Disparities widened with boosters: for dose 3, uptake was significantly lower in ultraorthodox cities (period-2 IRR = 0.38 [0.20-0.74], period-3: IRR = 0.39 [0.20-0.75]); and Arab cities (period-2 IRR = 0.55 [0.38-0.79], period-3 IRR = 0.56 [0.39-0.81]). For dose 4, gaps were largest in adults aged ≥ 60 years (ultraorthodox: IRR = 0.24 [0.12-0.47]; Arab: IRR = 0.15 [0.10-0.22]). Higher socioeconomic status was consistently associated with uptake, particularly for boosters. The peripherality index was associated with lower dose 4 uptake, suggesting geographic disparities and access barriers. Policy analysis highlighted Israel's rapid mass vaccination rollout and evidence-based booster adoption, but also declining booster uptake and widening sociodemographic inequities. The primary campaign relied on centralized mass vaccination efforts and intensive public messaging, achieving high coverage, while the booster phase was mainly integrated into existing infrastructure, with more targeted outreach and reduced media emphasis, shifting from infection prevention to severe-disease prevention policy.

Persistent disparities in COVID-19 vaccine uptake widened during the booster phase in Israel. While rapid, centralized rollout achieved high initial coverage, sustaining equitable uptake proved challenging. These findings highlight the need for ongoing, equity-focused strategies, including targeted outreach and culturally tailored interventions throughout all phases of public health emergencies, particularly in the long-term phase, to strengthen existing healthcare infrastructure.

Influenza vaccine hesitancy remains a major barrier to achieving adequate vaccination coverage, particularly in densely populated urban areas with aging populations. Seven Chinese megacities are especially vulnerable to influenza transmission, yet evidence on drivers of vaccine hesitancy in these contexts remains limited. This study aimed to assess the prevalence and determinants of influenza vaccine hesitancy (IVH) among urban populations to inform strategies for improving vaccine uptake in China.

We conducted a multi-city cross-sectional survey from March to June 2025 across seven Chinese megacities (Beijing, Shanghai, Guangzhou, Shenzhen, Tianjin, Chongqing, and Chengdu). Participants were selected using a stratified sampling strategy within communities; eligible participants were residents (aged ≥ 18 years) who had lived in the selected communities for at least six months. Data on demographic, socioeconomic, attitudinal factors, and behavioural factors were collected. Multivariable logistic regression was used to identify factors associated with IVH and pre-season influenza vaccine uptake.

A total of 8689 participants were included. Overall, 45% of participants were classified as vaccine hesitant, while the self-reported influenza vaccination coverage for the 2024 season was 30%. Substantial variation in hesitancy was observed across megacities. Older adults (≥ 65 years) were less likely to report IVH than younger adults (18-44 years) [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI): 0.55-0.93] and more likely to be vaccinated (aOR = 1.63, 95% CI: 1.35-1.96). Psychosocial factors were the strongest predictors of hesitancy, particularly low perceived vaccine benefit (aOR = 11.18, 95% CI: 8.45-14.64) and low trust in health authorities (aOR = 17.13, 95% CI: 13.51-21.71). Vaccination uptake was primarily associated with behavioural factors, especially prior COVID-19 vaccination (aOR = 0.32, 95% CI: 0.25-0.39).

Influenza vaccination in Chinese megacities is driven by a mix of demographic, psychosocial, and behavioural factors. Targeted strategies addressing both hesitancy and uptake are needed to improve coverage and reduce influenza transmission.

Nurse and patient outcomes in South Africa were poor before COVID-19 and are believed to have worsened during and after the pandemic. Limited evidence exists on modifiable organisational factors contributing to these outcomes hindering targeted interventions.

This paper aims to develop a better understanding of potentially modifiable organisational factors of hospitals that, if addressed, would likely contribute to improving nurse wellbeing and retention, and quality and safety of patient care.

Data were collected from 143 private and public hospitals (n = 4298 nurses) across South Africa using a cross-sectional survey. Independent variables included working time with COVID-19 patients, incidence of death and dying, resources, staffing, and the practice environment; dependent variables focused on nurse outcomes (job satisfaction, intent to leave, burnout, mental and physical health) and patient outcomes (quality of care and patient safety).

Nurse and patient outcomes were worse in public compared to private hospitals. Favourable practice environments had the strongest association with nurse and patient outcomes, followed by staffing and resources. Within the practice environment, nurse management, leadership and support of nurses showed the greatest association with job satisfaction (OR = 4.71^∗∗; 95% CI = 3.97-5.58), lower intent to leave (OR = 2.81^∗∗; 95% CI = 2.33-3.38) and more favourable mental health (OR = 2.58^∗∗; 95% CI = 2.19-3.04). Greater nurse participation in hospital affairs was associated with more favourable nurse assessments of quality of care (OR = 3.74^∗∗; 95% CI = 3.22-4.33 to OR = 6.51^∗∗; 95% CI = 3.81-4.95) and patient safety (OR = 4.35^∗∗; 95% CI = 3.81-4.95).

Interventions to improve nurse wellbeing and retention as well as quality and safety of care should focus on improving hospital practice environments, specifically nurse manager expertise, nurse leadership, nurse participation in hospital affairs, and adequate staffing and resources.