This study aimed to assess the associations between post-diagnostic gestational weight gain (GWG) and adverse pregnancy outcomes among women with gestational diabetes mellitus (GDM) and to systematically compare the predictive performance of three mainstream GWG guidelines (IOM-2009, CNS-2021, NHCC-2023), so as to provide real-world evidence for precise GWG management in clinical GDM care.

This retrospective population-based study was conducted utilizing the standardized prenatal surveillance system in Tianjin, China. Women with GDM were stratified into insufficient, appropriate, and excessive GWG groups according to the IOM-2009, CNS-2021, and NHCC-2023 criteria. Independent associations of abnormal GWG with adverse perinatal outcomes were analyzed using independent t-tests, chi-squared tests, and multivariable logistic regression models in SPSS 26.0.

A total of 69,859 pregnant women were enrolled in the present study, including 7,198 women diagnosed with GDM. The NHCC-2023 guideline identified the highest proportion of excessive GWG (56.6%), compared with CNS-2021 (52.7%) and IOM-2009 (53.3%). Notably, only NHCC-2023 revealed a significant bidirectional association between GWG and PE risk: insufficient GWG (OR = 1.512, 95% CI: 1.057-2.162) and excessive GWG (OR = 2.449, 95% CI: 1.844-3.253) were both independently correlated with higher PE susceptibility. Excessive postdiagnostic GWG was associated with elevated risks of cesarean section and large for gestational age (LGA) infants across all three guideline frameworks, while associations for preterm birth and small-for-gestational-age (SGA) varied by guideline criteria.

The GDM-specific NHCC-2023 guideline supports precise, population-tailored GWG management for Chinese women with GDM and holds promising clinical applicability for Asian GDM populations.

Automated segmentation of diabetic foot ulcers (DFUs) supports clinical diagnosis, treatment planning, and longitudinal wound monitoring, but remains difficult owing to the heterogeneous appearance, irregular morphology, and cluttered backgrounds of ulcers in clinical photographs. Convolutional networks such as U-Net localise well but model long-range context poorly, whereas Vision Transformers capture global dependencies. We employ a hybrid ViT-bottleneck U-Net that combines a convolutional encoder-decoder with a Transformer bottleneck and attention-gated skip connections, and we emphasise that the contribution is a rigorously validated and explainable application rather than a new architecture. The model was trained on the public Foot Ulcer Segmentation Challenge (FUSeg) dataset with a hybrid Dice and cross-entropy loss, and all results are reported over five seeds as mean ± 95% confidence interval at a single fixed threshold. On the internal validation set it achieved a Dice of 0.8035 ± 0.0053 and an IoU of 0.7149 ± 0.0073 (HD95 = 19.74 px, ASSD = 6.12 px). A component-wise ablation showed that only the hybrid loss produced a statistically significant change in Dice (- 0.038, p < 0.001); the Transformer bottleneck, attention gates, and augmentation each had small, non-significant in-domain effects. External validation without retraining retained about 92% of internal Dice on the Advancing the Zenith of Healthcare (AZH) Wound Care Center cohort (Dice 0.7460, n = 278), while a small Medetec subset (n = 8) served only as a qualitative check, indicating partial rather than robust generalisation under domain shift. A quantitative explainability analysis found Grad-CAM more wound-localised (energy-in-mask 0.871 versus 0.102) but attention rollout significantly more faithful (p = 0.038, n = 200), showing the two are complementary. Predicted and expert wound areas agreed strongly (Pearson r = 0.944), and the model is lightweight (8.79 M parameters).

Diabetic neuropathic pain (DNP) is a condition that affects about 20-30% of people with diabetes, significantly reducing health-related quality of life and having a significant economic impact on healthcare economics. Although conventional "gold standard" treatments such as gabapentinoids, serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) are widely used in the clinic, a substantial number of patients have poor results with these medications in terms of the quality of their analgesia or their systemic side effects.

In order to overcome these drawbacks, this review examines the status of the current pharmacotherapy and evaluates the new classes of drugs in late-stage clinical development.

A thorough search of PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov (2015-2025) of randomised controlled trials and meta-analyses reveals a clear ceiling effect for the traditional gabapentinoids in terms of therapeutic benefit.

On the other hand, new mechanistically targeted therapies like selective Nav1.7 sodium channel blockers, alternative voltage-gated calcium channel ligands, and angiotensin II AT2 receptor antagonists show therapeutic potential and achieve marked improvement in pain scores while maintaining improved safety profiles. Moreover, new lines of therapy are emerging with the incorporation of advanced non-systemic and integrative treatments such as the development of nanotechnology-based drug delivery systems, phytoconstituents with therapeutic properties, structured physical exercise and advanced neuromodulation therapies, which are aimed at reducing the effect of neuroinflammation and microvascular damage.

Finally, modern management of DNP is shifting to a mechanism-based approach. A change from a generic, empirical drug prescription to a more precise, individual-based approach to drug prescription (phenotypic pain profile) has great potential to improve therapeutic outcomes, especially for refractory diabetic neuropathy.

Dermoscopy has enabled the detection of increasingly subtle melanocytic lesions and has contributed to a marked rise in early melanoma diagnoses. However, this shift has not been matched by a proportional reduction in mortality, raising the question of whether all lesions currently classified as early melanoma are biologically meaningful. Part of the problem lies in the definition itself. "Early melanoma" is often treated as a uniform entity, yet it likely includes lesions with widely different biological trajectories. Dermoscopy, based on the recognition of morphological patterns, does not access this biological dimension. It captures structure, not behavior and therefore operates within an inherent limitation: atypia does not necessarily equate to clinically relevant malignancy. In practice, lesions may appear suspicious yet remain unchanged over time, while others evolve. This simple observation introduces a critical dimension that static assessment cannot capture. Stability challenges the significance of atypia, while change raises concern-but neither fully resolves the underlying uncertainty. Dermoscopy, therefore, does not diagnose early melanoma in a definitive sense. It identifies lesions that warrant attention within a biologically heterogeneous spectrum. Sequential observation does not eliminate ambiguity, but places it in context, where time becomes part of the evaluation rather than an afterthought. The key issue may not be how early melanoma can be detected, but how to distinguish lesions that will evolve from those that will not.

This study aims to: (1) quantify the association between dietary intake of curcumin-containing foods (oranges and carrots) and the risk of oral cancer using NHANES data; (2) identify the consumption frequency threshold associated with reduced oral cancer risk; and (3) evaluate the predictive performance of a model incorporating curcumin-related dietary factors.

This study is based on the 2003-2004 cycle data of the National Health and Nutrition Examination Survey (NHANES) in the United States, and a total of 2762 research subjects were included. Multiple statistical methods were comprehensively employed, including descriptive statistics to present differences in demographic characteristics and lifestyles, correlation analysis to measure the degree of association between variables, logistic regression analysis to identify the independent association between dietary intake of curcumin and the risk of oral cancer, trend test to determine whether there is a significant linear trend between dietary intake of curcumin and the risk of oral cancer, 3D bubble chart to visually display the interaction effect of the frequency of intake of two types of foods on the risk of oral cancer, SHAP-value analysis to quantify the influence of features on model output, confusion matrix and ROC curve to evaluate model performance, and a comprehensive analysis of the role of dietary intake of curcumin-containing foods in the onset of oral cancer.

The results show that there are significant differences between the oral cancer group and the non-oral cancer group in terms of social economic status, lifestyle, and dietary intake of curcumin-containing foods. Social economic disadvantage may be associated with an increased risk of oral cancer, and the proportion of not consuming curcumin-containing foods is higher in the oral cancer group. Correlation analysis indicates that education level, poverty-income ratio, and dietary intake of foods containing curcumin such as oranges and carrots are negatively correlated with oral cancer, while smoking and drinking have positive correlations. Logistic regression analysis reveals that occasional consumption of oranges, frequent consumption of oranges, etc., rich in curcumin, are associated with the risk of oral cancer. Trend test analysis shows that as the frequency of intake of oranges and carrots increases, the proportion of oral cancer cases decreases (all p-values are all less than 0.01), indicating a statistically significant negative correlation between the frequency of intake and the prevalence of oral cancer. Interaction analysis shows that high-frequency intake of oranges or carrots is associated with a lower risk of oral cancer, and high-frequency intake of both is associated with a lower risk, while low-frequency intake of both is associated with a higher risk. SHAP-value analysis highlights the key role of dietary intake of curcumin-containing foods in the model, with the weighted precision rate, recall rate, and F1 score of the model all above 0.96, indicating strong predictive ability for both sample types. The ROC curve verifies that the model AUC reaches 0.89, demonstrating good predictive performance and the ability to effectively identify high-risk individuals for oral cancer.

Dietary conditions containing curcumin are closely related to the risk of oral cancer and can serve as a potential predictive indicator. For clinical practice, we suggest that regular consumption of curcumin-containing foods (oranges or carrots ≥3 times per week, corresponding to an estimated daily curcumin intake of 20-40 mg) may be beneficial for oral cancer prevention. For future research, prospective cohort studies with quantitative dietary assessment and pharmacokinetic studies on curcumin bioavailability are needed to validate these findings.

Familial adenomatous polyposis (FAP)-associated desmoid disease is a rare but important manifestation of FAP and remains a major cause of morbidity and mortality. In contrast to sporadic desmoids, which most commonly occur in the abdominal wall or extra-abdominal sites, approximately 70% of FAP-associated desmoids arise intra-abdominally, usually within the small bowel mesentery. These lesions can cause bowel and ureteric obstruction, sepsis, intestinal failure, and death. This review summarizes current evidence regarding the pathogenesis, risk factors, diagnosis, surveillance, and management of FAP-associated desmoid disease, and identifies key evidence gaps.

A literature search was performed in accordance with PRISMA methodology using Medline, Embase, PROSPERO, Cochrane, Campbell, and Joanna Briggs Institute databases. Original research studies, reviews, and guidelines relating to desmoid disease, FAP-associated desmoid disease, and FAP published up to August 2025 were eligible. Data were extracted and synthesized narratively by topic.

Aberrant Wnt/β-catenin signalling resulting from a germline APC pathogenic variant and a somatic second hit underpin the development of FAP-associated desmoid disease. Established risk factors include a distal APC pathogenic variant, positive family history, and previous abdominal surgery. Diagnosis in patients with established FAP is usually clinicoradiological, and routine biopsy is generally unnecessary, except in select circumstances. Active surveillance is now recommended as first-line management for most patients because many lesions remain stable or regress spontaneously. Surgery is primarily reserved for complications, particularly in small bowel mesenteric disease, owing to substantial operative morbidity and a lack of demonstrated survival benefit from complete resection. Systemic therapy is indicated for progressive or symptomatic disease. Tyrosine kinase inhibitors and the γ-secretase inhibitor nirogacestat have demonstrated efficacy in randomized trials, although patients with FAP-associated disease comprise only a small proportion of enrolled patients. Evidence supporting the use of non-steroidal anti-inflammatory drugs and anti-oestrogens remains limited.

Important evidence gaps remain regarding optimal imaging strategies, predictors of aggressive disease, clinically meaningful trial endpoints, and FAP-specific treatment algorithms. Dedicated studies in genetically defined FAP cohorts are required to improve risk stratification and management.

Standardized uptake value maximum (SUVmax), metabolic tumor volumes (MTV), and total lesion glycolysis (TLG) are metabolic parameters used to quantify tumors detected on fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). This is a subset project from a larger pilot study where dogs diagnosed with lymphoma via lymph node aspirates were staged and monitored with serial 18F-FDG PET/CT before, during, and after completion of standard of care chemotherapy. The aim of this prospective study was to evaluate metabolic parameters within the spleen in dogs with naive lymphoma and establish cutoff values for these metabolic parameters to predict lymphoma dissemination to the spleen (n = 7 dogs, 17 splenic samples). Splenic contours were performed at each time point to compare splenic cytology to splenic SUVmax, MTV, and TLG. Statistically significant receiver operating characteristic (ROC) curve-derived cutoff values were found for SUVmax (cutoff > 3.55, p ≤ 0.05) and MTV with a threshold of 1.5 SUV (cutoff > 325.7, p ≤ 0.05). Additionally, there are significantly higher mean/median splenic SUV, MTV, and TLG among dogs with lymphoma in the spleen compared to those with benign splenic cytology. Therefore, certain cutoff values for SUVmax, MTV, and TLG may be able to predict splenic dissemination. These results may allow for noninvasive staging, monitoring of therapeutic response, and evaluation for recurrence of lymphoma following remission.

Isolated sternal recurrence from ovarian cancer is exceptionally rare, and its optimal surgical management remains poorly defined. In selected patients with a prolonged disease-free interval and a solitary metastatic lesion, radical resection may provide durable local control while preserving chest stability and respiratory function. This video tutorial describes the surgical technique and clinical outcome of segmental sternectomy performed for a single-site sternal recurrence of ovarian cancer occurring after a disease-free interval of 12 years. Following comprehensive multidisciplinary evaluation and staging confirming isolated disease, an en-bloc segmental resection of the involved sternum was performed. Chest wall reconstruction was achieved using a rigid methyl methacrylate prosthesis, restoring anterior thoracic stability while protecting the mediastinal structures without compromising respiratory mechanics. The postoperative course was uneventful, with satisfactory functional recovery and stable chest wall integrity. At 1-year follow-up, contrast-enhanced computed tomography positron emission tomography demonstrated no evidence of local or distant recurrence. This video tutorial highlights the feasibility and safety of segmental sternectomy with prosthetic reconstruction for highly selected patients with isolated sternal metastasis from ovarian cancer, and emphasizes the importance of individualized multidisciplinary decision-making in the management of uncommon late recurrences.

To describe the sociodemographic profile of individuals eligible for lung cancer screening according to Brazilian guidelines.

This was a cross-sectional study using data from the Brazilian Longitudinal Study of Aging. We included individuals 50-80 years of age, with a smoking history of ≥ 20 pack-years, who were either current smokers or former smokers who had quit within the past 15 years. Demographic, socioeconomic, and health characteristics were analyzed.

Among 8,946 participants, 577 were eligible. Most (57.4%) were male and 37.4% were between 55 and 59 years of age. Black and Brown (mixed-race) participants accounted for 53.5% of the sample, and 60.6% had < 9 years of schooling. Self-rated health was poor/fair in 52.5% of the individuals, 89.3% had no private health insurance, and 41.9% were in the lowest tertile for household income. Our findings show that eligible individuals often present features associated with social vulnerability, such as a low level of education, low income, and limited access to health care.

These results highlight the importance of considering sociodemographic factors in the implementation of lung cancer screening strategies, to ensure equity in access and effectiveness of public policies aimed at early diagnosis.

This study aimed to evaluate the prevalence of sexual dysfunction among women diagnosed with gestational trophoblastic disease (GTD) who were undergoing outpatient follow-up at a university hospital. A cross-sectional study was conducted involving 73 women aged ≥ 18 yr. Data were collected using a structured questionnaire addressing sociodemographic and clinical characteristics, in addition to the Sexual Quotient - Female Version (SQ-F) to assess sexual function. Most participants were aged 18-30 yr (58.9%), married (74.0%), and reported using oral contraceptives (52.1%). Based on the total SQ-F score, 63.0% (n = 46) of participantsdemonstrated adequate sexual satisfaction. However, 15.0% reported experiencing dyspareunia, and 45.2% reported difficulty maintaining concentration during sexual activity. Sexual dysfunction was significantly associated with smoking (Prevalence ratios (PR) = 2.88; p = 0.015) and residence in rural areas (PR = 3.47; p = 0.003). Although the overall prevalence of sexual dysfunction was not higher than national estimates, the findings identify specific vulnerabilities that may adversely affect sexual health. These factors should be considered in the comprehensive clinical management of women with GTD.