Hypertension is a common yet frequently underdiagnosed comorbidity in psoriasis patients. Early identification and blood pressure control are critical to improving outcomes. Although machine learning (ML) is widely used in disease prediction, a model for hypertension risk within the psoriasis population remains unavailable. This study aims to develop and validate such a model in patients with psoriasis.

In this retrospective study, 2,957 psoriasis patients from a single tertiary center were used for model development and internal validation, and 567 psoriasis participants from the National Health and Nutrition Examination Survey (NHANES) served as the external validation cohort. After missForest imputation and consensus feature selection, the Synthetic Minority Oversampling Technique (SMOTE) was applied to the training set only. Nine machine learning algorithms were trained and evaluated for discrimination, calibration, and clinical utility. Shapley Additive Explanations (SHAP) were used for model interpretation.

Nine nonredundant predictors were retained. The SMOTE-enhanced logistic regression model showed the most balanced and generalizable performance, with area under the receiver operating characteristic curve values of 0.850, 0.816, and 0.789 in the training, internal validation, and external validation cohorts, respectively, together with acceptable calibration and favorable net clinical benefit. SHAP identified age, dyslipidemia, and type 2 diabetes mellitus as the leading contributors. The final model was deployed as a publicly accessible web application.

This interpretable and externally validated machine learning model provides a practical tool for hypertension risk stratification in psoriasis patients and may support earlier identification and individualized preventive management in clinical practice.

Autoimmune diseases are frequently associated with neurological and cognitive dysfunction. Advances in neuroimaging and graph theory-based connectomics have enabled investigation of large-scale brain network alterations across autoimmune conditions. This review synthesizes structural and functional network studies in representative diseases, including multiple sclerosis, neuromyelitis optica spectrum disorder, systemic lupus erythematosus, thyroid eye disease, type 1 diabetes mellitus, and inflammatory bowel disease. Across these disorders, studies commonly report reduced global and local efficiency, altered modular organization, and regional hub vulnerability, although findings vary across disease subtype, imaging modality, and analytic methodology. Network alterations are often associated with cognitive impairment and neuropsychiatric symptoms, suggesting potential relevance for understanding disease burden and progression. However, current evidence remains heterogeneous and is derived largely from cross-sectional studies with modest sample sizes. Future longitudinal and standardized multimodal studies are needed to clarify the biological and clinical significance of connectomic alterations in autoimmune diseases.

We report a diagnostically challenging case of polymicrobial orbital apex syndrome in an immunocompromised patient, emphasizing the importance of early multidisciplinary intervention and consideration of fungal aetiologies in high-risk individuals. A 70-year-old woman with multiple comorbidities presented with subacute left orbital pain and frontotemporal headache, with early signs of cranial nerve VI palsy. Despite initial stability, the patient deteriorated over 2 weeks, developing complete left ophthalmoplegia, proptosis, and vision loss. Further investigation demonstrated a polymicrobial skull base osteomyelitis with orbital apex and cavernous sinus involvement. Histopathology revealed necrotic material with chronic inflammation, and cultures identified Aspergillus flavus, Pseudomonas aeruginosa, Staphylococcus aureus, and Candida parapsilosis. The patient was treated with intravenous vancomycin, oral ciprofloxacin, and voriconazole for 6-8 weeks. Diagnosing orbital apex syndrome in immunocompromised individuals is complex and early imaging is critical. A high clinical suspicion for fungal infection should be maintained, with a strong role for timely tissue diagnosis. Coordinated multidisciplinary care and targeted antimicrobial therapy can prevent further morbidity from intracranial extension.

Thyroid dysfunction and type 2 diabetes mellitus (T2DM) are common endocrine disorders with substantial public health implications. Increasing evidence suggests that alterations in thyroid function may influence glycemic regulation and the risk of T2DM. However, long-term population-based evidence on this relationship remains limited. Therefore, this study aimed to summarize the association between thyroid function and T2DM using findings from the Tehran Thyroid Study (TTS), a large community-based cohort with nearly 2 decades of follow-up.

A literature search was performed in PubMed, Scopus, Web of Science, and the library of the Research Institute for Endocrine Sciences to identify articles within the TTS framework. The retrieved articles were categorized according to their primary predictors and outcomes, including T2DM, thyroid function, thyroid hormone sensitivity, and insulin resistance.

Over 18 years, a longitudinal analysis of 1938 adults showed that each unit increase in log-transformed thyroid-stimulating hormone (TSH) was associated with a 25% lower risk of developing T2DM (HR, 0.75; 95% CI, 0.64 - 0.90), whereas higher free thyroxine (FT4) levels were associated with a slightly increased risk of T2DM. Cross-sectional data indicated that overt and subclinical hyperthyroidism significantly increased the odds of hyperglycemia, with the highest prevalence (31.3%) observed in subclinical hyperthyroidism. In studies of thyroid hormone sensitivity, a 1-SD increase in the thyroid feedback quantile-based index (TFQI) was associated with higher odds of T2DM, whereas higher central sensitivity indices were associated with lower odds of prediabetes. Lower FT4 levels were independently associated with higher insulin resistance in euthyroid men but not in women. Patients with diabetes had a higher prevalence of subclinical hyperthyroidism but a lower incidence of thyroid dysfunction compared with controls.

Trends toward lower TSH or relatively higher FT4 levels are associated with an increased incidence of T2DM. Both overt and subclinical hyperthyroidism are associated with hyperglycemia. Current evidence supports targeted metabolic monitoring in individuals with thyroid hormone excess or altered thyroid sensitivity indices but does not justify routine thyroid-directed therapy solely to prevent T2DM.

The prognostic value of CT-detected tumor necrosis in advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitor (ICI) monotherapy remains unclear. This two-center retrospective study investigated whether tumor necrosis on pretreatment CT independently predicts overall survival (OS).

A total of 151 advanced NSCLC patients who received ICI monotherapy between March 2016 and August 2021 at two Japanese institutions were retrospectively analyzed. Tumor necrosis was visually assessed and operationally defined as an intratumoral area of low attenuation or cavitary lesion ≥ 5 mm on pretreatment chest CT (contrast-enhanced in 113 patients [75%] and non-contrast in 38 [25%]). Cox regression analyses identified independent prognostic factors for OS, with internal validation using 1000 bootstrap resamples.

Among 151 patients (mean age 69 years; 90% with ECOG PS 0-1), 121 (80%) had CT-detected necrosis. Median OS was significantly shorter in necrosis-positive patients than in necrosis-negative patients (374 vs. 1035 days; log-rank p = 0.02). A multivariate Cox regression analysis identified tumor necrosis as an independent adverse prognostic factor (HR = 1.84, 95% CI = 1.03-3.30; p = 0.04), along with blood-based biomarkers, tumor size, and PD-L1 expression. The detection rate of necrosis differed between CT modalities (contrast-enhanced 84% vs. non-contrast 68%, p = 0.04).

This exploratory two-center retrospective study indicates the potential of CT-detected tumor necrosis as a readily accessible prognostic marker in ICI-treated NSCLC. However, the results obtained require validation in larger, prospective, multicenter studies with standardized CT imaging protocols before clinical implementation.

Raman Difference spectroscopy (RDS) presents a promising, non-invasive approach for facilitating rapid diagnosis of oral squamous cell carcinoma (OSCC). Many ex vivo studies rely on formalin-embedded tissue specimens. Spectroscopic changes and classification of formalin-fixed OSCC tissues were investigated. In an analysis of 47 specimens (n = 30 OSCC, n = 17 physiological mucosa), RDS was employed at 180 distinct measurement loci after storage in saline, and again at 125 measurement loci after storage in formalin. For classification, Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) were utilized. In distinguishing OSCC from physiological mucosa, LDA revealed a higher sensitivity (97.6% for NaCl-stored vs. 90.9% for formalin-fixed tissues), specificity (93.0% vs. 78.6%), and overall classification accuracy (95.2% vs. 85.4%) for specimens stored in saline. While formalin fixation is valuable for tissue preservation in histopathology, Raman spectra of OSCC tissues were substantially altered, with implications for validation of innovative optical techniques such as Raman Spectroscopy.

Subclassification of NSCLC is critical for therapeutic decision-making, particularly in small biopsies and cytology specimens where ancillary testing must be limited. Although the TTF-1/p40 panel is widely used to distinguish adenocarcinoma (ADC) from squamous cell carcinoma, a subset of NSCLCs remains unclassified, highlighting the need for adjunctive markers. Periodic acid-Schiff with diastase (PAS-D) is readily available but underutilized. We retrospectively reviewed 2611 NSCLC specimens from 2298 patients. Diagnosis was based on morphology alone in 38.6% of cases, while ancillary testing was required in 57.7%. Among 287 TTF-1_neg/p40_neg tumors, 30.3% were classified as ADC using PAS-D and/or Napsin A. PAS-D demonstrated higher sensitivity than Napsin A (71.8% vs. 69.3%), and markedly outperformed Napsin A in TTF-1-negative ADCs (89.7% vs. 25.9%, p < 0.001). This finding reflects biological differences between terminal respiratory unit-derived ADCs and non-terminal airway tumors, in which PAS-D positivity is more diagnostically informative. Combined testing improved sensitivity, with the TTF-1/PAS-D panel achieving 97.5%. This study highlights the underappreciated diagnostic value of PAS-D, particularly in TTF-1-negative tumors. PAS-D represents a simple, effective adjunct to routine diagnostic panels. Therefore, incorporating PAS-D into routine panels can enhance NSCLC subclassification, particularly in TTF-1_neg/p40_neg tumors and support accurate diagnosis and optimal clinical management.

Talazoparib plus enzalutamide improved overall survival (OS) in the biomarker-unselected TALAPRO-2 population, but OS benefit was not statistically significant in the homologous recombination repair (HRR) non-deficient or unknown subgroup, whereas radiographic progression-free survival (rPFS) was prolonged. We explored time-dependent patterns in estimated treatment effects in this subgroup.

Approximate individual-level data for 636 patients were reconstructed from published Kaplan-Meier curves; original trial-level patient data were unavailable. The proportional hazards assumption was assessed using Schoenfeld residuals and log-log plots. Interval-specific hazard ratios (HRs) were estimated using piecewise Cox models. A treatment-by-log(time + 1) interaction was evaluated formally. Sensitivity analyses included alternative interval schemes, landmark analyses, restricted mean survival time (RMST), and descriptive application of the same piecewise framework to the HRR-deficient subgroup.

The proportional hazards assumption was not rejected for OS (p = 0.63) or rPFS (p = 0.37). For OS, the 36-48-month interval showed a nominally lower hazard with talazoparib (HR 0.59; 95% confidence interval [CI] 0.36-0.97; nominal p = 0.039). For rPFS, the lowest HR occurred at 0-6 months (HR 0.56; 95% CI 0.37-0.86; p = 0.008). Treatment-by-log(time + 1) interactions were not statistically significant for OS (p = 0.44) or rPFS (p = 0.12).

This reconstructed-data post hoc analysis suggested exploratory time-dependent patterns in effect estimates without formal evidence of a time-varying treatment effect. Findings are descriptive, hypothesis-generating, and should not be extrapolated to molecularly confirmed HRR-proficient disease.

ClinicalTrials.gov: NCT03395197.

To investigate the prognostic impact of early-onset smoking history (started smoking before 24 years old) on the survival of Chinese patients aged ≥ 80 years with diffuse large B-cell lymphoma (DLBCL).

Patients aged ≥ 80 years DLBCL with smoke history admitted to our center from 2010 to 2024 were retrospectively enrolled. Patients who started smoking before 24 years old were defined as early-onset smoking group, while who started smoking after the age of < 24 years old were defined as late-onset smoking group. The overall survival (OS), progression-free survival (PFS) and treatment-related complications were compared between the two groups. Cox regression model was used to analyze the prognostic factors.

After follow-up duration of 28.7 months, 68 patients were included. The median OS of early-onset smoking group (n = 29) was 2.3 years, which was significantly lower than that of late-onset smoking group (n = 39, 3.7 years, p < 0.01). Multivariate analysis illuminated that late-onset smoking decreased the risk of death significantly (HR = 0.317, p = 0.031), as well as another risk factor: ECOG < 2 (HR = 0.569, p = 0.042).

Remarkably, late-onset smoking and better performance status portended a favorable prognosis of super-aged patients with lymphoma.

Schwannomas are relatively uncommon benign tumors of the peripheral nerve sheaths most commonly found in the head, neck, and extremities. Very few reported cases of abdominal wall schwannomas exist. We report the case of a 71-year-old man with a left-sided abdominal wall mass who subsequently underwent surgical excision with final histopathology demonstrating a cellular schwannoma. Histopathological analysis confirmed the diagnosis, revealing immunoreactivity for S100, SOX10, and vimentin while being negative for smooth muscle actin, CD34, and desmin. The Ki-67 proliferative index was 5%. These findings are consistent with a schwannoma. In this study, we emphasize the importance of considering schwannoma when evaluating soft tissue masses, even in atypical locations. This unusual finding adds to the available limited literature describing abdominal wall schwannomas.