To develop a scientifically sound and feasible death education program tailored to the needs of family caregivers of patients with advanced cancer, aimed at guiding clinical practice and enhancing the effectiveness of death education.

Family caregivers serve as crucial social support for patients with advanced cancer. Beyond bearing heavy caregiving responsibilities, they must also manage negative emotions arising from the patients' advanced illness or death. Family caregivers' levels of death anxiety may even exceed those of the advanced cancer patients themselves. Death education can transform individuals' attitudes toward death, alleviate death anxiety, reduce fear of death, and promote awareness and understanding of life. Currently, death education for family caregivers of patients advanced cancer receives limited attention, and comprehensive death education programs tailored to this group are lacking.

An initial draft of a death education program, specifically tailored to address the needs of family caregivers providing care for patients with advanced cancer, was systematically developed through a quantitative survey, semi-structured interviews and literature review. The program was then refined through two rounds of Delphi expert consultation and pilot testing.

The two rounds of Delphi expert surveys distributed 18 and 15 questionnaires, respectively. The valid response rates were 83% and 100%, with expert authority coefficients of 0.858 and 0.870, and Kendall's coefficient of concordance of 0.234 and 0.272 (P < 0.001). After Delphi expert consultation and pilot testing, the final program comprised 5 primary items, 17 secondary items, and 54 tertiary items. In the pilot test, the recruitment rate was 83% and the completion rate was 70%, providing preliminary evidence of the program's acceptability and feasibility.

By systematically integrating quantitative survey findings, qualitative interview findings, literature review evidence, Delphi expert consultation, and pilot testing, this study developed a death education program specifically designed to meet the needs of family caregivers of patients with advanced cancer. The program development process was scientifically sound and reliable, and the program content was comprehensive and targeted. The pilot test provided preliminary evidence of acceptability and feasibility; however, further validation in larger samples and real-world clinical settings is needed.

This study presents EffAtt-LungNet, an attention-guided deep learning framework for three-class lung histopathology classification. The model combines an EfficientNetB3 backbone with the Convolutional Block Attention Module (CBAM) to refine features and improve discrimination among benign lung tissue, lung adenocarcinoma, and lung squamous cell carcinoma. Experiments used the publicly released LC25000 lung subset, which contains 15,000 images across three classes and was itself produced by augmenting a smaller collection of underlying histopathology images. We generated 10,500 additional fixed variants, creating a balanced working corpus of 25,500 images with training, validation, and test partitions of 15,300, 2,550, and 7,650 images. EffAtt-LungNet reached 99.86% accuracy, 99.86% precision, 99.86% recall, 99.86% F1 score, and 0.9997 AUC on the image-level test partition. Performance was stable across five random seeds (mean accuracy 99.86±0.02%), and paired errors differed from those of the EfficientNetB3 backbone (McNemar's test, χ2=47.27, p < 0.001). Because pre-augmentation source identifiers for the released LC25000 images were unavailable, independence at the earliest source-image level could not be confirmed. The results therefore represent internal tile-level benchmark performance and require validation on independent, non-augmented, multi-centre datasets before any translational or clinical claim can be made.

Genomic or transcriptomic sequencing guides the precision of cervical cancer (CC) diagnosis; however, the molecular profile of Asian patients remains poorly understood. We established a comprehensive multi-omics cohort comprising 112 tumor-normal adjacent tissue pairs from Chinese CC patients. Our integrated analysis revealed a mutational burden comparable to other populations, with three major mutational signatures primarily attributed to APOBEC-associated, age-associated, and DNA repair-associated biological categories. Multi-omics profiling elucidated the functional consequences of somatic mutations and copy number variations, identifying PIK3CA, EP300, and MPRIP as key driver events. We further uncovered both concordant and discordant activation patterns across cancer-related signaling pathways. Transcriptomic and proteomic analyses nominated cell cycle regulation, epithelial-mesenchymal transition, and LAMC2 as promising diagnostic and therapeutic targets. Comprehensive immune characterization enabled stratification of patients into three major immune phenotypes with varying microenvironmental profiles. This study provides valuable resources and novel insights into the molecular architecture of cervical cancer in the Chinese population, identifying potential biomarkers to guide precision detection and immunotherapy strategies.

Cisplatin (DDP) is a cornerstone chemotherapeutic agent for gastric cancer, yet its clinical application is often limited by severe adverse effects, particularly dose-dependent nephrotoxicity. Quercetin (Que) is a dietary flavonoid widely present in everyday foods such as onions, apples, tea, and broccoli. It has been reported to possess both renoprotective and antitumor properties. This study evaluated the therapeutic potential of combining DDP with Que in gastric cancer treatment. In vitro, CCK-8 assays, flow cytometry, and scratch wound tests were employed to assess the impact of Que on DDP-induced nephrotoxicity and chemosensitivity, while potential mechanisms were investigated through western blot analysis. In vivo, the combined regimen was tested in tumor-bearing nude mice by monitoring tumor growth and renal function. Our results showed that Que alleviated DDP-induced suppression of proliferation and apoptosis in HK-2 cells, indicating protection against nephrotoxicity. In comparison, in AGS gastric cancer cells, Que potentiated DDP-induced inhibition of proliferation and migration, and improved apoptosis. Mechanistically, Que inhibited ERK1/2 activation in both cell types. In HK-2 cells, ERK1/2 inhibition increased c-Myc expression and decreased cleaved caspase-3 levels, whereas in AGS cells, ERK1/2 inhibition reduced c-Myc and MMP-2 levels while elevating cleaved caspase-3 expression. These effects were reversed upon TBHQ treatment. In vivo, Que enhanced the antitumor efficacy of DDP while attenuating its nephrotoxicity. Collectively, these results indicate that Que achieves the abovementioned dual effect via cell type-specific modulation of the ERK1/2 pathway, supporting its potential as an adjuvant for gastric cancer chemotherapy.

Medical objects play a crucial role in diagnosis and treatment, yet the ways in which individuals experience them remain underexplored in medical discourse. With its attention to lived experiences, graphic medicine can humanize and complement a more sterile biomedical perspective. This article analyzes the representation of medical objects and the experiential realities they constitute with reference to Brian Fies's Mom's Cancer (2006). The article traces how stakeholders' interactions with these objects reveal affective, social, and cultural resonances beyond the objects' clinical function. Reading medical objects as mediators of anxiety, authority, and care, this study challenges the conventional framing of medical objects as inert instruments and repositions them as active participants in the ecology of health care.

A 43-year-old woman presented with recurrent hypoglycemia and episodes of loss of consciousness. On admission, her blood glucose was 37 mg/dL (reference range: 70-99 mg/dl), with recovery after intravenous dextrose, fulfilling Whipple's triad. She had a two-year history of dizziness, fatigue, diaphoresis, and neuroglycopenic symptoms, often relieved by frequent soft drink intake, leading to weight gain. She was previously misdiagnosed with a neurologic disorder, resulting in delayed evaluation. Laboratory findings showed elevated serum insulin levels of 65 μU/mL (reference range: 2.6-24.9 μU/mL) during hypoglycemia. Contrast-enhanced CT identified a 1.7 × 1.3 cm mass in the pancreatic body without metastasis. The patient underwent distal pancreatectomy with splenectomy. Postoperatively, hypoglycemic episodes resolved completely. Histopathology confirmed insulinoma. This case highlights the importance of considering insulinoma in patients with recurrent hypoglycemia. Delayed diagnosis may occur due to nonspecific symptoms and misdiagnosis. Careful clinical assessment, basic biochemical testing, and imaging can facilitate timely diagnosis and effective surgical management in resource-limited settings.

Macrophages are highly plastic immune cells with tumor-homing capacity and immunomodulatory functions, making macrophage-based nanoplatforms attractive for cancer immunotherapy. Macrophage-based nanoplatforms include macrophage-derived extracellular vesicles (EVs), macrophage membrane-coated nanoparticles, and live macrophage carriers. The platforms combine the biological properties of macrophages with the advantages offered by nanocarriers to achieve targeted delivery and immune regulation. Beyond serving as delivery vehicles, macrophages can be therapeutically reprogrammed through strategies such as CD47-SIRPα blockade and TLR7/MyD88 pathway activation to enhance antitumor immunity. Despite promising preclinical outcomes, clinical translation of macrophage-based Biomimetic nano-drug delivery systems (BNDDS) remains challenging due to cytokine release syndrome risk, scalable manufacturing limitations, and species differences between animal models and human immunity. The review provides insights into the development and clinical translation of macrophage-based BNDDS for cancer therapy.

Chest wall tuberculosis (TB) is a rare manifestation of extrapulmonary TB and may present a significant diagnostic challenge, particularly in low-incidence TB countries such as the United Arab Emirates. We report two unusual cases of chest wall TB with distinct clinical presentations. The first case presented as a slowly enlarging chest wall mass that clinically and radiologically mimicked a soft-tissue neoplasm and was ultimately diagnosed as giant tuberculous lymphadenitis. The second case presented as a large posterolateral chest wall abscess without evidence of active pulmonary TB. Both patients were managed surgically for diagnostic and therapeutic purposes, and histopathological examination established the diagnosis of chest wall TB. Both patients received a 6-month course of anti-tuberculous therapy with complete recovery. These cases highlight the diverse clinical spectrum of chest wall TB and emphasize that the disease should be considered in the differential diagnosis of chest wall masses and abscesses, even in low-incidence TB settings. Histopathological confirmation remains essential for establishing the diagnosis and guiding appropriate management.

Adolescents and young adults with gynecologic cancer face distinctive psychosocial challenges. We examined associations between character strengths and psychological distress, anxiety, and depression and identified candidate strength-related nodes for future psychosocial research.

This cross-sectional study included 271 participants diagnosed with gynecologic cancer during adolescence or young adulthood. Gaussian graphical models estimated conditional associations and central and bridge nodes. Bayesian networks explored directed probabilistic dependencies under theory-constrained and unconstrained specifications. In silico simulations estimated model-implied outcome changes following hypothetical 1-standard deviation (SD) increases in individual character strengths.

The prespecified character-strength and psychological-outcome communities showed dense within-community and sparse between-community connections. Leadership, Creativity, Curiosity, and Teamwork had the highest strength centrality among character strengths. Psychological distress had the highest bridge strength among psychological-outcome nodes (0.148); Curiosity and Zest had the highest bridge strengths among character-strength nodes (both = 0.112). Results were similar after covariate adjustment. The theory-constrained and unconstrained Bayesian networks each retained 31 directed edges, 28 of which overlapped. The Curiosity-depression dependency was retained in both models, whereas the orientation of the Zest-distress dependency varied by model specification. A hypothetical 1-SD increase in Curiosity corresponded to the largest model-implied decrease in overall outcome severity (-0.230 SD), including depression (-0.306 SD); the model-implied change for Zest was primarily observed for distress (-0.123 SD).

Curiosity and Zest were candidate strength-related nodes with distinct, model-dependent associations with psychological outcomes. These hypothesis-generating findings require confirmation in longitudinal and intervention studies before clinical application.

We report a case of primary intramedullary infantile fibrosarcoma (IFS) in a 4-week-old infant with rapidly progressive cervical myelopathy. Histology showed a spindle cell tumour with diffuse S100 and pan-TRK expression. RNA sequencing identified an RBPMS::NTRK3 fusion. RNA-based clustering and DNA methylation profiling classified the tumour as IFS. Treatment with the TRK inhibitor, larotrectinib, achieved marked clinical and radiological recovery within 1 month, expanding the spectrum of NTRK-rearranged sarcomas and confirming TRK inhibition's efficacy in primary central nervous system IFS.