Parathyroid glands are the smallest organs in our body,that regulate calcium metabolism, by producing parathyroid hormone (PTH). They are four, at least, as they might be either supernumerary or ectopic, especially in patients with chronic renal failure. Hyperparathyroidism (HPT) is a common endocrine disease, characterized by hormone imbalance, which leads to increased secretion of PTH. Primary hyperparathyroidism (PHPT) is caused by hyperfunctioning parathyroid glands, mainly by a solitary parathyroid adenoma and less frequently by parathyroid hyperplasia or double parathyroid adenomas. The alteration in calcium homeostasis, that stimulates the excessive production of PTH is called secondary HPT. Diagnosis of HPT may be clinical or incidental on biochemical screening. Surgical removal of hyperfunctioning parathyroid gland is the only curative treatment available at the moment. Minimally invasive parathyroidectomy (MIP) seems to be the surgical procedure of choice, as it demonstrates multiple advantages, such as reduced duration of surgery shorter hospitalization, with better cosmetic outcome and fewer patient complications. Preoperative imaging is therefore essential for those patients who are going to be treated surgically.

¹⁸F-FDG PET/CT imaging has transformed the way lymphoma patients are managed, playing a pivotal role in diagnosis, staging, prognostication, and treatment response evaluation. PET/CT guided treatment is a reality in HL, having spared patients from unnecessary toxicities while maximizing responses. Advancements in imaging technology and methodologies, along with the development of artificial intelligence, are expected to revolutionize the evaluation of complex imaging data, enhancing the diagnostic and predictive power of PET in lymphoma.

Prostate-Specific Membrane Antigen (PSMA) PET/CT has rapidly become the preferred first-line imaging modality for primary staging of unfavourable intermediate-risk, high-risk, and very high-risk prostate cancer, and for restaging at biochemical recurrence. The objective of this review is to provide nuclear medicine physicians with a comprehensive and practical framework for PSMA PET/CT interpretation, structured reporting, and clinical decision integration, with emphasis on primary staging evidence, biochemical recurrence (BCR) detection rates, imaging pitfalls, and the PSMA-RADS reporting system.

A narrative review of published evidence was performed, encompassing landmark randomised controlled trials and guideline documents from the EAU, EANM, and NCCN. Key trials reviewed included proPSMA, OSPREY, PRIMARY, CONDOR, and VISION.

PSMA PET/CT demonstrated diagnostic accuracy (AUC) of 0.92 versus 0.38 for conventional imaging in primary staging (proPSMA). Detection rates in BCR ranged from 38% at PSA <0.2ng/mL to 97% at PSA >2ng/mL. In a phase 3 RCT, ¹⁸F-PSMA-1007 demonstrated superiority over ¹⁸F-Choline (84% vs 69%, OR 2.53, p<0.001).

PSMA PET/CT provides superior staging accuracy, enables detection of recurrence at low PSA levels, guides oligometastasis-directed therapy, and serves as the mandatory gatekeeper for ¹⁷⁷Lu-PSMA-617 theranostic eligibility. Structured reporting using PSMA-RADS and rigorous CT correlation - particularly to exclude unspecific bone uptakes (UBUs) with ¹⁸F-PSMA-1007 - are core professional competencies of the nuclear medicine physician.

Ovarian cancer is one of the most common gynecological cancers in women. Its diagnosis and treatment often cause significant psychological distress, mainly reflected in depression and anxiety, which arise from multiple interacting factors. This study, grounded in Lazarus's Stress and Coping Model and from the perspective of set theory, aimed to investigate the correlates and configurational pathways of high and low levels of depression and anxiety symptoms in ovarian cancer patients by integrating stress sources, coping styles, and coping resources.

The study recruited ovarian cancer patients from a tertiary general hospital in Shenyang, China. The analysis included 169 ovarian cancer patients. The configurational factors included self-perceived burden (SPB), positive and negative coping styles, self-esteem, and general self-efficacy. Multiple linear regression and fuzzy-set qualitative comparative analysis (fsQCA) were used to explore the factors and configurational pathways related to depression and anxiety symptoms.

The fsQCA identified six configurational pathways linked to high and low levels of depression symptoms. Similarly, the fsQCA identified two configurations linked to high anxiety symptoms and four configurations related to low anxiety symptoms. Moreover, the configurations associated with low psychological symptoms did not stand in opposition to those associated with high psychological symptoms. Substitutability and complementarity were observed among the various elements in the configuration.

The study generated multiple configurational pathways for depression and anxiety symptoms in ovarian cancer patients by examining the combined effects of stress sources, coping styles, and coping resources. The configuration allows caregivers and medical staff to implement targeted measures to reduce burden perception and negative coping, enhance positive coping and self-esteem considering their substitutability and complementarity.

Cancer-associated fibroblasts (CAFs) orchestrate immune-excluded tumor microenvironment (TME), but the CAF heterogeneity remains incompletely understood in gastric cancer (GC). In this study, we integrated multicohort single-cell RNA sequencing (scRNA-seq), spatial transcriptomics, and bulk transcriptomic data to construct a comprehensive atlas of the GC TME. Unsupervised clustering identified eight transcriptionally distinct CAF subpopulations, among which CTHRC1+ CAFs were selectively enriched in tumors and showed the strongest association with T cell exclusion. Pseudotemporal trajectory analysis, gene regulatory network inference, and cell-cell communication analysis revealed that basic helix-loop-helix family member e41 (BHLHE41) serves as a key transcription factor driving CTHRC1+ CAF differentiation, whereas spatial analyses demonstrated these fibroblasts contribute to fibrotic niches at the tumor-stroma interface through macrophage migration inhibitory factor (MIF)-mediated signaling. Finally, we developed and validated a CTHRC1+ cancer-associated fibroblast-related risk signature (CRS) that accurately predicts immunotherapy response across independent cohorts. These findings establish CTHRC1+ CAFs as a critical stromal determinant of immune exclusion in GC, suggesting that targeting the CTHRC1+ CAF-MIF axis or applying CRS-guided patient stratification may enhance immunotherapy efficacy.

Colorectal cancer (CRC) is a leading cause of cancer-related morbidity and mortality worldwide, with incidence rates in Lebanon among the highest in the Middle East and North Africa (MENA) region. Despite this, data on CRC epidemiology, tumor characteristics, and treatment outcomes in MENA populations remain limited. This study aimed to investigate these factors, with the goal of supporting early detection, guiding clinical decision-making, and informing personalized treatment strategies.

This retrospective cross-sectional study included patients diagnosed with CRC between 2019 and 2023 at the American University of Beirut Medical Center. Clinical data were retrieved from electronic health records and histopathological reports. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were assessed using Kaplan-Meier survival analysis and multivariable Cox regression models.

A total of 349 patients (mean age 61 years) were included. Most tumors were low-grade adenocarcinomas (88.1%; n=306/347), and 73.3% (n=243/331) of patients presented with advanced-stage disease (Stages III/IV). Among patients with available MMR testing (n=181/349), 5.5% (n=10/181) were mismatch repair-deficient (dMMR) by immunohistochemistry. Molecular testing revealed KRAS mutations in 42.9% (n=70/163 tested) and BRAF mutations in 7.0% (n=9/128 tested). Smoking (HR = 2.58, p = 0.007) and age ≥65 years (HR = 1.98, p = 0.050) were associated with reduced OS. Patients with inflammatory bowel disease had a significantly increased risk of progression (HR = 9.39, p = 0.032). Left-sided tumors were associated with improved OS (HR = 0.42, p = 0.018).

This study identifies key risk factors, including tumor location, age, IBD, and smoking, influencing survival outcomes in Lebanese patients with CRC. Findings support implementation of risk-adapted screening strategies and population-specific therapeutic approaches in Middle Eastern settings.

Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with few reliable early diagnostic markers. Bioinformatic screening identified hsa_circ_0100833 as a differentially expressed circRNA in OSCC. Its potential significance in OSCC was then examined experimentally.

Differential circRNA expression was profiled using the GSE145608 dataset and Limma software. ROC curve analysis, circRNA-miRNA-mRNA interaction prediction, functional enrichment, and survival analysis were then used. Hsa_circ_0100833 expression was measured by qRT-PCR in 20 paired OSCC and adjacent normal tissues. This analysis was also performed in CAL-27 and FaDu cell lines (n = 3 each) and three normal human gingival fibroblast cultures. hsa-miR-607 and SORBS1 were quantified in parallel.

Differential expression analysis of the GSE145608 dataset identified hsa_circ_0100833 as down-regulated in OSCC. Bioinformatic analysis then predicted a binding interaction between this circRNA and hsa-miR-607. Hsa_circ_0100833 was significantly reduced in OSCC tissues and cell lines relative to normal controls; hsa-miR-607 was up-regulated, and SORBS1 showed parallel downregulation. ROC analysis revealed AUC values of 0.799 in cell lines and 0.712 in tissue samples. The predicted ceRNA network was enriched for PI3K-Akt signaling and focal adhesion pathways.

hsa_circ_0100833 was down-regulated in OSCC and may act as a tumor suppressor through a hsa-miR-607/SORBS1-dependent mechanism. Its diagnostic potential warrants further investigation.

It has previously been demonstrated that the nuclear factor of activated T cells (NFAT) is crucial for the development of tumors. Given OSCC's drug resistance and poor outcomes, identifying NFAT-associated prognostic genes is urgent for better treatment.

The TCGA-OSCC and GSE41613 datasets were utilized to identify differentially expressed genes (DEGs) between oral squamous cell carcinoma (OSCC) and controls. Specifically, differentially expressed genes related to NFAT (DEG-NFATs) were further screened for NFAT scores in OSCC versus control. The intersection of DEGs and DEG-NFATs was taken to identify differentially expressed NFAT-related genes (DE-NFATRGs). Univariate Cox and least absolute shrinkage and selection operator (LASSO) regression analyses were employed to identify prognostic genes. A risk score was developed based solely on the expression levels of the seven-gene signature. Subsequently, independent prognostic analyses incorporating clinicopathological variables were performed using univariate and multivariate Cox regression to evaluate whether the risk score served as an independent predictor of survival. Lastly, targeted therapeutic agents for OSCC were predicted. In addition, prognostic gene expression was validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR).

Totally 4463 DEGs obtained were intersected with 310 DEG-NFATs to obtain 263 DE-NFATRGs. A risk model can be built using the seven prognostic genes associated with NFAT (ALB, PDK4, SERPINA5, SPINK6, SERPINA9, CGNL1 and IL17F). The risk score accurately predicts survival in OSCC patients. Finally, a total of 31 drugs with significant differences were predicted between risk groups. The most significant of these were AG.014699, Midostaurin, Gefitinib, and LFM.A13. Besides, the expression levels of ALB, PDK4, and SERPINA5 were significantly higher in tumors, while the expression levels of CGNL1 and IL17F were significantly lower in tumors.

The identification of new prognostic genes (ALB, PDK4, SERPINA5, SPINK6, SERPINA9, CGNL1, and IL17F) was provided for the prognosis and treatment of OSCC.

Vaccines are one of the most effective interventions used by public health services to reduce infectious diseases. However, individuals' attitudes toward vaccines are also crucial to vaccine effectiveness. Experiences with vaccines and trust in healthcare services can guide future vaccination decisions.

The aim of this study was to examine the relationship between COVID-19 vaccine regret, distrust of the healthcare system, and future vaccination intentions.

In this cross-sectional study with a qualitative component, data were obtained through face-to-face interviews (n = 402). Data were collected using the Decision Regret Scale (DRS), the Health System Distrust Scale (HCSDS), and open-ended questions regarding the reasons for COVID-19 vaccine regret. To ensure clarity of the findings, quantitative and qualitative data were integrated.

Of the participants in the study, 87.1% did not experience any adverse effects from the COVID-19 vaccine. 56.2% of participants regretted getting the COVID-19 vaccine. Additionally, 35.8% reported being 'undecided' about accepting a new vaccine in the future. Among participants, it was found that experiencing a side effect after the COVID-19 vaccine increased distrust in the healthcare system (p < 0.05). A weak positive correlation was found between participants' HCSDS and DRS scores (r = 0.282, p < 0.001). Qualitative analyses showed that participants' regrets regarding the COVID-19 vaccine were mainly grouped around two themes: (1) 'Concern about long-term effects', (2) 'Perception that the vaccine is unnecessary'.

Based on these findings, it can be said that the phenomenon of COVID-19 vaccine regret and the level of distrust in the healthcare system will make it even more difficult to control future pandemics and infectious diseases. In addition, the findings highlight the need for communication strategies aimed at increasing trust in vaccines and the healthcare system.

Postoperative pulmonary complications (PPCs) remain common after thoracoscopic lung resection. Butorphanol, a κ-opioid receptor agonist with analgesic and potential opioid-sparing properties, may influence postoperative respiratory recovery. This trial evaluated whether perioperative butorphanol reduces PPCs after elective thoracoscopic lung resection.

In this randomized, double-blind, placebo-controlled trial conducted at a tertiary teaching hospital in China from January to July 2025, adults aged 18-65 years with American Society of Anesthesiologists physical status I-III scheduled for elective thoracoscopic lung resection were assigned to receive butorphanol or placebo. The butorphanol group received an intravenous bolus of 10 μg/kg before anesthesia induction followed by 5 μg/kg/h until the end of surgery. The control group received volume-matched saline. The primary outcome was PPCs within 7 postoperative days.

Of 520 randomized patients, 506 were included in the modified intention-to-treat analysis. PPCs occurred in 54 of 254 patients (21.3%) in the butorphanol group and 83 of 252 patients (32.9%) in the control group (relative risk, 0.65; 95% CI, 0.48-0.87; P = 0.004), corresponding to an absolute risk reduction of 11.7% and a number needed to treat of 9. The difference was mainly driven by lower rates of atelectasis and pleural effusion. Butorphanol was also associated with higher QoR-40 scores at 24 h, lower opioid consumption, and a modestly shorter hospital stay. Safety outcomes were similar between groups.

Perioperative butorphanol reduced composite PPCs within 7 days after elective thoracoscopic lung resection, mainly through reductions in atelectasis and pleural effusion, without increasing early safety events.