Gastric cancer (GC) remains a major global health challenge, contributing substantially to cancer incidence and mortality worldwide. This study aimed to evaluate the worldwide disease burden and evolving trends of GC utilizing the Global Burden of Disease 2023 database, intending to offer a robust scientific foundation for public health policy. Utilizing pertinent information from the Global Burden of Disease 2023 database, we calculated the estimated annual percentage change to measure temporal trends. We applied age-period-cohort models to analyze the impacts of time periods and cohorts from 1990 to 2023. Additionally, we explored the correlation between the burden of GC and the socio-demographic index through frontier analysis and health inequality evaluation while forecasting future trends utilizing Bayesian age-period-cohort models. From 1990 to 2023, the global cases of GC rose by 20.04%, reaching 1262,000; the total number of deaths increased from 912,483 to 934,795; however, cancer-related disability-adjusted life years (DALYs) declined by 8.85% compared to 1990. The age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate of GC have generally demonstrated a downward trend since 1990. The disease burden is notably greater in males than in females. Bayesian age-period-cohort projections indicate that by 2035, GC incidence is anticipated to reach 1,159,745, while the expected numbers of deaths and DALYs are forecasted to decline to 667,145 and 15,783,072, respectively; additionally, the impact of GC in older age demographics is projected to increase significantly. Although the age-standardized incidence, mortality, and disability rates of GC have declined globally from 1990 to 2023, the absolute number of incident cases, deaths, and DALYs remains substantial, indicating a persistent global health burden. Future prevention strategies should consider differences in demographic structure, socioeconomic development, and regional disease patterns.

Past experiences, emotions, health behaviors, knowledge levels, and health beliefs about mammography can influence participation in future screening. Although nurses possess the necessary knowledge, their compliance with mammography screening schedules is lacking. This qualitative study explored the experiences of nurses who had undergone mammography screening. This study adopted a qualitative phenomenological research design. The study sample comprised 20 nurses who had undergone mammography in the last year, who were identified through purposive sampling, and who agreed to participate in the study. The study data were collected during in-depth interviews using information garnered from data on the sociodemographic characteristics of the participants and a semi-structured interview form comprising 8 questions. The nurses included in the study had a mean age of 51.05 ± 3.51 years, and 10 had postgraduate degrees. Descriptive and interpretive analyses of the gathered data revealed 4 main themes: deciding to have a mammogram, experiences before the mammography procedure, experiences during the mammography procedure, and experiences after the mammography procedure. Nurses experienced feelings of anxiety, fear, and doubt related to a possible cancer diagnosis before, during, and after their mammography procedures, suggesting the need to plan interventions to eliminate fears associated with mammography procedures among nurses. Targeted interventions such as educational workshops and emotional support programs can help nurses overcome their apprehensions and build confidence in the procedure.

Plasma lipid composition has been linked to multiple cancers, yet its causal contribution to gastric cancer and the potential intermediary role of immune cells remain unclear. We aimed to clarify these relationships and identify specific lipid and immune cell traits that either protect against or promote gastric cancer. We performed a 2-sample, 2-step Mendelian randomization analysis using summary statistics from large genome-wide association studies of gastric cancer (1423 cases, 3,14,193 controls), plasma lipidomics (179 molecular species), and 731 immune cell phenotypes. Independent, genome-wide significant single-nucleotide variants served as instrumental variables. First, we estimated the causal effects of each plasma lipid on gastric cancer. Then, we explored the potential intermediary role of lipid-associated immune cell traits using a 2-step Mendelian randomization framework. Two lipids - phosphatidylethanolamine (18:0 0:0) and phosphatidylcholine (O-18:0 16:1) - were causally associated with a lower risk of gastric cancer. Three immune cell traits (CD8br and CD8dim %leukocyte, IgD on IgD+ CD38- and CD3 on CD28- CD8br) similarly showed protective effects. In contrast, phosphatidylcholine (O-16:1 18:2), triacylglycerol (49:1), triacylglycerol (56:3), and triacylglycerol (56:4) increased gastric cancer risk, as did immune traits such as TD DN (CD4-CD8-)AC, CD19 on memory B cell, CD28 on CD39+ activated Treg, CD45 on CD4+, CD127 on CD28+DN(CD4-CD8-) and CCR2 on CD14+CD16+ monocyte. Exploratory mediation analyses found no statistically significant evidence that immune cell traits mediated the effects of plasma lipids on gastric cancer risk. Specific phosphatidylethanolamines and phosphatidylcholines confer protection against gastric cancer, whereas several triacylglycerols increase risk. However, exploratory mediation analyses provided no statistically significant evidence that immune cell traits mediated these associations.

The current study aimed to differentiate between benign and malignant medullary lesions in the appendicular skeleton of patients with plasma cell diseases using whole-body low-dose computed tomography (CT) and various clinical indicators. The clinical and radiological data of 234 patients with multiple myeloma (mean age, 59.5 ± 8.4; males: 128) who met the inclusion criteria and visited our hospital between December 2020 and February 2023 were retrospectively evaluated. A total of 234 lesions (1 lesion per patient) were categorized into plasma cell tumor (PCT; n = 154) and red bone marrow (n = 80) groups. Intergroup comparisons were carried out using the independent-samples t test, Mann-Whitney U test, or chi-square test. Variables exhibiting statistically significant differences (P < .05) were included in the receiver operating characteristic curve analysis to evaluate diagnostic accuracy. The sensitivity and specificity of a CT value ≥41.5 hounsfield unit (HU) as a diagnostic criterion for PCT were 94.2% and 91.8%, respectively, indicating a diagnostic accuracy of 93.5%. A well-defined boundary as a diagnostic parameter exhibited sensitivity, specificity, and diagnostic accuracy of 88.9%, 93.6%, and 88.7%, respectively. The sensitivity and specificity of the omitted variable (CT value ≥41.5 HU + well-defined boundaries) were 86.4% and 96.5%, respectively, indicating a diagnostic accuracy of 91.6%. CT value ≥41.5 HU and well-defined boundaries are excellent diagnostic variables for diagnosing PCTs.

Red blood cell distribution width-to-albumin ratio (RAR) has recently been suggested as a potential inflammatory biomarker in various malignancies. However, its role in lung cancer (LC) remains underexplored. Data utilized in this study were extracted from the National Health and Nutrition Examination Survey spanning 2003 to 2020. Associations between RAR and LC were explored using logistic regression and multivariable adjustment techniques. To investigate potential nonlinear trends, restricted cubic spline modeling was applied. The diagnostic capacity of RAR was further assessed through analysis of receiver operating characteristic curves. Subgroup analysis by race and sex was conducted to assess heterogeneity. All analyses were weighted to account for the sampling design. Through screening, a total of >42,746 respondents were included in our study, among whom 89 cases of LC were identified. After applying sample weighting, a notable link was identified between the RAR and higher odds of prevalent LC. Logistic regression analysis showed that, compared with the RAR < 0.287, the 0.287 to 0.310 category was associated with lower odds of prevalent LC, whereas the >0.341 category was associated with higher odds; the 0.310 to 0.341 category was not significantly associated with LC prevalence. Additionally, increased red blood cell distribution width (RDW) and reduced serum albumin (Alb) concentrations were independently associated with higher odds of LC prevalence. Restricted cubic spline analysis indicated a nonlinear relationship between Alb and LC, while both RDW and RAR showed linear associations. Subgroup analysis revealed that RAR had a consistent harmful trend among people of different genders, educational levels, and alcohol consumption levels. Receiver operating characteristic analysis confirmed that RAR, RDW, and Alb had modest discriminative ability for identifying prevalent LC cases in this cross-sectional population. RAR is significantly associated with LC prevalence in a nationally representative sample, suggesting a notable epidemiologic association that warrants further longitudinal investigation.

The relationship between obstructive sleep apnea (OSA) and hypertension has been well established. The Advanced Lung Cancer Inflammation Index (ALI), which integrates markers of inflammation and nutritional status, has been associated with hypertension in OSA patients. This study aimed to explore the association between ALI and hypertension among individuals with OSA. Data from 12,049 participants across four National Health and Nutrition Examination Survey (NHANES) cycles were analyzed. OSA was identified using a questionnaire-based sleep-related information. Logistic regression models adjusted for confounders and restricted cubic spline (RCS) analyses were conducted to evaluate the associations and potential nonlinear relationships. Logistic regression analysis showed that each unit increase in Log ALI was associated with higher odds of hypertension (OR = 1.44, 95% CI: 1.25-1.66, P < .001). Quartile analysis demonstrated that participants in the fourth ALI quartile had higher odds of hypertension than those in the lowest quartile (OR = 1.70, 95% CI: 1.40-2.07, P < .001). RCS analysis supported the nonlinear association between ALI and hypertension. This study suggests a significant association between ALI and hypertension in individuals with OSA, highlighting the potential relevance of inflammation and nutritional status in hypertension.

The Global Burden of Disease (GBD) project provides valuable insights into the global, regional, and national burdens of oral cancer (OC). This study aimed to assess the burden of OC from 1990 to 2021, analyze associated risk factors, and project future trends up to 2050. Data on OC were derived from the GBD 2021 report using the International Classification of Diseases, Tenth Revision codes C00-C08. Incidence, mortality, and disability-adjusted life years (DALYs) were estimated using DisMod-MR 2.1. Age-standardized rates were applied to assess temporal patterns. An autoregressive integrated moving average model was used to forecast future trends, with model selection and performance evaluated using standard diagnostic criteria. Potential risk factors, including smoking, alcohol consumption, and tobacco use, were further examined using Mendelian randomization analyses. From 1990 to 2021, global incidence, mortality, and DALYs attributable to OC increased, particularly in regions with lower Socio-demographic Index (SDI) levels, while high-SDI regions showed relatively stable or declining mortality. Smoking remained a major contributor to the OC burden, with alcohol use and other behavioral risks also playing important roles. Autoregressive integrated moving average projections suggested a continued increase in DALYs and deaths by 2050; however, these forecasts depend on current exposure and reporting assumptions. OC continues to impose a substantial global health burden, especially in low- and middle-income countries. Although projections indicate a likely increase in the future disease burden, these estimates should be interpreted with caution due to uncertainties in GBD data and long-term modeling. Strengthened prevention and tobacco control strategies remain essential to mitigating future risk.

To develop a predictive model based on spectral CT-derived parameters for preoperative assessment of extramural venous invasion (EMVI) in patients with colon cancer.

This retrospective study included 235 patients with pathologically confirmed colon cancer from two medical centers between September 2022 and July 2024 (192 from center 1 and 43 from center 2). Virtual monoenergetic images (VMIs) ranging from 40 to 120 keV (20 keV increments) were evaluated to identify the optimal energy level based on tumor CT value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). On the optimal VMI, spectral CT quantitative parameters were measured in the arterial, venous, and delay phases, and dynamic multiphase parameters were calculated. Patients from center 1 were randomly divided into a training cohort and an internal testing cohort at a 7:3 ratio. The nomogram model was developed using the training cohort and subsequently evaluated in the internal testing cohort and an independent external validation cohort from center 2.

(1) The 60 keV VMI demonstrated superior image quality, showing significantly higher tumor CT value, SNR, and CNR compared with other monoenergetic images (all P < 0.05). (2) Compared with EMVI negative patients, positive patients exhibited significantly higher values of ΔHU40 _{(delay-arterial)}, ΔHU60 _{(delay-arterial)}, ΔIC _{(delay-arterial)}, delay enhancement fraction (DEF), and ΔZeff _{(venous-arterial)} (all P < 0.05). Multivariable analysis further identified these five parameters as independent predictors of EMVI. (3) A nomogram was constructed based on these parameters and demonstrated AUCs of 0.93, 0.91, and 0.84 in the training, testing, and external validation cohorts, respectively.

The 60 keV VMI provides improved lesion delineation in colon cancer. A nomogram incorporating dynamic multiphase spectral CT parameters enables accurate preoperative prediction of EMVI and may support individualized clinical decision-making.

Prefrailty and frailty are associated with reduced physiological reserve and heightened vulnerability to surgical stress, which may compromise early recovery after radical prostatectomy. Although multimodal prehabilitation may enhance surgical readiness, evidence remains limited for prefrail and frail older men undergoing radical prostatectomy within the short preoperative waiting period typical of routine practice.

This prospective, outcome-assessor-blinded, parallel-group randomized controlled trial enrolled 80 men aged 60 or older with prostate cancer who were classified as prefrail or frail and scheduled for elective radical prostatectomy. Participants were randomly assigned to short-term home-based multimodal prehabilitation plus usual care or usual care alone. The intervention was delivered from enrolment until the day before surgery and included lifestyle-integrated exercise, nutritional optimisation, psychological support, pelvic floor muscle training, respiratory exercises, and perioperative health-behaviour guidance. The primary outcome was functional capacity measured by the 6-min walk test (6MWT) across the perioperative period. The primary comparison was the between-group difference in change in 6MWT from baseline to the day before surgery. Supportive secondary outcomes included frailty-related physical performance measures, and exploratory outcomes encompassed selected perioperative recovery indicators. Assessments occurred at baseline, the day before surgery, at discharge, and 4 weeks postoperatively.

All 80 randomized participants were included in the intention-to-treat analysis. The median duration of prehabilitation was 12 days. For the defined primary comparison, the prehabilitation group improved by 27.70 ± 16.86 m in 6MWT from baseline to the day before surgery, whereas the usual care group changed by - 3.12 ± 3.62 m, yielding a between-group difference of 30.82 m (95% CI, 25.32 to 36.33; P < 0.001). The generalized estimating equation (GEE) analysis showed a more favourable perioperative 6MWT trajectory in the prehabilitation group. Frailty-related physical performance outcomes showed directionally consistent improvements. Exploratory perioperative outcomes showed signals of earlier ambulation, faster gastrointestinal recovery, and shorter postoperative hospital stay. The mean overall programme execution rate was 79.3%, and no intervention-related adverse events were reported.

Short-term home-based multimodal prehabilitation improved the perioperative trajectory of functional capacity in prefrail and frail older men undergoing radical prostatectomy. Supportive and exploratory findings suggest potential benefits for early functional recovery; however, larger multicentre trials with longer follow-up are needed to confirm durability and broader clinical relevance.

Chinese Clinical Trial Registry, ChiCTR2400094812. Registered on 27 December 2024. Retrospectively registered.

Preoperative rehabilitation training can optimize functional reserve before radical prostatectomy (RP), thereby improving postoperative outcomes. However, its effects on urinary incontinence, erectile function, and quality of life (QoL) remain controversial. This study systematically evaluated these outcome measures.

Data from randomized controlled trials (RCTs) were retrieved from the PubMed, Cochrane Library, Embase, and CINAHL databases. The risk of bias was assessed using the RoB-2 tool, and meta-analysis was performed using Stata 18.0 software. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessment. Meta-analyses were conducted using fixed- or random-effects models according to heterogeneity. Outcomes included urinary incontinence incidence, urinary incontinence severity, erectile function, and QoL at different postoperative follow-up time points.

16 randomized controlled trials involving 1,542 participants were included. Prehabilitation significantly reduced the incidence of urinary incontinence at 1 month (OR = 0.58, 95% CI 0.39-0.84) and 6 months (OR = 0.52, 95% CI 0.28-0.96) after RP, with a non-significant borderline reduction at 3 months, and no significant benefit at 12 months. No significant improvement was observed in urinary incontinence severity or erectile function at any follow-up time point. Prehabilitation significantly improved QoL within 3 months (SMD = -0.70, 95% CI -1.08 to -0.32) and 6 months (SMD = -0.45, 95% CI -0.74 to -0.16) postoperatively. However, within 12 months, the effect size attenuated, showing only a marginal trend that did not reach statistical significance (SMD = -0.33, 95% CI -0.66 to 0.00). Risk of bias was generally moderate.

Prehabilitation reduces early incontinence and improves QoL post-RP, but its effects on severity and erectile function remain unclear.

PROSPERO [CRD420251183407].