BackgroundThis study aimed to evaluate differences in adherence to integrative therapy recommendations provided by the Consultation Service for Integrative Medicine (SIM) at the Women's Clinic of the University Hospital Erlangen, Germany, across patient subgroups. The study sought to identify opportunities for further optimization and refinement of the integrative care program.MethodsIn this cross-sectional study, data of 120 women who visited the SIM consultancy were collected at the first presentation (Baseline) and after 3 to 6 months of therapy (Follow-Up) using standardized questionnaires. The adherence variable was defined as the proportion of integrative therapy methods implemented for at least four weeks of the total number of therapy recommendations received per patient. Differences in patient-reported adherence to integrative therapies among cohorts defined by demographic characteristics, lifestyle factors, and tumor-related characteristics were evaluated using independent-samples t-tests and analyses of variance (ANOVA).ResultsThere was no significant difference in adherence with Integrative therapy recommendations in cohorts based on age, education, Body-mass-index (BMI), tumor localization and treatment modality. Factors significantly associated with lower adherence, were low physical activity, defined as self-reported absence of regular exercise, compared with patients reporting approximately 1 hour or 2-4 hours of exercise per week, and presence of distant metastases.ConclusionAdherence with SIM recommendations was significantly lower among patients with low physical activity levels, as well as among patients with distant metastatic disease. This shows that the treatment concepts of the SIM need to be adapted more individually and, in particular, body-based treatments need to be reviewed in order to make them accessible for patients with poorer physical condition.

Melanoma-related TikTok content lacks adequate skin of color representation and comprehensive educational content. This study found that engagement differed by content type, with response-style videos performing best and educational videos performing worst; in multivariate analysis, patient-created videos were also associated with higher engagement, while educational depth was not associated with engagement, suggesting that format, relatability, and presentation style may influence audience engagement more than educational depth, highlighting potential opportunities to improve the reach and inclusivity of melanoma-related health communication.

Social media has become an important channel for health information dissemination and public discussion of human papillomavirus (HPV) vaccination. Previous reviews have examined social media and HPV vaccination, often focusing on single platforms, broader HPV-related topics, or the potential effects on knowledge, leaving limited cross-platform synthesis specifically focused on HPV vaccine-related communication content, information sources, and analytical approaches.

This scoping review aimed to map and synthesize peer-reviewed studies examining HPV vaccine-related social media content, with particular attention to communication content, information sources, and methodological characteristics.

Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we searched PubMed, Web of Science, MEDLINE, Embase, and Scopus on June 10, 2026. Backward and forward citation searches were completed on July 17, 2026. We included peer-reviewed English-language original studies published between 2006 and 2026 that analyzed HPV vaccine-related communication content on social media. Data were charted using a structured extraction form and synthesized descriptively. No formal risk-of-bias assessment was conducted.

A total of 50 studies published between 2012 and 2026 met the eligibility criteria. Eight social media platforms were represented, with X (formerly Twitter; X Corp) most frequently studied, followed by Weibo (Weibo Corporation), and YouTube (Google LLC). HPV vaccine-related communication content was synthesized into 5 categories: risk- and concern-oriented, benefit- and prevention-oriented, misinformation- and distrust-related, experiential and narrative, and practical and policy-related communication. Across studies, prevention and benefit messages coexisted with safety concerns, side effects, access barriers, misinformation, distrust, and personal narratives. Personal accounts were often associated with experiential narratives or negative sentiment, whereas professional sources were less common but generally provided more informative or higher-quality content. Analytical approaches included content analysis, sentiment analysis, topic modeling, and network analysis, but theoretical frameworks were applied in only a minority of studies.

The evidence was limited by heterogeneity in platforms, sampling strategies, data collection periods, coding schemes, and analytical methods, limiting direct comparison across studies. Because most studies analyzed publicly available social media content, this review could not determine individual-level exposure, interpretation, vaccination intention, or vaccine uptake. Overall, HPV vaccine discourse cannot be adequately understood through sentiment polarity alone. This review provides a cross-platform, content-focused synthesis of how HPV vaccine-related social media communication has been studied. Unlike previous reviews, this review clarifies how HPV vaccine-related content has been described, who generates it, and which methods have been used to analyze it. These findings support theory-informed, platform-sensitive research and may inform public health communication strategies, including evidence-based education, transparent risk communication, credible source engagement, narrative-informed messaging, misinformation monitoring, and improved information quality.

Observational studies have suggested improved survival among patients with colorectal cancer (CRC) who start statin therapy after diagnosis, but such studies are vulnerable to time-related biases and informative censoring.

To estimate the association between statin initiation after CRC treatment and CRC-specific and all-cause mortality using target trial emulation.

This nationwide cohort study used Korean National Health Insurance Service claims data from January 1, 2005, through December 31, 2015. Eligible adults had newly diagnosed CRC and no statin prescriptions in the prior 6 months. Time zero was the date of first CRC treatment. A clone-censor weight approach with stabilized inverse probability of censoring weights emulated initiation within a 6-month grace period. Data were analyzed at 3-month intervals during 60 months of follow-up from August 22, 2023, to November 22, 2025.

Initiation of any statin within 6 months after first CRC treatment vs no initiation during the same grace period.

The primary outcome was CRC-specific mortality; the secondary outcome was all-cause mortality. Weighted pooled logistic regression was used to estimate hazard ratios (HRs), 60-month marginal survival probabilities, and risk differences. Sensitivity analyses deliberately introduced immortal time bias and prevalent user bias. The same design was applied in a cohort with ischemic heart disease as a positive control.

Among 88 516 patients (mean [SD] age, 62.7 [11.7] years; 56 424 [63.7%] male), 2071 initiated statins and 86 445 did not. Statin initiation was associated with modestly lower CRC-specific mortality compared with noninitiation (HR, 0.95 [95% CI, 0.92-0.99]); all-cause mortality was also lower but did not reach statistical significance (HR, 0.96 [95% CI, 0.93-1.00]). The 60-month absolute differences in CRC-specific and all-cause mortality were small (1.1 percentage points [pp] [95% CI, -0.1 to 2.3 pp] and 2.4 pp [95% CI, 1.0-3.8 pp], respectively). Conventional analyses yielded more protective estimates. In the positive-control cohort with ischemic heart disease, statin initiation was associated with lower all-cause but not cardiovascular disease-specific mortality.

In this nationwide cohort study of adults treated for CRC, the survival benefit associated with statin initiation was modest and substantially attenuated compared with conventional observational estimates, suggesting that earlier protective associations may have reflected time-related biases and informative censoring.

PD-1 and LAG-3 are frequently used as markers of T cell exhaustion, yet the prognostic relevance and phenotypic characteristics of PD-1⁺LAG-3⁺CD8⁺ T cells in gastric cancer (GC) remain poorly defined. This study aimed to investigate their association with clinical outcomes and characterize their immune characteristics across independent GC cohorts.

Four independent GC cohorts were analyzed: the Zhongshan Hospital cohort (ZSGC, n = 298), The Cancer Genome Atlas cohort (TCGA, n = 371), an Immune Checkpoint Blockade cohort (ICB, n = 45), and the Yonsei cohort (n = 433). Intratumoral PD-1⁺LAG-3⁺CD8⁺ T cell infiltration was quantified by immunofluorescence staining and transcriptomic gene signature scoring. Survival analysis was performed using Kaplan-Meier estimation and multivariate Cox regression. Functional characterization was performed by flow cytometry on resected GC tissue. The immune microenvironment composition was evaluated using computational analyses.

PD-1⁺LAG-3⁺CD8⁺ T cells were enriched within tumors compared to adjacent normal mucosa, and their infiltration correlated with advanced tumor stage, poor differentiation, microsatellite instability, and Epstein-Barr virus (EBV)-positive molecular subtypes. High intratumoral infiltration was significantly associated with improved overall survival in both the ZSGC and TCGA cohorts, whereas single-positive PD-1⁺CD8⁺ or LAG-3⁺CD8⁺ T cells showed no such association. In the ICB cohort, higher infiltration was associated with a higher response rate to pembrolizumab. Intratumoral PD-1⁺LAG-3⁺CD8⁺ T cells exhibit an activated phenotype characterized by increased expression of CD137, IFN-γ, perforin, and CXCL13, along with elevated TCF7 and lower PD-1 levels, suggesting a tumor-reactive, pre-exhausted state. High infiltration was further associated with an immune-active tumor microenvironment.

High intratumoral infiltration of PD-1⁺LAG-3⁺CD8⁺ T cells is associated with favorable prognosis and an immune-active microenvironment in GC. These cells display phenotypic features consistent with a pre-exhausted state and may serve as independent prognostic biomarkers and candidate predictive biomarkers for immunotherapy stratification.

Endometrial carcinoma (EC) is a common gynecological malignancy with an increasing incidence, particularly among younger and obese women. Although early-stage EC generally has favorable outcomes, advanced and recurrent disease remains difficult to treat, highlighting the need for reliable biomarkers and biologically relevant therapeutic targets. DHCR24, a terminal enzyme in cholesterol biosynthesis, has been implicated in tumor progression, but its clinical relevance and biological role in EC remain incompletely defined. In this study, we evaluated DHCR24 expression, prognostic significance, and functional relevance in EC using public transcriptomic datasets, independent clinical specimens, in vitro assays, and an in vivo xenograft model. DHCR24 was significantly upregulated in EC and was associated with advanced FIGO stage, high tumor grade, and poor survival. Functional assays showed that DHCR24 promoted EC cell proliferation, migration, invasion, and tumor growth. Bioinformatics analyses indicated that DHCR24-associated genes were enriched in cholesterol metabolism, PI3K-Akt signaling, PPAR signaling, ECM-receptor interaction, cell cycle regulation, and cellular senescence-related pathways. Further experiments showed that DHCR24 knockdown increased p53, p21, and p16 expression and enhanced SA-β-gal staining, whereas DHCR24 overexpression produced the opposite effects. Reciprocal Co-IP assays suggested a potential association between DHCR24 and p53, indicating a possible link between DHCR24 and p53/p21/p16-related cellular senescence-like changes. Exploratory immunoinformatics analyses further suggested that DHCR24 expression may be associated with immune-related features in EC. Overall, these findings support the potential value of DHCR24 as a prognostic biomarker in EC, although further mechanistic and immunological validation is required before its therapeutic potential can be established.

Cancer cells must deal with excessive reactive oxygen species (ROS) to survive severe hypoxia and anticancer therapy; however, anti-ROS mechanisms other than the well-known NFE2L2/NRF2 signaling pathway are poorly recognized. Here, we report a ROS scavenging mechanism mediated by HIF1α-KLF4-induced hemoglobin extraerythrocytically expressed in hepatocellular carcinoma (HCC). We found that the ROS pathway was aberrantly activated in HCC and was associated with hemoglobin upregulation, which independently predicts poor outcomes. Network analysis further identified heme binding as the top ROS-associated functional module, suggesting a previously unrecognized role of hemoglobin in maintaining redox homeostasis in HCC. Hemoglobin expression in cancer cells is transcriptionally controlled by HIF1α via KLF4 but not HIF2α or the recently identified KDM5A-KLF1 signaling. The upregulated hemoglobin counteracts the detrimental effects of oxidative stress by scavenging ROS, promoting sorafenib resistance, which could be effectively reversed by interfering with hemoglobin expression, leading to tumor suppression. Both in vitro and in vivo experiments consistently supported the functional importance of hemoglobin in regulating oxidative stress adaptation and therapeutic response. Overall, a previously unrecognized mechanism was identified for cancer cell survival under oxidative stress, where HIF1α-KLF4 signaling induces hemoglobin to scavenge ROS produced during hypoxia and anticancer therapy, providing a promising target of synthetic lethality for cancer therapeutics.

Salivary gland neoplasms (SGNs) represent a diverse group of benign and malignant tumors characterized by distinct genetic abnormalities that contribute to their pathogenesis and variable clinical behavior. This review synthesizes current evidence on the molecular alterations underlying SGNs and highlights emerging therapeutic targets with translational potential. A comprehensive literature search was conducted across PubMed, Google Scholar, Cochrane, and SCOPUS for studies published between 1990 and 2025, focusing on genetic aberrations, oncogenic fusions, and targeted treatment strategies. Data reveal that small molecule inhibitors and other targeted agents may offer promising alternatives to conventional chemotherapy. For instance, pleomorphic adenomas often have PLAG1 overexpression and FGFR1 fusions, activating the IGF and WNT signaling pathways; linsitinib, a dual IGF1R and tyrosine kinase inhibitor, has demonstrated antitumor activity in other malignancies and may hold potential in this context. Similarly, alterations in EGFR, HER2, and PI3K pathways across multiple salivary tumor subtypes highlight opportunities for small molecular inhibitor therapy. However, current data remain limited, and therapeutic applications are largely extrapolated from other cancers. Further research is needed to validate these findings in clinical trials. Overall, integrating molecular diagnostics with pathway-specific targeted therapies may enhance outcomes and expand treatment options for patients with SGNs.

Bayesian statistics provide direct probabilistic interpretations that align with clinical decision-making in prostate cancer. Unlike frequentist approaches, which yield P-values and confidence intervals, Bayesian methods generate posterior probabilities that directly address patient-facing questions. This review synthesizes Bayesian applications across the prostate cancer continuum. We conducted a narrative review informed by a structured search of PubMed, Web of Science, and the Cochrane Library. Searches yielded 465 records; after removal of 144 duplicates, 321 were screened, and 11 representative studies were selected. The review was prepared with reference to the Scale for the Assessment of Narrative Review Articles (SANRA) guidance. Bayesian methods produced clinically interpretable probabilities and individualized predictions across prostate cancer care. Joint modeling of longitudinal prostate-specific antigen with time-to-event outcomes enabled dynamic recurrence forecasting, and risk-triggered active surveillance schedules reduced biopsies while maintaining timely upgrading detection. Bayesian network meta-analyses ranked systemic therapies and imaging tracers. Adaptive, model-based designs optimized radiotherapy and radioligand dosing, while population pharmacokinetic/pharmacodynamic frameworks supported hypothesis-generating personalization. Bayesian networks also improved causal adjustment in observational studies. Collectively, these applications enhanced evidence synthesis, decision transparency, patient communication, and model calibration. Bayesian statistics complement frequentist methods by providing interpretable probabilities, incorporating prior knowledge, and supporting transparent clinical decisions. Familiarity with key concepts-posterior probabilities, credible intervals, prior specification, and calibration-enables clinicians to critically appraise Bayesian studies and communicate results effectively. As prostate cancer management increasingly emphasizes longitudinal monitoring and personalized treatment, Bayesian methods offer natural frameworks for evidence synthesis and decision-making under uncertainty.

Ki67 index assessment is crucial for breast cancer classification and prognosis. We compared Ki67 by immunohistochemistry (IHC) using visual counting-eyeballing (VA-E), manual counting on images (VA-M) and digital image analysis (DIA) to evaluate agreement levels and the impact when using IHC as a surrogate for molecular classification.

The study included needle biopsies of invasive breast cancers. The Ki67 index was re-estimated by DIA and VA-M. The re-estimated values were compared with previously reported VA-E values. Agreement was assessed by the kappa (κ) coefficient, and Bland-Altman plots were used to analyse the mean difference in the index and its impact on molecular classification.

The study included 389 invasive ductal carcinomas of no special type. The majority were grade 2 (n=205, 52.7%) and 44% (n=171) were hormone receptor-positive (HR+). Grade 1 and 2 tumours with a Ki67 index of <20% showed significantly lower estimates by VA-E than DIA. Bland-Altman analysis revealed mean differences of 1.8 (95% CI -0.24 to 3.4) for all IDC and 4.2 (95% CI -1.91 to 6.49) for HR+ luminal cancers. Re-evaluation of the Ki67 index by DIA reclassified 28/62 luminal-A-like tumours to luminal-B-like and 16/109 luminal-B-like tumours to luminal-A-like, with an absolute discordance of 25.7%. VA-M estimates correlated more closely with DIA than VA-E.

Lower Ki67 was observed with VA-E compared with DIA. There was discordance in the classification of luminal-like tumours, highlighting potential clinical implications when applying Ki67 cut-offs. VA-M demonstrated greater concordance with DIA than VA-E. For facilities lacking DIA, VA-M may be performed for Ki67, particularly in low-grade HR+ tumours.