This study aimed to evaluate dentists' knowledge, awareness, and clinical approaches regarding myasthenia gravis (MG), with a focus on diagnostic methods, medication safety, and emergency crisis management in dental practice.

A cross-sectional survey was conducted among 93 dentists after obtaining ethical approval (Van Yuzuncu Yil University, 2025/09-28). The questionnaire comprised 29 items grouped into demographics (7 items), knowledge (8 items), and attitude/awareness (14 items). Reliability was tested by the test-retest method, and content validity was confirmed through expert review. Data were analyzed using IBM SPSS 23.0 with Chi-square, Mann-Whitney U, and Kruskal-Wallis tests (p < 0.05).

Dentists reported limited knowledge and awareness regarding MG. While 75.5% correctly identified long and stressful procedures as potential crisis-triggering factors, substantial gaps were observed in recognizing diagnostic methods and contraindicated medications. Professional experience was significantly associated with better knowledge (p = 0.021), and regression analysis confirmed that workplace (β = -0.23, p = 0.033) and prior clinical encounter with MG patients (β = -0.28, p = 0.008) were significant predictors of knowledge. In contrast, no demographic variables significantly predicted awareness (p > 0.05). Non-parametric correlation analysis showed no significant relationship between self-reported knowledge and awareness scores (Spearman's rho = 0.053, p = 0.613).

This study is the first to comprehensively assess dentists' self-reported knowledge, awareness, and clinical approaches regarding MG. The findings reveal substantial self-reported deficiencies, particularly in diagnostic methods, medication safety, and emergency crisis management, highlighting the need to strengthen MG-related content in dental education and continuing professional training. Enhanced interdisciplinary collaboration and targeted educational strategies are essential to support safe and effective dental care for patients with MG.

Breast cancer is one of the most common cancers and a leading cause of death among women worldwide. Early and accurate classification of tumors as benign or malignant is essential for improving patient outcomes. In recent years, statistical and machine learning methods have been widely used to improve diagnostic accuracy; however, combining these approaches in a single framework remains limited.

A retrospective analysis was conducted using the Breast Cancer Wisconsin Diagnostic Dataset (569 tumor samples). Eight morphological features were analyzed. The dataset was split into training (70%) and testing (30%) sets using stratified random sampling. Logistic regression, random forest, and support vector machine (SVM) models were developed. Hyperparameter tuning was performed using five-fold cross-validation. Model performance was evaluated using accuracy, sensitivity, specificity, precision, F1-score, Matthews correlation coefficient (MCC), and area under the curve (AUC). Logistic regression assumptions and model diagnostics were also assessed.

Radius, texture, smoothness, and concavity were significant predictors of malignancy. Five-fold cross-validation indicated stable model performance. On the test set, logistic regression achieved the highest accuracy (95.3%) and AUC (0.983), followed by SVM (94.1%, AUC = 0.980) and random forest (92.9%, AUC = 0.979). Additional performance metrics, including precision, F1-score, and MCC, also demonstrated strong classification performance. Diagnostic analyses confirmed acceptable model fit and no major violations of logistic regression assumptions. No significant differences in AUC were observed among the models (DeLong test, p > 0.05).

The study demonstrates that an integrated statistical and machine learning approach provides a robust and accurate method for breast cancer classification. Logistic regression showed slightly better performance, whereas machine learning models also achieved comparable results. This approach has strong potential to support early detection and clinical decision-making.

Oesophageal cancer (OC) remains a major global public health challenge. This study aims to analyse the global, regional, and national burden of OC from 1990 to 2023 using the latest data from the Global Burden of Disease (GBD) Study 2023.

Data on EC prevalence, incidence, mortality, and disability-adjusted life years (DALYs) were extracted from GBD 2023. Age-standardised rates (ASRs) were calculated, and temporal trends were assessed using estimated annual percentage changes (EAPCs). Stratified analyses were conducted according to the sociodemographic index (SDI) and risk factor contributions. The disease burden was projected to 2040.

In 2023, there were an estimated 1 075 606 prevalent cases of OC globally, with an ASPR of 11.7 per 100 000 population. Although age-standardised rates declined, the absolute number of cases increased by 67% from 1990 to 2023. The disease burden varied substantially across SDI regions and geographical areas, with sub-Saharan Africa and East Asia bearing the heaviest burden. Tobacco use was the leading risk factor contributing to DALYs. The global ASPR is projected to rise to 18.8 per 100 000 by 2040.

Despite decreases in age-standardised rates, the absolute burden of OC remains high, with significant variations across regions, countries, and SDI levels. Efforts should be taken in prevention and early diagnosis for OC and to better identify high-risk populations to inform targeted prevention and screening, and ultimately reduce the OC burden in an efficient and cost-effective way.

Sarcopenia (SP) affects 43.8% of men with prostate cancer (PCa), correlating with higher all-cause mortality and reduced quality of life. Systematic SP screening could reduce treatment complications and improve prognosis. Although several validated software tools exist for CT-based skeletal muscle assessment, their implementation in routine clinical practice remains limited due to time constraints, operator dependency, and lack of integration into radiotherapy planning systems.

We aimed to validate a new SP screening method using MIM® software, a program commonly used in radiotherapy planning, to facilitate its implementation in daily practice.

In 41 patients with PCa, Skeletal Muscle Index (SMI) was retrospectively calculated using MIM® and compared with the validated ImageJ® method. Agreement was assessed via Bland-Altman analysis, while sarcopenic status was classified using literature-based SMI thresholds. Measurement time and reproducibility were evaluated using Wilcoxon tests, Intraclass Correlation Coefficient (ICC), and Fleiss kappa coefficients (κ). Additionally, an automated MIM-workflow was developed and compared to the semi-manual MIM-method in terms of agreement and processing time.

The cohort had a median age of 71 years, with 66% overweight or obese and 22% classified as sarcopenic. The new method demonstrated high concordance with the validated method (mean SMI difference: -0.04 cm²/m², p = 0.23), while significantly reducing calculation time (3.5 ± 1 min vs. 10 ± 1 min, p < 0.001). Reproducibility was excellent, with an ICC of 0.99 for SMI and perfect agreement on sarcopenic classification (κ = 1). The automated MIM-workflow further decreased processing time (median 3.2 min vs. 3.5 min, p < 0.001) but yielded slightly higher SMI values (mean difference: 2.3 cm²/m², p < 0.0001).

MIM® software provides a reproducible, reliable, and time-efficient alternative for SP screening, allowing radiation-oncologists to implement this assessment immediately into routine radiotherapy planning. Although the automated MIM-workflow requires further calibration to correct for systematic SMI overestimation, it represents a promising step toward full automation and broader clinical integration of SP assessment within radiation-oncology.

BackgroundBreast cancer is the leading cause of cancer-related deaths worldwide and the second most common cancer among women globally. Breast self-examination is a highly cost-effective method for the early detection of breast cancer in asymptomatic women. Despite this, the practice of breast self-examination remains low in Ethiopia.ObjectivesThis study aimed to evaluate the practice of Breast Self-Examination and Its Associated Factors among Women of reproductive age in Seven Public Health Facilities in Addis Ababa, Ethiopia.DesignThis study employed a quantitative, multicenter, institution-based, cross-sectional, analytical design.MethodsThe study was conducted among women of reproductive age receiving medical care at designated public health facilities in Addis Ababa, Ethiopia. The study participants were selected using a simple random sampling technique from the study population. The data were reviewed, coded, and entered into Epi Info version 7.0, then transferred to SPSS version 27 for analysis. A P-value of less than 0.05 was considered statistically significant. Results were reported by using texts and frequency distribution tables.ResultA total of 553 respondents participated in the study; of these, only 96 (17.3%) participants ever practiced breast self-examination. Education and Occupational status were found to have a significant association with the practice of breast self-examination. There is a strong association between knowledge and the practice of breast self-examination (BSE). Women of reproductive age who were knowledgeable about BSE were 4.75 times more likely to perform it compared to those with poor knowledge [AOR = 4.75, 95% CI (3.85, 7.45)].ConclusionThe practice of breast self-examination among the study participants was low. Therefore, we recommend that the Ministry of Health and other relevant organizations promote community awareness about breast cancer and the importance of breast self-examination.

Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are a growing population with unfavorable outcomes relative to pediatric peers. Historic underrepresentation in prospective studies has complicated unifying recommendations surrounding optimal therapeutic strategy for this group. Retrospective studies highlighting the superiority of pediatric-inspired regimens in this context have given rise to small prospective trials supporting these findings. Data demonstrating concordant implementation of these protocols outside of clinical trials is lacking. We designed a retrospective study summarizing therapeutic strategies for over 200 AYAs with ALL treated within an integrated healthcare system. We found increasing usage of pediatric protocols over the study period associated with higher utilization of outpatient clinic appointments, lower number of inpatient days, equivalent toxicity profiles, and favorable mortality rates. Our findings highlight the wide implementation and superiority of pediatric regimens for AYAs undergoing treatment for ALL in the community setting, for which more data have been needed.

The purpose of this pilot study was to examine the feasibility and acceptability of Reiki therapy for cancer survivors with moderate-to-severe symptom clusters. Adult patients with a neoplasm diagnosis, not currently undergoing active treatment, and reporting a fatigue score of ≥ 4 and two other symptoms were eligible to participate. The intervention was six 30-45-minute Reiki sessions within 6-8 weeks. The Edmonton Symptom Assessment System (ESAS-9) was completed pre- and post-Reiki session. Quality of life (PROMIS-29) measures were completed at baseline and 8 weeks after the first Reiki session. As a pilot feasibility study, recruitment, retention, attendance, data completeness, and acceptability were the focus. Descriptive statistics were generated for ESAS and PROMIS data, but no hypothesis testing was done. Twenty-three patients were pre-screened and ten were eligible, enrolled in the study, and completed baseline measures. Nine signed up for Reiki and six of those participants completed the intervention and follow-up measures (67%). All participants were female and non-Hispanic, 70% were White, 20% were African American/Black, and 10% were multiracial. Participants attended an average of 5.5 Reiki sessions. Outcome data completeness was 100%. Numerical improvements in all symptom scores and quality of life domains after Reiki were observed. Participants were overall satisfied with the Reiki. This pilot study of Reiki for cancer survivors demonstrated satisfactory feasibility. Highly preliminary assessment of outcome measures revealed sensitivity to change following Reiki. This study provides support to proceed with more research; however, modifications are needed before conducting a fully powered randomized controlled trial.

Robotic hepatectomy using the Hugo robotic-assisted surgery (RAS) system has recently been introduced; however, clinical experience remains limited. We report our initial experience in five patients, focusing on surgical techniques and short-term outcomes. All procedures were completed robotically without conversion to open or laparoscopic surgery. The median operative time was 175 min (range, 162-209), and the median console time was 100 min (range, 79-139). The median inflow occlusion time was 31 min (range, 14-62). Intraoperative blood loss was minimal, with a median of 0 mL (range, 0-10). No intraoperative or postoperative complications were observed. The median postoperative hospital stay was 7 days (range, 4-11). The series included lesions in both left- and right-sided liver segments, including technically demanding areas such as segment 7. These findings suggest that Hugo RAS minor hepatectomy appears feasible and safe in selected cases, with favorable short-term outcomes.

Objective: To explore the feasibility and safety of CT-guided brain biopsy based on fused preoperative MRI images. Methods: A retrospective analysis was conducted on the clinical data of 158 patients with brain tumors who underwent MRI-CT fusion-guided brain biopsy at the Interventional Medicine Center of the Affiliated Hospital of Qingdao University between January 1, 2019, and December 31, 2025. Pathological results, positive diagnostic rate, tissue adequacy rate, and complication rate were analyzed. The Common Terminology Criteria for Adverse Events version 6.0 (CTCAE v6.0) was used to grade the severity of complications and to calculate the rate of severe adverse events (sAEs). The positive pathological diagnostic rate and the incidence of hemorrhagic complications among lesions with different diameters was compared. Results: Among the 158 patients who underwent brain biopsy, 150 obtained a positive histological diagnosis, representing a diagnostic yield of 94.9% (95%CI 90.3%-97.4%). There were 78 males (49.4%) and 80 females (50.6%). The age range was 12-82 years, with a mean age of 56±14 years. These diagnosed cases comprised 109 gliomas, 32 metastatic tumors, 5 lymphomas, and 4 other pathological types. The remaining 8 cases were negative. A total of 89 patients had molecular testing requirements, and 83 patients completed molecular testing. The tissue sufficiency rate was 93.3% (95%CI 86.1%-96.9%), including 73 gliomas, 8 metastatic tumors, 1 lymphoma, and 1 other tumor. The biopsy positive rate was significantly lower in patients with lesion diameter <5 cm than in those with larger diameters (89.1% vs. 98.1%, χ²=6.00, P=0.022). Postoperative complications occurred in 25 patients (15.8%,95%CI 11.0%-22.3%), including 23 cases (14.6%,95%CI 9.9%-20.9%) of intracranial hemorrhage detected on postoperative CT. Of these 23 cases, 21 were Grade 1 (13.3%, 95%CI 8.4%-19.6%) and 2 were Grade 2 (1.3%, 95%CI 0.4%-4.5%). The sAE rate was 0.6%, which was due to one patient with Grade 3 cerebral edema. The incidence of hemorrhagic complications was significantly higher in patients with lesion diameter <5 cm than in those with larger diameters (25.5% vs. 8.7%, χ²=8.06, P=0.008). Conclusion: CT-guided brain biopsy based on fused preoperative MRI images demonstrates good diagnostic efficacy and safety, presenting a low and manageable complication rate. The high tissue adequacy rate satisfies clinical requirements for immunohistochemistry and molecular testing. This technique provides a safe and reliable approach for establishing a pathological diagnosis in patients with unresectable brain tumors.

This real-world study aimed to investigate the cancer therapy-induced thrombocytopenia (CTIT) profile and evaluate the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in its management.

Retrospective analysis included 12,431 CTIT patients treated with rhIL-11 across 58 Chinese centers (July 2023-June 2024). Multivariate logistic regression analysis identified CTIT risk factors. Treatment outcomes and adverse events (AEs) were assessed.

Independent CTIT risk factors included advanced age, medical history, prior myelosuppression, tumor type, bone marrow involvement, and previous anti-tumor therapy. RhIL-11 demonstrated significant thrombopoietic effects, with a mean treatment duration of 6.79 ± 2.59 days. Platelet (PLT) recovery to 50 × 10⁹/L and 100 × 10⁹/L was 4.60 ± 4.40 days and 7.68 ± 5.09 days, respectively. Hematologic malignancy patients required longer treatment and slower PLT recovery compared to those with solid tumors. Urologic and head/neck malignancy patients had faster recovery, while uterine, colorectal, and liver cancer patients exhibited poorer outcomes. Fluoropyrimidine monotherapy delayed PLT recovery compared to platinum-, taxane-, anthracycline-based regimens, or gemcitabine/platinum combinations (all p < 0.05). Furthermore, patients with "impaired" PLT recovery capacity or grade IV CTIT demonstrated longer treatment and PLT recovery times, while grade I/III CTIT was associated with higher PLT recovery response rates. AEs occurred in 28.9% of patients, primarily mild fatigue (15.3%) and edema (7.5%). COVID-19 infection correlated with prolonged treatment duration and delayed PLT normalization.

This large-scale real-world study confirms the efficacy and safety of rhIL-11 in CTIT management. Treatment responses vary slightly across patient subgroups, but tolerability remains acceptable. Findings emphasize individualized CTIT strategies and proactive AEs monitoring.