Global illness-related stigma is increasingly recognized as a formidable barrier to health-seeking behavior, engagement in care, and adherence to treatments across a range of disease conditions. Stigma is experienced by many patients with lung cancer (PwLC) in the United States; however, less is known about how lung cancer stigma operates in Nigeria.

This qualitative study was conducted to describe lung cancer stigma and examine the cultural adaptability of the conceptual model of lung cancer stigma in Nigeria.

Individual and small group interviews were conducted with PwLC (N = 16) at University College Hospital (UCH), Ibadan and at Obafemi Awolowo University Teaching Hospitals Complex (OAU), Ile-Ife.

Data analyses revealed that overall, the responses mapped onto the conceptual model of lung cancer stigma and participants described their perceptions of others' stigmatizing attitudes or behaviors, consistent with "perceived stigma" as well as feelings of self-blame, guilt, shame, and regret, consistent with "internalized stigma." Participants also characterized both adaptive and maladaptive consequences of stigma, including distress/depression and constrained disclosure. Further, participants described some specific cultural contexts (moderators) that are important in understanding the landscape of lung cancer stigma in Nigeria, namely causal attributions, cancer as a spiritual attack, financial constraints, systemic delays, and non-disclosure by clinicians.

PwLC experience stigma in Nigeria, which may get triggered during clinical interactions with oncology care clinicians. Communication skills trainings for clinicians in empathy and compassion may help mitigate lung cancer stigma and improve quality of care for PwLC in Nigeria.

The International Agency for Research on Cancer classifies night shift work as Group 2A, a probable human carcinogen. This study updates the evidence on the association between night shift work and the risk of breast and prostate cancer.

Searches were conducted in PubMed and Web of Science. Case-control and cohort studies were included if they assessed night work as a risk factor for breast or prostate cancer, had =100 participants, provided full text in English or Spanish, scored =6 on the Newcastle-Ottawa Scale, and reported relative risks or odds ratio with 95% confidence interval. Heterogeneity and study quality were evaluated. Data synthesis followed PRISMA guidelines.

Twenty-one studies including 586,890 participants were analysed. For breast cancer, significant association were found only in cohort studies, both overall (RR=0.82; 95%CI: 0.67-0.99; I2=91%) and for <10 years of night work (RR=0.75; 95% CI: 0.68-0.82; I2=0%). Average study quality was acceptable (score 7), although heterogeneity was substantial. For prostate cancer, case-control studies reported an OR of 1.14 (95%CI; 1.02-1.27; I2=25%). For exposures =10 years, both RR (2.20; 95%CI: 1.35-3.59) and OR (1.16; 95%CI: 1.03-1.30) were significant. Overall quality was moderate (score 6) with low heterogeneity (25%).

Weak associations between night shift work and prostate cancer are observed in case-control studies and among individuals with =10 years of exposure, but no consistent association was found for breast cancer. These findings remain inconclusive and highlight the need for further research.

Childhood cancer mortality is disproportionately higher in low- and middle-income countries than high-income countries. The World Health Organization Global Initiative for Childhood Cancer aims for a survival of 60% by 2030. This initiative prioritizes timely diagnosis, access to standardized therapy and supportive care, and prompt management of treatment-related complications. Collaborative work is linked to better performance of health systems and delivery of high-quality care. While collaborative strategies between high- and lower-income countries can advance cancer care in low- and middle-income countries, local and regional initiatives are essential to improve clinical outcomes. The high treatment-related mortality in children with cancer in low- and middle-income countries highlights the critical need to collaborate. To decrease treatment-related mortality in children with cancer in Colombia, a new model of transdisciplinary collaboration was built among Colombian scientific societies (pediatrics, pediatric hematology/oncology, infectious diseases, critical care), academic institutions, grassroots foundations, and the Colombian Childhood Cancer Clinical Outcomes Surveillance System: VIGICANCER. The network supports resource and knowledge exchange to tackle public health challenges related to accessing cancer care for children. It enables the design of targeted and tiered multilevel interventions to enhance quality of care for Colombian children and adolescents with cancer. This transdisciplinary network aims to improve survival in Colombian children with cancer and close the gap with high-income countries by establishing data-informed targets and developing a strategic roadmap to address sepsis, the most actionable cause of treatment-related mortality. Our ultimate goal is to reduce the number of years of life lost, thereby supporting societal progress in Latin America.

This study explores the knowledge, attitude, and practice (KAP) regarding the sexual health of breast cancer patients among nurses in Nanjing, China.

Conducted from June to July 2023 across six hospitals, this web-based cross-sectional study utilized a self-administered questionnaire, resulting in 252 valid responses, predominantly from female nurses (98.41%).

The mean scores indicated inadequate knowledge (8.82 ± 5.33), a positive attitude (38.43 ± 5.23), and inactive practice (27.75 ± 6.68) regarding patients' sexual health. Multivariate logistic regression identified that the lack of training on breast cancer sexual health was significantly associated with lower knowledge (OR = 0.31, p = 0.001), while job satisfaction correlated positively with knowledge levels (OR = 1.28, p = 0.018). Age (OR = 1.13, p = 0.001) and attitude (OR = 1.22, p < 0.001) were linked to higher levels of practice. Structural equation modeling revealed that knowledge significantly positively influenced attitude (β = 0.493, p < 0.001), and both knowledge and attitude directly affected practice (β = 0.563 and β = 0.897 respectively, p < 0.001).

Overall, nurses demonstrated a need for improved knowledge and active practices concerning the sexual health of breast cancer patients.

This study aims to assess treatment preferences among newly diagnosed low-risk papillary thyroid microcarcinoma (PTMC) patients and analyse the trade-offs they make in treatment decisions.

Cross-sectional study.

Conducted at the Fourth Affiliated Hospital of Harbin Medical University from June 2023 to April 2024, this study employed a discrete choice experiment. Participants were asked to choose among three treatment options with varying levels across seven attributes. A mixed logit model was used to analyse patient preferences, calculate the relative importance (RI) of attributes, and estimate marginal willingness to pay (mWTP). Subgroup analyses were also performed.

The final sample of 418 participants yielded 11,286 observations. The most influential attribute affecting treatment choice was the 10-year risk of disease recurrence or progression (RI = 58.4%), followed by the risk of short-term complications (RI = 8.9%), treatment type (RI = 8.5%), length of hospital stay (RI = 7.7%), need for lifelong thyroid medication (RI = 7.3%), and out-of-pocket treatment costs (RI = 6.9%). The risk of permanent voice change had minimal impact (RI = 2.4%). Regarding treatment type, participants significantly preferred thermal ablation over open surgery, while endoscopic thyroidectomy was less preferred, and active surveillance was the least favoured option. The mWTP analysis reinforced these priorities. Additionally, sociodemographic and psychological factors also influenced preferences.

These findings highlight the need for healthcare providers to clearly communicate the long-term impacts of different treatment options to support informed decision-making. They also underscore the importance of improving patient-centred care, enhancing health education, and addressing the issue of overtreatment in PTMC.

To identify risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) and to establish clinical prediction models.

We retrospectively collected clinical data from 249 patients with PTC and suspected LLNM, 222 patients met the inclusion criteria. Based on postoperative pathology of the lateral compartment, 145 patients without metastasis were classified as the non-metastasis group, 77 patients with metastasis were classified as the metastasis group. All included patients were randomly assigned to training set and validation set. Univariate and multivariate logistic regression analyses were performed to screen predictors of LLNM and construct nomogram models for preoperative and postoperative prediction. Model performance was evaluated using the Hosmer-Lemeshow goodness-of-fit test, calibration curves with bootstrap resampling, receiver operating characteristic (ROC) curves and the area under the curve (AUC), as well as decision curve analysis (DCA).

In preoperative analyses, age, maximum tumor diameter ≥1 cm on ultrasound, hyperechoic area in the lateral cervical lymph node, and lateral cervical lymph nodes perinodal vascularity were independent predictors of LLNM. In postoperative analyses, age, multifocality, pathological maximum tumor diameter ≥1 cm, and concomitant central lymph node metastasis were independent predictors. The AUCs for the preoperative model were 0.805 (training set) and 0.719 (validation set), and for the postoperative model were 0.885 (training set) and 0.762 (validation set). After 1,000 bootstrap resamples, the mean absolute errors (MAE) of the calibration curves were 0.047 and 0.066 for the preoperative model (training set and validation set), and 0.021 and 0.046 for the postoperative model.

DCA showed a higher net clinical benefit of both models than the treat-all or treat-none strategies, indicating good predictive accuracy and clinical utility.

An accurate assessment of ¹³¹I accumulation capacity in lung metastases of differentiated thyroid cancer (DTC) is pivotal for guiding radioiodine therapy and avoiding ineffective ¹³¹I administration. This study aimed to develop a deep convolutional neural network (DCNN) model to predict ¹³¹I uptake in lung metastases of DTC before radioiodine therapy.

In this retrospective, multicenter, population-based cohort study, we collected chest CT image datasets for DTC patients with lung metastases from three hospitals in China. Pulmonary metastases were classified into two categories based on the post therapeutic ¹³¹I whole-body scan: ¹³¹I-avid (positive ¹³¹I uptake) and non-¹³¹I-avid (negative ¹³¹I uptake). For DCNN model development, patients were assigned to the primary dataset (140 patients with ¹³¹I-avid, 121 with non-¹³¹I-avid). For model validation, patients were assigned to the internal validation dataset (36 patients with ¹³¹I-avid, 23 with non-¹³¹I-avid), external validation dataset 1 (25 patients with ¹³¹I-avid, 18 with non-¹³¹I-avid), and external validation dataset 2 (23 patients with ¹³¹I-avid, 18 with non-¹³¹I-avid). Using these datasets, we assessed the performance of our model, ResNeSt50, and compared it with two models: Inception V3 and ResNet50.

Compared to Inception V3 and ResNet50, our model, ResNeSt50, demonstrated the highest prediction performance in the internal (area under the curve [AUC] = 0.722, 95% confidence interval [CI] = 0.716-0.725), external validation dataset 1 (AUC = 0.720, 95% CI = 0.691-0.749), and external validation dataset 2 (AUC = 0.731, 95% CI = 0.713-0.748).

We developed a simple and robust DCNN model for predicting the ¹³¹I uptake in lung metastases of DTC before radioiodine therapy, which can provide improved screening for patients who may benefit from ¹³¹I therapy.

Chinese Clinical Trial Registry (ChiCTR), ChiCTR1800018047. Registered on 28 August 2018.

The deep inferior epigastric perforator (DIEP) flap is a favored option for autologous breast reconstruction. However, complications related to insufficient perfusion, such as flap loss and fat necrosis, remain significant concerns. SPY Elite Fluorescence Imaging enables real-time tissue perfusion assessment during surgery, potentially reducing complications through superior visualization compared with clinical assessment alone. This study evaluates surgical outcomes and healthcare utilization patterns before and after the implementation of SPY imaging for DIEP flap breast reconstruction.

This retrospective study examined 271 breast cancer patients undergoing DIEP flap reconstruction at Rigshospitalet, Copenhagen (November 2016-June 2024), with 164 in the SPY group and 107 in the non-SPY group. Outcomes included flap complications and frequency of postoperative visits.

The interrupted time series revealed a significant decrease in complications over time (β = -0.110, p < 0.001) with SPY implementation. Overall rate of flap complications saw a relative risk reduction of 21.3%, explained by a reduction in rates of flap infection, flap loss, and seroma. Healthcare utilization decreased across all categories: hospital visits (-21.6%), doctor visits (-17.4%), and nurse visits (-23.6%). The number needed to treat to prevent one complication was 6.0.

SPY imaging implementation was associated with significant reductions in flap complications and healthcare utilization. While our interrupted time series design strengthens causal inference by accounting for temporal trends and learning curves, the observational nature precludes definitive causal claims. The technology shows potential clinical and economic value. Prospective studies are needed to validate these findings and establish standardized protocols for optimal application.

Given inconsistent findings from previous epidemiologic studies on the association between antidepressant exposure and colorectal cancer (CRC), our study provides a rigorous investigation to clarify the temporality of this association, including early-age onset (EAO) and average-age onset (AAO) CRC.

We conducted a population-based case-control study using administrative health databases from British Columbia, Canada. We included CRC cases and controls, matched (1:10) on age, sex, and index date (i.e., CRC diagnosis date/matched date). Antidepressant exposures were ascertained by duration (i.e., varying windows from 15 to 1 year before CRC diagnosis), drug classes (tricyclic antidepressants (TCAs), selective serotonin reuptake inhibiters (SSRIs), other), cumulative dose and treatment intensity. We used multivariable conditional logistic regression models and interpreted odds ratios as relative risks.

Among 10,171 CRC cases (688 EAO-CRC; 9483 AAO-CRC) and 90 928 controls, antidepressants exposure in the 15-year window was associated with a lower risk of CRC overall (adjusted relative risk [aRR] 0.84; 95% CI 0.80, 0.89), EAO-CRC (aRR 0.54; 95% CI 0.44, 0.66), and AAO-CRC (aRR 0.87; 95% CI 0.83, 0.92). Across narrowing exposure windows, associations persisted up to 7 years before CRC diagnosis, then weakened. Inverse associations were also observed for TCAs (aRR 0.83; 95% CI 0.77, 0.89) and SSRIs (aRR 0.86; 95% CI 0.81, 0.91) and CRC. Cumulative dose and treatment intensity showed no associations.

Across all age groups, antidepressant exposure in the earlier exposure windows (15-7 years) was associated with a lower CRC risk, with the strongest effect at the 15-year window.

The tumour suppressor TP53 is frequently mutated in breast cancer and drives poor outcomes. The impact of mutant p53 (mutp53) on subtype-specific gene and non-coding RNA networks, and their clinical significance, remains largely underexplored. Here, using TCGA-BRCA data, we have delineated subtype-specific mRNA, lncRNA, and microRNA signatures, pathways, co-expression/interaction networks, and prognosis associated with hotspot mutp53 or wildtype p53 tumours. Our study shows that mutp53 deregulates the genes related to EMT, chemoresistance, and prognosis in a subtype-specific manner. The EMT-associated signature was able to stratify HER2 and Basal patients by their p53 status. Construction of lncRNA-mRNA-miRNA interaction networks led to the identification of various feedback loops and hub genes with prognostic relevance that possess binding sites for p53 and EMT-TFs within their promoters. In the basal mutp53 tumours, we found Androgen Receptor (AR) to be a downregulated EMT-associated gene, with its higher levels linked to a better prognosis. We validated that mutp53 breast cancer cell lines show reduced levels of AR and its predicted transcriptional target, miR-196a-5p. Overexpression of WTp53 resulted in the upregulation of AR and miR-196a-5p, while mutp53 (R175H) suppressed their expression. Basal mutp53 tumours with low AR displayed higher EMT scores. Enforced expression of AR led to suppression of mesenchymal markers in basal cell lines. Overall, we have identified novel prognostically relevant RNA signatures and networks that may serve as attractive therapeutic targets in mutp53 breast cancer patients in a subtype-specific manner. Additionally, we have discovered a novel AR:mutp53 association that may be implicated in EMT and chemoresistance.