This study aimed to identify the association of dapagliflozin treatment with renal function and safety profile in patients with Type 2 Diabetes Mellitus (T2DM) and chronic kidney disease (CKD) in comparison with patients not treated with dapagliflozin.

This was a single-centre, retrospective study including adult patients (≥18 years) with T2DM and CKD treated between January 2020 and December 2024. Patients with missing medical records, patients treated for heart failure and patients with estimated glomerular filtration rate (eGFR) < 25 mL/min were excluded.

A total of 200 patients were included, of these 49.5% were male. The median follow-up was 2.1 years. Mean eGFR showed significantly lower deterioration in the dapagliflozin group compared to the non-dapagliflozin group (-2.1 ± 7.0 vs. -8.6 ± 10.9 mL/min/1.73 m²; p < 0.01). Multivariate analysis revealed that dapagliflozin was an independent predictor of renal protection (OR = 4.279, 95% CI: 1.002-7.56; p = 0.011). Dapagliflozin was associated with less hospital admissions (30% vs. 44%; p = 0.04) with no differences in the adverse effects profiles between the two groups.

The use of dapagliflozin was associated with significant renal protection and lower hospitalizations without compromising patient safety. These findings support the beneficial role of dapagliflozin in preserving renal function in this high-risk population.

This study aimed to investigate the protective effects of berberine (BBR) on pancreatic β-cells and explore its underlying molecular mechanisms via a proteomics-based approach.

Using db/db mice as a diabetes model, BBR was administered at doses of 100 mg/kg and 200 mg/kg for 8 weeks. The protective effects were assessed through fasting blood glucose (FBG), oral glucose tolerance test (OGTT), insulin tolerance test (ITT), pancreatic histopathological analysis, and TUNEL staining. Proteomic analysis employing the data-independent acquisition (DIA) method identified differentially expressed proteins (DEPs), whereas Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted to identify potential pathways. Molecular docking, surface plasmon resonance (SPR), and immunohistochemistry (IHC) were performed to validate key target proteins.

BBR significantly reduced blood glucose levels, improved insulin resistance, enhanced insulin secretion, and reversed pathological changes in pancreatic tissue, thereby alleviating β-cell damage. Proteomic analysis identified 171 DEPs, implicating the AGE/RAGE signaling pathway as a key mechanism through which BBR exerts its protective effects. The results of molecular docking, SPR and IHC confirmed that BBR markedly inhibited the activation of the AGE/RAGE pathway.

These findings suggest that BBR alleviates pancreatic β-cell damage, potentially through regulation of the AGE/RAGE pathway, providing insights into its therapeutic potential for diabetes management.

Diabetes is closely related to increased production of reactive oxygen species, which leads to oxidative stress, chronic inflammation, and increased apoptosis, especially in kidney tissues. Irisin is a recently discovered myokine with the potential to offer hope for the treatment of many metabolic diseases, while BAIBA is also a newly identified endogenous protective myokine. In this study, the effects of thymoquinone (TIM), known for its antioxidant activity, as well as the possible agonistic interaction between irisin and BAIBA on cellular stress and apoptosis occurring in diabetic kidneys were investigated using immunohistochemical methods. In this study, 35 Sprague Dawley rats were equally separated into five groups: Control, STZ, TIM, BAIBA and STZ + TIM + BAIBA. Type 1 diabetes was induced by a single intraperitoneal injection of streptozotocin (STZ, 50 mg/kg). The same protocol was applied to induce diabetes in the TIM and BAIBA groups. Following induction, TIM (20 mg/kg) and BAIBA (100 mg/kg) were administered daily via gavage for five weeks. In the STZ + TIM + BAIBA group, diabetes was induced similarly, followed by daily oral administration of a combination of TIM and BAIBA at the same doses for five weeks. At the conclusion of the study, kidney samples were obtained and analysed using both histochemical and immunohistochemical methods. Results demonstrated that TIM significantly reduced intersitial fibrosis by 55% in the kidneys. It is revealed that both TIM and BAIBA reduced NF-κB immunointensity by 63% and when used simultaneously by %48. Caspase3 immunointensity was reduced by 38%, 46% and 26% following TIM, BAIBA and TIM + BAIBA administration respectively. Also both TIM and BAIBA was observed to cause positive up-regulation on irisin expression. The findings of this study demonstrated that TIM and BAIBA effectively prevented renal fibrosis and apoptosis in STZ-induced diabetic rats, particularly through the downregulation of NF-κB.

Current colorectal surveillance guidelines emphasize adenoma characteristics but overlook temporal, racial, and sex-based heterogeneity in recurrence risk, a gap that limits equitable and personalized care.

To evaluate the associations of demographic factors, obesity, and adenoma features with recurrence risk over time in a large longitudinal surveillance cohort.

This retrospective cohort study included adults who underwent their first colonoscopic polypectomy between January 1990 and July 2024 at a tertiary medical center.

Demographic variables included race and ethnicity, sex, obesity (body mass index >30), family history of colorectal cancer (CRC) or polyps, and age at adenoma onset (<50 vs ≥50 years). Adenoma features included histology, size, number, and dysplasia.

The primary outcome was recurrence-free survival, defined as time from initial polypectomy to histologically confirmed recurrence. Time-varying coefficient Cox models were fitted to handle the nonconstant associations of exposure over the follow-up time. The follow-up time was categorized into 3 periods (less than 5 years, 5 to 10 years, and 10 or more years). The heterogeneity of exposure associations across the 3 follow-up periods was assessed with likelihood ratio tests.

Among 59 667 patients (mean [SD] age, 60 years [11.2]; 29 401 [49.3%] female; 1007 [1.7%] Asian and Pacific Islander, 646 [1.1%] Hispanic, 5972 [10.0%] non-Hispanic Black, and 52 042 [87.2%] non-Hispanic White; median [IQR] follow-up, 4 [1-9] years), 17 596 (29.5%) experienced overall recurrence within 5 years. High-grade dysplasia demonstrated the largest early phase association (adjusted hazard ratio [aHR], 4.00; 95% CI, 3.56-4.50) with complete midterm and late attenuation, while villous histology exhibited biphasic patterns with early elevation (aHR, 2.89; 95% CI, 2.63-3.18) and late-phase (>10 years) reemergence (aHR, 2.71; 95% CI, 2.15-3.41). Obesity conferred persistent risk across all surveillance intervals (early: aHR, 1.16; 95% CI, 1.11-1.21; late: aHR, 1.22; 95% CI, 1.09-1.35). Female patients with high-risk adenomas exhibited marked late-term (>10 years) elevation exceeding male patients (female patients: aHR, 1.73; 95% CI, 1.43-2.08 vs male patients: aHR, 1.29; 95% CI, 1.06-1.58).

Both histopathologic features and demographic factors demonstrated distinct time-dependent patterns in adenoma recurrence, underscoring the need for surveillance strategies that account for temporal variation and population-specific risk profiles.

In patients with ipsilateral breast tumor recurrence (IBTR) previously treated with breast-conserving surgery (BCS) followed by radiotherapy, salvage mastectomy (SM) is still considered standard of care. Currently, there is little evidence available about complication rates of repeat BCS or salvage mastectomy in patients with IBTR and possible differences.

The primary aim was to report postoperative complication rates after IBTR treatment with salvage mastectomy or repeat BCS after previous BCS (± radiotherapy). Secondary, risk factors associated with complications were examined.

Complication rates were reported using descriptive statistics. Complications were classified between short-term (less than 3 months after surgery) and long-term (more than 3 months after surgery). Logistic regression was used to evaluate possible risk factors after salvage mastectomy to report an odds ratio (OR) with a 95% confidence interval (CI).

A total of 549 cases with IBTR after primary BCS were included. Short-term complications occurred in 200 (45.2%) of 442 patients treated with salvage mastectomy and in 9 (16.4%) of 55 patients treated with repeat BCS. Seroma and surgical site infection (SSI) were most common in salvage mastectomy (31.7% and 10.9%, respectively). Long-term complications were reported in 16.7% treated with salvage mastectomy and in 14.5% with repeat BCS. The risk of short-term postoperative complications after salvage mastectomy increased significantly with higher BMI. The regression analysis showed that adjuvant radiotherapy after IBTR surgery was associated with long-term postoperative complications.

Salvage mastectomy in case of IBTR after primary BCS is associated with high short-term complication rates, especially seroma. The risk of short-term complications after salvage mastectomy increased with increasing BMI, while adjuvant radiotherapy after salvage mastectomy is associated with long-term complications.

Breast cancer is the most common non-skin cancer and the second leading cause of cancer death in U.S. women. Early detection and timely intervention are thus critical in reducing breast cancer-related deaths. Existing literature for the design of personalized mammography screening is mainly concerned with modeling the problem as a partially observable Markov decision process, which are computationally difficult to solve. In this study, we propose a machine learning-based approach for identifying the personalized screening recommendations using medical history and associated risk factors for individual patients. We find that machine learning models could provide a high degree of accuracy at drastically reduced computational complexity. Furthermore, once trained to sufficient accuracy, we ascertain explainable insights into machine learning model decisions. These insights yield a set of actionable decision rules that healthcare providers could use to support informed patient screening decisions. Overall, our study showcases the potential of machine learning in providing accurate and actionable recommendations for breast cancer screening.

The impact of Carmustine wafer implantation on epileptic seizure control in adult patients with newly diagnosed supratentorial glioblastoma, IDH-wildtype, remains unclear. We assessed whether Carmustine wafer implantation influences postoperative seizure control.

We conducted an observational, retrospective, single-centre cohort study at a tertiary neurosurgical oncology center between January 2006 and December 2024. We included adults treated with surgical resection for a newly diagnosed supratentorial glioblastoma, IDH-wildtype with or without Carmustine wafer implantation in the early postoperative period and during the first six months of adjuvant oncological treatment.

676 patients who benefited from a first-line surgical resection with (n = 257) or without (n = 419) Carmustine wafer implantation were included. Epilepsy at diagnosis was present in 244 patients (36.1%), with no difference in prevalence (35.8% vs. 36.3%, p = 0.483) or in preoperative seizure control (96.1% vs. 92.1%, p = 0.070) between groups. Uncontrolled seizures occurred in 17.6% (n = 43/244) of patients in the early postoperative period and in 18.6% (n = 41/221) of patients during the first six months of adjuvant oncological treatment. In multivariable analysis, preoperative uncontrolled seizures (adjusted Odds Ratio 76.9, 95%CI 34.5-187.7, p < 0.001) was independently associated with uncontrolled seizure in the early postoperative period, while Carmustine wafer implantation was not (aOR 0.78, 95%CI 0.36-1.60, p = 0.496). Similarly, a history of epilepsy at diagnosis (aOR 2.38, 95%CI 1.43-3.98, p < 0.001), but not Carmustine wafer implantation (aOR 0.92, 95%CI 0.55-1.54, p = 0.761), predicted uncontrolled seizures during the first six months of adjuvant oncological treatment.

Carmustine wafer implantation does not impact the risk of uncontrolled epileptic seizures in the postoperative and adjuvant oncological treatment periods. No specific adaptation of antiseizure medication is required following Carmustine wafer implantation for newly diagnosed supratentorial glioblastoma, IDH-wildtype patients.

To describe upper-body function in women after breast cancer treatment; and to explore the relationship between upper-body function, quality of life and breast cancer- related lymphoedema up to 7-years post-diagnosis.

This study uses data collected in a prospective, longitudinal, population-based, breast cancer cohort study. The Disability of Arm, Shoulder and Hand questionnaire (short version -QuickDASH), the Functional Assessment of Cancer Therapy-Breast questionnaire (FACT-B) and self-report of a clinical diagnosis were used to assess upper-body function, quality of life and breast cancer-related lymphoedema, respectively, in 2,876 women with invasive breast cancer at three time points: baseline (up to 9 months post-diagnosis), and at 2- and 7-years post-diagnosis. Unadjusted cross-sectional relationships between outcomes of interest were tested at each time point. Unadjusted and adjusted regression analyses were used to explore the potential predictive relationship between upper-body function and lymphoedema.

Upper-body impairment was common up to 7-years post-diagnosis with > 60% of women reporting at least mild impairment and 23.8-25.6% reporting moderate to very severe impairment. Impaired upper-body function at baseline assessment was associated with poorer overall quality of life (mean (standard deviation) FACT-B for no versus mild impairment: 77.5 (11.8) versus 70.9 (12.1), p < 0.05) and increased odds of breast cancer-related lymphoedema at 2 and 7 years follow-up (moderate to severe upper-body function impairment at 2- and 7- years post-diagnosis: Odds Ratio (95% Confidence interval) 2.49 (1.57, 3.93) and 2.54 (1.51, 4.26), respectively).

Future research evaluating whether prospective monitoring of upper-body function and interventions that can address impairment can reduce the risk of breast cancer-related lymphoedema are warranted.

Artificial intelligence (AI) is increasingly being used in oncology to support early diagnosis and develop personalized treatment plans. However, its successful use in cancer care depends not only on the technology itself, but also on whether people trust it, understand it, and are open to accepting it. This study explored how digitally engaged adults living in Abu Dhabi, UAE, perceive AI-assisted cancer treatment, focusing on how factors like demographics, AI familiarity, and personal cancer experience influence acceptance and concern. A cross-sectional survey was completed by 413 adults using a structured, bilingual (Arabic-English) questionnaire. Participants were asked about their awareness of AI in healthcare, their willingness to accept AI-assisted cancer treatment, and their concerns about issues such as safety, accuracy, cost, and data privacy. Chi-square tests were used to analyze the relationships between these factors. Familiarity with AI had a significant impact on acceptance (p = 0.0006), with those who were very familiar with AI more likely to accept its use in cancer treatment. In contrast, education level (p = 0.664) and personal experience with cancer (p = 0.3562) were not significantly associated with acceptance. Participants who were less familiar with AI expressed more concerns about its accuracy, safety, cost, and the privacy of their data (p = 0.0073), pointing to awareness as a key factor in shaping trust. These findings suggest that trust in AI-assisted cancer care is driven more by how familiar people are with the technology than by their educational background or cancer experience. To build public trust and encourage responsible use of AI in oncology, it is essential to keep healthcare professionals actively involved and to communicate clearly and transparently with patients.

Prophylactic nipple-sparing mastectomy (PNSM) is performed to prevent the development of breast cancer. Despite the increasing usage of PNSM, large-cohort, long-term follow-up data is lacking. We aim to review a large cohort of PNSM cases to evaluate oncologic outcomes.

We retrospectively reviewed all PNSMs between 2000 and 2021 at a single institution. Clinicopathologic variables were collected and analyzed. Descriptive statistics and Kaplan Meier (KM) based survival analyses were used.

A total of 1,255 PNSMs in 972 patients were performed from 2000 to 2021 with a median age of 43 years (IQR 37, 49) and a median follow-up of 81.3 months (IQR 50.8, 123.0). There were 38 (3.0%) cases of incidental breast cancer discovered on surgical pathology. There were 3 (0.3%) new primary breast cancer occurrences after PNSM. The KM estimates for 5-year rates in the entire cohort (n = 972) of incidence of new breast cancer, breast cancer-related mortality, and overall mortality were as follows: 0.15% (95%CI 0, 0.44%), 0.93% (95%CI 0.28%, 1.57%), and 1.63% (95%CI 0.78%, 2.48%), respectively. The KM estimates for 5-year rates in the BRCA-only cohort (n = 333) of incidence of new breast cancer, breast cancer-related mortality, and overall mortality were as follows: 0.44% (95%CI 0, 1.30%), 1.75% (95%CI 0.21%, 3.26%), and 2.09% (95%CI 0.42%, 3.73%), respectively.

New primary breast cancer infrequently developed after PNSM in this study. Incidental breast cancer was identified on surgical pathology in a small subset of patients. PNSM may be associated with preventing breast cancer development.