Insulin resistance is one of the main causes of type 2 diabetes mellitus and metabolic disorders. Histone deacetylase 9 (HDAC9) belongs to the class IIa histone deacetylase family. It remodels chromatin structure and modulates gene expression to regulate adipocyte differentiation, inflammatory responses, and hepatic glucose homeostasis, thereby inhibiting insulin signaling. However, the complete and precise molecular mechanisms underlying these processes remain unclear. This review systematically summarizes the molecular characteristics and regulatory mechanisms of HDAC9, and analyzes its biological functions under insulin resistance from the perspectives of chromatin remodeling and transcriptional regulation. This review further explores whether HDAC9 exacerbates insulin resistance through regulating adipocyte differentiation, mediating inflammatory responses and disrupting hepatic glucose metabolic homeostasis. Meanwhile, this review evaluates HDAC9-targeted therapeutic prospects for metabolic diseases and offer theoretical support for future precision interventions.

Patients facing a new diagnosis of high-grade glioma may not be felt to benefit from active treatment after multidisciplinary team (MDT) review. Inadequate local knowledge may limit patient information provision and treatment refusal justification. A best supportive care-clinic (BSC-C) enables neurosurgical and clinical nurse specialist (CNS) review. This study assesses uptake and utility of the BSC-C, including appointment acceptance rates, onward referrals generated, and patient feedback.

Electronic records between January and May 2024 of referrals to the BSC-C were retrospectively analysed. Data collected included demographics, diagnoses, time taken from presentation to diagnosis, diagnosis until BSC-C appointment date, content of BSC-C discussions, and follow-up.

Twenty-nine patients were offered a BSC-C appointment between January and May 2024. Of these, 72.4% (n = 21) were accepted. Mean time from MRI diagnosis to an MDT decision was 11.8 days, and to a BSC-C appointment was 13.7 days. After the first appointment, a further 32 follow-up telephone calls were made across 15 patients (range 1-6 calls per patient). This resulted in 29 interventions made by the CNS, including palliative care referrals and changes to corticosteroid doses. A patient-reported feedback form indicated that patients benefitted from the clinic.

The BSC-C offers support to palliative neuro-oncology patients, who might otherwise be discharged to the community with little insight into their diagnosis or clinical advice on their symptom management. Appointments and follow-up calls are accepted by most patients, and offer both specialised advice, and a point-of-contact during a time of uncertainty.

Patients with cancer represent a substantial and growing proportion of the ICU population. Although short-term survival has improved, it remains unclear how often anticancer treatment is resumed after critical illness. We aimed to synthesize the available evidence on treatment resumption following ICU discharge in adult patients with cancer.

We searched PubMed, Embase, Scopus, and Web of Science from inception to February 24, 2025 (PROSPERO CRD420251080476). We included studies reporting resumption of systemic anticancer treatment after unplanned ICU admission in adults with solid or hematological malignancies. The primary outcome was the proportion of patients resuming any anticancer treatment after discharge. The secondary outcome was resumption of the originally planned treatment.

Twenty studies encompassing 3,551 patients were included. Fifteen studies encompassed patients with solid cancer (N = 1800), three patients with hematological cancer (N = 261), and two included both solid and hematological malignancies (N = 1490). Two studies were multicenter. The pooled rate of resuming any anticancer treatment after discharge was 61% (95% CI, 51-70%), with substantial heterogeneity (I² = 95.6%). Resumption rates were 60% (95% CI, 48-71%) in patients with solid tumors and 77% (95% CI, 56-89%) in patients with hematological malignancies. Eight studies (1,736 patients) assessed resumption of the original planned regimen, with a pooled rate of 48% (95% CI, 36-60%) at 6 months post-discharge.

Most patients surviving ICU admission resume anticancer therapy, but fewer than half continue their originally planned treatment. ICU admission may represent a turning point in the oncologic trajectory, highlighting the need for early post-ICU reassessment of disease status, functional capacity, and patient preferences. However, there is a lack of prospective multicenter studies with standardized definitions of treatment resumption and predefined assessment time points.

Glioblastoma progression is strongly influenced by evolving mechanical interactions between the tumor and surrounding brain tissue. However, the extent to which finite-deformation mechanics and constitutive assumptions improve subject-specific prediction as tumor burden evolves remains unclear. We introduce a sequential Bayesian inference and dynamic model selection framework that assimilates longitudinal murine magnetic resonance imaging (MRI) data to calibrate spatially varying tumor diffusivity, proliferation rate, and tissue stiffness in biomechanical tumor growth models. Competing formulations were compared at each imaging time, including reaction-diffusion without mechanics and reaction-diffusion coupled to linear elasticity or hyperelastic mechanics, using posterior model plausibility to adapt model choice for individualized one-scan-ahead prediction as new MRI scans are acquired. Across the studied animals, mechanically coupled models were consistently more plausible than the uncoupled reaction-diffusion model, and the evolution of model plausibility indicated an increasing role of mass effect and stress-mediated feedback of tumor growth during progression. While linear and hyperelastic coupled tumor growth models often produced similar tumor morphology, they yield distinct stress, deformation, and inferred stiffness fields, with the hyperelastic formulation often receiving higher posterior plausibility at later imaging times. These results indicate that, within the present longitudinal murine dataset, mechanical coupling is favored for image-informed glioma growth prediction and that constitutive assumptions should be evaluated sequentially for each subject rather than fixed a priori.

The Psychological Expectation Scale for Patients with Middle- and Late-Stage Cervical Cancer (PES-PMLSCC) was developed to assess the psychological expectations of patients with middle and late cervical cancer, and its reliability, validity, and acceptability were tested.

Employing classical test theory methodology, a cohort of 148 cervical cancer patients classified as FIGO Stage III or IV (or equivalent TNM staging) was enrolled in this study. The PES-PMLSCC scale was developed. The initial iteration of the PES-PMLSCC was refined through item analysis. To assess the structural validity of the final scale, exploratory factor analysis (EFA) was conducted, followed by preliminary internal validation using confirmatory factor analysis (CFA) and structural equation modeling (SEM). The criterion-related validity (CRV) of the final PES-PMLSCC version was evaluated by calculating the Pearson correlation coefficient between the PES-PMLSCC and the QLQ-C30.

The PES-PMLSCC scale comprises 14 items distributed across four subscales: physiological needs (three items), safety needs (four items), social needs (two items), and self-actualization (five items). Preliminary evidence of reliability, as indicated by a Cronbach's alpha of 0.819, a Spearman-Brown coefficient of 0.912, and a test-retest reliability coefficient of 0.928. The preliminary internal validation of the validity showed that χ²/df = 1.39, GFI = 0.93, CFI = 0.98, NFI = 0.93, IFI = 0.98, TLI = 0.97, RMSEA = 0.05, and the I-CVIs exceeded 0.80.

The findings indicate that the PES-PMLSCC is applicable for assessing the level of psychological expectations among patients with middle- and late-stage cervical cancer in China, particularly in the southwestern region.

Rural patients experience healthcare disparities due to multiple factors including travel distance. However, the impact on colorectal cancer (CRC) care for Veterans remains undefined.

We aimed to describe the association between distance and timeliness of care for Veterans with CRC.

We assembled a retrospective cohort of Veterans with Stage I-III CRC who underwent resection at a Veterans Affairs Medical Center (VAMC) between 2001 and 2018. Time from diagnosis to initiation of treatment, length of stay, 30-day readmissions and mortality were compared based on distance (≤ 40 mi; 41-100 mi, and > 100 mi). Among 375 patients, the median travel distance was 67.9 mi and median time to treatment initiation was 33 days. In a multivariable linear regression adjusted for age, stage, year of surgery, race and co-morbidities, the time to initial treatment was 11.8 days longer for patients > 100 mi away compared to those who live within 40 mi (CI 1.4-22.1, p = 0.026). No significant difference was observed for patients within 40 mi vs. 41-100 mi away (0.13 days, CI -9.4 to 9.8, 0.98). Common contributors to delays > 60 days included transitions from non-VAMC care, cardiac optimization and additional testing or treatment. There were no associations between distance and surgical length of stay, 30-day readmissions, or mortality.

Travel distance > 100 mi was associated with timeliness of care for Veterans, though no differences in clinical outcomes were observed. Distance-related outcome disparities may be mitigated through integrated, high-volume VA care system.

After the loss of a parent, families with minor children face psychosocial stressors. The bereaved parent has to deal with their own grief and at the same time support the children. Providing professional support to the parents can improve well-being of parents, children and the family as a whole. However, such manualised interventions are missing for the German context. This study aims to translate and culturally adapt the parent group 'Resilient Parenting for Bereaved Families' (RPBF) of the Family Bereavement Program for the German context specifically for loss due to cancer, and to pilot evaluate its feasibility and potential effects.

In this mixed-methods pilot study, six to eight group leaders, who are experienced in working in bereavement support, will be trained to conduct the parent group and afterwards lead parent groups. We aim to conduct three to four parent groups with 6-8 parents each (total target sample size n=24-32). Parents participate in 10 biweekly parent group sessions on-site or online. We will assess feasibility, acceptability, satisfaction and preliminary effects on parental well-being, family coping and communication (baseline (t₀), post-intervention (t₁) and 12-week post-intervention follow-up (t₂)). Semistructured interviews with 10-12 parents will further explore experience and suggestions for refinement. Quantitative data will be analysed using descriptive and exploratory analyses and qualitative data will be analysed using qualitative content analysis.

The study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-0919). Upon completion, a German version of the Resilient Parenting for Bereaved Families (RPBF) parent group and the group leader training will be available. Findings will be disseminated through peer-reviewed publications and conference presentations. To make the results available to affected families, a lay summary will be written and disseminated in several ways.

The study was registered with the German Clinical Trials Register (DRKS00039060 (date of registration: 19 February 2026)).

Human papillomavirus (HPV) is a leading cause of both cervical and non-cervical cancers, including anal, oropharyngeal, vaginal and vulvar cancers. While most HPV vaccination impact assessments have focused on preventing cervical cancer among women, the broader benefits of vaccination against other HPV-attributable cancers in low- and middle-income countries (LMICs) remain less explored.

We used a static cohort model to assess the potential health impact of bivalent HPV vaccination on HPV-attributable female non-cervical cancers in 117 LMICs from 2030 to 2100. The model incorporated country-specific data on cancer mortality, HPV type distribution, demographic projections and vaccine coverage. Sensitivity analyses were performed to account for uncertainties in cancer incidence, cancer mortality and HPV type distribution.

Our projections suggest that HPV vaccination could contribute to prevention of approximately five 90 000 cases of anal, 880 000 cases of oropharyngeal, 1.27 million cases of vaginal and 2.18 million cases of vulvar cancers over the analytic period. In total, 3.02 million deaths from these non-cervical cancers among women could be averted by 2100. The African region is expected to see the largest relative reductions in both cases and deaths while the European region showed the smallest gains. By the end of the century, 58 countries are projected to reach at least a 25% reduction in anal cancer mortality compared with just 25 countries for oropharyngeal cancer. These findings reflect substantial regional disparities in both burden and vaccination impact.

HPV vaccination holds considerable promise in reducing the burden of non-cervical cancers among women in LMICs, especially in regions with high incidence and limited access to care. Recognising and harnessing these broader benefits can strengthen the public health case for scaling up vaccine access, implementing region-specific strategies and investing in equitable healthcare systems to decrease global disparities.

Advanced melanoma treatment remains debated, particularly in patients with B-Raf proto-oncogene serine/threonine kinase (BRAF) V600 mutations eligible for both immune checkpoint inhibitors (ICI) and BRAF/MEK inhibitors. Additional biomarkers are needed to improve treatment selection. Mutations of the telomerase reverse transcriptase (TERT) promoter are frequent in melanoma, although their clinical role remains unclear.

We conducted a retrospective single-center study including patients with metastatic melanoma treated with first-line ICI or BRAF/MEK inhibitors. TERT mutational status and co-mutations were assessed using a customized next-generation sequencing panel. Overall (OS) and progression-free (PFS) survival were estimated using the Kaplan-Meier method and compared with the log-rank test.

Among 159 patients, TERT mutations were detected in 73% of cases and frequently co-occurred with BRAFV600 mutations (84%). In the overall population, TERT status was not associated with OS or PFS. Brain and liver metastases, lactate dehydrogenase levels, and metastatic burden were the main determinants of outcome. In the BRAFV600-mutant subgroup, exploratory analyses suggested a potential interaction between TERT status and the agents used in first-line treatment. Patients with BRAF/TERT co-mutations showed longer OS when treated with ICI than with BRAF/MEK inhibitors (50.3 vs. 14.6 months), whereas the opposite trend was observed in patients with wild-type TERT (7.8 vs. 20.9 months). Similar patterns were observed for PFS, although findings were based on small subgroups and not consistently supported by multivariable analyses.

TERT promoter mutations were not independently associated with survival outcomes in metastatic melanoma. Although exploratory findings suggest a possible interaction between TERT status and treatment type, further investigation of its biological relevance in well-designed prospective studies are needed.

Although melanoma represents only approximately 1% of skin cancers, it causes the majority of skin-cancer deaths. In its early stages, melanoma can be treated successfully with surgery alone, yet a meaningful proportion of patients still present with advanced disease. Geographic variation in demographic and socioeconomic profiles of patients with melanoma across U.S. regions remains poorly characterized. Assessment of regional disparities in patient composition and stage at diagnosis is necessary for the advancement of targeted public health strategies. This study examined geographic variation in demographic, socioeconomic, and clinical characteristics among U.S. patients with melanoma.

We conducted a cross-sectional analysis of patients diagnosed with melanoma between 2004 and 2020 using the National Cancer Database (NCDB). Patients were assigned to one of six U.S. geographic regions based on reporting facility location. Descriptive analyses were performed to evaluate age, sex, race and ethnicity, insurance type, income, urban-rural residence, and American Joint Committee on Cancer (AJCC) stage at diagnosis.

Among 986,555 patients (mean age, 65.3 years; 60.1% male), substantial socioeconomic variation was identified across regions. Uninsured rates were highest in the Southwest (3.4%) and Southeast (2.4%). Lower-income households (<$63,000) predominated in the Southwest (75.9%) and Southeast (67.9%). Advanced-stage (III-IV) disease at diagnosis was most common in the Southwest (13.0%) and least common in the Northeast (7.6%). The cohort was predominately White (99.1%).

Substantial geographic variation exists in the demographic and socioeconomic profile of patients with melanoma, which may correlate to meaningful differences in stage at diagnosis and, given melanoma's strongly stage-dependent prognosis, potentially survival outcomes as well. These disparities likely reflect structural inequities in screening access, insurance coverage, and healthcare infrastructure. Region-specific interventions, including Medicaid expansion, increased access to dermatologic care, public awareness campaigns, and targeted screening, are warranted to improve outcomes nationwide.