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26 pages, 954 KB  
Review
Post-CDK4/6 Inhibitor Therapeutic Approaches in Hormone Receptor-Positive, HER2-Negative Metastatic Breast Cancer: Current Evidence and Emerging Strategies—A Narrative Review
by Humaid O. Al-Shamsi, Nadia Abdelwahed, Siddig Ibrahim Abdelwahab, Mawada Hussein, Amin Abyad, Saeed Rafii, Hassan Jaafar, Sonia Otsmane, Dima Abdul Jabbar, Hala Abdellatif, Faryal Iqbal, Mudhasir Ahmad, Hampig Kourie and Kefah Mokbel
Diagnostics 2026, 16(12), 1790; https://doi.org/10.3390/diagnostics16121790 - 10 Jun 2026
Viewed by 373
Abstract
Background: Therapeutic resistance following cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) plus endocrine therapy (ET) represents a key unmet need in hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (mBC). Treatment paradigms have advanced from non-targeted options, such as fulvestrant [...] Read more.
Background: Therapeutic resistance following cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) plus endocrine therapy (ET) represents a key unmet need in hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) metastatic breast cancer (mBC). Treatment paradigms have advanced from non-targeted options, such as fulvestrant monotherapy or everolimus-based combinations, to precision medicine strategies, including inhibitors of the PI3K/AKT pathway, oral selective estrogen receptor degraders (SERDs), and novel ER-modulating agents, often guided by biomarkers and molecular surveillance. Methods: This narrative review synthesizes evidence from randomized clinical trials, real-world studies, and biomarker-driven analyses published from 2010 to 2026, with emphasis on next-generation sequencing (NGS)-guided genomic profiling, targeted pathway therapies, and circulating tumor DNA (ctDNA)-based proactive interventions in the post-CDK4/6i setting. This review was conducted and reported in accordance with the SANRA recommendations for narrative reviews. Results: Early second-line standards, including fulvestrant and alpelisib for PIK3CA-mutated tumors, established the basis for biomarker-guided treatment in hormone receptor–positive, HER2-negative metastatic breast cancer. With the widespread use of CDK4/6 inhibitors in the first-line setting, the optimal post-progression strategy has shifted toward molecularly selected combination approaches rather than single-agent endocrine therapy, as endocrine monotherapy has shown limited efficacy in acquired resistance. Multiple randomized studies have demonstrated that adding targeted agents to endocrine therapy improves progression-free survival compared with hormonal therapy alone, supporting combination regimens as the preferred strategy after CDK4/6 inhibitor progression, except in carefully selected patients with low disease burden, indolent biology, or frailty where tolerability is a major concern. Precision-based trials have further refined this approach. Elacestrant improved progression-free survival in ESR1-mutated disease in the EMERALD trial, capivasertib plus fulvestrant demonstrated significant benefit in tumors harboring AKT/PIK3CA/PTEN pathway alterations in CAPItello-291, and inavolisib plus palbociclib and fulvestrant achieved both progression-free and overall survival improvement in PIK3CA-mutated patients with early relapse in INAVO120. Real-world analyses further support the effectiveness of these biomarker-directed strategies across diverse clinical subgroups. Comprehensive genomic profiling has identified multiple resistance mechanisms, including ESR1 mutations, PI3K/AKT/mTOR pathway activation, RB1 loss, and FGFR alterations, which may co-occur and reduce sensitivity to endocrine monotherapy. While ESR1 and PI3K pathway alterations now guide approved therapies, FGFR alterations remain investigational targets, with ongoing trials evaluating selective FGFR inhibitors. Proactive switching approaches evaluated in SERENA-6 and PADA-1 demonstrate that serial circulating tumor DNA (ctDNA) monitoring can detect emergent ESR1 mutations before radiographic progression, providing a clinically actionable lead time for early therapeutic modification and extending endocrine-based disease control by approximately 5 to 7 months. Conclusions: Post-CDK4/6i management increasingly relies on NGS-guided precision approaches, integrating pathway-specific therapies and ctDNA surveillance to tailor sequencing based on resistance profiles, prior ET response, and tumor heterogeneity. Future investigations into novel ER degraders and multi-targeted combinations hold potential to further optimize algorithms, extend non-chemotherapy options, and enhance survival in HR+/HER2− mBC. Full article
(This article belongs to the Special Issue Precision Diagnosis and Management of Breast Cancer)
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22 pages, 22711 KB  
Article
Structural Prioritization of FatB Thioesterase Candidates Potentially Related to Lauric Acid-Rich Seed Oil in Litsea cubeba
by Wenyan Yuan, Changzhu Li, Jingzhen Chen, Peiwang Li, Xiao Zhou, Wei Wu, Lijuan Jiang, Wenbin Zeng, Feng Wen, Yunzhu Chen and Yan Yang
Biomolecules 2026, 16(6), 813; https://doi.org/10.3390/biom16060813 - 30 May 2026
Viewed by 289
Abstract
Lauric acid is a characteristic component of Litsea cubeba seed oil, but FatB thioesterase candidates with predicted structural compatibility for C12 acyl-substrate accommodation remain insufficiently defined. In this study, seed oil content and fatty acid composition were examined during L. cubeba seed development. [...] Read more.
Lauric acid is a characteristic component of Litsea cubeba seed oil, but FatB thioesterase candidates with predicted structural compatibility for C12 acyl-substrate accommodation remain insufficiently defined. In this study, seed oil content and fatty acid composition were examined during L. cubeba seed development. The fatty acid profile shifted from a C18:2-rich pattern at the early stage to a C12:0-dominated composition at later stages, providing the biochemical context for FatB candidate prioritization. Three FatB-like candidates were retrieved from a de novo seed transcriptome assembly and named LcFatB1, LcFatB2, and LcFatB3. Phylogenetic analysis, conserved motif comparison, sequence alignment, and homology modeling showed that LcFatB1 and LcFatB2 retained more complete FatB-like sequence and structural features than LcFatB3. S-dodecanoyl-4′-phosphopantetheine was used as a C12 acyl-4′-phosphopantetheine surrogate for molecular docking. Docking analysis indicated that LcFatB1 and LcFatB2 formed more interpretable C12-bound poses than LcFatB3. Subsequent 150 ns molecular dynamics simulations, free energy landscape analysis, residue–ligand interaction profiling, and catalytic tunnel analysis further distinguished the two main candidates. Compared with LcFatB2, LcFatB1 maintained a lower-displacement C12-bound state, a more compact contact environment involving Tyr116, Ser125, and Asn278, and a main tunnel with higher throughput and shorter length in the representative global-minimum conformation. LcFatB2 also retained the C12 surrogate but stabilized it in a distinct rearranged binding environment. These results support LcFatB1 as the strongest structurally prioritized FatB candidate among the three transcriptome-derived proteins, while LcFatB2 remains a plausible FatB-like candidate with a distinct C12-bound state. This prioritization provides computational structural clues for future biochemical testing but should not be interpreted as direct functional confirmation of FatB activity in vivo. Full article
(This article belongs to the Section Enzymology)
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15 pages, 5859 KB  
Article
A De Novo USP24 Variant as a Candidate Driver in a Neurodevelopmental Disorder: Insights from Trio-Based Whole-Exome Sequencing
by Mirella Vinci, Antonino Musumeci, Simone Treccarichi, Miriam Virgillito, Siria Calì, Angelo Gloria, Concetta Federico, Salvatore Saccone, Maurizio Elia and Francesco Calì
Int. J. Mol. Sci. 2026, 27(9), 4086; https://doi.org/10.3390/ijms27094086 - 2 May 2026
Viewed by 597
Abstract
Neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD), are increasingly recognized as conditions with a complex, multisystemic origin. ASD frequently co-occurs with other neurological conditions, such as epilepsy. We report a female patient, born to unrelated healthy parents, presenting with a complex clinical [...] Read more.
Neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD), are increasingly recognized as conditions with a complex, multisystemic origin. ASD frequently co-occurs with other neurological conditions, such as epilepsy. We report a female patient, born to unrelated healthy parents, presenting with a complex clinical phenotype characterized by ASD level 1 with fluent speech, borderline intellectual functioning (BIF), coordination disorder, and epilepsy. Trio-based whole-exome sequencing (WES) revealed a de novo variant in the USP24 gene (c.3155G>T; p.Ser1052Ile), classified as likely pathogenic according to ACMG criteria (PS2, PM2, PP2, BP4). USP24 has previously been associated with Parkinson’s disease and has recently emerged as a candidate risk gene for ASD. In addition, WES detected two variants of uncertain significance (VUS), both inherited from the clinically unaffected father: c.388G>C (p.Gly130Arg) in NRXN2 and c.6395C>A (p.Ser2132Tyr) in LRP2. Although neither gene shows a fully penetrant causal relationship with the observed phenotype, both have been implicated in neurodevelopmental disorders. Array-CGH analysis did not reveal pathogenic copy number variants; however, the presence of additional genetic contributors not detectable by WES cannot be excluded. Overall, the de novo USP24 variant likely represents the primary genetic driver of the phenotype, while the potential contribution of the inherited NRXN2 and LRP2 variants remains plausible. This case underscores the complexity of the genetic architecture underlying NDDs and supports a model involving cumulative effects of multiple variants rather than a strictly multigenic interaction. Full article
(This article belongs to the Section Molecular Genetics and Genomics)
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13 pages, 1209 KB  
Article
Efficacy and Safety of Oral Progestogens (Megestrol Acetate and Medroxyprogesterone Acetate) in Heavily Pretreated Oestrogen Receptor-Positive Metastatic Breast Cancer: A 10-Year Multi-Site Study
by Iseult M. Browne, Heng Chun Wong, Tazia Irfan, Chloe Chan, Stephen R. D. Johnston, Zoe Kemp, Emma Kipps, Marina Parton, Nicholas C. Turner and Alicia F. C. Okines
Cancers 2026, 18(8), 1191; https://doi.org/10.3390/cancers18081191 - 8 Apr 2026
Viewed by 703
Abstract
Background: Oral progestogens, including megestrol acetate (MA) and medroxyprogesterone acetate (MPA), have largely been superseded by aromatase inhibitors, tamoxifen, and selective oestrogen receptor degraders (SERDs) in oestrogen receptor-positive (ER-positive) metastatic breast cancer. However, they remain an option as late-line therapy after failure of [...] Read more.
Background: Oral progestogens, including megestrol acetate (MA) and medroxyprogesterone acetate (MPA), have largely been superseded by aromatase inhibitors, tamoxifen, and selective oestrogen receptor degraders (SERDs) in oestrogen receptor-positive (ER-positive) metastatic breast cancer. However, they remain an option as late-line therapy after failure of standard treatments. Contemporary data are limited, particularly in patients previously treated with CDK4/6 inhibitors. Methods: We conducted a multi-site retrospective analysis of patients with ER-positive metastatic breast cancer treated with MA or MPA between 2014 and 2024 at four hospital sites across London, United Kingdom. Patients were identified using pharmacy dispensing records. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method and Cox regression. Subgroup analyses included prior CDK4/6 inhibitor exposure, histology and liver metastases. Results: A total of 116 patients were included. Median PFS was 2.4 months (95% CI 2.2–2.9), and median OS was 3.3 months (95% CI 2.7–4.9). Prior CDK4/6 inhibitor exposure was associated with shorter PFS (1.9 vs. 2.8 months; HR 1.59; 95% CI 1.08–2.35, p = 0.019) and a trend toward shorter OS (3.1 vs. 3.6 months; HR 1.18, 95% CI 0.80–1.75, p = 0.41). Similarly, liver metastases were associated with shorter PFS (2.3 vs. 2.8 months; HR 1.78, 95% CI 1.12–2.85, p = 0.015), with a trend toward worse OS (3.1 vs. 4.9 months; HR 1.45, 95% CI 0.93–2.25, p = 0.103). A subset of patients derived prolonged benefit, with a 6-month PFS rate of 16%. Toxicity was manageable; thromboembolic events and oedema occurred in 9% and 11% of patients respectively. Appetite improvement was reported in 10%. Conclusions: MA and MPA demonstrated modest but clinically relevant late-line activity in heavily pretreated, endocrine-refractory ER-positive metastatic breast cancer. While prior exposure to CDK4/6 inhibitors was associated with shorter PFS, patients without liver metastases appeared to derive the greatest benefit. These findings support a role for oral progestogens in selected patients who have exhausted standard therapeutic options. Full article
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27 pages, 1941 KB  
Review
Kv11.1 Channels in Cardiac Health and Disease: Molecular Insights and Clinical Relevance
by Mitko Mladenov, Vadim Mitrokhin, Stanislav Schileyko, Anastasija Rodina, Alexandra Zolotareva, Valentin Zolotarev, Natalia Bocharnikova, Dmitry Kaminer, Emilija Antova, Radoslav Stojchevski, Slavica Josifovska, Dimiter Avtanski, Andre Kamkin and Nikola Hadzi-Petrushev
Cardiovasc. Med. 2026, 29(2), 15; https://doi.org/10.3390/cardiovascmed29020015 - 7 Apr 2026
Viewed by 881
Abstract
Kv11.1 (hERG1) channels, encoded by KCNH2, mediate the rapid delayed rectifier potassium current (IKr) crucial for cardiac repolarization. Disruptions, via mutations or antiarrhythmic drugs like dofetilide cause severe arrhythmogenic disorders, including Long QT Syndrome Type 2 (LQT2), Brugada Syndrome [...] Read more.
Kv11.1 (hERG1) channels, encoded by KCNH2, mediate the rapid delayed rectifier potassium current (IKr) crucial for cardiac repolarization. Disruptions, via mutations or antiarrhythmic drugs like dofetilide cause severe arrhythmogenic disorders, including Long QT Syndrome Type 2 (LQT2), Brugada Syndrome (BrS), and Torsades de Pointes (TdP). While Kv11.1’s role in channelopathies and drug-induced arrhythmias is established, understanding its complex regulation and therapeutic targeting remains a challenge. This review synthesizes the structural, functional, and regulatory aspects of Kv11.1 channels and their clinical implications. Recent studies using iPSC-derived cardiomyocytes highlight regulation by PI3K/Akt, PKC, and PKA signaling via phosphorylation (Ser283, Ser890) and interactions with proteins like 14-3-3. Beyond electrophysiology, Kv11.1 influences pathological hypertrophy and non-cardiac functions including insulin secretion. Pharmacological efforts focus on activators to shorten action potential duration and suppress TdP, and blockers with overdose risks. Mutation heterogeneity, exemplified by trafficking impairment (G785D) in LQT2 and gain-of-function (R397C) in BrS, complicates precision therapy. Clinically, systematic risk stratification using electrocardiographic parameters and genotype-specific approaches enables personalized management. Beta-blockers remain first-line therapy for LQTS2, while rigorous avoidance of QT-prolonging medications and electrolyte monitoring form the cornerstones of preventive care. Advancing Kv11.1-targeted therapies with approaches like CRISPR-Cas9 and pharmacological chaperones (e.g., lumacaftor) holds promise for personalized treatments, ultimately reducing arrhythmic events and sudden cardiac death. Full article
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17 pages, 745 KB  
Article
The Shift in Delivery of Care from Hospital to Community Care Settings: What Changes in Terms of Healthcare Workers’ Exposure to Violence
by Ettore Minutiello, Pietro Marraffa, Manuela Martella, Alessia Pascarella, Stefano Savigni, Gianfranco Politano and Maria Michela Gianino
Healthcare 2026, 14(7), 896; https://doi.org/10.3390/healthcare14070896 - 31 Mar 2026
Viewed by 521
Abstract
Background: Despite the general interest in WPV against healthcare workers, there is evidence that this topic has comparatively fewer studies conducted in the context of community settings than in hospital settings. Given the current general transition of care from hospital to community, [...] Read more.
Background: Despite the general interest in WPV against healthcare workers, there is evidence that this topic has comparatively fewer studies conducted in the context of community settings than in hospital settings. Given the current general transition of care from hospital to community, this study aims to analyze whether community settings present different characteristics in comparison with hospital settings on this topic in Italy. Methods: A retrospective observational study was conducted from 2020 to 2024 on aggressions reported by HCWs in hospitals and community settings belonging to a Local Health Authority of Turin in Piedmont. For physical and non-physical aggressions, a monthly time trend series was constructed. A Mantel–Haenszel fixed-effect meta-analysis was performed to obtain the odds ratio (OR) in two settings. Variables relative to aggressions included the gender of victims, their professional category (medical doctors, nurses, other HCWs), the type and gender of perpetrators (relative, patient, or unknown person), age groups of perpetrators (under 30, 30–49, ≥50), the nature of aggression (physical, non-physical), recidivism, involvement of law enforcement, and time of occurrence (morning, afternoon, or evening/night). Events within hospitals were further classified into emergency department, psychiatric ward, and other wards, while events within community settings were classified as drug addiction service units (serDs), long-term care (including specialist outpatient services, home services, and nursing homes) (LTC), mental health centres, and penitentiary assistance. Results: The results highlighted that fewer WPV incidents were reported in community settings than in hospital settings, even though reported incidents showed a more pronounced increase over time. Differences were observed in a few characteristics of WPV (age classes of aggressors, recidivism, time of aggression, profession of the assaulted worker, and specific location). Only the gender of the assaulted (female workers) (OR = 3.11, 95% CI: 1.27–7.61; p = 0.013; OR = 0.32, 95% CI: 0.13–0.79; p = 0.013 for non-physical and physical violence, respectively, compared to male workers) was identified as a specific risk factor for community settings. Conclusions: Modern health systems are experiencing a transition from hospital-centred to community-centred care settings. This study suggested that WPV is a significant concern, even outside the hospital. Community-based services often involve direct interaction with frail and chronically ill patients and their caregivers, as well as care delivery in diverse and sometimes less controlled environments, which may influence exposure to aggressive behaviours. The identification of setting-specific risk patterns in both hospital and community contexts provides valuable insights into workplace violence and may support the planning and implementation of targeted interventions aimed at mitigating the frequency and burden of WPV. Full article
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26 pages, 18310 KB  
Article
Identification and Validation of MTFP1 as a Mitochondrial Target Restoring Dynamics and ECM Remodeling in Acute Myocardial Infarction
by Xi Hu, Hailong Bao, Yue Huang, Zhaoxing Cao, Wei Yang, Cheng Huang, Xin Chen, Yanbing Chen, Bingxiu Chen, Guiling Xia, Xiao Yang, Runze Huang and Zhangrong Chen
Curr. Issues Mol. Biol. 2026, 48(3), 293; https://doi.org/10.3390/cimb48030293 - 9 Mar 2026
Viewed by 895
Abstract
Background: Mitochondrial dysfunction is central to the pathogenesis of acute myocardial infarction (AMI), but mitochondria-related molecular biomarkers and mechanisms remain incompletely defined. This study aimed to identify mitochondria-associated biomarkers in AMI and elucidate their functional roles in mitochondrial dynamics, extracellular matrix (ECM) [...] Read more.
Background: Mitochondrial dysfunction is central to the pathogenesis of acute myocardial infarction (AMI), but mitochondria-related molecular biomarkers and mechanisms remain incompletely defined. This study aimed to identify mitochondria-associated biomarkers in AMI and elucidate their functional roles in mitochondrial dynamics, extracellular matrix (ECM) remodeling, and cardiac protection. Methods: Two GEO datasets (GSE19322, GSE71906) were analyzed to identify mitochondria-related differentially expressed genes (DE-MRGs) by intersecting DEGs with MitoCarta3.0 genes. Functional enrichment (GO/KEGG), LASSO regression, ROC curves, and nomogram modeling were employed to screen biomarkers. Immune infiltration profiling, GeneMANIA, GSEA, TF-mRNA and ceRNA network construction, and drug prediction analyses were performed. Expression validation was conducted via RT-qPCR, Western blot (WB), and immunohistochemistry (IHC) in murine AMI models and hypoxia-induced cardiomyocytes. Functional assays assessed cardiac performance (echocardiography), infarct size (TTC staining), fibrosis (Masson/Sirius red), oxidative stress (ROS), and ECM remodeling (MMP9/TIMP1 axis). Results: We identified 295 DE-MRGs, enriched in oxidative phosphorylation and mitochondrial metabolic pathways. Machine learning and validation analyses pinpointed MTFP1 and DNAJC28 as AMI biomarkers with strong diagnostic accuracy. In vivo and in vitro studies confirmed marked downregulation of MTFP1 post-AMI and under hypoxia. AAV9-mediated MTFP1 overexpression improved cardiac function, reduced infarct size, attenuated fibrosis, and decreased ROS levels. Mechanistically, MTFP1 upregulated phosphorylated DRP1 (Ser616) without altering total DRP1, balanced MMP9/TIMP1 activity, and suppressed fibrosis markers (COL1A1, α-SMA). Gelatin zymography indicated that MMP9 activation remained restrained despite elevated pro-MMP9, consistent with TIMP1-mediated regulation. Hypoxia-induced cardiomyocytes showed similar antifibrotic and antioxidative responses following MTFP1 overexpression. Conclusions: Our study identified MTFP1 as a novel mitochondria-related biomarker and therapeutic modulator in AMI. MTFP1 exerts cardioprotective effects by restoring mitochondrial fission balance and ECM remodeling through the p-DRP1/MMP9/TIMP1 signaling axis, attenuating fibrosis and oxidative stress. These findings provide mechanistic insight into mitochondria-targeted cardioprotection and highlight MTFP1 as a promising diagnostic and therapeutic target for AMI. Full article
(This article belongs to the Topic Molecular and Cellular Mechanisms of Heart Disease)
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17 pages, 786 KB  
Review
First Reported Use of Recombinant Parathyroid Hormone in Kenny–Caffey Syndrome Type 2: A Case Report and Literature Review
by Maja Djordjevic Milosevic, Anita Skakic, Marina Andjelkovic, Angelica Maria Delgado-Vega, Håkan Thonberg, Kristel Klaassen, Jovana Komazec, Bozica Kecman, Nikola Jocic, Erik Björck, Anna Lindstrand and Maja Stojiljkovic
Diseases 2026, 14(3), 91; https://doi.org/10.3390/diseases14030091 - 3 Mar 2026
Viewed by 880
Abstract
Background/Objectives: Hypoparathyroidism (HPT) is a disorder caused by the insufficient production of parathyroid hormone (PTH). Its main features include decreased serum calcium, increased serum phosphorus, and abnormal bone modeling. In children, HPT is most commonly due to genetic disorders. Among rare genetic [...] Read more.
Background/Objectives: Hypoparathyroidism (HPT) is a disorder caused by the insufficient production of parathyroid hormone (PTH). Its main features include decreased serum calcium, increased serum phosphorus, and abnormal bone modeling. In children, HPT is most commonly due to genetic disorders. Among rare genetic syndromes that can include HPT in their clinical spectrum is Kenny–Caffey syndrome (KCS) type 2. Conventional therapy for HPT primarily consists of oral calcium and active vitamin D metabolites. The major limitation of conventional therapy is hypercalciuria with an increased risk of nephrocalcinosis. However, a subset of patients fails to achieve the desired therapeutic response to conventional treatment; the reasons for this remain incompletely understood in some cases. The failure to achieve therapeutic targets and persistent hypercalciuria are the main indications for considering therapy with recombinant human parathyroid hormone (rhPTH). Methods: In addition to the review of the literature on rhPTH use in pediatric hypoparathyroidism, the first application of rhPTH in the treatment of genetically caused HPT in a child with Kenny–Caffey syndrome type 2 (KCS2) was described. Results: In this paper, we present a two-month-old infant who received rhPTH for 14 months. A heterozygous de novo p.Ser541Pro variant in the FAM111A gene was identified through whole-genome sequencing, indicating a diagnosis of KCS2. A biological mechanism linking FAM111A protein function with a more profound disruption of parathyroid development or function was proposed, suggesting that rhPTH therapy may be particularly beneficial in KCS2 cases. Conclusions: This is the first reported use of rhPTH in a child in Serbia and the first reported use in KCS type 2. By reviewing the literature, we analyzed the conditions in which rhPTH has been used, dosing approaches and durations, requirements for concomitant conventional therapy during rhPTH treatment, and the effects of rhPTH on calciuria. We provide an overview of rhPTH use in children. Additionally, based on the pathogenic genetic variant responsible for KCS2 in our patient, we propose possible etiologic explanations. This work aims to encourage a consideration of rhPTH use in children following its official approval. Full article
(This article belongs to the Special Issue Diseases: From Molecular to the Clinical Perspectives)
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23 pages, 1752 KB  
Review
Endocrine Therapy for Endometrial Carcinoma: Current Evidence, Resistance Mechanisms, and Biomarker-Driven Patient Selection
by Taro Yamanaka, Hiroshi Yoshida, Tatsunori Shimoi, Kazuki Sudo and Kan Yonemori
Curr. Oncol. 2026, 33(2), 124; https://doi.org/10.3390/curroncol33020124 - 19 Feb 2026
Cited by 2 | Viewed by 1671
Abstract
The treatment landscape for endometrial carcinoma (EC) is undergoing a paradigm shift from traditional histopathological dualism to precision medicine grounded in the Cancer Genome Atlas (TCGA) molecular classification. The “No Specific Molecular Profile” (NSMP) subgroup, the largest molecular cohort, has emerged as a [...] Read more.
The treatment landscape for endometrial carcinoma (EC) is undergoing a paradigm shift from traditional histopathological dualism to precision medicine grounded in the Cancer Genome Atlas (TCGA) molecular classification. The “No Specific Molecular Profile” (NSMP) subgroup, the largest molecular cohort, has emerged as a particularly promising target for endocrine-based strategies. While endocrine therapy (ET) has been a mainstay for over 60 years due to its favorable safety profile, its efficacy as monotherapy remains modest. This review provides a comprehensive overview of current endocrine strategies, including traditional agents like progestins and aromatase inhibitors, and focuses on novel combination therapies designed to overcome resistance. Recent clinical trials have demonstrated that integrating molecularly targeted agents, such as CDK4/6 and mTOR inhibitors, significantly improves clinical outcomes. Specifically, patients with TP53 wild-type status and CTNNB1 mutations exhibit exceptional responses to these combinations. Furthermore, we discuss the potential of next-generation selective estrogen receptor degraders (SERDs) and the importance of refining patient selection through robust predictive biomarkers. Driven by molecular insights, endocrine therapy is transitioning from a secondary palliative option into a definitive cornerstone of precision oncology, offering a personalized and effective treatment for patients with advanced or recurrent endometrial carcinoma. Full article
(This article belongs to the Section Gynecologic Oncology)
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43 pages, 4356 KB  
Review
A Systematic Review of Major Advances in Breast Cancer Therapeutics in 2025: Synthesis of Conference and Published Evidence
by Nabil Ismaili
Int. J. Mol. Sci. 2026, 27(4), 1971; https://doi.org/10.3390/ijms27041971 - 19 Feb 2026
Cited by 4 | Viewed by 3505
Abstract
The year 2025 has been transformative in breast oncology, marked by the maturation of pivotal adjuvant trials, the introduction of novel ADCs, and the validation of proactive biomarker-driven strategies across all molecular subtypes. ASCO, ESMO, and SABCS contributed pivotal updates that further refined [...] Read more.
The year 2025 has been transformative in breast oncology, marked by the maturation of pivotal adjuvant trials, the introduction of novel ADCs, and the validation of proactive biomarker-driven strategies across all molecular subtypes. ASCO, ESMO, and SABCS contributed pivotal updates that further refined treatment paradigms. This systematic review synthesizes and critically evaluates pivotal Phase II/III clinical trials presented at major oncology conferences (ASCO 2025, ESMO 2025, SABCS 2025) and published in high-impact journals during 2025. A curated selection of pivotal Phase II/III trials, and major prospective trials published or presented in 2025 was performed. Data extraction focused on trial design, population, interventions, efficacy endpoints, and safety outcomes. Narrative synthesis was organized by disease stage and molecular subtype. Key 2025 findings (50 clinical trials) include: (1) confirmation of overall survival benefit with adjuvant CDK4/6 inhibitors in HR+/HER2− early breast cancer (monarchE: HR = 0.842, p = 0.0273); (2) establishment of trastuzumab deruxtecan (T-DXd) as a new standard in high-risk HER2+ early disease (DESTINY-Breast05: IDFS HR = 0.47) and first-line metastatic settings (DESTINY-Breast09: PFS HR = 0.58); (3) validation of TROP2-directed ADCs as first-line therapy for metastatic triple-negative breast cancer (ASCENT-03: PFS HR = 0.62; BEGONIA: ORR 79%); (4) paradigm shift to proactive, liquid biopsy-guided therapy switching (SERENA-6: PFS HR = 0.44); (5) updated efficacy and safety of the oral SERD imlunestrant from the EMBER-3 trial, supporting its role in ESR1-mutated advanced breast cancer and in combination with abemaciclib; (6) confirmation of long-term survival benefit for neoadjuvant carboplatin in early TNBC and new positive adjuvant data; (7) pivotal advances in HER2+ metastatic disease sequencing with tucatinib and T-DXd; (8) evidence supporting optimized adjuvant endocrine therapy in HER2+/HR+ early disease; and (9) emergence of novel agents with improved therapeutic indices, including PROTAC degraders, oral SERDs, and mutant-selective PI3K inhibitors. The 2025 evidence base has fundamentally reshaped breast cancer management, establishing new standards of care across all subtypes. Unifying themes include biomarker-driven personalization, strategic treatment sequencing, management of unique toxicities, and emphasis on patient-reported outcomes. Future challenges include optimizing treatment integration, managing financial toxicity, and ensuring equitable global access. Full article
(This article belongs to the Special Issue Advances in Molecular Pathology and Treatment of Breast Cancer)
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19 pages, 10956 KB  
Article
High-Frame-Rate Low-Noise Global Shutter CMOS Image Sensor for High-Speed Machine Vision
by Abhinav Agarwal, Jatin Hansrani, Kazuhisa Suzuki, Karthik Venkatesan, Wilson Law, Varun Shah, Kai Ling Ong, Danny Marine, Oleksandr Rytov, Tim Lu, Neil Kumar, Edward Enriquez, Liviu Oniciuc, Sam Bagwell, Loc Truong, Anders Andersson and Radu Corlan
Sensors 2026, 26(4), 1117; https://doi.org/10.3390/s26041117 - 9 Feb 2026
Viewed by 2225
Abstract
In this paper we present a low-noise, high-frame-rate global shutter CMOS image sensor with UHD resolution (3840 × 2160), targeting high-speed machine vision applications. The sensor (ForzaFAST581) supports video capture at up to 1141 FPS at 12 bits and 1694 FPS at 8 [...] Read more.
In this paper we present a low-noise, high-frame-rate global shutter CMOS image sensor with UHD resolution (3840 × 2160), targeting high-speed machine vision applications. The sensor (ForzaFAST581) supports video capture at up to 1141 FPS at 12 bits and 1694 FPS at 8 bits at full resolution, consuming a total power of 5.5 W. Fabricated in a 65 nm, four-metal BSI process, the imager features a 5 µm voltage-domain global shutter pixel with dual-gain capability for improved dynamic range and a read noise of 3.04 e in global shutter and 2.15 e in rolling shutter mode for high-gain at maximum frame rate operation. For compact camera integration and low power consumption, the sensor is designed to stream video through 16 CML data ports, each operating at 7.44 Gbps, achieving a total aggregate throughput of 119 Gbps. Additionally, the sensor supports selectable output bit depths—8-bit, 10-bit, and 12-bit—allowing frame rate optimization based on application-specific requirements. Full article
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43 pages, 1125 KB  
Review
A Decade of Innovation in Breast Cancer (2015–2025): A Comprehensive Review of Clinical Trials, Targeted Therapies and Molecular Perspectives
by Klaudia Dynarowicz, Dorota Bartusik-Aebisher, Sara Czech, Aleksandra Kawczyk-Krupka and David Aebisher
Cancers 2026, 18(3), 361; https://doi.org/10.3390/cancers18030361 - 23 Jan 2026
Cited by 4 | Viewed by 2859
Abstract
The past decade has witnessed an unprecedented transformation in breast cancer management, driven by parallel advances in targeted therapies, immunomodulation, drug-delivery technologies, and molecular diagnostic tools. This review summarizes the key achievements of 2015–2025, encompassing all major biological subtypes of breast cancer as [...] Read more.
The past decade has witnessed an unprecedented transformation in breast cancer management, driven by parallel advances in targeted therapies, immunomodulation, drug-delivery technologies, and molecular diagnostic tools. This review summarizes the key achievements of 2015–2025, encompassing all major biological subtypes of breast cancer as well as technological innovations with substantial clinical relevance. In hormone receptor-positive (HR+)/HER2− disease, the integration of CDK4/6 inhibitors, modulators of the PI3K/AKT/mTOR pathway, oral Selective Estrogen Receptor Degraders (SERDs), and real-time monitoring of Estrogen Receptor 1 (ESR1) mutations has enabled clinicians to overcome endocrine resistance and dynamically tailor treatment based on evolving molecular alterations detected in circulating biomarkers. In HER2-positive breast cancer, treatment paradigms have been revolutionized by next-generation antibody–drug conjugates, advanced antibody formats, and technologies facilitating drug penetration across the blood–brain barrier, collectively improving systemic and central nervous system disease control. The most rapid progress has occurred in triple-negative breast cancer (TNBC), where synergistic strategies combining selective cytotoxicity via Antibody-Drug Conjugates (ADCs), DNA damage response inhibitors, immunotherapy, epigenetic modulation, and therapies targeting immunometabolic pathways have markedly expanded therapeutic opportunities for this historically challenging subtype. In parallel, photodynamic therapy has emerged as an investigational and predominantly local phototheranostic approach, incorporating nanocarriers, next-generation photosensitizers, and photoimmunotherapy capable of inducing immunogenic cell death and modulating antitumor immune responses. A defining feature of the past decade has been the surge in patent-driven innovation, encompassing multispecific antibodies, optimized ADC architectures, novel linker–payload designs, and advanced nanotechnological and photoactive delivery systems. By integrating data from clinical trials, molecular analyses, and patent landscapes, this review illustrates how multimechanistic, biomarker-guided therapies supported by advanced drug-delivery technologies are redefining contemporary precision oncology in breast cancer. The emerging therapeutic paradigm underscores the convergence of targeted therapy, immunomodulation, synthetic lethality, and localized immune-activating approaches, charting a path toward further personalization of treatment in the years ahead. Full article
(This article belongs to the Section Cancer Therapy)
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23 pages, 8773 KB  
Article
Integrated Phosphoproteomics Identifies TGFβ-Dependent Phosphorylation Events Linking Kinase Signaling to Autophagy in Palatogenesis
by Xia Peng, Jing Chen, Xiaoyu Zheng, Xige Zhao, Yijia Wang, Xiaotong Wang and Juan Du
Proteomes 2026, 14(1), 5; https://doi.org/10.3390/proteomes14010005 - 23 Jan 2026
Viewed by 1481
Abstract
Background: Cleft palate (CP) is a prevalent craniofacial malformation, with the TGFβ pathway playing a critical role. Recent evidence links autophagy to regulating mouse embryonic palatal mesenchyme (MEPM) cells, but its interaction with TGFβ-activated phosphorylation cascades remains largely unknown. Here, we investigated the [...] Read more.
Background: Cleft palate (CP) is a prevalent craniofacial malformation, with the TGFβ pathway playing a critical role. Recent evidence links autophagy to regulating mouse embryonic palatal mesenchyme (MEPM) cells, but its interaction with TGFβ-activated phosphorylation cascades remains largely unknown. Here, we investigated the interplay between these pathways during palatogenesis. Methods: H&E and IHC analyses revealed increased expression of Beclin 1 and LC3 during the critical period of palatal shelf elevation and fusion (E13.5–E15.5). Bulk RNA sequencing (Bulk RNA-seq) further revealed enrichment of autophagy-related pathways and their interaction with TGFβ signaling. TMT-based phosphoproteomics was performed on TGFβ2-treated MEPM cells. Results: We identified 23,471 peptides and 3952 proteins, including 6339 phosphopeptides corresponding to 2195 phosphoproteins. Differential analysis found 477 phosphopeptides with increased abundance and 53 with decreased abundance, revealing the enrichment of seven serine (p-Ser) motifs (RxxS, SDxD, SDxE, SP, SxDE, SxEE, SxxxxD) and one threonine (p-Thr) motif (TP). Notably, kinase-substrate enrichment analysis identified CSNK2A as a previously unrecognized phosphorylation regulator, together with MAPKs and CDKs. Functional enrichment showed significant involvement of mTOR, MAPK, and autophagy/mitophagy pathways. Conclusions: Our findings revealed that TGFβ2 reshapes the MEPM phosphoproteome through Smad-independent pathway, expanding the palate-specific phospho-signaling atlas beyond the canonical Smad cascade. Full article
(This article belongs to the Section Animal Proteomics)
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18 pages, 47766 KB  
Article
Scalable AI + DSP Compute Frameworks Using AMD Xilinx RF-SoC ZCU/VCU Platforms for Wireless Testbeds for Scientific, Commercial, Space, and Defense Applications
by Buddhipriya Gayanath, Gayani Rathnasekara, Kasun Karunanayake and Arjuna Madanayake
Electronics 2026, 15(2), 445; https://doi.org/10.3390/electronics15020445 - 20 Jan 2026
Viewed by 1507
Abstract
This paper describes recent engineering designs that allow full-duplex SerDes connectivity between a number of cascaded Xilinx radio frequency system-on-chip (RF-SoC) and VCU FPGA systems. The design allows for unlimited scalability with all-to-all connectivity across FPGA systems and RF-SoCs that allow for bidirectional [...] Read more.
This paper describes recent engineering designs that allow full-duplex SerDes connectivity between a number of cascaded Xilinx radio frequency system-on-chip (RF-SoC) and VCU FPGA systems. The design allows for unlimited scalability with all-to-all connectivity across FPGA systems and RF-SoCs that allow for bidirectional data transport in streaming mode at a capacity of 50 Gbps per ADC-DAC channel. A custom massively parallel systolic-array architecture supporting 8 parallel data streams from time-interleaved ADC/DACs allow real-time matrix–vector-multiplication (MVM). The MVM can be 8 × 8, 8 × 16, …, 8 × 1024 in supported matrix size, and is demonstrated in real time sustained throughput of 1 TeraMAC/second, for matrix size 8 × 512. The MVM is the building block supporting machine learning and filtering, with the computational graph split across FPGA systems using the SerDes connections. The RF data processed by the FPGA chain can be further utilized for higher-level AI workloads on an NVIDIA DGX Spark platform connected to the system. We demonstrate two platforms in which ZCU111 and ZCU1285 RF-SoC boards perform direct-RF data acquisition, while compute engines operating in real time on VCU128 and VCU129 FPGA boards showcase both digital beamforming and polyphase FIR filterbanking in a real-time bandwidth of 1.0 GHz. Full article
(This article belongs to the Special Issue Emerging Applications of FPGAs and Reconfigurable Computing System)
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14 pages, 3061 KB  
Review
Rational Engineering in Protein Crystallization: Integrating Physicochemical Principles, Molecular Scaffolds, and Computational Design
by Sho Ito and Tatsuya Nishino
Crystals 2026, 16(1), 36; https://doi.org/10.3390/cryst16010036 - 31 Dec 2025
Viewed by 1257
Abstract
X-ray crystallography remains the gold standard for high-resolution structural biology, yet obtaining diffraction-quality crystals continues to pose a major bottleneck due to inherently low success rates. This review advocates a paradigm shift from probabilistic screening to rational engineering, reframing crystallization as a controllable [...] Read more.
X-ray crystallography remains the gold standard for high-resolution structural biology, yet obtaining diffraction-quality crystals continues to pose a major bottleneck due to inherently low success rates. This review advocates a paradigm shift from probabilistic screening to rational engineering, reframing crystallization as a controllable self-assembly process. We provide a comprehensive overview of strategies that connect fundamental physicochemical principles to practical applications, beginning with contact design, which involves the active engineering of crystal contacts through surface entropy reduction (SER), introduction of electrostatic patches. Complementing these molecular approaches, we discuss physicochemical strategies that exploit heterogeneous nucleation on functionalized surfaces and gold nanoparticles (AuNPs) to lower the energy barrier for crystal formation. We also address scaffold design, utilizing rigid fusion partners and polymer-forming chaperones to promote crystallization even from low-concentration solutions. Furthermore, we highlight principles for controlling the behavior of multi-component complexes, based on our experimental experience. Finally, we examine de novo lattice design, which leverages AI tools such as AlphaFold and RFdiffusion to program crystal lattices from first principles. Together, these strategies establish an integrated workflow that links thermodynamic stability with crystallizability. Full article
(This article belongs to the Special Issue Reviews of Crystal Engineering)
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