Search Results (905)

Melanoma-associated antigens (MAGEs) are cancer-testis antigens (CTAs) aberrantly expressed in multiple cancer types, including hepatocellular carcinoma (HCC), and associated with aggressive phenotypes. Although MAGE proteins are widely studied as cancer immunotherapy targets, their roles in HCC and the regulation of their expression during liver pathogenesis in mouse models, including dietary effects, remain poorly understood. We analyzed Mage gene expression in liver tissues from 78 C3H/HeJ mice with chronic diet-induced obesity. While type I MAGE genes are frequently expressed in human HCC, we found no evidence of their expression in mouse liver tumors, suggesting species-specific regulation. In contrast, type II Maged2, previously reported to be upregulated in human HCC, was significantly increased in mouse liver tumors. Analysis of human HCC samples from The Cancer Genome Atlas (TCGA) database confirmed MAGED2 upregulation and its association with patient prognosis. Together, these findings identify MAGED2 as a conserved marker of liver cancer in both humans and mice and emphasize the importance of cross-species comparative approaches for selecting appropriate models and accurately interpreting results, particularly for CTAs, which often evolved recently and in a species-specific manner. Full article

The investigation primarily focuses on synthesizing Polyvinyl Chloride (PVC)-coordination polymer (CP) polymeric membranes that employ L-Cu-NO₃ (¹_∞[Cu₃L₂(NO₃)]NO₃·2MeOH·2H₂O based on the Schiff base H₂L, where H₂L stands for N,N’-bis[(2-hydroxybenzilideneamino)-propyl]-piperazine)) as a coordination polymer. The membrane’s capacity to hold moisture is greatly improved by the addition of CPs. The water contact angle dropped from 73.4° for the PVC to about 71° for the composite membrane, indicating that the CP–PVC polymer interactions improved the hydrophilicity. Impedance spectroscopy (EIS) was used to determine the membranes response to the tested concentrations of phenol solution at pH 9.11 in the concentration range of 10⁻¹⁰ to 10⁻² mol·L⁻¹. A PVC membrane with a 0.6 wt% L-Cu-NO3 deposit on a Cu electrode yields the best response. Between 10⁻⁸ and 10⁻⁵ mol·L⁻¹ phenol, a linear dependence was found. The detection limit was 4.64 × 10⁻⁸ mol·L⁻¹. Full article

Climate change is the greatest health threat of the 21st century, with healthcare contributing approximately 4–5% of global greenhouse gas emissions. Decarbonising healthcare, the deliberate reduction of emissions across all healthcare activities, is essential to reduce the health sector’s environmental impact while maintaining equitable, high-quality care. Preparing future health professionals for sustainable, low-carbon practice is increasingly recognised as critical; however, education on healthcare decarbonisation remains inconsistent and weakly embedded in curricula. This scoping review mapped existing educational resources for pre-registration health profession students. Following the JBI methodology, six databases (Scopus, Web of Science, MEDLINE, CINAHL, PsycINFO, and GreenFILE) were searched in April 2025 (updated in October 2025). Data were thematically analysed. In total, 32 studies met inclusion criteria, comprising 17 mixed-methods, 11 quantitative, and 4 qualitative designs. Most interventions were multimodal, addressing sustainability or climate change through simulation, digital, formal, or didactic methods. Knowledge and attitudes were the most frequently evaluated outcomes. Thematic analysis identified knowledge and awareness, attitudes and emotional responses, behavioural intent and action, identity formation through collaborative learning, and barriers to decarbonisation. Findings suggest that blended, interactive, and technology-enhanced education improves knowledge, attitudes, and identity, but sustained impact requires longitudinal, skills-based, and policy-aligned interventions to drive meaningful healthcare decarbonisation action. Full article

Background/Objectives: The role of female surgeons in urology has been steadily increasing. We performed a contemporary review of American Board of Urology (ABU) case logs focused on oncologic procedures and evaluated the role of female surgeons over the past two decades. Methods: Operative logs from ABU examinees from 2003 to 2023 were analyzed. We identified open-approach (OA) and minimally invasive (MIS) radical nephrectomy (RN), partial nephrectomy (PN), radical nephroureterectomy (RNU), radical prostatectomy (RP), and adrenalectomy (RA) using CPT codes. Total case volumes as well as reported fellowship training were recorded and tabulated. The counts and proportions of OA and MIS procedures were analyzed over time and by surgeon gender. Results: From 2003 to 2023, 54,972 surgical procedures were reported to ABU with only 2.1% (1127) being performed by female surgeons. Of these, 32.5% (366) were OA and 67.5% (761) were MIS. Despite the low overall composition of female-performed procedures, the number of surgeries performed by females increased over time. Among female surgeons, the proportion of MIS surgeries increased over time, from 37.5% to 71.5% in 2003–2009 to 2017–2023, respectively. Females versus males performed comparably for OA for RN and RA; however, females performed more open PN, RNU, and RP than their male counterparts. Moreover, the number of procedures performed by oncology fellowship-trained females increased significantly. Conclusions: Our analysis of over twenty years of data submitted to the ABU indicates that the surgical volume of oncologic procedures by female urologists has been increasing. These findings demonstrate the increased contributions by female surgeons to the field urologic oncology. Full article

Cervical cancer is a largely preventable disease, with over 90% of cases caused by persistent infection with human papillomavirus (HPV). Despite the availability of HPV vaccination and cervical screening, incidence rates in Canada have been rising since 2015, particularly among underserved populations. This study investigates contributing factors behind cervical cancer diagnoses in Eastern Ontario over a two-year period to identify gaps leading to failures in prevention and screening. A retrospective chart review was conducted for cervical cancer cases diagnosed between January 2022 and December 2023 at two regional cancer centres in Eastern Ontario. Cases were categorized as screen-detected, inadequately screened, or system failure, based on prior screening history and care processes. Data was collected on patient, screening, and cancer characteristics. Of 132 cases, 22 (16.7%) were screen-detected, 73 (55.3%) were inadequately screened, and 37 (28.0%) were attributed to healthcare system failure. Later-stage disease was significantly more common in the latter two groups. Thirty-one (23.5%) cases presented with palliative diagnoses, and 18 (13.6%) individuals died within 2.5 years. Inadequate screening was associated with rurality, deprivation, and lack of a primary care provider. System failures included false-negative Pap tests, loss to follow-up, and misapplication of screening guidelines. This study evaluated failures in cervical cancer prevention, which led to cervical cancer diagnoses in Eastern Ontario. Gaps included suboptimal screening participation, lack of access to care, health care system breakdowns, and limitations of the Pap test. Findings provide concrete suggestions for eliminating cervical cancer in Canada. Full article

Background: Pancreatic cancer is the least survivable malignancy, with five-year survival below 10%. Its vague, non-specific symptoms contribute to late diagnosis and poor outcomes. Targeted education for healthcare professionals, students, patients, carers, and the public may improve awareness, confidence, and early help-seeking. This scoping review aimed to map and synthesize peer-reviewed evidence on pancreatic cancer education, identifying intervention types, outcomes, and gaps in knowledge. Methods: A scoping review was undertaken using the Joanna Briggs Institute (JBI) framework and the Arksey and O’Malley framework and reported in accordance with PRISMA-ScR guidelines. The protocol was registered on the Open Science Framework. Four databases (MEDLINE, Embase, CINAHL, PsycINFO) were searched for English-language, peer-reviewed studies evaluating educational interventions on pancreatic cancer for healthcare students, professionals, patients, carers, or the public. Grey literature was excluded to maintain a consistent methodological standard. Data were charted and synthesised narratively. Results: Nine studies (2018–2024) met inclusion criteria, predominantly from high-income countries. Interventions targeted students and professionals (n = 3), patients (n = 2), the public (n = 2), or mixed groups (n = 2), using modalities such as team-based learning, workshops, virtual reality, serious games, and digital animations. Four interrelated themes were identified, encompassing (1) Self-efficacy; (2) Knowledge; (3) Behavior; and (4) Acceptability. Digital and interactive approaches demonstrated particularly strong engagement and learning gains. Conclusions: Pancreatic cancer education shows clear potential to enhance knowledge, confidence, and engagement across diverse audiences. Digital platforms offer scalable opportunities but require quality assurance and long-term evaluation to sustain impact. The evidence base remains limited and fragmented, highlighting the need for validated outcome measures, longitudinal research, and greater international representation to support the integration of education into a global pancreatic cancer control strategy. Future studies should also evaluate how educational interventions influence clinical practice and real-world help-seeking behaviour. Full article

Background: Effectively managing pain in adults remains challenging, particularly in individuals with cognitive impairment or communication difficulties. Digital technologies, including artificial intelligence (AI)-enabled facial recognition and mobile applications, are emerging as innovative tools to improve the objectivity and consistency of pain evaluation. This scoping review aimed to map the current evidence on digital pain-assessment tools used with adult and older populations, focusing on validity, reliability, usability, and contributions to person-centred care. Methods: The review followed the Joanna Briggs Institute methodology and Arksey and O’Malley framework and was reported in accordance with PRISMA-ScR guidelines. Systematic searches were conducted in PubMed, CINAHL Complete, Medline (ALL), and PsycINFO for English-language studies published from 2010 onwards. Eligible studies included adults (≥18 years) using digital tools for pain assessment. Data extraction and synthesis were performed using Covidence, and findings were analyzed thematically. Results: Of 1160 records screened, ten studies met inclusion criteria. Most research was quantitative and conducted in high-income clinical settings. Five tools were identified: ePAT/PainChek^®, Painimation, PainCAS, Pain Clinical Assessment System, and Active Appearance Model. Four key themes emerged: (1) Validity and Reliability of Digital Pain Assessment Tools; (2) Comprehensive Pain Evaluation Across Contexts (Rest vs. Movement); (3) Usability and Integration into Clinical Practice; (4) Enabling Person-Centred Pain Management and Future Directions. Conclusions: Emerging evidence suggests that facial-recognition-based digital pain-assessment tools may demonstrate acceptable psychometric performance and usability within dementia care settings in high-income countries. However, evidence relating to broader adult populations, diverse care contexts, and low-resource settings remains limited, highlighting important gaps for future research. Full article

Monogenic forms of severe early-onset obesity often involve genetic disruptions in the hypothalamic leptin-melanocortin pathway. Pathogenic variants in the SIM1 gene, a key transcription factor required for the development of the paraventricular nucleus, are a known cause of Prader–Willi-like syndrome, characterized by hyperphagia, severe obesity, and developmental delay. We performed targeted next-generation sequencing of 52 obesity-associated genes on a cohort of pediatric patients with severe early-onset obesity. Identified variants were analyzed for population frequency and predicted pathogenicity using in silico tools. The structural impact of the novel missense variants was assessed using protein domain modeling with AlphaFold3. We identified five rare SIM1 variants in eleven patients. Four were heterozygous nonsynonymous variants: one frameshift in the bHLH domain (p.Ser18Ter), one frameshift in the Per-ARNT-Sim domain (p.His143Ter), and two missense variants, p.Pro30Ala and p.Ser663Leu. Structural modeling suggested that the missense variants are likely to disrupt critical protein–protein interactions. The fifth variant was a synonymous change, c.1173G>A, p.(Ser391Ser), which was detected in five unrelated patients. Bioinformatic analysis predicted that this variant could alter splicing. Structural modeling suggested that the missense variants interfere with SIM1 function. This study expands the mutational spectrum of SIM1-linked monogenic obesity, reporting novel likely pathogenic frameshift variants, a missense variant, and a recurrent synonymous variant with a potential splice-site effect. The majority of the variants are predicted to affect the SIM1 protein. Our findings strengthen the critical role of the SIM1 gene in hypothalamic development and energy homeostasis. The results underscore the importance of including the SIM1 gene in genetic testing panels for children with severe obesity and hyperphagia, enabling precise diagnosis and potential future personalized management. Functional in vitro or in vivo validation of these variants is required to confirm their pathogenicity. Full article

HIV-associated distal sensory polyneuropathy (HIV-DSP) remains prevalent even in the antiretroviral therapy (ART) era. Previously, we identified the upregulation of nociceptive ion channels transient receptor potential vanilloid 1 (TRPV1) and ankyrin 1 (TRPA1) in the dorsal root ganglia (DRG) of simian immunodeficiency virus (SIV)-infected ART-treated macaques. To investigate upstream mechanisms, we performed bulk RNA-seq and pathway analysis on DRGs from uninfected, SIV-infected, and SIV-infected/ART macaques. SIV infection drove strong activation of upstream regulators of interferon γ (IFNγ) and lipopolysaccharide (LPS). Although ART reduced overall IFNγ and LPS pathway activity, the IFNγ-inducible chemokines C-X-C motif chemokine ligand (CXCL)9 and CXCL10 remained significantly upregulated. To determine whether these chemokines influence TRPV1/TRPA1 expression, we treated induced pluripotent stem cell-derived peripheral sensory neurons (iPSC-PSNs) with CXCL9 and CXCL10, which induced a significant increase in TRPV1 but not TRPA1 expression. In parallel experiments, IFNγ but not LPS stimulated monocyte-derived macrophages (MDMs) to release CXCL9 and CXCL10. Conditioned media from IFNγ-treated MDMs modestly increased TRPV1 expression in iPSC-PSNs, and pharmacological inhibition of CXCR3, the receptor of CXCL9/10, did not reduce this effect. Together, these data indicate that persistent IFNγ-driven CXCL9/10 signaling may be one contributor to nociceptor sensitization underlying HIV-DSP, even in the presence of ART. Full article

Background/Objectives: Non-melanoma skin cancer, which includes cutaneous squamous cell carcinoma (cSCC), ranks as the 5th most common cancer globally with high morbidity and more total deaths than melanoma despite having a lower mortality rate. While most cSCC cases can be treated with surgery, locally advanced, metastatic, and high-risk cSCC tumors are associated with a worse prognosis with higher rates of recurrence and require multimodality therapy. However, there is limited data on animal models of cutaneous squamous cell carcinoma for the use of combinatory immunotherapy and radiation. Methods: In this study, spontaneously generated tumors using DMBA/TPA were treated over three weeks with either IgG control, anti-PD1 antibody monotherapy, 8 Gy of localized radiation, or a combination of anti-PD1 and 8 Gy of radiation followed by anti-PD1 therapy. Results: We found that while anti-PD1 therapy showed a trend toward slowed tumor growth compared to controls, this difference was not statistically significant (p = 0.0775), with most mice showing continued tumor progression. Preliminary histological analysis suggested that anti-PD1 treatment increased CD8+ T cell infiltration, and the addition of radiation further enhanced CD8+ responses but added greater variability. A pathologic review revealed that irradiated tumors were associated with fibroblastic spindle-like cell morphology. Conclusions: This animal model represents a potential preclinical model for studying CSCC with limited responses to immunotherapy to understand potential mechanisms of resistance. Full article

Objectives: Non-A Non-B (NANB) aortic dissections (ADs) are uncommon. Because of their rarity, their therapeutic pathway is not yet standardized, and anatomic or goal-directed treatments are not reported in current practices. We reviewed the treatment strategies of NANB AD across Europe, aiming to identify factors associated with increased mortality and the need for intervention, outlining optimal management pathways for future care. Methods: This multicentre cohort study was carried out in four European aortic centres, retrospectively including patients affected by NANB AD over the last 10 years. Patients’ anatomical clinical and treatment data were collected with the aim of investigating the factors associated with their need for intervention and increased mortality, comparing the characteristics of those requiring surgery with those who responded to medical treatment alone. Results: Thirty-eight NANB patients (26, 68.4% men; mean age 60.6 ± 12.87) were included. The primary entry tear was identified in Ishimaru zone 1 or 2 in most cases (24, 63.2%) and the dissection extended distally to the ilio-femoral arteries in half of the patients (21, 55.3%). Surgical repair was indicated in 21 (55.3%) cases within 90 days of acute onset for end-organ ischemia, impending aortic rupture, or retrograde extension of the dissection (including 11 emergent/urgent operations), with most patients requiring surgery within 15 days of acute onset (17, 44.7%). The mean aortic diameter among patients requiring surgery was significantly higher in both zone 1 (7 37 IQR 3 versus 34 IQR 7, p = 0.043) and 2 (36 IQR 6 versus 32.5 IQR 7, p = 0.044) when compared with patients who underwent medical treatment alone. An increased in-hospital mortality rate was noted among patients with indication for surgery after medical treatment (0% versus 30.8%, p = 0.023). Conclusions: This cohort provides an additional description of clinical aspects and current practices in the treatment of NANB in Europe. Most patients of this series had an indication for surgery within two weeks of acute onset, demonstrating a frequently complicated course; moreover, this raises questions surrounding the most appropriate timing for interventional management. Although a diameter threshold was not identified, the baseline enlarged aortic diameter in zones 1 and 2 seemed to be associated with a need for early intervention. Further study is needed to fully refine the indications for treatment in NANB patients; this will support the study of the independent risk factors for increased mortality risk and complications among this group, and will allow the identification of subgroups of patients that may benefit from more aggressive treatment from acute onset. Full article

Climate change poses a major global health threat, with healthcare systems contributing substantially to global greenhouse gas emissions. Health professionals and students play an essential role in advancing sustainable practice, yet many lack the knowledge, skills, and confidence needed to address the environmental impacts of healthcare. This study aims to co-design and evaluate a gamified e-resource that enhances pre-registration health profession students’ knowledge, self-efficacy, and attitudes towards healthcare decarbonisation, while encouraging sustainable behaviour change. A sequential explanatory design will be employed in three phases: (1) a scoping review of the literature; (2) four co-design workshops with students (n = 20) followed by post-workshop focus groups using focused ethnography to explore co-design experiences; and (3) pre- and post-test questionnaires (n = 200) assessing knowledge, attitudes, self-efficacy, behaviours, willingness to act, and usability, followed by focus groups (n = 30) exploring behavioural changes after using the e-resource. The study will generate evidence on how a co-designed, gamified e-resources influence student learning and engagement with healthcare decarbonisation. Findings will inform the integration of sustainability and decarbonisation principles within education and support efforts to equip future health professionals with the competencies required for a low-carbon healthcare system. Full article

The design of sustainable hydrogel materials with tunable mechanical and thermal properties is essential for emerging applications in flexible and wearable electronics. In this study, hydrogels based on natural gums such as Guar, Tara, and Xanthan and their composites with Cellulose Citrate were developed through a mild physical crosslinking process, ensuring environmental compatibility and structural integrity. The effect of cellulose citrate pretreatment under different alkaline conditions (0.04%, 5%, and 10% NaOH) was systematically investigated using Fourier Transform Infrared Spectroscopy (FT-IR), Thermogravimetric Analysis (TGA), and dynamic rheology. Overall, the results show that the composites exhibit different properties of the hydrogel networks compared to the pure hydrogel gums, strongly depending on the alkaline treatment. In all composite hydrogels, a significant increase in the number of interacting rheological units occurs, though the strength of the interactions decreases in Guar and Tara composites, which exhibit partial structural destabilization. In contrast, Xanthan–Cellulose Citrate hydrogels display enhanced strong gel character, and crosslinking density. These improvements reflect stronger intermolecular associations and a more compact polymer network, due to the favorable H-bonding and ionic interactions among Xanthan, Cellulose and Citrate mediated by water and sodium ions. Overall, the results demonstrate that Xanthan–Cellulose Citrate systems represent a new class of eco-friendly, mechanically robust hydrogels with controllable viscoelastic and thermal responses, features highly relevant for the next generation of flexible, self-supporting, and responsive soft materials suitable for wearable and stretchable electronic devices. Full article

Background/Objectives: COVID-19 and long COVID remain prevalent, with household transmission being an important mode of spread. To quantify household transmission of subclinical SARS-COV-2 infection and identify sociodemographic risk factors that may explain disparities in transmission, we conducted a case-ascertained antibody surveillance study of households in Cincinnati, Ohio. Methods: A partnership was formed between the Cincinnati Health Department and Cincinnati Children’s Hospital Medical Center. The Health Department identified cases of COVID-19. Infected individuals, along with their household contacts (n = 245), completed multiple questionnaires about symptoms, demographics, psychosocial (Adverse Childhood Experiences Scale and Everyday Discrimination Scale) and social risk factors, and conditions before and during the pandemic. In addition, they completed a non-fasting blood draw for IgG, IgM, IgA, and nucleocapsid protein serology testing. Results: Household contacts experienced few symptoms of COVID-19. However, according to the presence of the nucleocapsid protein, nearly 50% contracted the SARS-CoV-2 virus. This rate was similar by vaccination status but it was higher for household contacts who experienced high levels of early life adversity compared with those with lower levels. Conclusions: Our results confirm the high transmission of subclinical disease among household contacts, which may vary due to psychosocial factors. This reinforces the importance of isolating cases to prevent transmission, regardless of vaccination status. Full article

Care homes are an energy-intensive component of the health and social care sector, with high demands on heating, lighting, laundry, catering and medical technologies. This constant energy use makes care homes a notable contributor to global greenhouse gas emissions. Decarbonising care homes presents an opportunity to reduce emissions, operational costs, and deliver health co-benefits by improving air quality and thermal comfort. This scoping review mapped the international evidence on decarbonisation in care homes to inform sustainable practice and policy development. Guided by Joanna Briggs Institute methodology, seven databases (CINAHL, EMBASE, IEEE, MEDLINE, PubMed, Scopus, and Web of Science) were searched. Eligible studies included care home facilities, residents or staff with data managed in Covidence and extracted using the “The Greenhouse Gas Protocol Corporate Standard Inventory Accounting”. A total of 22 studies met the inclusion criteria. The evidence was concentrated around Scope 2 emissions, through efforts to monitor and reduce electricity use, while Scope 1 (facility emissions) and Scope 3 (supply chain emissions) remain comparatively underexplored. Evidence was fragmented and revealed risk aversion and care quality concerns related to adopting low-carbon technologies, as well as a growing interest in digital technologies and sustainable food procurement. Care homes should be prioritised within net zero healthcare frameworks, with targeted research, policy guidance, and investment to support decarbonisation. Full article