Search Results (430)

Background/Objectives: Displaced femoral neck fractures in older adults are associated with substantial morbidity, loss of functional independence, and reduced quality of life. Although total hip arthroplasty (THA) and hemiarthroplasty (HA) are widely used surgical options and have been extensively compared, differences in postoperative functional recovery in routine clinical practice continue to be investigated. This study aimed to compare postoperative functional outcomes between THA and HA in elderly patients with femoral neck fractures during postoperative follow-up. Methods: This prospective cohort study included 100 patients aged 70–85 years treated surgically for displaced femoral neck fractures from 1 May to 1 December 2024. Patients underwent THA (n = 57) or HA (n = 43). Functional recovery was evaluated using the Barthel Index (BI) and modified Harris Hip Score (mHHS) at 3 weeks, 3 months, and 6 months postoperatively. Changes in functional outcomes during follow-up were analyzed using repeated-measures general linear models adjusted for age, body mass index (BMI), and educational level. Exploratory binary postoperative outcomes were analyzed using logistic regression. Results: Patients treated with THA demonstrated significantly better postoperative functional outcomes compared with HA throughout follow-up. In both unadjusted and adjusted analyses, THA patients achieved consistently higher BI and mHHS scores across repeated postoperative assessments, including at 6 months postoperatively. Independent outdoor walking at 3 months postoperatively differed significantly between groups in the unadjusted analysis, although this association did not remain statistically significant after adjustment. In adjusted analyses, patients in the HA group demonstrated significantly higher odds of movement-related hip pain at 6 months postoperatively. Conclusions: THA was associated with significantly better postoperative functional outcomes compared with HA in elderly patients with femoral neck fractures. These findings highlight the importance of considering functional recovery outcomes, in addition to traditional surgical outcomes, when selecting arthroplasty strategies in geriatric hip fracture management. Given the observational study design, these findings should be interpreted as associations rather than evidence of a causal treatment effect. Full article

In the scallop shucking industry, labor-intensive manual operations and inconsistent product quality remain persistent challenges. To address these issues, this study develops a scallop shucking system based on visual feedback temperature control. To support this system, systematic experiments are conducted to determine the baseline shucking method and its initial parameters. On this basis, the scallop doneness detection model SDD-RT-DETR, serving as the system’s core, integrates an enhanced backbone centered on the self-developed module HierarchicalRepBlock, a frequency-domain self-attention module AIFI-EDFFN, a neck featuring the self-developed EfficientBalanceFusion module as the feature fusion unit and the Converse2DC3 module as the feature extraction unit, and the Wise-DIoU loss function. A scallop doneness image dataset specifically constructed for this task was used to train and validate this model. Experimental results demonstrate that the model achieves 95.5% accuracy, 93.6% recall, and 96.1% mAP50, improving by 4.7%, 3.2%, and 4.2%, respectively, over the baseline model RT-DETR. Additionally, the model’s computational cost was reduced by 18.9%, and its parameters were reduced by 14.1% compared to the baseline model. This model provides real-time, accurate doneness assessment, thereby filling a gap in computer vision for scallop doneness detection. Furthermore, this study integrated this model into a water bath scallop shucking system with feedback temperature control, ensuring that the doneness of scallops after shucking is maintained within an optimal range. Batch tests show that this system achieves a 96.6% shucking rate and an 88.5% properly cooked rate, outperforming the conventional method. This improves the quality of automatically shucked scallops while offering a practical solution for the intelligent upgrading of the seafood processing industry. Full article

Objectives: The facial nerve (FN) possesses one of the most intricate anatomical courses in the head and neck, traversing the brainstem, temporal bone, and parotid gland before terminating within the muscles of facial expression. Owing to its complex anatomy, marked anatomical variability, and frequent distortion by adjacent pathology, preservation of FN integrity remains a fundamental challenge in skull base, otologic, and head and neck surgery. This review aims to provide a comprehensive synthesis of the contemporary literature regarding the clinical anatomy of the FN and to examine how anatomical variation, pathology-induced distortion, surgical strategy, and emerging technologies influence nerve preservation and functional outcomes. Methods: A comprehensive narrative review of the literature was conducted using PubMed, Scopus, and Google Scholar. Publications from 1983 through 2026 were searched using combinations of keywords, including “facial nerve,” “facial nerve anatomy,” “anatomical variation,” “vestibular schwannoma,” “hemifacial spasm,” “parotid surgery,” “facial nerve injury,” “facial nerve reconstruction,” “facial reanimation,” “diffusion tensor imaging,” “intraoperative neurophysiological monitoring,” and “artificial intelligence.” Peer-reviewed anatomical, radiological, clinical, and review articles published in English were included, while conference abstracts and studies lacking direct anatomical or surgical relevance were excluded. Particular emphasis was placed on surgically relevant anatomical variations, pathology-related anatomical distortion, advanced imaging modalities, intraoperative neurophysiological monitoring, reconstructive techniques, and predictors of postoperative facial nerve function. Results: Facial nerve preservation was found to depend on the interplay between individual anatomical variability, disease-related anatomical distortion, and operative strategy. In vestibular schwannoma surgery, nerve displacement, capsular adhesion, and cystic tumor degeneration were consistently associated with increased surgical complexity and less favorable postoperative facial function. In hemifacial spasm, successful microvascular decompression relied on precise identification of neurovascular conflict at the root exit zone. Within the parotid gland, substantial variability in branching architecture and surgical landmarks contributed to an increased risk of iatrogenic injury. Advanced imaging techniques, particularly diffusion tensor imaging tractography, improved preoperative prediction of FN location, while intraoperative neurophysiological monitoring enabled real-time assessment of neural integrity and functional preservation. Emerging artificial intelligence-based predictive models demonstrated potential to enhance patient-specific surgical planning and prognostication. Conclusions: Contemporary facial nerve surgery has evolved toward an individualized, anatomy-driven, and function-preserving paradigm supported by advanced imaging, intraoperative monitoring, and reconstructive strategies. Detailed understanding of both normal FN anatomy and pathology-induced anatomical distortion remains essential for optimizing surgical decision-making, maximizing nerve preservation, and improving long-term functional outcomes. Future developments integrating multimodal imaging, predictive analytics, and artificial intelligence may further refine patient-specific management and enhance postoperative facial function. Full article

Background: Post-burn neck contractures continue to represent a complex reconstructive problem, with significant functional limitations and a marked impact on patients’ appearance and quality of life. This systematic review and meta-analysis aimed to assess surgical outcomes in adult patients undergoing reconstruction for post-burn neck contractures. Methods: A comprehensive search of Medline, Web of Science, and Scopus was performed up to January 2025. Studies reporting surgical management of post-burn neck contractures were included. Primary outcomes were functional and aesthetic improvement, while secondary outcomes included complications, recontracture, and disfiguring scarring. Results: In total, 46 studies comprising 1636 patients were included. Flap-based reconstruction was the most frequently applied approach. Overall, functional improvement was achieved in 92% of cases (95% CI: 89–94%), while satisfactory aesthetic outcomes were reported in 90% (95% CI: 85–93%). The pooled complication rate was 15% (95% CI: 11–20%), with higher rates observed following free flap reconstruction. The incidence of recontracture and disfiguring scarring remained relatively low, about 6%. Although functional outcomes were comparable across flap types, regional flaps appeared to offer the most favorable balance between aesthetic results and complication rates. In contrast, skin grafts and dermal substitutes showed less consistent outcomes and a higher tendency toward recurrence. Conclusions: Flap-based reconstruction remains the cornerstone of treatment for post-burn neck contractures. Surgical planning should be individualized, taking into account defect severity, tissue availability, and surgical expertise. Further prospective studies using standardized outcome measures are needed to strengthen current evidence. Full article

The association of atrial fibrillation (AF) and neck of femur fractures (NOF) are common in old people, creating a complex clinical scenario with significant implications for morbidity, mortality, and healthcare systems. This narrative review explores the bidirectional relationship between AF and NOF, focusing on shared risk factors, pathophysiological links, and challenges in clinical management, and also reviews the benefit of an orthogeriatric model. Advanced age, frailty, osteoporosis, polypharmacy, and cardiovascular comorbidities predispose patients to both conditions, while AF itself increases fall risk through haemodynamic instability, syncope, and adverse effects of rate- or rhythm-controlling medications. Importantly, the physiological stress of hip fracture and subsequent surgery can precipitate new-onset or worsening AF via inflammatory, neurohormonal, and metabolic mechanisms. The main challenge for ortho-geriatricians lies in anticoagulation management and preoperative and postoperative management. While anticoagulation reduces thromboembolic risk in AF, it increases perioperative bleeding risk in patients with NOF, often leading to delays in surgery that are independently associated with poorer outcomes. This review examines the current evidence regarding perioperative anticoagulation strategies, timing of surgery, and postoperative resumption of therapy. In addition, the review examines important outcome parameters such as mortality, stroke, bleeding, length of hospital stay, and functional recovery. This highlights the importance of not only improving multidisciplinary care involving orthopaedics, cardiology, geriatrics, and anaesthesia to optimise outcomes, but also enhancing risk stratification. Standardised perioperative pathways and integrated geriatric–cardiac assessment may help mitigate complications. Therefore, understanding how AF and NOF interact is key to delivering holistic, patient-centred care for an increasingly elderly population in orthogeriatric wards. Full article

Background/Objectives: Persistent spinal pain, including chronic low back pain (CLBP), chronic neck pain, and whiplash-associated disorders (WAD), is a highly prevalent musculoskeletal condition. The recent literature emphasizes a biopsychosocial framework, acknowledging that altered pain processing, psychological impairments, and autonomic nervous system dysfunction are associated with chronic pain. However, the concurrent within-sample relationships between these domains remain poorly understood and inconsistently reported. To systematically evaluate the associations among physiological autonomic measures, validated psychosocial scales, and pressure algometry in adults with persistent spinal pain. Methods: A systematic search was conducted in accordance with PRISMA guidelines. A systematic search was conducted across four electronic databases (PubMed, Web of Science, Scopus, and CINAHL) for studies evaluating all three domains within the same cohort. The search was restricted to peer-reviewed articles published in English and Spanish. Two independent blinded reviewers screened and selected the studies. Eligible studies evaluated within-sample relationships across three domains: autonomic indices (e.g., heart rate variability (HRV) and blood pressure (BP)), psychosocial factors (e.g., kinesiophobia and pain catastrophizing), and quantitative sensory testing (QST) (e.g., pressure pain threshold (PPTs)). Quality assessment was performed using the National Institutes of Health (NIH) tools. Due to significant methodological heterogeneity, the data were synthesized narratively. Results: Six studies fulfilled the eligibility criteria. The narrative synthesis revealed a preliminary pattern showing that objective functional outcomes and experimental pain processing tend to show closer associations with autonomic proxies (such as heart rate variability), whereas subjective clinical outcomes (such as perceived disability) are more consistently linked to psychosocial factors (such as kinesiophobia and catastrophizing). Conclusions: These preliminary findings suggest potentially distinct domain-specific associations rather than a uniform pathophysiological mechanism. Future specialized research and research-informed practice should incorporate multimodal assessments to better characterize individual patient profiles. Full article

Study Objective: This study investigated the effects of chronic ankle instability (CAI) on axial (neck and trunk) and lower-extremity joint kinematics during a side cutting jump to identify compensatory strategies across the kinetic chain. Methods: Twenty-seven male adults in their 20s participated, including fourteen with CAI and thirteen healthy controls. CAI was defined as a Cumberland Ankle Instability Tool-Korean version (CAIT-K) score ≤ 24 and an Identification of Functional Ankle Instability-Korean version (IdFAI-K) score ≥ 11. Participants performed side cutting jumps on a force plate while three-dimensional joint kinematics were captured using a 14-camera motion system (100 Hz). Eighteen joint angles from the upper body to the ankle were analyzed. Group differences across the movement phase (initial contact to 1 s post-landing) were assessed using Statistical Parametric Mapping (SPM1D) with Bonferroni correction (α = 0.00085). Results: Compared with controls, the CAI group showed smaller neck motions across all planes, which may suggest a potential reliance on visual stabilization. Trunk flexion and rotation were greater, which is consistent with a potential mechanism for impact absorption. At the pelvis and hip, CAI participants displayed increased anterior tilt, greater flexion and internal rotation, and reduced abduction. Notably, at the knee, flexion was significantly greater during the 1.7–32.8% phase (peak d = 1.06, large effect size) with smaller valgus and rotational angles. At the distal level, the ankle showed a significant increase in eversion during the 3.4–15.5% phase (d = 0.00–0.28) and external rotation during the 5.2–13.8% phase (d = 0.28–0.48), representing a compensatory pronation-bias strategy. Conclusions: CAI alters not only ankle function but also global coordination during side cutting jumps, reflecting multi-joint compensatory mechanisms to stabilize posture and modulate kinematic forces. Compensatory strategies involving visual fixation, trunk modulation, and proximal joint adjustments highlight the need for an integrated kinetic chain approach in CAI evaluation and rehabilitation. Full article

Background/Objectives: The PRO-CTCAE Average Composite Score (ACS), calculated as the mean of PRO-CTCAE composite scores, summarizes overall symptom and side effect burden. This study evaluated the test–retest reliability, responsiveness to change, known-groups validity, and sensitivity to group differences in the ACS. Methods: Analyses used the original PRO-CTCAE validation dataset, including lung (n = 174), breast (n = 222), and head and neck (n = 139) cancer cohorts, and data from the COMET-2 randomized phase III trial comparing cabozantinib (n = 53) and mitoxantrone–prednisone (n = 54) in men with previously treated prostate cancer. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs) from two-way mixed-effects models for agreement. Responsiveness was evaluated by relating ACS change scores (Visit 1 minus follow-up Visit 2) to patient-reported global ratings of change (GRC; worsened, unchanged, or improved) using standardized response means (SRMs) and Jonckheere–Terpstra trend tests. Known-groups validity was examined by comparing mean ACS values between ECOG performance status groups (0–1 vs. 2–4). Sensitivity to treatment group differences was assessed using model-based area-under-the-curve (AUC) comparisons of longitudinal ACS trajectories. Results: Test–retest reliability was acceptable, with ICCs among GRC-defined stable patients of 0.80 (95% CI: 0.70–0.87) in lung cancer, 0.84 (95% CI: 0.77–0.89) in breast cancer, and 0.77 (95% CI: 0.63–0.86) in head and neck cancer; ICCs based on assessments completed one day apart ranged from 0.88 to 0.90. The ACS demonstrated responsiveness, with SRMs of 0.30/0.15/−0.37 (lung), 0.29/0.14/−0.40 (breast), and −0.01/−0.20/−0.56 (head/neck) for improved/no-change/worsened groups, respectively, and significant monotonic trends across GRC categories (all p < 0.01). Known-groups validity was supported by conceptually expected differences in ACS values across distinct levels of self-reported patient-reported physical functioning and ECOG performance status categories. Mean ACS values were lower among patients with good versus limited physical functioning (0.71 vs. 1.23 in lung cancer, 0.52 vs. 1.19 in breast cancer, and 0.69 vs. 1.29 in head and neck cancer) and among patients with ECOG PS 0–1 versus 2–4 (0.93 vs. 1.31, 0.74 vs. 1.22, and 0.90 vs. 1.06, respectively). In COMET-2, higher symptom burden was detected in the cabozantinib arm compared with the mitoxantrone–prednisone arm (AUC difference = 1.5, 95% CI: 0.2–2.8, p = 0.02). Conclusions: The ACS demonstrated acceptable test–retest reliability, responsiveness, and known-groups validity across multiple cancer populations. These findings support its use as a complementary summary measure of overall symptomatic adverse event burden alongside individual symptom-level analyses. Full article

Background/Objectives: Head and neck cancer (HNC) is associated with substantial morbidity, functional impairment, and represents a substantial socioeconomic burden worldwide. Although advances in surgery, radiotherapy (RT), and systemic therapies have improved oncologic outcomes, treatment-related toxicities frequently overlap with profound economic consequences for patients and caregivers. Financial toxicity (FT), defined as the objective financial burden and subjective financial distress associated with cancer care, has emerged as a clinically relevant determinant of treatment adherence, quality of life (QoL), and survival. In HNC, FT appears particularly critical during active treatment, when multimodal therapies, nutritional compromise, work interruption, transportation costs, and supportive care needs converge. Methods: This structured narrative review synthesizes current literature regarding FT during active treatment for HNC, focusing on conceptual definitions, measurement approaches, temporal dynamics, clinical and psychosocial consequences, and health system determinants. The review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA) framework using searches of PubMed/MEDLINE, Scopus, Embase, and Google Scholar. Results: Available evidence suggests that FT may emerge early during treatment and evolve dynamically throughout the care trajectory. Lower socioeconomic status, treatment intensity, work interruption, and limited social support have been reported in association with increased FT. FT has also been linked to worse health-related QoL, higher symptom burden, treatment interruptions, hospitalization, and reduced survival, although the limited number of studies and methodological heterogeneity preclude definitive conclusions. Emerging evidence suggests that FT may be partially modifiable through interventions such as financial counseling and patient navigation. Conclusions: Future research should prioritize prospective and interventional designs using standardized multidimensional instruments capable of capturing both objective and subjective domains of FT. Integrating routine FT assessment into supportive oncology workflows may help identify vulnerable patients and support more equitable, patient-centered HNC care. Full article

Introduction: The COVID-19 pandemic profoundly disrupted healthcare, prompting adaptations in oncological practices. This systematic review evaluates the pandemic’s impact on the management of non-melanoma skin cancer (NMSC) of the head and neck (H&N) region. Methods: The review was reported according to PRISMA guidelines. Eligible studies compared pre-pandemic and pandemic periods in adult patients treated for head and neck NMSC reporting outcomes related to histological distribution, time to treatment initiation, reconstructive method, and surgical margin status. Risk of bias was assessed using the Newcastle–Ottawa Scale. Random-effects meta-analyses were performed for outcomes with sufficient extractable data. Results: The review comprised five studies involving 1318 cases. The relative distribution of basal cell carcinoma and squamous cell carcinoma did not differ significantly between pre-pandemic and pandemic periods. Time to treatment initiation showed no significant overall change, although heterogeneity was high, indicating substantial variability among healthcare settings. Reconstruction shifted significantly toward primary closure compared with flap reconstruction during the pandemic period (OR 1.90; 95% CI: 1.46–2.47; p < 0.0001). Negative surgical margins were reported in 1119 of 1266 excisions/cases with available data (88.4%), with no significant difference between pre-pandemic and pandemic periods (OR 0.77; 95% CI: 0.46–1.32; p = 0.34). Conclusions: The pandemic was associated with a shift toward simpler reconstructive strategies, particularly increased use of primary closure, likely reflecting attempts to reduce operative complexity and resource use. While short-term oncologic outcomes appeared broadly preserved, long-term functional, aesthetic, and patient-reported outcomes remain insufficiently characterized. Future studies should evaluate these outcomes to better inform crisis-adapted oncologic and reconstructive care pathways. Full article

Background/Objectives: Degenerative cervical myelopathy (DCM) is the leading cause of non-traumatic spinal cord dysfunction in adults. Both anterior and posterior surgical approaches are widely used for its treatment, yet their comparative impact on clinical outcomes and complication profiles remains clinically relevant. This study aimed to describe early and one-year postoperative outcomes between anterior and posterior surgical strategies in a consecutive single-center cohort. Methods: We conducted a retrospective single-center study of 102 consecutive adult patients surgically treated for DCM between 2013 and 2024, with complete datasets and a minimum one-year follow-up. Surgical approaches were classified as anterior, posterior, or combined. Clinical outcomes were assessed using the modified Japanese Orthopaedic Association scale (mJOA), Neck Disability Index (NDI), and Numeric Rating Scale for arm pain (NRS-arm) preoperatively, at 4–6 weeks and at one year. Complications were systematically recorded and stratified by approach. Nonparametric tests were used for all comparisons (significance threshold p < 0.05). Results: Anterior procedures were performed in 82 patients (80.4%), posterior in 18 (17.6%), and combined in 2 (2.0%). No significant between-group differences were observed in neurological, functional, or pain outcomes at either time point (ΔmJOA p = 0.268; ΔNDI p = 0.632; ΔNRS p = 0.562 at one year). Complications occurred in 13 patients (12.7%), with approach-specific profiles: anterior surgery was associated with hematoma, dysphagia, and dysphonia, posterior surgery with CSF leak, wound infection, and kyphosis. No C5 palsy was recorded. Conclusions: Both anterior and posterior surgical approaches were followed by neurological and functional improvement at one year. Given the descriptive nature of the study and the baseline differences between groups, these findings should not be read as a formal comparison of effectiveness, but they reinforce the importance of individualized, pathology-driven surgical planning in DCM. Full article

Background/Objectives: Chronic pain represents a major global health burden and significantly impacts quality of life and functional capacity. Physiotherapy plays a central role in its management, yet the rapid growth of research in this field makes it difficult to identify current trends and emerging directions. The aim of this study was to analyze global research trends in chronic pain physiotherapy using a bibliometric approach. Methods: A bibliometric analysis was conducted using data retrieved from PubMed, Scopus, and Web of Science. A predefined search strategy was applied to identify relevant publications. Data were analyzed and visualized using VOSviewer. Co-occurrence analysis of terms based on titles and abstracts was performed using full counting. The most relevant terms were selected using a relevance score threshold, and a thesaurus file was applied to improve data quality. Results: The number of publications increased steadily from 2015 to 2025, indicating growing research interest in chronic pain physiotherapy. Network analysis revealed key research clusters related to clinical interventions, functional assessment, and outcome evaluation. The most prominent and central terms included “pelvic pain”, “neck disability index”, and “radicular pain”. Overlay visualization identified emerging topics such as “stratified care”, “multidisciplinary rehabilitation”, and “psychometric property”, reflecting a shift toward personalized and patient-centered approaches. Conclusions: Research in chronic pain physiotherapy is rapidly expanding, with a clear transition from traditional intervention-focused approaches toward individualized, multidisciplinary, and outcome-driven strategies. These findings provide insight into current research directions and may support clinicians and researchers in identifying future priorities in chronic pain management. Full article

Background: Head and neck squamous cell carcinoma (HNSCC) remains a highly aggressive malignancy with poor clinical outcomes. Although poly(ADP-ribose) polymerase (PARP) inhibitors have shown promising activity in tumors with homologous recombination deficiency, their efficacy in BRCA wild-type HNSCC remains limited. Reactive oxygen species (ROS)-induced DNA damage may increase cellular dependence on DNA repair pathways and thereby enhance sensitivity to PARP inhibition. This study investigated whether ROS-mediated DNA damage could sensitize BRCA wild-type HNSCC cells to the PARP inhibitor olaparib. Methods: BRCA wild-type HSC-3 and SCC-25 HNSCC cell lines were exposed to H₂O₂ to induce oxidative stress. Intracellular ROS levels were quantified using DCFDA assays, DNA double-strand breaks were evaluated by γ-H2AX ELISA, PARP activity was assessed by ELISA, and cell viability was determined using MTT assays. Expression levels of DNA repair genes (PARP1, PARP2, BRCA1, BRCA2, RAD51, and MLH1), checkpoint kinases (ATM, ATR, and CHK1), the homologous recombination regulator FANCD2, and redox defense genes (NQO1, GPX4, and SLC7A11) were analyzed by qRT-PCR. Therapeutic selectivity was assessed using HGF-1 normal human gingival fibroblasts as a normal cell control. Apoptosis was measured through caspase-3/7 activity assays, and drug interactions were evaluated using the Chou–Talalay method. Results: H₂O₂ treatment increased intracellular ROS levels in both cell lines, accompanied by significant induction of DNA damage as demonstrated by elevated γ-H2AX levels. ROS induction markedly enhanced olaparib sensitivity, significantly reducing IC₅₀ values in both HSC-3 and SCC-25 cells. Combined H₂O₂ and olaparib treatment produced strong synergistic cytotoxicity, suppressed DNA repair, checkpoint kinase, and redox defense gene expression, and increased caspase-3/7 activity compared with control cells. Importantly, the combination demonstrated selective cytotoxicity toward cancer cells, with normal HGF-1 cells retaining significantly higher viability. Conclusions: ROS-induced DNA damage significantly enhances the anti-tumor activity of olaparib in BRCA wild-type HNSCC cells through a functional synthetic lethal-like interaction involving the simultaneous collapse of DNA repair capacity, checkpoint activation, and oxidative stress buffering, culminating in apoptosis induction. These findings support the rationale for combining ROS-generating therapies with PARP inhibitors in HNSCC treatment. Full article

Background/Objectives: Radiotherapy (RT) for head and neck cancer (HNC) is associated with oral and functional toxicity, but integrated data combining dental status, nutritional indicators and patient-reported outcomes remain limited. This study evaluated oral, dental, functional, nutritional and quality-of-life outcomes after RT. Methods: This exploratory observational study combined a retrospective record review with a prospective cross-sectional assessment of patient-reported outcomes and included 20 adults treated with RT for HNC in a regional Slovenian clinical setting. Clinical, oncological, dental and nutritional variables were extracted from records, while patient-reported outcomes were assessed once at post-treatment follow-up using the EORTC QLQ-C30, EORTC QLQ-HN43 and a focused oral-health questionnaire. Results: The median time from RT completion to questionnaire assessment was 3.0 months. Dysphagia, xerostomia and taste disturbances after treatment were recorded in 85.0%, 80.0% and 75.0% of patients, respectively. Trismus was present in 40.0%, and weight loss >10% in 55.0%. QLQ-HN43 domains with the highest burden included fear of progression, dry mouth/sticky saliva, problems opening the mouth, social eating, weight loss and teeth problems. Swallowing was strongly associated with social eating (rho = 0.798, p < 0.001), and mouth opening was inversely associated with patient-reported problems opening the mouth (rho = −0.610, p = 0.004). Conclusions: In this small exploratory cohort, substantial early post-treatment oral-functional morbidity was observed. The findings suggest the potential value of integrated survivorship follow-up incorporating dental, nutritional, functional, and patient-reported outcome monitoring. Full article

Cancer stem cells (CSCs) drive therapeutic resistance and tumor relapse by exploiting redundant regulatory networks that integrate Wnt/β-catenin, Notch, and Hedgehog signaling with metabolic reprogramming, epigenetic plasticity, and tumor microenvironment crosstalk, a network architecture that renders single-pathway inhibition strategies insufficient. This review systematically examines evidence that natural compounds (curcumin, sulforaphane, resveratrol, EGCG, berberine, and quercetin) act as multitarget modulators of CSC plasticity, analyzing their molecular mechanisms of action in specific cancer models. Each compound engages distinct regulatory nodes: curcumin suppresses β-catenin nuclear translocation and STAT3 phosphorylation in lung cancer CSC models; sulforaphane represses ΔNp63α-driven stemness transcription in colorectal cancer and reduces CSC self-renewal in prostate and head and neck models; resveratrol dissociates the β-catenin–GLI-1 interaction in oral and lung CSC populations and induces Wnt/β-catenin-dependent autophagy in breast CSCs; EGCG inhibits DNMT and HDAC activity in glioblastoma and colorectal models; berberine activates AMPK-mediated suppression of mTORC1 in colorectal cancer; and quercetin suppresses PI3K/AKT/mTOR signaling while downregulating EMT transcription factors in breast and colorectal systems. We critically assess persistent methodological limitations, including bulk cell-line models, supraphysiological concentrations, and the absence of functional tumor-initiating validation, that currently prevent stronger translational conclusions. Natural compounds from Latin American biodiversity are identified as an underexplored source of CSC-active molecules. We conclude by defining the experimental standards required to reposition natural compounds as clinically relevant network-level modulators of CSC plasticity. Full article