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18 pages, 1684 KiB  
Article
Data Mining and Biochemical Profiling Reveal Novel Biomarker Candidates in Alzheimer’s Disease
by Annamaria Vernone, Ilaria Stura, Caterina Guiot, Federico D’Agata and Francesca Silvagno
Int. J. Mol. Sci. 2025, 26(15), 7536; https://doi.org/10.3390/ijms26157536 - 4 Aug 2025
Abstract
The search for the biomarkers of Alzheimer’s disease (AD) may prove essential in the diagnosis and prognosis of the pathology, and the differential expression of key proteins may assist in identifying new therapeutic targets. In this proof-of-concept (POC) study, a new approach of [...] Read more.
The search for the biomarkers of Alzheimer’s disease (AD) may prove essential in the diagnosis and prognosis of the pathology, and the differential expression of key proteins may assist in identifying new therapeutic targets. In this proof-of-concept (POC) study, a new approach of data mining and matching combined with the biochemical analysis of proteins was applied to AD investigation. Three influential online open databases (UniProt, AlzGene, and Allen Human Brain Atlas) were explored to identify the genes and encoded proteins involved in AD linked to mitochondrial and iron dysmetabolism. The databases were searched using specific keywords to collect information about protein composition, and function, and meta-analysis data about their correlation with AD. The extracted datasets were matched to yield a list of relevant proteins in AD. The biochemical analysis of their amino acid content suggested a defective synthesis of these proteins in poorly oxygenated brain tissue, supporting their relevance in AD progression. The result of our POC study revealed several potential new markers of AD that deserve further molecular and clinical investigation. This novel database search approach can be a valuable strategy for biomarker search that can be exploited in many diseases. Full article
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7 pages, 1853 KiB  
Interesting Images
Mucinous Carcinoma, Mucinous Borderline Tumor and Pseudomyxoma Ovarii in a Cystic Teratoma: A Histological Conundrum
by Cinzia Giacometti, Mariateresa Mirandola, Camillo Aliberti, Filippo Molinari, Lisa Marcolini, Daniele Mautone and Guido Martignoni
Diagnostics 2025, 15(15), 1957; https://doi.org/10.3390/diagnostics15151957 - 4 Aug 2025
Abstract
Mature teratomas account for approximately 20% of all ovarian tumors identified in pathological studies. Benign or malignant somatic neoplasms developing within teratomas can arise from any tissue in up to 2% of mature cystic teratomas, including low-grade malignant mucinous neoplasms. This report presents [...] Read more.
Mature teratomas account for approximately 20% of all ovarian tumors identified in pathological studies. Benign or malignant somatic neoplasms developing within teratomas can arise from any tissue in up to 2% of mature cystic teratomas, including low-grade malignant mucinous neoplasms. This report presents the case of a 34-year-old woman with no previous gynecological or general health issues, who was admitted to our Hospital after an asymptomatic pelvic mass was detected during a routine exam. A transvaginal ultrasound revealed a unilateral pelvic mass in the left adnexal region, measuring 8 cm. The CT scan showed a cystic-appearing formation measuring nearly 12 cm, which indented the bladder dome. Final diagnosis indicated a mucinous carcinoma arising from a mucinous borderline lesion within the context of a mature ovarian teratoma. No other involvement or lymphadenopathies were detected on 18FDG-PET CT scan, and the patient is now well and free of recurrences. Full article
(This article belongs to the Special Issue Pathology and Diagnosis of Gynecologic Diseases, 3rd Edition)
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19 pages, 286 KiB  
Review
Does the Anatomical Type of the Plantaris Tendon Influence the Management of Midportion Achilles Tendinopathy?
by Łukasz Olewnik, Ingrid C. Landfald, Bartosz Gonera, Łukasz Gołek, Aleksandra Szabert-Kajkowska, Andrzej Borowski, Marek Drobniewski, Teresa Vázquez and Kacper Ruzik
J. Clin. Med. 2025, 14(15), 5478; https://doi.org/10.3390/jcm14155478 - 4 Aug 2025
Abstract
Background: Midportion Achilles tendinopathy (Mid-AT) is a complex condition that may be exacerbated by anatomical variations of the plantaris tendon. Recent anatomical studies, particularly the classification proposed by Olewnik et al., have enhanced the understanding of plantaris–Achilles interactions and their clinical implications. Objective: [...] Read more.
Background: Midportion Achilles tendinopathy (Mid-AT) is a complex condition that may be exacerbated by anatomical variations of the plantaris tendon. Recent anatomical studies, particularly the classification proposed by Olewnik et al., have enhanced the understanding of plantaris–Achilles interactions and their clinical implications. Objective: This review aims to assess the anatomical types of the plantaris tendon, their imaging correlates, and the impact of the Olewnik classification on diagnosis, treatment planning, and surgical outcomes in patients with Mid-AT. Methods: We present an evidence-based analysis of the six anatomical types of the plantaris tendon and their relevance to Achilles tendinopathy, with emphasis on MRI and ultrasound (USG) evaluation. A diagnostic and therapeutic algorithm is proposed, and clinical outcomes of both conservative and operative management are compared across tendon types. Results: Types I and V were most strongly associated with symptomatic conflict and showed the highest benefit from surgical resection. Endoscopic approaches were effective in Types II and III, while Type IV typically responded to conservative treatment. Type VI, often misdiagnosed as tarsal tunnel syndrome, required combined neurolysis. The classification significantly improves surgical decision-making, reduces overtreatment, and enhances diagnostic precision. Conclusions: The Olewnik classification provides a reproducible, clinically relevant framework for individualized management of Mid-AT. Its integration into imaging protocols and treatment algorithms may improve therapeutic outcomes and guide future research in orthopaedic tendon pathology. Full article
(This article belongs to the Section Orthopedics)
23 pages, 4728 KiB  
Article
A Web-Deployed, Explainable AI System for Comprehensive Brain Tumor Diagnosis
by Serra Aksoy, Pinar Demircioglu and Ismail Bogrekci
Neurol. Int. 2025, 17(8), 121; https://doi.org/10.3390/neurolint17080121 - 4 Aug 2025
Abstract
Background/Objectives: Accurate diagnosis of brain tumors is one of the most important challenges in neuro-oncology since tumor classification and volumetric segmentation inform treatment planning. Two-dimensional classification and three-dimensional segmentation deep learning models can augment radiological workflows, particularly if paired with explainable AI techniques [...] Read more.
Background/Objectives: Accurate diagnosis of brain tumors is one of the most important challenges in neuro-oncology since tumor classification and volumetric segmentation inform treatment planning. Two-dimensional classification and three-dimensional segmentation deep learning models can augment radiological workflows, particularly if paired with explainable AI techniques to improve model interpretability. The objective of this research was to develop a web-based brain tumor segmentation and classification diagnosis platform. Methods: A diagnosis system was developed combining 2D tumor classification and 3D volumetric segmentation. Classification employed a fine-tuned MobileNetV2 model trained on a glioma, meningioma, pituitary tumor, and normal control dataset. Segmentation employed a SegResNet model trained on BraTS multi-channel MRI with synthetic no-tumor data. A meta-classifier MLP was used for binary tumor detection from volumetric features. Explainability was offered using XRAI maps for 2D predictions and Gaussian overlays for 3D visualizations. The platform was incorporated into a web interface for clinical use. Results: MobileNetV2 2D model recorded 98.09% classification accuracy for tumor classification. 3D SegResNet obtained Dice coefficients around 68–70% for tumor segmentations. The MLP-based tumor detection module recorded 100% detection accuracy. Explainability modules could identify the area of the tumor, and saliency and overlay maps were consistent with real pathological features in both 2D and 3D. Conclusions: Deep learning diagnosis system possesses improved brain tumor classification and segmentation with interpretable outcomes by utilizing XAI techniques. Deployment as a web tool and a user-friendly interface made it suitable for clinical usage in radiology workflows. Full article
(This article belongs to the Section Brain Tumor and Brain Injury)
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27 pages, 747 KiB  
Review
An Insight into the Disease Prognostic Potentials of Nanosensors
by Nandu K. Mohanan, Nandana S. Mohanan, Surya Mol Sukumaran, Thaikatt Madhusudhanan Dhanya, Sneha S. Pillai, Pradeep Kumar Rajan and Saumya S. Pillai
Inorganics 2025, 13(8), 259; https://doi.org/10.3390/inorganics13080259 - 4 Aug 2025
Viewed by 72
Abstract
Growing interest in the future applications of nanotechnology in medicine has led to groundbreaking developments in nanosensors. Nanosensors are excellent platforms that provide reliable solutions for continuous monitoring and real-time detection of clinical targets. Nanosensors have attracted great attention due to their remarkable [...] Read more.
Growing interest in the future applications of nanotechnology in medicine has led to groundbreaking developments in nanosensors. Nanosensors are excellent platforms that provide reliable solutions for continuous monitoring and real-time detection of clinical targets. Nanosensors have attracted great attention due to their remarkable sensitivity, portability, selectivity, and automated data acquisition. The exceptional nanoscale properties of nanomaterials used in the nanosensors boost their sensing potential even at minimal concentrations of analytes present in a clinical sample. Along with applications in diverse sectors, the beneficial aspects of nanosensors have been exploited in healthcare systems to utilize their applications in diagnosing, treating, and preventing diseases. Hence, in this review, we have presented an overview of the disease-prognostic applications of nanosensors in chronic diseases through a detailed literature analysis. We focused on the advances in various nanosensors in the field of major diseases such as cancer, cardiovascular diseases, diabetes mellitus, and neurodegenerative diseases along with other prevalent diseases. This review demonstrates various categories of nanosensors with different nanoparticle compositions and detection methods suitable for specific diagnostic applications in clinical settings. The chemical properties of different nanoparticles provide unique characteristics to each nanosensors for their specific applications. This will aid the detection of potential biomarkers or pathological conditions that correlate with the early detection of various diseases. The potential challenges and possible recommendations of the applications of nanosensors for disease diagnosis are also discussed. The consolidated information present in the review will help to better understand the disease-prognostic potentials of nanosensors, which can be utilized to explore new avenues in improved therapeutic interventions and treatment modalities. Full article
(This article belongs to the Section Bioinorganic Chemistry)
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11 pages, 231 KiB  
Review
The Current Landscape of Molecular Pathology for the Diagnosis and Treatment of Pediatric High-Grade Glioma
by Emma Vallee, Alyssa Steller, Ashley Childress, Alayna Koch and Scott Raskin
J. Mol. Pathol. 2025, 6(3), 17; https://doi.org/10.3390/jmp6030017 - 1 Aug 2025
Viewed by 157
Abstract
Pediatric high-grade glioma (pHGG) is a devastating group of childhood cancers associated with poor outcomes. Traditionally, diagnosis was based on histologic and immunohistochemical characteristics, including high mitotic activity, presence of necrosis, and presence of glial cell markers (e.g., GFAP). With advances in molecular [...] Read more.
Pediatric high-grade glioma (pHGG) is a devastating group of childhood cancers associated with poor outcomes. Traditionally, diagnosis was based on histologic and immunohistochemical characteristics, including high mitotic activity, presence of necrosis, and presence of glial cell markers (e.g., GFAP). With advances in molecular tumor profiling, these tumors have been recategorized based on specific molecular findings that better lend themselves to prediction of treatment response and prognosis. pHGG is now categorized into four subtypes: H3K27-altered, H3G34-mutant, H3/IDH-WT, and infant-type high-grade glioma (iHGG). Molecular profiling has not only increased the specificity of diagnosis but also improved prognostication. Additionally, these molecular findings provide novel targets for individual tumor-directed therapy. While these therapies are largely still under investigation, continued investigation of distinct molecular markers in these tumors is imperative to extending event-free survival (EFS) and overall survival (OS) for patients with pHGG. Full article
(This article belongs to the Collection Feature Papers in Journal of Molecular Pathology)
20 pages, 1383 KiB  
Review
The Multifaceted Role of miR-211 in Health and Disease
by Juan Rayo Parra, Zachary Grand, Gabriel Gonzalez, Ranjan Perera, Dipendra Pandeya, Tracey Weiler and Prem Chapagain
Biomolecules 2025, 15(8), 1109; https://doi.org/10.3390/biom15081109 - 1 Aug 2025
Viewed by 246
Abstract
MicroRNA-211 (miR-211) is a versatile regulatory molecule that plays critical roles in cellular homeostasis and disease progression through the post-transcriptional regulation of gene expression. This review comprehensively examines miR-211’s multifaceted functions across various biological systems, highlighting its context-dependent activity as both a tumor [...] Read more.
MicroRNA-211 (miR-211) is a versatile regulatory molecule that plays critical roles in cellular homeostasis and disease progression through the post-transcriptional regulation of gene expression. This review comprehensively examines miR-211’s multifaceted functions across various biological systems, highlighting its context-dependent activity as both a tumor suppressor and oncogene. In physiological contexts, miR-211 regulates cell cycle progression, metabolism, and differentiation through the modulation of key signaling pathways, including TGF-β/SMAD and PI3K/AKT. miR-211 participates in retinal development, bone physiology, and protection against renal ischemia–reperfusion injury. In pathological conditions, miR-211 expression is altered in various diseases, particularly cancer, where it may be a useful diagnostic and prognostic biomarker. Its stability in serum and differential expression in various cancer types make it a promising candidate for non-invasive diagnostics. The review also explores miR-211’s therapeutic potential, discussing both challenges and opportunities in developing miRNA-based treatments. Understanding miR-211’s complex regulatory interactions and context-dependent functions is crucial for advancing its clinical applications for diagnosis, prognosis, and targeted therapy in multiple diseases. Full article
(This article belongs to the Special Issue DNA Damage, Mutagenesis, and Repair Mechanisms)
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14 pages, 3666 KiB  
Article
A Sensitive Sandwich-Type Electrochemical Immunosensor for Carbohydrate Antigen 19-9 Based on Covalent Organic Frameworks
by Ting Wu, Rongfang Chen, Yaqin Duan, Longfei Miao, Yongmei Zhu and Li Wang
Biosensors 2025, 15(8), 492; https://doi.org/10.3390/bios15080492 - 1 Aug 2025
Viewed by 190
Abstract
Since carbohydrate antigen 19-9 (CA 19-9) is a significant biomarker for the clinical diagnosis and treatment of pancreatic cancer, a sensitive sandwich-type immunosensor was proposed with an epoxy functionalized covalent organic framework (EP-COFTTA-DHTA) as the antibody carrier and an electroactive COF [...] Read more.
Since carbohydrate antigen 19-9 (CA 19-9) is a significant biomarker for the clinical diagnosis and treatment of pancreatic cancer, a sensitive sandwich-type immunosensor was proposed with an epoxy functionalized covalent organic framework (EP-COFTTA-DHTA) as the antibody carrier and an electroactive COFTTA-2,6-NA(OH)2 as the signal amplification probe for the sensitive detection of CA 19-9. The flexible covalent linkage between the epoxy-functionalized EP-COFTTA-DHTA and the antibodies was employed to improve the dynamics of the antigen–antibody interaction significantly. Meanwhile, AuNPs@COFTTA-2,6-NA(OH)2 with abundant electroactive sites enhanced the current response of the immunoreaction significantly. After optimizing the incubation time and concentration of the antibody, CA 19-9 was quantitatively detected by differential pulse voltammetry (DPV) based on the sensitive sandwich-type immunosensor with a low detection limit of 0.0003 U/mL and a wide linear range of 0.0009–100 U/mL. The electrochemical immunosensor exhibits high specificity, stability and repeatability, and it provides a feasible and efficient method for the pathologic analysis and treatment of tumor markers. Full article
(This article belongs to the Special Issue Advances in Biosensors Based on Framework Materials)
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15 pages, 1566 KiB  
Systematic Review
Diagnostic Accuracy of Insulinoma-Associated Protein 1 in Pulmonary Neuroendocrine Carcinomas: A Systematic Review and Meta-Analysis
by Risa Waki, Saya Haketa, Riona Aburaki and Nobuyuki Horita
Cancers 2025, 17(15), 2544; https://doi.org/10.3390/cancers17152544 - 31 Jul 2025
Viewed by 143
Abstract
Background and Objective: Insulinoma-associated protein 1 (INSM1) is a novel immunohistochemical marker with potential utility in identifying neuroendocrine differentiation in lung cancer. Unlike conventional neuroendocrine (NE) markers, INSM1 can potentially serve as a standalone diagnostic biomarker. This study presents the first meta-analysis assessing [...] Read more.
Background and Objective: Insulinoma-associated protein 1 (INSM1) is a novel immunohistochemical marker with potential utility in identifying neuroendocrine differentiation in lung cancer. Unlike conventional neuroendocrine (NE) markers, INSM1 can potentially serve as a standalone diagnostic biomarker. This study presents the first meta-analysis assessing the diagnostic accuracy of using INSM1 to distinguish LCNEC and SCLC from other lung cancer subtypes, addressing the variability across individual studies. Methods: A systematic review and meta-analysis were conducted to comprehensively evaluate the diagnostic performance of INSM1 in the pathological classification of lung cancer. The online databases PubMed, Web of Science, and Embase were systematically searched for data collection. Studies reporting the sensitivity and specificity of INSM1 in diagnosing LCNEC and SCLC were included. Pooled estimates were calculated using two models: the NSCLC model, which distinguishes LCNEC from other non-small cell lung cancers (NSCLCs), and the lung cancer model, which differentiates both LCNEC and SCLC from non-neuroendocrine (non-NE) lung cancer. Results: Fourteen studies comprising 3,218 specimens were included in this systematic review and meta-analysis. In the NSCLC model, INSM1 demonstrated a pooled sensitivity of 0.67 (95% CI: 0.61–0.73) and specificity of 0.97 (95% CI: 0.96–0.98), with an area under the curve (AUC) of 0.943. In the lung cancer model, the pooled sensitivity and specificity were 0.86 (95% CI: 0.84–0.88) and 0.97 (95% CI: 0.96–0.98), respectively, with an AUC of 0.974. Conclusions: INSM1 demonstrated excellent diagnostic accuracy and consistently high specificity for pulmonary neuroendocrine carcinomas, supporting its utility as a reliable standalone immunohistochemical marker with the potential to replace conventional NE markers in the pathological diagnosis of LCNEC and SCLC. Full article
(This article belongs to the Section Systematic Review or Meta-Analysis in Cancer Research)
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33 pages, 2423 KiB  
Review
Chaperone-Mediated Responses and Mitochondrial–Endoplasmic Reticulum Coupling: Emerging Insight into Alzheimer’s Disease
by Manish Kumar Singh, Minghao Fu, Sunhee Han, Jyotsna S. Ranbhise, Wonchae Choe, Sung Soo Kim and Insug Kang
Cells 2025, 14(15), 1179; https://doi.org/10.3390/cells14151179 - 31 Jul 2025
Viewed by 431
Abstract
Alzheimer’s disease (AD) is increasingly recognized as a multifactorial disorder driven by a combination of disruptions in proteostasis and organelle communication. The 2020 Lancet commission reported that approximately 10 million people worldwide were affected by AD in the mid-20th century. AD is the [...] Read more.
Alzheimer’s disease (AD) is increasingly recognized as a multifactorial disorder driven by a combination of disruptions in proteostasis and organelle communication. The 2020 Lancet commission reported that approximately 10 million people worldwide were affected by AD in the mid-20th century. AD is the most prevalent cause of dementia. By early 2030, the global cost of dementia is projected to rise by USD 2 trillion per year, with up to 85% of that cost attributed to daily patient care. Several factors have been implicated in the progression of neurodegeneration, including increased oxidative stress, the accumulation of misfolded proteins, the formation of amyloid plaques and aggregates, the unfolded protein response (UPR), and mitochondrial–endoplasmic reticulum (ER) calcium homeostasis. However, the exact triggers that initiate these pathological processes remain unclear, in part because clinical symptoms often emerge gradually and subtly, complicating early diagnosis. Among the early hallmarks of neurodegeneration, elevated levels of reactive oxygen species (ROS) and the buildup of misfolded proteins are believed to play pivotal roles in disrupting proteostasis, leading to cognitive deficits and neuronal cell death. The accumulation of amyloid-β (Aβ) plaques and tau neurofibrillary tangles is a characteristic feature of AD. These features contribute to chronic neuroinflammation, which is marked by the release of pro-inflammatory cytokines and chemokines that exacerbate oxidative stress. Given these interconnected mechanisms, targeting stress-related signaling pathways, such as oxidative stress (ROS) generated in the mitochondria and ER, ER stress, UPR, and cytosolic chaperones, represents a promising strategy for therapeutic intervention. This review focuses on the relationship between stress chaperone responses and organelle function, particularly the interaction between mitochondria and the ER, in the development of new therapies for AD and related neurodegenerative disorders. Full article
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8 pages, 9195 KiB  
Case Report
Fatal Case of Viral Pneumonia Associated with Metapneumovirus Infection in a Patient with a Burdened Medical History
by Parandzem Khachatryan, Naira Karalyan, Hasmik Petunts, Sona Hakobyan, Hranush Avagyan, Zarine Ter-Pogossyan and Zaven Karalyan
Microorganisms 2025, 13(8), 1790; https://doi.org/10.3390/microorganisms13081790 - 31 Jul 2025
Viewed by 207
Abstract
Background: Human metapneumovirus (hMPV) is a respiratory pathogen that causes illness ranging from mild upper respiratory tract infections to severe pneumonia, particularly in individuals with comorbidities. Fatal cases of hMPV-induced hemorrhagic pneumonia are rare and likely under-reported. Diagnosis is often delayed due to [...] Read more.
Background: Human metapneumovirus (hMPV) is a respiratory pathogen that causes illness ranging from mild upper respiratory tract infections to severe pneumonia, particularly in individuals with comorbidities. Fatal cases of hMPV-induced hemorrhagic pneumonia are rare and likely under-reported. Diagnosis is often delayed due to overlapping symptoms with other respiratory viruses and the rapid progression of the disease. Case presentation: We report the case of a 55-year-old man with a complex medical history, including liver cirrhosis and diabetes mellitus, who developed acute viral pneumonia. Initial symptoms appeared three days before a sudden clinical deterioration marked by shortness of breath, hemoptysis, and respiratory failure. A nasopharyngeal swab taken on the third day of illness tested positive for hMPV by qRT-PCR. The patient died the following day. Postmortem molecular testing confirmed hMPV in lung tissue and alveolar contents. Autopsy revealed bilateral hemorrhagic pneumonia with regional lymphadenopathy. Histopathological examination showed alveolar hemorrhage, multinucleated cells, neutrophilic infiltration, activated autophagy in macrophages, and numerous cytoplasmic eosinophilic viral inclusions. Conclusions: This is the first documented case of fatal hMPV pneumonia in Armenia. It highlights the potential severity of hMPV in adults with chronic health conditions and emphasizes the need for timely molecular diagnostics. Postmortem identification of characteristic viral inclusions may serve as a cost-effective histopathological marker of hMPV-associated lung pathology. Full article
(This article belongs to the Section Virology)
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21 pages, 570 KiB  
Review
Healthcare Complexities in Neurodegenerative Proteinopathies: A Narrative Review
by Seyed-Mohammad Fereshtehnejad and Johan Lökk
Healthcare 2025, 13(15), 1873; https://doi.org/10.3390/healthcare13151873 - 31 Jul 2025
Viewed by 280
Abstract
Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences [...] Read more.
Background/Objectives: Neurodegenerative proteinopathies, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), and dementia with Lewy bodies (DLB), are increasingly prevalent worldwide mainly due to population aging. These conditions are marked by complex etiologies, overlapping pathologies, and progressive clinical decline, with significant consequences for patients, caregivers, and healthcare systems. This review aims to synthesize evidence on the healthcare complexities of major neurodegenerative proteinopathies to highlight current knowledge gaps, and to inform future care models, policies, and research directions. Methods: We conducted a comprehensive literature search in PubMed/MEDLINE using combinations of MeSH terms and keywords related to neurodegenerative diseases, proteinopathies, diagnosis, sex, management, treatment, caregiver burden, and healthcare delivery. Studies were included if they addressed the clinical, pathophysiological, economic, or care-related complexities of aging-related neurodegenerative proteinopathies. Results: Key themes identified include the following: (1) multifactorial and unclear etiologies with frequent co-pathologies; (2) long prodromal phases with emerging biomarkers; (3) lack of effective disease-modifying therapies; (4) progressive nature requiring ongoing and individualized care; (5) high caregiver burden; (6) escalating healthcare and societal costs; and (7) the critical role of multidisciplinary and multi-domain care models involving specialists, primary care, and allied health professionals. Conclusions: The complexity and cost of neurodegenerative proteinopathies highlight the urgent need for prevention-focused strategies, innovative care models, early interventions, and integrated policies that support patients and caregivers. Prevention through the early identification of risk factors and prodromal signs is critical. Investing in research to develop effective disease-modifying therapies and improve early detection will be essential to reducing the long-term burden of these disorders. Full article
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10 pages, 529 KiB  
Article
Comparative Outcomes in Metastatic Spinal Cord Compression and Femoral Metastatic Disease: Distinct Clinical Entities with Divergent Prognoses?
by Oded Hershkovich, Mojahed Sakhnini, Eyal Ramu, Boaz Liberman, Alon Friedlander and Raphael Lotan
Medicina 2025, 61(8), 1390; https://doi.org/10.3390/medicina61081390 - 31 Jul 2025
Viewed by 162
Abstract
Background and Objectives: Acute metastatic cord compression (AMSCC) and femoral impending/pathological fracture negatively impact a patient’s quality of life, morbidity and survival, and are considered significant life events. This study aims to compare AMSCC and FMD as distinct yet overlapping metastatic orthopedic [...] Read more.
Background and Objectives: Acute metastatic cord compression (AMSCC) and femoral impending/pathological fracture negatively impact a patient’s quality of life, morbidity and survival, and are considered significant life events. This study aims to compare AMSCC and FMD as distinct yet overlapping metastatic orthopedic emergencies, addressing whether they represent sequential disease stages or distinct patient subpopulations—an analysis critical for prognosis and treatment planning. Materials and Methods: Records of all patients who underwent surgery for a femoral metastatic disease (FMD) over a decade (2004–2015) and patients who were treated for acute metastatic spinal compression (AMSCC) (2007–2017) were retrieved. There were no patients lost to follow-up. Results: The treatment cohorts were similar in terms of age, gender, tumour origin, and the number of spinal metastases. Fifty-four patients were diagnosed with AMSCC. Following treatment, the Frankel muscle grading improved by 0.5 ± 0.8 grades. Two hundred and eighteen patients underwent surgical intervention for FMD. Seventy percent of femoral metastases were located in the femoral neck and trochanteric area. Impending fractures accounted for 52% of the cohort. The FMD cohort, including impending and pathological fractures, was similar to the AMSCC cohort in terms of age and the time interval between cancer diagnosis and surgery (56.7 ± 74.2 vs. 51.6 ± 69.6, respectively, p = 0.646). The Karnofsky functional score was higher for the FMD cohort (63.3 ± 16.2) than for the AMSCC cohort (48.5 ± 19.5; p < 0.001). The mean survival time for the FMD cohort was double that of the AMSCC, at 18.4 ± 23.5 months versus 9.1 ± 13.6 months, respectively (p = 0.006). Conclusions: In conclusion, this study is novel in proposing that FMD and AMSCC are distinct clinical entities, differing in their impact on patient function and, most importantly, on patient survival. Full article
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12 pages, 1990 KiB  
Article
Vaginal Intraepithelial Neoplasia (VaIN)—A Retrospective Cohort Analysis of Epidemiology, Risk Factors, and Management in an Academic Clinical Center
by Barbara Suchońska, Franciszek Ługowski, Magdalena Papież and Artur Ludwin
J. Clin. Med. 2025, 14(15), 5386; https://doi.org/10.3390/jcm14155386 - 30 Jul 2025
Viewed by 256
Abstract
Background: Vaginal intraepithelial neoplasia (VaIN) is a rare but potentially precancerous condition strongly associated with human papillomavirus (HPV) infection. Despite increased detection rates due to HPV screening and colposcopy, diagnosis and management remain challenging. This study aimed to evaluate the epidemiological characteristics, [...] Read more.
Background: Vaginal intraepithelial neoplasia (VaIN) is a rare but potentially precancerous condition strongly associated with human papillomavirus (HPV) infection. Despite increased detection rates due to HPV screening and colposcopy, diagnosis and management remain challenging. This study aimed to evaluate the epidemiological characteristics, risk factors, and outcomes of VaIN in patients referred to a tertiary academic center. Methods: We conducted a retrospective analysis of 48 patients who underwent colposcopy-directed vaginal biopsies between January 2019 and June 2024 at the Medical University of Warsaw. Data collected included patient demographics, HPV status, cytology, histopathology, and treatment outcomes. Patients were grouped based on the presence and grade of VaIN (VaIN 1 vs. VaIN 2/3). Statistical analyses were performed using SPSS software. Results: VaIN was diagnosed in 24 patients (50%), VaIN was confirmed in half of the cohort, VaIN 2 in 30%, and VaIN 3 in 18% of cases. HPV infection and prior cervical pathology were significantly associated with VaIN diagnosis (P = 0.03 and P = 0.05, respectively), and high-risk HPV infection correlated with higher-grade lesions (P = 0.04). Among VaIN 2+ cases, most patients required laser ablation or surgical excision, while VaIN 1 often regressed spontaneously. Regression occurred in 11 cases, and high-risk HPV infection was inversely associated with spontaneous regression (P = 0.04). Conclusions: This study confirms the central role of HPV, particularly high-risk subtypes, in VaIN pathogenesis. Conservative management may be appropriate for VaIN 1, while VaIN 2+ requires active intervention. HPV genotyping should be integrated into diagnostic workups, and long-term follow-up is essential due to the risks of persistence and recurrence. Full article
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18 pages, 9470 KiB  
Article
DCS-ST for Classification of Breast Cancer Histopathology Images with Limited Annotations
by Suxing Liu and Byungwon Min
Appl. Sci. 2025, 15(15), 8457; https://doi.org/10.3390/app15158457 - 30 Jul 2025
Viewed by 260
Abstract
Accurate classification of breast cancer histopathology images is critical for early diagnosis and treatment planning. Yet, conventional deep learning models face significant challenges under limited annotation scenarios due to their reliance on large-scale labeled datasets. To address this, we propose Dynamic Cross-Scale Swin [...] Read more.
Accurate classification of breast cancer histopathology images is critical for early diagnosis and treatment planning. Yet, conventional deep learning models face significant challenges under limited annotation scenarios due to their reliance on large-scale labeled datasets. To address this, we propose Dynamic Cross-Scale Swin Transformer (DCS-ST), a robust and efficient framework tailored for histopathology image classification with scarce annotations. Specifically, DCS-ST integrates a dynamic window predictor and a cross-scale attention module to enhance multi-scale feature representation and interaction while employing a semi-supervised learning strategy based on pseudo-labeling and denoising to exploit unlabeled data effectively. This design enables the model to adaptively attend to diverse tissue structures and pathological patterns while maintaining classification stability. Extensive experiments on three public datasets—BreakHis, Mini-DDSM, and ICIAR2018—demonstrate that DCS-ST consistently outperforms existing state-of-the-art methods across various magnifications and classification tasks, achieving superior quantitative results and reliable visual classification. Furthermore, empirical evaluations validate its strong generalization capability and practical potential for real-world weakly-supervised medical image analysis. Full article
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