Search Results (498)

Background/Objectives: The management of occlusion in implant-supported fixed partial restorations (ISFPRs) remains a controversial topic due to the limited availability of high-level clinical evidence and the biomechanical differences between natural teeth and dental implants. The absence of the periodontal ligament and the altered biomechanics of implants have led to the development of specific occlusal concepts. This narrative review provides an up-to-date overview of the biological basis and biomechanical principles underlying occlusal management in ISFPRs, with a particular focus on translating these into clinically applicable recommendations. Methods: A narrative review was conducted using an electronic search of PubMed/MEDLINE, covering the period from 1 March 2001, to 1 March 2026. Clinical studies and review articles were included, along with in vitro studies and finite element analyses when relevant to the biomechanical principles of implant occlusion. Additional publications were selectively included to provide biological, biomechanical, historical, and prosthetic context. Results: The available literature indicates that the evidence supporting specific occlusal protocols for ISFPRs remains limited and heterogeneous. Contemporary occlusal concepts emphasize the minimization of non-axial loads, the optimization of occlusal morphology, the control of cantilever extension, and the consideration of patient-specific factors, such as bruxism. Monolithic zirconia represents a viable restorative option due to its favorable mechanical properties and reduced technical complications. Long-term maintenance and periodic reevaluation of the occlusion remain essential, as occlusal relationships continue to change throughout a patient’s lifetime. Conclusions: Although numerous occlusal concepts have been proposed, high-level scientific evidence remains limited. Clinicians should adopt individualized occlusal strategies based on sound biological and biomechanical principles and tailored to each patient’s specific functional needs and risk factors. The dynamic nature of occlusion in ISFPRs necessitates periodic reevaluation as an integral part of long-term maintenance. Further well-designed clinical studies are needed to establish evidence-based occlusal protocols specific to ISFPRs. Full article

Background/Objectives: Chimeric antigen receptor T-cell (CAR-T) therapy has been approved for the management of relapsed and refractory hematologic malignancies, transforming the oncologic landscape and producing durable remissions in patient populations with limited alternatives. The systemic adverse events of CAR-T are well characterized; however, the orofacial adverse events have not been well described. The objective of this study is to leverage a large, de-identified, real-world dataset to (1) estimate the prevalence of orofacial adverse events following CAR-T, (2) compare event rates with the general population, and (3) directly contrast the orofacial toxicity burden of CAR-T with that observed after hemopoietic stem cell transplant (HSCT). Methods: We performed a retrospective cohort study using de-identified electronic health record data from TriNetX. CAR-T and HSCT cohorts were identified via RxNorm and procedure codes; a non-exposed control cohort was included. Patients with prior orofacial conditions or confounding therapies were excluded. New adverse orofacial events within one year were identified by International Classification of Diseases, 10th Revision (ICD-10) codes. Cohorts were 1:1 propensity-matched by age and sex; associations were estimated as odds ratios with two-sided 95% CIs. Results: In 1142 CAR-T recipients (mean age of 62), gastroesophageal reflux disease (GERD) was most frequent (5.18%). Oral mucosal events included stomatitis in 1.52%, mucositis in 1.31%, and lichenoid reactions in 1.03%. Dysphagia occurred in 1.8% and oral candidiasis in 1.6%. Several severe oral conditions were absent. Compared with the general population (CART vs. general population): mucositis—[12/995 vs. 0/1112] (OR 28.3)—and stomatitis—[16/987 vs. 0/1119] (OR 38)—risks were significantly increased, while CAR-T patients had significant lower risks of mucosal complications than HSCT recipients in this analysis (CART vs. HSCT): mucositis—[1.21% vs. 3.72%] (OR 0.316) and stomatitis—[1.42% vs. 3.91%] (OR 0.354). Conclusions: CAR-T therapy carries a distinct and generally lower orofacial toxicity burden than HSCT, but targeted dental assessment and prospective surveillance remain important to optimize supportive care for cellular therapy recipients. Full article

Background: Community-acquired respiratory viruses (CARVs) cause significant morbidity and mortality in patients with haematological malignancies and those undergoing haematopoietic cell transplantation (HCT). Despite this, clinical management remains variable. This study evaluated clinicians’ awareness, diagnostic practices, and treatment approaches to major respiratory viruses in this high-risk population. Methods: An international electronic survey using non-probability convenience sampling was conducted among haematology, oncology, intensive care and emergency medicine physicians. Four real-life clinical cases were converted into standardised vignettes covering human metapneumovirus (HMPV), respiratory syncytial virus (RSV), human parainfluenza virus (HPIV) and influenza A virus (IAV). The questionnaire assessed reported testing strategies and intended management, including antiviral and immunoprophylactic interventions. Responses were analysed descriptively; no inferential between-group comparisons were performed. Results: Ninety-eight clinicians from 26 countries responded. Diagnostic approaches, including testing indications and panel selection, varied among respondents. For HMPV and HPIV, respondents mainly reported supportive care, immunoglobulin replacement, and infection-control measures in the absence of established pathogen-specific interventions. RSV practice was heterogeneous: systemic ribavirin was considered by 45/96 (46.9%) respondents, including 34/96 (35.4%) when guided by an immunodeficiency score. IAV management was more consistent, with reported availability of vaccination and antiviral therapy and frequent use of post-exposure prophylaxis. Conclusions: Within this international convenience sample, clinicians reported variation in respiratory viral testing and in how results informed intended management. Because sampling was non-probability-based and respondent groups were small and unevenly distributed, the findings should not be interpreted as representative estimates of international practice. IAV testing was most consistently linked to established treatment and prevention, RSV showed greater therapeutic and preventive heterogeneity, and HMPV/HPIV testing primarily informed infection control, monitoring and antimicrobial stewardship. Full article

Liver transplantation (LT) has evolved from a contraindicated procedure for malignancy into an established oncologic therapy for selected primary and secondary hepatic cancers. Advances in tumor biology, molecular profiling, immunotherapy, and peri-transplant management have expanded transplant indications beyond hepatocellular carcinoma (HCC) to include perihilar cholangiocarcinoma, intrahepatic cholangiocarcinoma, colorectal liver metastasis (CRLM), neuroendocrine liver metastasis (NELM), and rare hepatic malignancies. The 2024 TransMet randomized controlled trial, demonstrating a 5-year overall survival (OS) of 73% with LT plus chemotherapy versus 9% with chemotherapy alone for unresectable CRLM, established the first Level 1 evidence supporting transplantation as a curative oncologic intervention in metastatic disease. These advances necessitate a modern framework for clinical trial design and research prioritization in transplant oncology. This manuscript proposes a comprehensive framework for future transplant oncology trials addressing endpoint selection, biomarker-driven patient selection, trial methodology, immunosuppression optimization, surveillance strategies, and ethical organ allocation. OS and transplant benefit are emphasized as the preferred primary endpoints for CRLM and NELM, whereas recurrence-free survival is recognized as retaining distinct clinical and prognostic value in HCC, underscoring that endpoint selection should be disease-specific rather than universally standardized. Emerging biomarkers—including circulating tumor DNA, AFP dynamics, and molecular and functional imaging profiling—are stratified into established, prospectively validated, and investigational categories to clarify their current clinical applicability. Randomized controlled trials, adaptive platform and enrichment designs, biomarker-stratified randomization, registry-based trials, and prospective registries are presented as complementary strategies tailored to disease prevalence and feasibility, alongside explicit consideration of how graft source—particularly the predominance of living donor liver transplantation in Asia versus deceased donor systems elsewhere—shapes trial design and interpretation. The manuscript further examines tumor biology-based immunosuppression, immune checkpoint inhibitor integration, and management of post-transplant recurrence. A precision medicine vision is proposed in which transplant candidacy is determined by biologic behavior and molecular signatures rather than morphology alone, with proposed trial frameworks offering an actionable research agenda for the next decade of transplant oncology. Full article

Background: Exercise-based cardiac rehabilitation (CR) is a cornerstone of secondary cardiovascular prevention and improves functional capacity, quality of life, and clinical outcomes. However, maintaining long-term participation remains a major challenge in routine clinical practice. Adapted Physical Activity (APA) programs represent a community-based strategy to promote continued exercise after outpatient cardiac disease, although evidence regarding long-term retention and functional outcomes in real-world settings remains limited. The aim of this study was to evaluate attrition patterns during a 12-month APA follow-up pathway following cardiac rehabilitation and to explore longitudinal changes in functional outcomes among participants who remained under follow-up. Methods: This retrospective longitudinal observational study included 78 consecutive patients referred to an APA program following outpatient cardiac rehabilitation for myocardial infarction or other cardiovascular conditions. Assessments were performed at baseline (T0), 2 months (T1), 6 months (T2), and 12 months (T3). The primary outcome was attrition, operationally defined as failure to attend scheduled follow-up assessments. Secondary outcomes included walking speed during the 1 km Treadmill Walk Test, lower-limb functional performance, handgrip strength, balance, pain, and self-reported physical activity. Longitudinal changes were analyzed using linear mixed-effects models adjusted for age and sex. Results: Seventy-eight patients were enrolled (48 men, 29 women, one participant with missing sex data; mean age 64 ± 11 years). Follow-up attendance progressively declined from 81% at 2 months to 27% at 6 months and 18% at 12 months. Among participants with available follow-up data, significant improvements were observed in walking speed, lower-limb performance, balance, and motor pain during the early supervised phase of the program, with the most robust changes evident at the 2-month assessment (all p < 0.001). Although favorable values were also observed at later assessments, the marked loss to follow-up substantially limited interpretation of the 6- and 12-month estimates. Handgrip strength showed no significant longitudinal changes, while self-reported physical activity increased at 6 months but remained highly variable across participants. Conclusions: In this real-world APA follow-up pathway after cardiac rehabilitation, substantial attrition was observed, with fewer than one-fifth of participants attending follow-up assessments at 12 months. The most robust secondary finding was the short-term improvement in functional outcomes during the initial supervised phase. Long-term functional estimates should be considered exploratory because of the high attrition rate and potential survivor/selection bias. These findings highlight long-term retention as a key outcome for future community-based exercise programs and support the development of strategies aimed at improving sustained participation after cardiac rehabilitation. Full article

Hepatocellular carcinoma (HCC) remains a major global health challenge and one of the leading causes of cancer-related mortality, with advanced disease continuing to be associated with limited therapeutic options and substantial heterogeneity in response to systemic treatment. Recent evidence has established the gut microbiota, through the gut–liver axis, as a critical determinant of immunotherapy efficacy, while also influencing antitumor immunity and liver carcinogenesis. Microbial dysbiosis may promote chronic inflammation, intestinal barrier disruption, bacterial translocation, and immune dysfunction, thereby contributing to hepatocarcinogenesis. Moreover, gut microbial composition and microbial-derived metabolites, including bile acids, short-chain fatty acids (SCFAs), and inosine, have been associated with modulation of antitumor immune responses and differential outcomes to immune checkpoint inhibitors (ICIs). Emerging clinical evidence in HCC has identified distinct gut microbial signatures associated with response to nivolumab, pembrolizumab, and atezolizumab-based regimens, including enrichment of Akkermansia muciniphila and SCFA-producing taxa such as Ruminococcaceae, Roseburia, and Prevotella in responders. However, these findings remain inconsistent across studies, with no reproducible microbial signature identified because of small cohort sizes, heterogeneous patient populations, geographic variation, cirrhosis-related confounding factors, and methodological differences in microbiome analysis. This review summarizes the current understanding of microbiome–immune interactions in HCC, examines mechanistic pathways linking the microbiota to immunotherapy response, critically evaluates available clinical evidence, and discusses current limitations and future therapeutic strategies, including fecal microbiota transplantation, probiotics, dietary modulation, and engineered bacterial platforms. Collectively, microbiome-based approaches may contribute to the development of personalized immunotherapeutic strategies in HCC, although larger standardized prospective studies are required before microbiome-derived biomarkers can be implemented in routine clinical practice. Full article

Marked interindividual variability in drug response remains a major challenge in clinical pharmacology and cannot be fully explained by host genetics alone. Increasing evidence indicates that the gut microbiota constitutes an additional determinant of drug efficacy and toxicity through bidirectional interactions with pharmacological therapies. This recognition has led to the emergence of pharmacomicrobiomics, a field that investigates how microbial communities influence drug disposition and response, and how drugs, in turn, alter the microbiome. Microbiome-mediated effects on drug efficacy and toxicity have been described across several therapeutic areas, including oncology, multiple sclerosis, and type 2 diabetes mellitus. Although these findings are promising, most mechanistic evidence derives from preclinical and animal studies, with relatively limited validation in controlled clinical trials. Strategies to modulate the gut microbiota, including prebiotics, probiotics, and faecal microbiota transplantation, have shown preliminary promise in optimising drug efficacy and reducing adverse effects, although methodological heterogeneity and incomplete mechanistic understanding limit their current clinical application. The identification of robust microbiome-derived biomarkers and the integration of multi-omics approaches, particularly metabolomics, are expected to accelerate the translation of pharmacomicrobiomics into precision medicine. This review summarises current evidence regarding microbiome–drug interactions, the mechanisms underlying microbiome-mediated modulation of pharmacokinetics and pharmacodynamics, emerging therapeutic strategies, and the challenges that remain before pharmacomicrobiomics can be implemented in clinical practice. Full article

Background: Predicting recurrence after liver transplantation (LT) for hepatocellular carcinoma (HCC) remains important for post-transplant risk stratification and surveillance planning. The Milan criteria discriminate only moderately and some machine-learning re-analyses report overly optimistic results because of information leakage. Aim: The current study aimed to re-evaluate a previously published transplant cohort under a leakage-free survival-analysis framework and to benchmark post-transplant, explant-informed survival learners against the Milan criteria as a fixed pre-transplant reference. We hypothesised moderate rather than near-perfect discrimination, similar performance across learners of differing complexity, and better discrimination than the Milan criteria. Methods: This secondary analysis included 356 patients with HCC who underwent LT. The primary endpoint was recurrence-free survival, analysed from the observed event indicator and follow-up time rather than from a derived risk label. Seven survival learners were benchmarked with repeated nested cross-validation, using three repeats of a five-fold outer loop with a three-fold inner tuning loop. All data-dependent preprocessing, including robust multivariable outlier handling and imputation, was fitted within training folds only. Performance was assessed by the concordance indices of Harrell and Uno, the time-dependent area under the curve, the integrated Brier score, calibration, decision-curve analysis and descriptive competing-risk assessment. Results: Recurrence developed in 183 of the 356 patients over a median follow-up of 52 months. Discrimination was moderate rather than near-perfect and similar across learners; the random survival forest ranked highest and the Elastic-Net Cox model performed comparably. All learners showed higher descriptive concordance than the Milan criteria, and dependency-corrected comparisons supported higher concordance for the full-feature Cox model than for the Milan criteria, whereas the random survival forest and Cox did not differ materially. Out-of-fold calibration of the Elastic-Net Cox model at 36 months was acceptable, decision-curve analysis indicated positive net benefit across clinically relevant thresholds, and tumour size and alpha-fetoprotein were the leading contributors to prediction. Findings were stable in ablation and threshold-sensitivity analyses. Conclusions: Leakage-free survival modelling gave moderate but internally validated prediction of post-transplant recurrence and higher concordance than the Milan criteria in this cohort, supporting the stated hypotheses. Careful study design may matter more than architectural complexity in this setting, and leakage-free survival analysis is a practical standard for prognostic modelling in transplant oncology. Full article

Hematologic malignancies, including acute myeloid leukemia, myelodysplastic syndromes, lymphoma, and multiple myeloma, are characterized by profound biological heterogeneity and highly dynamic treatment trajectories that conventional, static prognostic systems incompletely capture. Cellular therapies, such as chimeric antigen receptor T-cell therapy and hematopoietic stem cell transplantation, offer potentially curative options for relapsed or refractory disease, yet outcomes remain highly variable, and management decisions regarding conditioning intensity, lymphodepletion, immunosuppression, and toxicity surveillance continue to be largely protocol-driven rather than individually adapted. Artificial intelligence (AI) and machine learning (ML) have demonstrated substantial promise in diagnostic support, prognostic stratification, and multimodal data integration across hematologic malignancies, but existing models remain predominantly static and related to pre-treatment in orientation, limiting their utility for real-time clinical guidance. This review summarizes current AI applications in hematologic oncology; critically compares the strengths, limitations, and clinical applicability of major AI model classes, including traditional machine learning, deep learning, multimodal integrative frameworks, reinforcement learning, digital twins, and emerging foundation models and large language models; and proposes an adaptive, multimodal paradigm. We examine key enabling technologies and address the clinical, regulatory, ethical, and implementation challenges that must be resolved before these systems can be deployed at the bedside. We argue that the central challenge facing the field is no longer whether AI can predict outcomes, but whether it can actively guide real-time therapeutic decisions, and that achieving this transition will require interdisciplinary collaboration, prospective validation, and governance frameworks capable of ensuring interpretability, equity, and clinical trustworthiness. Full article

Background: Stress is regarded as one of the natural and unavoidable elements of human life and, at the same time, one of the key determinants of physical and mental health. Stress is not a new phenomenon; it has accompanied human beings since the beginning of life as a reaction to everyday challenges. This study aimed to assess the prevalence and severity of stress, as well as stress-coping strategies, in a group of patients treated for oncological reasons. Methods: The study included 108 patients hospitalized at the Independent Public Clinical Hospital No. 1 in Lublin, Poland, in the following departments: the 2nd Department of General, Gastroenterological and Gastrointestinal Oncological Surgery; the Department of Oncological Surgery; and the Department of Hemato-Oncology and Bone Marrow Transplantation. Three standardized questionnaires were used: the Perceived Stress Scale (PSS-10), the Type D Personality Scale (DS-14), and the “How Do I Cope” Inventory (JSR). Statistical analysis was performed with IBM SPSS Statistics, version 25; statistical significance was set at α < 0.05. Results: Patients treated for oncological reasons constitute a group exceptionally exposed to stress, which accompanies them at every stage of the disease, from diagnosis, through treatment, to the terminal phase. In patients whose treatment resulted in remission, stress related to the possibility of recurrence accompanies every follow-up examination and every worrying symptom. Given the range of situations that provoke stress, the overall level of stress in this group can be regarded as high. Stress-coping strategies among oncological patients are shaped by multiple factors, including selected sociodemographic characteristics; taking into account the diversity of these factors, coping strategies varied considerably across the sample. The level of coping strategies was not associated with age or sex but was significantly associated with educational attainment. Conclusions: Oncological patients experience a high and pervasive level of stress that persists throughout diagnosis, treatment, and follow-up. Stress-coping strategies are heterogeneous, are not determined by age or sex, but are shaped by education, indicating a need for individualized psychosocial and educational support integrated into routine oncological care. Full article

Endogenous matrix metalloproteinases (MMPs) are activated in dentin during carious lesion progression and restorative procedures, degrading the tooth-restoration interface and contributing to restoration failure. This study investigated by means of in situ zymography whether cold atmospheric plasma activation (PA) of distilled water (DW) and phosphate-buffered saline (PBS) modulates endogenous dentinal MMP activity. A Dielectric Barrier Discharge-rod source generated PA liquids, treating DW and PBS for 22 min. Chemical characterization demonstrated that PADW yielded 9.61 mg/L H₂O₂, 18.3 mg/L NO₂⁻, 375.70 mg/L NO₃⁻, and a pH of 3.2. PAPBS yielded 9.79 mg/L H₂O₂, 36.01 mg/L NO₂⁻, 505.74 mg/L NO₃⁻, and a pH of 7.13. Both liquids served as 1 min dentin pretreatments in a simulated restorative procedure using a universal adhesive and resin composite, tested after 24 h. MMP activity was assessed via in situ zymography with fluorescein-conjugated gelatin and confocal microscopy. Data were statistically analyzed (p < 0.05). PADW increased dentinal enzymatic activity, while PAPBS reduced it (p < 0.05). Non-activated PBS elicited higher baseline MMP activity than non-activated DW. The divergent responses likely reflect differences in RONS composition, pH, and initial ionic content between the two liquids. The precise mechanism underlying PA liquid interactions with dentinal MMPs warrants further investigation. Full article

Background/Objectives: To describe therapy-associated oral stomatitis and perianal mucosal lesions in pediatric oncohematology patients and compare healing time according to the treatment approach used in routine clinical practice. Methods: This retrospective observational study was conducted at Meyer Children’s Hospital, Florence, Italy. Electronic health records of patients admitted to the Oncology or Bone Marrow Transplantation units between 1 January and 31 December 2024, were screened. Eligible patients were aged 0 to 18 years and had documented oral stomatitis and/or perianal mucosal lesions with sufficient clinical and nursing documentation to determine lesion localization, treatment, clinical evolution, and healing time. Demographic, clinical, pharmacological, nutritional, and nursing variables were extracted. Oral mucositis severity was classified using the World Health Organization Oral Toxicity Scale. Results: Among 525 screened records, 89 eligible patients aged 5 months to 18 years were included in the final analysis. Lesions were distributed across three mutually exclusive categories: oral-only (39.3%), perianal-only (42.7%), and combined oral–perianal involvement (18.0%). Most oral cases were grade 2 to 4. Oral stomatitis treated with Mucosamin^® Spray healed faster than conventional therapy (3.5 ± 0.8 vs. 6.7 ± 1.1 days; mean difference, −3.21 days; 95% CI, −3.75 to −2.67; p < 0.001). Perianal fissures treated with Mucosamin^® Rectal Gel also showed a shorter healing time than conventional therapy (3.4 ± 0.8 vs. 6.1 ± 0.8 days; mean difference, −2.76 days; 95% CI, −3.30 to −2.21; p < 0.001). Conclusions: Mucosamin^® Spray and Rectal Gel were associated with shorter documented healing times than conventional approaches in this real-world pediatric cohort. These findings should be interpreted as preliminary and confirmed in controlled prospective multicenter studies. Full article

(1) Background: This study aimed to assess how two different adhesive solvent evaporation techniques affect the microtensile bond strength (µTBS) of a universal adhesive to dentin, as well as the enzymatic activity of dentinal matrix metalloproteinases (MMPs) at baseline and after 6-month aging under simulated pulpal pressure. (2) Methods: Middle-depth dentin surfaces of 32 sound extracted human molars were bonded under simulated pulpal pressure using a universal adhesive (Clearfil Universal Bond Quick) in either etch-and-rinse (ER) or self-etch (SE) mode. Two solvent evaporation approaches were compared: evaporation with a disposable air/water syringe (air) and with a disposable suction device (suction), yielding four experimental groups (n = 8): ER/air, ER/suction, SE/air, and SE/suction. After light-curing for 10 s, a 4 mm composite build-up was created. Specimens were stored in distilled water under simulated pulpal pressure at 37 °C for either 24 h (T0) or 6 months (T6) and then sectioned into sticks and subjected to µTBS testing. Fracture surfaces were examined by scanning electron microscopy (SEM). An additional subset of teeth from each group (n = 3) underwent in situ zymographic analysis, in which bonded sticks were ground and exposed to fluorescein-conjugated gelatin, with enzymatic activity quantified by confocal microscopy. Statistical analysis was performed at a significance threshold of p < 0.05. (3) Results: Air-drying yielded significantly higher µTBS values than suction drying, irrespective of adhesive application mode (p < 0.05). At T6, SE groups retained bond strength values comparable to baseline (p > 0.05), whereas ER groups showed a significant reduction in bond strength with aging (p < 0.05). The ER mode and suction were associated with significantly increased MMP activity at T0 (p < 0.05), while there were no differences between SE/ER at T6 (p > 0.05), and air increased MMP activity (p < 0.05). (4) Conclusions: When using an ethanol-based universal adhesive under pulpal pressure, evaporation with a disposable air syringe combined with the self-etch application mode appears to offer greater bonding reliability and stability. Full article

Background/Objectives: Microsatellite-stable colorectal cancer (MSS CRC) accounts for the vast majority of CRC cases and remains largely resistant to immune checkpoint inhibitors. Emerging evidence suggests that the gut microbiome is an important regulator of antitumor immunity and may contribute to immunotherapy resistance through multiple mechanisms involving the tumor microenvironment. This review aims to summarize current knowledge of the microbiome–immunity–therapy axis in MSS CRC and to explore microbiome-based strategies to enhance immunotherapy responsiveness. Methods: A narrative review of the recent literature was conducted, focusing on studies published within the last five years that investigated gut microbiota composition, microbial metabolites, tumor immune regulation, immunotherapy response, and microbiome-targeted therapeutic interventions in CRC. Evidence from mechanistic studies, translational research, clinical investigations, and multi-omics analyses was integrated. Results: Current evidence indicates that gut dysbiosis contributes to immune resistance in MSS CRC through immune exclusion, myeloid-driven immunosuppression, T-cell dysfunction, chronic inflammation, and altered microbial metabolite signaling. Specific microorganisms, including Fusobacterium nucleatum, enterotoxigenic Bacteroides fragilis, pks-positive Escherichia coli, and other CRC-associated pathobionts, have been implicated in tumor progression and modulation of antitumor immunity. Microbial metabolites such as short-chain fatty acids, tryptophan-derived compounds, bile acids, succinate, and inosine represent key functional mediators linking microbial communities to host immune responses. Emerging microbiome-targeted interventions, including fecal microbiota transplantation, next-generation probiotics, postbiotics, selective microbial depletion, and engineered bacterial therapeutics, have shown promising results in preclinical models and early translational or clinical studies, although robust clinical evidence remains limited. In parallel, advances in metagenomics, metabolomics, spatial transcriptomics, and artificial intelligence are facilitating the development of precision immuno-microbiome oncology approaches. Conclusions: The gut microbiome functions as a critical regulator of immune resistance in MSS CRC through coordinated effects on microbial composition, metabolite production, and tumor immune remodeling. Microbiome-targeted interventions, combined with multi-omics-based patient stratification, may provide new opportunities to overcome immunotherapy resistance and expand the clinical benefits of immune checkpoint blockade in this traditionally refractory disease. Full article

Objectives: To assess whether muscle morphology and metabolism can inform personalised care in ventral hernias and to define which parts of a proposed postoperative remodelling model are supported by direct evidence. Methods: We conducted a structured narrative review of PubMed/MEDLINE, Scopus and Web of Science from 1 January 2010 through 30 April 2026. Two authors selected 38 publications. Evidence was classified as direct when generated in ventral or incisional hernia cohorts and indirect when drawn from inguinal hernia, transplantation, geriatric, oncological, animal or general muscle studies. No quantitative synthesis was undertaken. Results: Direct studies document lateral muscle displacement, impaired abdominal wall function, inconsistent associations between low muscle mass and clinical outcomes, and CT-derived increases in muscle cross-sectional areas after transversus abdominis release (TAR). The evidence for anterior abdominal wall myosteatosis, biomarker-guided care and the three proposed remodelling trajectories remains largely indirect. In a 37-patient TAR series, the median rectus abdominis cross-sectional area increased by 16.1% (IQR 11.4–27.0%); muscle function and metabolic recovery were not measured. Conclusions: Routine CT can yield muscle area, attenuation and intermuscular adipose tissue measures without further imaging. No anterior abdominal wall-specific thresholds or biomarker cut-offs have been validated, so these measures should not determine current treatment in isolation. Prospective studies should test whether combined imaging, functional and clinical phenotyping improves the selection of prehabilitation and follow-up. Full article