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Objective: To assess the survival benefit of synchronous systemic therapy plus thermal ablation (TA) in oligometastatic colorectal lung metastases (CRLM) and identify independent prognostic factors.

Background: Optimizing the integration of systemic therapy and TA for potentially curable CRLM remains a significant clinical challenge.

Methods: This study employed a retrospective cohort design, including 326 patients who underwent TA treatment at six tertiary medical centers from March 2014 to October 2022. Patients were categorized into synchronous therapy, upfront ablation, delayed ablation, and no systemic therapy groups based on the timing of systemic therapy relative to TA. Kaplan-Meier analysis and log-rank tests were used to assess survival outcomes.

Results: Synchronous systemic therapy yielded the longest median progression-free survival (PFS) (22.0 months) and overall survival (OS) (61.3 months) compared to delayed ablation (13.0 and 49.2 months, respectively) and no systemic therapy (11.9 and 29.3 months, respectively) (all p < 0.05). Synchronous systemic therapy was an independent protective factor for PFS [hazard ratio (HR) = 0.493] and OS (HR = 0.211). Independent risk factors for local tumor progression included tumor size ≥3 cm (HR = 1.75) and peridiaphragmatic location (HR = 1.48). For PFS, independent predictors included tumor numbers (p < 0.001), synchronous metastases (HR = 1.431), and extrapulmonary metastases (p = 0.001). OS was adversely influenced by tumor burden (p < 0.05), extrapulmonary metastases (p < 0.001), and mediastinal lymph node involvement (HR = 1.518).

Conclusions: Synchronous systemic therapy combined with TA significantly enhances PFS and OS in potentially curable oligometastatic CRLM patients.

Background: Osteoporosis significantly impacts global morbidity. Recent evidence suggests anaemia may contribute to osteoporosis risk. This systematic review and meta-analysis investigates this association.

Methods: PubMed, Scopus, EBSCO, and ScienceDirect were searched for papers. Studies with definition of anaemia and assessing osteoporosis outcomes were included. Meta-analysis utilized random-effects models (DerSimonian-Laird method), and study quality was assessed via Newcastle-Ottawa Scale (NOS). Analyses were performed using R Studio.

Result: Eighteen studies (861,540 participants) were analyzed. Anaemia significantly increased osteoporosis risk in univariate analysis (OR 1.62; 95% CI 1.33-1.98; p < 0.001), despite high heterogeneity (I² = 92.7%). The results remain significant in studies that reported multivariate analysis (OR 2.01; 95% CI 1.26-3.21; p = 0.004). Sensitivity analyses confirmed the robustness of our result.

Conclusion: Anaemia significantly associated with osteoporosis, emphasizing the need for targeted screening in anaemic individuals. Further studies should consider incorporating anaemia into osteoporosis and fracture prediction tools.

Objective: This study aimed to identify risk factors associated with the development of VTE in patients admitted to the intensive care unit (ICU).

Methods: A systematic literature search was conducted via PubMed, Embase, Web of Science, and Cochrane databases up to 25 April 2025, to identify studies examining the association between risk factors and the occurrence of venous thromboembolism (VTE) in ICU patients. Data were pooled using odds ratios (ORs) and 95% confidence intervals (CIs).

Results: A total of 2465 relevant studies were identified through the systematic search, of which 30 were included in the meta-analysis. The pooled data showed that the following were significant risk factors for venous thromboembolism (VTE) in ICU patients: central venous catheterization (OR = 2.67, 95% CI: 1.67-4.28; I² = 28%), invasive mechanical ventilation (OR = 2.08, 95% CI: 1.46-2.96; I² = 0%), advanced age (OR = 2.06, 95% CI: 1.28-3.31; I² = 86%), length of ICU stay (OR = 4.24, 95% CI: 1.43-12.57; I² = 98%), malignancy (OR = 2.30, 95% CI: 1.03-5.12; I² = 67%), elevated D-dimer levels (OR = 2.46, 95% CI: 1.37-4.40; I² = 34%), and a history of VTE (OR = 2.84, 95% CI: 1.45-5.55; I² = 51%). According to the GRADE assessment, the quality of evidence was rated as moderate for invasive mechanical ventilation, low for central venous catheterization and D-dimer levels, and very low for the remaining factors.

Conclusion: Invasive mechanical ventilation, central venous catheterization, and elevated D-dimer levels are associated with VTE risk, supported by relatively high-quality evidence. These findings may help identify ICU patients at higher risk of VTE, inform the development of risk assessment models for patient stratification, and ultimately contribute to improved prognosis through optimal screening and management strategies.

Background: Rapid autonomic recovery after physical stress is a hallmark of cardiovascular health. While both yoga and conventional exercise modulate autonomic function, direct comparisons of their effect on post-exercise recovery are scarce. This study compared autonomic recovery in yoga practitioners versus those in aerobic or resistance training.

Methods: We conducted a cross-sectional study of 51 healthy adults (18-35 years) in three long-term training groups: Yoga (n = 17), Aerobic (n = 17), and Resistance (n = 17). Participants performed a 5-minute submaximal Harvard step test. Heart rate variability (HRV) was analyzed from electrocardiograms recorded at baseline and during a 10-minute post-exercise recovery.

Results: After adjusting for baseline differences, the Yoga group showed a more efficient autonomic recovery profile. ANCOVA revealed a significant group effect on vagal reactivation, as measured by High-Frequency (HF) power (p = 0.001). Post-hoc tests confirmed that the Yoga group's recovery was significantly greater than that of the Aerobic and Resistance groups. Similar significant effects favouring Yoga were found for pNN50, SDNN, LF power, and total power (all p < 0.05). No significant group differences were observed for pulse rate, blood pressure, or RMSSD recovery.

Conclusion: Regular yoga practice is associated with more efficient parasympathetic reactivation after physical exertion. This suggests yoga's integrative nature is associated with unique advantages for autonomic strength compared to conventional aerobic and strength training.

Aims: This study aimed to predict post-transplant malignancy risks at multiple levels among lung transplant recipients using machine learning (ML) and to identify key clinical and immunogenetic predictors.

Materials and methods: A dataset of 30,917 lung transplant recipients with no prior cancer history was analyzed using pre-, peri-, and post-transplant variables. Multiple ML algorithms-gradient boosting, random forest, neural networks, and logistic regression-were applied to predict: (1) overall de novo malignancies (DNM), (2) skin versus non-skin cancers, and (3) skin cancer subtypes, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).

Results: Gradient boosting achieved the highest AUC for overall malignancies (0.746) and skin versus non-skin cancers (0.642), while random forest performed best for BCC versus SCC classification (AUC = 0.726). Significant predictors included HLA-DR alleles (DR52, DR1, DR53), A locus mismatch, recipient ethnicity, BMI, serum albumin, CMV/EBV serostatus, and cardiac-related measures (LV remodeling, cardiac output, prior cardiac surgery). Additional subtype predictors included peak PRA Class I sensitization, insulin signaling, donor-derived transfusions, and waiting list duration.

Conclusions: ML-driven predictive modeling enables personalized assessment of post-transplant malignancy risk, supporting early detection, targeted surveillance, and optimized long-term care for lung transplant recipients.

Background: The use of computer-aided design and manufacturing technologies in diagnosis, treatment planning, and fabrication of prosthetic restoration is changing how prosthodontic treatment is offered to patients. This study compares the precision of three-dimensional (3D) printed casts produced from optical scanners using the stereolithographic 3D printing technique, their digital replicas, and conventional stone casts.

Materials and methods: Impressions were taken from 13 patients. Inter-arch widths (intercanine/premolar/molar) were made for digital and prototyped models and compared with the original stone casts. The measurements on printed and conventional casts were taken using a digital caliper, whereas those on digital casts were measured directly.

Results: Digital casts showed significantly higher maxillary and mandibular intercanine width measurements than 3D-printed and Stone (Gypsum) measurements counterparts (p < 0.001). Additionally, digital casts exhibited significantly lower maxillary and mandibular inter-1st molar and inter-2nd molar widths than their 3D printed and gypsum counterparts (p < 0.001). There were no statistically significant differences between measurements obtained with gypsum and 3D-printed casts.

Conclusion: The 3D-printed casts may be considered a viable alternative to gypsum casts, offering clinically acceptable precision for diagnosis, treatment planning, and the fabrication of prosthetic restorations. On the other hand, digital cast measurements exhibit significant variations from gypsum and 3D-printed casts.

Background: No effective treatment strategy for acute respiratory distress syndrome (ARDS) has been established. Conflicting reports on the effects of insulin-like growth factor (IGF)-1 stimulation and the inhibition of IGF-1 receptor (IGF-1R) signalling in tissue injury across several organs have led to hesitation in advancing IGF-1-based treatment strategies for tissue damage.

Objective: We aim to examine whether IGF-1/IGF-1R signalling contributes to recovery from acute lung injury in mouse models and to further explore its potential mechanisms.

Methods: Lipopolysaccharide (LPS) was intratracheally injected into mice to create acute lung injury models. Experiments were conducted to acquire or inhibit IGF-1 signalling through the intratracheal injection of recombinant IGF-1 or JB1, an IGF-1 receptor antagonist during the recovery phase of the models, starting on day 4 after LPS administration. Bone marrow monocyte-derived macrophages (MDMs) cocultured with IGF-1 and/or JB1 were intratracheally injected during the recovery phase.

Results: Inflammatory cell counts and lung injury scores were significantly decreased when recombinant IGF-1 was administered in the later phase, while they increased with the administration of JB1. On day 4 after LPS injection, IGF-1 receptor (IGF-1R, also known as CD221) was strongly expressed on macrophages, particularly in CD11c⁺SiglecF⁺ alveolar macrophages (AMs). Intratracheal injection of MDMs cocultured with IGF-1 decreased lung neutrophil counts, whereas the addition of JB1 to MDMs cocultured with IGF-1 counteracted the effect of IGF-1. JB1 also reduced efferocytosis capacity of AMs in the later phase. In the phagocytosis assay, LPS decreased the efflux capacity of macrophages, but recombinant IGF-1 improved this capacity regardless of the presence or absence of LPS.

Conclusion: IGF-1/IGF-1R signalling in macrophage facilitates the recovery from acute lung injury via enhancing efferocytosis. IGF-1 delivery potentially offers a new treatment strategy for ARDS.

Results: LASSO-logistic regression analysis identified seven predictors associated with PSS: C-reactive protein, albumin, creatine kinase, fasting blood glucose, hyperlipidemia, sleep disorders, and manual muscle testing (MMT) score at admission. The model had an area under the curve (AUC) of 0.844 (95% CI: 0.793-0.896) in the training set and 0.842 (95% CI: 0.765-0.920) in the validation set, which means it was good at making predictions. The calibration curves showed excellent agreement between predicted and observed probabilities in the training set. Good calibration was maintained in the validation set, indicating only minimal overestimation of risk. DCA and CIC both agreed that the nomogram model could be used in a wide range of therapeutic situations.

Conclusion: The nomogram based on routine clinical data in this study, after internal validation, can effectively predict the risk of PSS and provides a practical decision-making tool for clinicians. However, future multi-centre external validation is still required to confirm its broad applicability.

Background: Immunotherapy offers potential benefits for recurrent or metastatic cervical cancer (R/M CC), yet personalized predictive tools are essential for optimizing treatment. This study aims to develop a nomogram integrating nutritional-inflammatory biomarkers and clinical features to predict survival in R/M CC patients undergoing immune checkpoint inhibitor (ICI) therapy.

Patients and methods: We retrospectively analyzed 98 R/M CC patients treated with ICIs. Overall survival (OS) was the primary endpoint. Demographic characteristics and peripheral blood biomarkers before and after ICI treatment were collected. Univariate analysis screened potential variables, followed by LASSO regression to select key biomarkers and compute the Risk-Score. Prediction models combining clinical features and the Risk-Score were evaluated using ROC curves and decision curve analysis (DCA). The optimal nomogram model was developed and validated with ROC curves, calibration plots, and DCA.

Results: Three models were established: (i) a clinical model based on age and squamous cell carcinoma antigen (SCC-Ag), (ii) a Risk-Score model, and (iii) a combined model integrating age, SCC-Ag, and Risk-Score.  The combined model showed superior predictive performance. A nomogram incorporating age, stage, SCC-Ag, and Risk-Score predicted 6-month, 1-year, and 2-year survival probability, with respective AUC values of 0.892, 0.868, and 0.846. Calibration curves and DCA affirmed high predictive accuracy and clinical utility.

Conclusion: The nomogram integrating nutritional-inflammatory biomarkers and clinical parameters may serve as a promising tool for predicting survival in R/M CC patients undergoing ICI therapyand may help guide individualized treatment strategies following further validation.

Background: Hip fractures and acute kidney injury (AKI) are common among older adults and are each associated with increased morbidity and mortality. We aimed to evaluate whether AKI severity is associated with increased mortality and institutionalization in older adult patients with hip fractures.

Methods: This single-centre, retrospective study included patients aged ≥65 years who underwent surgery for hip fractures. Those with stage 4 or 5 chronic kidney disease or end-stage kidney disease were excluded. AKI was defined and categorized according to the Kidney Disease: Improving Global Outcomes guideline. Patients who did not develop AKI served as the reference group for subsequent analyses.

Results: Overall, 661 older adults with hip fractures were included (median age: 82.0 [76.0-86.0] years, women: 76.3%). Among these, 35.9% had AKI, with 80.2, 11.8, and 8.0% classified as stages 1, 2, and 3, respectively. Thirteen patients died during hospitalization. During a median follow-up period of 4.3 (2.6-5.9) years, 301 patients died. Stage 3 AKI was associated with in-hospital mortality compared to patients without AKI (HR, 7.82 [1.21-50.72], p = 0.031). Higher AKI stages were associated with increased long-term mortality in multivariable analyses (HR, 1.32 [0.97-1.80], p = 0.076 for stage 1, HR, 2.52 [1.52-4.20], p < 0.001 for stage 2 and HR, 3.15 [1.76-5.63], p < 0.001 for stage 3). Age, men, cardiovascular disease, and low albumin level were associated with long-term mortality in patients with AKI. The proportion of institutionalization did not differ among patients across the AKI stages.

Conclusions: Higher AKI stages are associated with increased in-hospital and long-term mortality in older adults with hip fractures. Preventing AKI development and progression is essential to improve prognosis in this vulnerable population.