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Background: Renal cell carcinoma (RCC) remains one of the most prevalent urological malignancies. Although targeted therapies have expanded therapeutic options, a substantial proportion of patients still experience poor outcomes, underscoring the need for more effective and less toxic strategies. Ticagrelor, a novel antiplatelet agent, has recently shown antineoplastic potential in several cancers; however, its role and mechanism in RCC remain undefined.

Methods: In vitro effects of ticagrelor on RCC cells were evaluated using CCK-8, EdU, and AO/PI assays for proliferation/apoptosis, wound healing and Transwell assays for migration/invasion. In vivo efficacy was assessed in an RCC cell-derived xenograft (CDX) model. Network pharmacology and Western blotting were employed to elucidate the underlying mechanism.

Results: Ticagrelor suppressed proliferation, migration, invasion and adhesion, and promoted apoptosis in RCC cells. In CDX mice, tumor growth was significantly inhibited. Mechanistically, the EGFR/PI3K/AKT pathway was identified as the key mediator of ticagrelor's antitumor activity in RCC.

Conclusions: Ticagrelor exerts anti-RCC effects via blockade of the EGFR/PI3K/AKT signaling axis, highlighting its translational potential and positioning this pathway as a therapeutic target and possible biomarker in RCC.

Objective: To evaluate the awareness and understanding of breast cancer (BC) etiology among Jordanian women and identify associated demographic factors.

Materials and methods: A multiregional cross-sectional survey of 381 women was conducted via online snowball sampling. BC knowledge was assessed using a translated version of the Breast Cancer Awareness Measure. Statistical analyses included univariate and bivariate tests, followed by a multivariate ordinal logistic regression to adjust for potential confounders.

Results: Only 39.9% of participants demonstrated proficient comprehension of BC etiology. Knowledge correlated significantly with age, marital status, and expertise (p < 0.05). Awareness was highest among single pharmacy students; notably, 64.8% were single pharmacy students, potentially inflating overall scores. A misconception was identified: 66.1% believed a diagnosis in one breast reduces risk in the other. Age 41-50 (OR = 5.23) and holding a diploma (OR = 0.09) were significant predictors of knowledge compared to postgraduates, while marital status was not significant in the model.

Conclusions: Educational backgrounds significantly influence breast cancer awareness among Jordanian women. There is an urgent need for targeted, community-based training programs to address persistent clinical misconceptions and knowledge gaps, specifically focusing on married women and individuals working or studying in non-medical fields, to improve overall public health standards nationwide.

Background: Ivarmacitinib (SHR0302) is a novel and highly selective Janus kinase 1 inhibitor for treating moderate to severe atopic dermatitis (AD).

Objective: This study aimed to evaluate the impacts of patient characteristics on the efficacy and safety of Ivarmacitinib.

Methods: This post-hoc analysis used data from a randomized, double-blind, placebo-controlled, multicenter phase 3 trial of Ivarmacitinib in patients with moderate to severe AD in which patients were randomized (1:1:1) to receive Ivarmacitinib 4 mg or 8 mg or placebo for 16 weeks. Subgroup analyses were conducted based on baseline characteristics.

Results: At week 16, both Ivarmacitinib 4 or 8 mg showed better efficacy over placebo in achieving Eczema Area and Severity Index (EASI) 75, EASI 90, and Worst Itch Numeric Rating Scale (WI-NRS) score ≥4-point responses in most subgroups based on age, sex, body mass index, AD duration, Investigator's Global Assessment score, EASI score, WI-NRS score, body surface area involvement, history of comorbid allergies, or previous systemic therapies. The overall incidence of adverse events and most of the adverse events of special interest were similar between Ivarmacitinib and placebo across all subgroups.

Conclusion: Ivarmacitinib demonstrated efficacy and good tolerability in treating moderate to severe AD with diverse patient characteristics.

This case report characterizes the molecular pathology of two synchronous IDH mutant gliomas in a 28-year-old female patient. The patient exhibited symptoms of dizziness, retro-orbital pain, headache, and numbness with paresthesia in her right arm. MRI imaging revealed two distinct non-enhancing T2/FLAIR hyperintense lesions in the left frontal and parietal lobes. Histopathologic and molecular analyses, including whole exome sequencing, were performed on the resected specimens from each location. The left parietal tumor was diagnosed as a grade 4 astrocytoma with an IDH1 R132H mutation, while the left frontal tumor was classified as a grade 2 oligodendroglioma with an IDH1 R132S mutation. Given the distinct molecular profiles of both synchronous tumors, treatment consideration was given to each individual primary tumor.

Background and objective: Chlamydia psittaci and Legionella pneumophila are common atypical pathogens that cause severe community-acquired pneumonia (CAP). This study aimed to compare the clinical features and outcomes of Chlamydia psittaci pneumonia (CPP) and Legionella pneumophila pneumonia (LPP) identified using next-generation sequencing (NGS) for accurate identification.

Methods: This retrospective study included 68 patients with CPP and 42 patients with LPP. All cases were confirmed by metagenomic or targeted next-generation sequencing (mNGS/tNGS) of bronchoalveolar lavage fluid, serum, or sputum samples.

Results: Patients with LPP had a higher prevalence of diabetes and were predominantly male. Poultry contact was common in CPP (64.7% vs. 14.3%), whereas recent travel was associated with LPP (47.6% vs. 2.9%). LPP presented with increased extrapulmonary symptoms. Inflammatory marker levels were higher in LPP, including leukocytosis, neutrophilia, C-reactive protein, and procalcitonin (all p < 0.05). Organ dysfunction was more frequent in LPP, with higher creatinine levels. Patients with LPP had more severe hypoxemia, required more respiratory support, and had higher intensive care admission rates. Targeted therapy guided by NGS was effective, with no significant differences in mortality or hospital stay between the two groups.

Conclusion: LPP demonstrated greater initial clinical and laboratory severity compared to CPP. Under NGS-guided targeted therapy, both groups achieved comparable outcomes. The observational finding that both pathogens respond to azithromycin and cause severe disease when left undetected underscore the value of guideline-recommended β-lactams/macrolide combination therapy in CAP settings, particularly where these intracellular pathogens remain undiagnosed without NGS.

Background: While the association between vitamin D and non-alcoholic fatty liver disease (NAFLD) is well-established in obese populations, its role in lean NAFLD remains controversial.

Objective: This study aimed to investigate the potential nonlinear dose-response relationship between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lean NAFLD by leveraging large-scale data from the National Health and Nutrition Examination Survey (NHANES).

Methods: We conducted a cross-sectional analysis of 4,201 adults with BMI < 25 kg/m². Lean NAFLD was defined using the US Fatty Liver Index (USFLI). The association between serum vitamin D and lean NAFLD was assessed employing multivariable logistic regression models, alongside more advanced techniques including restricted cubic splines (RCS) and generalized additive models (GAM) to capture potential nonlinearity.

Results: Initial linear models revealed no significant association. However, subsequent nonlinear analyses uncovered a pronounced 'L-shaped' curve relationship (P-nonlinear < 0.05). A segmented regression approach identified an inflection point at 60.3 nmol/L. Notably, at serum vitamin D levels below this threshold, concentrations were significantly inversely associated with lean NAFLD risk (Odds Ratio [OR] = 0.71, 95% Confidence Interval [CI]: 0.57-0.89). Conversely, above this inflection point, the inverse association attenuated and plateaued. The robustness of this nonlinear association was corroborated by the GAM analysis.

Conclusion: This large-scale study is the first to identify a significant 'L-shaped' nonlinear association between serum vitamin D and lean NAFLD, wherein the association is most potent at concentrations below approximately 60 nmol/L. This finding highlights an epidemiological inflection point and underscores the need for nonlinear approaches in future research.

Background: Hypertension remains a major public health challenge in China, particularly in socioeconomically transitioning regions. This study aims to evaluate changes in hypertension prevalence, awareness, treatment, and control rates between 2019 and 2024 in a Tibetan-predominant area of Sichuan Province.

Methods: Two cross-sectional surveys were conducted in 2019 (n = 1,880) and 2024 (n = 1,870). Inverse probability of treatment weighting (IPTW) and age-standardization were applied to enhance comparability. Subgroup analyses were performed to examine disparities across gender, residence, age, and education groups.

Results: Age-standardized hypertension prevalence decreased significantly from 22.86% to 15.53%. Awareness, treatment, and control rates all improved markedly, from 24.63% to 53.43%, 16.08% to 43.93%, and 3.98% to 17.37%, respectively. Health inequities narrowed substantially between urban and rural areas and between genders. However, absolute control rates remained suboptimal (18.14% in 2024). Rising obesity prevalence (5.11% to 11.44%) and persistent gaps in treatment quality were observed.

Conclusions: Substantial progress in hypertension management and health equity was observed in the area between 2019 and 2024. However, persistently low control rates and rising obesity highlight the need to enhance treatment quality and implement integrated cardiovascular risk reduction strategies. These findings provide important insights for chronic disease management in similar transitioning regions.