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The Psychological Underpinnings of Financial Well-Being

ABSTACTAims: The purpose of this study was to evaluate the association between exposure to urinary heavy metals and cancer risk in adults in the United States.Methods: The statistical data for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2018. Participants lacking complete data on urinary heavy metals exposure burden and/or cancer status information were excluded. Urinary heavy metal concentrations were quantified using inductively coupled plasma mass spectrometry (ICP-MS). Cancer diagnoses were ascertained through self-reported medical histories. Multivariable-adjusted regression analyses and cubic smoothing plots were employed to assess independent associations between urinary heavy metal concentrations and cancer risk. Subgroup analyses were performed to assess result robustness.Results: The study included 7797 participants. Based on the first quartile (Q1), cadmium quartiles showed odds ratios (95% CI) of 1.20 (0.92, 1.66) 1.50 (1.16, 1.94) and 1.57 (1.22, 2.03) for cancer prevalence (P = 0.0008). Cobalt quartiles were 1.22 (0.98, 1.54), 1.24 (0.98, 1.56), and 1.43 (1.13, 1.80) compared to the first quartile (Q1) (P = 0.0053). In comparison with the first quartile (Q1), Lead quartiles were 0.99 (0.77, 1.27), 1.06 (0.83, 1.35), and 1.06 (0.83, 1.35) (P = 0.0011). In the RCS plot, the association between log2-transformed urinary metal levels and cancer risk was not linear(P＜0.05). An analysis of subgroups confirmed the robustness of the results.Conclusion: Elevated urinary heavy metal concentrations among U.S. adults demonstrated a significant association with increased cancer risk. These findings suggest that mitigating exposure to urinary heavy metals should be prioritized as a preventive strategy for cancer control.

Heavy metal burden in the urine and cancer risk

Cervicovaginal anomalies are rare and form 4-7% of the Müllerian anomalies. Traditionally, cervicovaginal agenesis/dysgenesis had been treated by hysterectomy due to the high risks of restenosis and sepsis which are associated with cervical canalization. In this work, we report the case of a 14-year-old patient who presented with amenorrhea and cyclic abdominal pain. The patient had normal secondary sexual development. Magnetic resonance imaging revealed hematometra and bilateral hematosalpinx. Laparoscopic exploration identified an obstructed cervix and blunt vagina.The patient underwent direct cervicovaginal anastomosis under laparoscopic guidance. After one month of follow-up, the patient had normal menstruation and a healthy uterine cavity and cervical canal upon hysteroscopy.

Laparoscopy-Assisted Uterovaginal Anastomosis in a Patient with Atypical Cervicovaginal Malformation

The high incidence, substantial mortality, and marked heterogeneity in chemotherapy responses among gastrointestinal tumors accentuate the imperative for individualized treatment strategies. This study aims to evaluate the reliability and clinical significance of the histoculture drug response assay (HDRA) in predicting chemotherapy sensitivity and prognosis. Specifically, it focuses on Chinese patients diagnosed with gastrointestinal cancers.Methods: This study enrolled 283 patients with gastrointestinal tumors, comprising 124 esophageal cancer cases, 92 gastric/cardia cancer cases, and 67 colorectal cancer cases. Immunohistochemistry was conducted to assess tumor structure integrity and the expression of Ki -67, CD31, and E -cadherin before and after the HDRA assay. HDRA evaluated the efficacy and inhibition rates of single and combination chemotherapy regimens. Moreover, the effect of HDRA -guided treatment on patient survival was analyzed.The results indicated that HDRA effectively preserved the three-dimensional structure and microenvironment of gastrointestinal tumors, as no significant changes were observed in the expression of Ki-67, CD31, or E-cadherin. Furthermore, combination regimens showed significantly higher efficacy and inhibition rates than single -agent therapies. Notably, platinum-based combination therapy was most effective in esophageal cancer. Survival analysis revealed that esophageal and gastric cancer patients receiving HDRA -sensitive regimens (HDRA group) had significantly longer disease -free survival (DFS) compared to those on non -sensitive regimens (N -HDRA group) and untreated patients. Cox regression analysis indicated that HDRA-guided treatment serves as a protective factor for DFS (hazard ratio, HR<1).  Conclusion: In summary, the HDRA assay represents a reliable assay for accurately evaluating chemotherapy regimens, thereby furnishing guidance for individualized treatment in gastrointestinal cancer patients.

Histoculture Drug Response Assay Predicts Chemotherapy Efficacy and Improves Survival in Gastrointestinal Cancers

Background: Acute stent thrombosis (AST) is a rare but serious complication occurring within 24 hours after percutaneous coronary intervention (PCI), typically caused by insufficient antiplatelet therapy, stent under-expansion, or malapposition. Tissue prolapse (TP) within the stent is less frequently reported as a cause of AST and lacks direct imaging-based evidence. Case Summary: We report a case of a patient with acute ST-segment elevation myocardial infarction (STEMI) who experienced recurrent ST-segment elevation one hour after primary PCI. Coronary angiography revealed mid-stent occlusion, and intravascular ultrasound (IVUS) identified tissue prolapse with echogenic features consistent with fibrolipidic plaque. The initial stent was appropriately sized and welldeployed, and activated clotting time (ACT) indicated adequate anticoagulation. In the absence of traditional risk factors for AST, the large-volume tissue prolapse was considered the likely cause. Balloon angioplasty failed to resolve the prolapse, so an additional stent was implanted at the site. After this intervention, no further thrombotic events occurred. Conclusion: This case provides clear intravascular imaging evidence that tissue prolapse can induce AST. For cases of early stent thrombosis with angiographic haziness and no signs of dissection or malapposition, clinicians should suspect tissue prolapse. Intravascular imaging facilitates accurate diagnosis and helps guide treatment. Further research is warranted to define high-risk features of tissue prolapse-such as volume, protrusion, and composition-to establish thresholds and interventional criteria that may prevent AST.

Tissue Prolapse-Induced Acute Stent Thrombosis: A Case Report and Intravascular Imaging-Based Insight

Mesenchymal Stem Cell-Derived Extracellular Vesicles, as carriers for intercellular communication, are rich in bioactive substances such as proteins and nucleic acids, and show unique potential in the treatment of neurodegenerative diseases. Their vesicular structure, with a diameter of 30-150 nm, can penetrate the blood-brain barrier and modulate the activity of microglia and astrocytes by delivering functional molecules. This process inhibits the release of pro-inflammatory factors and enhances the expression of anti-inflammatory mediators, thereby alleviating neuroinflammation in the pathological process of neurodegenerative diseases. As natural drug carriers, extracellular vesicles can improve the targeted delivery efficiency of therapeutic molecules. However, their specific anti-inflammatory mechanisms remain not fully understood and require further exploration. This article discusses the anti-inflammatory effects in the context of neurodegenerative diseases and provides a summary and outlook on the anti-inflammatory actions associated with extracellular vesicles from past research.

Stem cell extracellular vesicles: A new dawn for anti-inflammatory treatment of neurodegenerative diseases

Background: Anastomotic leakage is one of the most severe complications after esophageal cancer surgery. The purpose of this study was to evaluate the impact of preoperative inflammatory status on anastomotic leakage after esophageal cancer surgery and to construct a model for predicting anastomotic leakage after esophageal cancer surgery. Methods: A retrospective analysis was conducted on 1106 patients with esophageal cancer who underwent surgical treatment between September 2018 and December 2022. Patients were randomly divided into training and testing sets at a ratio of 7:3. Logistic regression analysis and LASSO regression analysis were performed on the training set. Independent influencing factors selected from the analysis were used for model construction. Internal validation was then performed. Results: A total of 1106 patients with esophageal cancer, with a mean age of 64.05 years, were included in our study. Among them, there were 785 male patients (71.0%) and 321 female patients (29.0%). Multivariate analysis revealed that a history of smoking (OR = 2.121, P = 0.016; 95% CI, 1.151-3.938), history of diabetes mellitus (OR = 5.473, P < 0.001; 95% CI, 2.587-11.382), high NMR (OR = 3.423, P = 0.002; 95% CI, 1.628-7.489), high PLR (OR = 3.675, P < 0.002; 95% CI, 1.642-8.406), and low PLT (OR = 0.986, P = < 0.001; 95% CI, 0.980-0.993) were independent risk factors for anastomotic leakage after esophageal cancer surgery. A forest plot was constructed for the independent risk factors, and the ROC curve analysis results showed that the model had good predictive ability in both the training and testing sets. Additionally, calibration curve and DCA curve analyses showed that the model had good predictive ability and net benefit. Conclusion: This study found that smoking history, diabetes history and preoperative inflammatory status (preoperative high NMR, high PLR, and low PLT) were risk factors for postoperative anastomotic leakage in patients with esophageal cancer. Based on these findings, we constructed a model for predicting anastomotic leakage after esophageal cancer surgery that demonstrated good predictive ability.

The Predictive Value of Preoperative Inflammatory Status for Anastomotic Leakage After Esophagectomy for Esophageal Cancer

Climate change presents significant challenges to vulnerable regions, yet educational systems often lack systematic approaches to climate change education (CCE), particularly in resource-constrained settings. While research has examined CCE implementation in developed countries, little is known about effective delivery in climate-vulnerable regions. This study investigates the implementation of CCE in Northeast Thailand, emphasizing the interaction among teacher training, institutional support, and resource accessibility in a developing context where climate impacts directly affect communities. The study employed a sequential explanatory mixed-methods approach, integrating quantitative survey data from 400 teachers with qualitative insights from semi-structured interviews and focus group discussions among 15 teachers and 5 school administrators. Regression analysis revealed teacher training as the strongest predictor of effective CCE implementation, followed by institutional support and resource availability. The study showed significant differences between urban and rural areas, with 85% of rural schools reporting insufficient resources compared to 40% of urban institutions. Additionally, 60% of teachers reported actively incorporating climate-related topics into their teaching. These findings demonstrate that successful CCE implementation requires the alignment of targeted teacher professional development, supportive institutional frameworks, and equitable resource distribution. Based on these findings, the study recommends establishing regional CCE teacher training centers, implementing resource-sharing networks between urban and rural schools, and developing locally adaptive curricula. This research provides an evidence-based framework for strengthening climate education in developing contexts.

Bridging Policy and Practice in Climate Change Education: Evidence from Northeast Thailand

Background:Personalized medicine has transformed disease management by focusing on individual characteristics, driven by advancements in genome mapping and biomarker discoveries.Objectives:This study aims to develop a predictive model for the early detection of treatment-related cardiac side effects in breast cancer patients by integrating clinical data, high-sensitivity Troponin-T (hs-TropT), radiomics, and dosiomics. The ultimate goal is to identify subclinical cardiotoxicity before clinical symptoms manifest, enabling personalized surveillance strategies. It is the first study to utilize heart-segmented dosiomics in breast cancer patients.Methods and Materials:This retrospective study included clinical, dosimetric, radiomic, and dosiomic data from 42 women with localized breast cancer. Heart-specific Troponin T levels were measured 2–3 weeks post-radiotherapy, with 14 ng/L as the cutoff. Patients were grouped on this threshold to identify potential treatment-related cardiac events. Radiomics and dosiomics were extracted using PyRadiomics. Machine learning models were optimized using the Tree-based Pipeline Optimization Tool (TPOT), identifying the gradient-boosted classification as the best-performing algorithm. Feature selection was conducted using gradient-boosted recursive feature elimination. Model performance is assessed by the area under the curve (AUC).Results:A total of 111 dosiomic and 119 radiomic features were extracted per patient. The highest predictive accuracy was achieved using clinical, dosiomic, and radiomic parameters (validation cohort-AUC = 0.96), outperforming the clinical + dosimetric model (validation cohort-AUC = 0.67). Permutation tests confirmed the non-randomness of these two models results (p <0.05). Cross-validation indicated that the clinical + dosiomic + radiomic model had a fair-to-good generalizable performance (mean AUC = 80.33 ± 21%).Discussion:This study may demonstrate that radiomics and dosiomics provide superior predictive capabilities for cardiac events in breast cancer patients compared to traditional parameters.

Machine Learning Modeling of Cancer Treatment-Related Cardiac Events in Breast Cancer: Utilizing Dosiomics and Radiomics Biomarkers of Cardiac Events in Breast Cancer