Endovascular thrombectomy for acute large-vessel occlusion in patients with active cancer remains a difficult clinical decision. Multiple cohort studies and meta-analyses indicate that, when standard imaging and clinical criteria are applied, reperfusion success is high and symptomatic intracranial hemorrhage is broadly comparable with non-cancer populations, arguing against categorical exclusion. At the same time, registries show lower 90-day functional independence and higher 90-day mortality in active-cancer cohorts—effects likely driven by malignancy-related systemic factors and pre-existing functional compromise rather than procedural harm. This narrative review synthesizes efficacy and safety signals, highlights decision-grade outcomes that are seldom reported—early neurological change, performance status around 90 days, and whether systemic anticancer therapy is started or resumed. It sets out a clinical–ethical–economic framework to support selection, consent, and aftercare, including a pragmatic pathway for under-resourced settings based on non-contrast computed tomography (CT) or single-phase CT angiography where advanced perfusion imaging or magnetic resonance imaging are unavailable. We outline an Asia–Pacific collaborative program designed to identify subgroups that may benefit from reperfusion and initiation of active cancer care.

ObjectiveThe controllability changes of structural brain network were explored based on the control and brain network theory in young smokers, this may reveal that the controllability indicators can serve as a powerful factor to predict the sleep status in young smokers. MethodsFifty young smokers and 51 healthy controls from Inner Mongolia University of Science and Technology were enrolled. Diffusion tensor imaging (DTI) was used to construct structural brain network based on fractional anisotropy (FA) weight matrix. According to the control and brain network theory, the average controllability and the modal controllability were calculated. Two-sample t-test was used to compare the differences between the groups and Pearson correlation analysis to examine the correlation between significant average controllability and modal controllability with Fagerström Test of Nicotine Dependence (FTND) in young smokers. The nodes with the controllability score in the top 10% were selected as the super-controllers. Finally, we used BP neural network to predict the Pittsburgh Sleep Quality Index (PSQI) in young smokers. ResultsThe average controllability of dorsolateral superior frontal gyrus, supplementary motor area, lenticular nucleus putamen, and lenticular nucleus pallidum, and the modal controllability of orbital inferior frontal gyrus, supplementary motor area, gyrus rectus, and posterior cingulate gyrus in the young smokers’ group, were all significantly different from those of the healthy controls group (P<0.05). The average controllability of the right supplementary motor area (SMA.R) in the young smokers group was positively correlated with FTND (r=0.393 0, P=0.004 8), while modal controllability was negatively correlated with FTND (r=-0.330 1, P=0.019 2). ConclusionThe controllability of structural brain network in young smokers is abnormal. which may serve as an indicator to predict sleep condition. It may provide the imaging evidence for evaluating the cognitive function impairment in young smokers.

Objective: To understand the growth and development levels of four physical measurements in children aged 3-6 years in China, so as to provide a reference for child nutrition improvement and health promotion. Methods: A stratified random sampling method was used to collect physical measurement data from 120 kindergartens 25 842 children aged 3-6 years across 24 provinces and cities in seven natural geographical regions of North China, Northeast China, East China, Central China, South China, Southwest China and Northwest China from 2020 to 2023. The development levels of head circumference, chest circumference, waist circumference, and hip circumference were evaluated using a grading method. The analysis of gender and age differences was conducted using Mann-Whitney U- test and Kruskal-Wallis test, and the comparison of abnormal detection rates for different genders was conducted using Chi square test. Results: The distribution range of children aged 3-6 was 51.74(50.08, 53.33) cm in terms of head circumference, 55.73(52.09, 59.04) cm in terms of chest circumference, 53.04(48.92, 56.40) cm in terms of waist circumference, and 59.36(56.30, 62.32) cm in terms of hip circumference. The detection rate of abnormal head circumference in boys and girls aged 3-6 years old was relatively high (19.71%-42.02%), and the detection rate of abnormal physical circumference development levels in boys was higher than that in girls of all ages ( χ 2=5.63-83.35, P <0.05). The detection rate of abnormal hip circumference (4.89%-6.53%) and chest circumference (4.51%-6.38%) in boys and girls aged 3-6 was relatively low, and there was no statistically significant difference in the abnormal rate between different ages and genders ( χ 2=0.00-1.61, 0.00-3.71, P >0.05). The detection rate of abnormal waist circumference in boys and girls aged 3-6 was relatively high (13.70%-42.45%), and the detection rate of abnormal waist circumference in girls was higher than that in boys aged 4-6 groups ( χ 2=10.49-58.18, P < 0.05). Conclusions The overall physical development of children aged 3-6 years in China is improving, but the abnormal detection rates for head circumference and waist circumference are relatively high. Child healthcare should focus on preventing and treating abdominal obesity, with differentiated health intervention strategies based on different age groups and genders.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

Objective:To investigate the differential expression of Nuclear Factor Kappa B(NF-κB)and Tumor Necrosis Factor-Alpha(TNF-α)in endometrial polyp tissues,polyp-adjacent endometrium,and normal endometrium,and to analyze their correlation with local inflammatory responses,thereby elucidating the pathogenesis of endometrial polyps.Methods:Thirty-six patients with hysteroscopically confirmed endometrial polyps at Qingdao University Affiliated Hospital(September 2023-December 2024)were enrolled.Polyp tissues and adjacent endometrial tissues(0.5 cm-1 cm from polyps)were collected during surgery.Twenty-six patients undergoing hysterectomy for uterine fibroids,with pathologically confirmed normal endometrium,served as controls.The expression of NF-κB and TNF-α proteins was assessed using immunohistochemistry(IHC).Real-time quantitative PCR(RT-qPCR)was employed to detect the mRNA expression levels of NF-κB and TNF-α,and Western blot analysis was used to measure their protein expression.Differences among the three groups were compared.Results:Immunohistochemical analysis demonstrated:NF-κB p65 was predominantly localized to the cytoplasm and/or nucleus;TNF-α-positive expression was principally observed in the cytoplasmic compartment and/or cell membrane,manifesting as brown-yellow to brownish granules.The positive expression rate of NF-κB protein was significantly elevated in endometrial polyp tissues compared to both adjacent endometrial tissues and normal endometrial tissues(P＜0.05),whereas no statistically significant difference was observed between adjacent and normal endometrial tissues(P＞0.05).TNF-α protein expression exhibited a gradient pattern:Endometrial polyp tissues＞Adjacent endometrial tissues＞Normal endometrial tissues(with all inter-group comparisons demonstrating statistically significant differences,P＜0.05).Real-time quantitative PCR analysis revealed a significant gradient trend in the mRNA expression of NF-κB and TNF-α in endometrial polyp tissues:NF-κB mRNA:Polyp group(7.15±3.15)＞parapolyp group(4.38±2.01)＞normal group(1.03±0.30),with significant intergroup differences(all P＜0.05).TNF-α mRNA:Polyp tissue(17.66±9.25)＞parapolyp tissue(9.35±5.75)＞normal endometrium(1.16±0.58),with statistically significant differences among all groups(all P＜0.05).Western blot quantification further confirmed this trend:NF-κB protein:Expression in the polyp group(0.87±0.11)was 2.23-fold higher than in the normal group(0.39±0.02)(P=0.0007),while the parapolyp group(0.59±0.07)showed a 51％increase compared to the normal group(P=0.0435).TNF-α protein:Expression in the polyp group(1.13±0.21)was elevated by 94.8％versus the parapolyp group(0.58±0.03,P=0.0036)and by 494.7％versus the normal group(0.19±0.03,P=0.0002).One-way ANOVA indicated significant intergroup differences(F=43.56,P＜0.05).Conclusion:The TNF-α-mediated NF-κB signaling pathway is abnormally activated in endometrial polyps,exhibiting its highest expression at the polyp site.This suggests that the localized chronic inflammatory microenvironment may promote polyp formation through persistent stimulation of the NF-κB pathway.Targeted regulation of this pathway offers a novel strategy for preventing polyp recurrence.

The scaphoid bone is one of the important bone of hand,which is frequently injured and difficult to treat in clinical practice.Therefore,it is very important to deeply study the microstructure and biomechanical characteristics of the scaphoid bone for understanding its injury mechanism and optimizing treatment scheme.Microcomputed tomography(micro-CT)provides high-resolution imaging of bone tissue,while finite element analysis can help to simulate the stress distribution and behavioral patterns of the scaphoid bone under various physiological and pathological states.The high-resolution three-dimensional image of the scaphoid bone obtained by micro-CT technology can be used to construct finite element models of real anatomical structure of the scaphoid bone,thus achieving accurate simulation of the mechanical properties of the scaphoid bone.The fusion of these two advanced technologies provides a new perspective for revealing the structural and functional relationships and injury mechanism of the scaphoid bone.Therefore,this paper reviews the anatomical characteristics of the scaphoid bone and its biomechanical behavior in different states,emphasizing the specific applications and advantages of micro-CT and finite element analysis techniques in the study of the scaphoid bone.By summarizing the research findings in recent years,this paper provides novel scientific basis and methods for the diagnosis,treatment,and prevention of scaphoid bone-related disorders.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

BACKGROUND

Intimate partner violence (IPV) is a global public health issue with profound physical, psychological, and social consequences. Despite legislative measures in the Philippines, there is limited research on the profile of IPV survivors consulting specialized healthcare units.

This study aimed to describe the profile of female survivors of IPV consulting at the Philippine General Hospital Women’s Desk (PGH-WD), focusing on sociodemographic, psychological, relationship, community, and partner factors as contributors to their risk of experiencing IPV.

A cross-sectional study was conducted to analyze data from IPV survivors who consulted the PGH-WD between January 2022 and December 2023. Data collection involved a chart review of eligible cases, guided by predefined inclusion and exclusion criteria. Inclusion criteria required that participants be female survivors of IPV aged 19 years and above, with consultations specifically related to IPV. Exclusion criteria included male survivors, non-Filipino nationals, individuals not residing in the Philippines, and charts missing key components. Descriptive statistics were used to analyze sociodemographic, psychological, relationship, community, and partner-related factors. Survivors were categorized into low-, moderate-, or high-risk groups based on the number of identified risk factors.

A total of 518 charts were reviewed, of which 106 met the inclusion criteria and were analyzed. Survivors’ ages ranged from 19 to 74 years, with 46 (43.4%) aged 19–34. Most survivors belonged to lower socioeconomic strata, with 61 (57.5%) categorized as poor. Psychological distress was common, with 24 (22.6%) reporting depression and 22 (20.8%) having attempted suicide. Relationship factors included dissatisfaction in 91 cases (85.9%) and prior abuse by partners in 88 (83.0%). Community factors showed that 104 survivors (98.1%) were aware of the Anti-Violence Against Women and Children (Anti-VAWC) law, and 101 (95.5%) reported having social support networks. Partner-related factors were less frequently reported, with 3 survivors (2.8%) indicating perpetrator substance use and 2 (1.9%) reporting histories of childhood abuse. Risk profiling categorized survivors into low-risk (39/106, 36.8%), moderate-risk (39/106, 36.8%), and high-risk (28/106, 26.4%) groups based on the number of identified risk factors.

This study provided a detailed profile of female IPV survivors consulting at the PGH-WD. Survivors were predominantly younger women from lower socioeconomic backgrounds, with high rates of psychological distress, relationship dissatisfaction, and histories of prior partner abuse. Community factors, including strong social support networks and awareness of the Anti-VAWC law, were identified as potential protective mechanisms post-IPV.

BACKGROUND

Intraoperative transfusion for gynecologic surgery, when appropriately used, can improve patient outcomes. However, when utilized incorrectly, blood transfusion can worsen patient outcomes and increase patient cost. This study aimed to evaluate the blood transfusion practices of tertiary hospitals in the Philippines.

The study utilized a cross-sectional design wherein prospective data were gathered through multiple sources across seven tertiary-level hospitals. Women admitted to undergo gynecologic surgery were recruited based on a set of criteria. A chart review was conducted, and blood utilization indices were calculated. Outcomes were compared between public versus private facilities and transfused versus nontransfused patients.

Among 514 patients, 79.7% underwent cross-matching and 75.1% received transfusions. Adverse events were rare, with no transfusion-related deaths. The overall crossmatch-to-transfusion ratio (C/T ratio) was 2.8, exceeding the 2.5 optimal benchmark; all public hospitals recorded a C/T ratio >2.5, whereas private centers had more efficient usage. Six hospitals met acceptable benchmarks for transfusion probability and transfusion index. Open abdominal procedures, particularly hysterectomy, accounted for the most blood used. Transfused patients had longer operative times, greater blood loss, lower preoperative hemoglobin, and more frequently involved resident physicians in training. Public hospitals recorded higher cross-match and transfusion rates, greater resident physician participation, and broader use of general anesthesia.

Results of the study highlight the importance of monitoring blood transfusion parameters to optimize blood utilization. The observed differences between public and private institutions in the country highlight the urgent need for standardized and evidence-based practice to ensure efficient transfusion protocols nationwide.

OBJECTIVES

This study described the demographic and clinical profile, mental health problems, prevalence of psychiatric conditions, psychosocial interventions used, and outcomes of the management of mental health problems among in-patients admitted to non-psychiatry units of tertiary hospitals referred to mental health care providers; and described gender-disaggregated data related to mental health care providers and patients receiving psychosocial interventions in tertiary hospitals.

This study employed a mixed-method design, using both qualitative and quantitative methodologies following the convergence model of triangulation. The following were the data sources: (1) cross-sectional review of charts of patients referred for psychosocial problems using the ICD-10 classification; (2) a survey of mental health service providers; (3) key informant interviews of mental health service providers; and (4) focus group discussions of mental health providers. All data were collated, compared, and contrasted, then analyzed using the convergence model of triangulation design.

Among the 3,502 patients in the chart review, 1,870 (53.40%) were males. The median age was 46.08 years and 92.06% were adults. The most common diagnosis among the patients were mood disorder (744, 21.25%) and organic mental disorder (710, 20.27%). Combination treatment of psychosocial intervention and pharmacology was the most common strategy received by patients. There was a higher proportion of patients admitted to public hospitals (996, 45.27%) who received psychosocial interventions only compared to those admitted to private hospitals (235, 18.05%). There were 3,453 out of 3,502 in-patients referred for psychiatric intervention. Of these 2,420 (70%) received psychoeducation, 2,365 (68.5%), received supportive psychotherapy/counseling, 535 (15.5%) family therapy, and 286 (8.3%) behavior modification. There were more patients given psychosocial interventions 2,541 (72.56%) who were discharged with instruction to follow-up, while around one in 10 (456, 13.02%) was not instructed to do a follow-up consultation. The types of interventions across all data sources were similar.

The most common type of management for psychosocial problems of in-patients in tertiary hospitals was a combination of psychosocial intervention and pharmacotherapy. Psychoeducation, supportive psychotherapy/ counseling, and family therapy were the most often given psychosocial interventions. The patient-related reasons for the choice of interventions were patient’s medical status (diagnosis and severity of symptoms) and psychological status (psychological mindedness), while the provider-related factors influencing the choice of intervention were provider’s skills and personal preference. Moreover, resources (human and material) and service provision policies (treatment guidelines and aftercare interventions) were the most common hospital-related factors. Further prospective research to determine the associated patients, providers, and hospital factors in larger geographic and cultural settings will provide evidence for the effectiveness and outcomes of psychosocial interventions.