Cancer is the second-leading cause of death in developed societies. Specifically, cancers of the spine and brain come with significant therapeutic challenges. Chordomas are semi-malignant tumors that develop from embryonic residuals at the skull base (clival) or coccyx (sacral). Small tumor fragments can remain in the operation cavities during surgical resection, forming new tumor sites. This requires repeated surgeries or the application of proton-beam radiation and chemotherapy, which often do not lead to complete remission of the tumors. Hence, there is a need for novel therapeutic avenues that are not limited to killing visible tumors but can be applied after surgery to decrease chordoma recurrences. Reactive oxygen species (ROS) generated locally via novel medical gas plasma technologies are one potential approach to address this clinical problem. Previously, broad-spectrum free radicals generated by these cold physical plasmas operated at about body temperature were shown to oxidize cancer cells to the disadvantage of their growth and induce immunogenic cancer cell death (ICD), ultimately promoting anticancer immunity. This review outlines the clinical challenges of chordoma therapy, how medical gas plasma technology could serve as an adjuvant treatment modality, and potential immune-related mechanisms of action that could extend the longevity of gas plasma therapy beyond its acute local tissue effects.

• Book : 17(4)
• Pub. Date : 2025
• Page : pp.681-681
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Abstract Background Optic pathway gliomas (OPGs) are tumors in the optic nerve, chiasm, or hypothalamus, primarily affecting children. They can cause visual disturbances and increased intracranial pressure. The current treatment approach includes chemotherapy, radiotherapy, or surgery, but the optimal management strategy remains uncertain. Gamma Knife radiosurgery (GKS) has emerged as a promising option for managing OPGs, offering lower toxicity rates and improved neurocognitive function. However, the effectiveness and safety of GKS for OPGs require further investigation. A systematic review was conducted to evaluate the outcomes and potential complications of GKS for OPGs. The study aimed to assess the safety and efficacy of GKS in terms of tumor control, visual outcome, and endocrine outcome. Methods Using the related key terms, we comprehensively searched relevant articles from PubMed, Embase, Scopus, and Web of Science databases from inception to June 15, 2024. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were included according to the eligibility criteria, and the relevant data were extracted. Results The current systematic review included seven studies (n = 83, 40 males and 43 females). All studies employed Gamma Knife as the radiation source, and the reported progression-free survival rates ranged from 78 to 100% during one to five years following treatment. During a one to five-year follow-up period, the preservation of visual acuity was reported to range between 77 and 92%. Furthermore, no cases of radiation necrosis or other neurological impairments were reported in the studies. Conclusion GKS appears to be a safe and effective treatment option for patients with OPGs, minimizing the risk of radiation-induced toxicity. However, further controlled studies are needed to establish the current study's findings regarding safety and efficacy.

• Book : 40(1)
• Pub. Date : 2025
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Abstract Electron cyclotron resonance heating (ECRH) staircase discharges in strongly shaped plasmas were performed at the full-tungsten ASDEX Upgrade tokamak to investigate the enhanced Dα (EDA) H-mode, a high-confinement regime without edge localized modes (ELMs) that exhibits numerous desirable qualities for future reactors. Heating power, fueling, and plasma current scans reveal rich dynamics as the plasma traverses different confinement regimes. The L-H transition typically occurs with a brief I-phase, sometimes followed by a short nonstationary ELM-free H-mode, before the quasi-coherent mode (QCM) sets in, marking the start of the EDA H-mode. After the pedestal fully develops, the plasma remains stationary until the heating power is raised above a certain threshold, causing ELMs. A novel criterion based on the normality of the divertor shunt current distribution is introduced to identify phases with ELMs, showing general applicability under a wide range of discharges and conditions. The no-ELM power boundary is found to increase with fueling, and too little deuterium gas puff results in a pathological nonstationary ELM-free H-mode without the QCM. Empirical scalings are derived for core, pedestal, and global parameters in EDA H-mode. These show, for example, that pedestal electron pressure increases sublinearly with power and almost quadratically with current. Line-averaged density is approximately proportional to plasma current but very weakly affected by power and fueling, whereas energy confinement time decreases sublinearly with power and increases supralinearly with current. The EDA H-mode achieves several reactor-relevant dimensionless parameters, most notably high Greenwald fraction and confinement enhancement factor over the entire heating power range. This dataset constitutes a versatile resource to plan EDA experiments in present and upcoming devices, also serving as a testbed for validating physics-based theories and models of the regime. Overall, the EDA H-mode remains promising and could become an important no-ELM scenario in future reactors such as SPARC and the full-tungsten ITER.

• Book : ()
• Pub. Date : 2025
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The wave functions of converted harmonic-oscillator in local scaling transformations are employed to evaluate charge distributions and elastic charge electron scattering form structures for 6,7Li, 9Be, 14,15N and 16O nuclei. The nuclear shell-model was fulfilled using Warburton-Brown  psd-shell (WBP) interaction with  truncation in  model space. Very good agreements with the experimental data were obtained for the aforementioned quantities. 

• Book : ()
• Pub. Date : 2025
• Page : pp.423-432
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Abstract Background The differentiation of benign and malignant breast masses is a critical aspect of breast cancer diagnosis. The aim of this study was to assess the capability of IVIM variables to discriminate between benign and malignant breast lesions by obtaining diffusion and perfusion data from normal tissues of breast and breast lesions through intravoxel incoherent motion (IVIM) imaging utilising biexponentially analysis of multiple b-value diffusion-weighted imaging (DWI) and comparing these variables to the apparent diffusion coefficient (ADC) derived from monoexponentially analysis. Results In this prospective work, each subject provided informed consent. Forty-two patients with fifty-two lesions with 31 malignancies and 21 benign lesions were scanned using 1.5 T MRI and DWI with 12 b-values (range 0–1000 s/mm2). Tissue diffusivity (D), perfusion fraction (f), and pseudo-diffusion coefficient (D p) were determined by segmented biexponentially analysis. The ADC (b = 0 and 1000 s/mm2) was computed using monoexponentially fitting of the DWI information. D, f, D p, and ADC values have been acquired for normal tissues of the breast, benign lesions, and malignancies. The contrast of these four variables among each pair indicated that the D and ADC values of malignancies had been substantially lower compared female patients of benign tumours and normal tissues (P < 0.001). The f of malignancies was substantially greater contrasted to that of benign lesions (P < 0.001); nevertheless, no substantial variation in D p was seen between both groups. D, f, and values of ADC exhibited superior sensitivity and specificity in distinguishing benign lesions from malignancies, with areas under the curve (AUC) of 0.945, 0.883, and 0.796, correspondingly. At the same time, D p showed the lowest AUC of 0.515. Conclusions IVIM may play a crucial role in differentiating malignancies and benign lesions of the breast by providing separate quantitative measurements of D for cellularity and D p and f for vascularity.

• Book : 56(1)
• Pub. Date : 2025
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AbstractPurposeBreath‐hold techniques are widely used in radiation therapy to minimize respiratory‐induced tumor or organ‐at‐risk motion. However, residual motion persists, necessitating a reliable daily evaluation method.MethodsAt our institution, fiducial markers serve as surrogates for target localization in pancreatic cancer treatment. We developed an automated method to detect fiducial markers in every projection image of cone‐beam computed tomography (CBCT) scans acquired for patient setup and positioning verification. This method was retrospectively validated using data from nine pancreatic cancer patients.ResultsResidual motion was observed in all patients during breath‐hold maneuvers. Intrafraction target motion in repeated breath‐hold simulation CT scans averaged 1.9 ± 2.2 mm, with a maximum displacement of 8 mm in the superior‐inferior direction. Within a single CBCT scan, residual motion reached up to 7.3 mm, with an average drifting range of 3.8 ± 1.1 mm across 94 CBCT scans. The average standard deviation of drift was 1.5 ± 0.5 mm. Significant drift (1.3 ± 1.2 mm) and inter‐breath‐hold gaps (2.6 ± 2.0 mm) were detected within the same CBCT scan.ConclusionOur method enables daily residual motion assessment without additional equipment or extra radiation exposure. This information is critical for refining planning margins in online adaptive radiation therapy, improving treatment precision and patient safety.

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• Pub. Date : 2025
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ABSTRACTBackgroundThe comparative effectiveness of radiotherapy and surgery for treating intracranial meningioma is unknown.ObjectivesTo compare survival after treatment of suspected intracranial meningioma by either surgery or radiotherapy.AnimalsTwo hundred eighty‐five companion dogs with suspected intracranial meningiomas presenting to 11 specialty clinics in three countries.MethodsParallel cohort comparison study on retrospective data. Dogs diagnosed with intracranial meningioma by board‐certified veterinary neurologists or radiologists and treated by radiotherapy or surgery were identified through medical record searches and presenting and survival data extracted. Lesion site was classified as rostro‐ or caudotentorial and size was measured on contrast magnetic resonance images. Outcome was all‐cause death. Analysis of survival by Cox proportional hazards, including selection for optimal multivariable model using lasso, counterfactual modeling including variables associated with treatment allocation and survival.ResultsOne hundred sixty‐eight dogs received radiotherapy and 117 received surgery. All analyses indicated reduced survival associated with surgery compared to radiotherapy. There was a median survival after surgery of 297 (IQR: 99–768) days compared with 696 (IQR: 368–999) for dogs treated by radiation, associated with a univariable hazard ratio of 1.802 (95% CI: 1.357–2.394). Counterfactual modeling estimated a mean survival of 480 (95% CI: 395–564) days after surgery and 673 (95% CI: 565–782) days after radiotherapy, representing a decrease in survival of 29%. Location and size of the lesion were not associated with survival duration.Conclusions and Clinical ImportanceDogs with suspected intracranial meningioma have substantially superior survival after radiotherapy compared to surgery.

• Book : 39(2)
• Pub. Date : 2025
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Many antifungal agents, including isoconazole nitrate (ISN), suffer from low aqueous solubility and inconsistent dissolution kinetics, which limit their therapeutic potential. To address these challenges, this study aimed to enhance the solubility and stability of ISN through the development of inclusion complexes with hydroxypropyl-β-cyclodextrin (HP-β-CD). HP-β-CD inclusion complexes were prepared using a spray-drying technique and characterized through phase-solubility studies, scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (1H-NMR), and differential scanning calorimetry (DSC). The inclusion complex significantly improved ISN solubility, increasing from 0.5088 mg/mL to 3.6550 mg/mL. These complexes were incorporated into a thermosensitive, mucoadhesive in situ gel system using Pluronic® F127 and hydroxypropyl methylcellulose (HPMC) to optimize vaginal drug delivery. The formulations were evaluated for gelation temperature, viscosity, swelling behavior, and pH, confirming their suitability for vaginal application. Antimicrobial studies demonstrated that the ISN/HP-β-CD gels exhibited superior activity against Candida albicans, C. glabrata, and C. krusei compared to ISN alone. In vitro release studies further revealed sustained drug release following Peppas-Sahlin kinetics, supporting enhanced bioavailability and prolonged therapeutic action. This study demonstrates that the ISN/HP-β-CD-loaded in situ gel system offers a promising and effective approach for improving the solubility, stability, and antifungal efficacy of ISN for the treatment of vaginal infections.

• Book : 17(4)
• Pub. Date : 2025
• Page : pp.514-514
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The concept of thyroid status is much broader than assessing the levels of thyroid stimulating hormone, free and bound thyroid hormones in the systemic circulation. It includes features of transport, tissue bioavailability, receptor interaction, metabolism, biomolecular mechanisms of action and inactivation, as well as the physiological or pathophysiological basis of changes in function and the pathomorphological substrate of diseases, including malignancies. Therefore, the question of the mechanisms through which thyroid status influences the processes of tumor initiation and promotion in the gastrointestinal tract is extremely relevant. Regarding colorectal cancer, an ambiguous link between thyroid status has been identified – in some studies, an increase in free T4 concentration and thyrotoxicosis are associated with a decreased risk of developing colon cancer, while in others, the administration of levothyroxine in hypothyroidism had a protective effect. The risk of gastric cancer is elevated in men living in regions with suboptimal or above-normal iodine consumption and suffering from various thyroid pathologies. This paper analyzes modern ideas about pathogenetic relationship between gastric and colon cancer and patients' thyroid status. It presents physiological and biochemical basics of thyroid status formation. Deiodinase expression profile in gastric and colon cancer is stated. The problem of iodine-induced disthyroidoses following radiation procedures using iodine-containing contrasts is described in detail.

• Book : 26(4)
• Pub. Date : 2025
• Page : pp.478-483
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AbstractBackgroundThe integrity of brain function is at stake due to cerebral ischemia‐reperfusion injury (CIRI), which encompasses mitochondrial dysfunction, autophagy, and neuroinflammation. The role of E2F1 in mediating these processes in microglia during CIRI remains unclear.MethodsA CIRI mouse model was utilized for single‐cell RNA transcriptome sequencing of brain tissues. The research comprised diverse gene expression, gene ontology (GO), and the enrichment of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Experimental techniques included oxygen‐glucose deprivation (OGD/R) cell models, RT‐qPCR, Western Blot, ChIP assays, and microglia‐neuron co‐cultures.ResultsA significant aspect highlighted in the study was the involvement of CDK5 in the induction of mitochondrial abnormalities associated with CIRI. Upregulation of E2F1 and CDK5 in post‐CIRI microglia was observed. E2F1 facilitated CDK5 transcription, leading to DRP1 phosphorylation, exacerbating neurotoxic effects. Silencing E2F1 improved neurobehavioral outcomes in CIRI mice.ConclusionsActivation of E2F1‐mediated CDK5 drives mitochondrial division while inhibiting mitophagy in microglia, triggering inflammation, neuronal apoptosis, and exacerbating CIRI damage. Targeting this pathway could offer novel therapeutic strategies for mitigating CIRI‐induced brain injury.Key points Identification of the E2F1/CDK5/DRP1 Axis in CIRI This study reveals that the E2F1 transcription factor upregulates CDK5 expression, which in turn phosphorylates DRP1, promoting excessive mitochondrial fission and inhibiting mitophagy in microglia. This mechanism plays a critical role in cerebral ischemia‐reperfusion injury (CIRI). Mitochondrial Dysfunction and Neuroinflammation The activation of DRP1 leads to mitochondrial fragmentation and excessive ROS accumulation, triggering microglial activation and inflammatory responses, exacerbating neuronal apoptosis and brain injury in CIRI. Therapeutic Potential of E2F1 Silencing Knockdown of E2F1 in microglia effectively reduces mitochondrial damage, restores mitophagy, suppresses inflammation, and improves neurological outcomes in a CIRI mouse model, highlighting a promising therapeutic target for ischemic stroke intervention.

• Book : 15(2)
• Pub. Date : 2025
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