Background Lung cancer progression involves systemic alterations in coagulation, inflammation, nutritional decline, and hematologic impairment. Although individual biomarkers show prognostic relevance, their integrated clinical value remains insufficiently explored. This study aimed to evaluate the prognostic performance of a novel DANH axis comprising D-dimer, albumin, neutrophil to lymphocyte ratio (NLR), hemoglobin for risk stratification in lung cancer. Methods This retrospective observational study included 184 patients with histologically confirmed lung cancer. Pretreatment laboratory parameters, including D-dimer, NLR, serum albumin, and hemoglobin, were analyzed. Composite biomarker indices were constructed by integrating three-factor combinations (DAN, DAH, DNH, ANH) and a four-factor model (DANH). Predictive performance for advanced disease, metastasis, and cancer associated thrombosis was analysis. Bootstrap resampling (1,000 iterations) was applied to evaluate model stability. Results Individual biomarkers showed moderate discrimination for advanced disease (AUC 0.687–0.747), while composite models improved accuracy, with DANH performing best (AUC = 0.784). For thrombosis, D-dimer was the top single marker (AUC = 0.711), and composite models improved performance, led by DANH (AUC = 0.750). In contrast, both single and composite biomarkers had limited ability to predict metastasis. Composite scores based on optimal cut offs (D-dimer ≥ 986 ng/mL, NLR ≥ 4.07, hemoglobin ≤ 120 g/L, albumin ≤ 36.6 g/L) showed significant stage dependent stratification, with higher risk categories associated with advanced disease (all p ≤ 0.01; strongest for DANH: p < 0.0001). Bootstrap analysis confirmed robustness, with the DANH model achieving the highest performance and stability (F1 = 0.9595; 95% CI: 0.9323–0.9819; win rate 76.9%), while other models showed greater degeneration and lower discrimination. Conclusions Integration of coagulation, inflammatory, nutritional, and hematologic biomarkers into a DANH axis improves discrimination of advanced disease and cancer-associated thrombosis in lung cancer. Although not predictive of metastasis, the DANH score provides a simple, cost-effective framework for systemic risk stratification in routine clinical practice.
BACKGROUND:Iatrogenic surgical bur fracture is a rare, clinically significant complication in third molar surgery. A standardized management approach may prevent fragment migration and permanent neurosensory injury. PURPOSE:This study evaluated the clinical efficacy and neurosensory safety of a standardized clinical management protocol for mandibular fractured bur retrieval. STUDY DESIGN, SETTING, AND SAMPLE:A retrospective cohort study was conducted at the Artdentist Dental Clinic, with institutional affiliation and ethical approval from the Hai Phong Medical University Hospital. The sample included consecutive subjects with cone beam computed tomography-confirmed mandibular bur fragments (types 1 to 3) referred from 2023 to 2025. Exclusions comprised nonbur foreign bodies and incomplete records. PREDICTOR VARIABLE:The primary predictor was anatomic localization of the fractured bur fragment: type 1 (intrabony fragment), type 2 (subperiosteal fragment), or type 3 (lingual soft tissue fragment). MAIN OUTCOME VARIABLE(S):Clinical efficacy was defined by retrieval success (complete radiographic removal) and operative duration (minutes). Neurosensory safety was measured using objective and subjective neurosensory testing and complications. COVARIATES:Variables included demographic (age and sex), radiographic, anatomic, and operative (operator experience and surgical approach) categories. ANALYSES:Descriptive statistics and the Kruskal-Wallis test were used to compare operative duration across localization types. Statistical significance was set at P < .05. RESULTS:The sample comprised 15 subjects (median age, 24.0 years; interquartile range [IQR], 21.0 to 30.0). Retrieval success was 100%. Fragment localization was statistically significantly associated with operative duration (P = .016). Type 3 retrievals using a lingual flap were fastest (median, 21.0 minutes; IQR, 15.5 to 23.5), compared to type 1 (median, 37.0 minutes; IQR, 31.0 to 48.5) and type 2 (median, 41.5 minutes; range, 31.0 to 52.0). Furthermore, fractures during tooth sectioning required longer retrieval times than those during bone removal (median, 46.0 minutes; IQR, 32.0 to 52.0 vs 27.0 minutes; IQR, 20.5 to 34.0; P = .009). No postoperative neurosensory deficits or complications occurred (n = 0/15). CONCLUSIONS AND RELEVANCE:Guided by the cone beam computed tomography classification, this standardized protocol is highly effective for retrieving fractured burs. It achieved complete success, efficient operative durations, and neurosensory preservation.
Introduction Schizophrenia is a chronic mental illness characterized by psychobiological vulnerability, where stress can exacerbate symptoms and precipitate relapses. Mind-body exercises have gained attention as non-pharmacological interventions that may support symptom management and improve clinical outcomes. Aim To evaluate the impact of mind-body exercises on stress-related outcomes in individuals with schizophrenia. Design A systematic review. Methods A systematic search was conducted across six electronic databases to identify eligible studies published from database inception to February 13, 2025. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Results A total of 140 articles were identified through our search of six electronic databases. Ultimately, six randomized controlled trials involving 433 participants were included. While most studies reported significant within-group improvements in stress-related outcomes following mind-body exercise interventions, only two studies demonstrated significant between-group differences. Discussion Mind-body exercises may be beneficial in reducing stress among patients with schizophrenia, offering psychological benefits despite limited evidence of superiority over control groups. Implications for practice Mind-body exercises may serve as a safe, complementary therapy for stress management in schizophrenia care. Integration into nursing-led treatment programs could support emotional well-being and reduce relapse risk, especially when reinforced through ongoing patient interaction and coaching. Trial and protocol registration This study was registered in PROSPERO (CRD42025638156).
Background:Immediate lymphatic reconstruction (ILR) is a prophylactic approach for breast cancer-related lymphedema (BCRL) following axillary lymph node dissection (ALND). This study assessed the preventive effect of ILR by evaluating data from prior studies, with a focus on time-course dynamics. Methods:A systematic review and meta-analysis was performed of 17 studies comparing ALND plus ILR with ALND alone. The primary outcome was BCRL incidence. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were stratified by follow-up duration (1-48 months). Results:ILR significantly reduced BCRL incidence (RR: 0.37; 95% CI: 0.28-0.49). Time-stratified analysis indicated that the prophylactic effect was robust within the first 2 years postoperatively, peaking at 12 months (RR: 0.13; 95% CI: 0.04-0.46). Limited data beyond 2 years necessitates further studies to clarify long-term results. Conclusion:ILR reduces BCRL risk, remaining a valuable preventive strategy for breast cancer patients. This benefit remains unclear in the long term, highlighting the need for further high-quality trials with extended surveillance.
OBJECTIVES:Sexual dysfunction is a prevalent and often overlooked issue among COVID-19 survivors. This study aimed to investigate the factors associated with sexual dysfunction in this population. STUDY DESIGN:A cross-sectional study. METHODS:A multicenter survey was conducted involving 2809 COVID-19 survivors. Sexual dysfunction was assessed using the 14-item Sexual Functioning Questionnaire (CSFQ-14). Unadjusted and adjusted logistic regression analyses were performed to determine the factors associated with sexual dysfunction. RESULTS:The CSFQ-14 scores indicated that 52.2% of the participants experienced sexual dysfunction, with higher rates observed among males (53.1%) compared to females (46.9%). Several risk factors were identified, including higher age (odds ratio, OR, 2.20; 95% confident interval, 95%CI, 1.58, 3.07; p < 0.001), a greater number of family members with COVID-19 (OR, 1.28; 95%CI, 1.02, 1.62; p = 0.037), multiple COVID-19 infections (OR, 2.13; 95%CI, 1.20, 3.77; p = 0.01), higher body mass index (BMI) (OR, 1.50; 95%CI, 1.23, 1.81; p < 0.001), COVID-19 treatment at the hospital (OR, 1.26; 95%CI, 1.06, 1.50; p = 0.01), and a history of tobacco use (OR,1.48; 95%CI, 1.13, 1.95; p = 0.005). Conversely, higher education levels (OR, 0.66; 95%CI, 0.53, 0.84; p = 0.001), current employment (OR, 0.64; 95%CI, 0.44, 0.93; p = 0.019), and greater health literacy (OR, 0.98; 95%CI, 0.97, 0.99; p = 0.004) were found to be protective factors against sexual dysfunction. CONCLUSION:This study highlights the significant burden of sexual dysfunction among COVID-19 survivors. Targeted interventions should focus on weight management, smoking cessation, and improving education and health literacy to enhance sexual well-being in this population.
