.
Multi-dimensional voice assessment is critical for monitoring recovery in patients treated with radiotherapy (RT) for early glottic carcinoma. This study investigated the longitudinal cross-parametric correlations between subjective (AVHI-10), functional (LVS), and objective (acoustic) voice measures at baseline and 6 months post-RT. Thirty-seven patients with T1–T2N0M0 glottic carcinoma were prospectively evaluated. Spearman correlation matrices (ρ) were employed to analyze the relationships between the Voice Handicap Index-10 (AVHI-10), laryngeal videostroboscopy (LVS), and acoustic parameters (HNR, Jitter, Shimmer and MPT). All parameters showed significant clinical improvement at 6 months (P < 0.001). Post-RT, the AVHI-10 demonstrated exceptionally strong concordance with objective efficiency measures, specifically HNR (ρ = − 0.893) and MPT (ρ = − 0.844), as well as robust correlations with perturbation metrics (Jitter: ρ = 0.761; Shimmer: ρ = 0.753). In contrast, while functional LVS parameters remained significantly correlated with acoustic output, these associations were more moderate (ρ ranging from = 0.41 to 0.67). Glottic closure was the most prominent functional predictor of acoustic spectral purity (ρ = − 0.674 with HNR), whereas mucosal wave parameters (Phase Symmetry and Periodicity) exhibited a relative weakening in their correlation with acoustic instability, suggesting a complex interplay following radiation-induced tissue changes. Subjective handicap (AVHI-10) serves as a highly reliable surrogate for objective acoustic efficiency in the post-RT larynx. While functional laryngeal dynamics improve universally, the attenuation of correlations observed between mucosal wave parameters and acoustic output highlights the complex, non-linear impact of radiation-induced fibrosis. Residual glottic closure remains the primary functional determinant of vocal efficiency, emphasizing its role as a key clinical biomarker for post-treatment success.
Depression rates among young adults (aged 18–25) continue to rise, and suicide remains one of the leading causes of death in this population. The aim of this study was to examine risk factors impacting depression severity, suicidal behavior (SB), and non-suicidal self-injury (NSSI) in young adults with depression, focusing on childhood trauma, impulsivity, and resilience. Young adults with a clinical diagnosis of depression were included in this observational study. Clinical assessments included validated measures of depression severity, SB, NSSI, childhood trauma, impulsivity, and resilience. Spearman’s correlation showed that demographic factors, childhood trauma, and impulsivity were significantly associated with depression severity, SB, and NSSI. However, multiple regression analyses showed that resilience was a significant protective factor for depression severity (p = .042), while other factors did not reach significance. In contrast, total childhood trauma score was a significant risk factor for SB (p < .001) and NSSI (p = .008). A positive family history of mental disorders was also a significant risk factor for SB (p = .009). These findings may contribute to the development of therapeutic interventions aimed at modifying these risk factors and protective factors. Such an approach may contribute to decreasing depression severity and the risk of SB and NSSI in young adults with depression.
Background/Objectives: The risk factors for ovarian and uterine cancer remain insufficiently known. This study aimed to assess global trends in mortality from ovarian and uterine cancer attributable to high body-mass index (BMI) in 1990-2023. Methods: An observational epidemiological study was conducted. The age-standardized rates (ASRs) of mortality were retrieved from the Global Burden of Disease study. Trends were evaluated using joinpoint analysis. The Average Annual Percentage Change (AAPC, %), with a 95% Confidence Interval (CI), was calculated. Results: Globally, the trend in ASRs of ovarian cancer deaths attributable to high BMI increased significantly (AAPC = +0.4%, 95% CI = 0.3 to 0.5). The growth trend in South Asia (AAPC = +8.7%, 95% CI = 8.1 to 9.2) was 30 times greater than in Eastern Europe (AAPC = +0.3%, 95% CI = 0.1 to 0.5). Declining trends in mortality from ovarian cancer were observed only in Australasia (AAPC = -0.2%, 95% CI = -0.4 to -0.1), High-income North America (AAPC = -0.3%, 95% CI = -0.6 to -0.0), and Western Europe (AAPC = -0.7%, 95% CI = -0.8 to -0.6). For uterine cancer, the global trend of mortality also increased (AAPC = +0.1, 95% CI = 0.0 to 0.2), with the trend growing fastest in South Asia (AAPC = +4.2%, 95% CI = 4.0 to 4.4). Decreasing trends in mortality from uterine cancer due to high BMI were observed only in Central Asia (AAPC = -0.6%, 95% CI = -0.9 to -0.4), East Asia (AAPC = -2.2%, 95% CI = -2.6 to -1.8), and Southern Latin America (AAPC = -0.4%, 95% CI = -0.6 to -0.1). Additionally, an accelerated increase in mortality trends for both ovarian and uterine cancer attributable to high BMI was observed in 2020-2023, which corresponds to the period of the COVID-19 pandemic. Conclusions: Further analytical epidemiological studies are required to clarify the relationship between ovarian and uterine cancer and high BMI.
Background: Metastatic melanoma is an extremely aggressive malignancy with limited therapeutic options, despite advances in targeted and immunotherapy. MicroRNAs are key post-transcriptional regulators of gene expression and play a critical role in tumor adaptation, invasion, and metastasis. The aim of our study was to identify dysregulated miRNAs which may serve as novel biomarkers and therapeutic targets. Materials and Methods: The study was conducted on FFPE samples from metastatic melanoma (n = 15), compared to healthy skin tissue (n = 6). BRAF V600E/Ec mutation status was established by Real-Time qPCR. Expression miRNA analysis was performed, using digital counting of 827 miRNAs on the NanoString platform, with data normalization and fold change calculations. Results: Following normalization and quality control metrics, 58 differentially expressed miRNAs were identified in BRAFwt melanoma samples: 6 overexpressed and 52 inderexpressed miRNAs. In BRAFmut melanoma, 37 microRNAs were differentially expressed: 11 overexpressed and 26 underexpressed. Four miRNAs showed elevated expression in both melanoma groups. Among them, miR-146a-5p and miR-4286 demonstrated the highest elevation, especially in BRAFmut tumors. We focused further on their targeted genes. Conclusion: This study demonstrates significant alterations in the miRNA expression profile in metastatic melanoma and highlights the potential of miR-146a-5p and miR-4286 as key regulators of tumor biology.
Early glottic carcinoma primarily affects the vocal folds and most commonly presents with the symptom of dysphonia, which is an effect of the tumor interfering with normal vocal fold vibration. Radiotherapy for early glottic carcinoma is highly effective in controlling the tumor while preserving the larynx and voice. The aim of this study was to evaluate changes over time in voice outcomes among patients with early stage glottic cancers treated with definitive radiotherapy using stroboscopy as well as voice acoustic analysis. The assessment was applied on 24 patients with T1 and T2 glottic carcinoma. It was conducted pre-radiotherapy, 3 months and 6 months post-radiotherapy as follow-ups. The assessment included laryngoscopic, videostroboscopic examination, and voice acoustic analysis. Marked improvement was found in videostroboscopic parameters, with parameters highly significant differences across the three phases for nearly all stroboscopic parameters, p-values (<0.001), with a significant difference noted specifically for the periodicity of mucosal waves in the right vocal fold p-value (0.005). Significant improvement was detected in voice acoustic analysis parameters, including the increase in harmonic to noise ratio and maximum phonation time, and reduction in jitter and shimmer by 6 months (p < 0.001). The overall outcomes of the current study pointed to improved glottic manifestations based on videostroboscopy parameters and voice acoustic analysis parameters by 6 months post-radiotherapy.
