Pancreatic and colorectal cancers are often diagnosed at advanced stages, which limits therapeutic options and drastically reduces survival rates. To address this critical issue, we propose a novel, non-invasive early detection method that leverages the analysis of circulating tumor DNA (ctDNA) for identifying tumor-specific genetic mutations in plasma. ctDNA analysis offers a high-precision, dynamic approach to detecting molecular signatures of cancer at much earlier stages compared to traditional diagnostic tools such as endoscopy, imaging, or biopsy, which typically identify tumors when they are already advanced. This review analyzes current research pertaining to next-generation sequencing (NGS) and highly sensitive digital PCR to detect minimal amounts of ctDNA shed by cancer cells into the bloodstream. The novelty of this approach lies in its capacity for the continuous monitoring of ctDNA fluctuations, enabling not only early detection but also real-time assessment of tumor progression or response to therapy. This technology holds promise for significantly improving early diagnosis, particularly for high-risk populations with a genetic predisposition to these cancers. However, further research is required to enhance the sensitivity and specificity of ctDNA detection, especially in distinguishing between benign and malignant alterations, and to evaluate its effectiveness in larger, more diverse cohorts. Ultimately, ctDNA-based early detection could revolutionize cancer screening and patient management, providing a personalized, molecular-level approach to identifying and monitoring these deadly cancers.

Background: Accurate anomaly detection in brain and cardiac signals is essential for advancing diagnostic accuracy in neurological and cardiological research. Traditional signal processing methods often face challenges in preserving signal integrity while identifying anomalies.

Objective: This study investigates the application of Bessel activation functions in transforming brain and cardiac signals to facilitate effective anomaly detection and correlation analysis.

Methods: Bessel activation functions were applied to a dataset of brain and cardiac signals to transform the data. The transformed signals were then compared with the original signals using Pearson correlations to evaluate the preservation of signal integrity. Additionally, anomaly detection was performed by identifying peaks in the activated signals.

Results: The application of Bessel activation functions resulted in a significant improvement in the identification of anomalies, with the method effectively discerning peaks corresponding to signal anomalies. Pearson correlation analyses demonstrated that the Bessel activation preserved signal integrity, with correlation coefficients consistently above 0.9 across all samples.

Conclusion: This study demonstrates the potential of Bessel activation functions in enhancing the accuracy of anomaly detection in brain and cardiac signals while maintaining the integrity of the original data. These findings contribute to the broader field of signal processing and offer promising implications for improving diagnostic approaches in medical and scientific research.

Background: Jaw cyst surgery is a common intervention in oral surgery. A cyst is an epithelium-lined sac containing fluid and/or semisolid material due to epithelial cell proliferation, degeneration, and liquefaction; the hypertonic solution withdraws liquids from the surrounding tissues, while internal pressure exerts an equal strength on the cyst walls. Dentigerous cysts are the second most common odontogenic cysts and commonly report no symptoms. Mandibular dentigerous cysts are common in children and adults, while rare in elderly patients. Treatment usually involves removal of the entire cyst and the associated unerupted tooth. This intervention may be more difficult if the cyst is large, the third molar is in contact with mandibular nerve, and/or the patient has medical history that may represent a relative or absolute contraindication.

Materials and Methods: the case of a dentigerous cyst in an elderly patient in treatment with dabigatran therapy is presented, with jaw cyst surgery and tooth extraction. A systematic literature review was performed to evaluate previous cases of dentigerous cyst in elderly patient.

Results: No complications, in particular excessive bleeding, occurred neither during the surgery nor in the week after. Mandibular sensitivity returned with the pass of the dental anesthesia. One year after the surgery, a new panoramic radiograph was performed, revealing the complete healing of the site. The systematic literature review reported two cases of previously documented cases, one treated with irrigation, the other one treated with cyst enucleation and tooth extraction.

Conclusions: This paper reports the first case of spontaneous oral bleeding as a first clinical sign of a dentigerous cyst in a geriatric patient, with one year of follow-up. Clinicians should consider the possibility of dentigerous cysts in elderly patients and, on the basis of multidisciplinary evaluation with cardiologists and geriatrician doctors, choose the most effective treatment to reduce the risks of surgery.

Background: The aim of this study was to assess the neurological status and the condition of the brain in patients with ischemic heart disease.

Methods: We examined 170 patients, all men and middle age, with an average age of 58.6 years. All of them passed a neurological examination and a Mini-mental State Examination (MMSE) test. The brain examination was performed with the multi-spiral computer tomograph “Somatom Sensation 64 Siemens” (Germany). On a native multi-detector computed tomography (MDCT) of the brain, the ventriculocranial index Evance, the width of ventricle III, and the presence of leukoarayozis, cysts, and gliosis were estimated.

Results: The frequency of vestibulopathy syndrome was 24%, that of asthenia syndrome was 56%, that of mild cognitive impairment was 46%, and the average of the MMSE test results was 27 [26; 28] points.

The width of ventricle III was 7.6 ± 2.0 mm, the ventriculocranial index Evance was 3 – 4.2%, leukoarayozis was found in 26% of the patients, signs of cortical atrophy were found in 19% of the patients, and cysts were found in 5% of the patients. The average age of our patients was no more than 60 years, but the width of ventricle III corresponded to the expected values for the age category of healthy persons over 60 years old, and the values of the ventriculocranial index Evance corresponded to the age norms for healthy subjects over 70 years old.

Conclusions: Mild cognitive impairment, asthenia syndrome, and vestibulopathy syndrome are very common among patients with ischemic heart disease. Signs of cerebral angiopathy (leukoarayozis, cysts, width of ventricle III) indicate the vascular nature of neurological disorders.

Introduction: The diagnosis of infectious complications, in particular secondary bacterial meningitis, in patients who have undergone neurosurgical interventions is an urgent task, since, regardless of the cause of their occurrence, their differential diagnosis is an important factor in the successful treatment of patients. Aromatic metabolites of tyrosine, phenylalanine and tryptophan, determined by chromatography–mass spectrometry, are promising markers of infectious complications in patients of different groups. The goal of this study was to identify the aromatic metabolites that are clinically significant for the diagnosis of secondary bacterial meningitis in patients who have undergone neurosurgical interventions.

Methods: Residual cerebrospinal fluid (CSF) samples obtained from neurosurgical patients after routine laboratory analysis were analyzed by gas chromatography–mass spectrometry (n=82) and high-performance liquid chromatography–tandem mass spectrometry (n=29). The levels of 11 phenyl- and indole-containing acids were determined. Patients were divided into two groups depending on the presence or absence of signs of secondary meningitis based on the clinical picture and clinical and laboratory analysis of CSF.

Results: Chromatography–mass spectrometry methods were used to determine the levels of aromatic metabolites in CSF samples of neurosurgical patients at the level of μmol/L and nmol/L. Metabolite profiles were compared in groups of patients with or without signs of secondary meningitis. Statistically higher levels of 4-hydroxyphenyllactic (p = 0.005), phenyllactic (p = 0.002), 3-indolelactic (p = 0.006) and 3-indolecarboxylic (p = 0.027) acids were found in patients with signs of secondary meningitis.

Conclusions: CSF levels of aromatic microbial metabolites may be potential markers of secondary bacterial meningitis in patients undergoing neurosurgery.

Background: Developing nursing capacity worldwide includes training nurses to a doctorate level. Due to a global shortage of PhD nursing programs, a large number of nurses are pursuing their doctorates abroad. International nurse students frequently face challenges brought on by prejudice, discrimination, and stigma during their time studying internationally because of sociocultural differences. To the best of the authors' knowledge, there is limited research on the experiences of international nurse students. Therefore, the aim of this paper is to explore the experiences of international nursing students at Zhengzhou University.

Methods: This study employed a phenomenological approach among international nurse’s students at Zhengzhou University, China. Purposive sampling was used to select the participants. The sample size was determined by information saturation. A semi-structured interview guide was used. All data were recorded electronically during the interview. The conventional content analysis approach was employed to enable a deeper understanding and the formation of themes.

Results: In this study, ten international nursing students were interviewed. All the participants conveyed positive and negative feedback and their concerns, along with the challenges, prejudice, and discrimination that came with it. Two major themes were identified from the student data: situations outside the school (skin color, language, and sociocultural differences) and inside the school (expectations and reality of learning experiences, supervisory concerns, and lack of support from the school or university).

Conclusion: This study indicated that international nursing students experienced different challenges and concerns as an international nursing student. The university/school must create a culturally competent and good environment and create opportunities to visit clinical areas for international nursing students. To a greater extent, all students beginning their studies require some support as they transition to universities and acclimate to the new university context. Furthermore, the establishment of relationships between international and domestic students is crucial for the formation of future nurse–researcher communities of practice.

Breast cancer (BC) is one of the major causes of cancer death among women around the world, and the available therapeutic strategies still need to be improved. Monosaccharides, as a natural product, possess the capability to impair the growth of cancer cells, which has been confirmed, but the efficacy of L-arabinose on the epithelial–mesenchymal transition (EMT) of tumor cells remains unclear. In the present study, we found that L-arabinose treatment significantly influences EMT marker protein (N-cadherin, E-cadherin and Vimentin) expression and decreases migration and invasion potential in vivo and in vitro. Mechanistically, L-arabinose induced autophagy and abrogated the nuclear and cytoplasmic expression of β-catenin in BC cells. After adding the Wnt/β-catenin activator LiCl, the efficacy of s on the EMT of BC cells was reversed. Intriguingly, the expression of β-catenin was elevated by the suppression of autophagy using sh-Atg5 lentivirus under L-arabinose treatment. Here, we found L-arabinose contributed to the inhibition of the epithelial–mesenchymal transition (EMT) in breast cancer cells. Moreover, the suppressive effects of L-arabinose on the EMT were regulated by autophagy in BC cells. In addition, we demonstrated that L-arabinose affected the EMT via down-regulating the Wnt/β-catenin signaling pathway, which is dependent on autophagy. Thus, this study provides a novel potential drug for breast cancer therapy.

Musculoskeletal disorders are prevalent occupational health issues among construction workers. These disorders are a leading cause of reduced productivity, functional impairment, and lasting disability in this workforce.
This study aims to determine the prevalence and risk factors associated with musculoskeletal pain among construction workers in Al-Mukalla City.
A cross-sectional study was conducted in Al-Mukalla City, Yemen, from November 2022 to March 2023. A total of 378 construction workers, including general laborers, plumbers, electricians, bricklayers, tile setters, painters, carpenters, and blacksmiths, were interviewed using a structured questionnaire. Pain severity and interference were assessed using the Brief Pain Inventory (BPI) scores. The BPI scores were calculated as the mean of the severity and interference items. Respondents who had experienced pain in the past week rated their pain intensity at its worst, average, least, and current levels on a numerical scale ranging from 0 to 10.
Results: The findings indicated that 150 (39.7%) construction workers reported musculoskeletal pain, with bricklayers and general laborers showing the highest prevalence at 37.33% and 24%, respectively. Significant associations were observed between pain and factors, such as BMI, marital status, smoking, awkward posture, prolonged static positions, and work satisfaction. However, no significant associations were found between pain and educational level, type of work, or additional work. Lower back pain was the most common (59.33%), followed by knee pain (30.66%). Among workers with musculoskeletal pain, 53.3% reported moderate pain severity, 44.67% reported mild pain, and 2% reported severe pain. Pain interference with daily activities was mostly mild (74%), with some experiencing moderate interference (22%) and a minority facing severe interference (4%).
Conclusion: The study conducted in Al-Mukalla City highlights a high prevalence of musculoskeletal pain among construction workers, particularly affecting the lower back and knees. Overall, the pain severity was rated as moderate (mean= 3.51), with mild interference in most activities except for general activity and mood where pain had a moderate interference (mean= 3.81 and mean= 3.56, respectively).

The integration of Artificial Intelligence (AI) and telemedicine is transforming pediatric healthcare management, presenting unprecedented opportunities for improving the quality, accessibility, and efficiency of care. This review explores how these technologies impact pediatric healthcare, focusing on diagnostic accuracy, treatment personalization, and patient monitoring. AI-driven tools, including machine learning algorithms and natural language processing, enhance early diagnosis and intervention by analyzing vast datasets to identify patterns indicative of pediatric diseases. These tools support clinicians in making more informed decisions, reducing diagnostic errors and improving outcomes. Telemedicine, facilitated by advancements in communication technologies, extends the reach of pediatric care to remote and underserved areas, ensuring timely medical attention. Virtual consultations and remote monitoring enable continuous care for chronic conditions, reducing hospital visits and minimizing the risk of exposure to infectious diseases. Telemedicine also fosters better patient and family engagement, providing education and support through digital platforms. The synergy of AI and telemedicine offers a comprehensive approach to pediatric healthcare, combining both technologies' strengths to deliver personalized and proactive care. AI algorithms can process real-time data from telemedicine consultations, refining treatment plans and predicting potential health issues before they escalate. This integrated approach enhances clinical outcomes and optimizes resource allocation, reducing healthcare costs. India's eSanjeevani telemedicine platform, which has served over 241 million patients through more than 122,000 Health and Wellness Centers, exemplifies this integration. It ensures that specialized care reaches remote and underserved areas, improving clinical outcomes and optimizing resource allocation. Despite the promising benefits, challenges such as data privacy, algorithmic bias, and the need for robust regulatory frameworks must be addressed to ensure these technologies' safe and ethical implementation. This review highlights the critical role of AI and telemedicine in revolutionizing pediatric healthcare, underscoring the importance of continued research, collaboration, and policy development to fully realize their potential in improving children's health and well-being.

Integrated Bioinformatic Analysis of Diabetes Mellitus and
Cardiovascular Diseases' Shared Molecular Mechanisms

Introduction: Cardiovascular Diseases (CVDs) and Type 2 Diabetes Mellitus (T2DM) are
closely interconnected, sharing several molecular mechanisms. Notably, insulin resistance
and inflammation are common pathophysiological factors that contribute to the progression
of both conditions. Given that CVD is the leading cause of mortality in individuals with
T2DM, this study aims to explore these shared mechanisms to provide insights that could
inform the development of more targeted therapeutic strategies.

Aim: The primary aim of this research is to identify the shared molecular pathways and
mechanisms between CVDs and T2DM. Specifically, this study focuses on uncovering
differentially expressed genes (DEGs), curated pathways, common miRNAs, and other
related molecular factors that could contribute to the co-occurrence of these diseases.

Methods: A bioinformatic approach was utilized to analyze gene expression data, leading to
the identification of DEGs and the isolation of curated pathways and genes. The analysis was alsoextended to miRNAs and other chemicals associated with both CVDs and T2DM.

Results: This study identified four differentially expressed genes (DEGs) and one shared
miRNA, hsa-mir-223, which are potentially implicated in the development of both CVDs and
T2DM. Additionally, the analysis uncovered 6 curated genes, 37 curated chemicals, and 253
inferred pathways. The statistical analysis confirmed the significance of these findings, with
the DEGs showing a strong correlation (p < 0.05) between the two diseases.

Conclusion: The results highlight potential molecular interconnections between CVDs and
T2DM, providing a foundation for further research into the development of targeted
therapies. The findings underscore the importance of collaborative efforts among researchers,
clinicians, and the pharmaceutical industry to advance early detection, improve drug
development, and refine treatment strategies for individuals at risk or suffering from both
conditions.