Rooted in "the real human being and their practice", the humanistic thought of Traditional Chinese Medicine (TCM) encompasses four core dimensions: the Theory of Valuing Life and Attaining Sagehood, the Theory of Temperament and Human Nature, the Theory of Subject Mutual Benefit, and the Theory of Body-State Synchronism. It provides crucial support for the mutual learning of Chinese and Western medical humanities. The Theory of Valuing Life and Attaining Sagehood resonates with Western bioethics while adding a unique dimension of spiritual self-cultivation; the Theory of Temperament and Human Nature aligns with the precision medicine paradigm and complements the perspective of cultural ethical examination; the Theory of Subject Mutual Benefit firmly opposes the objectification of patients and theoretically expands the Western concept of "patient-centered care"; the Theory of Body-State Synchronism integrates individual physical and mental health with collective public well-being, aligning with the core values of contemporary global health governance. As an ideological system deeply embedded in Chinese civilization, it takes the Qi ontology and Yin-Yang balance as its profound metaphysical foundation, constructing a holistic medical humanistic paradigm independent of the Western biomedical model. In the contemporary academic context where medical humanities are moving toward pluralistic coexistence, the value of non-Western medical traditions has attracted increasing scholarly attention. It can not only enrich the Western medical humanistic tradition through cross-cultural dialogue but also provide solid ethical support for the global dissemination and clinical practice of TCM, ultimately realizing two-way mutual learning, complementarity and symbiosis between Eastern and Western medical humanities across cultures.
Child and Adolescent Mental Health Services (CAMHS) are currently marked by a paradox: growing public recognition of youth mental health difficulties coincides with increasingly fragile and underresourced services. Beyond organisational strain, the field is shaped by competing narratives about its mission and limits (hopeful progressivism which emphasises innovation, early intervention and developmental plasticity; on the other, defensive pessimism which foregrounds chronicity, clinical realism and institutional constraint. To examine how these competing narratives operate within CAMHS and to articulate an alternative orientation capable of supporting ethical clinical practice. A conceptual and narrative analysis drawing on medical humanities and social sciences perspectives, in particular the concept of moral economy, illustrated by a clinical vignette. Hopeful progressivism and defensive pessimism function as moral postures that distribute responsibility, legitimacy and emotional labour within institutions, with hope and cynicism operating as institutional currencies. Although seemingly opposed, both positions risk obscuring the structural determinants of care and relocating difficulties onto clinicians or families. Rather than choosing between optimism and cynicism, CAMHS may benefit from holding these narratives in productive tension through a dialogical, reflexive approach that re-centres families and re-politicizes the conditions of care. A form of realistic hope, grounded in developmental temporality and attentive to material conditions is essential to ethical and clinically meaningful care.
The study of human anatomy is foundational to education and research in the anatomical and health sciences. In 2012, the International Federation of Associations of Anatomists (IFAA) first published Recommendations to promote ethical practice in the acquisition of human remains for this purpose. In the intervening period, increased awareness of contemporary ethical issues and challenges in the discipline have made revision necessary. These revised Recommendations update and expand prior guidance to reflect evolving sociocultural expectations and technological developments, including revisions that address new concerns such as the international transfer of human remains. The 2026 Recommendations, developed by the Federative International Committee for Ethics and Medical Humanities (FICEM) of the IFAA, provide an updated framework to assist institutions in strengthening or establishing body donation programs to meet contemporary international ethical expectations. They also acknowledge that institutions may acquire human remains through avenues other than body donation programs, incorporating guidance around multiple aspects of good practice where use of human remains occurs. Through the use of these revised Recommendations, it is hoped the global anatomy community can continue to develop and apply ethical practices while promoting and supporting the sustainable use of human remains in anatomical education and research.
To explore the effect of comprehensive nursing on improving daily living ability in patients with adenomyosis through a retrospective analysis. A retrospective analysis was conducted on the data of 80 patients who underwent adenomyosis surgery at our hospital from October 2023 to March 2025. The patients were divided into a study group (comprehensive nursing) and a control group (conventional nursing) based on the nursing method, with 40 cases in each group. Propensity score matching was used to balance the baseline data of the two groups. The recovery indicators (postoperative exhaust time, fever time, first time to get out of bed, and hospital stay), Visual Analogue Scale (VAS) scores for pain, Hamilton Anxiety Scale (HAMA-l4) and Depression Scale (HAMD-24), Rosenberg Self-Esteem Scale, Quality of Life Scale, and Activities of Daily Living (ADL) Scale were compared between the two groups. There was no significant difference in clinical data between the two groups (p > 0.05). The postoperative exhaust time, fever time, first time to get out of bed, and hospital stay in the study group were all shorter than those in the control group (p < 0.05). After nursing intervention, the VAS, HAMA-l4, and HAMD-24 scores in the study group were lower than those in the control group (p < 0.05), while the Rosenberg Self-Esteem Scale and ADL scores were higher than those in the control group (p < 0.05). All sub-scores of the Quality of Life Scale (physical function, mental function, cognitive level, social relationships) in the study group were higher than those in the control group (p < 0.05). Comprehensive nursing can promote rapid postoperative recovery, improve daily living ability, alleviate pain and psychological states, and enhance quality of life in patients with adenomyosis, providing a reference for clinical intervention.
To evaluate the effects of a three-dimensional interconnected continuity of care intervention (hospital-community-family linkage) on self-care capacity, negative emotions, stigma, quality of life, and complication rates in patients with ostomies. A retrospective comparative study was conducted on 94 patients with intestinal or urinary ostomies treated from October 2021 to June 2024. Patients receiving routine nursing care were assigned to the control group (n = 47), while those receiving additional three-dimensional linked continuity care intervention were assigned to the observation group (n = 47). The intervention included enhanced follow-up, WeChat-based remote support, and scheduled home visits. Outcomes included compliance, self-care ability (ESCA), anxiety and depression (SAS, SDS), stigma (SIS), quality of life (Stoma-QOL), and complication rates. The observation group showed significantly higher total compliance than the control group (93.62% vs. 76.60%, p < 0.05). After intervention, ESCA scores improved more significantly in the observation group (all p < 0.05). SAS and SDS scores decreased more substantially in the observation group (p < 0.05). SIS subscores for economic discrimination, social exclusion, social isolation, and internalized shame were significantly lower in the observation group (p < 0.05). Stoma-QOL scores improved significantly, while the impact of the stoma bag decreased more markedly in the observation group (p < 0.05). The complication rate was also significantly lower in the observation group (12.77% vs. 29.79%, p < 0.05). Compared with routine nursing care, the three-dimensional interconnected continuity of care intervention was associated with improved compliance, self-care ability, and quality of life, while reducing negative emotions, stigma, and complication risks in patients with ostomies.
Financial toxicity (FT), encompassing objective and subjective impacts of cancer care costs, is linked to poorer quality of life, reduced treatment adherence, and higher mortality. While patient-level risk factors have been examined, a system-level perspective incorporating socioeconomic context is needed to understand global variation in FT. MEDLINE, CINAHL, Embase, and Web of Science were searched from inception to 06/27/2025 for peer-reviewed, English-language studies describing self-reported FT outcomes among adults with cancer. Reviewers extracted study characteristics, FT prevalence, predictors, and measurement tools. Financial, physical, and social asset measures from the World Bank were merged with FT data by study country and year of data collection. Focusing on studies reporting Comprehensive Score for Financial Toxicity (COST) scores, multilevel random effects meta-analysis was performed. Univariate and multivariate multilevel meta-regression evaluated relationships between country-level assets and COST. One hundred thirty-two studies from 22 countries were included, with FT prevalence ranging from 4.0% to 100.0%. Three-level meta-analysis of 75 COST-based studies (15 countries; 83,623 patients) yielded a pooled mean COST score of 21.2 (95% CI: 19.1-23.3; 95% prediction interval: 13.3-32.4), though substantial heterogeneity (I2 = 99.2%) and a predominance of studies from the US (55%) limited its standalone interpretability. Variance decomposition showed that 46% of heterogeneity was attributable to between-country differences. Higher log GDP per capita was associated with higher COST (β = 4.44, 95% CI: 2.90-5.98), explaining 43.1% of between-country variance. Higher out-of-pocket health expenditure, population-level financial hardship, and vulnerable employment were associated with worse FT. GDP associations were robust to sensitivity analyses excluding US-based studies. FT among cancer patients is linked to structural conditions governing access to education, employment, and financial systems, although expanded research in low-resource settings is needed. These findings highlight the roles of economic development strategies and investment in human capital in helping to safeguard against population-level FT.
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Social media is vital for improving healthcare access, especially among disadvantaged groups. During the COVID-19 pandemic, young breast cancer survivors (YBCSs) in China increasingly relied on social media for health information, shaping their experiences and needs. However, little is known about how their online behaviors changed during such crises. This study examines the characteristics and health needs of Chinese YBCSs on social media during the pandemic, providing evidence to inform public health management in emergencies. We used web crawlers to collect 6,415 breast cancer-related posts from Sina Weibo and Zhihu (November 30, 2017-May 31, 2022). Posts were filtered using operational criteria, combining manual screening and machine learning models. Text mining and natural language processing were applied to construct multidimensional user profiles across three pandemic phases: pre-pandemic, outbreak, and normalization. In total, 2,640 posts from YBCSs were included for analysis. YBCSs' online activity increased markedly during the outbreak (from 0.37 to 2.22 posts/hour), with peak engagement during leisure times but shorter active durations. Content shifted from treatment-focused discussions to collective encouragement and pandemic-related topics, then returned to disease management in the normalization phase. Sentiment was generally positive, with fluctuations during the outbreak and stabilization in the normalization phase (sentiment index 0.17-0.38). This study underscores the significant impact of the COVID-19 pandemic on YBCSs, highlighting shifts in temporal routines, content priorities, and emotions. The findings redefine the perspective on managing healthy lives of these vulnerable and fragile groups in the post-crises era, and emphasize the urgent need for timely health information support and equality in healthcare through social media platforms with machine-learning approaches.
Digital health technologies (DHTs) are transforming healthcare by enabling for example new care models, improving patient access and engagement, and streamlining healthcare workflows. They have the potential to increase efficiency, reduce administrative burdens, and enhance the overall quality of care. However, across Europe, DHTs evaluation frameworks remain fragmented, and while new approaches continue to emerge, they often focus on specific types of DHTs or particular stages of the product lifecycle. Moreover, traditional Health Technology Assessment (HTA) frameworks have been developed mostly to evaluate medicinal products, which may limit their applicability to DHTs, ultimately constraining health systems' ability to capture DHTs' added value. The European Digital Health Technology Assessment (EDiHTA) is a EU-funded project, which started in January 2024 to co-create an HTA framework for DHTs in order to face these challenges. It is aimed at co-developing together with different key stakeholders a comprehensive and flexible assessment framework tailored to different DHTs, applicable across DHTs lifecycle and across EU member states. In this perspective article, we present our concept design that is being used as foundation of the development of the EDiHTA framework, and we address current challenges in the assessment of DHTs, and the opportunities that lie ahead.
Translational biomedical research is increasingly collaborative and multimodal, making secure, high-quality data capture, curation, and analytics a major challenge. This work aims to provide an overview of existing medical research data platforms to support informed platform selection for translational biomedical research. As part of an ongoing Fraunhofer Request for Proposal (RFP) process, we developed a requirements assessment tool for users across the Fraunhofer ecosystem. In parallel, we compiled a structured overview of medical research data platforms through an open collaboration between academic and industry experts, who supplemented our market screening by identifying additional relevant platforms. Using a standardized questionnaire on key aspects of distributed data collaboration, we collected harmonized platform descriptions and organized them into a side-by-side overview with an accompanying feature weighting matrix. The study yielded a structured, comparative characterization of medical research data platforms across five functional classes, highlighting common strengths in security, interoperability, data quality, and multimodal data support. We devised (developed) a platform feature-partner weight matrix that enables context-sensitive platform scoring without imposing a predefined global ranking. In this way, users can align platform scoring with their specific translational research requirements. This structured, overview is intended to accelerate decision-making in the medical research community when choosing data platforms. By supporting context-sensitive, feature-weighted selection rather than one-size-fits-all comparisons, it acknowledges diversified research needs and can be updated as technologies and practices evolve.
Substance use during pregnancy is linked to adverse neonatal and longer-term outcomes in offspring, yet evidence syntheses have primarily focused on maternal outcomes. An umbrella review is needed to consolidate and critically appraise findings from systematic reviews on how interventions to treat substance use in pregnancy affect outcomes in offspring of pregnant women and pregnant individuals. We will conduct an umbrella review of systematic reviews (with or without meta-analysis) that include quantitative primary studies of pregnant women and pregnant individuals with substance use who receive pharmacological, psychosocial/behavioural, integrated care, or community-based interventions. Searches will cover MEDLINE (PubMed), Embase, Web of Science, Scopus, the Cochrane Database of Systematic Reviews and Epistemonikos from inception. Two independent reviewers will perform title/abstract screening, full-text screening, and data extraction at every stage; a third reviewer will arbitrate disagreements. Methodological quality of included systematic reviews will be assessed using AMSTAR 2; risk of bias of primary studies will be reported as appraised in the original systematic reviews. Overlap of primary studies will be quantified using the Corrected Covered Area (CCA), with attention to multi-arm studies and to whether overlapping primary studies actually answer the same PICO question. We will narratively synthesise findings (avoiding vote counting) and, where systematic reviews report pooled estimates, we will summarise these without conducting de novo meta-analyses of primary studies. Certainty of evidence will be reported using existing GRADE assessments, complemented by a structured umbrella-level appraisal that incorporates large effects and dose-response gradients when relevant. This umbrella review will clarify which interventions have the strongest evidence of benefit (or harm) for neonatal, congenital, neurodevelopmental, and behavioural/mental health outcomes in offspring, identify evidence gaps and methodological limitations, and inform clinical guidance and maternal-child health policy. PROSPERO CRD420261321678.
This article presents KannadaLit4NLP, a large-scale, machine-readable corpus of Kannada literary texts designed to support natural language processing (NLP) research for a low-resource language. The dataset comprises 24,746 literary verses from three major Kannada literary traditions-Vachanas (11th-19th century), Tripadis (16th century), and Kagga (20th century)-along with 22,369 corresponding interpretations curated from scholarly sources. The corpus captures linguistic, stylistic, and semantic variations across historical periods and literary forms. The dataset was developed through a systematic pipeline that included source identification, digitisation via optical character recognition (OCR), manual verification, and structured annotation. Each entry is organised in a structured format that includes the original verse, metadata (literary form, author, and source), and associated interpretation(s), enabling its use in tasks such as semantic textual similarity, textual entailment, information retrieval, and generative modelling. KannadaLit4NLP addresses the limited availability of culturally grounded Kannada datasets by providing a resource that integrates classical and modern literary content with interpretative annotations. The dataset can facilitate the development and evaluation of NLP models in areas such as semantic understanding, translation, and knowledge representation, while also supporting computational studies of literary and cultural texts. The dataset is made publicly available to encourage further research and reproducibility in Kannada NLP.
Loss of facial structures due to trauma, congenital anomalies, or ablative surgery induces profound psychosocial consequences that impact beyond functional impairment. While rehabilitation with advanced prosthetic materials have improved esthetics and comfort, standardized measurement of psychosocial outcomes remains limited. To assess psychosocial reintegration following maxillofacial prosthetic rehabilitation using a modified Psychosocial Impact of Assistive Devices Scale (PIADS-10) and to support the findings through a focused review of the literature. A case series of five patients who reported with maxillofacial defects as a result of trauma and ablative surgery rehabilitated with customized orbital and ocular prosthesis were evaluated. A PIADS-10, adaptation tailored to maxillofacial prosthesis was recorded pre rehabilitation and 4 weeks postrehabilitation. The changes across competence, adaptability, and self-esteem domains were analyzed. The prerehabilitation PIADS scores showed substantial negative psychosocial impact particularly in self-confidence, perceived appearance, social participation, and ease of daily activities. It was observed that following prosthetic rehabilitation all the domains showed a positive shift, with greatest scores in social participation (+3), satisfaction with facial expression (+3), and overall quality of life (+3). Customized maxillofacial prosthetic rehabilitation yields significant benefits as evident with the PIADS-10 noted in this study. Incorporating structured PROMs supports patient-centered care and strengthens the evidence for prosthetic interventions.
Cell Structure and Function (CSF), the official journal of the Japan Society for Cell Biology (JSCB), celebrates its 50th anniversary in 2025. This essay traces the scientific evolution of CSF from its founding in 1975 to the present, drawing on bibliometric data retrieved from OpenAlex at ten-year intervals. Over five decades, CSF published 1,737 articles, with the Field-Weighted Citation Impact (FWCI) showing a consistent upward trend, even as total output declined following the journal's shift to electronic publication in 2005. A decade-by-decade analysis of the five most-cited articles reveals a clear evolution in research themes: early issues were dominated by plant cell biology and methodological papers in microscopy and biochemistry, while subsequent decades saw increasing focus on autophagy, the unfolded protein response, and intracellular membrane trafficking-fields in which Japanese researchers have played globally recognized pioneering roles. The turn of the millennium marked a peak in absolute citations, with landmark papers on bafilomycin A1, SNARE proteins, and a review of autophagy co-authored by Nobel Prize laureate Yoshinori Ohsumi. Two major milestones-electronic publication in 2005 and gold open-access adoption in 2016-fundamentally transformed the journal's publishing model. Looking ahead, the essay considers the role of artificial intelligence in peer review, arguing that while AI can assist in assessing novelty and reproducibility, the judgment of a manuscript's scientific significance must remain a human responsibility. CSF remains committed to disseminating reliable, foundational cell biology to the international community.Key words: Cell Structure and Function (CSF), bibliometrics, open access, artificial intelligence in peer review.
CLL patients have immune deficiencies and are at high risk of SARS-CoV-2 infection. Limited research exists on risk factors and survival outcomes of SARS-CoV-2 infection in Asian CLL patients during the COVID-19 pandemic. Therefore, this study aims to explore the relationship between SARS-CoV-2 infection and survival in this population. A retrospective analysis was conducted on 119 CLL patients treated at a large tertiary comprehensive hospital in western China from January 2020 to May 2023, coinciding with a surge in the epidemic in the city. (1) During the epidemic, the treatment group had a higher proportion of males, second-line and initial treatment, 11q- chromosome, LDH level, and lower erythrocyte count (P < 0.05). Patients in this group had longer median duration of malaise, more headaches and coughs, longer cough and sputum duration, higher rates of hyposmia, and more patients received antiviral treatment for COVID-19 and suffered weight loss. The treatment group had more CLL patients affected by SARS-CoV-2, and more patients developed secondary COVID-19 infection, and had lower RBC count and hemoglobin levels (P < 0.05). (2) Compared to the non-BTKi treatment group, more patients in BTKi treatment received treatment lasting ≥ 1 month, more had abnormal karyotyping, high-risk cytogenetics, less recent cytotoxic drug and rituximab exposure, lower lymphocyte count, elevated creatinine level, and lower glomerular filtration rate (P < 0.05). (3) Firth's penalised-likelihood logistic regression revealed that male sex increased hospitalization risk, while normal karyotyping decreased this risk. Male sex and recent rituximab exposure (within 6 months) were SARS-CoV-2 infection risk factors. Both frontline and second-or-more line therapies were associated with higher SARS-CoV-2 mortality risk compared to untreated patients (all P < 0.05). Male sex and recent exposure to rituximab within the past six months are risk factors for SARS-CoV-2 infection in CLL patients. Both frontline and second-or-more line therapies are risk factors for mortality (compared to untreated patients). Treatment with BTK inhibitors does not increase the risk of SARS-CoV-2 infection or mortality.
Patients with obstructive sleep apnea (OSA) are at increased risk of perioperative complications, such as hypoxemia, respiratory depression, and airway obstruction. This study aims to evaluate the effectiveness of individualized nursing in the perioperative management of patients with OSA. We retrospectively analyzed 107 patients with OSA undergoing elective surgery between January 2023 and January 2025, who were allocated to a conventional group (n = 55) or an individualized group (n = 52) according to the nursing approach. Perioperative respiratory safety (postanesthesia care unit [PACU], minimum oxygen saturation [SpO2], Aldrete score, and respiratory adverse events within 48 h), analgesia and functional recovery (visual analog scale [VAS] scores, opioid consumption, time to first ambulation), postoperative Epworth Sleepiness Scale (ESS) scores, continuous positive airway pressure (CPAP) adherence, Short Form-36 (SF-36) quality of life, complications, ICU transfer, length of stay, and hospitalization costs were compared between groups. Compared with the conventional group, the individualized nursing group showed significantly higher PACU minimum SpO2 (p = 0.001) and Aldrete scores (p < 0.001), a lower incidence of postoperative respiratory adverse events within 48 h (p < 0.05), reduced 24-h and 48-h VAS scores and opioid consumption (p < 0.05), and earlier ambulation (p < 0.001). During the 6-month follow-up, the individualized group demonstrated lower ESS scores, improved CPAP adherence, and greater improvements across all SF-36 domains (all p < 0.001), as well as reduced overall complications, ICU transfer rates, length of hospital stay, and hospitalization costs (p < 0.05). Individualized nursing is associated with improved perioperative respiratory safety and recovery quality, better long-term sleep outcomes and quality of life, and reduced complications and healthcare resource use in patients with OSA.
Depression is a prevalent neuropsychiatric disorder that poses a significant global health burden. However, current pharmacotherapies are limited by adverse effects and substantial interindividual variability in efficacy. Medicine food homology (MFH), characterized by high safety and suitability for long-term use, has emerged as a promising complementary approach for depression management. This review summarizes the nutritional and functional properties of MFH, with emphasis on the antidepressant potential of MFH. Major bioactive constituents, including saponins, polysaccharides, alkaloids, polyphenols, and flavonoids, are discussed in relation to their regulatory effects on depressive symptoms. Representative MFH materials, such as lily, rehmannia, ginseng, saffron, panax notoginseng, and suanzaoren, are highlighted based on extensive experimental and emerging clinical evidence. However, there are still several challenges in the research on the antidepressant effects of MFH. These include unclear mechanisms of action, insufficient identification of active compounds, lack of standardized quality control, and limited large-scale clinical validation. Overall, MFH represents a safe and promising therapeutic strategy for depression. It also holds considerable potential to support the modernization of traditional Chinese medicine and to improve public mental health.
The present study aimed to design, develop, and validate a training package for treating student procrastination based on grounded theory. In the first phase, a qualitative grounded theory study was conducted to develop this intervention. The study population consisted of students enrolled at the Persian Gulf University in the academic year 2023-2024. In the quantitative phase of this study, a quasi-experimental pre-test-post-test control group design was employed. A multi-stage random sampling technique was used to select participants. The procrastination questionnaire was randomly distributed to 1000 students from the Persian Gulf University, stratified by faculty, major, and year of entry. The findings indicated that the procrastination treatment package was effective in reducing procrastination among students.
Child mental health represents a global public health priority. However, evidence regarding the association between family income and mental health among preschool children in Western China remains limited, and the potential indirect role of parental depressive symptoms has not been fully examined. This cross-sectional study included 21,366 preschool children (aged 3-6 years) and their parents in Western China. Family income was classified into low, middle, and high groups. Child mental health outcomes (total difficulties and prosocial behavior) were assessed using the Strengths and Difficulties Questionnaire (SDQ), and parental depressive symptoms were measured via the Center for Epidemiological Studies Depression Scale (CES-D). Multivariable logistic regression and mediation analyses were performed, adjusting for relevant covariates. Higher family income was significantly associated with a reduced risk of child mental health problems and increased prosocial behaviors. Compared with low-income families, middle- and high-income families had 27 and 39% lower odds of total difficulties, and 9 and 30% higher odds of prosocial behavior, respectively. Parental depressive symptoms accounted for 30.5 and 44.3% of the associations with total difficulties, and 57.2 and 43.8% of the associations with prosocial behavior, in middle- and high-income groups, respectively. Family income is associated with preschool mental health in Western China, with parental depressive symptoms playing a substantial indirect role. These findings provide population-level evidence for understanding early childhood mental health in understudied regions of China.
Poly(ADP-ribose) polymerase (PARP) inhibitors have made significant advances in the treatment of breast cancer, especially in tumors with homologous recombination deficiency such as BRCA1/2-mutated cancers. Nevertheless, intrinsic and acquired resistance restrict their clinical usefulness in the long term. This review synthesizes existing evidence about the biological roles of PARPs and the molecular aspects of resistance to PARP inhibition in breast cancer. The major mechanisms of resistance are restoration of homologous recombination, loss of 53BP1, stabilization of replication forks, increased drug efflux, loss of PARG and epigenetic changes. We also discuss the interaction of PARP signaling with key therapeutic pathways, including endocrine, HER2-targeted, and PI3K/AKT signaling and contributes to the tumor microenvironment modulation and immune evasion. Notably, the next-generation PARP1-selective inhibitors, rational combination therapies, and biomarker-guided treatment approaches are emerging strategies that can be used to overcome resistance. All of these observations point towards the necessity to combine mechanistic knowledge with clinical innovation to enhance the selection of patients and the sustainability of therapy. The development of biomarker-mediated and combination approaches will play a vital part in increasing the efficacy of PARP inhibitors and the results achieved among patients with breast cancer.