Postoperative wound infections (surgical site infections, SSIs) remain among the most clinically and health-economically significant nosocomial infections worldwide. In Germany, according to current evidence and guideline recommendations, they play a leading role and-according to the S3 guideline on perioperative antibiotic prophylaxis-rank first among nosocomial infections [1]. The aim of the present work is to summarize the current evidence on prevention, diagnostics, and modern management of postoperative wound infections in otorhinolaryngology, with a particular focus on site-specific risk constellations and evidence-based preventive strategies. A narrative literature review of current guidelines, clinical studies, and review articles on the treatment of infected wounds in the head and neck region as well as on the use of modern wound dressings and riskassessment systems was performed. The use of structured risk assessments, e.g., the wounds-at-risk score or the therapeutic index for local infections (TILI), facilitates early identification of wounds at risk of infection. Modern wound care materials such as hydrophobic or silver-containing dressings support antiseptics in infection control and promote wound healing. A multimodal therapeutic approach consisting of surgical debridement, targeted antimicrobial therapy, and stage-appropriate wound care improves the course of healing. Systematic risk assessment enables early intervention and may reduce complications. HINTERGRUND: Postoperative Wundinfektionen („surgical site infections“, SSI) zählen weltweit weiterhin zu den klinisch und gesundheitsökonomisch bedeutsamsten nosokomialen Infektionen. In Deutschland nehmen sie nach aktueller Evidenz und Leitlinienempfehlungen eine führende Rolle ein und stehen gemäß der S3-Leitlinie zur perioperativen Antibiotikaprophylaxe an erster Stelle der nosokomialen Infektionen [1]. Ziel der vorliegenden Arbeit ist es, die aktuelle Evidenz zur Prävention, Diagnostik und modernen Versorgung postoperativer Wundinfektionen in der HNO-Heilkunde zusammenzufassen, mit besonderem Fokus auf lokalisationsspezifische Risikokonstellationen und evidenzbasierte Präventionsstrategien. Narrative Literaturübersicht aktueller Leitlinien, klinischer Studien und Übersichtsarbeiten zur Behandlung infizierter Wunden im Kopf-Hals-Bereich sowie zum Einsatz moderner Wundauflagen und Risikobewertungssysteme. Der Einsatz strukturierter Risikoassessments, z. B. des Wounds-at-Risk (W.A.R.)-Scores oder des therapeutischen Index für lokale Infektionen (TILI-Score), erleichtert die frühe Identifikation infektionsgefährdeter Wunden. Moderne Wundversorgungsmaterialien wie hydrophobe oder silberhaltige Wundauflagen können Antiseptika bei der Infektkontrolle unterstützen und die Wundheilung fördern. Ein multimodales therapeutisches Vorgehen, bestehend aus chirurgischem Débridement, gezielter antimikrobieller Therapie und phasengerechter Wundversorgung, verbessert den Heilungsverlauf. Eine systematische Risikobewertung ermöglicht frühzeitige Interventionen und kann Komplikationen reduzieren.
Lecture-based learning (LBL) and case-based learning (CBL) are widely used teaching methods across disciplines, especially in medical and health sciences education. However, both methods may fail to fully engage students' intrinsic motivation for active participation. The aim of this study is to combine integrated whole-course clinical learning (IWCL) with CBL in the context of an undergraduate clerkship in otolaryngology. A total of 79 undergraduate students participated in this project and were assigned to one of two groups. The first group received the IWCL combined with the CBL teaching model and was designated the IC group, whereas the second group received the LBL combined with the CBL teaching model and was designated the LC group. Differences between the two groups in terms of teaching effectiveness during the otorhinolaryngology clinical clerkship were evaluated using multiple outcome measures, including specialty physical examination proficiency level, admission note documentation quality, anatomical proficiency level, and satisfaction with the teaching model. Comparison of specialty physical examination proficiency between the IC and LC groups revealed no significant difference. However, the results suggest potential advantages of the IC approach across several key domains, including admission note documentation quality and level of anatomical proficiency. In addition, the students in the IC group achieved higher subject scores. Moreover, compared with the LC group, the IC group exhibited higher levels of satisfaction in dimensions. The combined teaching model includes the strengths of CBL, emphasizing case analysis, interactive participation, and continuous clinical engagement. As a result, the IC group exhibited a clear advantage over the LC group in terms of overall teaching effectiveness.
Digital interventions are increasingly used to support hearing aid users; however, evidence for first-time hearing aid users remains unclear. This systematic review and meta-analysis evaluated the efficacy and effectiveness of digital interventions to improve outcomes for first-time hearing aid users. The protocol was pre-registered (PROSPERO; CRD420251125785) and conducted in accordance with PRISMA 2020. PubMed, Scopus, and Web of Science were searched (January 2026). Eligible studies included randomized controlled trials, controlled clinical trials, and quasi-experimental studies evaluating internet-, app-, or web-based interventions. Outcomes were grouped into six domains: hearing aid use, benefit and satisfaction, hearing and communication, knowledge, skills and self-management, speech-in-noise performance, and psychosocial and emotional adjustment. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE. Random-effects meta-analyses were conducted where ≥3 randomized trials reported comparable outcomes. Eleven publications (nine trials) were included. Most interventions focused on education, self-management, and counseling, with few targeting perceptual training. The most consistent improvements were observed in knowledge, skills and self-management (moderate-certainty). Evidence for hearing aid use, benefit and satisfaction, hearing and communication, and psychosocial and emotional adjustment was limited and inconsistent (low-certainty), while speech-in-noise evidence was of very low certainty. Meta-analyses of hearing aid use and IOI-HA outcomes showed no significant pooled effects. Digital interventions show the most consistent evidence for improving knowledge, skills, and self-management. Evidence for other outcomes remains limited and inconsistent. Clinicians may consider digital educational programs complementing standard care. Future research should prioritize larger, pre-registered trials with broader interventions and standardized outcomes.
Unlike some other sensory systems, the sense of smell does not benefit yet from a ready-to-use or advanced olfactory implant or prosthesis. The principle of an olfactory implant rests upon volatile compounds that are captured by sensors mimicking the olfactory epithelium, translating them into different stimulation patterns which are then sent to central brain structures. The potential of stimulating a brain structure that does not seem to belong to the primary olfactory pathway, but is part of olfactory networks, has to our knowledge not been considered. We report a case series of patients with pharmacoresistant epilepsy who underwent stereoencephalography (SEEG) for diagnostic reasons, including intracranial stimulation. Firstly, the patients performed a task of passive smelling of two odors (peach and fish), during which electroencephalographic signals were recorded. In a second phase, intracranial electrical stimulation was applied. In two patients, this evoked olfactory sensations specifically after stimulation respectively of the amygdala or temporal pole. Based on these observations, a post-hoc analysis of the SEEG data from the passive smelling task was conducted, focusing on these two structures. Functional connectivity measures have been calculated in different frequency bands using the amygdala or the temporal pole as seeds. Although conclusions are limited due to the small sample size, the results along with the literature underline the interest of considering non-primary olfactory structures, such as the temporal pole, as a contributor to olfactory processing. The efficacy of a potential olfactory implant may rely not only on the primary location of stimulation, but also in the type of oscillations elicited and potential engagement of association brain structures.
Despite the prevalence of neurogenic chronic cough (NCC), treatment options remain limited. This study investigates selective laryngeal cryotherapy (SLC) as a potential sensory neurolytic therapy. The primary objective was to explore the feasibility and safety of SLC, while the secondary objectives assessed efficacy in the reduction of laryngeal hypersensation and cough symptoms. Patients with refractory NCC were prospectively recruited. Patients underwent laryngeal laser sensory testing (LST), immediately followed by awake SLC treatment. Cough measures including the cough severity index (CSI) and urge to cough visual analog scale (UTC-VAS) were collected at baseline and regular intervals. At 1-month postprocedure, additional LST was performed. Safety, tolerability, and adverse events were recorded. Thirty patients with NCC were enrolled. All patients successfully completed awake SLC. There were no serious adverse events or unanticipated adverse device effects. 21% of patients experienced at least one treatment-emergent adverse event, all of which self-resolved within 2 days. Post-SLC patients had a higher mean laser power threshold, 7.5 W (SD 2.42) to trigger a cough response compared to their baseline threshold of 2.8 W (SD 2.76) (p < 0.001). By 6 months, patients demonstrated sustained improvement compared to their baseline, with a reduction in CSI of -8.25 (95% CI 11.60, -4.91) (p < 0.001) and UTC-VAS -18.07 (95% CI -29.71, -6.43) (p = 0.003). The data suggest that awake laryngeal cryotherapy is feasible, tolerable, and safe. SLC reduced laryngeal hypersensitivity, and while it is a promising treatment option for neurogenic cough, further research is required to confirm its long-term effectiveness.
To examine clinically-meaningful benefit that may be achieved by early adenotonsillectomy (eAT) vs. watchful waiting with supportive care (WWSC) in children with mild sleep-disordered breathing (MSDB, snoring but little or no obstructive sleep apnea), and to identify baseline demographic, symptom, physical exam, historical, or polysomnographic features that may predict such benefit. Secondary analysis of participants (aged 3.0-12.9 years) in the 12-month multi-center randomized clinical trial of eAT vs. WWSC for MSDB, the Pediatric Adenotonsillectomy Trial for Snoring (PATS). Meaningful benefit was defined as a composite outcome of clinically-significant change in at least 2 of 4 domains - behavior, quality of life, subjective sleepiness, and blood pressure - each of which had shown greater improvement 12 months after AT versus WWSC in PATS. Among 363 participants, the mean age was 6.6 (SD 2.3) years, 199 (55%) were > 5 years old at enrollment, and 185 (51%) were male. A total of 115 (65%) vs. 73 (39%) in the eAT vs. WWSC arms, respectively, experienced clinically-meaningful improvement on ≥2 domains (p < 0.01). Among variables explored for effect modification - including demographics, health factors, symptoms and signs, and polysomnographic data - only a high Mallampati score of III or IV vs. I or II showed predictive value (OR 4.16, 95% CI [1.22, 15.6], p = 0.027). Clinically-meaningful positive outcomes occur more often after eAT vs. WWSC for children with MSDB. However, many clinical features accessible prior to AT, with the intriguing exception of a high Mallampati score, may not help to identify which children stand to benefit. Pediatric Adenotonsillectomy for Snoring (PATS); HYPERLINK "https://clinicaltrials.gov/study/NCT02562040;" https://clinicaltrials.gov/study/NCT02562040; Registration number: NCT02562040.
The vestibular-organ site that is responsible for vertigo-associated idiopathic sudden sensorineural hearing loss (ISSNHL) has not been identified clearly. To analyze the function of each semicircular canal (SCC) separately in patients with vertigo-associated ISSNHL. ISSNHL patients with or without vertigo (n = 19 each) underwent a video head impulse test. Their vestibulo-ocular reflex (VOR) and catch-up saccades (CUS) were recorded. As for the affected side, the VOR gains of the lateral and posterior SCCs were lower in the vertigo group versus the nonvertigo group. The percentage of patients with decreased VOR gains of the posterior SCC and those with CUS (+) for the lateral and posterior SCCs were higher in the vertigo group versus the nonvertigo group. In the vertigo group, the VOR gain was lower in the affected side in all SCCs. The percentage of patients with decreased VOR gains and that with CUS (+) were higher for the posterior SCC in the affected side versus the unaffected side. The posterior SCC was predominantly impaired in patients with vertigo-associated ISSNHL. Considering the vascular anatomy of the inner ear, these results indicate that a microcirculatory disturbance plays a crucial role in the pathophysiology of ISSNHL.
This Viewpoint advocates for establishing Current Procedural Terminology (CPT) codes for tracheostomy tube exchange and decannulation.
Post-thyroidectomy scars remain a major concern that adversely impacts the patient's quality of life despite surgical advancements. Recently interventions such as laser and Botulinum toxin type A (Botox) have emerged to enhance the cosmetic outcome of these operations. To evaluate the effectiveness of laser and Botox in treating post-thyroidectomy scars. We conducted searches through various databases involving PubMed, Scopus, Web of Science, and Cochrane Library from inception until February 2025. Studies evaluating the effectiveness of laser or Botox for managing post-thyroidectomy scars were included. Our study outcomes were the modified Stony Brook Scar Evaluation Scale (mSBSES), Vancouver Scar Scale (VSS), Patient Scar Assessment Scale (PSAS), and Observer Scar Assessment Scale (OSAS). Continuous data were pooled as mean difference (MD) with 95% confidence interval (CI). In total, 24 studies encompassing 919 patients were included. Our pooled effect estimate revealed higher mSBSES scores in patients treated with Botox compared to placebo (MD = 1.69, 95% CI [0.17 to 3.22], P = 0.03). Additionally, the laser plus steroid therapy showed a significant reduction in PSAS score (MD = -10.77, 95% CI [-14.03 to -7.51], P = 0.001) and OSAS score (MD = -6.11, 95% CI [-9.63 to -2.60], P = 0.001) compared to control group. Botox and laser therapy showed promising results in improving the cosmetic outcomes of post-thyroidectomy scars. Due to the significant heterogeneity in the intervention protocols, assessment durations, and different scar assessment tools, further studies with standardized intervention protocols and assessment methods are required. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Ménière's disease (MD) is a chronic vestibular disorder that significantly impacts patients' quality of life (QoL). However, the influence of comorbid conditions on QoL in MD patients remains inadequately explored. To investigate the prevalence of comorbidities in patients with MD and analyze their impact on patients' QoL. A cross-sectional analysis was conducted on 473 MD patients who received treatment in our hospital. Demographic data, comorbidity information, psychological symptoms (assessed by Hospital Anxiety and Depression Scale, HAD) and QoL (evaluated by Ménière's disease Quality of Life Questionnaire, MDoQ) were collected. Spearman correlation analysis was used to explore the relationship between comorbidities and QoL scores, and independent-samples t-test was applied for intergroup comparison. A multiple linear regression analysis was conducted to identify comorbidities influencing MDoQ. The study included 328 females (69.3%) and 145 males (30.7%) with a mean age of 45.6 ± 14.5 years and an average disease duration of 4.5 ± 2.0 years. The most common comorbidities were hypertension (49.0%), sleep disorders (36.6%), and diabetes mellitus (28.8%). Clear anxiety symptoms were observed in 59.2% of subjects, whereas distinct depressive symptoms were detected in 53.9%. The mean MDoQ score was 43.62 ± 12.50 (range: 25-76). Correlation analysis revealed that hypertension (r = -0.521, p < 0.001), diabetes mellitus (r = -0.459, p < 0.001), sleep disorders (r = -0.447, p < 0.001), anxiety (r = -0.438, p < 0.001) and depression (r = -0.391, p < 0.001) were strongly negatively correlated with MDoQ scores. Multiple linear regression analysis showed that hypertension, diabetes, sleep disorder, migraine, thyroid disease and anxiety symptoms were significant factors affecting the QoL of patients with MD (F = 114.18, p < 0.001). Comorbidities are highly prevalent in MD patients, with hypertension, sleep disorders and diabetes mellitus being the most common. These comorbidities, together with the high incidence of anxiety and depression, significantly impair patients' QoL. Comprehensive management of MD should include systematic screening, early intervention for common comorbidities and psychological support to improve patients' clinical outcomes and QoL.
While both cannabis and music have demonstrated significant independent impacts on emotional states, the synergies between these two modalities remain underexplored. This study investigates the interactions between cannabis consumption and music listening, focusing on their effects on emotional experiences, mood regulation, and sensory perceptions. An online cross-sectional survey consisting of 176 questions was administered to 122 cannabis users. The survey captured detailed information on demographics, cannabis use patterns, music engagement behaviors, emotional responsiveness, and the interplay between cannabis and music perception. Most participants viewed the combination of cannabis and music favorably, reporting enhanced relaxation, improved mood, and increased feelings of connection. Cannabis use was also associated with altered responses to imposed music in various settings and a heightened likelihood of using music during routine activities. In addition, participants frequently reported the use of cannabis as a substitute for pharmaceutical treatments for pain, anxiety, and sleep disorders, with music further amplifying these therapeutic effects. However, no significant differences were observed in overall music reward experiences with or without cannabis, highlighting the nuanced and context-dependent nature of these interactions. These findings provide novel insights into the potential for cannabis and music to act as complementary tools for emotional well-being, underscoring the need for further research to elucidate the mechanisms underlying their combined effects. This study provides a foundation for future investigations into the therapeutic integration of music as a supportive adjunct to cannabinoid-based interventions targeting emotional and psychological health.
Heterozygous mutations of the gene encoding caspase-8 protease occur in 10% of human head and neck squamous cell carcinomas (HNSCCs). Cell line studies indicate that these mutations block apoptosis induced by death ligands. However, the in vivo role of caspase-8 mutations in the development of HNSCC and their impact on response to immune checkpoint blockade have not been determined. We generated mice with heterozygous, epithelium-specific knock-in of a representative, HNSCC-associated caspase-8 mutation (D305G). The impact of the caspase-8 mutation was assessed following treatment with the carcinogen 4-nitroquinoline-1-oxide (4NQO) in drinking water. Treatment of the D305G caspase-8 mutant mice with 4NQO resulted in a greater number of tongue tumors per mouse and a higher percentage of advanced-stage invasive carcinomas than was observed in 4NQO-treated mice with wild-type caspase-8, and tumors from the mutant mice were more resistant to anti-PD-1. We also engineered the murine oral cancer cell line MOC1 for heterozygous expression of caspase-8 mutations. Tumors generated from these engineered cells in syngeneic, immunocompetent mice demonstrated reduced responsiveness to anti-PD-1, relative to tumors with wild-type caspase-8. Further, the caspase-8 mutant tumors displayed reduced intratumoral and splenic CD8+ T cells and impaired recruitment of monocytes and dendritic cells during PD-1 blockade. Collectively, these findings demonstrate that caspase-8 mutation promotes carcinogen-induced HNSCC development and resistance to anti-PD-1. Investigation of caspase-8 mutations as potential biomarkers of poor response to immunotherapy in patients with HNSCC is warranted.
Access to audiological services and support for individuals with hearing loss varies widely across low- and middle- income countries (LMICs) and high-income countries (HICs). This study examines disparities in the availability of audiological services across World Bank income groups. An international cross-sectional survey was developed and distributed by the Global Otolaryngology Head and Neck Surgery Initiative. The survey evaluated the availability of audiology and support services across countries. Multiple responses from one country were combined into one entry. Statistical significance between groups was assessed using chi-squared tests.Study Sample: A total of 135 responses were received from 47 countries (30 LMICs and 17 HICs). Significant disparities were identified across most service categories. HICs reported greater availability of newborn hearing screening, diagnostic tests, paediatric and adult hearing assessments, vestibular services, and hearing technologies compared to LMICs. Advanced diagnostic tools and hearing devices such as cochlear implants were significantly more accessible in HICs. Substantial differences were observed in audiological and rehabilitative services across HICs and LMICs. Efforts to bridge significant gaps are essential for achieving equitable hearing health care worldwide.
Hypopharyngeal squamous cell carcinoma (HSCC) is often diagnosed at an advanced stage and characterized by poor prognosis. While primary (chemo)radiotherapy is frequently preferred for early and intermediate stage disease, total laryngopharyngectomy (TLP) remains the gold standard for the primary treatment of locally advanced tumors and for salvage treatment of residual and recurrent HSCC. However, reconstruction of a circumferential hypopharyngeal defect is challenging. This retrospective cohort analysis evaluates the oncological and functional outcomes of TLP with free jejunal transfer (FJT). 22 patients with histopathologically confirmed HSCC requiring TLP with FJT were included. Data on patient demographics, tumor characteristics, and functional and oncological outcomes were analyzed with overall survival (OS) as primary outcome. Overall, 22 patients were included (18.2% female, mean age 65.6 years). Mean follow-up time was 3.9 years. Primary and salvage TLP was performed in 8 (36.4%) and 14 (63.6%) patients respectively. All primary tumors were stage IV. In the salvage group, patients had disease stage II (n = 1, 7.1%), III (n = 5, 35.7%) and IV (n = 8, 57.1%). Successful FJT was achieved in 95.5% of patients with only 1 FJT failure (4.5%). Pharyngocutaneous fistula (PCF) formation was the most common complication and was observed in 6 patients (27.3%); 2 were managed conservatively and 4 required surgical intervention. No in-hospital deaths were encountered. Two- and five-year OS rates were 52.3% and 26.9%, respectively. Disease-specific survival (DSS) rates were 54.7% and 42.8% respectively. Complete oral intake and voice rehabilitation were achieved in 68.2% and 52.3% of patients respectively. FJT deserves its place in the reconstructive armamentarium following TLP. Oncological outcomes are good and functional outcomes are acceptable but there is room for improvement.
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Identifying individuals who undergo cognitive decline is vital to the success of prevention trials that aim to slow cognitive decline. Yet, the benefits of using blood-based biomarkers of neurodegeneration, as well as amyloid and tau, to enrich population-based prevention trials have not been quantified. The association of thresholds of Quanterix single molecule array (SiMoA) assays with subsequent change in cognition was estimated in the Atherosclerosis Risk in Communities cohort (N = 1826) using linear mixed effects models, validated in the Multi-Ethnic Study of Atherosclerosis cohort (N = 383), and extended to Alamar Nucleic acid Linked Immuno-Sandwich Assay (NULISA) assays in the Aging and Cognitive Health Evaluation in Elders cohort (N = 552). Elevated plasma biomarker levels identified dementia-free older adults with faster cognitive decline. By selecting participants with Quanterix SiMoA measurements of neurofilament light > 30.65 pg/mL, the sample size needed to detect a 33% reduction in cognitive decline in a clinical trial decreased by 57%. Clinical trials can use plasma biomarkers as a screening tool to increase statistical power.
Immune checkpoint inhibitors (ICIs) which target immune checkpoint proteins like programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) have revolutionized cancer therapy. Skeletal toxicities are emerging immune-related adverse events for patients treated with ICIs, and PD-1 blockade in pre-clinical mouse models significantly reduces bone mass. However, the effect of PD-L1 inhibition on the bone throughout development is not well understood. We investigated the role of PD-L1 loss on bone microarchitecture with genetic PD-L1 knockout in myeloid cells using LysM-Cre;PD-L1Flox/Flox mice and pharmacologic inhibition with a PD-L1 neutralizing antibody in adult and aged mice. We report that neither PD-L1 deletion in myeloid cells nor inhibition with α-PD-L1 significantly impacts femoral trabecular bone microarchitecture; however, α-PD-L1 treatment increases vertebral trabecular bone volume. Additionally, PD-L1 blockade influences T cell expansion by decreasing naïve T cells and increasing effector memory T cells in the bone marrow, consistent with previous studies on the effects of PD-1 inhibition. The trabecular bone-sparing effect of PD-L1 inhibition is strikingly different from the bone loss observed with PD-1 blockade. Clinical studies are necessary and justified to determine if PD-L1 may be a less bone destructive alternative for cancer patients treated with ICIs who are at high risk of fracture. Immune checkpoint inhibitors (ICIs) are a type of therapy that unleash the immune system to kill off tumor cells and are used alone and in combination with other anti-cancer therapies to treat a variety of cancer types. Some studies suggest that cancer patients treated with ICIs may be at increased risk for bone loss and fractures. We now understand that blocking a protein called programmed cell death protein 1 (PD-1) causes bone loss in adult and aged mice, but we do not know if blocking proteins that have similar functions to PD-1 (called immune checkpoint proteins) also causes bone loss. We report that in contrast to blocking PD-1, inhibiting another immune checkpoint protein called programmed cell death ligand 1 (PD-L1) does not reduce femoral bone mass and modestly increases vertebral bone mass. These data suggest that PD-L1 targeted therapy be a safer alternative that PD-1 targeted therapy for patients at high risk of fracture.
Nasopharyngeal carcinoma (NPC) is an Epstein-Barr virus (EBV)-driven malignancy, making the viral protein EBNA1 a pivotal therapeutic target. This study evaluates VK-2019, a clinical-stage EBNA1 inhibitor, for its potential to sensitize NPC cells to chemotherapy. We report that VK-2019 synergistically enhances gemcitabine efficacy, reducing the IC50 by nearly 30-fold in EBV-positive C666-1 cells. Transcriptomic profiling combined with in vitro and in vivo models reveals a distinct mechanism: VK-2019 inhibition of EBNA1 downregulates c-MYC, thereby derepressing its downstream target, Proline Dehydrogenase (PRODH). Furthermore, we demonstrate that gemcitabine independently upregulates PRODH via p53 pathway activation. This dual induction of PRODH drives enhanced anti-tumor cytotoxicity. These results provide a prominent preclinical rationale for evaluating VK-2019 in combination regimens and offer a potential therapeutic strategy for patients with EBV-associated nasopharyngeal carcinoma.
ImportanceConstant rates of head and neck cancer (HNC) and increasing rates of Human Papillomavirus (HPV)-driven oropharyngeal cancer highlight the need for increased awareness of HNC risk factors for primary and tertiary prevention.ObjectiveTo assess awareness of HNC and its risk factors, especially HPV, in patients with a confirmed or suspected HNC diagnosis and healthy controls.DesignA cross-sectional survey was conducted.SettingThe study was carried out at two university hospitals.ParticipantsIn total, 354 participants were included in the study, comprising 139 patients with confirmed HNC, 49 patients with suspected HNC, and 166 healthy controls.Interventions/ExposuresParticipants completed a questionnaire including HNC in general, its risk factors, and the role of HPV.Main Outcome MeasuresPrimary outcomes were awareness of HNC risk factors and HPV-driven cancers. The evaluation was based on correct answers to knowledge questions.ResultsA general awareness of HNC was found in 70.3% of all participants. The major risk factors of HNC (smoking cigarettes and alcohol abuse, and HPV infection) were correctly identified in 63.3%, 39.5%, and 17.8%, respectively, with no statistical differences in the identification of the risk factors between the 3 groups. The correct recognition of HPV-associated cancer entities (cervical, anal, oropharyngeal, and vulvar/vaginal/penile cancer) was low, with 31.6%, 7.1%, 10.7%, and 13.6%, respectively. Notably, 63.0% of all participants were unaware of the possibility of an HPV vaccination.ConclusionAwareness of HNC and its risk factors, particularly alcohol and HPV, remains low across all groups, even among patients with a confirmed HNC diagnosis. Findings suggest a critical need for targeted educational efforts to improve primary and tertiary HNC prevention.RelevanceAddressing gaps in HNC awareness can help in prevention and early diagnosis, reducing the HNC burden. Future studies should explore effective educational strategies tailored to at-risk populations.
Traditional fermented foods harbor functionally diverse microbial communities that represent an underexplored source of probiotic strains. Lactic acid bacteria were systematically isolated from traditionally fermented bamboo shoots collected across Zhejiang Province, China, with the aim of identifying superior probiotic candidates. Among the isolates recovered, Lactococcus lactis ZB2 demonstrated robust gastrointestinal tolerance, favorable adhesion properties, and broad-spectrum antimicrobial activity, consistently matching or exceeding the reference strain Lactobacillus rhamnosus GG across all evaluated in vitro criteria. Molecular identification via 16S rRNA gene sequencing confirmed ZB2 as L. lactis subsp. lactis (>99.7% sequence identity). To evaluate its in vivo effects, ZB2 (1 × 109 CFU/day, 200 μL of bacterial suspension in 0.01 M PBS, pH 7.4) was administered by oral gavage to healthy C57BL/6 J mice for 28 days. ZB2 supplementation significantly reinforced intestinal epithelial barrier integrity, evidenced by reduced serum permeability markers (FITC-dextran flux, DAO, D-lactic acid, and LPS), upregulation of tight junction proteins (ZO-1, Occludin, Claudin-1) and the mucin gene Muc2, and a significant increase in goblet cell number per crypt. Immune homeostasis was modulated toward an anti-inflammatory phenotype, characterized by elevated serum IL-10 and TGF-β, reduced IFN-γ, downregulation of colonic pro-inflammatory cytokines (Tnf-α, Il-6, Il-1β), and upregulation of the antimicrobial peptides Reg3γ and β-defensin 1. 16S rRNA amplicon sequencing revealed selective enrichment of butyrate-producing genera within the Lachnospiraceae family, accompanied by marked increases in fecal short-chain fatty acid concentrations-particularly butyrate and propionate. Systemic antioxidant capacity was also enhanced, as reflected by elevated SOD, CAT, and GSH-Px activities and reduced malondialdehyde. These findings support the characterization of L. lactis ZB2 as a multifunctional probiotic candidate and highlight Zhejiang fermented bamboo shoots as a valuable, underexplored reservoir of superior probiotic strains with broader functional food development potential.