Spatial cognition enables adaptive goal-directed behavior through structured internal models of space. Robust biological systems consolidate spatial knowledge into three interconnected forms: landmarks for salient cues, route knowledge for movement trajectories, and survey knowledge for map-like representations. While recent advances in multi-modal large language models (MLLMs) have enabled visual-language reasoning in embodied agents, these efforts lack structured spatial memory and instead operate reactively, limiting their generalization and adaptability in complex real-world environments. Here we present Brain-inspired Spatial Cognition for Navigation (BSC-Nav), a unified framework for constructing and leveraging structured spatial memory in embodied agents. BSC-Nav builds allocentric cognitive maps from egocentric trajectories and contextual cues, and dynamically retrieves spatial knowledge aligned with semantic goals. Integrated with powerful MLLMs, BSC-Nav achieves state-of-the-art efficacy and efficiency across diverse embodied navigation tasks (e.g., improving success weighted by path length from 17.6% to 44.9% in instance-level navigation and from 42.7% to 53.1% in zero-shot long-horizon instruction-following), while also supporting versatile embodied behaviors in the real physical world. These results highlight a scalable path toward general-purpose spatial intelligence.
A mechanism-guided framework for prioritizing membrane-interaction antimicrobial peptide candidates from proteomics-derived peptide mixtures is presented. The framework integrates conservative machine-learning-based antimicrobial peptide (AMP) screening with a literature-derived membrane-interaction plausibility (MAP) assessment and a data-driven membrane-interaction ranking function (AIPx), followed by structural visualization for interpretability. MAP encodes physicochemical characteristics commonly associated with peptide-membrane interaction and provides a graded plausibility assessment. Building upon this physicochemically interpretable framework, AIPx ranks peptides using feature weights calibrated from experimentally characterized anti-Vibrio peptides, where minimum inhibitory concentration (MIC) values are used as a coarse-grained ranking reference rather than a direct prediction target. In a peptidomics-based peptide fractionation study targeting Vibrio spp., AIPx exhibited a consistent relationship with experimentally observed antibacterial activity. Distributional analysis revealed that peptide fractions exhibiting high anti-Vibrio activity are characterized by enrichment of high-ranking peptides rather than by AMP abundance alone. By structuring AMP identification and prioritization as sequential stages, the MAP + AIPx framework enables interpretable and experimentally actionable candidate selection by reducing biologically implausible candidates. The framework facilitates species-oriented prioritization of AMP candidates, addressing a key challenge in antimicrobial peptide discovery where activity may depend on target-specific membrane characteristics. Moreover, the approach is extensible through species-specific calibration and supports interpretable, mechanism-informed prioritization in antimicrobial peptide discovery.
Rare diseases (RDs) are a highly heterogeneous and underserved group of conditions. Most RDs have a strong genetic basis but their causal pathophysiological mechanisms remain poorly understood, limiting the development of targeted therapies. We systematically characterised the cell type-specific mechanisms underlying all genetically defined RD phenotypes by integrating the Human Phenotype Ontology (HPO) with whole-body single-cell transcriptomic atlases from embryonic, foetal, and adult samples. Associations were validated against orthogonal biomedical knowledge graphs and then prioritised by strength of supporting evidence, clinical severity, and gene-therapy compatibility. We identified significant associations between 201 cell types and 9,575/11,028 (86.7%) phenotypes across 8,628 RDs, substantially expanding knowledge of phenotype-cell type links. Prioritisation by severity (e.g. lethality, motor or mental impairment) and gene-therapy compatibility (e.g. cell type specificity, postnatal treatability) identified candidate phenotypes and cell types for therapeutic targeting. We present a scalable, reproducible framework for phenome-wide, cell type-specific mechanism prediction in rare diseases, providing a major step toward systematic therapeutic development for patients across a broad spectrum of serious RDs. Interactive web portal: https://neurogenomics-ukdri.dsi.ic.ac.uk/. R packages introduced in this study: KGExplorer (https://github.com/neurogenomics/KGExplorer), HPOExplorer (https://github.com/neurogenomics/HPOExplorer), and MSTExplorer (https://github.com/neurogenomics/MSTExplorer). Manuscript analyses and reproducibility code: https://github.com/neurogenomics/rare_disease_celltyping.
Latiné populations in the United States face a persistent health and mental health burden, in part driven by stressors associated with social determinants of health. In response, it is critical to develop a nuanced understanding of Latiné communities' perceptions of government- and community-based social safety-net services, both as distinct and interacting systems, designed to support health and social needs of Latiné adults. We conducted semi-structured interviews with Latiné adults (N = 13) in English and Spanish to explore perceptions of and experiences with government-sponsored and community-based safety-net services, as well as the implications for health and wellbeing. A thematic analysis approach was used to identify emergent themes. Themes highlight shared and unique factors that enable and inhibit access to safety-net services from government- and community-based systems. Awareness of safety-net services and their benefits facilitated access to both systems, but knowledge of rights surrounding eligibility enabled access to government-based services in particular. In contrast, limited awareness of service availability and concerns about quality of services created barriers to access across both community- and government-based services. Unique to government-based services, complex and burdensome application processes, mistrust, and stigma associated with using public assistance were highlighted as barriers. Findings provide critical insights to improve Latiné communities' access to safety-net systems to support health and wellbeing. Our results highlight the need to: strengthen communication strategies to inform resource awareness and counteract misinformation; rebuild trust between government institutions and communities; reduce stigma and shame surrounding safety-net service utilization; simplify bureaucratic processes for using government safety-nets; and foster connections between community and government systems to enhance access to services that address upstream social determinants of health. These strategies represent steps towards building more accessible safety-net systems to support the health and wellbeing of Latiné communities.
Cause-specific mortality provides useful clues regarding the driving forces behind mortality trends in high income countries. Nevertheless, conventional data sources to measure cause-specific mortality trends are affected by recurring changes in the International Classification of Diseases (ICD). They also lack the degree of detail needed to construct consistent time series, at least for the periods before implementation of the 10th ICD Revision. The Human Cause-of-Death Data series (HCD@HMD) is an extension of the Human Mortality Database designed to provide cause-specific mortality time series with causes of death classified according to consistent lists of causes of death, taking changes to the ICD into account. The HCD@HMD provides high-quality detailed continuous data series for three standard lists of cause-of-death categories (short, intermediate, and long) coded to the 10th ICD Revision, harmonized over time and across populations. The reconstructed series are currently available for 18 countries. All HCD@HMD data series are updated periodically and include the most recent data available. The data follow the FAIR principles and they are publicly available.
Polysaccharide- and protein-based hydrogels possess good biocompatibility, abundant functional groups, and tunable network structures, making them sustainable materials for food packaging. Through the regulation of crosslinking, pore architecture, and intermolecular interactions, these hydrogels can achieve diverse packaging functionalities, ranging from basic barrier protection to active preservation and even intelligent regulation. This review focuses on how the structure-function relationships of hydrogels realize specific packaging functionalities and comparatively discusses four representative morphologies: coatings, films, absorbent pads, and microspheres. The discussion covers the transition from matrix-dominated passive barrier functions to additive-enabled active preservation, and finally to stimuli-responsive systems. It further elucidates how precise structural regulation in these functional systems impacts key preservation behaviors, such as moisture control, gas permeability, antimicrobial activity, and controlled release. Building on these structure-function principles, this paper further introduces data-assisted strategies for hydrogel food packaging, showing their potential in accelerating formulation screening, predicting transport behavior, and reducing trial-and-error costs.
Constructing high-activity natural enzyme and nanozyme catalytic systems have long been a central research goal in biosensing. Small extracellular vesicles (sEVs) are natural nanovesicles with good biocompatibility and unique membrane structure, providing a novel strategy for enzyme activity regulation. Herein, we employ sEVs with cytochrome c (Cytc) and quantum dots (QDs) to construct enhancement Cytc@sEVs and QDs@sEVs enzyme system. The Cytc@sEVs, CQDs@sEVs and WQDs@sEVs exhibit around 15-fold, 2-fold and 12-fold higher peroxidase activity than free Cytc, CQDs and WO2 QDs, respectively. Benefiting from the enhanced activity of Cytc, the Cytc@sEVs show a low detection limit of 43 particles/μL towards sEVs. The as-constructed sEVs-driven enhancement offers a new route for building high-performance enzyme system.
Infant and Early Childhood Mental Health Consultation (IECMHC) is a capacity-building, prevention-focused service that supports early childhood professionals and families in promoting young children's social-emotional development. This conceptual analysis addressed the research question: How can IECMHC programs systematically and efficiently measure fidelity using existing documentation systems? The study examined data from a large, government-sponsored IECMHC program in a mid-Atlantic U.S. metropolitan region, involving 17 consultants (50% Black or African American, 36% other racial minority) serving 102 early childhood education centers with mostly racial minority staff and families. Through an iterative process with program leadership, 15 fidelity metrics were developed and operationalized at the programmatic, classroom, and child-specific levels using consultants' electronic documentation. The resulting fidelity database enables programs to assess consultant adherence to core consultation activities, identify areas for quality improvement, and facilitate reflective supervision. This approach offers a practical, replicable strategy for other IECMHC programs to adopt or adapt to enhance implementation fidelity and, ultimately, the equity, quality and effectiveness of mental health consultation services for infants, young children, and their caregivers.
A preparative scalable approach to 3,7-bifunctional 5H-pyrrolo[3,2-c]pyridazines and 3,5-bifunctional 7H-pyrrolo[2,3-c]pyridazines with a diverse set of functionalities (C(sp2)-Br/I, CO2H, CHO, SO2Cl, NH2) in the pyrrole and an active chlorine atom in the pyridazine parts, respectively, was developed. The suitability of these groups for synthesizing various derivatives of the above-mentioned cores is demonstrated, thereby declaring the compounds as MedChem-relevant building blocks. The possibility of introducing a carboxylic function to the pyridazine ring through Pd-catalyzed carbonylation has been provided. A solution for the selective preparative partial hydrogenation of the pyrrole ring to dihydropyrrole was also proposed. As a result, a convenient tool for implementing the "nitrogen walk" approach around indole and azaindole scaffolds was suggested for medicinal chemistry purposes.
Against the backdrop of China's aging society and under the macro policy of building a Healthy China proposed at the Fifth Plenary Session of the 18th Central Committee of the Communist Party of China, the dissemination of Traditional Chinese Medicine (TCM) health knowledge has emerged as particularly crucial and imperative. This paper systematically examines the current status of TCM health knowledge dissemination in China. It identifies multiple challenges in the dissemination process, including multidimensional constraints related to content dissemination, media channels, and audience characteristics. Drawing on these findings, this paper proposes a strategic framework centered on high-quality content, with standardized media platforms as key hubs and audience empowerment as the ultimate goal.
The most common indications for lower limb revision arthroplasty are aseptic loosening of the implant and adverse reactions to particulate debris, both of which are driven by host immune responses to orthopaedic biomaterials. Pharmacoepidemiologic studies suggest that statins may improve lower limb arthroplasty survival, potentially through pleiotropic anti-inflammatory effects, but the biology underpinning this remains unclear. The aim of this study was to investigate the effect of simvastatin on orthopaedic bio-material-induced inflammation in-vitro. Gene expression was measured by qPCR and protein secretion was measured by ELISA and Meso scale discovery assays. In THP-1 macrophages, co-culture with simvastatin significantly abrogated cobalt-mediated increases in IL-8 gene expression in addition to IL-8, IL-1β, CCL3, CCL4 and CCL20 protein secretion. Simvastatin also inhibited zirconium oxide-mediated levels of CCL2 and CCL4, as well as alumina oxide-mediated increases in CCL2. These novel findings demonstrate that statins can significantly reduce orthopaedic biomaterial-induced expression of pro-inflammatory cytokines in-vitro. As statins are widely used in clinical practice and inexpensive, this provides an exciting basis for future work to leverage statins to reduce the impact of a burgeoning demand for revision arthroplasty on patients.
Adverse experiences during childhood such as family violence, neglect, poverty, poor parental mental or physical health have negative immediate and lifelong impacts on children's health and development. Although many families experience adversities, families experience barriers to seeking support, and many professionals lack confidence to have sensitive conversations with these families. Aiming to inform the development of resources to guide professionals, we undertook a scoping review to (1) identify and describe communication frameworks for professionals and (2) describe if/how they were evaluated. Searches were conducted in Medline, Emcare, PsycInfo, Cumulative Index in Nursing and Allied Health Literature and Scopus from inception to January 2025. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), we located 15 communication frameworks contained within 33 manuscripts. Key characteristics of the communication frameworks are presented, such as practice setting and intended users, which adversities were addressed and how they were evaluated. There were two broad types of communication framework, those which required professionals to actively screen and respond to family adversities, and those which provided opportunistic guidance and response without explicit screening. Most communication frameworks were in the global north, and many were not evaluated beyond their initial context. We could not locate any communication frameworks embedded within non-health-related settings, and none comprehensively addressed all adverse experiences known to impact children. Nonetheless, this review identified available evidence that can help inform tailoring and development of communication frameworks to build professionals' capacity for early intervention for family adversities.
Patients with neck pain (NP) commonly display impairments in cervical movement control. Improvements in technology used to assess movement control allow extraction of various parameters that could enable more precise classification, but this has not yet been investigated. This study aimed to assess validity (classification performance of different machine learning models) of different parameters and difficulty levels of the Butterfly cervical movement control test. Sixty-five patients with NP and fifty asymptomatic controls performed the Butterfly test. Random forest, support vector machines and logistic regression classification methods were used to build models based on individual or multiple parameters across different difficulty levels. The area under the curve (AUC), classification accuracy, F1 score, precision, recall, specificity, information gain and Gini index were reported. Models using amplitude accuracy, time-on-target or undershoot achieved the highest classification performance. However, models combining directional accuracy or all parameters of the Butterfly test at all difficulty levels yielded the most balanced probability of classification. Results of our study suggest that either directional accuracy or all parameters of the Butterfly test (calculated for all difficulty levels) should be used for classifying patients with NP to provide the most clinically valid tool.
Marginalized populations experience increased eating disorder (ED) risk and encounter significant barriers to treatment. Intersectionality provides a framework for understanding how systemic oppression contributes to inequities in EDs; however, intersectional approaches have yet to be applied to a clinical ED sample. The current study examined inequities in ED severity and treatment outcome across the intersections of race/ethnicity, sexual orientation, and socioeconomic status (SES). Adult women (N=3016; M = 27.2 years) with transdiagnostic EDs presenting to affiliated treatment sites across the United States completed the Eating Disorder Examination-Questionnaire (EDE-Q) at admission and discharge. Race/ethnicity and sexual orientation were self-reported; SES was measured using the area deprivation index of participants' neighborhoods. Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) was used to estimate baseline EDE-Q global score; change in EDE-Q global score and binge eating, self-induced vomiting, laxative use, and driven exercise frequency from admission to discharge; and reason for discharge (routine or non-routine) across intersectional subgroups. In this sample of women with access to treatment, MAIHDA models predicted higher baseline levels of overall ED pathology among sexual minorities (predicted M = 4.10). Few differences in ED symptom improvement were observed across intersectional subgroups, with some small yet potentially meaningful inequities. Racially/ethnically minoritized subgroups appeared slightly less likely to complete treatment (predicted percent non-routine discharge = 41.50%). Future research should build on these findings by analyzing other dimensions of inequity (e.g., gender, weight status, disability status) to further characterize and address intersecting systems of oppression that disparately influence ED outcomes.
To identify latent profiles of change fatigue among nurses in Southwestern China and explore factors associated with distinct profiles. Healthcare resources in Southwestern China are unevenly distributed, and the region features considerable ethnic diversity. Against the backdrop of ongoing reforms in the healthcare system, nurses-as frontline implementers-are constantly exposed to intensive and frequent updates in policies, technologies, and workflows, making them susceptible to change fatigue. This sustained exposure precipitates "change fatigue," a syndrome that erodes psychological resilience and professional identity, and is prospectively linked to heightened turnover intention, measurable deterioration in nursing quality and an increased incidence of patient-safety events. From July to September 2025, we recruited nurses from various tiers and types of medical institutions across Southwestern China. Data were collected using a general information questionnaire, the Change-Related Stress Scale, the Grandey Emotional Labor Strategy Scale, the Connor-Davidson Resilience Scale (CD-RISC), and the Chinese Nurse Job Stressors Scale. Latent profile analysis (LPA) was employed to identify subgroups of change fatigue. Univariate analysis and multinomial logistic regression with Firth's penalized likelihood estimation were used to examine factors associated with profile membership. A total of 1383 valid questionnaires were included. LPA revealed three distinct profiles of change fatigue: low fatigue (17.5%, n = 242), moderate fatigue (61.6%, n = 852), and high fatigue (20.9%, n = 289). Multinomial logistic regression showed that nurses in the high fatigue group were significantly more likely to work in the intensive care unit (OR = 2.31, 95% CI: 1.40-3.85, p = 0.001) and internal medicine (OR = 2.12, 95% CI: 1.26-3.61, p = 0.005). Working 1-2 night shifts per week increased odds of high fatigue by 53% (OR = 1.53, 95% CI: 1.03-2.27, p = 0.034). Compared with minimal emotional labor (Level 1, 14-30 points), both moderate (Level 2, 31-50 points: OR = 0.14, p = 0.030) and high (Level 3, 51-70 points: OR = 0.09, p = 0.010) emotional labor levels were associated with significantly lower odds of high fatigue, suggesting that deficient emotional labor engagement may represent a risk configuration. Work stress Level 3 increased odds of high fatigue 33-fold (OR = 32.71, 95% CI: 13.27-103.37, p < 0.001). Psychological resilience showed no independent significant association with profile membership in multivariate models. Change fatigue exhibits a heterogeneous tripartite structure. Minimal emotional labor engagement (Level 1) was associated with higher odds of high fatigue compared with moderate and high levels, suggesting that deficient emotional labor may represent a distinct risk configuration. Both modifiable workplace factors (ICU/internal medicine placement, night shifts, and job stress) and emotional labor patterns were associated with profile membership, supporting the potential value of organizational interventions and targeted emotional labor training. These findings provide an evidence-based foundation for precision prevention. Nursing leaders should integrate the six-item Change Fatigue Measurement Scale into routine occupational health surveillance to enable profile-based risk stratification. High-fatigue nurses (20.9%) require immediate workload relief and mental health referral; moderate-fatigue nurses (61.6%) represent a critical prevention window for resilience training and peer support; low-fatigue nurses (17.5%) should serve as peer mentors and change champions. Priority interventions should target ICU and internal medicine units given the 2- to 2.3-fold increased high-fatigue risk. Leaders should limit consecutive night duties to ≤ 2 shifts, ensure ≥ 11 h rest between shifts, and enforce weekly overtime caps (≤ 8 h). Differentiated emotional labor training is essential: Nurses with minimal engagement need professional identity strengthening and authentic expression workshops, while those with excessive engagement require boundary-setting training and mindfulness-based stress reduction. Resilience-building interventions must be embedded within organizational support initiatives rather than implemented as standalone programs. In ethnically diverse, resource-constrained contexts, culturally tailored change communications and phased implementation timelines are critical to avoid "reform stacking."
Epigenome editing has emerged as a powerful platform to modulate gene expression in a precise and reversible manner. Recent advances have significantly improved the efficiency, specificity, and durability of epigenome editing systems, enabling fine-tuned transcriptional control. Building on these developments, epigenome editing platforms are now being explored for therapeutic applications. In this review, we summarize the evolution of clustered regularly interspaced short palindromic repeats (CRISPR)-based epigenome editing technologies, highlighting key improvements in effector modules. We then discuss the disease models in which epigenome editing has been applied, including monogenic disorders, cancer, neurological diseases, and chronic diseases. These examples demonstrate the broad therapeutic promise of targeted epigenetic modulation across diverse pathological contexts. Finally, we tackle key barriers to clinical translation, including cell-type and chromatin context-specific design, in vivo delivery, and multi-gene targeting for complex disease. Collectively, this review underscores the potential of epigenome editing as a versatile platform for precision medicine.
Digital health interventions (DHIs) are increasingly popular as a potential method to address educational and support needs of individuals with long-term conditions, as they are largely accessible to most people, can be highly effective, and delivered at low cost. We have developed a DHI to better support chronic kidney disease (CKD) self-management and demonstrated its efficacy in a UK-based clinical trial. The trial population, however, was fairly homogeneous, and those from underserved populations (including ethnic minority groups), who would have likely benefited from the DHI, were underrepresented. Understanding how ethnic minority communities perceive DHIs is essential for identifying their needs, priorities and challenges, and for ensuring that future DHIs are relevant, acceptable and equitable. Given the potential impact of DHIs, patients should be actively involved in their design and implementation. To support this, patient and public involvement and engagement (PPIE) consultations were conducted to: 1) understand people with CKD from South Asian (SA) backgrounds' perspectives of DHIs; 2) identify factors that require consideration when adapting DHIs to address health inequities; and 3) clarify how best to conduct PPIE projects in adapting DHIs for traditionally underserved groups, particularly ethnic minority groups. PPIE consultation focus groups were conducted in-person with ten individuals (60% male, age: 69 ± 7) from SA backgrounds thrice, audio-recorded and transcribed verbatim. Data were analysed using thematic analysis. Participants identified several barriers and facilitators to accessing and using DHIs. Language was reported to be the biggest barrier to accessing and using online health information. Having culturally appropriate information available in their own language would increase the acceptability and uptake of the DHI among SAs. Not making assumptions and being respectful about individual choices, cultural or religious beliefs, was considered key to engaging people. Promotion by a trusted person (doctors, peers, community leaders) was perceived to help alleviate the fear of DHIs and improve uptake and usage. People from SA backgrounds are open to using DHIs, but they need to be available in their own language and be culturally appropriate. The findings will be used to adapt our CKD self-management DHI to better address the needs of those from SA backgrounds. Patients and members of the public were directly involved in the participation of the patient and public involvement and engagement (PPIE) consultations. Community engagement officers from the Centre of Ethnic Health, who were from South Asian backgrounds, were involved in the PPIE consultation, recruitment, development of a semi-structured focus group guide, and facilitation of consultation focus groups. Digital health tools are becoming an important way to help people manage long‐term health conditions because they are easy to access, cost‐effective, and can provide useful support. We developed a digital health intervention (DHI) to help people with chronic kidney disease (CKD) manage their condition and showed that it works well in a clinical trial. However, the trial included mostly similar participants, and people from underserved communities, who might benefit the most, were not well represented. This study looked at what makes it easier or harder for people from South Asian backgrounds to use DHIs. We held patient and public involvement and engagement (PPIE) consultation focus groups with 10 participants and analysed their views. The biggest barrier was language, and participants said they would be more likely to use DHIs if information was available in their own language and reflected their cultural needs. They also felt that recommendations from trusted people, such as doctors or community leaders, would help build confidence. These findings will guide changes to make our CKD DHI more inclusive.
Previous studies have shown mixed results regarding the relationship between snack food intake, child temperament, and weight-for length-z (WFL-z) score; therefore, this study examined these associations in young children. We conducted a cross-sectional analysis of 96 mother-child dyads (mean child age = 14.9 months, SD = 2.6). Mothers completed the Infant Behavior Questionnaire, assessing Surgency, Negative Affectivity and Regulation. Three 24-hour dietary recalls were analyzed using the Nutrition Data System for Research. Snack foods were categorized as Salty, Sweet and Commercial Snack Foods. Child height and weight were measured. Pearson's Correlations examined associations between unhealthy snack food intake (e.g., chips, cookies), child temperament, and child WFL-z scores. Multivariable linear regressions were conducted to further examine these associations, adjusting for covariates. The results show that Surgency was positively associated with mean sweet snack intake (β = 0.183, p = 0.044) and with mean daily energy consumption from snack food (β = 35.458, p = 0.040). While mean commercial snack food intake was negatively associated with WFL-z scores (β = -0.569, p = 0.031), mean sweet snack intake was positively associated with WFL-z scores (β = 0.406, p = 0.05). Surgency was not directly associated with WFL-z score, suggesting that other factors, such as parental feeding practices, may play a more prominent role. No significant associations were observed between Negative Affectivity or Regulation with snack food consumption or WFL-z scores. These findings highlight the need for further research on the nuanced role of temperament in early childhood to inform potential interventions for healthy eating.
Tumour stroma is acknowledged as a fundamental constituent of the tumour microenvironment, which drives cancer progression. Cancer-associated fibroblasts are an integral part of the cancer stroma. However, their role in thyroid cancer is not fully elucidated. The aim of this study is to determine the relationship between the expression of stromal cancer-associated fibroblasts' immunohistochemical biomarkers in thyroid cancer and clinicopathological features of the disease. Eighty-five formalin-fixed paraffin-embedded tissue sections of different thyroid cancer cases were stained with Masson's trichrome, α-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP) and scored based on the extent of the stained area and staining intensity. Statistical analysis was performed to assess any correlation with clinicopathological features. α-SMA showed a positive correlation with male gender (p = 0.02), tumour size greater than 1 cm (p = 0.0014) and histopathologic features of aggressiveness (p = 0.023). FAP was positively correlated with extent of desmoplasia (p = 0.024). Additionally, stromal desmoplasia was negatively correlated with tumour size greater than 1 cm (p = 0.0082). Cancer-associated fibroblasts are associated with increased tumour progression and desmoplasia in thyroid cancer.
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