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Prognostic Value of Circulating Tumor DNA in HR+/HER2- Stage I-III Breast Cancer: A Systematic Review

Cancers (Basel). 2025 Aug 29;17(17):2831. doi: 10.3390/cancers17172831.

ABSTRACT

Background: Hormone receptor-positive (HR+), HER2-negative breast cancer accounts for the majority of breast cancer diagnoses. While outcomes have improved with neoadjuvant and adjuvant therapies, the risk of late recurrence persists, and there remains a critical need for reliable biomarkers to guide prognosis and post-treatment surveillance. Circulating tumor DNA (ctDNA), detectable via liquid biopsy, has emerged as a promising tool for monitoring minimal residual disease and predicting survival outcomes. This systematic review evaluates the association between ctDNA detection during neoadjuvant or adjuvant treatment and survival outcomes in early-stage HR+/HER2- breast cancer. Methods: This systematic review was conducted in accordance with PRISMA guidelines. A comprehensive literature search of Ovid MEDLINE and Embase was conducted to identify studies published through 3 May 2024 that evaluated ctDNA as a prognostic biomarker in stage I-III HR+/HER2- breast cancer. We included studies reporting recurrence-free survival, invasive disease-free survival, or overall survival and excluded non-original studies, conference abstracts, and non-English articles. Data extraction and qualitative synthesis were performed, and the risk of bias was qualitatively assessed across studies. No review protocol was registered. Results: Eleven studies comprising 1644 patients met the inclusion criteria. In the neoadjuvant setting, ctDNA positivity prior to treatment initiation was associated with inferior survival outcomes. In the adjuvant setting, detection of ctDNA during or after treatment was consistently linked to poorer recurrence-free and invasive disease-free survival. Across studies, ctDNA detection was a significant negative prognostic marker. Conclusions: This systematic review supports the prognostic value of ctDNA in HR+/HER2- early-stage breast cancer. Limitations include small sample sizes, observational study designs, and heterogeneity in ctDNA assays. Standardization of ctDNA testing methods and further prospective trials are needed to validate its clinical utility and explore its potential role in guiding therapeutic interventions.

PMID:40940926 | PMC:PMC12427406 | DOI:10.3390/cancers17172831

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Functions of the global health system in a new era

Nature Medicine, Published online: 11 September 2025; doi:10.1038/s41591-025-03936-9

In an irrevocably changed landscape, reform of the global health system needs to answer key questions on functions, what should be delivered in different contexts and at different levels, and how the system should operate.
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Interventions Based on Biofeedback Systems to Improve Workers’ Psychological Well-Being, Mental Health, and Safety: Systematic Literature Review

Background: In modern, high-speed work settings, the significance of mental health disorders is increasingly acknowledged as a pressing health issue, with potential adverse consequences for organizations, including reduced productivity and increased absenteeism. Over the past few years, various mental health management solutions, such as biofeedback applications, have surfaced as promising avenues to improve employees’ mental well-being. However, most studies on these interventions have been conducted in controlled laboratory settings. Objective: This review aimed to systematically identify and analyze studies that implemented biofeedback-based interventions in real-world occupational settings, focusing on their effectiveness in improving psychological well-being and mental health. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We searched PubMed and EBSCO databases for studies published between 2012 and 2024. Inclusion criteria were original peer-reviewed studies that focused on employees and used biofeedback interventions to improve mental health or prevent mental illness. Exclusion criteria included nonemployee samples, lack of a description of the intervention, and low methodological quality (assessed using the Physiotherapy Evidence Database [PEDro] checklist). Data were extracted on study characteristics, intervention type, physiological and self-reported outcomes, and follow-up measures. Risk of bias was assessed, and VOSviewer was used to visualize the distribution of research topics. Results: A total of 9 studies met the inclusion criteria. The interventions used a range of delivery methods, including traditional biofeedback, mobile apps, mindfulness techniques, virtual reality, and cerebral blood flow monitoring. Most studies focused on breathing techniques to regulate physiological responses (eg, heart rate variability and respiratory sinus arrhythmia) and showed reductions in stress, anxiety, and depressive symptoms. Mobile and app-directed interventions appeared particularly promising for improving resilience and facilitating recovery after stress. Of the 9 studies, 8 (89%) reported positive outcomes, with 1 (11%) study showing initial increases in stress due to logistical limitations in biofeedback access. Sample sizes were generally small, and long-term follow-up data were limited. Conclusions: Biofeedback interventions in workplace settings show promising short-term results in reducing stress and improving mental health, particularly when incorporating breathing techniques and user-friendly delivery methods such as mobile apps. However, the field remains underexplored in occupational contexts. Future research should address adherence challenges, scalability, cost-effectiveness, and long-term outcomes to support broader implementation of biofeedback as a sustainable workplace mental health strategy.
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The Impact of Artificial Intelligence on Lung Cancer Diagnosis and Personalized Treatment

Int J Mol Sci. 2025 Aug 31;26(17):8472. doi: 10.3390/ijms26178472.

ABSTRACT

Lung cancer is the leading cause of cancer mortality globally, despite the advancements in screening and management. Survival rates for lung cancer remain suboptimal, largely due to late-stage diagnoses and tumor heterogeneity. Recent advancements in artificial intelligence and radiomics provide a promising outlook for lung cancer screening, diagnosis, personalized treatment, and prognosis. These advances use large-scale clinical and imaging datasets that help identify patterns and predictive features that may be missed by human interpretation. Artificial intelligence tools hold the potential to take clinical decision-making to another level, thus improving patient outcomes. This review summarizes current evidence on the applications, challenges, and future directions of artificial intelligence (AI) in lung cancer care, with an emphasis on early diagnosis and personalized treatment. We examine recent developments in AI-driven approaches, including machine learning and deep neural networks, applied to imaging (radiomics), histopathology, biomarker analysis, and multi-omic data integration. AI-based models demonstrate promising performance in early detection, risk stratification, molecular profiling (e.g., programmed death-ligand 1 (PD-L1) and epidermal growth factor receptor (EGFR) status), and outcome prediction. These tools may enhance diagnostic accuracy, optimize therapeutic decisions, and ultimately improve patient outcomes. However, significant challenges remain, including model heterogeneity, limited external validation, generalizability issues, and ethical concerns related to transparency and clinical accountability. AI holds transformative potential for lung cancer care but requires further validation, standardization, and integration into clinical workflows. Multicenter collaborations, regulatory frameworks, and explainable AI models will be essential for successful clinical adoption.

PMID:40943394 | PMC:PMC12429163 | DOI:10.3390/ijms26178472

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Single-cell multiome and spatial profiling reveals pancreas cell type-specific gene regulatory programs of type 1 diabetes progression

Sci Adv. 2025 Sep 12;11(37):eady0080. doi: 10.1126/sciadv.ady0080. Epub 2025 Sep 10.

ABSTRACT

Cell type-specific regulatory programs that drive type 1 diabetes (T1D) in the pancreas are poorly understood. Here, we performed single-nucleus multiomics and spatial transcriptomics in up to 32 nondiabetic (ND), autoantibody-positive (AAB+), and T1D pancreas donors. Genomic profiles from 853,005 cells mapped to 12 pancreatic cell types, including multiple exocrine subtypes. β, Acinar, and other cell types, and related cellular niches, had altered abundance and gene activity in T1D progression, including distinct pathways altered in AAB+ compared to T1D. We identified epigenomic drivers of gene activity in T1D and AAB+ which, combined with genetic association, revealed causal pathways of T1D risk including antigen presentation in β cells. Last, single-cell and spatial profiles together revealed widespread changes in cell-cell signaling in T1D including signals affecting β cell regulation. Overall, these results revealed drivers of T1D in the pancreas, which form the basis for therapeutic targets for disease prevention.

PMID:40929272 | PMC:PMC12422192 | DOI:10.1126/sciadv.ady0080

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The Impact of Artificial Intelligence on Lung Cancer Diagnosis and Personalized Treatment

Int J Mol Sci. 2025 Aug 31;26(17):8472. doi: 10.3390/ijms26178472.

ABSTRACT

Lung cancer is the leading cause of cancer mortality globally, despite the advancements in screening and management. Survival rates for lung cancer remain suboptimal, largely due to late-stage diagnoses and tumor heterogeneity. Recent advancements in artificial intelligence and radiomics provide a promising outlook for lung cancer screening, diagnosis, personalized treatment, and prognosis. These advances use large-scale clinical and imaging datasets that help identify patterns and predictive features that may be missed by human interpretation. Artificial intelligence tools hold the potential to take clinical decision-making to another level, thus improving patient outcomes. This review summarizes current evidence on the applications, challenges, and future directions of artificial intelligence (AI) in lung cancer care, with an emphasis on early diagnosis and personalized treatment. We examine recent developments in AI-driven approaches, including machine learning and deep neural networks, applied to imaging (radiomics), histopathology, biomarker analysis, and multi-omic data integration. AI-based models demonstrate promising performance in early detection, risk stratification, molecular profiling (e.g., programmed death-ligand 1 (PD-L1) and epidermal growth factor receptor (EGFR) status), and outcome prediction. These tools may enhance diagnostic accuracy, optimize therapeutic decisions, and ultimately improve patient outcomes. However, significant challenges remain, including model heterogeneity, limited external validation, generalizability issues, and ethical concerns related to transparency and clinical accountability. AI holds transformative potential for lung cancer care but requires further validation, standardization, and integration into clinical workflows. Multicenter collaborations, regulatory frameworks, and explainable AI models will be essential for successful clinical adoption.

PMID:40943394 | PMC:PMC12429163 | DOI:10.3390/ijms26178472

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Liquid biopsy- A pivotal test to help navigate clinical decisions at a precision center in India!

J Liq Biopsy. 2025 Aug 9;9:100323. doi: 10.1016/j.jlb.2025.100323. eCollection 2025 Sep.

ABSTRACT

Liquid biopsy, specifically circulating tumor DNA (ctDNA) analysis, has emerged as a transformative tool in precision oncology, providing real-time, minimally invasive characterizations of the tumor and tumor dynamics. While tissue biopsy is a critical tool for baseline diagnosis of malignancy, it is often limited by sampling constraints and an inability to capture tumor heterogeneity. In this study, we explored the clinical utility of serial ctDNA testing in guiding therapeutic decisions across a cohort of 30 patients with diverse solid tumors. Our real-world analysis demonstrates that ctDNA profiling meaningfully influenced treatment escalation, de-escalation, disease monitoring, and early relapse prediction. Cases where ctDNA positivity indicated minimal residual disease prompted timely escalation of therapy, while ctDNA clearance allowed safe treatment de-intensification, minimizing toxicity without compromising outcomes. Longitudinal ctDNA monitoring provided a dynamic, non-invasive method for assessing treatment response and detecting recurrence months before radiological progression. Our study highlights the potential of integrating liquid biopsy into routine clinical practice to enable dynamic treatment monitoring, early detection of therapeutic resistance, and more informed, personalized decision-making across various cancer types.

PMID:40919127 | PMC:PMC12409318 | DOI:10.1016/j.jlb.2025.100323

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The WHO global landscape of cancer clinical trials

Nature Medicine, Published online: 09 September 2025; doi:10.1038/s41591-025-03926-x

This Review of the WHO’s International Clinical Trials Registry Platform presents a snapshot of the global cancer trial landscape and provides critical empirical evidence to inform policy, practice and investment.
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STAT+: FDA greenlights trial of gene-edited pig kidneys as treatment for end-stage kidney disease

DOVER, N.H. — Not long after he woke from surgery in June, Bill Stewart made a  pact with his newest organ. He wasn’t sure how long the thing would last. The doctors had been up-front from the get-go: It could be three months or six, one year or four. Still, the uncertainty hit him as he started getting back preliminary lab results, which were okay but left room for improvement. “My pig kidney and I had a little conversation while I was laying there. I just basically said, ‘I’m going to do everything I can to make sure that you stay healthy, and I appreciate you doing everything you can to keep me upright and breathing,” Stewart said.

It’s been almost three months, and Stewart is home, back to work, and has even been able to go e-biking on a lakeside trail with his wife, blessedly untethered to the grueling schedules of dialysis for the first time in years, all thanks to a gene-edited Yucatan miniature pig named Lavender. 

Stewart is the most recent recipient of a pig kidney — but chances are, he won’t hold that distinction for long. On Monday, eGenesis, a Cambridge-based biotechnology company, announced that it had been cleared by the Food and Drug Administration to begin a trial of kidneys from donor pigs that have been CRISPR’d to make their organs more human-friendly. Now, Massachusetts researchers will be performing more surgeries like Stewart’s to see whether these animal parts could serve as a lifeline for people with end-stage renal disease.

Continue to STAT+ to read the full story…

© Cheryl Senter for STAT

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Clinical applications of cell-free DNA-based liquid biopsy analysis

Transl Oncol. 2025 Nov;61:102519. doi: 10.1016/j.tranon.2025.102519. Epub 2025 Sep 6.

ABSTRACT

Liquid biopsies, particularly those involving circulating tumor DNA (ctDNA) from patient blood, have emerged as crucial and minimally invasive adjuncts to standard tissue-based testing. ctDNA testing enables the identification of actionable mutations for targeted therapy and can be routinely used when tissue samples are unavailable for genotyping. Compared to tissue-based testing, ctDNA testing has the advantages of capturing spatial or temporal genomic heterogeneity and facilitating repeated assessments. The utility of liquid biopsies extends to multiple clinical applications, including cancer diagnosis, treatment monitoring, and minimal residual disease (MRD) detection. Numerous clinical trials are currently evaluating treatment strategies using ctDNA testing. In particular, the implementation of adjuvant treatment escalation or de-escalation based on MRD detection could dramatically transform future approaches to solid tumor treatment. Various ctDNA assays have been developed, and it is important to understand their strengths and weaknesses for effective clinical applications. Furthermore, ctDNA testing faces several technical challenges, including low sensitivity in detecting copy number alterations and fusions, as well as the possibility of detecting mutations associated with clonal hematopoiesis of indeterminate potential. In this review, we comprehensively discuss the methodologies and recent advancements in cfDNA-based liquid biopsies for cancer patients, covering diagnosis, genomic profiling, and treatment monitoring. Furthermore, we explore clinical trial designs employing ctDNA testing and anticipate forthcoming changes in patient care.

PMID:40915174 | PMC:PMC12450568 | DOI:10.1016/j.tranon.2025.102519

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Article: Virtual Panel: How Software Engineers and Team Leaders Can Excel with Artificial Intelligence

Artificial intelligence is impacting the individual work of software developers, how professionals work together in teams, and how software teams are being managed. In this panel, we'll discuss how artificial intelligence is reshaping software development, and what mindset and skills are required for software developers and engineering leaders to become adaptable and resilient in the age of AI.

By Ben Linders, Courtney Nash, Mandy Gu, Hien Luu
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Scalable generation and functional classification of genetic variants in inborn errors of immunity to accelerate clinical diagnosis and treatment

In lieu of traditional genetic variant testing approaches, an approach using scalable variant classification in primary human T cells with a clinically relevant readout can inform rapid diagnosis and treatment of inborn errors of immunity.
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STAMP: Single-cell transcriptomics analysis and multimodal profiling through imaging

Single-cell transcriptomics analysis and multimodal profiling (STAMP) by imaging enables single-cell analysis of cells in suspension without the need for sequencing. The markedly reduced costs and flexible experimental designs support the profiling of millions of cells or the large-scale multiplexing of conditions, perturbations, and sample types.
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Meta revises AI chatbot policies amid child safety concerns

Meta is revising how its AI chatbots interact with users after a series of reports exposed troubling behaviour, including interactions with minors. The company told TechCrunch it is now training its bots not to engage with teenagers on topics like self-harm, suicide, or eating disorders, and to avoid romantic banter. These are temporary steps while it develops longer-term rules.

The changes follow a Reuters investigation that found Meta’s systems could generate sexualised content, including shirtless images of underage celebrities, and engage children in conversations that were romantic or suggestive. One case reported by the news agency described a man dying after rushing to an address provided by a chatbot in New York.

Meta spokesperson Stephanie Otway admitted the company had made mistakes. She said Meta is “training our AIs not to engage with teens on these topics, but to guide them to expert resources,” and confirmed that certain AI characters, like highly sexualised ones like “Russian Girl,” will be restricted.

Child safety advocates argue the company should have acted earlier. Andy Burrows of the Molly Rose Foundation called it “astounding” that bots were allowed to operate in ways that put young people at risk. He added: “While further safety measures are welcome, robust safety testing should take place before products are put on the market – not retrospectively when harm has taken place.”

Wider problems with AI misuse

The scrutiny of Meta’s AI chatbots comes amid broader worries about how AI chatbots may affect vulnerable users. A California couple recently filed a lawsuit against OpenAI, claiming ChatGPT encouraged their teenage son to take his own life. OpenAI has since said it is working on tools to promote healthier use of its technology, noting in a blog post that “AI can feel more responsive and personal than prior technologies, especially for vulnerable individuals experiencing mental or emotional distress.”

The incidents highlight a growing debate about whether AI firms are releasing products too quickly without proper safeguards. Lawmakers in several countries have already warned that chatbots, while useful, may amplify harmful content or give misleading advice to people who are not equipped to question it.

Meta’s AI Studio and chatbot impersonation issues

Meanwhile, Reuters reported that Meta’s AI Studio had been used to create flirtatious “parody” chatbots of celebrities like Taylor Swift and Scarlett Johansson. Testers found the bots often claimed to be the real people, engaged in sexual advances, and in some cases generated inappropriate images, including of minors. Although Meta removed several of the bots after being contacted by reporters, many were left active.

Some of the AI chatbots were created by outside users, but others came from inside Meta. One chatbot made by a product lead in its generative AI division impersonated Taylor Swift and invited a Reuters reporter to meet for a “romantic fling” on her tour bus. This was despite Meta’s policies explicitly banning sexually suggestive imagery and the direct impersonation of public figures.

The issue of AI chatbot impersonation is particularly sensitive. Celebrities face reputational risks when their likeness is misused, but experts point out that ordinary users can also be deceived. A chatbot pretending to be a friend, mentor, or romantic partner may encourage someone to share private information or even meet in unsafe situations.

Real-world risks

The problems are not confined to entertainment. AI chatbots posing as real people have offered fake addresses and invitations, raising questions about how Meta’s AI tools are being monitored. One example involved a 76-year-old man in New Jersey who died after falling while rushing to meet a chatbot that claimed to have feelings for him.

Cases like this illustrate why regulators are watching AI closely. The Senate and 44 state attorneys general have already begun probing Meta’s practices, adding political pressure to the company’s internal reforms. Their concern is not only about minors, but also about how AI could manipulate older or vulnerable users.

Meta says it is still working on improvements. Its platforms place users aged 13 to 18 into “teen accounts” with stricter content and privacy settings, but the company has not yet explained how it plans to address the full list of problems raised by Reuters. That includes bots offering false medical advice and generating racist content.

Ongoing pressure on Meta’s AI chatbot policies

For years, Meta has faced criticism over the safety of its social media platforms, particularly regarding children and teenagers. Now Meta’s AI chatbot experiments are drawing similar scrutiny. While the company is taking steps to restrict harmful chatbot behaviour, the gap between its stated policies and the way its tools have been used raises ongoing questions about whether it can enforce those rules.

Until stronger safeguards are in place, regulators, researchers, and parents will likely continue to press Meta on whether its AI is ready for public use.

(Photo by Maxim Tolchinskiy)

See also: Agentic AI: Promise, scepticism, and its meaning for Southeast Asia

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The post Meta revises AI chatbot policies amid child safety concerns appeared first on AI News.

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Resident Preferences for Telemedicine Services in China in the Digital Health Era: Mixed Methods Study

Background: In the digital health era, telemedicine has become a key driver of health care reform and innovation globally. Understanding the factors influencing residents’ choices of telemedicine services is crucial for optimizing service design, enhancing user experience, and developing effective policy measures. Objective: This study aims to explore the key factors influencing Chinese residents’ choices of telemedicine services, including consultation fee, physician qualifications, appointment waiting time, scope of services, privacy protection, and service hours. The study also analyzes preference heterogeneity among residents with different demographic characteristics to provide scientific evidence for optimizing telemedicine services in the digital health era. Methods: This study used a mixed methods design combining qualitative interviews and a discrete choice experiment. Interviews identified key telemedicine attributes, informing the discrete choice experiment scenarios. Preferences and willingness to pay were analyzed using mixed logit and latent class models. Results: Residents’ preferences for telemedicine services were primarily shaped by the scope of services, appointment waiting time, and privacy protection, with substantial willingness to pay for more comprehensive, secure, and timely services. The optimal telemedicine services configuration—offering consultation plus prescription, high privacy, immediate access, 24-hour availability, and expert physicians—yielded a maximum willingness to pay of RMB 661.6 (a currency exchange rate of US $1=RMB 7.1803 is applicable). Latent class analysis revealed pronounced heterogeneity: while privacy and service scope remained universally prioritized, older, male, rural, and less-educated residents favored broader coverage, easier platforms, and lower costs; younger, female, and highly educated groups preferred faster, higher-quality, and more privacy-sensitive services. Conclusions: This study reveals key drivers and significant demographic heterogeneity in Chinese residents’ preferences for telemedicine services. Residents demonstrated a high willingness to pay for comprehensive services (eg, “consultation + prescription”), enhanced privacy protection, and shorter appointment waiting times. Additionally, the study innovatively identified 3 distinct resident profiles: “Diverse-Service-Oriented,” “Utility-Oriented,” and “Value-Oriented,” and proposed differentiated optimization strategies to effectively address diverse resident needs, thereby promoting equitable access and efficient adoption of telemedicine services.
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Evolving Medical Students’ Digital Health Perceptions and Intentions: Insights From a Prepandemic and Postpandemic Survey Study

Background: The COVID-19 pandemic has underscored the importance of digital health (dHealth) technologies in medical practice. Despite this, medical curricula often provide limited exposure to these technologies. Objective: This study investigates the effects of the COVID-19 pandemic on medical students’ intentions to integrate dHealth technologies into their future practice. Methods: We employed a two-phase survey at the University of Montreal’s medical school to assess changes in perceptions before (N=184) and after (N=138) the pandemic. The survey used component-based structural equation modeling (SEM) and qualitative comparative analysis (QCA) to analyze our dataset. Results: Findings indicate limited exposure to dHealth technologies within the medical curriculum. However, there was a strong consensus on the necessity of formal dHealth training. A notable shift towards the acceptance of artificial intelligence (AI) and telehealth tools was observed, emphasizing the pandemic’s significant role in altering students' views on these technologies. Conclusions: The study advocates for the integration of formal dHealth training in medical curricula to better prepare future physicians for the demands of an increasingly digital healthcare landscape. The COVID-19 pandemic has significantly influenced medical students' perceptions, highlighting the urgent need to adapt medical education to include comprehensive dHealth training.
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