医学最新文献

Therapeutic immunization against tumor neoantigens has the potential to induce potent and highly selective CD8⁺ T-cell-mediated antitumor immunity. Consequently, immunization strategies that generate robust neoantigen-specific T-cell responses are needed. Here, we tested homologous and heterologous DNA- and peptide-based immunization strategies using a neoantigen model. We observed that priming with DNA followed by peptide boost immunization elicited the strongest CD8⁺ T-cell responses, which exhibited effector and memory precursor phenotypes and led to the formation of circulating and skin-resident memory T cells. In prophylactic settings, this immunization regimen delayed the growth of B16F10 melanoma and rejected EL4 lymphoma cells expressing a self-antigen. In a therapeutic setting, a DNA prime-peptide boost eliminated EL4 tumors expressing the neo-epitope model in most mice. Consistently, DNA prime-peptide boost targeting two bona fide neoepitopes of MC38 tumor model elicited neoepitope-specific CD8⁺ T-cell responses and a marked therapeutic effect, which may be enhanced by combining with anti-PD-1 antibody. These results highlight the potential of DNA prime-peptide boost as a promising strategy for therapeutic neoantigen immunization that elicits strong CD8⁺ T-cell responses and potent antitumor effects.

Purpose: The pathophysiology of benign prostatic hyperplasia (BPH), a prevalent condition among aging males, remains unclear. Given emerging evidence implicating oxidative stress (OS) in prostatic pathogenesis, this study investigated the association between the comprehensive Oxidative Balance Score (OBS) and BPH prevalence.

Materials and methods: The National Health and Nutrition Examination Survey (NHANES) database was selected to determine BPH using a self-report questionnaire, and multivariate logistic regression was performed to explore the correlation between OBS and BPH. Smoothed curve fitting, threshold effect analysis, and stratified analysis were performed.

Results: The present study, which ultimately included 621 participants, showed that after adjusting for potential confounders, an increase in OBS was associated with a slightly increased risk of developing BPH compared with the lowest tertile (T1) (OR = 1.07, 95% CI: 1.02,1.13, P = 0.015; OR = 1.09, 95% CI: 1.01, 1.17, P = 0.029). Smoothed curve fitting showed that when OBS was >21, the risk of developing BPH was associated with a 27% increase in the risk (OR = 1.27, 95% CI: 1.13, 1.43).

Conclusion: This study reveals a significant non-linear association between OBS and BPH: when OBS > 21, higher OBS scores are associated with an increased risk of BPH.

Background: Rates of hypertensive disorders affecting pregnancy are increasing, and bipolar disorder is more common in pregnancy than previously thought.

Objective: The authors investigated differences in the incidence of hypertensive disorders of pregnancy between those with and without bipolar disorder (BPD) and between those receiving and not receiving pharmacotherapy for BPD. Differences in the incidence of hypertensive disorders of pregnancy in those with BPD between those on prophylactic aspirin (ASA) and not, were also examined.

Methods: EPIC COSMOS was used to examine records from 2019 to 2023.

Results: The authors found a meaningful difference in proportions between those with and without BPD when observing development of hypertensive disorders of pregnancy across years. Slightly increased odds of hypertensive disorders were found among those reporting BPD pharmacotherapy compared to those not. Slightly increased odds of hypertensive disorders occurred in those with BPD reporting ASA.

Conclusions: The increased odds among those reporting BPD pharmacotherapy could be due to sequelae of disease, medication used, or comorbidities. These findings further corroborate prior evidence of the increasing prevalence of both maternal health complications and mental health disorders int eh United States.

Introduction: Artificial intelligence (AI) is rapidly transforming healthcare systems and clinical practice, increasing the need to prepare future physicians to work effectively with AI technologies in clinical contexts. Despite growing interest in integrating AI into medical education, empirical evidence regarding medical students' readiness to use AI remains limited. This study aimed to assess medical AI readiness among Korean medical students and explore factors associated with their readiness.

Methods: A cross-sectional survey was conducted among medical students enrolled in a six-year medical program at a university in Korea. A total of 204 students participated in the study. Medical AI readiness was measured using the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS), which assesses four domains: cognition, ability, vision, and ethics. Descriptive statistics, independent t-tests, and Pearson's correlation analyses were performed using SPSS version 27.

Results: The overall mean score of medical AI readiness was 4.19 on a 7-point Likert scale, indicating a moderate level of medical AI readiness. Among the subscales, ethics showed the highest mean score (4.69), followed by vision (4.44), ability (4.18), and cognition (3.92). The frequency of AI use was significantly associated with medical AI readiness, whereas the daily duration of AI use was not. No significant gender differences were observed. When students were divided into the low (pre-medical years 1-2) and high (medical years 1-4) groups, the high group showed significantly higher scores only in the ability subscale.

Conclusions: The findings suggest that medical students are not yet sufficiently prepared to utilize AI technologies in clinical practice, particularly in terms of knowledge and practical competencies related to AI. These results highlight the need for structured and longitudinal AI education in medical curricula to better prepare future physicians for AI-integrated healthcare environments.

Purpose: This study aimed to qualitatively examine the daily lives of motorcycle-based food delivery workers, focusing on how they experience, perceive, and interpret their health-related issues.

Methods: Semi-structured in-depth interviews were conducted with nine MFDWs in South Korea between July and September 2024 to explore their perceptions of health. Participants were recruited through purposive and snowball sampling, and data were analyzed using thematic analysis.

Results: Thematic analysis revealed the following key findings: MFDWs' challenging working conditions posed physical and emotional stressors, which contributed to negligent driving and unhealthy habits. Although they recognized traffic accidents as the most critical health risk, they exhibited a tendency toward risky driving behaviors. Unhealthy lifestyles were linked to further health deterioration. While the majority showed a passive attitude toward health management, a few adopted individual strategies to maintain their health.

Conclusions: The findings suggest the need for policy-level attention to mitigate traffic accident risk factors among MFDWs. Larger and more diverse studies are required to confirm these findings and to provide a stronger evidence base for policy recommendations. In addition, delivery applications could be further refined to help reduce occupational risks, and the development of tailored health promotion interventions may support their health and well-being.

IgA vasculitis (IgAV) primarily affects small vessels, but rare cases with necrotizing arteritis (NA) raise questions about overlap with polyarteritis nodosa (PAN). To characterize IgAV with necrotizing arteritis (IgAV-NA) and compare its phenotype with classical IgAV and PAN. We performed a multicenter retrospective study combined with a systematic literature review (1990-2025). Patients fulfilled EULAR/PRINTO/PRES IgAV criteria, had pathological or imaging evidence of NA in small or medium arteries, and were ANCA-negative. Thirty patients were included (7 from databases, 23 from the literature). NA was confirmed by biopsy (n = 16) or vascular imaging (n = 14). Clinical features, treatments, remission, and mortality were compared with 257 adult IgAV and 196 PAN patients. Median age was 54.5 years. IgAV-NA was characterized by severe manifestations, including gastrointestinal bleeding, perforation, surgical abdomen, neuropathy, pancreatitis, and livedo. Compared with classical IgAV, IgAV-NA showed significantly higher rates of multi-organ involvement and mortality. Compared with PAN, IgAV-NA shared vascular complications but had less fever and neuropathy. Despite arterial involvement, patients did not fulfil PAN criteria. IgAV-NA represents a rare, severe IgAV phenotype with life-threatening complications rather than an IgAV-PAN overlap. Severe or atypical IgAV presentations should prompt vascular imaging and intensified immunosuppression.