Annals of translational medicine最新文献

{"title":"Light therapy in medicine: where do we stand?","authors":"Yoshimasa Oyama, Andrea Witowski, Michael Adamzik, Karsten Bartels, Tobias de la Garza Eckle","doi":"10.21037/atm-2026-0041","DOIUrl":"10.21037/atm-2026-0041","url":null,"abstract":"<p><p>Light therapy encompasses a broad spectrum of interventions, ranging from established clinical applications to emerging and experimental indications. This review evaluates the current state of light therapy across medical disciplines, emphasizing the need to distinguish validated clinical uses, exploratory findings, and preclinical research. The biological effects of light therapy are diverse, with mechanisms depending on wavelength, route of delivery, and biological target. Ocular exposure to bright light primarily acts through the circadian system to influence mood and sleep, whereas peripheral photobiomodulation (PBM) and ultraviolet (UV) phototherapy act directly on local tissues to promote healing. Mitochondrial activation is a proposed general mechanism, but its centrality is likely modality- and context-dependent. Robust clinical evidence supports bright light therapy for seasonal affective disorder (SAD) and UV-B for psoriasis, while moderate evidence exists for dermatological and sleep applications. For delirium, bright light therapy has shown promise in small-scale studies, but large-scale confirmatory clinical trials are still lacking. Other reported uses, including pain management, ischemia-reperfusion (IR) injury, clotting disorders, and infectious lung injury, are largely supported by preclinical and mechanistic studies, particularly those involving intense light that elicits the circadian core protein Period 2 (PER2). The clinical relevance of these mechanisms remains under investigation. Overall, light therapy remains safe when used according to established protocols. This review aims to provide a nuanced synthesis of the field, highlighting both the promise and the limitations of light therapy and emphasizing the importance of the evidence hierarchy in guiding clinical translation and research priorities.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"35"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Electroacupuncture attenuates spared nerve injury-induced neuropathic pain possibly by promoting the progression of AMPK/mTOR-mediated autophagy in spinal microglia.","authors":"","doi":"10.21037/atm-2025b-2","DOIUrl":"10.21037/atm-2025b-2","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/atm-22-5273.].</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"46"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menin inhibition reshapes therapy in <i>NPM1</i>-mutated acute myeloid leukemia.","authors":"Thura Win Htut, Musa Yilmaz","doi":"10.21037/atm-2026-0051","DOIUrl":"10.21037/atm-2026-0051","url":null,"abstract":"","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"40"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does lung adenocarcinoma subtyping offer clinical benefits?-a retrospective population-based cohort study from Sweden.","authors":"Frantisek Zitricky, Kristina Sundquist, Jan Sundquist, Asta Försti, Akseli Hemminki, Rudolf Kaaks, Kari Hemminki","doi":"10.21037/atm-2026-0046","DOIUrl":"10.21037/atm-2026-0046","url":null,"abstract":"<p><strong>Background: </strong>Classification of lung adenocarcinoma into subtypes is relatively recent and not universally practiced. Consequently, large representative studies describing clinical outcomes are rare, failing to pervasively present the advantages of subtyping, which might potentially improve treatment and survival. Although many related studies have been published, few of them include large patient numbers of unselected adenocarcinoma subtypes, which has probably resulted in discrepant results. We describe the situation in Sweden with the largest study on a European population with a focus on survival.</p><p><strong>Methods: </strong>Patient data were obtained from the Swedish Cancer Registry from 2005 to 2021, accounting for 1,418 patients, less than 5% of the reference group 'adenocarcinoma not otherwise specified (NOS)'. All reported adenocarcinoma patients were included from the cancer registry, with complete national coverage of patients and pathological verification of diagnoses. Non-parametric survival estimates were calculated using the Kaplan-Meier method and testing for linear consistency using Weibull modelling.</p><p><strong>Results: </strong>Survival was generally better for women compared to men and this was most prominent for early-stage cancers. Female 5-year survival decreased in order, lepidic [59%, 95% confidence interval (CI): 55-65%], papillary (51%, 95% CI: 40-64%), invasive mucinous (46%, 95% CI: 32-66%), colloid (36%, 95% CI: 30-43%) and adenocarcinoma NOS (24%, 95% CI: 24-25%). Male 5-year survival for lepidic (46%, 95% CI: 40-53%) and colloid subtypes (22%, 95% CI: 16-29%) was significantly lower than female survival. Survival slopes for T1, T2, N0, M0 cases of lepidic, papillary and adenocarcinoma NOS were almost linear, suggesting homogeneous diagnostics. Survival kinetics were in agreement with Weibull modelling k-values of 1.00 or slightly higher, implying that mortality increased slowly with time, only moderately faster than for the background population of similar age.</p><p><strong>Conclusions: </strong>The present study is among the largest ones so far published on unselected stages of adenocarcinoma subtypes. Our findings demonstrate a significant female survival advantage across most adenocarcinoma subtypes. Survival in T1 and T2 classes with N0 and M0 for lepidic, papillary and adenocarcinoma NOS was close to linear, suggesting that patients are homogeneously diagnosed and treated. Survival benefits of lepidic and papillary subtypes over adenocarcinoma NOS give justification for adenocarcinoma subclassification, and independently validate the prognostic advantage of lepidic and papillary subtypes proposed in the World Health Organization (WHO) 2021 adenocarcinoma grading classification.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the algorithm: health technology assessment frameworks for AI in cardiology under the European Union Health Technology Assessment Regulation: a systematic review.","authors":"Lucía Osoro, Baptiste Vasey, Peter McCulloch, Felix Broghammer, Stephen Gilbert, Juan Carlos Rejon-Parrilla, Dipak Kalra, Rubén Casado-Arroyo","doi":"10.21037/atm-2026-0052","DOIUrl":"10.21037/atm-2026-0052","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is increasingly used in cardiovascular care to support diagnosis, monitoring and clinical decision-making. However, its dynamic and adaptive nature challenges conventional health technology assessment (HTA) frameworks, which are typically designed for static interventions. This review aims to assess how existing literature supports HTA-relevant evaluation of AI-based cardiovascular technologies and examine their alignment with the evidentiary requirements outlined in the European Union Health Technology Assessment Regulation (EU HTAR).</p><p><strong>Methods: </strong>A structured literature search was conducted in PubMed, Scopus, and ScienceDirect databases for studies published between January 2020 and December 2025. After screening 223 records, 33 full texts were reviewed and six met inclusion criteria. A narrative synthesis was performed, alongside a comparative analysis of three HTA frameworks.</p><p><strong>Results: </strong>Six studies were included in the final synthesis, covering cardiovascular AI applications such as stroke outcome prediction, atrial fibrillation screening and wearable-based monitoring. Supported by 17 documents. Four studies incorporated real-world data, though lifecycle adaptability and post-deployment evaluation were rarely addressed. Most focused on clinical or economic performance, without referencing formal HTA frameworks. Alignment with the EU HTAR was indirect and stakeholder engagement, particularly with cardiologists, was inconsistently reported. These findings indicate increasing clinical adoption of cardiovascular AI but limited integration with structured HTA processes or regulatory foresight.</p><p><strong>Conclusions: </strong>While AI tools in cardiology show increasing promise, current HTA practices do not yet fully align with the regulatory and methodological expectations of the EU HTAR. Adapted evaluation models are needed to support the effective, evidence-based adoption of AI technologies in cardiovascular care.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tutorial: translating a validated breast cancer prediction model into a web-based decision aid using R Shiny.","authors":"Emily A Wolfson, Long H Ngo, Mara A Schonberg","doi":"10.21037/atm-2026-0070","DOIUrl":"10.21037/atm-2026-0070","url":null,"abstract":"<p><p>Risk prediction model development has expanded rapidly, but few models have been translated into patient-facing tools that support informed decision-making. Existing breast cancer models provide no guidance on how to incorporate risk into decisions around screening or prevention medications, limiting their practical utility. To address this gap, we previously developed and validated a competing risk regression model that simultaneously predicts breast cancer and non-breast cancer death and then developed a web-based decision aid application that integrates this model with interactive, personalized information on screening and prevention medications. Using this application as a case study, we present a framework for developing an online decision aid using R Shiny. While prior Shiny tutorials have focused on simple applications or calculators, practical guidance for integrating risk prediction into multi-page, interactive decision support tools remains limited. In our tutorial, we describe key components of development, including application structure, user input collection, real-time calculation of individualized risk estimates, and presentation of results in a clear, interpretable format. We also demonstrate implementation of core Shiny functionalities, including reactive values for dynamic updates, data visualization techniques to contextualize risk estimates, and use of the observeEvent function to enable conditional display and navigation. Through this tutorial, we illustrate how risk calculators can be extended into comprehensive, dynamic and clinically useful tools that support informed decision-making.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"33"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic eczematous eruptions of aging: a clinical practice review.","authors":"J Skylar Westerdahl, Richard D Sontheimer","doi":"10.21037/atm-25-142","DOIUrl":"10.21037/atm-25-142","url":null,"abstract":"<p><p>Chronic eczematous skin disorders that first appear in later life are poorly characterized, partly because existing terminology is inconsistent and often conflates morphologic descriptors with specific diagnoses. This review introduces chronic eczematous eruptions of aging (CEEsA) as an umbrella term, summarizes current knowledge on its epidemiology, etiologies, and clinical presentation, outlines best practices in management, and highlights gaps requiring further investigation. CEEsA frequently present as ill defined, intensely pruritic eruptions on the trunk and extensor limbs, are often refractory to standard topical therapies, and may be precipitated by calcium channel blockers or thiazide diuretics. A structured diagnostic algorithm-incorporating exclusion of mimickers (e.g., tinea pedis-linked auto-eczematization, scabies, contact dermatitis, cutaneous T-cell lymphoma), lesional biopsy, patch testing, and strategic drug withdrawal-is essential before escalating to systemic therapy. This approach helps avoid unnecessary treatment or other etiologies with different management. Although traditional broad spectrum immunosuppressants carry age related safety concerns, emerging targeted agents that dampen type 2 cytokine signaling (dupilumab, tralokinumab) or Janus kinase pathways (upadacitinib) show promising efficacy and tolerability in small case series of CEEsA, including idiopathic forms. Recognizing CEEsA as a distinct clinical construct should streamline nomenclature, sensitize clinicians to reversible drug triggers, and catalyze research into pathophysiology-specific, age appropriate treatments for this under studied geriatric dermatology domain.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"37"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalization, ICU admission, and mortality among diabetic patients with inflammatory bowel disease receiving SGLT-2 inhibitors: a retrospective cohort study from the global collaborative network.","authors":"Omar Abdelhalim, Mohammed Y Youssef, Sawsan Al-Lababidi, Mohamed H Eldesouki, Ahmed Mohamed, Mohammed Abusuliman, Mahmoud Nassar, Mohammad Abushanab, Ahmed Salem, Hassan Shaheen, Ahmed Aref, Khaled M Elhusseiny, Chloe Lahoud, Zara Bhutta, Hazem Abosheaishaa","doi":"10.21037/atm-2026-0131","DOIUrl":"10.21037/atm-2026-0131","url":null,"abstract":"<p><strong>Background: </strong>Patients with coexisting type 2 diabetes mellitus (T2DM) and inflammatory bowel disease (IBD) represent a high-risk population with competing comorbidities, complex medication regimens, and overlapping inflammatory pathways. Although the role of sodium-glucose co-transporter-2 (SGLT2) inhibitors in managing type 2 diabetes is well-established, their impact on outcomes in diabetic patients with coexisting IBD remains unclear. This study aimed to investigate the association between SGLT2i use and hospitalization, intensive care unit (ICU) admission, mortality, IBD-related complications, and surgical procedures in diabetic patients with IBD.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the TriNetX Global Collaborative Network. Cohort 1 comprised diabetic patients with IBD who received SGLT2 inhibitors with at least three dispensations within one year of IBD diagnosis, and Cohort 2 comprised diabetic patients with IBD never prescribed SGLT2i, matched on baseline characteristics, comorbidities, IBD-specific medications, and laboratory values, yielding 3,950 patients per cohort. Clinical outcomes were evaluated at 1 and 5 years following the index event.</p><p><strong>Results: </strong>At 1 year, hospitalization, ICU admission, and mortality were significantly lower in Cohort 1 [risk ratio (RR): 0.886, P<0.001; RR: 0.851, P=0.03; and RR: 0.525, P<0.001, respectively]. Kaplan-Meier analysis demonstrated improved survival in Cohort 1 [94.27% <i>vs.</i> 88.76%, P<0.001; hazard ratio (HR): 0.490]. IBD-related complications and surgical procedures were also significantly reduced (RR: 0.879, P=0.004 and RR: 0.548, P=0.02, respectively). At 5 years, hospitalization, ICU admission, and mortality remained significantly lower in Cohort 1 (RR: 0.932, P=0.002; RR: 0.848, P=0.003; and RR: 0.545, P<0.001, respectively). Kaplan-Meier analysis continued to demonstrate improved survival in Cohort 1 (85.01% <i>vs.</i> 74.95%, P<0.001; HR: 0.532), whereas IBD-related complications and surgical procedures were numerically lower but no longer statistically significant (RR: 0.954, P=0.18 and RR: 0.741, P=0.15, respectively).</p><p><strong>Conclusions: </strong>SGLT2i therapy in diabetic patients with IBD was associated with reduced hospitalization, ICU admission, and mortality, with persistent benefits observed at both 1 and 5 years of follow-up. Reductions in IBD-related complications and surgical procedures were observed, particularly at 1 year. These findings suggest a potential disease-modifying role warranting further prospective investigation.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of different atropine regimens: MOSAIC2.","authors":"Audrey Chia","doi":"10.21037/atm-2026-0039","DOIUrl":"10.21037/atm-2026-0039","url":null,"abstract":"","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic photodynamic therapy for endobronchial metastatic papillary thyroid carcinoma causing lobar airway obstruction: a case report.","authors":"Amir R Reihani, Bhavana Konda, Fadi A Nabhan, Peter Kobalka, Alberto E Revelo","doi":"10.21037/atm-2026-0057","DOIUrl":"10.21037/atm-2026-0057","url":null,"abstract":"<p><strong>Background: </strong>Bronchoscopic photodynamic therapy (PDT) is a guideline-supported, non-thermal modality for malignant central airway obstruction. It may be particularly advantageous for hypervascular endobronchial tumors in which immediate mechanical or thermal debulking carries heightened hemorrhage risk. While PDT is well described in primary lung malignancies, published experience in non-lung-primary endobronchial metastases remains limited.</p><p><strong>Case description: </strong>A 71-year-old never-smoking woman with advanced radioactive iodine (RAI)-refractory BRAF V600E-mutated papillary thyroid carcinoma (PTC) with pulmonary, brain, and bone metastases presented with imaging evidence of a left lower lobe (LLL) lesion with endobronchial extension. Bronchoscopy demonstrated a friable, highly vascular endobronchial tumor causing approximately 90% obstruction of the LLL bronchus and a smaller non-occlusive lesion in the superior segment of the right lower lobe (RLL). Given lesion vascularity and bleeding-risk concerns with immediate debulking, a staged PDT approach was selected. Porfimer sodium [Photofrin; 2 mg/kg intravenous (IV)] was administered, followed by bronchoscopic light activation (630 nm) using a 2-cm cylindrical diffuser fiber. PDT was delivered to both lesions (100 J over 250 seconds per site). A repeat bronchoscopy 72 hours later demonstrated approximately 50% airway lumen improvement following removal of necrotic tissue and mucus, and PDT was repeated with identical parameters. Subsequent re-evaluation demonstrated necrotic post-PDT changes, and adjunctive cryodebulking was performed. Pathology confirmed metastatic PTC. Follow-up chest computed tomography demonstrated recanalization of the LLL bronchus and mild decrease in the dominant LLL mass.</p><p><strong>Conclusions: </strong>Staged bronchoscopic PDT and adjunct cryotherapy provided effective local airway control for hypervascular endobronchial metastatic PTC causing lobar obstruction, with complete response of a smaller non-obstructive RLL lesion, without major bleeding or airway compromise. PDT may be a safe and effective adjunctive therapy for selected patients with metastatic endobronchial PTC.</p>","PeriodicalId":8216,"journal":{"name":"Annals of translational medicine","volume":"14 3","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13349721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}