by Freddy Oulia, Philippe Charton, Muhammad Kabir, Fabrice Gardebien, Cédric Damour, Frederic Cadet
Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adults, with a median survival of 14.6 months under standard radiotherapy and temozolomide (TMZ) chemotherapy. The methylation status of the O⁶-methylguanine-DNA methyltransferase (MGMT) promoter is a critical biomarker predicting TMZ response; however, its determination currently requires invasive tissue sampling. Non-invasive prediction of MGMT promoter methylation from multiparametric MRI (mpMRI) through deep learning represents a compelling alternative, yet its clinical feasibility remains unresolved. Using the BraTS 2021 dataset (582 patients, four MRI sequences: FLAIR, T1w, T1wCE, T2w), we conducted a systematic comparative study of unimodal and multimodal deep learning approaches based on VGG-16, exploring 1,380 experimental configurations (unimodal: 192; multimodal: 1,188) across three imaging planes, eight slice counts, and three multimodal fusion strategies (early, intermediate, and late fusion). In the unimodal setting, the best model trained on T2w coronal images (32 slices, no transfer learning) achieved an accuracy of 0.6458 and an AUC of 0.6422 on the validation set, but dropped to 0.5586 and 0.5533 on the independent test set, revealing substantial overfitting attributable to limited dataset size. Strikingly, multimodal fusion consistently failed to outperform the best unimodal model, with all three fusion strategies plateauing at ~0.64 accuracy and ~0.64 AUC on validation data. Transfer learning improved generalization across train/test distributions at the cost of peak performance. These findings suggest, for the tested framework in this study, that MGMT methylation status prediction from mpMRI remains fundamentally constrained by dataset heterogeneity and size, irrespective of modality combination strategy, and that T2w coronal acquisitions could be more interesting in future data collection efforts.To assess the burden of diabetes and prediabetes in the educational sector in Bahawalpur City, Pakistan.
Cross-sectional study.
Teaching institutes of Bahawalpur, Pakistan, during January 2024 to December 2024.
A total of 955 participants from 15 universities, colleges and schools were included. Eligible participants were aged 18–75 years and employed as teachers or academic staff and enrolled using a non-probability consecutive sampling technique. Primary anthropometric measurements, blood pressure, smoking status and HbA1c levels were recorded. Prediabetes was defined as HbA1c 5.7–6.4% and type 2 diabetes mellitus (T2DM) as HbA1c ≥6.5%.
Among 955 participants, 622 (65.1%) were male and 713 (74.7%) were teaching staff. The median age was 42 years, and median BMI was 27.3 kg/m². The prevalence of prediabetes and T2DM was 31.7% and 15.4%, respectively, with 8.5% newly diagnosed cases of T2DM. Multivariate binary logistic regression analysis found that age (p=0.006), BMI (p=0.008) and family history of diabetes (p
This study highlights a significant prevalence of T2DM and prediabetes in the educational sector of Bahawalpur, Pakistan. Increasing age, BMI and positive family history of diabetes were independent predictors of prediabetes/T2DM.
The EPHOR-NIGHT cohort was established to investigate how night shift work influences biological pathways and chronic disease risk using a comprehensive working-life exposome approach, focusing on cardiometabolic, mental health, cognitive and biological ageing outcomes.
The cohort includes 937 workers aged 20–65 years (88% female), primarily from the healthcare sector (96%) in Spain, Sweden, Denmark and the Netherlands. Participants were categorised as permanent day (39%), permanent night (35%) or rotating/other shift workers (26%). Data collection included questionnaires, daily ecological momentary assessments, wearable sensors tracking light, physical activity, heart rate and environmental exposures and biological samples (blood collected once and saliva collected during five points across the day), with harmonised protocols across countries.
From the 937 participants contributing data to the cohort, 708 had complete information from questionnaires, sensors and blood and saliva, with subsets undergoing advanced biological analyses, including genomics, targeted and genome-wide DNA methylation, telomere length and mtDNA copy number, metabolomics, transcriptomics, proteomics, hormone profiling and inflammatory biomarkers and blood metals. Many reported prevalent chronic conditions, including anxiety (27%), depression (18%) and metabolic disturbances. Night shift and rotating shift workers had greater exposure to long shifts and more scheduled rest days compared with day workers. Sleep duration and quality were poorest among permanent night shift workers.
A 2-year follow-up was completed in June 2025, including the collection of additional biomarker data, psychosocial work environment data and data related to female sexual and reproductive health. Findings from the EPHOR-NIGHT study aim to inform prevention strategies and occupational health policies. Data will be made available to support broader research efforts on shift work and health.
Commentary on: Skov SK, Hjorth S, Kirkegaard H et al. Mode of delivery and short-term maternal mental health: a follow-up study in the Danish national birth cohort. International Journal of Gynecology & Obstetrics. 2022 Nov;159(2):457-65.
Implications for practice and research Mode of delivery is associated with postpartum mental health, so mothers with emergency caesarean section (EmCS) need more support for their mental health. Therefore, healthcare providers should pay special attention to the increased risk of anxiety, depression and stress in these women and provide appropriate care and follow-up. Along with investing in technologies and clinical practice to minimise the number of EmCS, more research and education are needed to develop effective strategies to prepare and support women experiencing this delivery mode.
Caesarean section (CS) is a lifesaving intervention which can be used when complications arise during pregnancy or delivery. In the last...
To explore how persons with cancer construct and socially position themselves in online blogs. Clarifying the discursive practice of self-construction can deepen healthcare professionals' understanding of how persons with cancer perceive themselves and their place in society.
Mixed qualitative and quantitative design using corpus-assisted critical discourse analysis.
Online blogs active between 2015 and 2023 were evaluated. Google search with keywords: ‘Blog about cancer’ was conducted. Corpus-assisted critical discourse analysis, following Fairclough's framework, was used to analyse data from four persons with cancer living in Norway.
The analysis identified three discursive practices in which bloggers constructed themselves: a discourse of a person's existence, a discourse of norms, and a discourse of a paternalistic system. The bloggers constructed themselves as being trapped in their own bodies, changed and vulnerable individuals who should conform to the expected behaviours, and not being seen and heard by the healthcare system.
The bloggers with cancer struggled between holistic and dualistic ideology, wishing to separate their bodies from themselves and constructed themselves as changed persons. Moreover, they struggled with societal expectations and adapted themselves to a paternalistic healthcare system, despite their desire to be seen and heard as individuals.
This study investigated the experiences of patients living with cancer, offering valuable knowledge for nurses, other healthcare professionals, and the government. The study uncovered that persons with cancer constructed themselves as changed persons and felt vulnerable socially and within a paternalistic healthcare system. These results may provide a stimulus for further discussions on the patient roles in cancer treatment and how to meet their needs for care and treatment.
This study adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.
No patient or public contribution.