Patient's Perspective on the Impact of Psoriasis on Their Quality of Life After 1 Year of Tildrakizumab Treatment: Despite Clinical Improvement, Persistence of a Potential Mental Cicatricial Memory of the Disease

ABSTRACT Background Tildrakizumab showed high efficacy and safety for treating moderate‐to‐severe psoriasis in clinical trials. The development of biologics to treat psoriasis has allowed us to aim for increasingly ambitious objectives. However, patients' and physicians' perspectives on therapeutic goals and satisfaction concerning treatments may sometimes differ. Objectives To analyze the efficacy and safety of tildrakizumab and the impact of the psoriasis improvement regarding the physicians' and patients' point of view, in daily practice, after 1 year of treatment. Methods A prospective multicentric study was conducted in patients who were initiated with tildrakizumab for moderate‐to‐severe psoriasis. Assessments of psoriasis and its impact on patients' lives were performed at tildrakizumab initiation and after 6 and 12 months of treatment. Results At baseline, psoriasis deeply affected patients' lives, with 42% showing signs of clinical depression and 34.6% experiencing genital involvement with significant impact on their sex life. After 1 year, tildrakizumab was, overall, effective and safe, even in difficult‐to‐treat areas. Psoriasis Area Severity Index score decreased from 13.6 to 2.3, SF12‐mental component score improved from 41 to 48.7 and Dermatology Life Quality Index dropped from 10.4 to 2.5. Despite these improvements, some patients remained dissatisfied, expressing concerns about relapse and persistence of mental impact of the disease over the long term. Conclusions Tildrakizumab confirmed its efficacy and safety for the treatment of moderate‐to‐severe psoriasis. However, despite good control of their disease, some patients remained dissatisfied, over the long time, raising the issue of the cumulative mental impact of a disease left with no effective treatment for too long before the initiation of an effective treatment. These findings suggest that early treatment of psoriasis with effective therapies is important not only to target tissue‐resident memory T cells, as indicated by recent studies, but also to potentially address patients' cicatricial memory of their disease.

Nasopharynx Cancer in the United States : Racial and Ethnic Disparities in Stage at Presentation

Introduction Although nasopharynx cancer (NPC) is rare in the United States, global epidemiology varies greatly. Therefore, understanding NPC disparities in the diverse US setting is critical. Methods and Materials Data from the National Cancer Database (NCDB, 2004‐2021) identified patients with NPC; NCDB allows disaggregation by Asian American (AA) subgroups. Multivariable ordinal logistic regression adjusting for demographic and socioeconomic factors defined adjusted odds ratios (aORs). Results Of 15,862 patients, 11,173 (70.4%) were male (median age 59). Commonest groups included 10,034 (63.3%) White, 2,272 (14.3%) Black, 1,103 (7.0%) Chinese, 442 (2.8%) Filipino, and 338 (2.1%) Vietnamese patients. Prior to disaggregation, the proportion of stage IV disease at presentation was 43.2% among White (ref), 50.0% among Black (aOR 1.12, p  = 0.012), 52.0% among Native American (aOR 1.18, p  > 0.05), 41.9% among AA (aOR 0.97, p  > 0.05), and 55.1% among Native Hawaiian and Other Pacific Islander patients (aOR 1.47, p  = 0.021). Upon disaggregation, the proportion of stage IV disease was the greatest (>50%) among Black (50.0%, aOR 1.12, p  = 0.012), Laotian (61.5%, aOR 2.21, p  = 0.001), Hmong (73.2%, aOR 2.92, p  < 0.001), and Other Pacific Islander patients (60.9%, aOR 1.83, p  = 0.004); 44.2% of Filipino patients also presented with stage IV disease (aOR 1.21, p  = 0.033). Odds of presenting with advanced stage disease were lower among Chinese patients (35.7% stage IV, aOR 0.72, p  < 0.001). Conclusions Although most NPC patients were Chinese, White, or Black, stage IV disease at presentation was most common among Hmong, Laotian, non‐Hawaiian Pacific Islander, and Black patients. Efforts are needed to improve awareness of NPC among less canonically affected groups. Level of Evidence 4 Laryngoscope , 135:1113–1119, 2025

Surgical Complications for Oral Cavity Cancer: Evaluating Hospital Performance

Objective Complications of oral cavity cancer (OCC) surgery have an impact on the quality of life. Therefore, evaluating hospital performance on complication rates can help identify best practices for improving the quality of OCC care. As patient and tumor characteristics also impact hospital results, case‐mix adjustment should be considered to provide a valid hospital comparison. This study investigated hospital variation in the quality indicator “a complicated postoperative course” after OCC surgery. Methods This population‐based cohort included all first primary OCC patients diagnosed between 2018 and 2021 who were surgically treated with curative intent. A complicated postoperative course was defined as 30‐day mortality, unplanned readmission, surgical complications requiring reintervention or prolonged hospital stay, or fistula formation. Hospital performance was analyzed using funnel plots with case‐mix correction. Results A total of 2,266 OCC patients could be included. The distribution of case‐mix variables varied significantly between hospital populations. Nationally, a complicated postoperative course occurred in 13.9% and uncorrected hospital rates ranged from 2.7% to 31.1%. A WHO performance score ≥2, cT3‐T4 tumors, and floor‐of‐mouth tumors were associated with an increased risk of a complicated postoperative course, and non‐squamous cell carcinoma with a decreased risk. Significant outliers remained after case‐mix correction for patient, tumor, and treatment characteristics. Conclusion Complications after OCC surgery are prevalent, especially regarding extensive tumors and surgery. To identify best practices in OCC surgery, hospital performance on a complicated postoperative course should be adjusted for case‐mix and treatment variables. Providing feedback on hospital performance for complications can instigate improvement plans for better outcomes. Level of Evidence 3 Laryngoscope , 135:2411–2419, 2025

Neck Active Monitoring After Partial Laryngectomy for cT2N0M0 True Vocal Cord SCC : A 10‐Year STROBE Analysis

ABSTRACT Objective To evaluate 10‐year nodal outcome of active monitoring of the neck for cT2N0M0 true vocal cord (TVC) squamous cell carcinoma (SCC) after frontline partial laryngectomy (PL). Study Design Retrospective observational study adhering to the STROBE guideline. Setting French academic tertiary referral care center. Patients Inception cohort of 81 isolated and untreated cT2N0M0 TVC SCC consecutively managed between 1983 and 2013 with frontline PL and active monitoring of the neck. 85% of patients were followed until death or for at least 10 years. Main Outcome Measures Main endpoint was 10‐year actuarial nodal control analysis. Secondary endpoints were the search for potential variables increasing the risk for nodal recurrence, management of nodal recurrence, and analysis of the oncologic consequences of nodal recurrence. The significance threshold was set at p  < 0.005. Results The 10‐year actuarial nodal control estimate was 90% with salvage treatment, yielding a 99% overall nodal control rate. On univariate analysis, none of the variables assessed significantly statistically increased the risk for nodal recurrence. The 10‐year actuarial estimate of distant metastasis was 0% in patients with nodal control as compared with 35% in patients with nodal recurrence ( p  < 0.0001). The 10‐year actuarial survival estimate was 0% in patients with nodal recurrence as compared with 67% in patients with nodal control ( p  < 0.0001). Among the 37 patients who died, uncontrolled SCC was the cause of death in 33% of patients who had a nodal recurrence and 3% of those who did not. Conclusion Active monitoring of the neck for cT2N0M0 TVC SCC managed with PL, although not detrimental in terms of overall nodal control, is impaired by the negative oncological impact of nodal recurrence. Level of Evidence 4.

Head and Neck Cancer in Southeast Asia: 2022 Incidence, Mortality, and Projections to 2050

ABSTRACT Objectives To characterize the incidence, mortality, and disparities in head and neck cancer (HNC) across Southeast Asia (SEA) in 2022 and project trends to 2050 to inform cancer planning. Methods We conducted a population‐based analysis using 2022 Global Cancer Observatory data from 11 SEA countries. We analyzed cancers of the lip and oral cavity, salivary glands, oropharynx, nasopharynx, hypopharynx, larynx, and thyroid. Age‐standardized incidence and mortality rates (ASIR and ASMR) were calculated using the Segi‐Doll world standard. Projections to 2050 were based on demographic changes using UN World Population Prospects data, assuming stable incidence and mortality rates. Results Myanmar had the highest oral cancer rates (ASIR: 6.6 males, 2.6 females; ASMR: 3.9 males, 1.6 females). Elevated salivary gland cancer incidence was observed in Indonesia, the Philippines, and Singapore. Oropharyngeal cancers showed strong male predominance in Myanmar (ASIR ratio: 10:1). Nasopharyngeal cancer incidence in Brunei and Indonesia exceeded global averages (ASIR: 9.8 and 9.6 males). Projections to 2050 estimate 47,000 new male cases and 28,200 new female cases in Indonesia, with 30,600 male deaths and 12,200 female deaths. While SEA's overall ASIR for HNC (18.0) was comparable to the global average (18.9), the ASMR was significantly higher (9.5 vs. 5.3). Conclusions The rising burden of HNC in SEA highlights urgent disparities in incidence and mortality. Targeted prevention, early detection, and investment in cancer care systems are essential to mitigate future disease burden and improve outcomes. Level of Evidence Level III—Epidemiologic study using population‐based registry data.

Consistent cell‐specific carbon fixation rates by small eukaryotic phytoplankton in contrasting nutrient‐limited conditions

Abstract Small phytoplankton, consisting of pico and nano size fractions, are diverse in size and taxonomy. Yet, the differences in their productivity and taxonomic diversity are poorly described. Here, we measured the cell‐specific carbon fixation rates of picocyanobacteria Synechococcus , picoeukaryote, and nanoeukaryote populations, while unveiling their taxonomic composition in oligotrophic subtropical and high‐nutrient low‐chlorophyll subantarctic waters. We coupled 24 h in situ radiolabeled 14 C incubations to flow cytometry sorting and DNA metabarcoding from the same incubated samples, offering a direct account of the community associated with the carbon fixation rates measured. In both water masses, nanoeukaryotes had the highest cell‐specific carbon fixation rate, followed by picoeukaryotes and Synechococcus (2.24 ± 29.99, 2.18 ± 2.08, and 0.78 ± 0.55 fgC cell −1  h −1 , respectively). The cell‐specific carbon fixation rates and growth rates of Synechococcus were threefold higher in subtropical compared to subantarctic waters, while the rates of picoeukaryotes and nanoeukaryotes had no significant difference between the biogeochemically‐contrasting water masses. Sorted picoeukaryote populations were dominated by Mamiellophyceae, Pelagophyceae, Prymnesiophyceae, and Chrysophyceae, while nanoeukaryote populations were dominated by Dinophyceae and Prymnesiophyceae. Despite significant differences in their taxonomic composition, the sorted picoeukaryote populations in subantarctic waters and nanoeukaryote populations in subtropical and subantarctic waters were dominated by taxa reported in the literature as able to engage in phago‐mixotrophic strategies (Prymnesiophyceae, Chrysophyceae, and Dinophyceae), suggesting that such trophic strategy might be applied by discrete small photosynthetic eukaryote populations to alleviate macronutrient and iron stress.

Autonomous instrumentation and big data: New windows, knowledge, and breakthroughs in the aquatic sciences

First Clinical Feasibility and Safety Study of a Novel Multimodality Fallopian Tube Imaging Endoscope

ABSTRACT Study Objective We present the results of the first feasibility and safety study of a novel multi‐modality falloposcope, in 19 volunteers. The falloposcope incorporated multispectral fluorescence imaging (MFI) and optical coherence tomography (OCT) for evaluation of the fallopian tubes (FT). Methods Nineteen females undergoing elective salpingectomy were recruited in this IRB‐approved study. During a 15‐min pause in standard of care surgery, a novel falloposcope was inserted under hysteroscopic guidance and advanced into the FTs. The furthest cannulated segment (proximal, middle, distal) was noted, and acquisition of MFI and OCT images was attempted at each segment in a retrograde fashion. Surgical discard samples from each segment of both FTs were obtained per pathology discretion for ex vivo imaging. All samples were processed for histology to evaluate any device‐related injury. Results The falloposcope was inserted into the FTs of 12 patients and successfully cannulated the entire length of the tube to the distal segment in one‐third (4/12) of attempts. OCT and/or MFI images were obtained of all but one cannulated FT. Cannulation failure was attributed to proximal anatomy or obstruction, tortuosity of the FT, and limited study time. There were no adverse events related to the falloposcopy procedure. Focal epithelial cell denudation in the proximal segments of three patients, without no stromal involvement, was observed by histological examination. OCT images acquired in vivo showed characteristic tissue microstructures but were more susceptible to artifacts compared to ex vivo images. Conclusions The results of this first‐in‐human study suggest that falloposcopy with a novel multimodality imaging endoscope is feasible and safe. Future procedural and design modifications will be implemented to improve image quality and cannulation success rates.

Abnormal Connectivity of the Head Neural Integrator in Cervical Dystonia

Abstract Background Cervical dystonia is characterized by abnormal neck and head movements, possibly related to a dysfunction of the interstitial nucleus of Cajal (INC) and the head neural integrator, a system responsible for the control of head and eye movements. However, neuroanatomical evidence of alterations in the head neural integrator in cervical dystonia is sparse. Objectives We investigated structural and functional integrity of the INC and its connections in cervical dystonia. Methods This cross‐sectional, observational study compared 19 cervical dystonia patients and 21 healthy controls, using anatomical, diffusion‐weighted, and resting‐state functional images. We reconstructed tracts converging on the INC, and involved in the control of head movements. We evaluated group differences in microstructural integrity using fixel‐based analysis, and effective connectivity using dynamic causal modeling. Results Compared with controls, patients showed microstructural abnormalities within the INC and cerebral peduncle. Effective connectivity showed abnormal self‐inhibition in the INC, substantia nigra, and vermis in patients, with decreased excitation from the substantia nigra to the INC, increased inhibition from the deep cerebellar nuclei and primary sensorimotor cortex, and decreased excitation from the INC to the cerebellar vermis. Conclusions A dysfunction of the INC might contribute to altered sensorimotor integration in cervical dystonia, and abnormal feedback from its afferent connections could alter its integrative function, resulting in a disturbed head and neck posture. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Historical Control Analysis Demonstrates Greater Long‐Term Reduction in Plasma Globotriaosylceramide (Gb3) by Venglustat Compared With Placebo or Agalsidase Beta in Male Patients With Classic Fabry Disease

ABSTRACT Purpose To evaluate the disease biomarker response of venglustat in patients with Fabry disease (FD), utilizing data from a single‐arm phase 2 study of venglustat and a placebo‐controlled phase 3 study of agalsidase beta through historical control and case‐matched analyses. Methods Eleven venglustat‐treated male patients with classic FD in the phase 2 study were matched with placebo‐ or agalsidase beta–treated patients from the phase 3 study based on propensity scores at baseline. Changes from baseline in plasma globotriaosylceramide (GL‐3 or Gb3) concentrations were analyzed at approximately 6–36 months. Results Venglustat treatment resulted in greater significant reductions in plasma GL‐3 concentrations at 6 months from baseline vs. placebo (mean difference −2.56 μg/mL, p  < 0.001), and at 24 and 36 months from baseline vs. agalsidase beta (mean difference −1.8 μg/mL, p  < 0.05 and −2.35 μg/mL, p  < 0.01, respectively). GL‐3 concentrations continued to decline with venglustat for up to 3 years without plateauing. Conclusions Venglustat showed significantly greater reductions in plasma GL‐3 concentrations than placebo after 6 months and agalsidase beta after 24 and 36 months. These findings support the potential of long‐term venglustat treatment to reduce GL‐3 accumulation in patients with classic FD. Further studies are needed to confirm clinical benefit.