The susceptibility of athletes to long-term adverse outcomes following recurrent concussion remains controversial. Acute concussion precipitates a transient reduction in cerebral blood flow (CBF) that typically returns to pre-injury levels. Recent work suggests that long-term CBF alterations may be sex-specific. We assessed whether concussion history was associated with chronic CBF alterations and whether sex moderated this relationship in otherwise healthy, active collegiate-aged athletes. Collegiate-aged athletes from the community (N = 204, 37.8% female, Mage = 21.0 ± 1.7) underwent magnetic resonance imaging with pseudo-continuous arterial spin labeling to quantify global and regional CBF and spatial coefficient of variation. Participants also completed measures of depression, anxiety, and cognition. Multiple linear regressions incorporating prior concussion-by-sex interaction terms adjusted for relevant covariates were fit to estimate the extent to which sex moderated the concussion history-CBF relationship. Exploratory analyses further assessed whether oral contraceptive use or pill formulation moderated this association in females. The number of prior concussions was negatively associated with global and regional gray-matter CBF in female but not male athletes, with the strongest associations localizing to frontotemporal regions. CBF metrics were not related to cognitive performance or affective symptom burden. Contraceptive use did not appear to substantially moderate the concussion history-CBF association in female athletes. Female-specific associations between concussion history and cerebral hypoperfusion in early adulthood suggest potential sex differences in pathways and trajectories of adverse long-term outcomes. Early chronic CBF alterations may represent one vulnerability to future risk in a sex-specific manner.

BACKGROUND Retroperitoneal liposarcoma is a malignant soft tissue sarcoma arising from adipocyte precursors, with an incidence of 3-4 cases per million. Giant retroperitoneal tumors pose significant surgical challenges due to their size and proximity to vital structures. CASE REPORT We report the case of a 61-year-old woman who presented with progressive abdominal distension, mild discomfort, nausea, dyspepsia, and exertional dyspnea. Preoperative MRI revealed a giant retroperitoneal mass (28×23.6×24 cm) with heterogeneous adipose and non-lipomatous components, initially suggestive of dedifferentiated liposarcoma. However, ultrasound-guided core needle biopsy revealed histopathological findings consistent with well-differentiated liposarcoma (WDLPS). Complete surgical excision via midline laparotomy was performed; the tumor weighed 10 kg. Despite the massive tumor size, complete tumor removal was achieved while preserving adjacent organs, without the need for multivisceral resection. Histopathological examination was consistent with WDLPS with negative margins (R0), no vascular invasion (V0); staged pT4. Postoperative MRI, whole-body scintigraphy, and PET/CT showed no residual or metastatic disease. No adjuvant therapy was administered, and at 3-month short-term follow-up, there was no evidence of residual or recurrent disease. CONCLUSIONS This case suggests the feasibility of complete surgical excision with organ preservation in selected cases of giant retroperitoneal liposarcoma with clear dissection planes. It also underscores the role of preoperative imaging and core needle biopsy in diagnostic evaluation and surgical planning. Surgery remains the standard treatment, while the role of adjuvant therapy depends on histological subtype. Longer follow-up is required to assess long-term oncologic outcomes.

Thymoma is the most common tumor of the anterior mediastinum. Approximately 20%-30% of patients with a thymoma develop myasthenia gravis (MG), and an additional one third may possess positive acetylcholine receptor (AChR) antibodies without MG. Historical estimates suggest that thymoma associated MG (TAMG) represents roughly 15%-20% of MG patients, although the proportion of TAMG has been decreasing. Virtually all TAMG patients are seropositive for AChR antibodies. In comparison to MG without thymoma, TAMG is mostly generalized and more refractory to treatment. Chest CT with contrast is the imaging modality of choice in evaluating thymoma, while MRI and PET scan may have an ancillary role in defining tumor invasiveness, staging and further differentiating thymoma from other mediastinal masses. Surgical resection should be considered for all patients with thymoma, regardless of MG status as all thymomas are malignant. Minimally invasive surgery appears equally efficacious as sternotomy for patients with early stage thymoma, and has become more prevalent due to its lower complication rates. Preoperative optimization with intravenous immunoglobulin or plasmapheresis is unnecessary in patients with stable MG. New onset MG could occur in thymoma patients following thymectomy, and the presence of AChR antibody preoperatively may be a predictive risk factor. Patients with advanced stage thymoma may require neoadjuvant or adjuvant chemotherapy and/or radiation, typically managed in a multidisciplinary setting. The recurrence rate of thymoma is mainly dependent upon its pathological stage, and worsening myasthenic symptoms may herald a recurrence of thymoma.

Emerging evidence indicates that early-life lung injuries-including bronchopulmonary dysplasia, childhood asthma, recurrent respiratory infections, and environmental tobacco smoke exposure-are significantly associated with an increased risk of neurodevelopmental disorders such as cognitive impairment, autism spectrum disorder, attention-deficit/hyperactivity disorder, and emotional or behavioral affections. The developing brain is particularly vulnerable during infancy and childhood, and pulmonary insults during this critical window may disrupt normal neurodevelopment through multiple interconnected mechanisms along the lung-brain axis. These mechanisms include the hypoxia-oxidative stress axis, which impairs oligodendrocyte maturation and myelination; pulmonary microvascular injury leading to neuronal energy metabolism dysregulation; systemic inflammation-mediated disruption of the blood-brain barrier; and a cascade from pulmonary inflammation to neuroinflammation, characterized by microglial activation, synaptic dysfunction, and impaired myelination. Together, these pathways converge to produce long-lasting neurodevelopmental consequences. Understanding the lung-brain axis provides a novel theoretical framework for explaining this comorbidity and highlights the need to integrate neurodevelopmental risk assessment and early intervention into the clinical management of early-life lung diseases. Future research should focus on longitudinal cohorts, identification of critical developmental windows, and targeted therapeutic strategies that address both pulmonary and neurological health.

In situ cancer vaccines hold strong potential for addressing tumor heterogeneity by using the patient's own tumor as a personalized antigen source. However, their efficacy remains limited by insufficient antigen capture and inefficient cytosolic delivery. Here, we report an in situ antigen capture and delivery platform, DOX/PDiT@Gel, in which the pH-responsive function is provided by the polymer PDiT, while the hydrogel serves as a local retention matrix. In this system, doxorubicin (DOX) and a cationic polymer, PEG-DIPAMA-TAT (PDiT), are co-encapsulated within an oxidized dextran/carboxymethyl chitosan hydrogel. DOX induces immunogenic cell death, releasing diverse tumor antigens, while PDiT captures these antigens in situ via electrostatic interactions and promotes endo/lysosomal escape under acidic conditions. The hydrogel allows localized delivery of the therapeutic components at the postoperative tumor site. In vitro studies showed that PDiT markedly promoted antigen internalization, cross-presentation, and dendritic cell maturation. In murine models of postoperative recurrence and bilateral breast tumors, local treatment with DOX/PDiT@Gel inhibited the growth of both recurrent and distant tumors, together with stronger dendritic cell activation and enhanced memory T cell responses. Overall, this platform effectively amplifies antitumor immunity and offers a versatile strategy for personalized cancer immunotherapy.