Background: Extended skin malignancies of the head and neck region are among the most common cancer types and are associated with numerous diagnostic and therapeutical problems. The radical resection of skin cancer in the facial area often leads to severe functional and aesthetic impairment, and precise margin assessments can avoid the extensive safety margins. On the other hand, the complete removal of the cancer is essential to minimize the risk of recurrence. Reliable intraoperative assessments of the wound margins could overcome this discrepancy between minimal invasiveness and safety distance in the head and neck region. With the help of reflectance confocal laser microscopy (RCM), cells can be visualized in high resolution intraoperatively. The combination with deep learning and automated algorithms allows an investigator independent and objective interpretation of specific confocal imaging data. Therefore, we aimed to apply a deep learning algorithm to detect malignant areas in images obtained via in vivo confocal microscopy. We investigated basal cell carcinoma (BCC), as one of the most common entities with well-described in vivo RCM diagnostic criteria, within a preliminary feasibility study. Patients and Methods: We included 62 patients with histologically confirmed BCC in the head and neck region. All patients underwent in vivo confocal laser microscope scanning. Approximately 382 images with BCC structures could be obtained, annotated, and proceeded for further deep learning model training. Results: A sensitivity of 46% and a specificity of 85% in detecting BCC regions could be achieved using a convolutional neural network model (“MobileNet”). Conclusion: The preliminary results reveal the potential and limitations of the automated detection of BCC with in vivo RCM. Further studies with a larger number of cases are required to obtain better predictability.
While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era.
Objective: To quantify the gap between oral cancer disease burden and public awareness in Germany, and to characterize research dissemination patterns across social media platforms. Methods: We conducted a multi-dimensional analysis integrating: (1) Robert Koch Institut cancer registry data for oral and maxillofacial malignancies (ICD-10: C00–C06) from 2015 to 2023; (2) Google Trends search interest for cancer-related German terms; (3) Altmetric data for 2581 PubMed-indexed oral cancer publications; and (4) sentiment analysis of 10,308 social media posts. Age-standardized incidence rates were calculated using the European Standard Population. Results: Over the study period, 65,757 oral cavity cancer cases were registered. Google Trends analysis revealed a 64% attention deficit for “Mundkrebs” (oral cancer; mean: 17) compared to “Brustkrebs” (breast cancer; mean: 47). Case numbers declined from 7577 (2019) to 6870 (2023; −9.3%), while age-standardized rates decreased by 15.5% (11.6 to 9.8 per 100,000), with males disproportionately affected (−17.7%). Research dissemination was dominated by X/Twitter (86.2%), with minimal policy document (0.3%) or clinical guideline (0.3%) citations. Sentiment analysis revealed 77% positive public reception. Regional analysis identified an East–West divide, with Eastern German states showing 22% higher search interest. Conclusions: A substantial public awareness deficit exists for oral cancer in Germany, paradoxically widening during a period of declining diagnoses potentially associated with COVID-19-related diagnostic delays. The positive public sentiment toward oral cancer research suggests a favorable environment for targeted awareness campaigns, particularly in Western German states where search interest is lowest. These findings have practical implications for designing regionally tailored awareness campaigns prioritizing anatomically specific terminology. Future research should evaluate the effectiveness of such targeted interventions and assess whether post-pandemic diagnoses present at more advanced stages.