Glioblastoma (GBM) is a universally fatal cancer for which the standard of care has remained largely unchanged for the last 20 years. Recent work has demonstrated that most therapeutic trials for GBM fail due to complex mechanisms of immunosuppression mediated by both the innate and adaptive immune systems. Various metabolic alterations in the tumor microenvironment help maintain this local and systemic immunosuppression, of which the axis of hypoxia-driven tryptophan degradation has garnered substantial attention over the last decade. This paper synthesizes a much-needed elucidation of the immunometabolic reshaping of glioma, myeloid, endothelial, and lymphoid cell lineages induced by hypoxia. The current paper critically evaluates the role of IDO1/TDO2-mediated breakdown of tryptophan and the consequent accumulation of kynurenine, a metabolite that triggers GCN2- and AHR-mediated CD8+ T-cell exhaustion and supports regulatory T-cell differentiation and expansion. Furthermore, we propose a synthesis of mechanistic evidence that establishes a role for the Trp-GCN2-ATF4-VEGFA axis in hypoxia-induced immunosuppression, supporting that pro-tumoral metabolic dysregulation is directly linked to angiogenesis. In GBM, hypoxia and tryptophan–kynurenine pathway dysregulation operate as an integrated metabolic circuit that drives widespread immunosuppression. These mechanisms can be captured by a metabolic signature shared across nearly every cell type in the GBM microenvironment. Drawing on recent spatial transcriptomic, metabolomic, and pharmacologic studies, we outline how this metabolic axis shapes disease biology and how it can be targeted to restore effective antitumor immunity.

Osteoarthritis (OA) is a leading cause of chronic pain worldwide. This is driven by progressive cartilage degradation, inflammation, oxidative stress, and metabolic dysfunction. Current pharmacologic interventions mostly lead to symptomatic relief without actually affecting disease progression. Thus, there is a growing interest in the development of new interventional methods. Our review seeks to synthesize preclinical, translational, and clinical evidence on the impact nutritional methods have on OA management. Whole-diet approaches, such as Mediterranean and plant-based, have been linked to reduced pain, increased physical function, and positive biomarker changes. Bioactive compounds, including curcumin, polyphenols, omega-3 fatty acids, and select herbal extracts, have shown anti-inflammatory, antioxidant, and chondroprotective effects via NF-κB, Nrf2, AMPK, and SIRT1 pathways. This review particularly focuses on plant-derived substances. Emerging nanoparticle technology with regard to advanced delivery systems shows initial promise in nutraceutical pharmacokinetics and tissue targeting. Overall, nutritional interventions are adjunct interventions to OA management. Although these are not full treatment replacements, dietary modifications and targeted nutraceutical strategies with improved delivery systems may lead to more preventive, personalized, and holistic OA management and care.

Introduction: The advancement of artificial intelligence (AI) in neurosurgery is dependent on high quality, large, labeled datasets. Labeled neurosurgical datasets are rare, driven by the high expertise required for labeling neurosurgical data. A comprehensive resource overviewing available datasets for AI in neurosurgery is essential to identify areas for potential model building and areas of needed data construction. Methods: We conducted a systematic review according to PRISMA guidelines to identify publicly available neurosurgical datasets suitable for machine learning. A PubMed search on 8 February 2025, yielded 267 articles, of which 86 met inclusion criteria. Each study was reviewed to extract dataset characteristics, model development details, validation status, availability, and citation impact. Results: Among the 86 included studies, 83.7% focused on spine pathology, with tumor (3.5%), vascular (4.7%), and trauma (7.0%) comprising the remaining. The majority of datasets were image-based, particularly X-ray (37.2%), MRI (29.1%), and CT (20.9%). Label types included segmentation (36.0%), diagnosis (26.7%), and detection/localization (20.9%), with only 2.3% including outcome labels. While 97.7% of studies reported training a model, only 22.6% performed external validation, 20.2% shared code, and just 7.1% provided public applications. Accuracy was the most frequently reported performance metric, even for segmentation tasks, where only 60% of studies used the Dice score metric. Studies often lacked task-appropriate evaluation metrics. Conclusions: We conducted a systematic review to capture all publicly accessible datasets that can be applied to build AI models for neurosurgery. Current datasets are heavily skewed towards spine imaging and lack both clinical patient specific and outcomes information. Provided baseline models from these datasets are limited by poor external validation, lack of reproducibility, and reliance on suboptimal evaluation metrics. Future efforts should prioritize developing multi-institutional datasets with outcome labels, validated models, public access, and domain diversity to accelerate the safe and effective integration of AI into neurosurgical care.

Thymic malignancies are rare cancers arising from thymic epithelial cells and are characterized by a highly diverse clinical phenotype, substantial histologic and morphologic heterogeneity, and frequent associations with autoimmune syndromes. Although the clinical, immunological, and cytoarchitectural changes associated with thymomas have been increasingly elucidated in the contemporary literature, very few studies have interrogated the direct role of tumor staging and histological grading in shaping autoimmunity burden and infection risk. In this narrative review, we synthesize contemporary clinical, immunological, and morphologic evidence linking thymic architecture and selection defects to the spectrum of paraneoplastic autoimmunity (MG, pure red cell aplasia, Good’s syndrome) and to infectious vulnerability. We further appraise emerging therapeutic strategies, including immune checkpoint inhibition and adoptive cellular approaches, through a patient-stratified lens, emphasizing efficacy signals, immune-related adverse events, and practical considerations for selection and monitoring. We conclude by highlighting priorities for future investigation, including refining autoantibody signatures; mapping thymic microenvironments that drive tolerance failure, and prospectively evaluating stratified immunotherapeutic regimens that balance benefit with immune-mediated risk.

Background: Stroke remains a leading cause of mortality and morbidity globally, with a disproportionately high impact on older adults and socioeconomically disadvantaged groups. The STROKE-CARE study aimed to develop and assess a targeted stroke awareness workshop for seniors, addressing disparities in stroke knowledge and response readiness. Methods: The study recruited 73 seniors from Bay Area communities who completed pre- and postworkshop surveys on stroke knowledge, prevention attitudes, and response confidence. The workshop included presentations, videos, and a Q&A. Paired t -tests evaluated knowledge and confidence changes, with correlations and Kruskal–Wallis tests analysing demographic associations. Results: Postworkshop results indicated significant increases in stroke knowledge (mean increase of 2.17 points, p < 0.0001), attitudes towards prevention (0.35 points, p = 0.0002), and confidence in responding to stroke events (1.51 points, p < 0.001). Improvements were observed across all demographic groups without significant differences based on age, sex, or education level. Conclusions: This community-based, targeted workshop effectively enhanced stroke knowledge, stroke prevention attitudes, and response confidence in seniors and caregivers. The approach may serve as a model for improving stroke preparedness in vulnerable populations, highlighting the potential benefits of culturally sensitive, community-based stroke education initiatives.