bluuebunny/crossref_metadata_2025 huggingface dataset:
Factor structure and measurement invariance of the Depression anxiety stress scale (DASS-21) in Chinese left-behind and non-left-behind children: an exploratory structural equation modeling approach
Authors: Chen Wei , Peng Kaijing , Gao Meihui , Meng Zhu , Wang Luolan , Liao Yaxi
Published: June 2024

Background

Comprehensive data has shown that adolescents often suffer from depression, anxiety, and low self-esteem, and are in a particularly fragile stage of psychological, physiological, and social development. Left-behind children in particular tend to have significantly higher, state anxiety and depression compared to non-left-behind children. The Depression, Anxiety, and Stress Scale (DASS-21) is an effective tool for evaluating depression, anxiety, and stress, and is used to measure levels of depression, anxiety, and stress in groups from a variety of backgrounds. The purpose of this study was to determine the effectiveness, reliability, and measurement invariance of the DASS-21 in Chinese left-behind children.

Method

The test and re-test method was used (N = 676), and the exploratory structural equation model (Mplus v.8.3) used to verify basic measurement models. For measurement invariance, the configural, weak, strong, and strict models were tested. The reliability of the DASS-21 was also tested using the collected data.

Results

Analysis results showed that the DASS-21 had a stable three-factor structure in the sample of left-behind children in China. The measurement invariance test showed that gender and time not only had strong invariance, but also strict invariance. The results of cross left and non-left invariance indicated a lack of strict invariance. Finally, the McDonald’s omega coefficient of the DASS-21 total scale was 0.864, and the internal consistency of each subscale was also good.

Conclusions

The DASS-21 is shown to be an effective and reliable tool for measuring depression, anxiety and stress in Chinese left-behind children.
The optimal introversion angle and length of pedicle screw to avoid L1-S1 vascular damage
Authors: Chen Ying , Yang Junyi , Liang Jie , Wu Weifei
Published: June 2024

Background

posterior pedicle screw fixation is common method, one of the most severe complications is iatrogenic vascular damage, no report investigated association of different introversion angles (INTAs) and length of pedicle screw. The aims were to investigate the optimal introversion angle and length of pedicle screw for improving the safety of the operation, and to analyze the differences of vascular damage types at L1-S1.

Methods

Lumbar CT imaging data from110 patients were analyzed by DICOM software, and all parameters were measured by new Cartesian coordinate system, INTAs (L1-L5:5°,10°,15°,S1: 0°, 5°,10°,15°), DO−AVC (the distance between the origin (O) with anterior vertebral cortex (AVC)), DAVC−PGVs (the distance between AVC and the prevertebral great vessels (PGVs)), DO−PGVs (the distance between the O and PGVs). At different INTAs, DAVC−PGVs were divided into four grades: Grade III: DAVC−PGVs ≤ 3 mm, Grade II: 3 mm < DAVC−PGVs ≤ 5 mm, Grade I: DAVC−PGVs > 5 mm, and N: the not touching PGVs.

Results

The optimal INTA was 5° at L1-L3, the left was 5° and the right was 15° at L4, and screw length was less than 50 mm at L1-L4. At L5, the left optimal INTA was 5° and the right was 10°, and screw length was less than 45 mm. The optimal INTA was 15° at S1, and screw length was less than 50 mm. However, screw length was less than 40 mm when the INTA was 0° or 5° at S1.

Conclusions

At L5-S1, the risk of vascular injury is the highest. INTA and length of the pedicle screw in lumbar operation are closely related. 3 mm interval of screw length may be more preferable to reduce vascular damage.
Construction and application of procedural pathways combined with information management in nursing staff skills training system
Authors: Cui Liping , Dong Yuting , Zhang Shan , Ma Wenxia , Li Min
Published: June 2024

Objective

To explore the application effect of procedural pathways combined with information management in the construction of nursing staff skills training system.

Methods

This was a quasi-experimental study with a control group and an experimental group. A total of 300 newly admitted nurses or nurses who required training within three years of admission were selected as the experimental group, and 267 nurses who were trained in the same hospital during the same period in 2020 were selected as the control group. The experimental group received skills training using a system that combines procedural pathways with information management, while the control group received traditional teaching mode. The outcome measures included theoretical score, operation score, nurse competency, patient satisfaction, and nursing-related adverse events. The data were analyzed using t-test, chi-square test, and rank-sum test.

Results

The experimental group had higher scores in theoretical assessment, skills assessment, nurse competency, and patient satisfaction, and lower incidence of nursing-related adverse events than the control group (P < 0.05).

Conclusion

The strategy of procedural pathways combined with information management provides a new perspective and method for nursing operation skills training, effectively improves clinical nursing quality and ensures patient safety.
Bridging gaps in ophthalmology residency programs: the link between practice, training and confidence in ocular examination and gonioscopy for diagnosing glaucoma, a blinding disease
Authors: Fogel Tempelhof Ortal , Mezad-Koursh Daphna , Hilely Assaf , Gaton Dan , Kurtz Shimon
Published: June 2024

Background

To evaluate real-world utilization of gonioscopy for diagnosing glaucoma among ophthalmologists with diverse subspecialties, and understand current perceptions of teaching, training, and confidence in gonioscopy.

Methods

A nationwide anonymous online survey was conducted among practicing ophthalmologists, querying about demographics, professional experience, practice of routine ocular examination for glaucoma and perceptions of confidence in performing them.

Results

136 ophthalmologists participated in the survey, with various levels of experience from residency to over twenty years of ophthalmology practice. Glaucoma specialists comprised 23 (16.9%) of the participants. Of the non-glaucoma-specialist respondents, only 33 (29.2%) expressed being highly confident in interpreting gonioscopic findings, which correlated significantly with their self-reported inadequate level of training in gonioscopy during residency (p < 0.001) and even more so with their low frequency of implementing gonioscopy in routine examinations (p < 0.001). The commonly cited reasons for the low practice of gonioscopy were insufficient time allotted to examinations and lack of experience, knowledge or equipment.

Conclusions

Gonioscopy is fundamental to the detection of glaucoma. This study reveals underutilization of gonioscopy in the practice of ophthalmology and its association with lower training opportunities, calling for expedited changes in the residency’s curriculum, alongside measures to promote its use in clinical practice.
Factors associated with the local control of brain metastases: a systematic search and machine learning application
Authors: Kanakarajan Hemalatha , De Baene Wouter , Gehring Karin , Eekers Daniëlle B. P. , Hanssens Patrick , Sitskoorn Margriet
Published: June 2024

Background

Enhancing Local Control (LC) of brain metastases is pivotal for improving overall survival, which makes the prediction of local treatment failure a crucial aspect of treatment planning. Understanding the factors that influence LC of brain metastases is imperative for optimizing treatment strategies and subsequently extending overall survival. Machine learning algorithms may help to identify factors that predict outcomes.

Methods

This paper systematically reviews these factors associated with LC to select candidate predictor features for a practical application of predictive modeling. A systematic literature search was conducted to identify studies in which the LC of brain metastases is assessed for adult patients. EMBASE, PubMed, Web-of-Science, and the Cochrane Database were searched up to December 24, 2020. All studies investigating the LC of brain metastases as one of the endpoints were included, regardless of primary tumor type or treatment type. We first grouped studies based on primary tumor types resulting in lung, breast, and melanoma groups. Studies that did not focus on a specific primary cancer type were grouped based on treatment types resulting in surgery, SRT, and whole-brain radiotherapy groups. For each group, significant factors associated with LC were identified and discussed. As a second project, we assessed the practical importance of selected features in predicting LC after Stereotactic Radiotherapy (SRT) with a Random Forest machine learning model. Accuracy and Area Under the Curve (AUC) of the Random Forest model, trained with the list of factors that were found to be associated with LC for the SRT treatment group, were reported.

Results

The systematic literature search identified 6270 unique records. After screening titles and abstracts, 410 full texts were considered, and ultimately 159 studies were included for review. Most of the studies focused on the LC of the brain metastases for a specific primary tumor type or after a specific treatment type. Higher SRT radiation dose was found to be associated with better LC in lung cancer, breast cancer, and melanoma groups. Also, a higher dose was associated with better LC in the SRT group, while higher tumor volume was associated with worse LC in this group. The Random Forest model predicted the LC of brain metastases with an accuracy of 80% and an AUC of 0.84.

Conclusion

This paper thoroughly examines factors associated with LC in brain metastases and highlights the translational value of our findings for selecting variables to predict LC in a sample of patients who underwent SRT. The prediction model holds great promise for clinicians, offering a valuable tool to predict personalized treatment outcomes and foresee the impact of changes in treatment characteristics such as radiation dose.
Translation, cultural adaptation, and validation of the Nurse Self-Concept Questionnaire (NSCQ) for Portuguese nursing students
Authors: Almeida Inês F. , Bernardes Rafael A. , Sousa Liliana B. , Santos-Costa Paulo , Ventura Filipa , Rosa Amorim
Published: June 2024

Background

The professional self-concept of nursing students significantly influences their attitude and identity within the profession, ultimately impacting their mental health and overall well-being. Recent evidence underscores the importance of assessing students’ professional self-concept to prevent adverse outcomes such as burnout and stress. Since there are currently no validated instruments available in Portugal for this purpose, our objective was to translate, adapt, and validate the Nurse Self-Concept Questionnaire (NSCQ) with nursing students in Portugal.

Methods

A two-phase research study with a non-probabilistic sample of 216 undergraduate nursing students, using the QualtricsXM electronic platform for data collection. An exploratory factor analysis was performed to verify the validity of the theoretical construct and its internal consistency. Cronbach’s alpha was calculated, and a confirmatory factor analysis was performed to assess the model fit.

Results

The final instrument, designated as Questionário de Autoconceito dos/as Enfermeiros/as (Pt – NSCQ), is composed of 24 items distributed across five dimensions: “General self-concept”, “Staff relations”, “Leadership”, “Communication-care” and “Knowledge”, which explain 67.71% of the total variance. All dimensions and the global scale revealed good internal consistency values, ranging from 0.775 to 0.927. The resulting factorial structure is coherent with the theoretical framework.

Conclusion

The Pt – NSCQ proved to be a valid and reliable instrument to assess Portuguese nursing students’ professional self-concept. Future studies should be carried out on larger samples and different educational contexts, aligned with the importance to ensure the continuity of the psychometric analysis of the instrument.
Climate change worry among nurses and their hope levels for climate change prevention
Authors: Duran Songül , Kaynak Serap
Published: June 2024

Aim

This research aimed to determine nurses’ climate change worry, their level of hope for climate change prevention, and the relationship between climate change worry and hope for climate change.

Background

Nurses are healthcare professionals actively involved in the fight against climate change. However, their close involvement with the issue can also increase their own climate change worry. Therefore, it is important to maintain high levels of hope among nurses in preventing climate change.

Methods

This descriptive cross-sectional study was conducted with nurses working at a university hospital.

Results

The average score on the Climate Change Worry Scale for nurses was 29.22 ± 9.33, with sub-dimensions scores as follows: personal-sphere will and way 10.96 ± 2.09; collective sphere will 18.36 ± 3.39; lack of will and way dimensions 10.40 ± 2.48. The average score on the climate change hope scale was 39.73 ± 5.52. A statistically significant positive relationship was found between age and the climate change worry scale (r = 0.169, p = 0.020) as well as climate change hope (r = 0.148, p = 0.041).

Conclusion

The research findings indicate that nurses have a high level of climate change worry, but they also have a high level of hope in preventing climate change. It is considered essential to address the concerns of nurses who are actively combating the climate crisis.
Readiness levels of intern nursing students during the transition to professional practice within the Al Jouf Region in Saudi Arabia
Authors: Alruwaili Abeer N. , Alruwaili Majed M. , Colby Normajean
Published: June 2024

Background

The transition of newly graduated nurses into the workforce is recognized as a complex undertaking and has been examined extensively in the literature.

Objective

This study aimed to assess the readiness levels of intern nursing students and investigate the factors affecting their transition to professional practice within the Al Jouf region in Saudi Arabia.

Methods

The study employed a combination of descriptive, correlational, and qualitative methodologies to conduct its investigation. Data were acquired via an online questionnaire that included demographic information, the Nursing Practice Readiness Scale (NPRS), and two open-ended questions. A total of 135 nursing intern students were recruited to participate in the study. Benner’s “novice-to-expert” theory of clinical competence was utilized to guide the theoretical underpinning of the study.

Results

Findings revealed that most intern nursing students (63.7%) exhibited a moderate level of readiness. Furthermore, 70.4% and 55.6% of the students showed moderate readiness in terms of their professional attitudes and patient-centeredness, respectively. More than one-third of the students demonstrated a high level of readiness in the self-regulation domain (36.3%), while a similar proportion indicated a high level of readiness in the domain of collaborative interpersonal relationships (33.3%). The students underscored their reliance on the education system as pivotal in enhancing their preparedness for clinical practice.

Conclusion

Nursing internship programs contribute to a more comprehensive readiness of nurses for active participation in clinical practice as compared to traditional educational programs.
Comprehensive analysis of the expression, prognostic, and immune infiltration for COL4s in stomach adenocarcinoma
Authors: Xu Ying , Jin Hangbin , Chen Yan , Yang Zhen , Xu Dongchao , Zhang Xiaofeng , Yang Jianfeng , Wang Yu
Published: June 2024

Background

Collagen (COL) genes, play a key role in tumor invasion and metastasis, are involved in tumor extracellular matrix (ECM)-receptor interactions and focal adhesion pathways. However, studies focusing on the diagnostic value of the COL4 family in stomach adenocarcinoma (STAD) are currently lacking.

Methods

The TCGA database was employed to retrieve the clinical features and RNA sequencing expression profiles of patients with STAD. We conducted an investigation to examine the expression disparities between STAD and adjacent normal tissues. Kaplan-Meier survival analysis was utilized to assess their prognostic significance, while Spearman correlation analysis was employed to determine their association with immune checkpoint genes and immunomodulatory molecules. Furthermore, GO and KEGG analyses were performed on the COL4s-related genes, revealing potential biological pathways through gene set enrichment analysis (GSEA). Subsequently, we explored the extent of immune infiltration of the COL4 family in STAD using the TIMER database. Lastly, the expression levels of the COL4 family in STAD were further validated through quantitative PCR (qPCR) and western blot techniques.

Results

The expression levels of COL4A1/2 were significantly upregulated, while COL4A5/6 were conspicuously downregulated in STAD. The survival analysis revealed that the upregulated COL4s indicated poorer overall survival, first progression and post-progression survival outcomes. Additionally, our findings demonstrated a positive correlation between the expressions of COL4A1/2/3/4 and the infiltration of immune cells, including CD8 + T cells, dendritic cells, macrophages, neutrophils and CD4 + T cells. Further correlation analysis uncovered a favorable association between the expression of COL4A1/2/3/4 and various crucial immunomodulatory molecules, immunological checkpoint molecules, and chemokines. Quantitative PCR analysis confirmed that the expression patterns of COL4A1/3/4/6 genes aligned with the finding from the TCGA database. However, gastric cancer cells exhibited downregulation of COL4A2. Consistently, the protein level of COL4A1 was elevated, whereas the protein level of COL4A2 was reduced in the gastric cancer cell lines.

Conclusion

COL4s could potentially serve as biomarkers for diagnosing and predicting the prognosis of STAD.
Laser-activated perfluorocarbon nanodroplets for intracerebral delivery and imaging via blood–brain barrier opening and contrast-enhanced imaging
Authors: Hallam Kristina A. , Nikolai Robert J. , Jhunjhunwala Anamik , Emelianov Stanislav Y.
Published: June 2024

Background

Ultrasound and photoacoustic (US/PA) imaging is a promising tool for in vivo visualization and assessment of drug delivery. However, the acoustic properties of the skull limit the practical application of US/PA imaging in the brain. To address the challenges in targeted drug delivery to the brain and transcranial US/PA imaging, we introduce and evaluate an intracerebral delivery and imaging strategy based on the use of laser-activated perfluorocarbon nanodroplets (PFCnDs).

Methods

Two specialized PFCnDs were developed to facilitate blood‒brain barrier (BBB) opening and contrast-enhanced US/PA imaging. In mice, PFCnDs were delivered to brain tissue via PFCnD-induced BBB opening to the right side of the brain. In vivo, transcranial US/PA imaging was performed to evaluate the utility of PFCnDs for contrast-enhanced imaging through the skull. Ex vivo, volumetric US/PA imaging was used to characterize the spatial distribution of PFCnDs that entered brain tissue. Immunohistochemical analysis was performed to confirm the spatial extent of BBB opening and the accuracy of the imaging results.

Results

In vivo, transcranial US/PA imaging revealed localized photoacoustic (PA) contrast associated with delivered PFCnDs. In addition, contrast-enhanced ultrasound (CEUS) imaging confirmed the presence of nanodroplets within the same area. Ex vivo, volumetric US/PA imaging revealed PA contrast localized to the area of the brain where PFCnD-induced BBB opening had been performed. Immunohistochemical analysis revealed that the spatial distribution of immunoglobulin (IgG) extravasation into the brain closely matched the imaging results.

Conclusions

Using our intracerebral delivery and imaging strategy, PFCnDs were successfully delivered to a targeted area of the brain, and they enabled contrast-enhanced US/PA imaging through the skull. Ex vivo imaging, and immunohistochemistry confirmed the accuracy and precision of the approach.

Graphical Abstract
Risk factors analysis of lateral cervical lymph node metastasis in papillary thyroid carcinoma: a retrospective study of 830 patients
Authors: Zhong Haifeng , Zeng Qingxin , Long Xi , Lai Yeqian , Chen Jiwei , Wang Yuedong
Published: June 2024

Objective

The aim of this study is to investigate the risk factors for lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC).

Methods

Clinicopathological data (age, gender, Hashimoto’s thyroiditis, preoperative circulating tumor cells (CTCs), multifocal, maximum lesion diameter, invaded capsule, T stage, and lymph node metastasis) of 830 PTC patients diagnosed and treated in Meizhou People’s Hospital from June 2021 to April 2023 were collected. The related factors of lateral cervical lymph node metastasis were analyzed.

Results

There were 334 (40.2%), and 103 (12.4%) PTC patients with central lymph node metastasis, and lateral cervical lymph node metastasis, respectively. Compared with patients without lateral cervical lymph node metastasis, PTC patients with lateral cervical lymph node metastasis had a higher proportion of multifocal, maximum lesion diameter > 1 cm, invaded capsule, T3-T4 stage. Regression logistic analysis showed that male (odds ratio (OR): 2.196, 95% confidence interval (CI): 1.279–3.769, p = 0.004), age < 55 years old (OR: 2.057, 95% CI: 1.062–3.988, p = 0.033), multifocal (OR: 2.759, 95% CI: 1.708–4.458, p < 0.001), maximum lesion diameter > 1 cm (OR: 5.408, 95% CI: 3.233–9.046, p < 0.001), T3-T4 stage (OR: 2.396, 95% CI: 1.241–4.626, p = 0.009), and invaded capsule (OR: 2.051, 95% CI: 1.208–3.480, p = 0.008) were associated with lateral cervical lymph node metastasis.

Conclusions

Male, age < 55 years old, multifocal, maximum lesion diameter > 1 cm, T3-T4 stage, and invaded capsule were independent risk factors for lateral cervical lymph node metastasis in PTC.
Syndecan-1 as a prognostic biomarker in COVID-19 patients: a retrospective study of a Japanese cohort
Authors: Hayashi Kiyohito , Koyama Daisuke , Hamazaki Yoichi , Kamiyama Takamichi , Yamada Shingo , Furukawa Miki , Tanino Yoshinori , Shibata Yoko , Ikezoe Takayuki
Published: June 2024

Background

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact, with millions of confirmed cases and deaths worldwide. While most cases are mild, a subset progresses to severe respiratory complications and death, with factors such as thromboembolism, age, and underlying health conditions increasing the risk. Vascular endothelial damage has been implicated in severe outcomes, but specific biomarkers remain elusive. This study investigated syndecan-1 (SDC-1), a marker of endothelial damage, as a potential prognostic factor for COVID-19, focusing on the Japanese population, which is known for its aging demographics and high prevalence of comorbidities.

Methods

A multicenter retrospective study of COVID-19 patients in Fukushima Prefecture in Japan who were admitted between February 2020 and August 2021 was conducted. SDC-1 levels were measured along with other clinical and laboratory parameters. Outcomes including thrombosis, 28-day survival, and disease severity were assessed, and disease severity was categorized according to established guidelines.

Results

SDC-1 levels were correlated with disease severity. Patients who died from COVID-19 had greater SDC-1 levels than survivors, and the area under the receiver operating characteristic curve (AUC) analysis suggested the potential of the SDC-1 level as a predictor of mortality (AUC 0.714). K‒M analysis also revealed a significant difference in survival based on an SDC-1 cutoff of 10.65 ng/mL.

Discussion

This study suggested that SDC-1 may serve as a valuable biomarker for assessing COVID-19 severity and predicting mortality within 28 days of hospitalization, particularly in the Japanese population. However, further investigations are required to assess longitudinal changes in SDC-1 levels, validate its predictive value for long-term survival, and consider its applicability to new viral variants.

Conclusions

SDC-1 is emerging as a potential biomarker for assessing the severity and life expectancy of COVID-19 in the Japanese population, offering promise for improved risk stratification and patient management in the ongoing fight against the virus.
Evaluation of OVOL1 and Filaggrin immunohistochemical expression and clinical relevance in psoriasis
Authors: Hemida Aiat Shaban , Hammam Mostafa Ahmed , Swilam Aya Ahmed , Shehata Wafaa Ahmed
Published: June 2024

Background

Psoriasis is a disease of overactive immune system. OVOL1 and Filaggrin have been associated with many inflammatory skin lesions. To the best of our knowledge, the correlation between OVOL1 and Filaggrin in psoriasis was not previously investigated. This work aims to search the immunohistochemical expression and correlation between OVOL1 and Filaggrin in psoriasis.

Materials and methods

Slides cut from paraffin blocks of 30 psoriasis cases and 30 control subjects were stained with OVOL1 and Filaggrin. Clinicopathological data were correlated with the results of staining.

Results

OVOL1 and Filaggrin expression in epidermis showed a significant gradual reduction from normal skin to peri-lesional and psoriasis biopsies (P < 0.001). In contrast, psoriasis dermis showed a significant overexpression of OVOL1 in inflammatory cells in relation to peri-lesional biopsies (P < 0.002). OVOL1 demonstrated a significant direct correlation with Filaggrin expression in psoriasis (r = 0.568, P < 0.004). OVOL1 and Filaggrin expression in psoriasis skin epidermis demonstrated a statistically significant negative correlation with PASI score.

Conclusion

OVOL1 and Filaggrin might be involved in psoriasis-associated inflammation and skin hyperproliferation. OVOL1 might have a protective barrier function in the skin and could be used to stratify progressive disease. Filaggrin may play a role in progression of psoriasis. OVOL1 inhibition could be considered in suppression of Filaggrin function. OVOL1 agonists may be beneficial in psoriasis treatment.
Emerging human pulmonary dirofilariasis in Hungary: a single center experience
Authors: Kuthi Levente , Zombori Tamás , Tiszlavicz László , Hegedűs Fanni , Almási Szintia , Baráth Bence , Almakrami Mohammed , EJ Mohammad Jamal , Barta Nikolett , Ujfaludi Zsuzsanna , Pankotai Tibor , Hajdu Adrienn , Furák József , Sejben Anita
Published: June 2024

Background

Human pulmonary dirofilariasis (HPD) is rare in Hungary, and it stems from Dirofilaria immitis, mainly transmitted through mosquito bites, with dogs as primary hosts. Despite its prevalence in veterinary settings, human cases are infrequent. Historically, Mediterranean countries report most HPD cases, but sporadic cases occur in temperate European regions. Radiologically, HPD often manifests in a non-specific manner, resembling pulmonary neoplasms, leading to unnecessary surgery and patient distress.

Methods

This study presents a notable case series from Hungary, encompassing a 12-year period, documenting 5 instances of HPD with the aim to provide baseline estimate of occurrence for future comparison.

Results

Among the patients studied, all were of middle age (median: 52 years, range: 37–69) and exhibited tumor-like lesions, primarily localized to the right lung, necessitating lobectomy or wedge resection. Histological examination consistently revealed a necrotizing granulomatous response characterized by remnants of helminths, without the presence of ovules. Furthermore, rigorous diagnostic procedures excluded other potential infectious agents through specialized staining techniques. Polymerase chain reaction analysis definitively confirmed the diagnosis of HPD in each case.

Conclusions

This case series highlights HPD as a seldom zoonosis, with a probable escalation in its occurrence within temperate regions. Therefore, clinicians should maintain a heightened awareness of HPD in the differential diagnosis of pulmonary coin lesions. Early recognition and diagnosis are paramount for appropriate management and prevention of potential complications associated with this increasingly recognized infectious entity.
Rare histologic transformation of a CTNNB1 (β-catenin) mutated prostate cancer with aggressive clinical course
Authors: Akhoundova Dilara , Fischer Stefanie , Triscott Joanna , Lehner Marika , Thienger Phillip , Maletti Sina , Jacquet Muriel , Lubis Dinda S.H. , Bubendorf Lukas , Jochum Wolfram , Rubin Mark A.
Published: June 2024

Background

Catenin (Cadherin-Associated Protein), Beta 1 (CTNNB1) genomic alterations are rare in prostate cancer (PCa). Gain-of-function mutations lead to overexpression of β-catenin, with consequent hyperactivation of the Wnt/β-catenin signaling pathway, implicated in PCa progression and treatment resistance. To date, successful targeted treatment options for Wnt/β-catenin - driven PCa are lacking.

Methods

We report a rare histologic transformation of a CTNNB1 (β-catenin) mutated metastatic castration resistant prostate cancer (mCRPC), clinically characterized by highly aggressive disease course. We histologically and molecularly characterized the liver metastatic tumor samples, as well as successfully generated patient-derived organoids (PDOs) and patient-derived xenograft (PDX) from a liver metastasis. We used the generated cell models for further molecular characterization and drug response assays.

Results

Immunohistochemistry of liver metastatic biopsies and PDX tumor showed lack of expression of typical PCa (e.g., AR, PSA, PSAP, ERG) or neuroendocrine markers (synaptophysin), compatible with double-negative CRPC, but was positive for nuclear β-catenin expression, keratin 7 and 34βE12. ERG rearrangement was confirmed by fluorescent in situ hybridization (FISH). Drug response assays confirmed, in line with the clinical disease course, lack of sensitivity to common drugs used in mCRPC (e.g., enzalutamide, docetaxel). The casein kinase 1 (CK1) inhibitor IC261 and the tankyrase 1/2 inhibitor G700-LK showed modest activity. Moreover, despite harbouring a CTNNB1 mutation, PDOs were largely insensitive to SMARCA2/4- targeting PROTAC degraders and inhibitor.

Conclusions

The reported CTNNB1-mutated mCRPC case highlights the potential challenges of double-negative CRPC diagnosis and underlines the relevance of further translational research to enable successful targeted treatment of rare molecular subtypes of mCRPC.
Comparison of functional outcomes following early and delayed arthroscopic repair for traumatic and non-traumatic rotator cuff injuries
Authors: Liu Aixin , Zhang Baorui , Lai Tong , Wang Mingxing , Wu Gongyi , Liu Shilin , Zhang Tao
Published: June 2024

Background

The effects of the timing of surgical repair on the outcomes of traumatic and non-traumatic rotator cuff injuries (RCI) remain elusive. Thus, this study aimed to compare differences in outcomes following the repair of traumatic and non-traumatic RCI at varying time points.

Methods

The study population comprised 87 patients with traumatic and non-traumatic RCI who underwent arthroscopic rotator cuff repair and were followed up for a minimum of 6 months. Next, the trauma and the non-trauma groups were stratified into subgroups according to the time of injury (early repair: occurring within 3 months; delayed repair: occurring after 3 months). Measurements before and after surgical interventions were compared to evaluate the effect of the duration of RCI on the functional status of patients in the trauma and non-trauma groups. Primary evaluation indices included the Visual Analog Scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder function score, and the University of California, Los Angeles (UCLA) shoulder score. Secondary evaluation indices consisted of shoulder range of motion (ROM), postoperative rotator cuff retear rate, and incidence of joint stiffness.

Results

Among the 40 patients in the trauma group, 22 underwent early repair, whereas the remaining 18 underwent delayed repair. In the non-trauma group consisting of 47 patients, 18 underwent early repair, whereas the remaining 29 underwent delayed repair. The minimum clinical follow-up time was 6 months, with an average follow-up time of 10.2 months. During postoperative follow-up, 1 and 6 patients who underwent early and delayed repair experienced re-tear in the trauma group, respectively. Contrastingly, 3 and 8 patients who underwent early and delayed repair presented with re-tear in the non-trauma group, respectively.

Conclusion

Early repair of traumatic RCI yielded superior outcomes, including improved range of motion, lower pain symptoms, and lower risk of postoperative re-tears compared to delayed repair. Additionally, non-surgical treatment is recommended as the preferred approach for patients with non-traumatic RCI.
Effect of probiotics on children with autism spectrum disorders: a meta-analysis
Authors: Zeng Ping , Zhang Cheng-zhi , Fan Zhi-xing , Yang Chao-jun , Cai Wan-yin , Huang Yi-fan , Xiang Zu-jin , Wu Jing-yi , Zhang Jing , Yang Jian
Published: June 2024

Background

Researches have found that alteration of intestinal flora may be closely related to the development of autism spectrum disorder (ASD). However, whether probiotics supplementation has a protective effect on ASD remains controversial. This meta-analysis aimed to analyze the outcome of probiotics in the treatment of ASD children.

Methods

The Pubmed, Cochrane Library, Web of Science and Embase were searched until Sep 2022. Randomized controlled trials (RCTs) relevant to the probiotics and placebo treatment on ASD children were screened. Quality assessment of the included RCTs was evaluated by the Cochrane collaboration’s tool. The primary outcomes were ASD assessment scales, including ABC (aberrant behavior checklist) and CBCL (child behavior checklist) for evaluating the behavior improvement, SRS (social responsiveness scale) for social assessment, DQ (developmental quotient) for physical and mental development and CGI-I (clinical global impression improvement) for overall improvement. The secondary outcome was total 6-GSI (gastrointestinal severity index).

Results

In total, 6 RCTs from 6 studies with 302 children were included in the systemic review. Total 6-GSI (MD=-0.59, 95%CI [-1.02,-0.17], P < 0.05) decreased significantly after oral administration of probiotics. Whereas, there was no statistical difference in ABC, CBCL, SRS, DQ and CGI-I between probiotics and placebo groups in ASD children.

Conclusion

Probiotics treatment could improve gastrointestinal symptoms, but there was no significant improvement in ASD.
PNSC928, a plant-derived compound, specifically disrupts CtBP2-p300 interaction and reduces inflammation in mice with acute respiratory distress syndrome
Authors: Li Fan , Yan Wenqing , Dong Weihua , Chen Zhiping , Chen Zhi
Published: June 2024

Background

Prior research has highlighted the involvement of a transcriptional complex comprising C-terminal binding protein 2 (CtBP2), histone acetyltransferase p300, and nuclear factor kappa B (NF-κB) in the transactivation of proinflammatory cytokine genes, contributing to inflammation in mice with acute respiratory distress syndrome (ARDS). Nonetheless, it remains uncertain whether the therapeutic targeting of the CtBP2-p300-NF-κB complex holds potential for ARDS suppression.

Methods

An ARDS mouse model was established using lipopolysaccharide (LPS) exposure. RNA-Sequencing (RNA-Seq) was performed on ARDS mice and LPS-treated cells with CtBP2, p300, and p65 knockdown. Small molecules inhibiting the CtBP2-p300 interaction were identified through AlphaScreen. Gene and protein expression levels were quantified using RT-qPCR and immunoblots. Tissue damage was assessed via histological staining.

Key findings

We elucidated the specific role of the CtBP2-p300-NF-κB complex in proinflammatory gene regulation. RNA-seq analysis in LPS-challenged ARDS mice and LPS-treated CtBP2-knockdown (CtBP2KD), p300KD, and p65KD cells revealed its significant impact on proinflammatory genes with minimal effects on other NF-κB targets. Commercial inhibitors for CtBP2, p300, or NF-κB exhibited moderate cytotoxicity in vitro and in vivo, affecting both proinflammatory genes and other targets. We identified a potent inhibitor, PNSC928, for the CtBP2-p300 interaction using AlphaScreen. PNSC928 treatment hindered the assembly of the CtBP2-p300-NF-κB complex, substantially downregulating proinflammatory cytokine gene expression without observable cytotoxicity in normal cells. In vivo administration of PNSC928 significantly reduced CtBP2-driven proinflammatory gene expression in ARDS mice, alleviating inflammation and lung injury, ultimately improving ARDS prognosis.

Conclusion

Our results position PNSC928 as a promising therapeutic candidate to specifically target the CtBP2-p300 interaction and mitigate inflammation in ARDS management.
In vitro investigations on interference of selected probiotic candidates with Campylobacter jejuni adhesion and invasion of primary chicken derived cecal and Caco-2 cells
Authors: Willer Thomas , Han Zifeng , Pielsticker Colin , Rautenschlein Silke
Published: June 2024

Background

Campylobacter (C.) jejuni is one of the most important bacterial foodborne pathogens worldwide. Probiotics such as Lactobacillus or Bacillus species are considered one option for reducing the colonization rate and magnitude in poultry, the most frequent source of human infections. Due to the lack of suitable avian in vitro models such as chicken intestinal cell lines, especially those derived from the cecum, most in vitro studies on C. jejuni host interaction have been conducted with human intestinal cell lines. In this study, we compared C. jejuni-cell interactions between primary chicken cecal cells and the human intestinal cell line Caco-2, which is derived from colorectal adenocarcinoma, and investigated possible interfering effects of selected probiotic candidates.

Results

We detected differences in adhesion and invasion between the two tested gut cell types and between different C. jejuni strains. The probiotic inhibition of C. jejuni adhesion and invasion of human and avian gut cells was affected by host cell type, investigated C. jejuni strain and time points of probiotic treatment. Additionally, our results suggest a possible correlation between C. jejuni invasion and the detected increase in IL-6 mRNA expression.

Conclusions

Our results indicate distinct differences between avian and human gut cells in their interaction with C. jejuni. Therefore, data obtained in one host species on C. jejuni-host interaction may not easily be transferrable to another one. The factors influencing the variable efficacy of probiotic intervention in chicken and human derived cells should be investigated further.
Surgical repair of an aortoesophageal fistula after salvage thoracic endovascular aortic repair: a case report
Authors: Uemura Hisashi , Matsue Hajime , Suehiro Yasuo , Nakagawa Takaya , Satoh Ayaka , Teshima Yoshio , Bungo Masashi , Satoh Hisashi
Published: June 2024

Background

An aortoesophageal fistula can prove to be fatal. Salvage thoracic endovascular aortic repair as a bridging therapy and radical surgery with thoracotomy should be considered while treating aortoesophageal fistula without spontaneous closure. Moreover, it is essential to select a technique that reduces the risk of reinfection. Here we report a rare case of a ruptured thoracic aortic aneurysm related to esophageal perforation by a fish bone that led to massive hematemesis and shock, and the surgical treatment of an aortoesophageal fistula that developed after salvage thoracic endovascular aortic repair.

Case presentation

A 70-year-old Japanese female patient was admitted with hematemesis, thoracic pain, and shock related to esophageal perforation of a ruptured descending aortic aneurysm caused by fish bone aspiration and esophageal perforation 1 month previously. An emergency thoracic endovascular aortic repair was performed. Postoperatively, an aortoesophageal fistula that remained open and a food intake-related increase in the inflammatory response was noted. Radical blood-vessel prosthesis implantation and fistula closure were performed. The patient’s postoperative course was favorable and the patient was discharged 22 days after the blood vessel prosthesis implantation.

Conclusion

Such a case of rupture of a descending aortic aneurysm related to perforation by a fish bone and an aortoesophageal fistula is considerably rare. Thus, we report the therapeutic strategy of this particular case and review the relevant literature.
“Thanks to my activists Friends”: a qualitative study of perspectives of young adults and professionals on the factors related to seeking support among victims of sexual violence in Spain
Authors: Durán-Martín Eva , Sanz-Barbero Belén , Muñoz-Haba Aitana , March Sebastià , Vives-Cases Carmen
Published: June 2024

Background

Sexual violence (SV) is a public health problem with high prevalence among the young population. The use of formal resources for SV care (e.g. institutional services) is low in this age group. This study applies a framework of health assets to identify the factors that positively influence the search for support for SV among young people, the functions of that support and the level of proximity as articulated by both young people and professionals.

Methods

A qualitative study was conducted through 38 semi-structured interviews with young people and professionals from SV resource centers and/or care services for the young population in Spain. A thematic theoretical analysis was conducted, embedded in inductive insights emerging from the data, following a particular adaptation of the constant comparative method, under the grounded theory approach. This analysis was carried out by coding the interview transcripts with the support of Atlas.ti.

Results

Young women identified assets, categorized as feminist, that they believe they are essential in the search for formal support services for SV. However, unlike young men, they considered the police and judicial system to be barriers and not assets. There were also differences between the young people and professionals in identifying assets. Young people also considered their partner and traditional media as health assets, in contrast to professionals who did not identify these as such valuable resources in the help-seeking process. Informal assets, such as family, friends and the internet are considered close resources. In contrast, specialized care services for gender-based violence/SV and the judicial and police systems were perceived as more distant resources among the young interviewees.

Conclusions

This study shows similarities and discrepancies among young women and men and SV response professionals in identifying assets for seeking SV support among youth. The study shows an inverse relationship between perceptions of proximity and the level of formality of the asset. This study also contributes to map the relationships and information exchanges between assets. It is advisable to inform professionals about the assets that professionals do not acknowledge, and about actions that allow young people to access formal resources.
Effect of internal limiting membrane surgical techniques on the idiopathic and refractory management of macular holes: a systematic review and meta-analysis
Authors: Quiroz-Reyes Miguel A. , Quiroz-Gonzalez Erick A. , Quiroz-Gonzalez Miguel A. , Lima-Gomez Virgilio
Published: June 2024

Macular holes (MHs), including atraumatic idiopathic and refractory MHs, affect central vision acuity due to full-thickness defects in the retinal tissue. The existing controversy regarding the pathophysiology and management of MHs has significantly improved with the implementation of internal limiting membrane (ILM) surgical techniques and improved MH closure rates. Thus, to determine the effect of ILM techniques on large idiopathic and refractory MH management, the present study systematically reviewed 5910 original research articles extracted from online literature databases, including PubMed, Cochrane, Google Scholar, and Embase, following the PRISMA guidelines. The primary outcome measures were MH closure rate and postoperative visual acuity. A total of 23 randomized controlled trials (RCTs) with adequate patient information and information on the effect of ILM peeling, inverted ILM flaps, autologous retinal transplantation (ART), and ILM insertion techniques on large idiopathic and refractory MH patients were retrieved and analyzed using RevMan software (version 5.3) provided by the Cochrane Collaboration. Statistical risk of bias analysis was also conducted on the selected sources using RoB2, which showed a low risk of bias in the included studies. A meta-analysis indicated that the inverted ILM flap technique had a significantly greater MH closure rate for primary MH than the other treatment methods (OR = 3. 22, 95% CI 1.34–7.43; p = 0.01). Furthermore, the findings showed that the inverted ILM flap group had significantly better postoperative visual acuity than did the other treatment options for patients with idiopathic MH (WMD = − 0.13; 95% CI = 0.22–0.09; p = 0.0002). The ILM peeling technique had the second highest statistical significance for MH closure rates in patients with idiopathic MH (OR = 2. 72, 95% CI: 1.26–6.32; p = 0.016). In refractory MHs, autologous retinal transplant (ART) and multilayer ILM plug (MIP) techniques improve the closure rate and visual function; human amniotic membrane grafting (hAMG) provides a high degree of anatomical outcomes but disappointing visual results. This study demonstrated the reliability and effectiveness of ILM techniques in improving the functional and anatomical outcomes of large idiopathic and refractory MH surgery. These findings will help clinicians choose the appropriate treatment technique for patients with idiopathic and refractory MH.
Comparative pharmacognosy and secondary metabolite analysis of Balanophorae herbs from different sources
Authors: Zhao Xueyan , Zheng Lihui , Shi Qingxin , Lin Yuqi , Zeng Zhaoxiang , Song Chengwu , Jin Shuna , Xiao Ling
Published: June 2024

The Balanophorae are not only traditional Chinese herbal medicines but also functional foods with diverse sources. This study aimed to distinguish pharmacognostic characteristics and secondary metabolites among different species of Balanophorae. Eight species of Balanophorae herbs were harvested, including 21 batches with 209 samples. Ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry was used to analyze secondary metabolites of Balanophorae from 21 sources. Targeted metabolomic analysis was performed to compare differences among the groups. Rhopalocnemis phalloide and B. indica can be identified by their pharmacognostic characteristics. Then, 41 secondary metabolites were identified or characterized in the mixed extracts of the 209 samples, mainly phenolic acids, flavonoids, and their derivatives. The distribution of these secondary metabolites revealed apparent differences among different species. In addition, targeted metabolomic analysis suggested that the secondary metabolite profiles of seven species of Balanophorae showed noticeable differences, and differences were also observed among different growing regions. Finally, five important metabolic markers were screened to successfully distinguish B. laxiflora, B. harlandii, and B. polyandra, including three phenolic acids and two flavonoids. This is the first study to systematically compare both the morphology and secondary metabolites among different sources of Balanophorae, which could provide effective information for identifying diverse species.