SAGE Open Medicine最新文献

Background: Nonsmall cell lung cancer is a leading cause of cancer-related death worldwide. The long noncoding RNA MIR4435-2HG has been shown to play a carcinogenic role in various cancers. The purpose of this study was to explore the role and regulatory mechanism of MIR4435-2HG in non-small cell lung cancer.

Methods: Quantitative real-time polymerase chain reaction was used to detect MIR4435-2HG and SRY-box transcription factor 2 in nonsmall cell lung cancer cells. Gain- or loss-of-function assays of MIR4435-2HG and SRY-box transcription factor 2 were subsequently conducted. Cell proliferation, apoptosis, migration, glycolysis, and invasion were tested. A nude mouse tumor model was constructed to determine the role of MIR4435-2HG and SRY-box transcription factor 2 in the growth of tumor cells in vivo. Furthermore, the interactions between MIR4435-2HG, miR-371a-5p and SRY-box transcription factor 2 were analyzed via a dual-luciferase reporter gene assay.

Results: Quantitative real-time polymerase chain reaction revealed that MIR4435-2HG and SRY-box transcription factor 2 were upregulated in nonsmall cell lung cancer cells. Forced MIR4435-2HG overexpression led to increased cell proliferation, migration, invasion, and glycolysis and repressed cell apoptosis. Overexpressing MIR4435-2HG promoted SRY-box transcription factor 2 expression and PI3K/Akt/mTOR pathway activation. Downregulating MIR4435-2HG had antitumor effects both in vitro and in vivo. SRY-box transcription factor 2 overexpression mostly reversed the suppressive effects of MIR4435-2HG downregulation. Mechanistic studies revealed that MIR4435-2HG, a competitive endogenous RNA, directly targeted and inhibited miR-371a-5p. Rescue assays revealed that miR-371a-5p overexpression or SRY-box transcription factor 2 downregulation significantly inhibited MIR4435-2HG-mediated oncogenic effects.

Conclusion: MIR4435-2HG promotes nonsmall cell lung cancer cell malignant behaviors and glycolysis by regulating the miR-371a-5p/SOX2 axis.

Background: Lipomas and atypical lipomatous tumors or well-differentiated liposarcomas (ALTs/WDLs), pose a diagnostic challenge due to their overlapping clinical and imaging features. Accurate differentiation is crucial as treatment strategies differ significantly between benign lipomas and malignant ALTs/WDLs. In recent years, medical imaging techniques have shown promise in distinguishing lipomas from ALTs/WDLs by providing enhanced visualization and assessment of various imaging parameters.

Objective: This systematic review aimed to investigate the use of magnetic resonance (MR) imaging and computed tomography (CT) scan to differentiate lipomas from ALTs/WDLs.

Methods: A systematic review was conducted by using MEDLINE, PubMed, PubMed Central, Cochrane Library, Google Scholar, and clinical trail.gov to identify imaging studies published between 2001 and 2022. Two independent reviewers reviewed 221 record to scrutinize the studies. The methodological quality of each included studies was assessed the using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool.

Results: Thirteen retrospective cohort studies included 1,390 of total patients. Among them, 11 studies used MR imaging, 2 studies used CT scan and MR imaging both to differentiate lipoma from ALTs/WDLs. The significant diagnostic variables identified in the included studies were age, size, texture, mean intensity, contrast enhancement, location, septation, and nodularity. The overall, sensitivity, specificity, and accuracy of the included studies for diagnosis of lesions range from 66% to 100%, 37% to 100%, and 76% to 95%, respectively. The positive and negative predictive values range from 46.9% to 90% and 86% to 100%, respectively.

Conclusion: The most frequent diagnostic features of ALTs/ WDLs include tumors ⩾110 mm in size, often in patients over 60, predominantly in the lower extremities, with an irregular shape, incomplete fat suppression, contrast enhancement, nodularity, septation >2 mm, and predictive markers such as lactate dehydrogenase >220 and a short tau inversion recovery-signal intensity ratio >1.18.

Background: Allied healthcare professionals face the intricate challenge of preventing burnout, which is marked by emotional exhaustion, depersonalisation and diminished personal accomplishment. Physical activity is proposed as a mitigating strategy that promises to reduce and effectively address burnout among allied healthcare professional.

Aim: The study aimed to determine the correlation between personal accomplishment and burnout among allied healthcare professionals.

Methods: A quantitative, non-experimental, cross-sectional, correlational design following the TREND statement amongst 82 allied healthcare professionals was conducted using the Maslach Burnout Inventory and the Global Physical Activity Questionnaire. Burnout was assessed using its three diagnostic characteristics: emotional exhaustion, depersonalisation and personal accomplishment.

Results: Participants (45.1%) experienced a low degree of emotional exhaustion, but overall, for the entire group emotional exhaustion was moderate (M = 20.51; standard deviation = 10.5), similar to depersonalisation (M = 6.46; standard deviation ±4.90), with 46.3% of the participants experiencing a low degree of depersonalisation. In the personal accomplishment category, 22% experienced a low degree of personal accomplishment; overall, for the entire group, personal accomplishment was low (M = 33.35; standard deviation = 7.58). Most participants (65.9%) engaged in moderate-intensity physical activities. The number of days performing moderate-intensity physical activity at work significantly increases the odds of allied healthcare professional experiencing low levels of emotional exhaustion, depersonalisation and personal accomplishment by 1.92, 2.33 and 2.09, respectively (p < 0.05).

Conclusions: Engaging in moderate-intensity physical activities increases the likelihood of allied healthcare professionals experiencing low emotional exhaustion, depersonalisation and personal accomplishment degrees. It underscores the importance of implementing physical activity programmes to improve healthcare and alleviate the effect of burnout in allied healthcare professional.

Objective: The aim of this study was to evaluate survival in patients with COVID-19 and cancer, and to find factors associated with early mortality.

Methods: Retrospective cohort derived from a registry of a referral center in Bogotá. Survival was analyzed according to the type of neoplasm using Kaplan-Meier method. A cox regression was performed to look for factors associated to higher risk of death.

Results: Two hundred fifty-four patients were included with cancer and COVID-19, most of whom were women (median age 68 years; range 19-97). Cardiovascular comorbidities were frequent. Patients with hematologic neoplasms had higher survival than those with solid neoplasms (log-rank test, p = 0.024). C-reactive protein levels (hazard ratio 1.02; 95% confidence interval 1.00-1.03, p = 0.025), Charlson's comorbidity index (hazard ratio 1.15; 95% confidence interval 1.06-1.26, p = 0.004) and respiratory failure (hazard ratio 4.83; 95% confidence interval 2.47-9.44, p = <0.001) were significantly associated with higher mortality. No interaction between active anticancer therapy and mortality was observed.

Conclusion: In contrast to other reports, survival was worse in patients with solid tumors than in those with hematologic neoplasms. Increased C-reactive protein, Charlson's comorbidity index and respiratory failure were associated with higher in-hospital mortality. This study reveals the complex impact of cancer and its treatment on COVID-19 outcomes, highlighting the persistent risks to cancer patients. It emphasizes monitoring C-reactive protein levels, comorbidities, and respiratory failure as key indicators of poor prognosis. Furthermore, we provide new insights into the differential impact of COVID-19 on cancer patients with solid organ versus hematologic neoplasms.

Background: Despite the known detrimental socio-economic consequences of leprosy morbidity, disability and social exclusion at the household level, research investigating the precise economic burden of leprosy remains scarce. This study aims to address this gap by examining the socio-economic burden of leprosy in Ho municipality in the Volta Region of Ghana.

Methods: This was a cross-sectional cost of illness study, and quantitative data were collected from leprosy patients between October and December 2023. Data collected included socio-demographic characteristics, direct and indirect costs related to treatment of leprosy from the patient's perspective. Stata version 14 was used for the analysis.

Results: A total of 35 respondents participated in the study, comprising 51.43% females and 48.57% males. All respondents (100%) reported having a valid National Health Insurance Scheme membership. The average total cost of leprosy treatment per patient, encompassing both direct and indirect expenses, was US$361.54 (SD ± 286.87). Disaggregating this cost further revealed a medical cost of US$44.30, a non-medical cost of US$47.07 and an indirect cost of US$290.16. The estimated annual household income of respondents was US$446.4 and 60% of respondents incurred expenditure that was more than 10% of their annual income and were deemed to have experienced catastrophic payment. Patients with sequelae incurred additional costs of US$46 (range: US$8.3-US$166.7) per case.

Conclusion: The costs of treating leprosy were considerably high leading to catastrophic health payments. This highlights the need for an all-encompassing strategy that addresses medical, non-medical and indirect costs. Implementing targeted support programs and ensuring medication affordability are key steps towards mitigating the economic susceptibility of leprosy patients and facilitating successful treatment outcomes.

Background and objectives: Extensive scrutiny within organizational research has positioned job satisfaction as a pivotal factor contingent upon organizational contexts. Our study aimed to refine job satisfaction measurement tools for diverse healthcare settings using insights from a university hospital in Vietnam, enhancing the validity and applicability of these instruments.

Methods: The procedure for the contextualization of a job satisfaction measurement tool was established encompassing six key steps: (1) Developing, selecting, or modifying the questionnaire; (2) Assessing face validity; (3) Ensuring content validity; (4) Designing the research for field testing; (5) Assessing the tool reliability and validity; and (6) Assessing discriminant validity between two tools. This procedure served as the foundation for a cross-sectional study involving 216 healthcare staff at a university hospital in Vietnam.

Results: The modified tool, comprising 35 items (6 fewer than the original 41-item reference tool), was derived through evaluations of face, content, and construct validity, conducted with 216 healthcare staff. The validity of the modified tool was subsequently confirmed through Confirmatory Factor Analysis, demonstrating favorable fit indices for the job satisfaction item, including a Chi-square/degrees of freedom ratio of 3.15, Comparative Fit Index of 0.86, Tucker Lewis Index of 0.85, and Root Mean Squared Error of Approximation of 0.1. Additionally, the modified tool exhibited a high Cronbach's alpha of 0.97, a good convergence ranged from 0.4 to 0.6 and a good divergence with the maximum shared variance values were lower than the corresponding average variance extracted values. The job satisfaction scores obtained using the modified tool surpassed significantly those of the original reference tool (p < 0.01), with percentages of 52.7% and 43.1%, respectively.

Conclusion: This contextualization procedure has been demonstrated to be both feasible, practical and yielded valid and reliable results, thus recommending its adoption in other healthcare settings along with further validation and adaptation, including rural settings.

Objectives: Nowadays, there is a global trend towards an increase in the prevalence and incidence of diabetes mellitus, including among children, which is a significant health problem in many countries. The analysis of data on diabetes among children is important for training medical personnel and planning preventive measures. The aim is to determine the trends in the prevalence and incidence of diabetes mellitus, as well as the gender and age structure among the paediatric population of different regions of Ukraine over the last 20 years (2002-2021) of peacetime.

Methods: The results of statistical evaluation and epidemiological analysis of the data of the Centre for Medical Statistics of the Ministry of Health of Ukraine on the prevalence and incidence of diabetes mellitus among children during 2002-2021 are presented. Statistical processing of the results was carried out using MS Excel (Microsoft Corporation, USA), XLSTAT-Pro (Addinsoft, USA).

Results: According to the Ministry of Health of Ukraine, as of 2021, 11,193 children aged 0-17 years inclusive with diabetes mellitus were registered, which is 15.0 cases per 10 thousand of the relevant population. Compared to 2002, the prevalence and incidence rates increased by 93% and 80%, respectively; the fastest rates were among children aged 0-6 years, and the lowest among adolescents aged 15-17 years. In 2021, the highest incidence of diabetes among infants over the past 15 years was recorded (0.05 per 1000 of the relevant population).

Conclusions: In Ukraine, over the past 20 years (2002-2021) of peacetime, there has been an annual gradual increase in the prevalence and incidence of diabetes mellitus among children in all age groups with gender balance, which generally corresponds to the global trend.

Background: Optimal guideline-directed medical therapy is rarely attained in practice, resulting in inadequate control of diseases such as hypertension, with poorer results in under-resourced communities. Technology, including artificial intelligence-driven decision support and software-driven workflow transformation, can potentially improve disease outcomes at a reduced cost, although it must be integrated with a holistic approach.

Methods: We describe the design of a software platform that enables rapid iterative remote management of >20 conditions across cardiac-kidney-metabolic disease. The platform distributes work across a care team of providers and care navigators, automates decision-making, ordering, and documentation, supports rapid incorporation of new evidence, and launches pragmatic trials. We describe software used in a 500-person community-based blood pressure control implemented as a single-arm quality improvement program. The primary endpoint was the proportion of patients meeting the Healthcare Effectiveness Data and Information Set quality measure blood pressure goal (<140/90) at 12 weeks.

Results: A total of 1609 patients were screened, 945 (59%) were found to have uncontrolled hypertension, and 512 patients consented to join the program. The average age was 61 ± 11 years; 59% were female, and 99% self-identified as Black. Blood pressure distribution was: 10% Stage 1 (SBP 130-139 mmHg or DBP 80-89 mmHg), 69% Stage 2 (SBP 140-179 mmHg or DBP 90-119 mmHg), and 21% Stage 3 (SBP >180 mmHg or DBP >120 mmHg). Two hundred four patients (39%) proceeded to a provider encounter, and 160 of these (78%) completed the program. The Healthcare Effectiveness Data and Information Set blood pressure goal was achieved in <12 weeks of enrollment for 141 participants (69% of those enrolled, 88% of those who completed the program).

Conclusion: Software-driven remote blood pressure is feasible, although strategies to improve patient enrollment will be needed to achieve maximum impact. Future work will be required to compare outcomes to usual care and evaluate concurrent management of multiple cardiac-kidney-metabolic conditions.

Objectives: Both dyslipidemia and hypertension contribute to poor glycemic control in patients with type 2 diabetes mellitus, but the combined effect of dyslipidemia and hypertension on glycemic control in patients with type 2 diabetes mellitus has not been evaluated. The aim of this study was to analyze the interaction effect between dyslipidemia and hypertension on glycemic control in patients with type 2 diabetes mellitus.

Methods: A total of 2485 patients with type 2 diabetes mellitus were selected from the Xuzhou community of China by multi-stage cluster random sampling for a cross-sectional survey. Their glycated hemoglobin, dyslipidemia, and hypertension were assessed, and the interaction effects between dyslipidemia and hypertension on glycemic control were analyzed using relative excess risk due to the interaction, the synergy index, and the attributable proportion of the additive interaction.

Results: Of the participants, 62.13% (1544/2485) had dyslipidemia and 55.01% (1367/2485) had hypertension. Of the participants, 76.66% (1905/2485) who had both dyslipidemia and hypertension also had poor glycemic control. The prevalence of poor glycemic control was higher in those with both dyslipidemia and hypertension (odds ratio 2.735, 95% confidence interval 2.117-3.532; p < 0.001) compared with those who had normal blood lipids and without hypertension, after adjustment for confounders. The relative excess risk due to the interaction, the attributable proportion, and the synergy index were 1.077 (95% confidence interval 0.558-1.596), 2.637 (95% confidence interval 1.268-4.006), and 0.394 (95% confidence interval 0.230-0.558), respectively, for the interaction between dyslipidemia and hypertension.

Conclusions: Dyslipidemia and hypertension have an additive interaction on poor glycemic control in patients with type 2 diabetes mellitus.

Objectives: Understanding the role of TRIB3 in cellular chemotherapy responsiveness and survival could facilitate its development as a prognostic marker that could be used to improve chemotherapeutic efficiency against specific tumors. Therefore, the role of TRIB3 to reflect the cytotoxic abilities of chemotherapeutic agents was clarified in the tested gastric cancer cell lines.

Methods: We have comprehensively investigated the protein expression of TRIB3 in three gastric cancer cell lines AGS, TMK-1, and MKN-45 cells treated with the anticancer drugs, 5-fluorouracil, cisplatin, and docetaxel. The Cell Count kit-8 was used to evaluate cell viability. Immunoblotting was performed to assay protein levels after drug treatment. Flow cytometry was carried out to evaluate the levels of sub-G1 cell population.

Results: Treatment of the tested gastric cancer cell lines dose-dependently decreased cell viability and protein levels of TRIB3 while increasing apoptosis. Overexpression of TRIB3 protects MKN-45 cells from endoplasmic reticulum stress-induced apoptosis but does not influence the induction of autophagy by anticancer drugs. In addition, overexpression of TRIB3 also rescued paroxetine-induced apoptosis and endoplasmic reticulum stress.

Conclusions: Our previous and present results indicate that TRIB3 can protect gastric cancer cells against anticancer drug treatment and that downregulating TRIB3 may increase these cells' sensitivity to anticancer drugs. We thus suggest that the capability of anticancer drugs to downregulate TRIB3 can indicate tumors' potential susceptibility to these drugs.