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Background: Shared decision-making (SDM) is becoming more popular in various medical specialties as a core component of patient-centered care. However, patients' lack of sufficient disease knowledge remains a barrier to implementing SDM. Objectives: This study aims to examine the effectiveness of two educational approaches for atopic dermatitis (AD) patients, a pamphlet and pamphlet plus video, using assessments of knowledge level and satisfaction. Methods: From August 2021 to February 2023, patients with AD from the dermatology outpatient clinic at Tri-Service General Hospital were included. Educational pamphlets were provided before educational videos, and patients were asked to complete an identical five-question test postpamphlet and postpamphlet plus video, respectively. A questionnaire was used to evaluate patients' satisfaction. The two test scores were compared, and the satisfaction levels were analyzed. Results: The mean postpamphlet plus video score (94.84 ± 10.20) was significantly higher than the mean postpamphlet score (77.42 ± 17.17, P < 0.001) across 62 eligible samples. Gender and age subgroups showed similar trends. In addition, most patients preferred educational pamphlet plus videos (ranging from 37.5% to 75.0% in different subgroups) compared with educational pamphlets (ranging from 0.0% to 3.85%). The educational pamphlet plus video demonstrated high satisfaction in promoting disease knowledge and treatment options for AD. Conclusion: Adding educational video is an efficient approach toward reinforcement of patients' knowledge of AD and further facilitates the implementation of SDM in dermatology practice. [ABSTRACT FROM AUTHOR]

Background: The improvement of survival after hematopoietic stem cell transplantation has brought about a need to evaluate long-term complications, for instance, secondary malignancies. The risk of subsequent malignancies after hematopoietic stem cell transplantation must be clarified in a large population. Aims: To estimate the risk of secondary malignancies in hematopoietic stem cell transplantation survivors and compare it with the risk in patients without hematopoietic stem cell transplantation history. Study Design: We conducted a population-based retrospective cohort study of 3,059 hematopoietic stem cell transplantation recipients from the National Health Insurance Research Database of Taiwan, containing 1,378 autologous, 1,641 allogeneic, and 40 cord blood stem cell transplantation recipients between 2000 and 2013. A control group of 12,236 patients without an hematopoietic stem cell transplantation history was identified. Methods: The covariates included age, sex, comorbidities, stem cell source, facility level of care, and history of total body irradiation. Comorbidities were estimated by the revised Charlson comorbidity index, and a higher score suggested more severe comorbidity. Adjusted hazard ratios were determined by adjusting for age, sex, comorbidity, and facility level of care. Results: Overall, hematopoietic stem cell transplantation recipients had a higher risk of secondary malignancies with an adjusted hazard ratios of 1.348 (p = 0.017). Being male and female (adjusted hazard ratios 1.395, p = 0.009 and adjusted hazard ratios 1.291, p = 0.042, respectively) and pre-hematopoietic stem cell transplantation total body irradiation (adjusted hazard ratios 1.591, p < 0.001) were correlated with a high risk of secondary malignancies. Among the subsequent neoplasms, bone cancer showed the highest risk (adjusted hazard ratios 27.899, p < 0.001), followed by laryngeal (adjusted hazard ratios 6.643, p < 0.001), kidney (adjusted hazard ratios 5.580, p < 0.001), esophageal, pancreatic, thyroid (adjusted hazard ratios 1.993, p < 0.001), and skin (adjusted hazard ratios 1.992, p < 0.001) cancers. The median follow-up duration was 2.16 years in the hematopoietic stem cell transplantation group and 2.57 years in the control group, and the overall median follow-up duration was 2.21 years. Conclusion: Medical practitioners should be aware of the high risk of secondary malignancies in hematopoietic stem cell transplantation recipients later in life. These recipients should be informed about the importance of regular follow-up and photoprotective measures. Lifelong surveillance is recommended. [ABSTRACT FROM AUTHOR]

Massive open online courses (MOOCs; online courses delivered over the Internet) enable distance learning without time and place constraints. MOOCs are popular; however, active participation level among students who take MOOCs is generally lower than that among students who take in-person courses. Students who take MOOCs often lack guidance, and the courses often fail to provide personalized learning materials. Artificial intelligence (AI) has been applied to manage increasing amounts of learning data in learners' online activity records. Driven by the trend in big data, AI technology has drawn increasing attention in various fields. AI-based recommendation systems (RSs) are powerful tools for improving resource acquisition through supply customization, and they can provide personalized learning materials as study guides. In this study, a personalized learning path for MOOCs based on long short-term memory (LSTM) was proposed to meet students' personal needs for learning. According to students' video-watching behaviors, we proposed an MOOC material RS that identifies students with similar learning behaviors through clustering and then uses the clustering results and the learning paths of each group of students to construct an LSTM model to recommend learning paths. The system's learning path recommendations can effectively improve the online participation of learners, and students who received recommendations progressed from the slow-progress group to the medium-progress or fast-progress group. In addition, the learning attitude questionnaire results indicated that the proposed system not only motivated learners to continue learning and achieve high learning capacity but also supported their study planning according to their individual learning needs. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) is the most common type of skin cancer. Polypoid BCC is very rare and distinguishes from other types of BCC by being female predominant, locating on nonsun‑exposed areas, prevailing in dark‑skinned races, and having large average size, but considered nonaggressive. We report a case of BCC presenting as an inconspicuous polyp. A 40‑year‑old female sustained a slowly growing mass at the left groin for many years. Physical examination revealed a polypoid mass over the right groin without specific symptoms. Surgical removal with simple polypectomy was performed, whereas the pathological features revealed BCC with polyp feature. There has been no recurrence after the surgery. This case highlights the importance of remaining clinically alert to differentiate a benign‑looking polyp. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is a common neurodevelopmental disorder caused by impaired function of the neurofibromin RAS regulator. Using a combination of Nf1 genetically engineered mice and pharmacological/genetic inhibition approaches, we report that neurofibromin differentially controls neural stem cell (NSC) proliferation and multilineage differentiation through the selective use of the PI3K/AKT and RAF/MEK pathways. While PI3K/AKT governs neurofibromin-regulated NSC proliferation, multilineage differentiation is MEK-dependent. Moreover, whereas MEK-regulated multilineage differentiation requires Smad3-induced Jagged-1 expression and Notch activation, MEK/Smad3-regulated Hes1 induction is only responsible for astrocyte and neuronal differentiation. Collectively, these findings establish distinct roles for the RAS effector pathways in regulating brain NSC function. [ABSTRACT FROM AUTHOR]

Background: It is unclear whether women with psoriasis who receive adequate management or achieve better control of their psoriasis before and during pregnancy could eliminate the negative effects. Objectives: The objective of this study was to investigate the association between physician visits for psoriasis and adverse pregnancy outcomes. Methods: This study used the National Health Insurance database and Birth Certificate Application in Taiwan. This research further categorized the study subjects into mothers with mild/severe psoriasis who visited physicians for psoriasis before delivery, mothers with mild/severe psoriasis who did not visit a physician for psoriasis before delivery, and mothers without psoriasis. Logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the occurrence of adverse pregnancy outcomes, including maternal and neonatal outcomes. Results: 3,339 mothers with severe psoriasis, 41,296 mothers with mild psoriasis, and 2,017,271 mothers without psoriasis were included in this study. The mothers with mild/severe psoriasis demonstrated a significantly higher risk of labor complications and maternal risk factors. After adjusting for confounders, mothers with severe psoriasis who did not visit a physician for psoriasis demonstrated significantly higher odds of labor complications (OR: 1.217), maternal risk factors (OR: 1.507), having low‑birth weight infants (OR: 1.236), etc., than mothers without psoriasis. Conclusion: This study demonstrated that mothers with psoriasis had a higher risk of adverse pregnancy outcomes. In addition, seeking medical care for psoriasis, particularly for women with severe psoriasis, appeared to exert a protective effect against adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Tandem duplications involving the BRAF kinase gene have recently been identified as the most frequent genetic alteration in sporadic pediatric glioma, creating a novel fusion protein (f-BRAF) with increased BRAF activity. To define the role of f-BRAF in gliomagenesis, we demonstrate that f-BRAF regulates neural stem cell (NSC), but not astrocyte, proliferation and is sufficient to induce glioma-like lesions in mice. Moreover, f-BRAF-driven NSC proliferation results from tuberin/Rheb-mediated mammalian target of rapamycin (mTOR) hyperactivation, leading to S6-kinase-dependent degradation of p27. Collectively, these results establish mTOR pathway activation as a key growth regulatory mechanism common to both sporadic and familial low-grade gliomas in children. [ABSTRACT FROM AUTHOR]

Selenium has been shown to sustain the growth of selected human hepatocellular carcinoma cell lines under serum-free conditions, but the detailed mechanism remained undetermined. In the present study, the molecular mechanism(s) involving sodium selenite (Na[sub 2]SO[sub 3], Se) as a survival agent were determined. Selenite not only protects HuH7 cells from serum deprivation-induced apoptosis, it also supports its long-term growth in sodium selenite (10[sup -7] M) supplemented serum-free medium. The anti-apoptotic effect correlates with activation of focal adhesion kinase and the phosphatidylinositol 3-kinase (PI3K)-Akt kinase pathway. Using HuH7 cells stably transfected with a constitutively active Akt kinase and PI3K inhibitor LY294002, selenite-induced cell survival was shown to be PI3K-Akt-dependent. Parallel changes included a significant reduction in the intracellular reactive oxygen species content, the reversal of DNA fragmentation, and the suppression of caspase and apoptosis signal-regulating kinase 1 activities. HuH7 cells stably expressing a Racl mutant N17 (Rac1[sup N17]-HuH7) are refractory to selenite treatment. In these cells selenite supplement neither triggers Akt activation nor supports cell proliferation. Participation of Rac1 activation in this event is supported by the fact that selenite treatment drastically enhanced activation of Rac1. The exact link between selenite treatment, Rac1 activation, and activation of the focal adhesion kinase-PI 3-kinase, however, remains to be characterized. The mitogenic signaling mediated by selenite may involve unconventional growth stimuli including higher glutathione peroxidase 1 activity and higher transcription levels of selenoprotein P. The selenium-HuH7 systern we have established thus provides a unique tool that will allow the biological role of selenite in growth regulation of hepatocytes to be studied in detail. [ABSTRACT FROM AUTHOR]

Background and aim Low expression of cyclindependent kinase 2-associated protein (CDK2AP1) is associated with tumour progression in oral and oesophageal carcinomas, but is not well studied in patients with head and neck cancer and nasopharyngeal carcinoma (NPC). Methods A rabbit anti-human CDK2AP1 polyclonal antibody was prepared. Immunoblotting of CDK2AP1 was examined in three cell lines and immunoexpression was retrospectively assessed in biopsies of 124 consecutive NPC patients without initial distant metastasis and treated with consistent guidelines. Results Higher CDK2AP1 expression level was identified in dysplastic oral keratinocytes, compared with two NPCderived HONE-1 and TW01 cell lines. Low expression of CDK2AP1 (50.8%) was correlated with advanced nodal status (p=0.002) and American Joint Committee on Cancer (AJCC) stage (p=0.004). In multivariate analyses, low CDK2AP1 expression emerged as an independent prognosticator for worse disease-specific survival (DSS; p=0.037) and local recurrence-free survival (LRFS; p=0.042), along with AJCC stage IIIeIV (p=0.034, DSS; p=0.029, LRFS). Conclusions Low CDK2AP1 expression is common and associated with adverse prognosticators, conferring tumour aggressiveness through cycle cycle, cell growth or apoptosis cellular processes. [ABSTRACT FROM AUTHOR]

Backgrounds Urothelial carcinoma of the urinary bladder (UCUB) is prevalent in developed countries. It often shows genetic instability and is associated with amplification (or gain) of various oncogenic genes or suppressive genes. Rsf-1, a subunit of ATP-dependent chromatin-remodelling complexes that mediates ATPasedependent chromatin remodelling, confers tumour aggressiveness in certain carcinomas. The authors evaluate the Rsf-1 gene and expression status and its associations with clinicopathological features and survival in their UCUB collection. Methods Immunohistochemistry was used to assess the Rsf-1 expression profile in 295 UCUB specimens, and was found to correlate with clinicopathological data. Real-time RT-PCR and fluorescence in situ hybridisation were used to detect RSF-1 mRNA expression and gene dosage in 20 independent cases. Western blot analysis was used to evaluate Rsf-1 protein expression in human urothelial cell lines. Results Rsf-1 overexpression was demonstrated in 101 cases (34.2%), and was significantly associated with advanced primary tumour (p<0.001), nodal metastasis (p=0.004), higher histological grades (p=0.001) and frequent mitoses (p<0.001). Moreover, it was predictive in disease-specific survival and metastasis-free survival in both univariate and multivariate analyses (p<0.0001 for both). Although RSF-1 gene amplification can be barely detected, its mRNA expression is significantly enhanced in tumours with higher primary tumour (p=0.041) and positive nodal statuses (p=0.010), respectively. Rsf-1 protein was abundant in invasive urothelial carcinoma cells but was not benign. Conclusions Overexpression of Rsf-1 is associated with higher tumour stage and poorer clinical outcome. The current study by the authors suggests gene amplification-independent mechanisms driving Rsf-1 overexpression during UCUB tumour progression. [ABSTRACT FROM AUTHOR]

The article offers information on a medical research which focuses on Axolotl Nanog activity in mouse embryonic stem cells and shows that ground state pluripotency is conserved from urodele amphibians to mammals. Cells in the pluripotent ground state can give rise to somatic cells and the acquisition of pluripotency is dependent on the expression of Nanog. It was seen that protein interactions mediated by Nanog dimerization promote proliferation.