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Introduction A dilation and evacuation (D&E) is a safe and effective option for patients undergoing a second trimester abortion. Recent legislation and geographic restrictions threaten patients' access to this surgical procedure, prompting a call to action to strengthen abortion training. This quality improvement project aimed to assess if a standardized lecture and checklist would improve military trainee knowledge and comfort with performing D&Es. Materials and Methods Using society recommendations and incorporating available level I to III evidence, a standardized checklist for D&Es was created to include necessary equipment, procedural steps, perioperative considerations, and potential complications. The checklist and associated lecture were presented to gynecology residents from seven of the nine military training programs. Residents completed a six-question assessment regarding comfort and knowledge in performing D&Es prior to and following the intervention. Responses were ranked on a five-point Likert scale and analyzed with the Wilcoxon sign-rank test. This project was deemed exempt by the Institutional Review Board. The standard Plan, Do, Study, Act (PDSA) methodology was used for ongoing assessment of the efficacy of this quality improvement project. Results There were 67 trainees that completed the pre-intervention assessment and 44 who completed it post-intervention, with 27 responses paired for statistical analysis. All trainees self-reported improved comfort and knowledge in all procedural aspects of D&Es, with the largest improvement observed in equipment knowledge (mean difference 1.44, P <0.001), performing procedural steps (mean difference 1.26, P <0.001), and managing complications (mean difference 1.33, P <0.001). Conclusions Use of an evidence-based checklist significantly improves resident knowledge and comfort with performing second trimester D&Es. In a post Dobbs environment, the military is an appropriate proxy for larger society and training programs need to develop alternatives and adjuncts to clinical training. [ABSTRACT FROM AUTHOR]

Plantar fascia (PF) is the commonest causes of foot pain in the adult population. Several surgical treatments are available to treat PF. This study was aimed to investigate the clinical efficacy of three different treatments for plantar fasciitis. It was conducted among 60 patients, divided equally into three treatment groups named Needle Knife Therapy, Endoscopic Plantar Fasciotomy, and Conventional Painkillers. Descriptive and analytical analysis were done by using SPSS 25 software. VAS and AOFAS scores were analyzed. The maximum (n = 31) participants were in 41–60 year age range group with normal BMI. These differences of mean VAS and AOFAS pain scores between different treatment groups were statistically significant (One-way ANOVA, p < 0.01). Both scores found lower in the Endoscopic Plantar Fasciotomy group. This study opens a new window of knowledge to achieve sustained pain relief and functional improvement. Moreover, the superiority of Endoscopic Plantar Fasciotomy in treating plantar fasciitis compared to Needle Knife Therapy and Conventional Painkillers was explored. [ABSTRACT FROM AUTHOR]

Lactobacillus rhamnosus GG (LGG) is a widely used and extensively researched probiotic. Probiotic effects are considered to be strain specific. We aimed to comprehensively assess the strain-specific effects of LGG in preterm infants. A systematic review of RCTs and non-RCTs to evaluate the effect of LGG in preterm infants. We followed the Cochrane methodology, and preferred reporting items for systematic reviews (PRISMA) statement for conducting and reporting this review. We searched the Cochrane central register of controlled trials, PubMed, EMBASE and CINAHL databases till December 2023. The review was registered in PROSPERO 2022 CRD42022324933. Meta-analysis of data from RCTs that used LGG as the sole probiotic showed significantly lower risk of NEC ≥Stage II [5 RCTs, n = 851, RR:0.50 (95% CI: 0.26, 0.93), P = 0.03] in the LGG group. There was no significant difference in the risk of LOS [7 RCTs, n = 1037, RR:1.08 (95% CI 0.84, 1.39), P = 0.55], mortality [3 RCTs, n = 207, RR: 0.99 (95% CI: 0.42, 2.33), P = 0.99], time to reach full feeds [2 RCTs, n = 19, SMD = 0.11 days (95% CI: −0.22, 0.45), P = 0.51] and duration of hospital stay [3 RCTs, n = 293, SMD: −0.14 days (95% CI: −0.37 to 0.09), P = 0.23]. Meta-analysis of data from non-RCTs showed no significant effect of LGG on NEC, LOS, and mortality. RCTs showed beneficial effects of LGG when used as the sole probiotic in reducing the risk of NEC, whereas observational studies did not. Strain-specific systematic review of LGG provides important data for guiding research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Short-term intake of the egg-protein hydrolysate Newtricious (NWT)-03 improved executive function, but underlying mechanisms and long-term effects, including other cognitive domains, are unknown. Methods: A 36-week randomized controlled trial involving 44 overweight/obese individuals experiencing elevated Subjective Cognitive Failures (SCF; aged 60–75 years) assessed the impact of daily consumption of 5.7 g of NWT-03 or placebo powders on cognitive performance (psychomotor speed, executive function, memory) and Cerebral Blood Flow (CBF), a marker of brain vascular function. Cognitive performance was evaluated using a neurophysiological test battery (CANTAB) and CBF was measured using magnetic resonance imaging perfusion method Arterial Spin Labeling (ASL). Serum samples were collected to determine brain-derived neurotrophic factor (BDNF) concentrations. Results: Anthropometrics, and energy and nutrient intakes remained stable throughout the trial. NWT-03 was well tolerated, and compliance was excellent (median: 99%; range: 87–103%). No overall intervention effects were observed on cognitive performance or CBF, but post-hoc analyses revealed significant improvements on executive function in women, but not men. Specifically, a reduction of 74 ms in reaction latency on the multitasking task (95% CI: −134 to −15; p = 0.02), a reduction of 9 between errors (95%CI: −14 to −3; p < 0.001), and a reduction of 9 total errors (95%CI: −15 to −3; p < 0.001) on the spatial working memory task were found in women. No intervention effects were observed on serum BDNF concentrations (p = 0.31). Conclusion: Long-term consumption of NWT-03 improved multitasking abilities and working memory in women with elevated SCF. Brain vascular function remained unaffected. Sex differences in executive function require additional clarification. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted as a randomized controlled trial to evaluate the technology‐based parent school program. Design: The study was conducted in the well‐child care outpatient clinic of a hospital in Turkey. Data were collected between October 31, 2022 and February 17, 2023. The parent school was prepared based on Meleis' transition theory. Sample: Forty‐eight parents participated in the study. Parents in the intervention group participated in a 10‐week parent school program (five website modules, five online interactive group trainings, and counseling). Measures: Data were collected before the program, after the program, and 1 month after the program. Results: There were increases in the mean scores of the "Parent Skill Assessment Form" and "Skills Assessment Form for the Toddler Development" items in the intervention group compared to the control group. The difference between the groups in the mean scores of the Self‐Efficacy for Parenting Task Index Toddler Scale (1–3 years) was not statistically significant. However, the difference between the times was statistically significant. Conclusion: It was concluded that the technology‐based parent school training program could guide parents with children aged 1–3 years on child‐rearing. Trial registration: It was registered at ClinicalTrials.gov in May 2022 (NCT05370989). [ABSTRACT FROM AUTHOR]

Although family and school experiences play an important role in adolescents' adjustment during the transition to high school, most prior studies investigated the effects of these experiences in isolation; their joint implications for both adolescents' concurrent and long-term adjustment outcomes are less clear, and the potential role of individual characteristics within such associations remains understudied. Based on 525 10th graders (Mage = 15.48, SDage = 0.71, 43.6% boys) who participated in a longitudinal study, the present research aimed to identify distinct family and school experience profiles among first-year high school students and examine their associations with adolescents' internalizing problems and externalizing problems, both concurrently and 18 months later. Latent profile analysis revealed four distinctive profiles: thriving, low resources—moderate family risk, developmental stress—high parental conflicts, and developmental stress—high peer victimization profiles. The other three profiles (vs. the thriving profile) reported significantly higher levels of concurrent internalizing problems; while these differences diminished after 18 months. However, the enduring impacts of these profiles on internalizing problems persisted among adolescents with higher levels of environmental sensitivity. Additionally, adolescents characterized by two developmental stress profiles (vs. the thriving profile) exhibited significantly higher levels of externalizing problems both currently and longitudinally. Findings underscore the importance of identifying at-risk populations among adolescents during the transition to high school by including both family and school experiences when examining environmental influence on their adjustment, as well as the necessity to take individual environmental sensitivity into account when examining these associations. [ABSTRACT FROM AUTHOR]

Introduction Information from published studies describing dental treatment of nonmilitary personnel in a military theater of operations is sparse. The primary objective of this study is to determine the number of dental emergencies (DEs) and the types of dental treatment rendered on non-U.S. military (civilian) personnel treated by Navy dentists in 2007-2008 in Iraq and 2009 in Afghanistan. The second objective is to compare the type of DE treatment procedures provided to civilian personnel to the type of DE treatment procedures performed on U.S. military personnel. Materials and Methods Navy Dental Officers documented the diagnoses of unscheduled DEs. All treatment provided was described at the time of treatment using the Current Dental Terminology codes of the American Dental Association. Current Dental Terminology Code A0145 (2007 and earlier) and A0199 (2008 onward) in the patient encounter indicated a DE. This study is limited to DE occurring in (1) patient categories: U.S. civilian employees, other beneficiaries of the U.S. Government, foreign national civilian/dependents, and civilian, no government connection and (2) U.S. military service members. Chi-square analysis was performed to compare the proportion of dental treatment category procedures on civilian patients compared to those on U.S. military patients. Results During the reporting period, 308 patients were treated for DE in Afghanistan. Civilians treated accounted for 18.5% (n  = 57) of all DEs. Nearly 93.0% of civilians who were treated were U.S. (DoD) civilian employees. Of the 57 civilian patients treated for DE, 61.4% of patients (n  = 35) received oral surgery. There were 251 U.S. military patient encounters (81.5% of all DEs). Restorative dentistry was the most common dental procedure for military personnel DE. When comparing civilian and military patients, civilian patients are statistically more likely than military patients to receive oral surgery treatment for DE (P  < .00001). In Iraq, 3,198 patients were treated for DE during the reporting period. Civilians treated accounted for 18.8% (n  = 601) of all DEs. About 56.9% (n  = 342) of civilians who were treated were U.S. contract employees. Of the 601 civilian patients treated for DE, 37.1% (n  = 223) received oral surgery. There were 2,597 U.S. military patient DE encounters, and restorative dentistry was the most common dental procedure. When comparing civilian and U.S. military patients in Iraq, civilians are statistically less likely to have their DE treated by restorative dentistry (P  < .00001) and are more likely have it treated by oral surgery/extractions (P  < .00001). It is significantly more likely for civilians to have multiple categories of DE that must be treated (P < .00001). Conclusions The primary group of civilians treated for DE in Afghanistan was U.S. civilian employees. The primary group of civilians treated for DE in Iraq were contract employees of the U.S. Government. The primary dental treatment of civilian beneficiaries in both the theaters of operation was oral surgery. This brings into question what dental fitness standards are there for primarily U.S. civilian and contract employees. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate cancer is the second most common cancer among males and is a significant cause of morbidity and mortality. The chemokine C-C motif ligand 2 (CCL2) and its receptor C-C motif chemokine receptor 2 (CCR2) are expressed in prostate cancer but their prognostic value is unclear. This study investigated CCL2 and CCR2 as prognostic biomarkers in locally advanced prostate cancer using the large TROG 03.04 RADAR clinical trial cohort. The results demonstrate that despite being expressed in prostate tumours, CCR2 and CCL2 have no prognostic value in the disease. This study investigated the prognostic value of the chemokine C-C motif ligand 2 (CCL2) and its receptor C-C motif chemokine receptor 2 (CCR2) expression in locally advanced prostate cancer treated with radiotherapy and androgen deprivation using the 10-year outcome data from the TROG 03.04 RADAR clinical trial. CCL2 and CCR2 protein expression in prostate cancer biopsies at the time of diagnosis were quantified by immunohistochemistry and digital quantification. CCR2 protein expression was detected in prostate cancer cells and was associated with prostate-specific antigen serum concentration (p = 0.045). However, neither CCL2 nor CCR2 tissue expression could predict prostate cancer progression, or other clinicopathological parameters including perineural invasion and patient outcome. In serum samples, CCL2 concentration at the time of diagnosis, as assayed by enzyme-linked immunosorbent assay, was significantly higher in patients with prostate cancer compared with benign prostatic hyperplasia (median difference 0.22 ng/mL, 95% CI, 0.17–0.30) (p < 0.0001) and normal controls (median difference 0.13 ng/mL, 95% CI, 0.13–0.17) (p < 0.0001). However, circulating CCL2 was not statistically significant as a predictor of disease progression and patient outcome. In conclusion, this study shows that although CCL2 and CCR2 are expressed in prostate cancer, with an increased level of CCL2 in the serum, neither CCL2 nor CCR2 expression has a clinical prognostic value in locally advanced prostate cancer. [ABSTRACT FROM AUTHOR]

Background: Describe trends in perpetrator characteristics and firearm use in pediatric homicides across the United States. Methods: Multiply-imputed data from the Federal Bureau of Investigation's 1976–2020 Supplementary Homicide Reports were used to estimate perpetrator characteristics (sex, age, and relationship to victim) and firearm use in pediatric homicides. Descriptive analyses were stratified by victim age group, sex, race, and five-year time periods. Results: Family members were the most common perpetrator of infant and toddler (ages 0–4) and child (ages 5–12) homicides, whereas acquaintances accounted for the majority of adolescent (ages 13–19) homicides. Perpetrator characteristics vary across victim sex and race, particularly among adolescents. Despite overall stability, there were changes in perpetrator characteristics from 1976 to 2020. There was a sustained increase in the proportion of homicides committed with a firearm. In 2016–2020, the proportion of firearm-involved homicides was an all-time high for infant and toddler (14.8%), child (53.1%), and adolescent victims (88.5%). Conclusions: Policy interventions that improve family stability and well-being may be most effective at preventing infant, toddler, and child homicides, whereas programs that target peer and community relationships, as well as policies that focus on firearm access, may be more crucial for preventing adolescent homicides. [ABSTRACT FROM AUTHOR]

Combat sports athletes often undergo rapid body mass loss (BML), which presents health risks. Hydration testing has been proposed as a possible solution to reduce or eliminate rapid BML. However, combat sports athletes may exhibit distinct physiological characteristics due to repeated exposure to BML. Thus, traditional and emerging hydration biomarkers should be investigated to determine their potential suitability for field use in this cohort. This study examined whether BML can explain changes in serum and urine osmolality (SosmΔ, UosmΔ), tear osmolarity (TosmΔ), hematocrit (HctΔ), and urine‐specific gravity (USGΔ) after mild–moderate passive dehydration. Biomarker reliability was also assessed across two trials. Fifteen male and female combat sports athletes (age: 26.3 ± 5.3 years, body mass: 67.7 ± 9.9 kg) underwent a sauna protocol twice (5–28 days apart) aiming for 4% BML. The average BML in Trials 1 and 2 was 3.0 ± 0.7%. Regression analysis revealed that BML explained HctΔ (R2 = 0.22, p = 0.009) but not SosmΔ (R2 = 0.11, p = 0.079) or other biomarkers. Intraclass correlation coefficients (ICCs) were significant for all biomarkers except TosmΔ (ICC = 0.06, p = 0.37) and post‐Tosm (ICC = 0.04, p = 0.42); post‐Hct performed best (ICC = 0.82, p < 0.001). Contingency tables with post‐Sosm (295 mOsm/kg) and post‐USG (1.020) cutoffs revealed an 80% true negative rate (TNR) and a 62% true positive rate (TPR). Increasing the Sosm cutoff to 301 mOsm/kg decreased the TNR to 52% but increased the TPR to 83%. Although blood parameters were most sensitive to BML, they could only explain 11%–22% of biomarker variation. The typical USG cutoff misclassified 42% of athletes postdehydration, and reliability was generally poor‐moderate. Alternative strategies should be pursued to manage rapid BML in combat sports. [ABSTRACT FROM AUTHOR]

In view of the core–shell nanocomposites can complement the functions of the core and shell components, we here demonstrate a facile self-template strategy for synthesizing a one-dimensional rod-like hierarchical ZnO@ZIF-8 core–shell structure composed of a stabilized core and an active shell. The ZnO nanorods not only served as the template, but also as source of Zn ions for the in situ formation of zeolitic imidazolate framework-8 (ZIF-8) crystal shell, and the well-stabilized ZnO core preserved its own nature during the growth of the ZIF-8 shell. Furthermore, a sensing platform using ZnO@ZIF-8 as electrocatalyst was developed, which demonstrated salient electrocatalytic activity for diethylstilbestrol (DES) oxidation. The concentration of DES was directly proportional to its anodic peak current in the range of 2 nmol/L to 2 µmol/L, and ultralow detection limit of 0.73 nmol/L (S/N = 3) was achieved. The proposed method also gave excellent selectivity, reproducibility, and stability, showing promising analytical performance for the measurement of DES in food samples of animal origin. [ABSTRACT FROM AUTHOR]

Drawing on oral history, this article analyses how Belgian families affected by diethylstilbestrol (DES) both constructed and deconstructed ignorance of the transgenerational side effects of this hormone from the 1970s onwards. It is the first historical study on the (lack of) knowledge production about DES in Belgium, where until today research has been left to investigative journalists who have pointed to the possibility of a cover-up. This article takes a different approach, producing a multifaceted long-term analysis that also looks at other factors that might have led to ignorance, wilful or otherwise. The emphasis here is on how impacted families themselves maintained or broke silences about DES across generations and over time. By focussing on women's experiences, this article contributes a bottom-up perspective to existing studies of ignorance production relating to the side effects of hormones, which tend to focus on governments, medical communities and pharmaceutical industries. [ABSTRACT FROM AUTHOR]

Simple Summary: Females prenatally exposed to diethylstilbestrol have an elevated risk of severe cervical dysplasia and some cancers, while testicular cancer is increased in males. We assessed these associations in the prenatally exposed female's offspring (third generation). Based on third-generation females' self-reports, diethylstilbestrol exposure was not associated with risks of overall cancer, breast cancer, or severe cervical dysplasia. Borderline ovarian cancer risk in exposed vs. unexposed was elevated but compatible with chance. Based on mothers' reports, diethylstilbestrol exposure did not increase the risk of overall or other cancers in third-generation females. Overall cancer risk in exposed males appeared elevated but compatible with chance. Testicular cancer risk was not elevated in exposed males, and there were no prostate cancers reported. These data do not provide evidence that diethylstilbestrol is associated with cancer risk in third-generation females or males. The third generation is relatively young and requires follow-up to assess risk as the cohort ages. Background: Females exposed prenatally to diethylstilbestrol (DES) have an elevated risk of cervical dysplasia, breast cancer, and clear cell adenocarcinoma (CCA) of the cervix/vagina. Testicular cancer risk is increased in prenatally exposed males. Epigenetic changes may mediate the transmission of DES effects to the next ("third") generation of offspring. Methods: Using data self-reported by third-generation females, we assessed DES in relation to the risk of cancer and benign breast and reproductive tract conditions. Using data from prenatally DES-exposed and unexposed mothers, we assessed DES in relation to cancer risk in their female and male offspring. Cancer risk was assessed by standardized incidence ratios (SIR) and 95% confidence intervals (CI); the risks of benign and malignant diagnoses were assessed by hazard ratios (HR) and 95% CI. Results: In self-reported data, DES exposure was not associated with an increased risk of overall cancer (HR 0.83; CI 0.36–1.90), breast cancer, or severe cervical dysplasia. No females reported CCA. The risk of borderline ovarian cancer appeared elevated, but the HR was imprecise (3.46; CI 0.37–32.42). Based on mothers' reports, DES exposure did not increase the risk of overall cancer (HR 0.80; CI 0.49–1.32) or of other cancers in third-generation females. Overall cancer risk in exposed males appeared elevated (HR 1.41; CI 0.70–2.86), but the CI was wide. The risk of testicular cancer was not elevated in exposed males; no cases of prostate cancer were reported. Conclusions: To date, there is little evidence that DES is associated with cancer risk in third-generation females or males, but these individuals are relatively young, and further follow-up is needed. [ABSTRACT FROM AUTHOR]

Background: To aim of this study is to assess the mechanism through which Desertliving Cistanche modulates the PI3K/AKT signaling pathway in the treatment of hyperlipidemic osteoporosis in ovariectomized rats. Methods: We randomly assigned specific-pathogen-free (SPF) rats into five groups (n = 10 per group). The normal control group received a standard diet, while the model group, atorvastatin group, diethylstilbestrol group, and treatment group were fed a high-fat diet. Four weeks later, bilateral ovariectomies were conducted, followed by drug interventions. After six weeks of treatment, relevant indicators were compared and analyzed. Results: Compared to the normal control group, rats in the model group exhibited blurred trabecular morphology, disorganized osteocytes, significantly elevated levels of bone-specific alkaline phosphatase (BALP), bone Gla-protein (BGP), total cholesterol (TC), tumor necrosis factor-α (TNF-α), and receptor activator of NF-κB ligand (RANKL). Also, the model group revealed significantly reduced levels of ultimate load, fracture load, estradiol (E2), bone mineral density (BMD), osteoprotegerin (OPG), and phosphoinositide 3-kinase (PI3K) and protein kinase B (Akt) in femoral tissue. The atorvastatin group presented with higher TC and TNF-α levels compared to the normal control group. Conversely, the treatment group demonstrated enhanced trabecular morphology, denser structure, smaller bone marrow cavities, and reduced BALP, BGP, TC, TNF-α, and RANKL levels. Furthermore, the treatment group exhibited higher levels of E2, BMD, OPG, and PI3K and Akt in bone tissue compared to the model group. The treatment group also had lower TC and TNF-α levels than the atorvastatin group. Biomechanical analysis indicated that after administration of Desertliving Cistanche, the treatment group had reduced body mass, increased ultimate and fracture load of the femur, denser bone structure, smaller bone marrow cavities, and altered periosteal arrangement compared to the model group. Conclusion: Our study revealed that Desertliving Cistanche demonstrated significant efficacy in preventing and treating postmenopausal hyperlipidemic osteoporosis in rats. [ABSTRACT FROM AUTHOR]

Intermittent fasting (IF), one of the most popular diets, can regulate inflammation and promote health; however, the detailed molecular mechanisms are not fully understood. The present review aims to provide an overview of recent preclinical and clinical studies that have examined the effect of IF on inflammasome signaling, and to discuss the translational gap between preclinical and clinical studies. Three databases (PubMed, Web of Science, and Embase) were searched to identify all relevant preclinical and clinical studies up to October 30, 2022. A total of 1544 studies were identified through the database searches, and 29 preclinical and 10 clinical studies were included. Twenty-three of the 29 preclinical studies reported that IF treatment could reduce inflammasome activation in neurological diseases, metabolic and cardiovascular diseases, immune and inflammatory diseases, gastrointestinal diseases, and pulmonary diseases, and 7 of the 10 clinical studies demonstrated reduced inflammasome activation after IF intervention in both healthy and obese participants. Among various IF regimens, time-restricted eating seemed to be the most effective one in terms of inflammasome regulation, and the efficacy of IF might increase over time. This review highlights the regulatory effect of IF on inflammasome activation in health and disease. Future studies using different IF regimens, in various populations, are needed in order to evaluate its potential to be used alone or as an adjunct therapy in humans to improve health and counteract diseases. [ABSTRACT FROM AUTHOR]

Purpose: Despite the clinical utility of sentence production and sentence repetition to identify language impairment in autism, little is known about the extent to which these tasks are sensitive to potential language variation. One promising method is strategic scoring, which has good clinical utility for identifying language impairment in nonautistic school-age children across variants of English. This report applies strategic scoring to analyze sentence repetition and sentence production in autistic adolescents and adults. Method: Thirty-one diverse autistic adolescents and adults with language impairment (ALI; n = 15) and without language impairment (ASD; n = 16) completed the Formulated Sentences and Recalling Sentences subtests of the Clinical Evaluation of Language Fundamentals–Fifth Edition. Descriptive analyses and regression evaluated effects of scoring condition, group, and scoring condition by group on outcomes, as well as group differences in finiteness marking across utterances and morphosyntactic structures. Results: Strategic and unmodified item-level scores were essentially constant on both subtests and significantly lower in the ALI than the ASD group. Only group predicted item-level scores. Group differences were limited to: percent grammatical utterances on Formulated Sentences and percent production of overt structures combined on Sentence Repetition (ALI < ASD). Discussion: Findings support the feasibility of strategic scoring for sentence production and sentence repetition to identify language impairment and indicate that potential language variation in finiteness marking did not confound outcomes in this sample. To better understand the clinical utility of strategic scoring, replication with a larger sample varying in age and comparisons with dialect-sensitive measures are needed. [ABSTRACT FROM AUTHOR]

In this research, the MIL-47/ACET/Nafion/GCE electrochemical senser for the determination of diethylstilbestrol (DES) was prepared with vanadyl sulfate (VOSO4· n H2O) and terephthalic acid (H2BDC) as the main raw materials, compounded with acetylene black (ACET) and perfluorosulfonic acid polymer (Nafion). The compound DES belongs to the category of estrogens, and prolonged exposure to the environment can have detrimental effects on the physiological functioning of both humans and animals. Due to the strong DES enrichment performance of MIL-47(V-MOFs) with large specific surface area, in addition to the excellent conductivity and electrocatalysis of composite materials, this modified senser had good electrochemical response to DES. With differential pulse voltammetry, in optimum condition of 0.1 M NaH2PO4–Na2HPO4 at pH = 7.0, potential interval of −1.0 to 1.0 V, enrichment time of 120 s and enrichment potential of 0.2 V, there was a good linear relationship between peak current and the concentration of DES over the range of 0.1 and 50 μ M, and the limit of detection was 0.008 μ M. The sensor accurately detected DES in actual water samples, with recovery rates ranging from 89.21% to 105.3%. The electrochemical sensor was simple to prepare and had practical significance for the detection of DES in water. The research results of the sensor provide another alternative analytical means for the sensitive detection of DES in the environment, which is important for maintaining public health. [ABSTRACT FROM AUTHOR]

In a previous study, diethylstilbestrol (DES) was shown to induce oocyte maturation in fish. In the present study, the interaction of DES on goldfish membrane progesterone receptor α (GmPRα) was investigated using a competitive binding assay with radiolabeled steroids. The results indicate that DES exerts its effects on membrane progesterone receptor alpha (mPRα) and induces oocyte maturation through nongenomic steroid mechanisms. This study provides empirical data that demonstrate the binding between DES and GmPRα. Binding of DES to GmPRα was achieved by using radiolabeled DES and recombinant GmPRα expressed in culture cells or purified GmPRα proteins that coupled to graphene quantum dots (GQDs). Additionally, the competitive binding of fluorescently labeled progesterone to GmPRα-expressing cells was evaluated. Although significant nonspecific binding of radiolabeled DES to the cell membrane that expresses GmPRα has been observed, specific binding of DES to GmPRα has been successfully identified in the presence of digitonin. Furthermore, the specific binding of DES to GmPRα was confirmed by a binding assay using GQD-GmPRα. The radiolabeled DES was shown to bind to GQD-GmPRα. Additionally, the competition for the binding of fluorescently labeled progesterone to GmPRα-expressing cells was achieved with the DES. The results of the experiments revealed that DES binds to GmPRα. Thus, it can be concluded that DES induces goldfish oocyte maturation by binding to GmPRα. [ABSTRACT FROM AUTHOR]

This content analysis aimed to assess misinformation themes regarding sodium reduction and blood pressure on X with the goal of providing strategies to address and debunk such misinformation. A total of 531 posts were manually coded into sodium-related misinformation themes, with inclusion criteria for posts asserting no association between sodium reduction and hypertension or claiming consuming sodium is beneficial for health. Numbers and post frequencies per misinformation theme were calculated. Post characteristics, including information sources, advertisements and narratives, were coded, and a correlation analysis was conducted to assess their association with each misinformation theme. Fourteen sodium-related misinformation themes were identified and consistently disseminated on X. The predominant theme, 'Natural Salt', accounted for 37.7% (n  = 200), reaching 1.6 million followers, followed by 'Reducing salt could be bad for my health' theme, comprising 28.6% (n  = 152) and reaching 1.5 million followers. There was a statistical correlation between the natural salt misinformation theme and advertisements. Many of the most frequent misinformation themes identified in this study have not been systematically debunked by organizations such as the World Health Organization and the American Heart Association. This study underscores the importance of continuous monitoring and analysis of sodium-related misinformation on social media platforms and their underlying commercial interests. Such monitoring has the potential to identify prevalent misinformation themes that may pose harm to the public and to inform public health organizations, enabling them to proactively address potential issues through debunking. [ABSTRACT FROM AUTHOR]

Diethylstilbestrol (DES), a synthetic non-steroid estrogen, it has been prohibited from being added to animal feed for any purposes. Herein, an indirect competitive enzyme-linked immunosorbent assay (ic-ELISA) based on a specific monoclonal antibody (mAb) was developed for the rapid screening of DES. Primarily, conjugates of mono-O-3-carboxypropyl diethylstilbestrol with keyhole limpet hemocyanin were used to raise a specific mAb, 1B7, which had IC50 value for DES of 213.0 ng L−1. The limits of detection and limits of quantification value for DES in animal-derived foods ranged from 68.1 to 103.1 ng L−1 and 100.8–192.7 ng L−1, respectively. The DES recovery ranged from 70.1 % to 103.1 %, with coefficients of variation below 13.9 %. A positive correlation (R2 = 0.997) was observed between the results of ic-ELISA and HPLC-MS/MS for milk. In order to inspect its detection effect, milk and animal-derived foods were chosen as the testing object. The results showed that this ic-ELISA method (specific mAb, 1B7) can effectively examine for DES residues.

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The present experience sampling study investigated the effect of age on emotion regulation patterns (i.e., emotion regulation strategy effectiveness, variability, and differentiation) in daily life. The study further explored the implications of potential age differences in emotion regulation patterns for well‐being. A sample of 406 adults (age range: 18–81, 62.8% female) were prompted five times a day for seven days to rate momentary emotions, emotion regulation strategy use, and emotion regulation strategy effectiveness. Based on these ratings, indicators of emotion regulation variability and differentiation were calculated. Well‐being outcomes included daily positive and negative emotions, and symptoms of depression and anxiety assessed at baseline. The findings revealed reduced emotion regulation variability with age and a negative association between emotion regulation variability and well‐being. There were no associations between age and emotion regulation effectiveness or differentiation. Emotion regulation effectiveness was associated with more positive and less negative daily emotions, and these associations were stronger for younger adults compared to older adults. Drawing on prominent lifespan theories, the findings may indicate that as people age, they select and apply a few strategies that they know will be effective given the context and their resources which leads to reduced emotion regulation variability but ultimately more well‐being. Concerning emotion regulation effectiveness, the findings suggest that effectiveness is less important for emotional well‐being in daily life in older adulthood possibly because well‐being is determined by other factors (e.g., less frequent and more predictable stressors) with age. [ABSTRACT FROM AUTHOR]

Caring is a universal phenomenon that influences nurse-patient interactions and feelings, forming the foundation of the nursing profession. How nurses perceive and experience caring in low-income settings is not well understood. Therefore, the purpose of this study was to explore Ethiopian nurses' perceptions and experiences of caring using a qualitative descriptive design. Individual semi-structured interviews were conducted with 13 nurses aged 28-57. Interviews were analyzed inductively using reflexive thematic analysis guided by the recommendations of Braun and Clarke. The analysis resulted in three themes: caring is the heartbeat of patient care, constraints to the provision of care, and ways to overcome constraints. The results revealed that nurses were committed to fulfilling their professional obligations and meeting patients' needs despite experiencing multiple constraints. The findings provide a comprehensive perspective in understanding nurses' experiences of caring. Their narratives demonstrate that they face constraints in their clinical practice, which limit the quality of care, including rotation and lack of resources. Cooperation between health policymakers and nurse authorities is essential for shifting the clinical environment from the prevailing traditional task-oriented approach to patient-centered care. [ABSTRACT FROM AUTHOR]

This article discusses the synthesis of new quinoline derivatives and their effectiveness against bacteria. Quinolines are important in the development of pharmaceuticals and fine chemicals. The researchers created five derivatives and tested their antimicrobial activity. Two of the compounds showed promising results against both gram-positive and gram-negative bacteria. The article also provides details on the synthesis process and characterization of three specific compounds. The authors acknowledge the University of Technology, Iraq, and the University of Tübingen/Institute of Pharmaceutical Sciences, Germany, for their laboratory facilities. [Extracted from the article]

Simple Summary: Faecal occult blood test interval cancer is one of the potential harms of colorectal cancer screening programmes. These tumours are diagnosed in people who have previously received a negative result in a screening test. The objective of this study was to evaluate interval cancer rates in colorectal cancer screening programmes in Spain, assess their risk factors and compare the characteristics of screen-detected and interval cancer tumours. Identifying interval cancer rates as well as the associated factors would make it possible to improve screening strategies and identify personal variables related to the occurrence of interval cancer. Furthermore, studying the characteristics that distinguish interval cancers from screen-detected cancers would help us understand the nature of these tumours. These results would help evaluate and improve colorectal cancer screening programmes, increase their quality and minimise interval cancer in such programmes. The objective of this study is to evaluate interval cancer (IC) in colorectal cancer (CRC) screening, which is CRC diagnosed in an individual after having received a negative faecal occult blood test and before the next invitation to participate in screening. A follow-up study was conducted on a cohort of participants in the first three screening rounds of four colorectal cancer screening programmes in Spain, n = 664,993. A total of 321 ICs and 2120 screen-detected cancers (SCs) were found. The IC and SC rates were calculated for each guaiac (gFOBT) or immunochemical (FIT) test. A Cox regression model was used to estimate the hazard ratios (HR) of IC risk factors. A nested case–control study was carried out to compare IC and SC tumour characteristics. The IC rate was 1.16‰ with the gFOBT and 0.35‰ with the FIT. Men and people aged 60–69 showed an increased probability of IC (HR = 1.81 and HR = 1.95, respectively). There was a decreased probability of IC in individuals who regularly participated in screening, HR = 0.62 (0.47–0.82). IC risk gradually rose as the amount of Hb detected in the FIT increased. IC tumours were in more advanced stages and of a larger size than SC tumours, and they were mostly located in the cecum. These results may play a key role in future strategies for screening programmes, reducing IC incidence. [ABSTRACT FROM AUTHOR]

The siblings of children with mental disorders are more likely to experience mental health issues themselves, but there has been a lack of sibling studies on selective mutism (SM). The aim of this population-based study was to use national registers to examine associations between children with SM and diagnoses of various mental disorder in their siblings. All singleton children born in Finland from 1987 to 2009, and diagnosed with SM from 1998 to 2012, were identified from national health registers and matched with four controls by age and sex. Their biological siblings and parents were identified using national registries and the diagnostic information on the siblings of the subjects and controls was obtained. The final analyses comprised 658 children with SM and their 1661 siblings and 2092 controls with 4120 siblings. The analyses were conducted using generalized estimating equations. Mental disorders were more common among the siblings of the children with SM than among the siblings of the controls. The strongest associations were observed for childhood emotional disorders and autism spectrum disorders after the data were adjusted for covariates and comorbid diagnoses among SM subjects. The final model showed associations between SM and a wide range of disorders in siblings, with strongest associations with disorders that usually have their onset during childhood. Our finding showed that SM clustered with other mental disorders in siblings and this requires further research, especially the association between SM and autism spectrum disorders. Strong associations with childhood onset disorders may indicate shared etiologies. [ABSTRACT FROM AUTHOR]

The positive impact of coworker social support on employee behaviour and well-being is well-described in the job demands–resources model. However, the specific mechanisms through which it operates have received scarce research attention. The current study investigated the distinct roles of relatedness need satisfaction (i.e. connectedness) and need frustration (i.e. isolation) to explain how available coworker social support relates to organizational citizenship behavior (OCB) and depersonalisation. We used a three-wave panel design (N = 1259/704/405 at Time 1/2/3) to test the indirect effects of social support on OCB via connectedness and on depersonalisation via isolation. Coworker social support at Time 1 predicted increases in connectedness and decreases in isolation from Time 1 to Time 2. Contrary to expectations, increases in connectedness predicted decreases in OCB, and decreases in isolation did not predict decreases in depersonalisation, from Time 2 to Time 3. Overall, our results highlight the importance of coworker social support to increase connectedness and decrease feelings of isolation in the workplace, which can ultimately affect interpersonal work outcomes. [ABSTRACT FROM AUTHOR]

Nano-Fe3O4 was prepared by solvothermal method, and the prepared Fe3O4 nanoparticles were dispersed in tetraethyl orthosilicate (TEOS) hydrolysate to deposite a layer of silica on the surface. Methacryloxypropyltrimethoxysilane (MPS) was used for SiO2-Fe3O4 surface modification to obtain MPS-SiO2-Fe3O4. Methacrylic acid (MAA) and diethylstilbestrol (DES) were added into acetonitrile solvent with molar ratio of 4 ∶1 for 12 h self-assembly, and MPS-SiO2-Fe3O4, ethylene glycol dimethacrylate (EGDMA) and azobisisobutyronitrile (AIBN) were added for ultrasonically dispersing for 30 min with latter mechanically stirring at 65 ℃ for 24 h to obtain DES magnetic molecularly imprinted polymer (MMIP). The characterization was conducted by transmission electron microscopy, vibrating sample magnetometer and adsorption experiments. The results show that the saturation magnetic intensity of MMIP is 268 kA/m without hysteresis and with zero coercivity and super paramagnetic properties, and MMIP can be rapidly separated from the solution in 17 s under the action of magnet. At room temperature, the maximum static adsorption capacity of MMIP to DES is 7.1 mg/g, and MMIP can reach more than 90% of the maximum adsorption capacity in 60 min during dynamic adsorption. The imprinting factor of MMIP to DES is 3.70, which shows great ability to identify DES. MMIP can be reused more than six times with good renewable performance. [ABSTRACT FROM AUTHOR]

Background: Norwegian public health nursing education is a postgraduate education in health-promoting and preventive community nursing with a focus on children, young people (0-20 years) and their families. It has its theoretical foundations in public health and nursing. Research from 2021 showed a clear public health focus, while the nursing foundation was less visible. Objectives: To explore the nursing content and abstraction levels in the reading lists from institutions that educate public health nurses in Norway. Method: Using an exploratory and descriptive design, a thematic content analysis of the curriculum literature was conducted with a focus on nursing content and abstraction levels. The results showed that the majority of nursing texts were related to practice. Very few texts were ethical/philosophical texts with a higher level of abstraction. Conclusion: There is a need for qualitative and quantitative studies that can shed light on the rationale behind the choice of curriculum content. [ABSTRACT FROM AUTHOR]

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There is an increasing concern regarding the mental health of healthcare workers during the COVID-19 pandemic. This study aimed to assess the psychological impact of the COVID-19 exposure among Paraguayan healthcare workers. A cross-sectional descriptive study has been carried out in five hospitals of Paraguay. Demographic and occupational exposure to COVID-19 were collected through a short questionnaire. Mental health status was assessed with the GAD-7, the PHQ-9, and the PCL-C. Logistic regression was used to determine psychological risk factors. 432 participants were surveyed. 218 (50.46%) were physicians. The prevalence of symptoms of anxiety, depression and PTSD was 48.15, 41.90, and 5.79%, respectively. There were no significant differences in anxiety (128 [29.63%] vs. 80 [18.52%]; p = 0.3303), depression (102 [23.61%] vs. 79 [18.29%]; p = 0.6703), or PTSD (14 [3.24%] vs. 11 [2.55%]; p = 0.8074) between frontline versus second-line workers. Main risk factors associated with psychological distress included work experience <5 years for depression and a COVID-19 positive diagnosis or having family/friends with a COVID-19 positive diagnosis for PTSD. Paraguayan healthcare workers reported high prevalence of anxiety, depression, and a low prevalence of PTSD. A positive diagnosis of COVID-19 and work experience <5 years are important psychological risk factors. [ABSTRACT FROM AUTHOR]

Photothermal immunochromatographic sensor is an emerging detection technology, and it is important to develop new sensing probes with excellent photothermal performance to improve its detection performance. In the present study, a novel photothermal sensing probe based on violet phosphorus nanosheets with satisfactory photothermal conversion efficiency (31.1 %) was reported for the first time. A photothermal immunochromatographic sensor using the above probe was applied for visual and photothermal detection of diethylstilbestrol. The diethylstilbestrol concentration was inversely proportional to photothermal sensing signal and showed a good linear correlation in the range of 0.75 ∼ 50 μg·L−1. After optimizing, the visual and photothermal detection limits were 6 μg·L−1 and 0.56 μg·L−1, respectively. The recovery rates in tap water, milk and pork samples ranged from 82.2 % to 115.2 %, with a coefficient of variation (CV) ranging from 2.0 % to 10.8 %. This work not only structured a new type of photothermal probe, but also expanded the application range of violet phosphorus.

Background: Various microorganisms which increase the mortality rate in the intensive care unit (ICU) cause microbial colonization of the nasogastric tube (NGT) and use the NGT as a reservoir. Aim: To detect the colonization on the NGT and to determine the effect that training regarding hand hygiene, NGT management, and enteral feeding (EF) provided to ICU nurses and auxiliary service staff (ASS) has on the level of NGT colonization. Study Design: A quasi‐experimental pre‐test and post‐test control design was used in this study. Microbial samples were taken from the outer and inner parts of NGT. The microorganisms were categorized as: group 1, no risk; group 2, low risk pathogenic; group 3, high‐risk pathogenic group. The training was given to nurses (n = 15) and ASS (n = 7). Hand hygiene, NGT, and EF care training are provided to nurses and ASS by researchers. A total of three training sessions were scheduled to be held in 3 weeks so that all health care staff members were trained. Each session lasted 2 h in total. Patients were assigned to a group if one of the microorganisms presented on the outer surface of the patient's feeding tube and/or on the hub. The hand hygiene compliance was evaluated by direct observation according to the World Health Organization hand hygiene indications. Results: The study was conducted with 46 patients. Evaluating the patients for the presence of microorganisms before education revealed that 4.3% were in group 1, 21.8% were in group 2, and 73.9% were in group 3. After the education, evaluating the samples for the presence of microorganisms revealed that 39.1% were in group 1, 13% were in group 2, and 47.8% were in group 3. A statistically significant difference was found between the number of samples included in the groups after the participants had received training (H = 8.186; p =.017). Conclusions: An NGT could act as a reservoir of microbial colonization and high‐risk microorganisms could be on the tube. Providing training not only to nurses but also to ASS will help reduce the risk of colonization. Relevance to Clinical Practice: Eliminating such colonization with effective hand hygiene during NGT feeding is a cost‐effective method. Providing training not only to nurses but also to ASS will help obtain the optimum benefit from patient care. [ABSTRACT FROM AUTHOR]

The adenohypophysis is comprised of the anterior and intermediate lobes (AL and IL, respectively). Cluster of differentiation 9 (CD9)- and sex-determining region Y-box 2 (SOX2)-positive cells are stem/progenitor hormone-producing cells in the AL. They are located in the marginal cell layer (MCL) facing Rathke’s cleft between the AL and IL (primary niche) and the parenchyma of the AL (secondary niche). We previously showed that, in rats, CD9/SOX2-positive cells in the IL side of the MCL (IL-side MCL) migrate to the AL side (AL-side MCL) and differentiate into prolactin-producing cells (PRL cells) in the AL parenchyma during pregnancy, lactation, and diethylstilbestrol treatment, all of which increase PRL cell turnover. This study examined the changes in CD9/SOX2- positive stem/progenitor cell niches and their proportions by manipulating the turnover of growth hormone (GH)- and thyroid-stimulating hormone (TSH)-producing cells (GH and TSH cells, respectively), which are Pit1 lineage cells, as well as PRL cells. After induction, the isolated CD9/SOX2-positive cells from the IL-side MCL formed spheres and differentiated into GH and TSH cells. We also observed an increased GH cell proportion upon treatment with GHreleasing hormone and recovery from continuous stress and an increased TSH cell proportion upon propylthiouracil treatment, concomitant with alterations in the proportion of CD9/SOX2-positive cells in the primary and secondary niches. These findings suggest that CD9/SOX2-positive cells have the potential to supply GH and TSH when an increase in GH and TSH cell populations is required in the adult pituitary gland. [ABSTRACT FROM AUTHOR]

A simultaneous analytical method for two prohibited fungicides and their metabolites was developed alongside a simultaneous analytical method for two hormone compounds. For the fungicides, conditions such as the SPE cartridge type, pH conditions, and additives were varied while for the hormones, the elution solvents and pH conditions were varied, and finally, the optimal conditions were selected for each compound group. Target fungicide compounds and medroxyprogesterone acetate were ionized in positive mode while diethylstilbestrol was ionized in negative mode. For the fungicides, with the injection of additives and buffer, the MCX cartridge showed more stable recoveries (85.1-140.0%) compared to the HLB (82.3-251.7%) and combined cartridges (56.1-277.2%). The accuracy and precision of the analytical method were 83.2-130.1% and 6.8-15.0%, respectively. The method detection limit and limit of quantification from this study were lower than those reported in previous studies. Meanwhile, for hormones, methanol was the most appropriate elution solvent in the presence of ascorbic acid additive and at pH 2.5. Accuracy and precision ranged from 75.3-106.6% and 4.3-9.1%, respectively. This study's optimized simultaneous analytical methods can be used to proactively detect prohibited substances in seawater and aquaculture farms. [ABSTRACT FROM AUTHOR]

Building heterogeneous structures can increase the rate of electron transport, generate synergistic effects, and get around the limitations of a single component. In order to create a label-free electrochemical immunological sensor, we created nanosheets with a dual-heterogeneous structure (Co9S8/Co3C@C) using ZIF-67. Diethylstilbestrol (DES) was detected sensitively in environmental samples (groundwater and lake water). This sensor has an acceptable detection ability, a wide linear response (0.000384–6 ng mL−1), and a low detection limit (3.24 fg mL−1) due to the excellent conductivity of the nanosheets. The stability, selectivity, and sensitivity of the electrochemical immunosensor are satisfactory. It is an effective, practical, and quantitative detection technique. [ABSTRACT FROM AUTHOR]

Significant decreases in fertility have been observed over the past 50 years, with female conception rates dropping by 44% and male sperm counts decreasing by over 50%. This dramatic decrease in fertility can be attributed in part to our increasing exposure to endocrine disrupting chemicals (EDCs). Diethylstilbestrol (DES) is an estrogenic EDC that was prescribed to millions of pregnant women between 1940 and 1970 and resulted in detrimental reproductive effects in the offspring that were exposed in utero. Women who were exposed to DES in utero experienced higher rates of infertility, pregnancy complications, and reproductive cancers. Alarmingly, there is evidence to suggest that these effects may persist in the grandchildren and great grandchildren of exposed women. To define the transgenerational reproductive impacts in females following exposure to DES, gestating mice were exposed to DES and the effects monitored in the female descendants across 3 generations. There was a trend for reduced pregnancy rate and fertility index seen across the generations and moreover, the anogenital distance (AGD) was significantly reduced up until the third, unexposed generation. The onset of puberty was also significantly affected, with the timing of vaginal opening occurring significantly earlier in DES descendants. These results indicate a transgenerational effect of DES on multiple reproductive parameters including fertility, timing of puberty, and AGD. These data have significant implications for more than 50 million DES descendants worldwide as well as raising concerns for the ongoing health impacts caused by exposures to other estrogenic EDCs which are pervasive in our environment. [ABSTRACT FROM AUTHOR]

The article discusses a longitudinal, descriptive pilot study which evaluated the influence of medical-surgical nursing certification on improving patient outcomes and other nursing indicators. The study evaluated the feasibility of a focused intervention to increase certification rate and examined the link between certification rate increases and improvement in nurse satisfaction and practice environment. Strategies to develop a certification program on a medical-surgical unit are suggested.

[Display omitted] Hypothesis: The ability of deep eutectic solvents (DES) to enhance solubility of poorly soluble drugs has attracted increasing attention. Researchers have shown that drugs could be dissolved well in DES. In this study, we propose a new existence state of drugs in DES: a quasi-two-phase colloidal system. Experiments: Six poorly soluble drugs were used as the models. The formation of colloidal systems was observed visually by the Tyndall effect and DLS. TEM and SAXS were performed to obtain their structure information. The intermolecular interactions between components were probed via DSC and 1H1H-ROESY. In addition, the properties of colloidal systems were further studied. Findings : Our key finding is that several drugs like lurasidone hydrochloride (LH) could form stable colloids in [Th (thymol)] - [Da (decanoic acid)] DES, resulting from weak interactions between drugs and DES, which is different from the true solution of drugs like ibuprofen where strong interactions were formed. In this LH-DES colloidal system, DES solvation layer was directly observed on the surface of drug particles. In addition, the colloidal system with polydispersity shows superior physical and chemical stability. Different to the prevailing view that substances are fully dissolved in DES, this study discovers another existence state as stable colloidal particles in DES. [ABSTRACT FROM AUTHOR]

Clear cell carcinoma is believed to be one of the rare neoplasms of cervix uteri and vagina. The etiology and pathogenesis of clear cell carcinoma of the cervix are unclear, with scarce information about the clinical behavior, optimal management, and prognosis of the tumor. The current treatment options are based on the experiences accumulated on squamous cell carcinoma and other types of adenocarcinoma. Prior intrauterine exposure to diethylstilbestrol (DES) is presumed to be a predisposing factor for clear cell adenocarcinoma in young patients. Metastasis is uncommon, but local recurrence may occur. The cure rate of this disease is 85%-90% in early stages with a small volume of tumors. In this study, we report a rare case of clear cell carcinoma of the cervix in a 21-year-old woman, who had no exposure to DES (in-utero) or synthetic non-steroidal estrogen; therefore, the present research supports the hypothesis that the risk factors, other than DES exposure, play an important role in carcinogenesis.

Primary clear cell adenocarcinoma of the vagina represents a rare form of cancer historically correlated with in-utero diethylstibestrol (DES) exposure. Mainstay treatment modalities include surgery, radiation, and chemotherapy. There has been a growing interest in immunotherapy in the field of oncology. KEYNOTE 826 demonstrated that patients with persistent, recurrent, or metastatic cervical cancer including patients who had adenocarcinoma showed improved progression and overall survival by the addition Pembrolizumab to chemotherapy plus or minus bevacizumab. To date, there are no documented cases using pembrolizumab as adjuvant treatment for active or recurrent vaginal clear cell adenocarcinoma. We present a case of a young patient with recurrent vaginal clear cell carcinoma who showed a complete and durable response to Pembrolizumab.

ABSTRACT: This study investigated the detrimental effects of diethylstilbestrol (DES), an estrogenic endocrine-disrupting chemical, on the viability of primordial germ cells (PGCs), embryonic precursors of germ cells, in Japanese quail. We injected 50 or 100 nmol DES solubilized in sesame oil into the yolk of stage X embryos and assessed changes in the population and cell cycle properties of circulating PGCs in blood vessels and gonadal PGCs after 2.5- and 7-day incubations, respectively. Liquid chromatography tandem mass spectrometer and Western blotting analyses identified DEAD-box polypeptide 4 (DDX4) and proliferating cell nuclear antigen (PCNA) as a stem cell marker and proliferation marker of quail PGCs, respectively. Immunochemical analyses revealed significant decreases in the number of DDX4- and PCNA-positive blood-circulating PGCs in males treated with 50 and 100 nmol DES than in the oil-treated control group. These reductions were not observed in females. Furthermore, the number of DDX4-positive gonadal PGCs was smaller in males treated with 50 and 100 nmol DES than in the control group, and these reductions were not observed in females. The protein expression of the Sertoli cell marker showed normal testis development in DES-treated embryos on d 7. These results demonstrate the potentially cytotoxic effects of DES on male germ cells, namely, the inhibition of cell cycle progression and induction of apoptosis in Japanese quail.

While there is extensive research on the adaptive grief styles developed by Doka and Martin, this study is the first of its kind to explore the language used among each style of grief. This study used clinical vignettes from a variety of sources on instrumental and intuitive grieving in an attempt to decipher the language use across various linguistic and psychological processes. Following this analysis, latent Dirichlet allocation (LDA) was used fitting a two-topic model to analyze differences between topics while additionally performing a supervised LDA analysis. The strongest data from this study relate to intuitive grief, which found a higher use of present-tense language in comparison to the instrumental grief style. In addition, results found that the language used by intuitive grievers is slightly more distinguishable than that of its instrumental counterpart. Several implications for counseling and research were developed in response to these findings. [ABSTRACT FROM AUTHOR]

Primary clear cell carcinoma of the vagina (PCCAV) is a rare form of vaginal cancer that typically affects young women with a history of prenatal exposure to DES. However, data on non-DES PCCAV cases are limited. This report describes a case of PCCAV in a 47-year-old patient who presented with post-coital bleeding and was diagnosed with clear cell adenocarcinoma via biopsy and MRI. The patient had no history of DES exposure and further testing showed no signs of metastasis, leading to surgery and chemotherapy. Four years later, the patient presented with dyspnea, and a chest CT scan revealed a lung nodule, later confirmed to be a metastasis of clear cell adenocarcinoma from the vaginal cancer. The patient passed away a month later due to complications from COVID-19. [ABSTRACT FROM AUTHOR]

Aims: To develop a deep learning model for pressure injury stages classification based on real‐world photographs and compare its performance with that of clinical nurses to seek the opportunity of its application in clinical settings. Design: This was a retrospective observational study using a deep learning model. Review Methods: A plastic surgeon and two wound care nurses labelled a set of pressure injury images. We applied several modern Convolutional Neural Networks architectures and compared the performances with those of clinical nurses. Data Sources: We retrospectively analysed the electronic medical records of hospitalized patients between January 2019 and April 2021. Results: A set of 2464 pressure injury images were compiled and analysed. Using EfficientNet, in classifying pressure injury images, the macro F1‐score was calculated to be 0.8941, and the average performance of two experienced nurses was reported as 0.8781. Conclusion: A deep learning model for classifying pressure injury images by stages was successfully developed, and the performance of the model was compared with that of experienced nurses. The classification model developed in this study is expected to help less‐experienced nurses or those working in under‐resourced healthcare settings determine the stages of pressure injury. Impact Our deep learning model can minimize discrepancies in nurses' assessment of classifying pressure injury stages. Follow‐up studies on improving the performance of deep learning models using modern techniques and clinical usability will lead to improved quality of care among patients with pressure injury. No Patient or Public Contribution: Patients or the public were not involved in our research's design, conduct, reporting or dissemination plans because this was a retrospective study that used electronic medical records. [ABSTRACT FROM AUTHOR]

The period during which tissue and organ development occurs is particularly vulnerable to the influence of environmental exposures. However, the specific mechanisms through which biological pathways are disrupted in response to developmental insults, consequently elevating the risk of hormone-dependent diseases, such as uterine fibroids (UFs), remain poorly understood. Here, we show that developmental exposure to the endocrine-disrupting chemical (EDC), diethylstilbestrol (DES), activates the inflammatory pathways in myometrial stem cells (MMSCs), which are the origin of UFs. Significantly, the secretome of reprogrammed MMSCs enhances the expression of critical inflammation-related genes in differentiated myometrial cells through the paracrine mechanism, which amplifies pro-inflammatory and immune suppression signaling in the myometrium. The expression of reprogrammed inflammatory responsive genes (IRGs) is driven by activated mixed-lineage leukemia protein-1 (MLL1) in MMSCs. The deactivation of MLL reverses the reprogramming of IRG expression. In addition, the inhibition of histone deacetylases (HDACs) also reversed the reprogrammed IRG expression induced by EDC exposure. This work identifies the epigenetic mechanisms of MLL1/HDAC-mediated MMSC reprogramming, and EDC exposure epigenetically targets MMSCs and imparts an IRG expression pattern, which may result in a "hyper-inflammatory phenotype" and an increased hormone-dependent risk of UFs later in life. [ABSTRACT FROM AUTHOR]