Acquired Perforating Dermatosis After Herpes Zoster: Wolf Isotopic Response.

Wolf isotopic response (WIR) is a phenomenon in which a second, unrelated skin disease arises at the same site as a previously healed dermatosis. WIR most commonly occurs in healed herpes zoster but has also been described in other conditions, such as herpes simplex virus, varicella-zoster virus, and skin tumors. Acquired perforating dermatosis (APD) is characterized by transepidermal elimination of collagen bundles that lead to the development of ulcerative papules, which are often associated with systemic conditions such as diabetes or renal failure. This report documents a rare occurrence of APD after WIR and reviews related published works.

The ability of peripheral neurophysiological biomarkers to predict future psychological conditions among geriatric populations.

OBJECTIVE: Though the association between peripheral neurophysiological biomarkers and psychological conditions is widely discussed, there is still limited evidence about the ability of peripheral biomarkers to predict psychological outcomes, especially among geriatric populations. METHODS: The study is designed as a prospective cohort study. We collected information from participants aged over 55 years. The participants were evaluated at the start of the study (T0) and 6-9 months later (T1). Information about demographic profiles, peripheral neurophysiological biomarker recordings (including heart rate variability, finger temperature, skin conductance, and electromyogram), and psychological measurements (including Brief Symptom Rating Scale-5, Chinese Happiness Inventory, and Short Portable Mental Status Questionnaire) were collected at T0. At T1, participants reported self-rated questionnaires for psychological outcomes (Patient Health Questionnaire-15, health anxiety questionnaire, Beck Depression Inventory-II, and Beck Anxiety Inventory) and were evaluated with Mini-Mental State Examination by the staff. The association between the peripheral biomarkers and psychological outcomes was evaluated via multiple regression models. RESULTS: A total of 385 participants were included in the study and the average age was 74.49 ± 7.34 years. Both stepwise multiple linear and logistic models showed a significant association between decreased skin conductance and increased/presence of depression at T1. The receiver operating characteristic (ROC) curve analysis of skin conductance for depression was fair (area under curve = 0.812). CONCLUSIONS: The ability of skin conductance to predict depression among geriatric populations may facilitate the detection of geriatric depression and future research on the pathophysiology.

O-Carboxymethyl chitosan nanoparticles: A novel approach to enhance water stress tolerance in maize seedlings.

Water stress, a significant abiotic stressor, significantly hampers crop growth and yield, posing threat to food security. Despite the promising potential of nanoparticles (NPs) in enhancing plant stress tolerance, the precise mechanisms underlying the alleviation of water stress using O-Carboxymethyl chitosan nanoparticles (O-CMC-NPs) in maize remain elusive. In this study, we synthesized O-CMC-NPs and delved into their capacity to mitigate water stress (waterlogging and drought) in maize seedlings. Structural characterization revealed spherical O-CMC-NPs with a size of approximately 200 nm. These NPs accumulated near the seed embryo and root tip, resulting in a substantial increase in fresh and dry weights. The application of O-CMC-NPs to water-stressed maize seedlings remarkedly elevated the chlorophyll content and activity of various antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), peroxidase (POD), and polyphenol oxidase (PPO). The malondialdehyde (MDA) content was significantly reduced compared to the untreated control. Additionally, the expression of stress-responsive genes, such as ZmSOD, ZmCAT, ZmPOD, ZmTIFY, ZmACO, ZmPYL2, ZmNF-YC12, and ZmEREB180, were significantly upregulated in the O-CMC-NPs treated seedlings. These findings unveil the novel role of O-CMC-NPs in enhancing plant stress tolerance, suggesting their potential application in safeguarding maize seedlings under water stress conditions and facilitating the recovery from oxidative damage.

In vivo pharmacokinetics of ginsenoside compound K mediated by gut microbiota.

Ginsenoside Compound K (GCK) is the main metabolite of natural protopanaxadiol ginsenosides with diverse pharmacological effects. Gut microbiota contributes to the biotransformation of GCK, while the effect of gut microbiota on the pharmacokinetics of GCK in vivo remains unclear. To illustrate the role of gut microbiota in GCK metabolism in vivo, a systematic investigation of the pharmacokinetics of GCK in specific pathogen free (SPF) and pseudo-germ-free (pseudo-GF) rats were conducted. Pseudo-GF rats were treated with non-absorbable antibiotics. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was validated for the quantification of GCK in rat plasma. Compared with SPF rats, the plasma concentration of GCK significantly increased after the gut microbiota depleted. The results showed that GCK absorption slowed down, Tmax delayed by 3.5 h, AUC0-11 increased by 1.3 times, CLz/F decreased by 0.6 times in pseudo-GF rats, and Cmax was 1.6 times higher than that of normal rats. The data indicated that gut microbiota played an important role in the pharmacokinetics of GCK in vivo.

Repeated platelet-rich plasma injections improve erectile dysfunction in a rat model of hyperhomocysteinemia.

ABSTRACT: Platelet-rich plasma (PRP) shows promise as a regenerative modality for mild-to-moderate erectile dysfunction (ED). However, its efficacy in treating severe ED remains unknown. Blood samples from 8-week-old male rats were used to prepare PRP through a two-step centrifugation procedure, followed by chitosan activation and freeze‒thaw cycle. A hyperhomocysteinemia (HHcy)-related ED model was established using a methionine-enriched diet, and an apomorphine (APO) test was conducted during the 4 th week. APO-negative rats were divided into two groups and were injected with PRP or saline every 2 weeks. Erectile function and histological analyses of the corpus cavernosum were performed during the 16 th week. The results revealed that erectile function was significantly impaired in rats with HHcy-related ED compared to that in age-matched rats but was improved by repeated PRP injections. Immunofluorescence staining revealed a reduction in reactive oxygen species and additional benefits on the recovery of structures within the corpus cavernosum in rats that received PRP treatment compared to those in the saline-injected control group. Therefore, PRP could enhance functional and structural recovery in a severe HHcy-related ED model. A notable strength of the present study lies in the use of a repeated intracavernous injection method, mirroring protocols used in human studies, which offers more reliable results for translating the findings to humans.

Development of a tool measuring various aspects of social detachment: The social detachment questionnaire for older population.

BACKGROUND: Social detachment includes the subjective aspect "loneliness" and the objective aspect "social isolation," but tools to assess both dimensions are limited. This study aims to develop a questionnaire, the Social Detachment Questionnaire for Older Population (SDQO), that considers multiple dimensions of social detachment simultaneously. METHODS: The study collected 600 valid samples from individuals aged 55 and above to examine the psychometric properties of the developed SDQO. Item analysis was conducted to assess the performance of each item, and exploratory factor analysis (EFA) was employed to analyze its initial structure and eliminate less ideal items. Subsequently, confirmatory factor analysis (CFA) was used to examine the model fit of the suggested structure by EFA, using different subsamples. Internal consistency, concurrent validity, and other analyses were also performed. RESULTS: The original 27-item SDQO was reduced to 17 items after removing 4 questions in item analysis and 6 questions in EFA. The Cronbach's alpha for the 17-item version of SDQO was 0.80. Both EFA and CFA supported its 6-factor structure, with factors identified as community activities, loneliness, personal resources, leisure activities, friendship, and family resources. SDQO also demonstrated expected performance in concurrent validity. CONCLUSION: The 17-item version of SDQO exhibited good reliability and validity, measuring various aspects of social detachment behavior, feelings, and resources. It holds value for future research applications.

TransMVAN: Multi-view Aggregation Network with Transformer for Pneumonia Diagnosis.

Automated and accurate classification of pneumonia plays a crucial role in improving the performance of computer-aided diagnosis systems for chest X-ray images. Nevertheless, it is a challenging task due to the difficulty of learning the complex structure information of lung abnormality from chest X-ray images. In this paper, we propose a multi-view aggregation network with Transformer (TransMVAN) for pneumonia classification in chest X-ray images. Specifically, we propose to incorporate the knowledge from glance and focus views to enrich the feature representation of lung abnormality. Moreover, to capture the complex relationships among different lung regions, we propose a bi-directional multi-scale vision Transformer (biMSVT), with which the informative messages between different lung regions are propagated through two directions. In addition, we also propose a gated multi-view aggregation (GMVA) to adaptively select the feature information from glance and focus views for further performance enhancement of pneumonia diagnosis. Our proposed method achieves AUCs of 0.9645 and 0.9550 for pneumonia classification on two different chest X-ray image datasets. In addition, it achieves an AUC of 0.9761 for evaluating positive and negative polymerase chain reaction (PCR). Furthermore, our proposed method also attains an AUC of 0.9741 for classifying non-COVID-19 pneumonia, COVID-19 pneumonia, and normal cases. Experimental results demonstrate the effectiveness of our method over other methods used for comparison in pneumonia diagnosis from chest X-ray images.

Prospective Impacts of Social Participation Activities on Cognitive and Psychopathological Statuses in Community-Dwelling Older Adults.

OBJECTIVES: This study investigated the impact of social activities on cognitive functioning and psychopathological symptoms. METHODS: Participants aged 55 or older were enrolled through communities. Initial measures assessed demographic data, neuropsychological functioning, psychopathological state, and happiness. Social activities were evaluated using a modified 12-item tool, with 3-4 activities as the cutoff. Follow-up after 6-9 months included Mini-Mental State Examination (MMSE), Beck Depression Inventory - II (BDI-II), Beck Anxiety Inventory (BAI), Health Assessment Questionnaire (HAQ), and Patient Health Questionnaire-15 (PHQ-15) measurements. Predictive models for psychiatric and cognitive statuses were built using multiple linear regression, adjusting for baseline conditions. RESULTS: Initially, 516 older individuals enrolled, with 403 undergoing follow-up. During follow-up, the low participation group reported lower MMSE scores, higher BAI scores, and increased PHQ-15 risk. Negative correlations between social activity numbers and PHQ-15 results were found. Engagement in social clubs correlated positively with higher MMSE scores, while regular interactions with one's adult child(ren) were linked to decreased BAI scores. CONCLUSIONS: The quantity of social activities was associated with lower somatic distress. Social club engagement positively influenced cognition, and regular interactions with one's adult child(ren) mitigated anxiety among older individuals. CLINICAL IMPLICATIONS: Enough types of social activities, participating in social clubs, and adequate interactions with children protected against psychopathologies.

Enhancing Hospital Efficiency and Patient Care: Real-Time Tracking and Data-Driven Dispatch in Patient Transport.

Inefficient patient transport in hospitals often leads to delays, overworked staff, and suboptimal resource utilization, ultimately impacting patient care. Existing dispatch management algorithms are often evaluated in simulation environments, raising concerns about their real-world applicability. This study presents a real-world experiment that bridges the gap between theoretical dispatch algorithms and real-world implementation. It applies process capability analysis at Taichung Veterans General Hospital in Taichung, Taiwan, and utilizes IoT for real-time tracking of staff and medical devices to address challenges associated with manual dispatch processes. Experimental data collected from the hospital underwent statistical evaluation between January 2021 and December 2021. The results of our experiment, which compared the use of traditional dispatch methods with the Beacon dispatch method, found that traditional dispatch had an overtime delay of 41.0%; in comparison, the Beacon dispatch method had an overtime delay of 26.5%. These findings demonstrate the transformative potential of this solution for not only hospital operations but also for improving service quality across the healthcare industry in the context of smart hospitals.

A new mechanism of thyroid hormone receptor ß agonists ameliorating nonalcoholic steatohepatitis by inhibiting intestinal lipid absorption via remodeling bile acid profiles.

Excessive dietary calories lead to systemic metabolic disorders, disturb hepatic lipid metabolism, and aggravate nonalcoholic steatohepatitis (NASH). Bile acids (BAs) play key roles in regulating nutrition absorption and systemic energy homeostasis. Resmetirom is a selective thyroid hormone receptor ß (THRß) agonist and the first approved drug for NASH treatment. It is well known that the THRß activation could promote intrahepatic lipid catabolism and improve mitochondrial function, however, its effects on intestinal lipid absorption and BA compositions remain unknown. In the present study, the choline-deficient, L-amino acid defined, high-fat diet (CDAHFD) and high-fat diet plus CCl4 (HFD+CCl4)-induced NASH mice were used to evaluate the effects of resmetirom on lipid and BA composition. We showed that resmetirom administration (10 mg·kg-1·d-1, i.g.) significantly altered hepatic lipid composition, especially reduced the C18:2 fatty acyl chain-containing triglyceride (TG) and phosphatidylcholine (PC) in the two NASH mouse models, suggesting that THRß activation inhibited intestinal lipid absorption since C18:2 fatty acid could be obtained only from diet. Targeted analysis of BAs showed that resmetirom treatment markedly reduced the hepatic and intestinal 12-OH to non-12-OH BAs ratio by suppressing cytochrome P450 8B1 (CYP8B1) expression in both NASH mouse models. The direct inhibition by resmetirom on intestinal lipid absorption was further verified by the BODIPY gavage and the oral fat tolerance test. In addition, disturbance of the altered BA profiles by exogenous cholic acid (CA) supplementation abolished the inhibitory effects of resmetirom on intestinal lipid absorption in both normal and CDAHFD-fed mice, suggesting that resmetirom inhibited intestinal lipid absorption by reducing 12-OH BAs content. In conclusion, we discovered a novel mechanism of THRß agonists on NASH treatment by inhibiting intestinal lipid absorption through remodeling BAs composition, which highlights the multiple regulation of THRß activation on lipid metabolism and extends the current knowledge on the action mechanisms of THRß agonists in NASH treatment.

Fly-Cutting Processing of Micro-Triangular Pyramid Arrays and Synchronous Micro-Scrap Removal.

Many micro-scraps are generated when a micro-triangular pyramid array (MTPA) is machined by the fly-cutting method. Micro-scraps are generally not removed quickly enough; therefore, these residual micro-scraps participate in the cutting process again, scratching the workpiece surface and accelerating diamond tool wear. To remove micro-scraps rapidly, a fly-cutting method to produce MTPAs on vertically oriented working surfaces was developed during this study. The results show that an MTPA produced by fly cutting on a vertical workpiece had a clearly outlined structure, high dimensional accuracy, and a low surface roughness. There was no micro-scrap residue on the workpiece surface and the diamond tool wear was small. The cutting inlet edges had no burrs, and the cutting outlet edges had only a small number of burrs. This method of fly cutting MTPAs on vertically oriented working surfaces provides a foundation for the development of high-precision micro-triangular pyramid optical elements.

Relationship between autoimmune thyroid antibodies and anti-nuclear antibodies in general patients.

Background: There is no doubt that both Hashimoto thyroiditis and Graves' disease are autoimmune thyroid diseases (AITDs), but the relationship between anti-nuclear antibody (ANA) and AITDs is poorly studied. The association between thyroid autoantibody levels and ANA positivity was evaluated to assess the role of ANA in AITDs. Methods: We conducted an analysis using data from 1,149,893 patients registered at our hospital and 53,021 patients registered in the National Health and Nutrition Examination Survey databases. We focused on patients with data for thyroid peroxidase antibody (TPOAb)/ANA, TPOAb/immunoglobulin G (IgG), thyroid-stimulating hormone (TSH) receptor antibody (TRAb)/ANA, TRAb/IgG, TSH/ANA, or TSH/IgG. Results: ANA positivity rates were 12.88% and 21.22% in TPOAb/ANA and TSH/ANA patients, respectively. In TPOAb/IgG and TSH/IgG data, high IgG levels (≥15 g/L) were detected in 2.23% and 4.06% of patients, respectively. There were significant differences in ANA positivity rates and high IgG proportions among patients with different TPOAb and TSH levels. TPOAb level was correlated with ANA positivity rate and high IgG proportion, and TSH level was correlated with ANA positivity rate. Regression analysis showed positive correlations between TPOAb levels and ANA positivity risk or high IgG risk, TSH levels and high IgG risk, and elevated TSH and ANA positivity risk. Of patients with TRAb/ANA data, 35.99% were ANA-positive, and 13.93% had TRAb levels ≥1.75IU/L; 18.96% of patients with TRAb/IgG data had high IgG levels, and 16.51% had TRAb levels ≥1.75IU/L. ANA positivity rate and high IgG proportion were not significantly different among different TRAb levels. TRAb levels, ANA positivity risk and high IgG risk were not correlated. Conclusion: ANA positivity and high IgG are related to Hashimoto thyroiditis but not Graves' disease, which implies distinct pathophysiological mechanisms underlying the AITDs.

Expression and Potential Significance of miR-499 and IL-1ß in Serum of Dilated Cardiomyopathy Patients with Atrial Fibrillation.

Context: Dilated cardiomyopathy (DCM) is the terminal manifestation of many heart diseases, and atrial fibrillation (AF) is the most common type of arrhythmia in DCM. The mutual influence of DCM and AF can ultimately lead to a poor prognosis for patients. Objective: The study intended to investigate the risk factors for DCM complicated with AF as well as the expression and clinical value of miR-499 and IL-1ß, to provide more research targets for controlling the risk of AF in clinical practice. Design: The research team conducted a retrospective, observational, case-control study. Setting: The study took place at Huai'an First People's Hospital. Participants: Participants were 79 patients with DCM who had been admitted to the hospital between January 2018 and January 2023. Groups: The study included two groups: (1) 31 participants with atrial fibrillation (AF), the AF group and (2) 48 participants without AF, the non-AF group. Outcome Measures: The research team: (1) examined the baseline characteristics of the two groups and compared the groups using single factor analysis; (2) compared the group's serum indicators and echocardiographic parameters; (3) evaluated the expression and potential relationship of microRNA (miR-499) and interleukin-1 beta (IL-1ß) to AF, using reverse transcription-polymerase chain reaction (RT-PCR) and Pearson, and compared the group's expressions of miR-499 and IL-1ß; and (4) analyzed the potential relationship between participants' characteristics and the occurrence of AF, using binary logistic regression. Results: Compared to the non-AF group, the AF group's: (1) age (P = .000) and number of participants with a high pulmonary artery pressure (P = .004) were significantly greater; (2) LVEF was significantly lower (P = .030) and LVESD (P = .000), LAD (P = .018), uric acid (P = .000), and BNP (P = .000) were significantly higher; and (3) serum miR-499 (P = .020) and IL-1ß (P = .000) were significantly higher. Also, a significant positive correlation existed between miR-499 (P = .019) and IL-1ß (P = .022) and DCM with AF. In addition, the AF group's age (P = .001), disease duration (P = .032), serum triglyceride levels (P = .036), uric acid value (P = .001), left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVESD), left atrial anteroposterior diameter, LAD, pulmonary hypertension were significant independent risk factors DCM with AF. Conclusions: A close relationship exists between the abnormal expression of serum miR-499 and IL-1ß and DCM complicated with AF, which will be of great importance in future research. In addition, the data of patients with DCM are related to the occurrence and development of AF, and clinicians should actively perform early drug interventions to reduce myocardial remodeling, so as to reduce the incidence of AF.

A Study on Decision-Making for Improving Service Efficiency in Hospitals.

The provision of efficient healthcare services is essential, driven by the increasing demand for healthcare resources and the need to optimize hospital operations. In this context, the motivation to innovate and improve services while addressing urgent concerns is critical. Hospitals face challenges in managing internal dispatch services efficiently. Outsourcing such services can alleviate the burden on hospital staff, reduce costs, and introduce professional expertise. However, the pressing motivation lies in enhancing service quality, minimizing costs, and exploring innovative approaches. With the rising demand for healthcare services, there is an immediate need to streamline hospital operations. Delays in internal transportation services can have far-reaching implications for patient care, necessitating a prompt and effective solution. Drawing upon dispatch data from a healthcare center in Taiwan, this study constructed a decision-making model to optimize the allocation of hospital service resources. Employing simulation techniques, we closely examine how hospital services are currently organized and how they work. In our research, we utilized dispatch data gathered from a healthcare center in Taichung, Taiwan, spanning from January 2020 to December 2020. Our findings underscore the potential of an intelligent dispatch strategy combined with deployment restricted to the nearest available workers. Our study demonstrates that for cases requiring urgent attention, delay rates that previously ranged from 5% to 34% can be notably reduced to a much-improved 3% to 18%. However, it is important to recognize that the realm of worker dispatch remains subject to a multifaceted array of influencing factors. It becomes evident that a comprehensive dispatching mechanism must be established as part of a broader drive to enhance the efficiency of hospital service operations.

Digital health interventions to promote healthy lifestyle in hemodialysis patients: an interventional pilot study.

Low physical activity has been associated with poor prognosis in hemodialysis (HD) patients. Interventions to maintain healthy lifestyle in this population are important to reduce mortality. This study aimed to evaluate the effectiveness of digital health interventions (DHIs) for improving the physical activity and health-related quality of life (HRQoL) in HD patients. The 24-week prospective study enrolled 31 clinically stable HD patients. All participants were assigned home exercises and provided with wearable devices. Dietary and exercise information was uploaded to a health management platform. Suggestions about diet and exercise were provided, and a social media group was created. Physical performance testing was performed at baseline and during weeks 4, 8, 12, 16 and 24. HRQoL and nutritional status were evaluated. A total of 25 participants completed the study. After the interventions, the daily step count increased 1658 steps. The 10-time-repeated sit-to-stand test reduced by 4.4 s, the sit-to-stand transfers in 60 s increased 12 repetitions, the distance of six-minute walk test (6MWT) increased by 55.4 m. The mental health components and burden of kidney disease of the Kidney Disease Quality of Life survey, and subjective global assessment (SGA) scores improved. By Spearman correlation, the monthly step count correlated positively with 6MWT and SGA. DHIs that combined wearable devices, a health management platform, and social media could strengthen physical activity and improve the HRQoL and nutrition of maintenance HD patients. The results outline a new model to promote healthy lifestyle behaviors in HD patients.

Optical coherence tomography with voxel-based morphometry: a new tool to unveil focal retinal neurodegeneration in multiple sclerosis.

Neurodegeneration is the main contributor to disability accumulation in multiple sclerosis. Previous studies in neuro-ophthalmology have revealed that neurodegeneration in multiple sclerosis also affects the neuro-retina. Optical coherence tomography has been used to measure thinning of retinal layers, which correlates with several other markers for axonal/neuronal loss in multiple sclerosis. However, the existing analytical tools have limitations in terms of sensitivity and do not provide topographical information. In this study, we aim to evaluate whether voxel-based morphometry can increase sensitivity in detecting neuroaxonal degeneration in the retina and offer topographical information. A total of 131 people with multiple sclerosis (41 clinically isolated syndrome, 53 relapsing-remitting and 37 progressive multiple sclerosis) and 50 healthy subjects were included. Only eyes with normal global peripapillary retinal nerve fibre layer thickness and no history of optic neuritis were considered. Voxel-based morphometry and voxel-wise statistical comparisons were performed on the following: (i) patients at different disease stages and 2) patients who experienced the first demyelination attack without subclinical optic neuritis, assessed by visual evoked potentials. Standard parameters failed to discern any differences; however, voxel-based morphometry-optical coherence tomography successfully detected focal macular atrophy of retinal nerve fibre layer and ganglion cell/inner plexiform layer, along with thickening of inner nuclear layer in patients who experienced the first demyelination attack (disease duration = 4.2 months). Notably, the atrophy pattern of the ganglion cell/inner plexiform layer was comparable across disease phenotypes. In contrast, the retinal nerve fibre layer atrophy spread from the optic nerve head to the fovea as the disease evolved towards the progressive phase. Furthermore, for patients who experienced the first neurological episode, the severity of retinal nerve fibre layer atrophy at entry could predict a second attack. Our results demonstrate that voxel-based morphometry-optical coherence tomography exhibits greater sensitivity than standard parameters in detecting focal retinal atrophy, even at clinical presentation, in eyes with no history of optic neuritis and with normal latency of visual evoked potentials. Thinning of the ganglion cell/inner plexiform layer primarily concentrated in nasal perifovea in all disease phenotypes, indicating selective vulnerability of retinal ganglion cells and their perifoveal axons. Conversely, the degree of retinal nerve fibre layer thinning seems to be related to the clinical course of multiple sclerosis. The findings suggest bidirectional neurodegeneration in the visual pathway. Voxel-based morphometry-optical coherence tomography shows potential as a valuable tool for monitoring neurodegeneration on a patient level and evaluating the efficacy of novel neuroprotective treatments.

A 6-Year Follow-up of a Chinese Child with Homozygous ß0-Thalaasemia and a Heterozygous KLF1 Mutation.

Patients with the genotype of ß0/ß0 for ß-thalassemia (ß-thal) usually behave as ß-thal major (ß-TM) phenotype which is transfusion-dependent. The pathophysiology of ß-thal is the imbalance between α/ß-globin chains. The degree of α/ß-globin imbalance can be reduced by the more effective synthesis of γ-globin chains, and increased Hb F levels, modifying clinical severity of ß-TM. We report a Chinese child who had homozygous ß0-thal and a heterozygous KLF1 mutation. The patient had a moderate anemia since 6 months old, keeping a baseline Hb value of 8.0-9.0 g/dL. She had normal development except for a short stature (3rd percentile) until 6 years old, when splenomegaly and facial bone deformities occurred. Although genetic alteration of KLF1 expression in ß0/ß0 patients can result in some degree of disease alleviation, our case shows that it is insufficient to ameliorate satisfactorily the presentation. This point should be borne in mind for physicians who provide the genetic counseling and prenatal diagnosis to at-risk families.

Successful pregnancy with in vitro fertilization after vaginal radical trachelectomy and pelvic lymphadenectomy in stage IB1 cervical cancer.

OBJECTIVE: To present a case of successful pregnancy after undergoing vaginal radical trachelectomy (VRT) and pelvic lymph node dissection (PLND) for early-stage cervical cancer. CASE REPORT: A 37-year-old female patient has been diagnosed with stage IB1 cervical cancer and underwent VRT and PLND. Two years after the surgery, the patient successfully conceived and delivered a healthy baby through a cesarean section. CONCLUSION: This case report demonstrates that pregnancy after VRT and PLND for stage IB1 cervical cancer is possible and can result in a successful outcome. This report provides valuable information for patients and physicians who are considering these surgical options.

Analysis of mental health status and related factors in patients with acute cerebral infarction.

BACKGROUND: Acute cerebral infarction (ACI) is characterized by a high incidence of morbidity, disability, recurrence, death and heavy economic burden, and has become a disease of concern in global researchers. As ACI has serious effects on patients' physical status, life and economy, often causing anxiety, depression and other psychological problems, these problems can lead to the aggravation of physical symptoms; thus, it is very important to understand the factors affecting the mental health of these patients. AIM: To understand the elements that affect the mental health of patients who have suffered an ACI. METHODS: A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals (Quanzhou First Hospital, Fuqing City Hospital Affiliated to Fujian Medical University, and the 900 Hospital of the Joint Service Support Force of the People's Liberation Army of China) in Fujian Province from January 2022 to December 2022 using the convenience sampling method. ACI inpatients who met the inclusion criteria were selected. Informed consent was obtained from the patients before the investigation, and a face-to-face questionnaire survey was conducted using a unified scale. The questionnaire included a general situation questionnaire, Zung's self-rating depression scale and Zung's self-rating anxiety scale. All questionnaires were checked by two researchers and then the data were input and sorted using Excel software. The general situation of patients with ACI was analyzed by descriptive statistics, the influence of variables on mental health by the independent sample t test and variance analysis, and the influencing factors on psychological distress were analyzed by multiple stepwise regression. RESULTS: The average age of the 220 patients with ACI was 68.64 ± 10.74 years, including 142 males and 78 females. Most of the patients were between 60 and 74 years old, the majority had high school or technical secondary school education, most lived with their spouse, and most lived in cities. The majority of patients had a personal income of 3001 to 5000 RMB yuan per month. The new rural cooperative medical insurance system had the largest number of participants. Most stroke patients were cared for by their spouses and of these patients, 52.3% had previously smoked. Univariate analysis showed that gender, age, residence, course of disease, number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI. Age, living conditions, monthly income, course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI. The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients' anxiety scores, and the course of disease was also the most important factor influencing patients' depression scores. CONCLUSION: Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders. These groups require more attention and counseling.

Experiences of person-centered care for sundown syndrome among nurses and nurse aides in dementia special care units: a qualitative study.

BACKGROUND: To explore the response and management experiences of nurses and nurse aides in dementia special care units when caring for residents with sundown syndrome based on the person-centered care model. METHODS: Focus group interviews were conducted among nurses and nurse aides from four dementia special care units that have been accredited by the Ministry of Health and Welfare in Taiwan. Content analysis was used for data analysis. RESULTS: The 29 nurses and nurse aides were recruited to participate in the study. Analysis of interview content revealed six themes, identifying the intra-individual, inter-individual, and organizational dimensions. The central topic was commitment. Under the umbrella of commitment, six themes including self-preparation, non-suppression, diversion, pacification, continuity of meeting, and collaboration, which had 18 subthemes, emerged as responsive care practices for person-centered care when supporting residents with sundown syndrome. CONCLUSIONS: The findings provide responsive care practices based on person-centered care for people living with dementia who develop sundown syndrome. The study can inform practices for quality of care for dementia in long-term care institutions and contribute to the development of materials for nursing training and education.