Assessment tools for stigma in breast cancer patients based on COSMIN guidelines: a systematic review.

OBJECTIVE: The objective of this study was to conduct a systematic review of the measurement properties and methodological quality of stigma assessment tools designed for breast cancer patients. The aim was to provide clinical medical staff with a foundation for selecting high-quality assessment tools. METHODS: A comprehensive computer search was carried out across various databases, including SinoMed, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database(VIP), Embase, PubMed, Web of Science, The Cochrane Library, and Scopus, which were searched from the inception of the databases until March 20, 2023. Literature screening and data extraction were performed independently by two researchers, adhering to predefined inclusion and exclusion criteria. The assessment tools were evaluated using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) systematic evaluation guidelines. RESULTS: In the final analysis, a total of 9 assessment tools were included. However, none of these tools addressed measurement error, cross-cultural validity, criterion validity, and responsiveness. Following the COSMIN guidelines, BCSS and CSPDS were assigned to Class A recommendations, while the remaining tools received Class B recommendations. CONCLUSION: The BCSS and CSPDS scales demonstrated comprehensive assessment in terms of their measurement characteristics, exhibiting good methodological quality, measurement attribute quality, and supporting evidence. Therefore, it is recommended to utilize these scales for evaluating breast cancer stigma. However, further validation is required for the remaining assessment tools.

Comparison of bracket bonding between two CAD/CAM guided bonding devices: GBD-U vs GBD-B.

OBJECTIVE: To compare the bracket bonding accuracy, efficiency, reproducibility, and three-dimensional (3D) printing duration of the computer-aided design/computer-aided manufacturing (CAD/CAM) unilateral contact guided bonding device (GBD-U) and the bilateral contact guided bonding device (GBD-B) in vitro. METHODS: Five resin dental model sets were scanned and virtually bonded with brackets. GBD-U and GBD-B were designed and 3D printed for each model. GBD-Us had guide blocks that fit the occlusal sides of the bracket tie-wings, while GBD-Bs had guide arms that fit the occlusal and distal sides of the tie-wings. Five orthodontic residents were recruited to bond brackets on the same 3D-printed copies of resin models in a dental mannequin using GBD-Us and GBD-Bs, respectively. The time for 3D printing of GBDs and bracket bonding was recorded. The linear and angular deviations between the bonded brackets and the virtually bonded ones were measured. RESULTS: A total of 50 sets of resin models (1000 brackets/tubes) were bonded. The time for 3D printing and bracket bonding was shorter for GBD-Us (41.96 mins/6.38 mins) than for GBD-Bs (78.04 mins/7.20 mins). In both devices, 100% linear deviations and over 95% angular deviations were below 0.5 mm or 2°, respectively. Deviations in the mesiodistal dimension, torque, angulation, and rotation were significantly lower in the GBD-U group (P<0.01). High inter-operator reproducibility of bracket bonding was confirmed for both devices. CONCLUSION: GBD-U was more time-efficient in 3D printing. Both GBDs showed clinically acceptable accuracy, whereas GBD-U had higher bonding accuracy in the mesiodistal dimension, torque, angulation, and rotation than GBD-B. CLINICAL SIGNIFICANCE: CAD/CAM GBD-U provides high bracket bonding accuracy in a time-efficient manner and has the potential to be clinically applied.

Discovery and functional assessment of a novel adipocyte population driven by intracellular Wnt/ß-catenin signaling in mammals.

Wnt/ß-catenin signaling has been well established as a potent inhibitor of adipogenesis. Here, we identified a population of adipocytes that exhibit persistent activity of Wnt/ß-catenin signaling, as revealed by the Tcf/Lef-GFP reporter allele, in embryonic and adult mouse fat depots, named as Wnt+ adipocytes. We showed that this ß-catenin-mediated signaling activation in these cells is Wnt ligand- and receptor-independent but relies on AKT/mTOR pathway and is essential for cell survival. Such adipocytes are distinct from classical ones in transcriptomic and genomic signatures and can be induced from various sources of mesenchymal stromal cells including human cells. Genetic lineage-tracing and targeted cell ablation studies revealed that these adipocytes convert into beige adipocytes directly and are also required for beige fat recruitment under thermal challenge, demonstrating both cell autonomous and non-cell autonomous roles in adaptive thermogenesis. Furthermore, mice bearing targeted ablation of these adipocytes exhibited glucose intolerance, while mice receiving exogenously supplied such cells manifested enhanced glucose utilization. Our studies uncover a unique adipocyte population in regulating beiging in adipose tissues and systemic glucose homeostasis.