Lymphatic endothelial cell RXRα is critical for 9-cis-retinoic acid-mediated lymphangiogenesis and prevention of secondary lymphedema.

Secondary lymphedema is a debilitating disease characterized by abnormal soft tissue swelling and caused by lymphatic system dysfunction. Despite a high prevalence of secondary lymphedema after cancer treatments, current management is supportive and there are no approved therapeutic agents that can thwart disease progression. We have previously demonstrated that 9-cis-retinoic acid (9-cisRA) has the potential to be repurposed for lymphedema as it mitigates disease by promoting lymphangiogenesis at the site of lymphatic injury. Although the efficacy of 9-cisRA has been demonstrated in previous studies, the mechanism of action is not completely understood. In this study, we demonstrate that when RXRα is specifically deleted in lymphatic endothelial cells, 9-cisRA fails to induce lymphangiogenesis in vitro and prevent pathologic progression of postsurgical lymphedema in vivo. These findings demonstrate that downstream nuclear receptor RXRα plays a critical role in the therapeutic efficacy of 9-cisRA in postsurgical lymphedema.

Low-Grade Papillary Schneiderian Carcinoma in the Nasal Cavity.

Only a limited number of documented low-grade papillary Schneiderian carcinoma (LGPSC) cases have been reported since its initial description in 2015. In this study, the authors present a case report involving a young female patient who presented with this rare condition localized in the nasal cavity. On the basis of histologic examination of a small tumor sample, the initial diagnosis pointed to squamous cell carcinoma. After the surgery, however, the final histologic diagnosis was confirmed as LGPSC. Finally, after surgical intervention, the histologic diagnosis was confirmed as LGPSC. Remarkably, over a period of 22 months, the patient showed no signs of recurrence or metastasis. To achieve an accurate diagnosis and implement appropriate treatment strategies for LGPSC, a comprehensive understanding of both its clinical and histologic characteristics is necessary.

The effect of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit.

BACKGROUND: Shared decision-making is essential for improving infant prognoses. Medical staff should consider the effect of illness uncertainty and self-efficacy on parents' perceptions of shared decision-making. AIMS: This study examined the impact of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit. STUDY DESIGN: A descriptive-analytical cross-sectional study design was used. Data were collected from April to June 2023. A total of 103 parents of infants admitted to the neonatal intensive care unit participated in this study. The participants used a self-report questionnaire that included general characteristics of their infants, uncertainty of illness, self-efficacy and perception of shared decision-making. Data were analysed using descriptive statistics, independent t-test, analysis of variance, Scheffe's test, Pearson's correlation coefficient and multiple linear regression. RESULTS: Illness uncertainty (r = -.659, p < .001, 95% confidence interval = [-1.209, -0.765]) was negatively correlated with self-efficacy, and self-efficacy (r = .255, p = .009, 95% confidence interval = [0.082, 0.569]) was positively correlated with the perception of shared decision-making. Using multiple linear regression, the number of visits to the intensive care unit (ß = -1.939, p = .015, 95% confidence interval = [-3.490, -0.389]) and parents' self-efficacy (ß = .271, p = .028, 95% confidence interval = [0.030, 0.512]) had a statistically significant effect on the perception of shared decision-making, accounting for 11.9% of the total explanatory power. CONCLUSIONS: The results support that higher self-efficacy is associated with a higher degree of perception of shared decision-making among parents of infants in the intensive care unit. Therefore, clinicians might support parents in taking a more active role in shared decision-making by discussing available options with clinicians and reaching treatment plans together. RELEVANCE TO CLINICAL PRACTICE: The study suggests creating scales to assess nurses' participation in shared decision-making and recommends educational programmes to boost parents' self-efficacy with infants, significantly affecting perceptions of shared decision-making.