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Diabetes mellitus, a chronic metabolic disease, often leads to numerous chronic complications, significantly contributing to global morbidity and mortality rates. High glucose levels trigger epigenetic modifications linked to pathophysiological processes like inflammation, immunity, oxidative stress, mitochondrial dysfunction, senescence and various kinds of cell death. Despite glycemic control, transient hyperglycemia can persistently harm organs, tissues, and cells, a latent effect termed "metabolic memory" that contributes to chronic diabetic complications. Understanding metabolic memory's mechanisms could offer a new approach to mitigating these complications. However, key molecules and networks underlying metabolic memory remain incompletely understood. This review traces the history of metabolic memory research, highlights its key features, discusses recent molecules involved in its mechanisms, and summarizes confirmed and potential therapeutic compounds. Additionally, we outline in vitro and in vivo models of metabolic memory. We hope this work will inform future research on metabolic memory's regulatory mechanisms and facilitate the development of effective therapeutic compounds to prevent diabetic complications.
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Complicações do Diabetes , Humanos , Animais , Complicações do Diabetes/metabolismo , Diabetes Mellitus/metabolismo , Diabetes Mellitus/etiologia , Epigênese Genética , Estresse Oxidativo , Hiperglicemia/metabolismoRESUMO
Chronic kidney disease (CKD) has historically been a significant global health concern, profoundly impacting both life and well-being. In the process of CKD, with the gradual loss of renal function, the incidence of various life-threatening complications, such as cardiovascular diseases, cerebrovascular accident, infection and stroke, is also increasing rapidly. Unfortunately, existing treatments exhibit limited ability to halt the progression of kidney injury in CKD, emphasizing the urgent need to delve into the precise molecular mechanisms governing the occurrence and development of CKD while identifying novel therapeutic targets. Renal fibrosis, a typical pathological feature of CKD, plays a pivotal role in disrupting normal renal structures and the loss of renal function. Ferroptosis is a recently discovered iron-dependent form of cell death characterized by lipid peroxide accumulation. Ferroptosis has emerged as a potential key player in various diseases and the initiation of organ fibrosis. Substantial evidence suggests that ferroptosis may significantly contribute to the intricate interplay between CKD and its progression. This review comprehensively outlines the intricate relationship between CKD and ferroptosis in terms of iron metabolism and lipid peroxidation, and discusses the current landscape of pharmacological research on ferroptosis, shedding light on promising avenues for intervention. It further illustrates recent breakthroughs in ferroptosis-related regulatory mechanisms implicated in the progression of CKD, thereby providing new insights for CKD treatment. Video Abstract.
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Doenças Cardiovasculares , Ferroptose , Insuficiência Renal Crônica , Humanos , Insuficiência Renal Crônica/complicações , Morte Celular , FerroRESUMO
Acute kidney injury (AKI) is one of the most common and severe clinical renal syndromes with high morbidity and mortality. Ferroptosis is a form of programmed cell death (PCD), is characterized by iron overload, reactive oxygen species accumulation, and lipid peroxidation. As ferroptosis has been increasingly studied in recent years, it is closely associated with the pathophysiological process of AKI and provides a target for the treatment of AKI. This review offers a comprehensive overview of the regulatory mechanisms of ferroptosis, summarizes its role in various AKI models, and explores its interaction with other forms of cell death, it also presents research on ferroptosis in AKI progression to other diseases. Additionally, the review highlights methods for detecting and assessing AKI through the lens of ferroptosis and describes potential inhibitors of ferroptosis for AKI treatment. Finally, the review presents a perspective on the future of clinical AKI treatment, aiming to stimulate further research on ferroptosis in AKI.
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BACKGROUND: The number of adolescents presenting with gender dysphoria (GD) in healthcare services has increased significantly, yet specialized services offering transition-related care (TRC) for trans youth is lacking. AIM: To investigate satisfaction with TRC, regret, and reasons for (dis)satisfaction with transition-related medical interventions (TRMIs) in trans adolescents who had presented to the Hamburg Gender Identity Service for children and adolescents (Hamburg GIS). METHODS: Data were collected from a clinical cohort sample of 75 adolescents and young adults diagnosed with GD (81% assigned female at birth) aged 11 to 21 years (M = 17.4) at baseline and follow-up (on a spectrum of ongoing care, on average 2 years after initial consultation). To determine progress of the youth's medical transitions, an individual treatment progress score (ITPS) was calculated based on number of desired vs received TRMIs. OUTCOMES: Main outcome measures were satisfaction with TRC at the time of follow-up, ITPS, social support, reasons for regret and termination of TRC, and (dis)satisfaction with TRMIs. RESULTS: Participants underwent different stages of TRMIs, such as gender-affirming hormone treatment or surgeries, and showed overall high satisfaction with TRC received at the Hamburg GIS. Regression analysis indicated that a higher ITPS (an advanced transition treatment stage) was predictive of higher satisfaction with TRC. Sex assigned at birth, age, and time since initial consultation at the clinic showed no significant effects for satisfaction with TRC, while degree of social support showed a trend. No adolescents regretted undergoing treatment at follow-up. Additional analysis of free-text answers highlighted satisfaction mostly with the physical results of TRMI. CLINICAL IMPLICATIONS: Because youth were more satisfied with TRC when their individual transition (ITPS) was more progressed, treatment should start in a timely manner to avoid distress from puberty or long waiting lists. STRENGTHS AND LIMITATIONS: This study is one of the first to report on treatment satisfaction among youth with GD from Europe. The ITPS allowed for a more detailed evaluation of TRMI wishes and experiences in relation to satisfaction with TRC and may close a gap in research on these treatments in adolescent populations. However, all participants were from the same clinic, and strict treatment eligibility criteria may have excluded certain trans adolescents from the study. Low identification rates with non-binary identities prevented comparisons between non-binary and binary genders. CONCLUSION: The study highlights the role of TRMI and individual treatment or transition progress for youth's overall high satisfaction with TRC received at the Hamburg GIS. Nieder TO, Mayer TK, Hinz S, et al. Individual Treatment Progress Predicts Satisfaction With Transition-Related Care for Youth With Gender Dysphoria: A Prospective Clinical Cohort Study. J Sex Med 2021;18:632-645.
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Disforia de Gênero , Pessoas Transgênero , Adolescente , Adulto , Criança , Estudos de Coortes , Europa (Continente) , Feminino , Disforia de Gênero/terapia , Identidade de Gênero , Humanos , Masculino , Satisfação Pessoal , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: Mutual support groups are an important source of long-term help for people impacted by addictive behaviors. Routine outcome monitoring (ROM) and feedback are yet to be implemented in these settings. SMART Recovery mutual support groups focus on self-empowerment and use evidence-based techniques (eg, motivational and behavioral strategies). Trained facilitators lead all SMART Recovery groups, providing an opportunity to implement ROM. OBJECTIVE: The aim of this stage 1 pilot study is to explore the feasibility, acceptability, and preliminary outcomes of a novel, purpose-built mobile health ROM and feedback app (SMART Track) in mutual support groups coordinated by SMART Recovery Australia (SRAU) over 8 weeks. METHODS: SMART Track was developed during phase 1 of this study using participatory design methods and an iterative development process. During phase 2, 72 SRAU group participants were recruited to a nonrandomized, prospective, single-arm trial of the SMART Track app. Four modes of data collection were used: ROM data directly entered by participants into the app; app data analytics captured by Amplitude Analytics (number of visits, number of unique users, visit duration, time of visit, and user retention); baseline, 2-, and 8-week follow-up assessments conducted through telephone; and qualitative telephone interviews with a convenience sample of study participants (20/72, 28%) and facilitators (n=8). RESULTS: Of the 72 study participants, 68 (94%) created a SMART Track account, 64 (88%) used SMART Track at least once, and 42 (58%) used the app for more than 5 weeks. During week 1, 83% (60/72) of participants entered ROM data for one or more outcomes, decreasing to 31% (22/72) by the end of 8 weeks. The two main screens designed to provide personal feedback data (Urges screen and Overall Progress screen) were the most frequently visited sections of the app. Qualitative feedback from participants and facilitators supported the acceptability of SMART Track and the need for improved integration into the SRAU groups. Participants reported significant reductions between the baseline and 8- week scores on the Severity of Dependence Scale (mean difference 1.93, SD 3.02; 95% CI 1.12-2.73) and the Kessler Psychological Distress Scale-10 (mean difference 3.96, SD 8.31; 95% CI 1.75-6.17), but no change on the Substance Use Recovery Evaluator (mean difference 0.11, SD 7.97; 95% CI -2.02 to 2.24) was reported. CONCLUSIONS: Findings support the feasibility, acceptability, and utility of SMART Track. Given that sustained engagement with mobile health apps is notoriously difficult to achieve, our findings are promising. SMART Track offers a potential solution for ROM and personal feedback, particularly for people with substance use disorders who attend mutual support groups. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619000686101; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377336. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/15113.
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Aplicativos Móveis , Telemedicina , Austrália , Estudos de Viabilidade , Retroalimentação , Humanos , Projetos Piloto , Estudos Prospectivos , Grupos de AutoajudaRESUMO
With the advent of the era of artificial intelligence, radiomics is an emerging field in which high-throughput imaging data are extracted from different types of images to model and predict clinical prognosis in a non-invasive manner. Currently, this field is in its initial stage of development and lacks standardized assessment criteria, but still remains a promising tool for the future research direction. Radiomics analysis of hepatocellular carcinoma will aid in the early diagnosis, prognostic evaluation and treatment plan, thereby promoting the continuous improvement of clinical treatment strategies, and providing precise treatment methods to improve the survival rate and cure rate of patients. This article introduces the radiomics research process of hepatocellular carcinoma, and discusses its application progress, challenges and future development directions in the precise diagnosis and treatment of hepatocellular carcinoma.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Inteligência Artificial , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/terapia , Diagnóstico por Imagem , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , PrognósticoRESUMO
Background: Limited research has examined factors associated with medication-assisted treatment for justice-involved individuals. Objectives: The current study used a mixed-method design to examine the influence of client- and counselor-level factors on 90-day treatment retention, satisfaction, and progress for justice-involved individuals referred to medication-assisted treatment. Methods: The effects of co-occurring disorders (i.e., psychiatric symptoms, anxiety, depression), social functioning (i.e., social support, self-esteem), substance use severity, and treatment motivation on treatment retention, treatment satisfaction, and treatment progress while controlling for counselor-level variance were assessed through multilevel modeling. Results: Fewer co-occurring disorders and more social support were related to greater treatment satisfaction and progress. A higher level of treatment motivation was associated with greater treatment progress. Mediation of treatment satisfaction on the relationship between client-level factors and treatment progress also was tested. Depression was negatively associated with treatment satisfaction, which in turn led to lower ratings of treatment progress. Social support was positively correlated with treatment satisfaction, which in turn was positively correlated with treatment progress. The association of client substance use severity with treatment retention differed between counselors, so did the association of co-occurring disorders and treatment motivation with treatment satisfaction. Qualitative analyses that were derived from counselors' perception of factors relating to recovery success underscored the importance of integrated interventions, social support, treatment motivation, and therapeutic alliance, and their associations with treatment outcomes. Conclusions/Importance: The current findings highlight the importance of integrated treatment services, collaborating with community corrections, and teaching clients strategies for dealing with deviant peers as to facilitating recovery.
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Satisfação do Paciente , Ajustamento Social , Justiça Social , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico , Adulto , Ansiedade/psicologia , Terapia Cognitivo-Comportamental , Aconselhamento , Depressão/psicologia , Diagnóstico Duplo (Psiquiatria) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoimagem , Transtornos Relacionados ao Uso de Substâncias/psicologia , Resultado do TratamentoRESUMO
OBJECTIVE: We examined the ability of scores on the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) scales to predict treatment progress (compliance and activity in therapy) and outcome at termination (success in therapy, readiness for termination, and functioning at termination). METHOD: Our sample included 448 (185 males, 263 females) community mental health center outpatients with an average age of 32.2 years (standard deviation = 10.2). We used MMPI-2-RF (self-report) indicators of personality and psychopathology and a composite outcome variable that represents therapist ratings of clients' treatment progress and outcomes. RESULTS: Scores on several MMPI-2-RF scales were correlated and associated with increased risk for poorer psychotherapy progress and outcomes in a mental health outpatient sample. CONCLUSIONS: Clinicians can utilize the MMPI-2-RF to identify clients at risk for therapy process challenges and adverse outcomes, suggesting possible problem areas for intervention.
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MMPI/normas , Transtornos Mentais/terapia , Avaliação de Resultados em Cuidados de Saúde/normas , Escalas de Graduação Psiquiátrica/normas , Psicoterapia , Adulto , Centros Comunitários de Saúde Mental , Serviços Comunitários de Saúde Mental , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/terapia , Adulto JovemRESUMO
The engagement process of sexual offenders in group-based cognitive-behavioral treatment is an important area of study. Disclosure management style (DMS), a model developed from grounded-theory research of men undertaking a prototypical program, provides a framework to assess engagement in treatment. Our goal was to develop a quantitative measure of DMS, to test its reliability and validity, and to evaluate its utility as a measure of treatment progress by examining relationships between DMS and established measures of treatment change. We studied a sample of men (N = 93) who undertook an intensive prison-based treatment program in New Zealand. Variables included DMS measures, psychometric measures of dynamic risk and treatment change, static risk, clinician rating of treatment progress, and recidivism outcomes. We found that (a) DMS shows an acceptable level of agreement between independent raters, (b) DMS-based ratings of engagement changed over the course of treatment and were correlated with measures of change based on offender self-reports, and (c) offenders showed heterogeneity in terms of their trajectories of change as assessed by DMS ratings.
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Terapia Cognitivo-Comportamental , Criminosos/psicologia , Psicoterapia de Grupo , Reincidência/prevenção & controle , Delitos Sexuais/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Teoria Fundamentada , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reincidência/psicologia , Delitos Sexuais/psicologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Health care for transgender and transsexual (ie, trans) individuals has long been based on a binary understanding of gender (ie, feminine vs masculine). However, the existence of non-binary or genderqueer (NBGQ) genders is increasingly recognized by academic and/or health care professionals. AIM: To gain insight into the individual health care experiences and needs of binary and NBGQ individuals to improve their health care outcomes and experience. METHODS: Data were collected using an online survey study on experiences with trans health care. The non-clinical sample consisted of 415 trans individuals. An individual treatment progress score was calculated to report and compare participants' individual progress toward treatment completion and consider the individual treatment needs and definitions of completed treatment (ie, amount and types of different treatments needed to complete one's medical transition). OUTCOMES: Main outcome measures were (i) general and trans-related sociodemographic data and (ii) received and planned treatments. RESULTS: Participants reported binary (81.7%) and different NBGQ (18.3%) genders. The 2 groups differed significantly in basic demographic data (eg, mean age; P < .05). NBGQ participants reported significantly fewer received treatments compared with binary participants. For planned treatments, binary participants reported more treatments related to primary sex characteristics only. Binary participants required more treatments for a completed treatment than NBGQ participants (6.0 vs 4.0). There were no differences with regard to individual treatment progress score. CLINICAL TRANSLATION: Because traditional binary-focused treatment practice could have hindered NBGQ individuals from accessing trans health care or sufficiently articulating their needs, health care professionals are encouraged to provide a holistic and individual treatment approach and acknowledge genders outside the gender binary to address their needs appropriately. STRENGTHS AND LIMITATIONS: Because the study was made inclusive for non-patients and individuals who decided against trans health care, bias from a participant-patient double role was prevented, which is the reason the results are likely to have a higher level of validity than a clinical sample. However, because of the anonymity of an online survey, it remains unclear whether NBGQ individuals live according to their gender identity in their everyday life. CONCLUSION: The study highlights the broad spectrum of genders in trans-individuals and associated health care needs and provides a novel approach to measure individual treatment progress in trans individuals. Koehler A, Eyssel J, Nieder TO. Genders and Individual Treatment Progress in (Non-)Binary Trans Individuals. J Sex Med 2018;15:102-113.
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Atenção à Saúde/organização & administração , Acessibilidade aos Serviços de Saúde , Pessoas Transgênero/estatística & dados numéricos , Transexualidade/psicologia , Adulto , Feminino , Identidade de Gênero , Pessoal de Saúde/organização & administração , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
The authors of this study explored the differences in treatment progress between men and women who were addicted to drugs. The differential rate of completion of/dropout from treatment in men and women with substance dependence was established. Moreover, comparisons between completers and dropouts, accounting for gender, were carried out for several variables related to treatment progress and clinical profile. A sample of 183 addicted patients (96 male and 87 female) who sought outpatient treatment between 2002 and 2006 was assessed. Information on socio-demographic, consumption, and associated characteristics was collected. A detailed tracking of each patient's progress was maintained for a minimum period of 8 years to assess treatment progression. The treatment dropout rate in the whole sample was 38.8%, with statistically significant differences between women (47.1%) and men (31.3%). Women who dropped out of treatment presented a more severe profile in most of the psychopathologic variables than women who completed it. Moreover, women who dropped out from treatment presented a more severe profile than men who dropped out. According to these results, drug-addicted women showed worse therapeutic progress than men with similar histories. Thus, women must be provided with additional targeted intervention to promote better treatment outcomes.
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Atitude Frente a Saúde , Comportamento Aditivo/psicologia , Usuários de Drogas/psicologia , Pacientes Desistentes do Tratamento/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto , Comportamento Aditivo/epidemiologia , Usuários de Drogas/estatística & dados numéricos , Feminino , Humanos , Masculino , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Personalidade , Distribuição por Sexo , Apoio Social , Espanha , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adulto JovemRESUMO
This research explored the therapeutic events both clients and therapists from community-based treatment interventions for perpetrators of sexual abuse identify as significant in their experience of psychological therapy. A qualitative design was utilized to address this research objective. The sample for the present research is comprised of three different treatment programs for sexual offending. Twenty-five clients and nine therapists participated in the study. Two qualitative measures were used to elicit client and therapist responses. Significant Aspects of Therapy Form was administered every second treatment session during each intervention program. The Significant Aspects Follow-Up Interview was conducted with a sub-sample of participants at the conclusion of each treatment module. Thematic analysis was used to identify significant themes noted by clients and therapists from forms and interviews. Thematic analysis resulted in a model of significant events in therapy. In this model, significant events were categorized into six domains. The six domains were as follows: (a) the process of therapy, (b) making changes and progress in therapy, (c) content and structure of therapy, (d) therapist contributions, (e) negative contributions to therapy, and (f) other factors Each domain further contained between 6 and 18 themes, which are also reported. This study found much overlap and similarity in the experiences of therapy between clients of sexual offender therapy and general psychotherapy. Furthermore, there is overlap between therapists and clients in the aspects of therapy they identify as significant. The implications of these findings on effective service development and comprehensive service evaluations are discussed.
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Criminosos/psicologia , Satisfação do Paciente/estatística & dados numéricos , Relações Profissional-Paciente , Psicoterapia/métodos , Delitos Sexuais/psicologia , Adulto , Análise Fatorial , Humanos , Masculino , Risco , Adulto JovemRESUMO
A randomized experiment was conducted in two outpatient clinics evaluating a measurement feedback system called contextualized feedback systems. The clinicians of 257 Youth 11-18 received feedback on progress in mental health symptoms and functioning either every 6 months or as soon as the youth's, clinician's or caregiver's data were entered into the system. The ITT analysis showed that only one of the two participating clinics (Clinic R) had an enhanced outcome because of feedback, and only for the clinicians' ratings of youth symptom severity on the SFSS. A dose-response effect was found only for Clinic R for both the client and clinician ratings. Implementation analyses showed that Clinic R had better implementation of the feedback intervention. Clinicians' questionnaire completion rate and feedback viewing at Clinic R were 50 % higher than clinicians at Clinic U. The discussion focused on the differences in implementation at each site and how these differences may have contributed to the different outcomes of the experiment.
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Retroalimentação , Transtornos Mentais/terapia , Serviços de Saúde Mental , Avaliação de Resultados em Cuidados de Saúde , Adolescente , Criança , Feminino , Humanos , Masculino , Avaliação de Processos em Cuidados de Saúde , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
OBJECTIVE: Research on the effects of Rogers's therapeutic relationship conditions has typically focused on the unilateral provision of empathy, unconditional positive regard, and congruence from therapist to client. METHOD: This study looked at both client and therapist mutuality of the Rogerian therapeutic conditions and the association between mutuality and treatment progress in the first three psychotherapy sessions. Clients (N = 62; mean age = 24.32; 77% female, 23% male) and therapists (N = 12; mean age = 34.32; nine female and three male) rated one another using the Barrett-Lennard Relationship Inventory after the first and third session. RESULTS: Both clients and therapists perceived the quality of the relationship as improved over time. Client rating of psychological distress (CORE-OM) was lower after session 3 than at session 1 (es = .85, [95% CIs: .67, 1.03]). Hierarchical multiple regression was used to test the predictive power of mutually high levels of the therapeutic conditions on treatment progress. The association between client rating of therapist-provided conditions and treatment progress at session 3 was higher when both clients and therapists rated each other as providing high levels of the therapeutic conditions (R(2) change = .073, p < .03). CONCLUSIONS: The findings suggest mutuality of Rogers's therapeutic conditions is related to treatment progress.
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Avaliação de Processos e Resultados em Cuidados de Saúde/normas , Relações Profissional-Paciente , Psicoterapia/normas , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
PURPOSE: Using a commercial orthodontic treatment planning system, tooth movements were simulated to analyse how precise predefined movements can be determined by three different superimposition methods. Additionally, a retrospective analysis on clinical patient models before and after orthodontic treatment was performed to analyse possible differences in determination of clinical tooth movements with these methods. METHODS: (1) A hexapod system was used to perform the tooth movements in physical maxillary dental models (Nâ¯= 70). The initial and final situations were scanned, superimpositions executed, movements calculated, and their accuracy compared to the predefined movements was determined. (2) Digital three-dimensional (3D) maxillary dental models representing pre- and postorthodontic treatment situations (Nâ¯= 100 patients) were superimposed. Selected tooth movements were calculated (Nâ¯= 3600), and the results of the different superimposition methods were compared pairwise. RESULTS: (1) The experimental study delivered only small location and scale shifts. Furthermore, concordance correlation coefficients above 0.99 for all three methods. This verified that all methods deliver values corresponding well to the predefined movements. (2) The retrospective analysis of the clinically performed orthodontic tooth movements comparing pairwise the three different methods intraindividually also showed small location and scale shifts. Furthermore, concordance correlation coefficients between 0.68 and 0.98 were observed, with only three of them below 0.8. This verified that the applied superimposition methods delivered values sufficiently close to each other. CONCLUSIONS: As the experimental study showed very good agreement between the predefined and determined movements, and as the retrospective clinical study showed that the methods compared pairwise delivered values close to each other for the performed orthodontic tooth movements, it can be concluded that orthodontic tooth movements can be determined adequately correct by each of the examined methods.
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Lung cancer persistently leads as the primary cause of morbidity and mortality among malignancies. A notable increase in the prevalence of lung adenocarcinoma has become evident in recent years. Although targeted therapies have shown in treating certain subsets of non-small cell lung cancers (NSCLC), a significant proportion of patients still face suboptimal therapeutic outcomes. Neuregulin-1 (NRG1), a critical member of the NRG gene family, initially drew interest due to its distribution within the nascent ventricular endocardium, showcasing an exclusive presence in the endocardium and myocardial microvessels. Recent research has highlighted NRG1's pivotal role in the genesis and progression across a spectrum of tumors, influencing molecular perturbations across various tumor-associated signaling pathways. This review provides a concise overview of NRG1, including its expression patterns, configuration, and fusion partners. Additionally, we explore the unique features and potential therapeutic strategies for NRG1 fusion-positive occurrences within the context of NSCLC.
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Diabetic kidney disease (DKD) is one of the most common and severe microvascular complications of diabetes mellitus (DM), and has become the leading cause of end-stage renal disease (ESRD) worldwide. Although the exact pathogenic mechanism of DKD is still unclear, programmed cell death has been demonstrated to participate in the occurrence and development of diabetic kidney injury, including ferroptosis. Ferroptosis, an iron-dependent form of cell death driven by lipid peroxidation, has been identified to play a vital role in the development and therapeutic responses of a variety of kidney diseases, such as acute kidney injury (AKI), renal cell carcinoma and DKD. In the past two years, ferroptosis has been well investigated in DKD patients and animal models, but the specific mechanisms and therapeutic effects have not been fully revealed. Herein, we reviewed the regulatory mechanisms of ferroptosis, summarized the recent findings associated with the involvement of ferroptosis in DKD, and discussed the potential of ferroptosis as a promising target for DKD treatment, thereby providing a valuable reference for basic study and clinical therapy of DKD.
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Diabetes Mellitus , Nefropatias Diabéticas , Ferroptose , Falência Renal Crônica , Neoplasias Renais , Animais , Nefropatias Diabéticas/metabolismo , Rim/metabolismoRESUMO
Acute kidney injury (AKI), a common and serious clinical kidney syndrome with high incidence and mortality, is caused by multiple pathogenic factors, such as ischemia, nephrotoxic drugs, oxidative stress, inflammation, and urinary tract obstruction. Cell death, which is divided into several types, is critical for normal growth and development and maintaining dynamic balance. Ferroptosis, an iron-dependent nonapoptotic type of cell death, is characterized by iron overload, reactive oxygen species accumulation, and lipid peroxidation. Recently, growing evidence demonstrated the important role of ferroptosis in the development of various kidney diseases, including renal clear cell carcinoma, diabetic nephropathy, and AKI. However, the exact mechanism of ferroptosis participating in the initiation and progression of AKI has not been fully revealed. Herein, we aim to systematically discuss the definition of ferroptosis, the associated mechanisms and key regulators, and pharmacological progress and summarize the most recent discoveries about the role and mechanism of ferroptosis in AKI development. We further conclude its potential therapeutic strategies in AKI.
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Partial-thickness cartilage defects (PTCDs) of the articular surface is the most common problem in cartilage degeneration, and also one of the main pathogenesis of osteoarthritis (OA). Due to the lack of a clear diagnosis, the symptoms are often more severe when full-thickness cartilage defect (FTCDs) is present. In contrast to FTCDs and osteochondral defects (OCDs), PTCDs does not injure the subchondral bone, there is no blood supply and bone marrow exudation, and the nearby microenvironment is unsuitable for stem cells adhesion, which completely loses the ability of self-repair. Some clinical studies have shown that partial-thickness cartilage defects is as harmful as full-thickness cartilage defects. Due to the poor effect of conservative treatment, the destructive surgical treatment is not suitable for the treatment of partial-thickness cartilage defects, and the current tissue engineering strategies are not effective, so it is urgent to develop novel strategies or treatment methods to repair PTCDs. In recent years, with the interdisciplinary development of bioscience, mechanics, material science and engineering, many discoveries have been made in the repair of PTCDs. This article reviews the current status and research progress in the treatment of PTCDs from the aspects of diagnosis and modeling of PTCDs, drug therapy, tissue transplantation repair technology and tissue engineering ("bottom-up").
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Cartilagem Articular , Cartilagem Articular/patologia , Engenharia Tecidual/métodos , Medula Óssea , Células-Tronco , Células CultivadasRESUMO
Introduction Outcome Questionnaire (OQ) measure is becoming a more popular assessment tool for monitoring treatment progress in psychiatry at different settings including inpatient and outpatient settings. It can also be used in non-clinical populations. However, little is known about the evaluation of this tool in the Adult Partial Hospital Program (PHP). Methods We conducted a study among patients in an Adult PHP where we extracted data from the OQ analysis program recorded for patients from January 1, 2015 to July 31st, 2020. Results We studied a total of 742 patients among which 509 (68.4%) were males. The mean age was 38.58 ± 14.86 years. Most of the patients had depressive disorder (56.9%). The mean numbers of days on admission were 17.37 ± 25.29 days. There is a consistent decrease in the total score average OQ score from initial to final measure with the year 2019 being 31.99 followed by 2017 (30.05) then 2020 (29.56) then 2015/2016 (28.38) and 2018 (27.27) p < 0.001. Also, for treatment progress it was observed that in years 2015/2016, there was significant improvement in 71.67% of the patients; in 2017, there was significant improvement in 78.53% of the patients; in 2018, there was significant improvement in 77.71% of the patients; while in 2019, there was significant improvement in 76.05% of the patients, and in 2020, there was significant improvement in 70.18% of the patients. Conclusion The direct benefit of the OQ measure to patients is to provide objective measurements of assessing clinical improvement or deterioration in the treatment progress of their clinical condition. Our study has proved that this is a useful tool to assess such in the Adult PHP.