Early Stages Of Treatment Research Articles

Information Needs Among Thai Women Breast Cancer Patients During the Initial Treatment Phase: A Cross-Sectional Study.

To examine the information needs of breast cancer patients during the initial phase of treatment and to analyse the factors that influenced these needs. Providing comprehensive and timely information during early breast cancer treatment is crucial for informed decision-making and effective coping. Healthcare providers must address these needs to enhance patient support and improve outcomes. A cross-sectional study was reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. A total of 123 post-mastectomy patients were selected through purposive sampling and completed the Thai version of the Sri Lankan Information Needs Assessment Questionnaire-BC (SINAQ-BC). Direct associations between demographic data and information needs were analysed descriptively, while bivariate analysis and linear regression were used to identify significant predictors of information needs. The findings revealed that patients exhibited high overall information needs (224.7/260.0), with the greatest demand focused on physical care, treatment and diagnosis. In contrast, needs related to disease specifics and psychosocial care were less prominent. A total of 94 respondents (76.4%) expressed a particularly high demand for information regarding physical care. Education level was identified as an influencing factor, accounting for 7.7% of the variance in information needs among women with breast cancer. Patients with higher education levels had significantly greater information needs. Nursing staff should provide customised information packages that are tailored to the participants' education levels. Further testing of the Thai version of the SLINQ-BC would also be warranted. Patients are increasingly expected to manage their own care even as medical treatment grows more complex and technical. Nursing staff can contribute to the care of patients by being ready to evaluate, monitor and address breast cancer patient's individual information needs in the early stage of treatment based on factors such as educational level. No patient or public contribution because the nature of the study's design, data analysis and writing did not require patient or public contribution.

Perceived Training Needs of the Informal Caregivers of Older Adults: A Cross-Sectional Study

Background: Due to the enormous caregiving burden faced by informal caregivers, providing appropriate skills training has become an important supporting strategy in many countries/regions. Understanding caregivers’ training needs is instrumental in designing effective training intervention programs, which are expected to reduce the caregiving burden of informal caregivers and avoid the health deterioration associated with caregiving. This paper aims to explore the potential training needs of informal caregivers in Shanghai, and to identify the factors associated with these perceived training needs. Methods: A total of 196 eligible informal caregivers participated in this survey. A multivariate analysis was conducted to explore the factors associated with informal caregivers’ perceived training needs. Results: 86.7% (N = 170) of the caregivers reported at least one need for targeted training activity, and 62.7% (N = 123) of them identified two or more training needs. The top three activities requiring training included the following: self-care skills; safety supervision; and functional rehabilitation. The factors associated with various training needs included the health status of the care recipient, complementary caregiving support, caregiving stress, and the personal attributes of the informal caregiver. The technical skills training needs were more related to the care recipients’ health status (e.g., dependency level, disease progression) and formal care support resources. Conversely, the intangible skills training needs were more sensitive to caregiver attributes (e.g., gender, age, and education level). Conclusions: A personalized training strategy and early-stage intervention program are critical to providing effective support to informal caregivers. The potential implications are to raise awareness of the importance of skills training for informal caregivers, and to inform the implementation of effective training strategies for improving the quality of informal care and the well-being of informal caregivers in China.

DNA Nanolock-Based Logic Gate-Directed Reciprocal Feedback for Stepwise Cell Typing and Combination Treatment.

To achieve accurate molecular diagnosis and early-stage intervention of disease on demand, there is an urgent need for the monitoring of multiple biomarkers and multipath information acquisition in living cells. The DNA combinatorial logic gate is an appropriate strategy for providing a systematic proof of concept with comprehensive information and function. Herein, a modular DNA logic gate nanomachine is designed for sufficient multistep reciprocal cell identification and therapy via the iteration of simple logic operations. In this logic gate system, this main module is constructed by G-quadruplex-locked gold nanocages (AuNCs), serving dual functions of drug encapsulation and cell recognition. The logic system is composed of OR, XNOR, AND, and NOR gates employing two intracellular disease biomarkers (microRNA 21 and microRNA 155) as inputs and the fluorescence signal of doxorubicin (Dox) as an output. The output signals of the four logic gates are iterated to process the imaging analysis data from the complex matrix in the living cell. Via positive and negative reciprocal feedback, the series circuit of different gates enables different functions, including the preliminary screening and the distinction of the cell type. Through the mutual preliminary screening and further proof, this logic system achieves accurate identification of cells, controlled drug release, and photothermal treatment using the AuNC as a photothermal transducer. This DNA logic system broadens the applications of the biocomputing system in disease screening and logic-controlled treatment fields.

Urban–rural disparities in hospital admissions for depression in Austria: A spatial panel data analysis

Medical practice variation in mental healthcare is a useful indicator for policymakers aiming to improve the efficiency of healthcare delivery. Previous studies have shown strong regional variation in healthcare utilisation in Austria, which seems to be a by-product of regionalised institutional rules and healthcare service mix rather than epidemiology. We use a set of routine municipality-level healthcare data on hospital admissions for depressive episodes of adult Austrian patients from 2009 to 2014 to examine spatial patterns in healthcare utilisation in mental health. Our data contains 93,302 hospital episodes by 65,908 adult patients across 2114 municipalities. We estimate a random-effects spatial autoregressive combined model to regress log hospital admission rates on hospital supply and urbanicity as proxies for municipality healthcare service mix alongside demographic and socioeconomic controls. We find that admissions for depression are substantially higher in suburban municipalities compared to rural areas and in municipalities with hospitals compared to those without. The spatial structure suggests positive spatial spillovers between neighbouring municipalities. Our main results are stable across virtually all model specifications used for robustness and show that healthcare service mix and supply of hospital services strongly correlate with spatial patterns of hospital admission rates in the population. Promoting timely access to high-quality primary care and early-stage treatments may reduce the burden of avoidable depression-related hospitalisations for patients and public budgets, and close a gap of unmet need for care of vulnerable populations.

Prolonged catamnesis of a child with type I mucopolysaccharidosis, Gurler syndrome, receiving enzyme replacement therapy

Hereditary pathology makes up a significant part of the structure of childhood morbidity, disability and mortality. Mucopolysaccharidosis type I is a hereditary lysosomal accumulation disease, with an autosomal recessive type of inheritance. At birth, children with Gurler syndrome look normal, but in the future, they develop symptoms characteristic of mucopolysaccharidosis, and the first clinical manifestations of the disease are often hernias and hepatosplenomegaly. The presented clinical case demonstrates the difficulties of early diagnosis of mucopolysaccharidosis type I, which lead to a later prescription of enzyme replacement therapy and the inability to use a more effective method of therapy – hematopoietic stem cell transplantation, due to the development of serious manifestations of the cardiovascular system. While the positive effects of enzyme replacement therapy in the early stages of treatment may seem promising, it does not guarantee a favorable prognosis for the future.Conclusion. Currently, early diagnosis of mucopolysaccharidosis type I is difficult due to the lack of early manifestations. Often, the progression of clinical manifestations leads to disability, and in severe cases, to death. Therefore, it is important to have early diagnosis and appropriate treatment.

Applying Evidence Synthesis for Constructing Directed Acyclic Graphs to Identify Causal Pathways Affecting U.S. Early-Stage Non-Small Cell Lung Cancer Treatment Receipt and Overall Survival

Background/Objectives: Directed acyclic graphs (DAGs) inform the epidemiologic statistical modeling confounders to determine close to true causal relationships in a study context. They inform the inclusion of the predictive model variables that affect the causal relationship. Non-small cell lung cancer (NSCLC) is frequently diagnosed, aggressive, and the second leading cause of cancer deaths in the United States. Determining factors affecting both the guideline-concordant treatment receipt and survival outcomes for early-stage lung cancer will help inform future statistical models aiming to achieve a close to true causal relationship. Methods: Peer-reviewed original research published during 2002–2023 was identified through PubMed, Embase, Web of Sciences, Clinical trials registry, and the gray literature. DAGitty version 3.1, an online software program, developed implied DAGs and integrated DAG graphics. The evidence synthesis for constructing directed acyclic graphs (ESC-DAGs) protocol was utilized to guide DAG development. The conceptual models utilized were Andersen and Aday for factors affecting treatment receipt and Shi and Steven for survival outcome factors. Results: A total of 36 studies were included in the DAG synthesis out of 9421 retrieved across databases. Eight studies served in the synthesis of treatment receipt DAG, while 28 studies were used for the survival outcomes DAG. There were 10 causal paths and 13 covariates for treatment receipt and 2 causal pathways and 32 covariates for survival outcomes. Conclusions: There are very few studies reporting on factors affecting early-stage NSCLC guideline-concordant care receipt compared to factors affecting its survival outcomes in the past two decades of original research. Future investigations can utilize data extracted in the current study to develop a meta-analysis informing effect size.

Clinical study of immune-targeting combined with attenuated chemotherapy in the treatment of children with classic Hodgkin lymphoma

Objective: To evaluate the efficacy and safety of brentuximab vedotin (BV) combined with rituximab and attenuated chemotherapy in the treatment of children with classic Hodgkin lymphoma (cHL). Methods: A prospective, non-randomized, risk-assigned study. Clinical data (including age, gender, B symptoms, bulky disease, CD30 and Epstein-Barr virus-encoded RNA(EBER) expression, clinical stage, risk stratification, etc.) of 28 intermediate to high-risk cHL children diagnosed and treated at Beijing Children's Hospital Affiliated to Capital Medical University from October 2022 to May 2024 were collected. Immuno-targeted combined with attenuated chemotherapy was administered based on risk stratification and early treatment response. The patients were followed up until May 1st, 2024. The infusion reactions and adverse reactions after treatment were recorded. Results: In all 28 patients, there were 22 males and 6 females, the age was 12 (5,16) years, 16 cases (57%) presented with bulky disease and 10 cases (36%) with B symptoms. The most common pathological type was nodular sclerosis (14 cases, 50%). There were 7 cases of stage Ⅱ, 14 cases of stage Ⅲ and 7 cases of stage Ⅳ according to the Ann Arbor staging system. There were 5 cases in the intermediate-risk group and 23 cases in the high-risk group. EBER was positive in 20 cases (71%) and negative in 6 cases (21%), and CD30 antigen was expressed in tumor cells of all enrolled children. Treatment duration: 5 cases (18%) received 4 courses of treatment, 21 cases (75%) received 6 courses of treatment, and 2 cases (7%) received 8 courses of treatment, 25 cases (89%) achieved complete metabolism response (CMR) through early assessment after 2 courses of chemotherapy. The CMR rates were 100% in intermediate-risk group and 87% (20/23) in high-risk group, respectively. Four patients (14%) finally received residual field radiotherapy. Toxicities included grade Ⅰ-Ⅱ myelosuppression, early infusion reaction and mild peripheral neuropathy, only one case of grade 3 adverse events was recorded and did not affect sequential treatment. At the end of treatment and 3 months of follow-up, the levels of IgA, IgG and IgM were all decreased compared with the baseline before chemotherapy, and the total B cell count began to be lower than the level before chemotherapy at the early stage of treatment (after 2 courses). The total B cell count monitored during treatment was 50 (0, 101)×106/L and was 12 (0, 25)×106/L at the end of treatment. The follow-up time was 6 (3, 13) months, all 28 children had event-free survival and all achieved complete remission. At 6 and 9 months of follow-up, IgA, IgG, IgM and total B cell counts returned to pre-chemotherapy baseline levels, respectively. Conclusion: BV combined with rituximab attenuated chemotherapy has demonstrated efficacy and a tolerable safety profile in the treatment of cHL in children, and significantly reduce radiation rate.

Assessing the impact of brachytherapy boost in intermediate-risk, early-stage cervical cancer treatment

Assessing the impact of brachytherapy boost in intermediate-risk, early-stage cervical cancer treatment

Overall and linked blood pressure variabilities in the first 24 hours and mortality after spontaneous intracerebral hemorrhage: a retrospective study of 1,036 patients.

This study aims to establish the individual contributions of blood pressure variability (BPV) indexes, categorized into overall and linked variability, to mortality following intracerebral hemorrhage (ICH) by examining the risk factors. Patients with spontaneous ICH (n = 1,036) were identified with valid blood pressures (BP) from the first 24-h systolic BP records in the Medical Information Mart for Intensive Care IV version 2.2 database (MIMIC IV). Information on the baseline characteristics, including age, sex, initial Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) scores, ICH location, Charlson comorbidity index score, and presence of diabetes with or without complications, were collected. Three indexes of BPV-range, standard deviation (SD), and generalized BPV (GBPV)-were calculated using the first 24-h systolic BPs. An automated stepwise variable-selection procedure was used to develop the final logistic model for predicting in-hospital mortality. Out of 1,036 patients, 802 (77.4%) survived and were discharged after spontaneous ICH. Factors associated with mortality included age; male sex; ICH in the brainstem, ventricle, or multiple locations; low GCS score (< 9); high NIHSS score (> 20); and diabetes with complications. Mean systolic BP, SD, and GBPV were also linked to mortality. Higher GBPV notably increased the risk of in-hospital death, with an odds ratio of 3.21 (95% confidence interval, 2.10 to 4.97) for every + 10 mmHg/h change in GBPV. This study underscores the additional impact of GBPV, herein linked to BPV, on mortality following ICH, providing further insights into the management of blood pressure in the early stages of ICH treatment.

Climate impact of early-stage NSCLC treatment: A comparison between radiotherapy and surgery using Life Cycle Assessment

IntroductionHealthcare systems contribute significantly to CO2 emissions, accounting for 7 % of emissions in the Netherlands. Understanding the environmental footprint of medical treatments can help identify opportunities for reducing climate impact. We evaluated the climate impact of stereotactic body radiotherapy (SBRT) and Video-Assisted Thoracic Surgery (VATS) when treating T1-2N0M0 Non-Small Cell Lung Cancer (NSCLC). Materials and methodsWe used life cycle assessment (LCA) to evaluate climate impact in emissions of kilograms of CO2 equivalent. Care trajectories were inventoried for both VATS and SBRT with the same entry and end point of the paths. We analyzed a range of factors contributing to climate impact, such as patient and staff travel, energy consumption, disposables and medication using direct measurements: questionnaires and waste audits, or retrospective record analysis. As is common in LCA, existing infrastructure was excluded from the analysis. Reductions that can be influenced by individual departments were also modeled. ResultsUsing LCA we calculated the impact of all categorized contributions for two treatments for NSCLC. In total, VATS generates approximately 547 kg CO2 equivalent (CO2e), whereas SBRT generates 172 kg CO2e per treatment. For SBRT, the largest contributors were energy use in the hospital (52 % of total), of which 22 % is from the linac, and patient travel (23 %). For VATS, major contributions were hospital energy use (52 %) and disposables (23 %). Climate impact could be reduced by 20 % (SBRT) by hypofractionation, reduced linac idle time and patient travel impact, and 13 % (VATS) with fast track recovery and a reduction of disposables. ConclusionWhen treating T1-2N0M0 NSCLC, surgery has a larger climate impact than SBRT. For both modalities reductions are possible.

Current Status of Diabetes Prevention and Control in China and Early-Stage Intervention Strategies

In recent years, the prevalence of diabetes in China has continued to rise, with the adult prevalence expected to reach 12.8% by 2023. To control this trend, the government has introduced several policies and invested substantial funds in the prevention and treatment of diabetes, achieving certain results. Prediabetes is a stage where blood glucose metabolism can still be restored. For individuals in this stage, dietary and exercise intervention programs are recommended to prevent or delay the onset of diabetes, improve quality of life, and reduce the burden of disease on individuals, families, and society.

Biofilm formation and drug susceptibility of biofilm Candida spp. clinically isolated from nasopharyngeal cancer patients in Vietnam.

The biofilm formation has been widely recognized as one of the main mechanisms of antimicrobial resistance development in microorganisms. However, few studies are focusing on this phenomenon in Candida spp. in clinical settings, especially on immuno-compromised patients. In this study, both the rate of biofilm formation in those patients and its drug susceptibility in initial and mature biofilm were assessed using crystal violet assay and dilution method. The results demonstrated that the biofilm formation rate was similar between albicans and non-albicans Candida. However, the biofilm formation capacity was more pronounced in non-albicans Candida, especially, C. glabrata. As expected, there was a significant relationship between biofilm formation and drug resistance. In addition, our study reconfirmed that the age of high concentration of antifungal agents only affected Candida before its biofilm formation regardless of its biofilm formation capacity. In the contrary, once the biofilm was formed even elevated drug concentrations did not show sufficient efficacy, highlighting a need for high dosage at the early stage of treatment for those patients. The results of this study highlighted the importance of using appropriate antifungal agents for Candida treatment before the formation of biofilm.

PO0324: Brachytherapy Seed Placement by Robotic Bronchoscopy with Cone-Beam CT Guidance for Early-Stage Lung Cancer Treatments: Evaluation of Implant Quality in Human Cadavers

PO0324: Brachytherapy Seed Placement by Robotic Bronchoscopy with Cone-Beam CT Guidance for Early-Stage Lung Cancer Treatments: Evaluation of Implant Quality in Human Cadavers

Thromboembolism adverse event profiles of thrombopoietin receptor agonists: a real-world, pharmacovigilance study

ABSTRACT Background Thrombopoietin receptor agonists (TPO-RAs) are currently approved for the treatment of thrombocytopenia in different conditions. The relationship between TPO-RAs and thromboembolic events (TEEs) remains controversial. Research design and methods We extracted TPO-RAs adverse reaction reports after their marketing until now, using the FDA adverse event reporting system (FAERS). Positive signals were detected by reporting odds ratios (RORs). And the Weibull shape parameter test was utilized to analyze the time-to-onset profiles. Result Thromboembolic events accounted for 8.97% among TPO-RAs reports. Increased reporting of TEEs was related to TPO-RAs treatment compared with the entire FAERS database [ROR = 2.65 (2.56, 2.73)]. In addition, venous thrombotic events [ROR = 4.13 (3.92, 4.35)] were reported more frequently than arterial events ROR = 1.81 (1.7, 1.93)]. Age over 60 years [odds ratio (OR) = 1.10 (1.01, 1.20), p = 0.029] and weight over 80 kg [OR = 1.36 (1.17, 1.58), p < 0.001] of patients might have higher risk of TEEs during TPO-RAs therapy. Conclusion Evidence from the real world suggested that TPO-RAs were associated with higher incidence of TEEs, particularly venous thrombosis. The risk of TPO-RAs-associated TEEs mostly happened in the early stages of treatment and decreased over time.

The Role of Parenteral Nutrition in Cancer in Indian Settings

Background: Almost 50% of patients with cancer suffer from malnutrition during their first hospital visit. However, it is often overlooked and undiagnosed and is associated with morbidity, mortality, poor tolerance to treatment, and treatment outcomes. Guidelines recommend supportive nutrition from the early stages of cancer treatment. However, in clinical practice, nutritional support is often prescribed only as an end-of-life intervention or is not prescribed at all; moreover, the use of parenteral nutrition (PN) is not well-defined. There are limited practical guidelines on the use of PN in patients with cancer. Methods: A multidisciplinary group of specialists in India formulated this consensus to guide oncologists on the judicious use of PN in Indian settings. It includes general and cancer-specific recommendations on the use of PN, supplemental PN (SPN), composition of PN, and monitoring patients to prevent adverse events associated with PN. Recommendations: The risk of malnutrition should be assessed at the very first presentation of a patient with cancer. These patients’ nutritional requirements are largely like those of the healthy population. Nutritional assessment of all cancer patients should begin at diagnosis and repeated regularly to initiate and monitor early nutritional intervention, before the general status is severely compromised. Oncologists and nutritionists need to be educated about using the appropriate nutrition support options according to the guidelines. While EN should be the preferred form of nutritional support, in specific circumstances PN might be a better option. Early PN in specific settings provides additional benefits, and is particularly important in some types of cancers. SPN as an additional nutritional support to EN can improve treatment tolerability and quality-of-life of patients with cancer. Education is also necessary for awareness about preventing and managing adverse effects of PN, which is the major reason for poor adoption of PN.

Multi-modal classification of breast cancer lesions in Digital Mammography and contrast enhanced spectral mammography images

Breast cancer ranks as the second most prevalent cancer in women, recognized as one of the most dangerous types of cancer, and is on the rise globally. Regular screenings are essential for early-stage treatment. Digital mammography (DM) is the most recognized and widely used technique for breast cancer screening. Contrast-Enhanced Spectral Mammography (CESM or CM) is used in conjunction with DM to detect and identify hidden abnormalities, particularly in dense breast tissue where DM alone might not be as effective. In this work, we explore the effectiveness of each modality (CM, DM, or both) in detecting breast cancer lesions using deep learning methods. We introduce an architecture for detecting and classifying breast cancer lesions in DM and CM images in Craniocaudal (CC) and Mediolateral Oblique (MLO) views. The proposed architecture (JointNet) consists of a convolution module for extracting local features, a transformer module for extracting long-range features, and a feature fusion layer to fuse the local features, global features, and global features weighted based on the local ones. This significantly enhances the accuracy of classifying DM and CM images into normal or abnormal categories and lesion classification into benign or malignant. Using our architecture as a backbone, three lesion classification pipelines are introduced that utilize attention mechanisms focused on lesion shape, texture, and overall breast texture, examining the critical features for effective lesion classification. The results demonstrate that our proposed methods outperform their components in classifying images as normal or abnormal and mitigate the limitations of independently using the transformer module or the convolution module. An ensemble model is also introduced to explore the effect of each modality and each view to increase our baseline architecture's accuracy. The results demonstrate superior performance compared with other similar works. The best performance on DM images was achieved with the semi-automatic AOL Lesion Classification Pipeline, yielding an accuracy of 98.85 %, AUROC of 0.9965, F1-score of 98.85 %, precision of 98.85 %, and specificity of 98.85 %. For CM images, the highest results were obtained using the automatic AOL Lesion Classification Pipeline, with an accuracy of 97.47 %, AUROC of 0.9771, F1-score of 97.34 %, precision of 94.45 %, and specificity of 97.23 %. The semi-automatic ensemble AOL Classification Pipeline provided the best overall performance when using both DM and CM images, with an accuracy of 94.74 %, F1-score of 97.67 %, specificity of 93.75 %, and sensitivity of 95.45 %. Furthermore, we explore the comparative effectiveness of CM and DM images in deep learning models, indicating that while CM images offer clearer insights to the human eye, our model trained on DM images yields better results using Attention on Lesion (AOL) techniques. The research also suggests a multimodal approach using both DM and CM images and ensemble learning could provide more robust classification outcomes.

Augmenting dermal collagen synthesis through hyaluronic acid-based microneedle-mediated delivery of poly(l-lactic acid) microspheres

Poly(L-lactic acid) (PLLA) can stimulate collagen synthesis through a foreign body response. However, inappropriate injection techniques and localized PLLA clustering can lead to complications and adverse events. This study developed a composite microneedle (MN) device comprising an array of PLLA microsphere (PLLA MP)-loaded hyaluronic acid needle tips with a supporting patch (PLLA MP-MN). This device was designed to deliver PLLA MPs precisely and uniformly to the dermis and to provide dual stimulation through MN puncture and MP implantation, thereby enabling the rapid and long-lasting regeneration of dermal collagen. When applied to rat skin, the MN array evenly distributed the PLLA MPs throughout the penetrated regions, which prevented local PLLA overdosing and elicited a milder inflammatory response compared with that induced by intradermal PLLA MP injections. An in vivo efficacy study revealed that MN-mediated delivery of PLLA MPs not only promptly initiated collagen production through microwound-triggered wound-healing cascades in the early treatment stage but also enabled the long-term stimulation of collagen deposition through MP-induced foreign body reactions, thereby significantly enhancing neocollagenesis. This innovative PLLA MP-MN system can augment the benefits and minimize the adverse effects associated with traditional PLLA fillers, providing a safe and reliable anti-aging therapeutic option.

Exploring the impact of baseline platelet count on linezolid-induced thrombocytopenia: a retrospective single-center observation study.

Patients treated with linezolid (LZD) frequently develop thrombocytopenia, and previous studies have identified the risk factors for this condition. However, the relationship between the development of LZD-induced thrombocytopenia and baseline platelet count has varied according to different reports. To explore the relationship between platelet count and the development of LZD-induced thrombocytopenia. Patients who underwent LZD at Hokkaido University Hospital in Japan from September 2008 to March 2023 were included. We collected data on patient characteristics and platelet counts at baseline and during LZD therapy from the electronic medical records. Thrombocytopenia was defined as a decrease in platelet count by 30% or more from baseline, or a platelet level < 100,000/µL. Two hundred and ninety-five patients who received LZD were included in this study, of whom 34.9% developed thrombocytopenia. In the early days of LZD treatment, the thrombocytopenia group showed a nearly 5% decrease in platelet count, while the non-thrombocytopenia group exhibited an increase of over 5%. Additionally, focusing on early onset thrombocytopenia (within 5 days), a baseline platelet count of < 150,000/µL was identified as a risk factor for early thrombocytopenia. Conversely, it was also observed that 24.7% of patients with a baseline platelet count ≥ 150,000/µL still developed early thrombocytopenia. Our findings suggest that while a baseline platelet count of < 150,000/µL is a risk factor for the early onset of thrombocytopenia, vigilant monitoring of platelet counts by clinical pharmacists in the early stages of LZD treatment is essential, regardless of baseline platelet levels.

Changing attachment orientation: Uncovering the role of shifting the emotion regulation tendency.

Changes in the individual's attachment orientation toward greater security are considered an important clinical goal. One promising underlying process of change in attachment orientation is shifting the emotion regulation tendency, in which the individual progresses from overreliance on the self or on the other to regulate emotional arousal. The present study utilized a computational approach to study shifts in the emotion regulation tendency as these manifest in the patient's and therapist's vocally encoded emotional arousal. The study examined whether shifts in the regulation tendency are associated with decreases in the level of insecure attachment and in strengthening of the therapeutic alliance. Shifts in the regulation tendency were examined throughout the early stages of treatment (Sessions 1-4) using 11,710 talk turns within 52 patient-therapist dyads. Findings suggest that shifts in the emotion regulation tendency are associated with greater strengthening of the therapeutic alliance and a decrease in the level of attachment avoidance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Tumor Microenvironment as a Therapeutic Target in Cutaneous T Cell Lymphoma.

Cutaneous T cell lymphomas (CTCLs) are a heterogeneous group of non-Hodgkin lymphomas, with mycosis fungoides and Sézary syndrome being the two common subtypes. Despite the substantial improvement in early-stage diagnosis and treatments, some patients still progress to the advanced stage with an elusive underpinning mechanism. While this unsubstantiated disease mechanism coupled with diverse clinical outcomes poses challenges in disease management, emerging evidence has implicated the tumor microenvironment in the disease process, thus revealing a promising therapeutic potential of targeting the tumor microenvironment. Notably, malignant T cells can shape their microenvironment to dampen antitumor immunity, leading to Th2-dominated responses that promote tumor progression. This is largely orchestrated by alterations in cytokines expression patterns, genetic dysregulations, inhibitory effects of immune checkpoint molecules, and immunosuppressive cells. Herein, the recent insights into the determining factors in the CTCL tumor microenvironment that support their progression have been highlighted. Also, recent advances in strategies to target the CTCL tumor micromovement with the rationale of improving treatment efficacy have been discussed.