University School Research Articles

Multiple primary tumors in children: a clinicopathological analysis of four cases

Objective: To investigate the clinicopathological features of children with metachronous or synchronous primary tumors and to identify related genetic tumor syndromes. Methods: The clinicopathological data of 4 children with multiple primary tumors diagnosed in the Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China from 2011 to 2023 were collected. The histological, immunophenotypic and molecular characteristics were examined using H&E staining, immunohistochemical staining, PCR, Sanger sequencing and next-generation sequencing (NGS). The patients were followed up. Results: Case 1 was an 8-year-old boy with the adrenal cortical carcinoma, and 5 years later a poorly differentiated gastric adenocarcinoma was detected. Case 2 was a 2-year-old boy, presented with a left ventricular choroid plexus carcinoma, and a hepatoblastoma was detected 8 months later. Case 3 was a 9-month-old girl, diagnosed with renal rhabdoid tumor first and intracranial atypical teratoid/rhabdoid tumor (AT/RT) 3 months later. Case 4 was a 7-year-old boy and had a sigmoid colon adenocarcinoma 3 years after the diagnosis of a glioblastoma. The morphology and immunohistochemical features of the metachronous or synchronous primary tumors in the 4 cases were similar to the corresponding symptom-presenting/first-diagnosed tumors. No characteristic germ line mutations were detected in cases 1 and 2 by relevant molecular detection, and the rhabdoid tumor predisposition syndrome was confirmed in case 3 using NGS. Case 4 was clearly related to constitutional mismatch repair deficiency as shown by the molecular testing and clinical features. Conclusions: Childhood multiple primary tumors are a rare disease with histological morphology and immunophenotype similar to the symptom-presenting tumors. They are either sporadic or associated with a genetic (tumor) syndrome. The development of both tumors can occur simultaneously (synchronously) or at different times (metachronously). Early identification of the children associated with genetic tumor syndromes can facilitate routine tumor screening and early treatment.

Preclinical obesity curriculum: audit, implementation, and evaluation

BackgroundThis study aimed to (1) evaluate the current status of obesity education at Case Western Reserve University School of Medicine (CWRU) (2), introduce a comprehensive first-year curriculum on obesity, and (3) assess the impact of the curriculum on self-reported attitudes and knowledge regarding obesity among first-year medical students.MethodsThe preclinical curriculum at CWRU was reviewed to determine the degree of coverage of Obesity Medicine Education Collaborative (OMEC) competencies for healthcare professionals, and recommendations were provided for revising the curriculum to better adhere to these evidence-based competencies. A survey on obesity attitudes and knowledge was given before and after the implementation of the new curriculum to measure intervention-related changes. Changes in obesity attitudes and knowledge were compared (1) before and after the intervention for the class of 2025 and (2) after the intervention for the class of 2025 to a historical cohort that did not receive the intervention.ResultsAmong the 27 competencies examined in the audit, 55% were unmet and 41% were partially met. Of 186 first-year medical students (M1s), 29 (16%) completed the baseline survey and 26 (14%) completed the post-intervention survey. Following the intervention, there was a notable improvement in attitudes and knowledge regarding obesity. Specifically, there was a significant decrease in the belief that obesity is caused by poor personal choices, and knowledge of obesity in fourteen out of fifteen areas showed significant improvement from pre- to post-intervention. Additionally, obesity attitudes and knowledge were significantly better post-intervention when compared to the historical cohort.ConclusionsThe improvements made to the preclinical curriculum through this project improved obesity attitudes and knowledge among first-year medical students. This method provides a practical approach for evaluating and enhancing obesity education in medical school curricula.

Correlation between geriatric nutritional risk index and intradialytic hypotension in elderly patients undergoing maintenance hemodialysis: a case-control study

BackgroundThere is a correlation between nutritional status and treatment outcomes and long-term survival in MHD patients but there is limited research on the relationship between GNRI and IDH. This case-control study aimed to investigate the correlation between Geriatric Nutritional Risk Index (GNRI) and intradialytic hypotension (IDH) in elderly patients undergoing maintenance hemodialysis (MHD).MethodsThis study was carried out on 129 cases of MHD patients with IDH and 258 non-IDH-controls in Ruijin Hospital, Shanghai Jiaotong University School of Medicine, China, between June 2020 and May 2022. Professional researchers collected patients’ general information on gender, primary disease, dialysis-related indicators, anthropometric measures, laboratory biochemicals, and GNRI. Logistic regression analysis was used to evaluate the correlation between GNRI and IDH.ResultsA total of 385 elderly MHD patients were included. Compared with GNRI Q4 group, the odds ratios for the risk of IDH in GNRI Q3 group, GNRI Q2 group, and GNRI Q1 group of elderly MHD patients were 1.227, 2.196, and 8.350, respectively, showing a significant downward trend (P-trend < 0.05). The area under the curve of GNRI for predicting IDH was 0.839 (95% CI: 0.799–0.879). Between different genders, a decrease in GNRI was closely related to an increase in IDH risk (P for trend < 0.05).ConclusionsThis research shows a significant association between GNRI and the incidence of IDH among elderly MHD patients and has an important warning effect. Encouraging the incorporation of GNRI assessment into the clinical assessment protocols of older patients with MHD may help to improve the nutritional status of those suffering from it and reduce the risk of IDH.

Frontline assessors’ opinions about grading committees in a medicine clerkship

BackgroundCollective decision-making by grading committees has been proposed as a strategy to improve the fairness and consistency of grading and summative assessment compared to individual evaluations. In the 2020–2021 academic year, Washington University School of Medicine in St. Louis (WUSM) instituted grading committees in the assessment of third-year medical students on core clerkships, including the Internal Medicine clerkship. We explored how frontline assessors perceive the role of grading committees in the Internal Medicine core clerkship at WUSM and sought to identify challenges that could be addressed in assessor development initiatives.MethodsWe conducted four semi-structured focus group interviews with resident (n = 6) and faculty (n = 17) volunteers from inpatient and outpatient Internal Medicine clerkship rotations. Transcripts were analyzed using thematic analysis.ResultsParticipants felt that the transition to a grading committee had benefits and drawbacks for both assessors and students. Grading committees were thought to improve grading fairness and reduce pressure on assessors. However, some participants perceived a loss of responsibility in students’ grading. Furthermore, assessors recognized persistent challenges in communicating students’ performance via assessment forms and misunderstandings about the new grading process. Interviewees identified a need for more training in formal assessment; however, there was no universally preferred training modality.ConclusionsFrontline assessors view the switch from individual graders to a grading committee as beneficial due to a perceived reduction of bias and improvement in grading fairness; however, they report ongoing challenges in the utilization of assessment tools and incomplete understanding of the grading and assessment process.

Genotypic and Phenotypic Spectrum of maple syrup urine disease in Zhejiang of China.

Maple Syrup Urine Disease (MSUD) is an autosomal recessive metabolic disorder originating from defects in the branched-chain α-ketoacid dehydrogenase (BCKDH) complex encoded by BCKDHA, BCKDHB, and DBT. This condition presents a spectrum of symptoms and potentially fatal outcomes. Although numerous mutations in the BCKDH complex genes associated with MSUD have been identified, the relationship between specific genotypes remains to be fully elucidated. Our objective was to predict the pathogenicity of these genetic mutations and establish potential links between genotypic alterations and the clinical phenotypes of MSUD. Retrospective population-based cohort. We analyzed 20 MSUD patients from the Children's Hospital at Zhejiang University School of Medicine (Hangzhou, China), recorded from January 2010 to May 2023. Patients' blood samples were collected by heel-stick through neonatal screening, and amino acid profiles were measured by tandem mass spectrometry. In silico methods were employed to assess the pathogenicity, stability, and biophysical properties. Various computation tools were utilized for assessment, namely PredictSNP, MAGPIE, iStable, Align GVGD, ConSurf and SNP effect. We detected 25 distinct mutations, including 12 novel mutations. The BCKDHB gene was the most commonly affected (53.3%) compared to the BCKDHA gene (20.0%) and DBT gene (26.7%). In silico webservers predicted all novel mutations were disease-causing. This study highlights the genetic complexity of MSUD and underscores the importance of early detection and intervention. Integrating neonatal screening with advanced sequencing methodologies is pivotal in ensuring precise diagnosis and effective management of MSUD, thereby significantly improving the prognosis for individuals afflicted with this condition.

Early predictive value of lipocalin-type prostaglandin D synthase for 28-day mortality in cardiac arrest patients: study protocol for a prospective study

IntroductionPublic training in cardiopulmonary resuscitation and treatment in emergency and intensive care unit have made tremendous progress. However, cardiac arrest remains a major health burden worldwide, with brain damage being...

Research on the global trends of COVID-19 associated acute kidney injury: a bibliometric analysis

Critically ill COVID-19 patients may exhibit various clinical symptoms of renal dysfunction including severe Acute Kidney Injury (AKI). Currently, there is a lack of bibliometric analyses on COVID-19-related AKI. The aim of this study is to provide an overview of the current research status and hot topics regarding COVID-19 AKI. The literature was retrieved from the Web of Science Core Collection (WoSCC) database. Subsequently, we utilized Microsoft Excel, VOSviewer, Citespace, and Pajek software to revealed the current research status, emerging topics, and developmental trends pertaining to COVID-19 AKI. This study encompassed a total of 1507 studies on COVID-19 AKI. The United States, China, and Italy emerged as the leading three countries in terms of publication numbers, contributing 498 (33.05%), 229 (15.20%), and 140 (9.29%) studies, respectively. The three most active and influential institutions include Huazhong University of Science and Technology, Wuhan University and Harvard Medical School. Ronco C from Italy, holds the record for the highest number of publications, with a total of 15 papers authored. Cheng YC’s work from China has garnered the highest number of citations, totaling 470 citations. The co-occurrence analysis of author keywords reveals that ‘mortality’, ‘intensive care units’, ‘chronic kidney disease’, ‘nephrology’, ‘renal transplantation’, ‘acute respiratory distress syndrome’, and ‘risk factors’ emerge as the primary areas of focus within the realm of COVID-19 AKI. In summary, this study analyzes the research trends in the field of COVID-19 AKI, providing a reference for further exploration and research on COVID-19 AKI mechanisms and treatment.

Using an ‘effective’ model of professional development in science education to improve primary teachers’ classroom practice: the CSSP experience

ABSTRACT The international research literature concludes that effective professional development for teachers needs to: be truly collaborative involving an active role for practitioners; help break down teacher insulation and isolation; provide opportunities for teachers to work together in developing their classroom practices. However, professional development, as understood in the Irish context, tends to be characterised by predominantly transmission of knowledge models. The Clare Small Schools Project (CSSP) is an innovative professional development programme in primary science education in Ireland. Its constituent partners are Clare Education Centre, Dublin City University and small rural primary schools in County Clare. It is planned and designed in accordance with agreed characteristics of transformative professional development: ongoing, collaborative, embedded in teachers’ work, with an emphasis on changing classroom practice. This paper draws on the key developments emerging from the programme. Findings show that the CSSP is making positive changes in teachers’ individual and collaborative practices and is helping teachers overcome professional isolation. Key to this is the prominent role the Education Centre plays in encouraging participatory approaches to practice. These findings add to what is known about providing transformative professional development. They have far-reaching implications for teacher educators in Ireland and farther afield.

Social Determinants of Health in a Kansas Community Health Center.

This study explored the connection between social determinants and patient self-rated health at Health Ministries Clinic (HMC) in a rural Kansas community. Community health centers, like HMC, strive to deliver comprehensive care that addresses patients' social needs. The authors employed a convenience sampling method to survey HMC patients with appointments from September to December 2018. The authors analyzed the data using Chi-square tests and descriptive statistics in RStudio, considering p <0.05 as significant. Among 200 patient responses, education, income, employment, and insurance status were negatively correlated with self-rated health. Notably, 86.2% of college or graduate school graduates reported positive health ratings, compared to 40% of those who did not finish high school (χ2(12, N = 185) = 25.75, p = 0.012). Lower income individuals (income <$34,000 per year) consistently rated their health poorer than their higher income counterparts (χ2(12, N = 174) = 23.96, p = 0.021). Patients without insurance or with public insurance (Medicaid/ CHIP) perceived their health as worse than those on private health insurance and Medicare (χ2(12, N = 137) = 35.67, p <0.001). Our findings suggest that low educational attainment, income, and lack of health insurance are associated with barriers to healthcare, resulting in poor health outcomes and chronic disease among those with lower socioeconomic status. This underscores the strong association between social determinants and self-rated health among HMC patients. These results can be used by other clinics to assess the needs of their patient population and enhance community health initiatives.

A multi-tiered mentoring community approach to research experiences for local students from disadvantaged and underrepresented minority backgrounds

IntroductionA research and mentoring program was developed to provide local first-generation students, students returning to school after a professional experience, and underrepresented minority students resources and relationships to guide them toward a STEM degree from a four-year university.MethodsA multi-tiered mentoring community was formed including direct mentoring from graduate students and faculty advisors, peer mentoring among undergraduate students from different colleges and universities, and high school students to increase the accessibility of research opportunities for this demographic. Local students were recruited from Northwest Arkansas Community College and Upward Bound to combine community college and high school students in a novel manner. The programs were integrated whenever possible to emphasize peer mentoring, including mentoring lunches, research meetings, presentation sessions, conference presentations, and professional development mentoring sessions.ResultsOn the post-program survey, students indicated the community formed in the program supported their STEM identity development, provided them with quality relationships, and developed skills valuable to completion of a STEM degree. This identity development was further evidenced by the students presenting their work at a conference and obtaining additional research positions after the summer program ended.ConclusionThe post-program scores and continued efforts of different demographics of students to pursue STEM highlight the versatility of the multi-tiered mentoring community model to serve students from different ages, backgrounds, and demographics.

Challenges and prospects for teaching ocean literacy in Brazilian schools

This study took as a case study the perspective of teachers working in the State of Rio de Janeiro by 53 interviews to investigate the challenges and prospects of including content about the ocean in Brazilian school classrooms. The data were subjected to content analysis and explored quantitatively using Descending Hierarchical Classification (DHC) and Factor Correspondence Analysis (FCA) of word and terms used by teachers in their discourse. The main difficulties reported in including themes related to the ocean and marine environments in classes were the absence of OL in the school curriculum and university education, as well as the limited time to work on these subjects in classes, which is in line with the challenges faced by teachers from other countries. On the other hand, Brazilian teachers cited particular problems of Brazilian formal education, such as the need for professional development, support for an education with an interdisciplinary emphasis, and provision of financial resources for schools. However, DHC analysis also indicates strong connection of the teachers with the ocean due to sea fascination (24% of the answers in the textual corpus), spiritual and emotional connection (26.7%), leisure (22.7%) and professional interest (26.7%). Furthermore, the textual corpus also identified that teachers recognize the importance of teaching marine topics due to: students live in coastal areas (32.2%), the provision of ecosystem services (19.9%), preservation issues (34.2%), and limited student knowledge on these themes (13.7%). These data can help formulate educational policies to mitigate OL teaching barriers in Brazilian schools.

Did the students’ satisfaction rates at Avalon University School of Medicine correlate with the occurrence of accreditation site visits?

Introduction Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program’s governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine. Methods A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test. Results The ratings for the basic science students’ survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students’ surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values. Conclusions The pre-accreditation preparation and the self-evaluation process while correcting the program’s deficiencies are essential triggers for the quality improvement process associated with accreditation.

Virtual reality as an engaging and enjoyable method for delivering emergency clinical simulation training: a prospective, interventional study of medical undergraduates

BackgroundIt is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students’ engagement and enjoyment of VR simulation to desktop computer-based simulation.MethodsWe conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students’ physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated ‘Behavioural Engagement Related to Instruction’ (BERI) protocol. Students’ subjective engagement and enjoyment levels were measured using a post-session survey.ResultsStudents’ maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p < 0.001), and eye tracking showed they spent a significantly greater mean percentage of time of 6.4% (5.1 to 7.7, p < 0.001) focusing on the scenarios in VR compared to standard desktop. Qualitative data showed students enjoyed and felt engaged with the sessions, which provided a safe space for learning.ConclusionsOur study shows that students found VR simulations enjoyable and were more engaged compared to standard desktop simulation. This suggests that 360-degree VR simulation experiences provide students with immersive, realistic training, which is scalable, giving them the unique opportunity to manage emergencies and work within emergency teams, which would not typically occur during traditional training.

Knowledge sharing among academics from Egyptian medical schools during the COVID-19 pandemic

BackgroundSharing knowledge among scientists during global health emergencies is a critical issue. So, this study investigates knowledge-sharing behavior and attitude among staff members of 19 Medical schools in Egyptian universities during the COVID-19 pandemic.MethodsAcross-sectional study was conducted using a web-based questionnaire. A total of 386 replies from the 10,318 distributed questionnaires were analyzed. Descriptive statistics were computed using SPSS (version 22) to summarize the demographic data. Inferential statistics such as the independent and chi-square test were used to achieve the study aims.ResultsMore than half of the respondents (54.4%) indicated that their levels of knowledge of COVID-19 were good. Most participants (72.5%) reported that scientific publications and international websites were the most reliable source of their knowledge concerning COVID-19. More than 46% stated they sometimes share their knowledge. The lack of time to share and organizational culture were the most important factors that could affect their knowledge sharing. Additionally, about 75% of participants shared knowledge about treatment.

High deductible health plans and survival among cancer survivors.

11005 Background: High deductible health plans (HDHP) enable lower premiums at the expense of potentially high out-of-pocket costs. They are associated with more advanced cancer stage diagnoses and delayed or forgone care among cancer survivors. However, it is unknown how HDHPs are associated with survival among cancer survivors. Methods: Individuals ages 18-84 years with non-Medicaid insurance were identified from the 2011-2018 National Health Interview Survey (NHIS) with linked mortality files from the National Death Index. HDHP status was defined by the NHIS as a yearly deductible ≥$1200-1350 for an individual or ≥2400-$2700 for a family (values depend on survey year with increases over time). Cox proportional hazards models using age as the time scale were utilized to determine: 1) association of HDHP status with overall survival (OS) and cancer survival (CS; i.e., freedom from cancer death) among cancer survivors, and 2) how associations differed for survivors compared to those without a cancer history. Models accounted for the NHIS survey design and survey weights and were adjusted for insurance status, marital status, sex, comorbidities, education, income, national region, and cancer site and time since cancer diagnosis (if applicable). Sensitivity analyses adjusting for age at cancer diagnosis were performed using time since diagnosis as the time scale. Results: A total of 147,254 respondents were identified, 5.9% of whom were cancer survivors. 25.6% of survivors and 28.5% of individuals without a cancer history reported being insured by a HDHP at the time of NHIS participation. HDHP status was associated with worse OS (HR: 1.46, 95% CI = 1.19 - 1.79) and CS (HR: 1.34, 95% CI = 1.01 - 1.77) among cancer survivors overall in the adjusted model. HDHP status was additionally associated with worse OS among the following subgroups of cancer survivors: non-Hispanic White (HR: 1.45, 95% CI = 1.16 - 1.82), income &gt; 400% federal poverty level (HR: 1.65, 95% CI = 1.16 - 2.36), college (HR: 1.47, 95% CI = 1.07 – 2.00) or high school (HR: 1.59, 95% CI = 1.19 - 2.12) education, and multiple cancers (HR: 1.58, 95% CI = 1.06 - 2.36), without clear patterns by sex, comorbidities, insurance, and cancer site. Sensitivity analyses provided similar results. In contrast, among adults without a history of cancer at the time of NHIS participation, HDHP status was not significantly associated with OS (HR: 1.08, 0.96 - 1.21; Pinteraction &lt; .01) or CS (HR: 0.90, 95% CI = 0.70 - 1.14; Pinteraction &lt; .01). Conclusions: This nationwide population-based analysis suggests that HDHPs are associated with both worse overall survival and cancer survival among cancer survivors but are not associated with survival in adults without a history of cancer. HDHPs may financially disincentivize cancer survivors from utilizing necessary medical care to optimize survivorship thereby compromising mortality and cure. Policy changes to limit the proliferation of these plans may improve cancer outcomes.

Pathway to cardiothoracic surgery: A primer for aspiring students

ObjectiveThe pathway to cardiothoracic surgery is often obscure for premedical students and aspiring applicants and requires navigating various known and unknown obstacles. Recognizing the challenges encountered on the path to a career in cardiothoracic surgery in the United States, we present this guide for students interested in the field to maximize success in their premedical, preclinical, and preresidency years. MethodsThis is a joint collaboration between the Thoracic Surgery Residents Association and the Thoracic Surgery Medical Student Association. Drawing from firsthand experiences and insights gathered from numerous student applicants and current surgical residents, a comprehensive guide was constructed for students from the point of undergraduate school to advanced training options, including super-fellowship training. ResultsSeveral intricacies to cardiothoracic surgery career planning were discussed, including differences between traditional and integrated/fast-track pathways, college and medical school selection, networking, performing during clinical rotations, extracurricular and research activities, building mentorship relationships, and pursuing alternate career and advanced training opportunities. ConclusionsFor premedical students and aspiring applicants, the road to cardiothoracic surgery requires meticulous planning, grit, and thoughtful dedication. This document consolidates firsthand insights and advice from numerous aspiring and matched applicants to serve as a comprehensive guide for students seeking a career in cardiovascular and thoracic surgery.

Trophoblast cell-surface antigen 2 is a biomarker and potential therapeutic target in human colon cancer.

e15514 Background: Trophoblast cell-surface antigen 2 (TROP2), a transmembrane glycoprotein in epithelial cells, is implicated in malignant progression, notably in breast cancer therapy. However, the clinicopathologic aspects of TROP2 in colorectal cancer (CRC) are unclear. This study aims to explore the association between TROP2 expression and clinicopathological features in CRC and investigate the inhibitory effects of the anti-TROP2 antibody-SN-38 conjugate (ADC-TROP2) on colon cancer cells. Methods: A retrospective analysis of 1296 CRC patients who underwent colorectomy at Renji Hospital, Shanghai Jiaotong University School of Medicine, was conducted. Immunohistochemistry determined the expressions of TROP2, HER2, and PD-L1 in colon cancer tissues. Statistical analyses, including the chi-square test and Cox proportional hazards model, assessed associations. Sacituzumab Govitecan (ADC-TROP2 drug) cytotoxicity on human cancer cells was determined using the MTT method. Results: TROP2 was predominantly expressed at the cell membrane of cancer tissues, with 50% of cases TROP2-positive. The overexpression of TROP2 (staining extension 2+ or 3+) were found in 356 (27.5%) cases. The clinicopathological features of all 1296 patients based on the TROP2 expression in their cancer cells were summarized in Table 1. Compared to TROP2 negativity expression, the high TROP2 expression was significantly associated with the advantaged tumor stage (III/IV, P = 0.022), high tumor invasion depth (T3/T4, P = 0.002), lymph node metastasis (N1/N2, p = 0.026), HER-2 expression (2+/3+, p = 0.013) ,PD-L1 CPS (CPS≤5,P = 0.007). Sacituzumab Govitecan exhibited stronger inhibition in TROP2-positive human CRC cells in TROP2-negative CRC cells compared to TROP2-negative cells and the control SN-38 agent. Conclusions: TROP2 expression positive in 50% of CRC cases is associated with with advantaged tumor stage, high tumor invasion depth, lymph node metastasis. Sacituzumab Govitecan demonstrates potent targeting of TROP2-positive CRC cells, suggesting TROP2 as a potential biomarker for clinical prognosis and therapeutic targeting in colon cancer. [Table: see text]

Analysis of the prevalence and clinical features of respiratory syncytial virus infection in a pediatric hospital in Zhejiang Province from 2019 to 2023.

The aim of this study was to investigate the epidemiological characteristics of respiratory syncytial virus (RSV) infections in children in Zhejiang from 2019 to 2023. Data from pediatric patients who visited the Children's Hospital of Zhejiang University School of Medicine for RSV infection between 2019 and 2023 were analyzed. Nasopharyngeal swabs were collected for RSV antigen detection, and relevant patient information was collected. Factors such as age were analyzed. A total of 673 094 specimens were included from 2019 to 2023, with a rate of positive specimens of 4.74% (31 929/673 094). The highest rate of positive specimens of 10.82%, was recorded in 2021, while the remaining years had a rate of approximately 3%-5%. In terms of seasonal prevalence characteristics, the rate of positive specimens in 2019, 2020, and 2022 peaked in the winter months at approximately 8% and decreased in the summer months, where the rate of positive specimens remained at approximately 0.5%. In contrast, summer is the peak period for RSV incidence in 2021 and 2023, with the rate of positive specimens being as high as 9%-12%. Based on the prevalence characteristics of gender and age, this study found that the detection rate of positive specimens was higher in boys than in girls in 2019-2023. In 2019-2022, among the different age groups, the highest rate of positive specimens was found in children aged 0 to <6 months, and it decreased with age. In 2023, the rate of positive specimens was above 8% in the 0 to <6 months, 6 to <12 months, and 1-2 years age groups, with the highest rate of positive specimens in the 1-2 years age group, and a gradual decrease in the rate of positive specimens with age for children over 3 years of age. Between 2019 and 2023, the epidemiological pattern of RSV changed. A summer peak was observed in 2021 and 2023.

Preventing Pilonidal Sinus Recurrence With Laser Hair Epilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pilonidal sinus disease (PSD) is a common condition associated with significant morbidity and healthcare costs. High recurrence rates still pose a considerable challenge in managing PSD, with no universally accepted guideline inplace to guide management. Laser hair epilation offers a way to reduce recurrence rates with reports within the current literature demonstrating positive outcomes compared to alternative approaches. This review was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement standards. The primary outcome measure was the recurrence rate of PSD at a minimum of one year following laser hair epilation. The electronic databases of MEDLINE, EMBASE, CINAHL, Google Scholar, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL)were searched. OpenMeta Analyst (Brown University School of Public Health, Providence, RI) software was used for data synthesis. Three randomized controlled trials met the inclusion criteria with laser hair epilation treatments offering a significant reduction in PSD recurrence rateson odds ratio analysis: 0.319 ( 0.160, 0.636), P-value = 0.0001. Secondary outcomes involving patient disability days, caregiver disability days, health-related quality-of-life (HRQOL) scores, healthcare satisfaction scores, and perceived stigma were discussed qualitatively. The authors offer a decisive recommendation in favor of laser hair epilation in PSD; however, they recommend further high-quality trials to investigate the ideal timing and frequency of laser hair epilation sessions.

Preventive Efficacy of Antibiotics after Impacted Mandibular Third Molar Surgery.

To explore the preventive efficacy of antibiotics following surgical removal of the impacted mandibular third molars and screen the potential risk factors. A cohort trial. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China, from August 2021 to 2022. Cases with impacted mandibular third molar were divided into two groups based on antibiotics use. The primary outcome variable post-operative infection, secondary clinical parameter analgesics intake, and other variables (the operative time, the history of pericoronitis, and wound closure) were documented. The post-operative infections occurred in 3.64% (n = 12) of the 330 cases (n = 330); 3.01% in the antibiotic group (n = 166) and 4.27% in the control group (n = 164, OR = 1.44, 95% CI: 0.49 to 4.06; p = 0.54). Concerning secondary outcome measures, the analgesics that the antibiotic group took was 5.40, and the control group took was 5.95 (95% CI = -0.21 to 1.30; p = 0.16). For those with post-operative infections, the average operative time was 22.83 minutes, whereas for those without post-operative infections it was 14.87 minutes (95% CI = -0.26 to 15.67; p = 0.04). When the operative time was greater than or equal to 15 minutes, it was related to more analgesics use (95% CI: -0.43 to 1.93; p <0.05), also was the history of pericoronitis (95% CI = 0.04 to 1.54; p = 0.04). Antibiotics are unnecessary for preventing post-operative infections or minimising analgesic requirements following extraction of the impacted mandibular third molars; operative time and pericoronitis showed a suppressive influence on post-operative recovery. Impacted molars, Antibiotics, Analgesics, Operative time, Pericoronitis.