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ABSTRACT Objective: circCPA4 has been defined to be an oncogenic gene. This study examined whether circCPA4 regulates Prostate Cancer (PC) development and revealed its molecular mechanism. Methods: PC tissues and PC cell lines were collected, in which circCPA4/miR-491-5p/SHOC2 levels were evaluated by RT-qPCR and immunoblot. Colony formation assay and EdU assay assessed cell proliferation, flow cytometry measured apoptosis, and Transwell assessed invasion and migration. Ki-67, cleaved caspase-3, E-cadherin, and N-cadherin were evaluated by immunoblot. Based on the luciferase reporter assay and RIP assay the authors investigated the targeting relationship between circCPA4/miR-491-5p/SHOC2. The effect of circCPA4 on tumor growth was evaluated by xenotransplantation in nude mice. Results: circCPA4 and SHOC2 levels were abundant while miR-491-5p expression was low in PC. Loss of circCPA4 decreased the proliferation and EdU-positive rate of PC cells, enhanced apoptosis, and inhibited invasion, migration, and EMT. Upregulation of circCPA4 forced the malignant behaviors of PC cells, and this promotion could be abolished when miR-491-5p was overexpressed or SHOC2 was silenced. CircCAP4 competitively decoyed miR-491-5p mediating SHOC2 expression. circCAP4 suppression inhibited PC tumor growth. Conclusion: circCAP4 acts as a novel oncogenic factor in PC, accelerating the malignant behavior of PC cells via miR-491-5p/SHOC2 interaction. This novel ceRNA axis may be a potential target for PC drug development and targeted therapy in the future.

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Abstract Objectives: This experimental study focused on the intra- and inter-rater reproducibility of vertical bone level (VBL) measurements at strategic mini-implants (MI) using digital panoramic radiographs (PR). Study design: VBLs of 152 MIs for removable partial denture stabilization at 50 randomly chosen PRs from a clinical trial were digitally evaluated by three ratters. Rater deviations exceeding 0.5 mm were re-examined. The intra-class correlation coefficient (ICC) was applied to estimate reliability. The smallest detectable change (SDC) was interrelated to the minimal clinically important change of 0.2 mm. Results: The first measurement round revealed intra- and inter-rater ICCs of > 0.8. However, 28 sites (9 %) were unreadable, and 97 sites (32 %) revealed differences between observers of ≥ 0.5 mm. Following a consensus session and re-training, an additional 8 sites were excluded and all remaining VBL differences were ≤ 0.5 mm. Thus, the SDCs with 95 % credibility were improved from 0.73 to 0.31 mm in the intra-rater and from 1.52 to 0.34 mm in the interrater statistics. Given a 50 % credibility for this special setting, both the intra- and inter-rater SDCs were 0.11 mm. Conclusions: Digital PR can be reliably utilized to determine VBLs around MIs under conditions of at least two trained observers, mutual calibration sessions, and exclusion of unquantifiable radiographs. German Clinical Trials Register ID:DRKS00007589, www.germanctr.de

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Abstract Objective: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. Methods: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. Results: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). Conclusions: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

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Highlights Effects of AGEs in Parkinson's disease patients. Recommendation healthy diet with a low AGE consumption. Parkinson's disease patients’ lower strength and worsened functional capacity.

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HIGHLIGHTS CS-31 seems to be appropriate for use in oncology and may help to monitoring adverse effects and HRQL.

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Highlights DM1 is associated with changes in skeletal muscle functionality. During pregnancy, the incidence of low back pain and pelvic pain is moderate and the presence of DM1 may be associated with the early appearance of this symptom. The study demonstrated that pregnant women with DM1 complain of pain with a moderate incidence in the second trimester of pregnancy. Factors such as length of illness are related to the higher frequency of pain in pregnant women with DM1.

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Highlights Correlation analysis of miR-141-5p and serum β-HCG, P4 and E2 levels in patients with ESA. miR-141-5p as a diagnostic biomarker for ESA. β-HCG, P4 and E2 levels.

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Highlights Tyrosine kinase domains with genomic alterations have oncogenic potential. Higher efficacy for infigratinib than larotrectinib. Infigratinib has a higher overall survival than larotrectinib. Infigratinib has higher adverse effects than larotrectinib. Bevacizumab initial therapy has a higher overall survival.

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Abstract Introduction The maternal mortality rate in developing countries, such as Brazil, has significantly increased since 2020. Obstetric Emergencies (OE) account for 72.5% of these deaths. A national survey was conducted in Brazil to evaluate how gynecologists and obstetricians deal with OE and identify the main difficulties regarding theoretical/practical knowledge and structural resources. Methods An electronic questionnaire assessing resource availability, health teams, institutional protocols, and provision of OE training courses was completed by Brazilian obstetricians. Results More than 90 % of the questionnaire respondents reported treating a pregnant and/or puerperal patient with severe morbidity and that their health network has human resources, trained professionals, and structural resources required for this type of care. However, few respondents participate in continuing education programs (36 %) or specific training for the medical team (61.41 %). The implementation rates of obstetric risk identification protocols (33.09 %), a rapid response team (46.54 %), and boxes and emergency cart assembly teams (71.68 %) were determined. Conclusion A high Maternal Mortality Ratio (MMR) may be related to disorganized healthcare systems, low implementation of risk classification protocols for the care of severe maternal and fetal conditions, and lack of access to continued/specific training programs. The Brazilian MMR is multifactorial. According to obstetricians, Brazilian health services include care teams, essential medications, obstetric centers, and clinical analysis laboratories, though they lack systematized processes and permanent professional training for qualified care of OE.

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Highlights XBJ improves LPS-induced lung cell inflammation and pyroptosis. miR-181d-5p inhibits LPS-induced inflammatory response and pyroptosis of lung epithelial cells. XBJ elevates miR-181d-5p and improves LPS-induced pyroptosis of lung epithelial cells. XBJ upregulates miR-181d-5p and inhibits SPP1 to protect lung epithelial cells from LPS-induced injuries.

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Highlights Few studies have examined outcomes after intrathoracic metastasectomy for nonseminomatous testicular germ cell tumors. Integration of local and systemic therapies yields favorable outcomes with low morbidity and mortality. Surgical management should be considered after chemotherapy, as histology prediction for metastatic lesions remains challenging. This study highlights the importance of aggressive surgical approaches in improving long-term survival in young patients with testicular NSGCT.

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Highlights Serum INSL-3 in patients with varicocele decreases with the severity of the disease. Serum INSL-3 is positively correlated with total sperm count. Serum InhB is associated with semen volume, concentration, and total sperm. Serum InhB and INSL-3 levels could distinguish the degree of varicocele.

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Highlights Impulse Oscillometry (IOS) can be used to analyze lung resistance and reactance in patients with PAH. Patients with PAH show increased resistance and pulmonary reactance compared to healthy individuals. The IOS findings showed a good correlation with the spirometric variables.

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Highlights Celiac disease and endometriosis share inflammatory markers and pathophysiology. HLA-DQ2 and/or HLA-DQ8 were similar between the control and endometriosis groups. Anti- transglutaminase igA was similar between the control and endometriosis groups. HLA-DQ2 and DQ8 had no difference in age, symptoms, endometriosis stage or location.

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Highlights Despite their importance, dignity and respect are woefully undefined, and often cast aside, which is reflected by the scarcity of in-depth studies. Brazilian patients feel respected, but when it comes to consideration and integrity, it is nothing short of heartbreaking. Brazilian health professionals do not ask their patients whom they would like to share information with. And this demands our utmost attention. A sting of disrespect and affronts to our dignity seldom escape our notice. The Scale of Perception of Respect for and Maintenance of the Dignity of the Inpatient sheds light on this aspect of human interaction.

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Highlights Visceral Pleural Invasion (VPI) in lung cancer is associated with skip N2 metastasis. Nodal upstaging is linked to lymph-vascular invasion. VPI impacts disease-free and overall survival rates. Consideration of VPI in treatment decisions is crucial for improved patient outcomes.

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Highlights Internal and external pessaries improved the quality of life of women with pelvic organ prolapse. The use of an internal pessary changed the POP-Q stage related to prolapse of the anterior and apical vaginal compartments in women with pelvic organ prolapse. Studies investigating alternative treatments for Pelvic organ prolapse, such as the use of an external pessary, are extremely important.

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Highlights 3D laparoscopic surgery for early-stage EC seems to be more effective than traditional laparotomy. 3D laparoscopic surgery for early EC can attenuate the inflammatory response and damage to immune function, foster urinary function recovery, and enhance the quality of life. 3D laparoscopic surgery for early EC impacts the patient's coagulation function, necessitating vigilant prevention and management of thrombotic events in clinical settings.

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Highlights COVID-19 profoundly affected global healthcare including breast cancer management. The pandemic delayed recurrence diagnosis and increased post-recurrence mortality. Strategies for cancer patients' follow-up during health crises need improvements.

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Highlights CLD infants had delayed auditory conduction at more central brainstem regions. Postnatal central auditory function is adversely affected by neonatal CLD. Monitoring post-term auditory change is warranted for managing CLD infants after term.

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Highlights To determine the prognostic value of perioperative hs-TnI in addition to traditional cardiac risk tools in patients undergoing elective major orthopedic surgery. To evaluate the incidence of perioperative myocardial injury through systematic hs-TnI monitoring in a tertiary orthopedic center in Brazil. Assessing mortality and cardiovascular complications in the short- and long-term periods after elective major orthopedic surgery.

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Highlights Patients presenting periodontal disease increased the risk of developing gastric adenocarcinoma by 17 %. The association remained regardless of the diagnostic method for periodontal disease, i.e., clinical examination and self-report. Moreover, Asian patients with periodontal disease had a higher risk of having gastric adenocarcinoma than American and European patients.

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Highlights Obstructive sleep apnea affects one billion people worldwide and is associated with cardiometabolic risk and cognitive impairment. Drug therapy for the management of sleep apnea has been investigated, but no robust evidence that supports its benefits has been found to date. The combination of noradrenergic and antimuscarinic drugs shows promising results.

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Highlights Photobiomodulation therapy seems to have little or no effect on pain perception during the anesthetic puncture in patients undergoing dental local anesthesia. Clinical trials found in the literature used different study samples, pain assessment tools, and photobiomodulation therapy protocols. Further randomized studies should be performed with a standardized methodology to strengthen the current evidence.

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Highlights Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder. Autism spectrum disorder has a significant impact on the patient and their family. To provide adequate advice is to carry out screening and diagnosis correctly and accurately. Screening test must be applied, M-CHAT-R/F is recommended. For diagnosis CARS and ADOS are the most recommended tools.

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Highlights The inclusion of dentists in multidisciplinary teams for patients with neurocutaneous syndromes is essential, both on an outpatient and hospital basis. Interestingly, dentistry can play a relevant role in the early diagnosis and differential diagnosis of patients with neurocutaneous syndromes. More research in this area is needed.