Genes Related to Frontonasal Malformations Are Regulated by miR-338-5p, miR-653-5p, and miR-374-5p in O9-1 Cells.

Frontonasal malformations are caused by a failure in the growth of the frontonasal prominence during development. Although genetic studies have identified genes that are crucial for frontonasal development, it remains largely unknown how these genes are regulated during this process. Here, we show that microRNAs, which are short non-coding RNAs capable of targeting their target mRNAs for degradation or silencing their expression, play a crucial role in the regulation of genes related to frontonasal development in mice. Using the Mouse Genome Informatics (MGI) database, we curated a total of 25 mouse genes related to frontonasal malformations, including frontonasal hypoplasia, frontonasal dysplasia, and hypotelorism. MicroRNAs regulating the expression of these genes were predicted through bioinformatic analysis. We then experimentally evaluated the top three candidate miRNAs (miR-338-5p, miR-653-5p, and miR-374c-5p) for their effect on cell proliferation and target gene regulation in O9-1 cells, a neural crest cell line. Overexpression of these miRNAs significantly inhibited cell proliferation, and the genes related to frontonasal malformations (Alx1, Lrp2, and Sirt1 for miR-338-5p; Alx1, Cdc42, Sirt1, and Zic2 for miR-374c-5p; and Fgfr2, Pgap1, Rdh10, Sirt1, and Zic2 for miR-653-5p) were directly regulated by these miRNAs in a dose-dependent manner. Taken together, our results highlight miR-338-5p, miR-653-5p, and miR-374c-5p as pathogenic miRNAs related to the development of frontonasal malformations.

SPARC - A multi-disciplinary team program for retroperitoneal sarcoma: the Royal Prince Alfred Hospital and Chris O'Brien Lifehouse Collaboration.

BACKGROUND: The Royal Prince Alfred Hospital (RPAH) and Chris O'Brien Lifehouse (COBLH) established a formal Sarcoma of the Pelvic and Abdominal Retroperitoneum Collaboration (SPARC) in November 2020. An established multidisciplinary team (MDT) with the aims to centralise patient referrals and treatment, establish database and research, coordinate surgical resections is critical in improving patient outcomes and quality of life. METHODS: A prospective database was established in October 2021. Clinical, pathological and radiological data points were recorded for all patients since the inception of SPARC. Quality of Life questionnaires were included and follow-up planned regularly for 5 years. RESULTS: From November 2020 to Feb 2024, 294 new referrals were discussed at the MDT meeting. Majority were from the metropolitan area (182) followed by regional NSW (87), interstate (20) and five internationals. 141 operations were performed during this period compared to 119 operations from 2010 to November 2020 in RPAH. The inception of the SPARC program has resulted in exponential growth in operations, improving from the previous rate of 15 cases annually to 35. Liposarcomas followed by leiomyosarcomas are the most common types of sarcomas resected. The majority were extended resections (81.6%) and 22% were pelvic exenterations. Overall R0 rate is 54.6%, R1 38.3% and R2 1.4% (131 (92.9%) had R0/R1 resections. Overall complication rate is 35.5% with one in-hospital mortality. CONCLUSION: Success and expansion of a robust retroperitoneal sarcoma program requires a collaborative surgical approach, an MDT meeting, centralized referral process, and a research team in specialized tertiary institutions.

The 2024 Taiwanese Presidential Election on social media: Identity, policy, and affective virality.

The 2024 Taiwanese Presidential Election is not just a critical geopolitical event, it also engages with themes of alternative candidacy, foreign policy, and affective polarization. At one point, a four-candidate race had emerged in a traditionally bipartisan election, with alternative candidates disrupting the dichotomy of Chinese vs. Taiwanese identity. Leveraging 911,510 posts and 101,600,047 engagements on social media, we analyze user discourse and engagement. First, we find traditional candidates derive more engagement on foreign policy and geopolitical issues, alternative candidates on domestic issues. Additionally, virality is generated by affective reasons, although in-group references generate more engagement than out-group references. Lastly, a puzzle is revealed where alternative candidates draw more homogeneous attention from national identity groups. Results suggest alternative candidacy can be generated by both positive and negative comparisons rooted in national identity.

Rural Disparities in Hospital Patient Satisfaction: Multilevel Analysis of the Massachusetts AHA, SID, and HCAHPS Data.

INTRODUCTION: Hospital patient satisfaction has been a salient policy concern. We examined rurality's impact on patient satisfaction measures. METHODOLOGY: We examined patients (age 50 and up) from 65 rural and urban hospitals in Massachusetts, using the merged data from 2007 American Hospital Association Annual Survey, State Inpatient Database and Survey of Patients' Hospital Experiences, utilizing Hierarchical binary logistic regression analyses to examine the rural disparities in patient satisfaction measures. RESULTS: Relative to the urban location, rurality reduced the likelihood of cleanliness of environment (odds ratio = 0.66, 95% confidence interval: [0.63-0.70]); but increased the likelihood of staff responsiveness and quietness. Compared to Caucasian counterparts, Hispanic patients were less likely to reside in a quiet hospital. Compared to other payments, Medicare or Medicaid coverage each reduced the likelihood of staff responsiveness and cleanliness. Compared to other diagnoses, depressive or psychosis disorders predicted smaller odds in responsiveness and cleanliness. Anxiety diagnosis reduced the likelihood of cleanness and quietness. At the facility level, higher registered nurse full-time equivalent (FTE)s or being a teaching hospital increased the likelihood of all measures. CONCLUSION: Relative to the urban counterparts, rural patients experienced lower likelihood of staff responsiveness after adjusting for other factors. Compared to Caucasian patients, Hispanic patients were less likely to reside in quiet hospital environment. Research is needed to further explore the basis of these disparities. Mental health diagnoses in depressive and psychosis disorders also called upon further studies in special care needs.

Mathematical Modeling of COVID-19 Control and Prevention Based on Immigration Population Data in China: Model Development and Validation.

BACKGROUND: At the end of February 2020, the spread of coronavirus disease (COVID-19) in China had drastically slowed and appeared to be under control compared to the peak data in early February of that year. However, the outcomes of COVID-19 control and prevention measures varied between regions (ie, provinces and municipalities) in China; moreover, COVID-19 has become a global pandemic, and the spread of the disease has accelerated in countries outside China. OBJECTIVE: This study aimed to establish valid models to evaluate the effectiveness of COVID-19 control and prevention among various regions in China. These models also targeted regions with control and prevention problems by issuing immediate warnings. METHODS: We built a mathematical model, the Epidemic Risk Time Series Model, and used it to analyze two sets of data, including the daily COVID-19 incidence (ie, newly diagnosed cases) as well as the daily immigration population size. RESULTS: Based on the results of the model evaluation, some regions, such as Shanghai and Zhejiang, were successful in COVID-19 control and prevention, whereas other regions, such as Heilongjiang, yielded poor performance. The evaluation result was highly correlated with the basic reproduction number (R0) value, and the result was evaluated in a timely manner at the beginning of the disease outbreak. CONCLUSIONS: The Epidemic Risk Time Series Model was designed to evaluate the effectiveness of COVID-19 control and prevention in different regions in China based on analysis of immigration population data. Compared to other methods, such as R0, this model enabled more prompt issue of early warnings. This model can be generalized and applied to other countries to evaluate their COVID-19 control and prevention.

Are older adults' demographic characteristics social determinants of their perceived importance, desire, and ability to perform end-of-life self-care actions?

BACKGROUND: Demographic characteristics play a role in influencing the decision to make end-of-life (EOL) directives among older adults living in the United States. AIMS: To examine the associations between older adults' demographic characteristics (age, sex, marital status, residential site, and educational level) and their perceived importance of four self-care actions for EOL planning, as well as their desire and ability to perform these actions. SETTINGS: A cross-sectional survey study of community-dwelling adults living in the southern United States from 2015 to 2016. PARTICIPANTS: Community-dwelling adults aged 65 years and older (N = 123). METHODS: A self-administered tool, the Patient Action Inventory for Self-Care and a demographic questionnaire were used. Multiple logistic regression was performed. RESULTS: Forty-seven of (38.2%) participants lived in an urban community and 76 (61.8%) in a rural community. Demographic variables that were significant across the predictive models were older adults' residence, education levels, age, and marital status. Four demographic characteristics of living in rural areas, without a high school education, being 75 years or older, and married could be social determinants of EOL planning. CONCLUSIONS: Older adults may need community-based support to address their end-of-life needs, especially those elders who want to remain independent in their home environment.

Tumor Thrombus From Urothelial Carcinoma of Renal Pelvis.

We present a case report of an unfortunate 67-year-old man. He developed symptoms of thromboembolic disease in the immediate post-operative period after nephroureterectomy with recurrent pulmonary embolism in spite of being on several different anticoagulation regimens. He was later found to have tumor thrombus in the pulmonary artery secondary to urothelial tumor extension.

Race and mental health disorders' impact on older patients' nursing home admissions upon hospital discharge.

INTRODUCTION: Despite policy efforts to reduce unwanted nursing home (NH) admissions, NH residents increasingly are being admitted from hospitals, with a significant share diagnosed with mental health disorders. OBJECTIVES: We examined interactive effect of Black race and mental health disorder's impact on older patients' (age 65 and older) NH admission upon hospital discharge. MATERIAL AND METHODS: We analyzed 186,646 older patients using pooled data from the 2007 through 2010 National Hospital Discharge Survey. Logistic regression analyses were used to examine the risk factors for NH admission. RESULTS: Diagnosis of mental health disorders increased the odds of NH admission among the older sample patients (OR = 1.15, 95%CI[1.04,1.28]). Black race was not associated with higher odds, whereas black patients experienced higher odds if they were diagnosed with mental health disorders (OR = 1.60, 95%CI[1.43,1.79]). Medicare as primary payer was associated with greater odds of NH admission. Admission from nursing facilities substantially increased the odds of NH admission upon hospital discharge. Patients discharged with diagnoses of stroke, lower-limb fractures, and a chronic ulcer, as well as those with a longer length-of-stay (> 5 days) experienced increased odds of NH admission. Being discharged from a larger hospital (with >200 beds) decreased the odds for NH admission; as did being discharged from a government-owned hospital. CONCLUSIONS: Older Black patients with mental health disorder experienced significantly greater odds of NH admission after adjusting for other factors. Public policy initiatives are needed to address the specific needs in the vulnerable population to avoid unwanted NH admission.