To explore whether preoperative CD4+ T-cell count is associated with postoperative infectious outcomes after endoscopic lithotripsy for upper urinary tract calculi in human immunodeficiency virus (HIV)-infected patients. The HIV-infected patients who underwent endoscopic lithotripsy for upper urinary tract stones at Shanghai Public Health Clinical Center from May 2019 to May 2025 were enrolled for this study. The exposure of interest was the preoperative peripheral blood CD4+ T-cell count. The primary endpoint was urosepsis. Secondary outcomes included postoperative fever, systemic inflammatory response syndrome (SIRS), and other postoperative complications. A total of 120 patients were enrolled in this study, including 20 patients with a CD4+ T-cell count < 200 cells/µL and 100 patients with a CD4+ T-cell count ≥ 200 cells/µL. None of the patients developed urosepsis or SIRS postoperatively. The overall rate of postoperative fever was 17.5

Background:Patients with prostate cancer undergoing androgen deprivation therapy (ADT) must manage complex treatment side effects over extended periods outside the hospital, making online health information-seeking a key approach to self-management. However, individual differences in motivation, digital literacy, and psychosocial context significantly influence how patients seek and use online health information. The patient persona approach, which synthesizes individuals with similar behavioral patterns and needs into representative profiles, offers a practical method for capturing this heterogeneity and informing the design of tailored information support. Objective:This study aimed to explore the differences in online health information-seeking behavior among patients with prostate cancer undergoing ADT and construct patient personas to characterize distinct patterns of online health information-seeking experiences and related information support needs. Methods:A qualitative descriptive study was conducted in a tertiary hospital in Zhejiang Province, China, from July to October 2025. Purposive sampling was used to recruit patients receiving ADT. Semistructured interviews were conducted, and data were analyzed using inductive content analysis to derive codes, subcategories, and 4 core categories. Participants were systematically compared across these categories and grouped into personas based on recurring patterns. The personas were then presented with illustrative portraits. Results:A total of 20 participants were included. Four core categories were identified for persona construction: motivation, information access preferences, barriers, and needs. The personas were categorized as follows: patients demonstrating proactive information management and high health literacy, patients exhibiting avoidant information-seeking driven by latent anxiety, patients engaging in family-doctor-mediated information-seeking, and patients displaying dependent and passive information-seeking behavior. Conclusions:Online health information-seeking behavior among patients with prostate cancer receiving ADT is highly heterogeneous and shaped by individual capability, emotional responses, and sociocultural factors. The identified personas may provide a preliminary and practice-oriented framework for developing more differentiated, culturally sensitive, and patient-centered online health information support strategies for patients receiving long-term ADT.

Urinary incontinence is one of the most distressing common symptoms in patients with prostate cancer after surgery. Auriculotherapy has been shown to improve a variety of symptoms effectively and has a certain potential in managing urinary incontinence, but the relevant studies are few and inconclusive. This study aimed to assess the effectiveness of auriculotherapy on urinary incontinence in men with prostate cancer. Participants were recruited from the urology ward of a tertiary hospital between October 2023 and April 2024. A total of 114 men who underwent radical prostatectomy were randomly assigned to the usual care (n = 38), sham-auriculotherapy (n = 38), or true-auriculotherapy (n = 38) groups. All groups received pelvic floor muscle training, and the intervention groups received four additional sham-auriculotherapy or true-auriculotherapy. The primary outcomes were the International Advisory Committee on Urinary Incontinence Questionnaire short form (ICIQSF) score and clinical effective rate, the secondary outcomes included the continence rate, pad usage, urinary incontinence severity, urinary incontinence episodes, and quality of life. Data were collected at week 2, week 4, week 8, and week 12 after surgery. Generalized estimating equations were applied for outcome comparison. The true-auriculotherapy group had significantly lower ICIQSF scores (β = -1.93, 95 www.chictr.org.cn ). The first registration date was 23/05/2023.

TP53 mutations were common genomic alterations in myelodysplastic neoplasms (MDS) and associated with adverse prognosis. While recent studies suggested that TP53 mutations may promote an immunosuppressive microenvironment in MDS and acute myeloid leukemia (AML), the role of T-cell dysregulation in the bone marrow (BM) niche of TP53-mutated MDS remain poorly characterized. Fresh bone marrow were obtained from MDS patients and healthy donors. Flow cytometry was performed to examine the expression of inhibitory checkpoint receptors or stimulatory checkpoint receptors on T-cell subsets. Single-cell RNA sequencing (scRNA-seq) was conducted on magnetically sorted CD3+ T cells to assess transcriptional profiles of T-cell differentiation and exhaustion. Flow cytometry revealed high expressions of checkpoint receptors inT-cell subsets of MDS with TP53mutations We performed comprehensive flow cytometry analyses of bone marrow samples from 108 MDS patients (including 92 with NGS data) and 15 healthy donors. Our analysis demonstrated that neither bone marrow blast percentages nor IPSS-R classification correlated with immune checkpoint expression on CD8+ T cells. However, when stratifying patients by TP53 mutational status, we observed significantly higher percentages of CTLA4+, PD-1+, TIM-3+, LAG3+, and TIGIT+ cells within CD8+ T-cell populations in TP53-mutated MDS patients compared to TP53 wild-type cases or healthy donors. Notably, this checkpoint upregulation pattern was exclusive to TP53 mutations, as no significant associations were observed with other commonly mutated genes in MDS, including TET2, ASXL1 and DNMT3A. Furthermore, parallel alterations were observed in the CD4+ T-cell compartment of TP53-mutated cases. MDS patients with TP53 mutations exhibited markedly elevated frequencies of checkpoint-positive CD4+ T cells compared to wild-type counterparts or healthy donors, including CTLA4+, TIM-3+, and LAG3+ populations. Additionally, the expressions of co-stimulatory molecules including ICOS and 4-1BB on Treg cells were substantially increased in TP53-mutated MDS. ScRNA-seq revealed T-cell differentiation abnormalities and exhaustion signatures inMDS with TP53mutations To gain deeper insight into T-cell landscape within the bone marrow microenvironment, we performed scRNA-seq on isolated CD3+ T cells from 3 healthy donors, 6 TP53 wild-type MDS, and 6 TP53-mutated MDS patients (all included were MDS-BiTP53). Following rigorous quality control, transcriptional profiles of 41,730 CD8+ and 37,256 CD4+ T cells were analyzed. At the transcriptional level, both CD8+ and CD4+ T-cell populations in TP53-mutated MDS demonstrated significantly elevated expression of multiple inhibitory receptors, including CTLA4, PD-1, TIM3, LAG3, and TIGIT. Also, Tregs in TP53-mutated MDS possessed enhanced expression of ICOS and 4-1BB. These findings corroborated our flow cytometry results at the protein level. Further subcluster analysis of T cells revealed a striking reduction in naive CD8+ and CD4+ T-cell frequencies in TP53-mutated cases compared to wild-type controls, suggesting impaired T-cell differentiation potential. Notably, we identified a distinct population of PD-1hi CD8+ memory T cells exhibiting exhausted phenotypes that was significantly expanded in TP53-mutated cases. Similarly, the percentages of PD-1hi CD4+ effector T cells with suppressive markers were obviously elevated in TP53-mutated patients. Moreover, an increased frequency of Treg cells in TP53-mutated MDS was observed, suggesting heightened regulatory activity. Our study revealed that TP53-mutated MDS exhibited profound T-cell dysfunction within the bone marrow microenvironment, including impaired naive T-cell population, expansion of exhausted T-cell subset with elevated checkpoint molecule expression, and enrichment of functionally suppressive regulatory T cells. Our findings collectively suggested that immunomodulatory therapeutic strategies especially targeting checkpoint receptors may be beneficial for MDS with TP53 mutations.

Objective:This study aims to develop an evidence-based auriculotherapy program for reducing urinary incontinence in men after radical prostatectomy. Methods:The Medical Research Council Framework for Developing and Evaluating Complex Interventions was used to guide the intervention development process, which consisted of four stages: (1) establishing the research team; (2) identifying existing evidence; (3) identifying relevant theories; and (4) refining and modeling the program via an expert panel. Results:An initial auriculotherapy program was developed based on available evidence from three practice standards, eight books, nine reviews, and two clinical trials. The Delphi study confirmed excellent consensus, with all items scoring ≥ 3.5 and a coefficient of variation < 0.25. The final auriculotherapy program comprises true-auriculotherapy and sham-auriculotherapy, each including six key components: (1) auricular acupoints, (2) auricular acupoints location, (3) auriculotherapy modality, (4) auricular sticking techniques, (5) auricular acupressure techniques, and (6) auriculotherapy dosage. Conclusions:This study develops an evidence-based and theory-driven auriculotherapy for postprostatectomy incontinence management, which will be further implemented in clinical settings to confirm its effectiveness. The methodology described in this study may provide implications for future studies to develop complex interventions in the field of alternative therapies. Trial registration:ChiCTR2300071700.

Objective:To evaluate the effectiveness of digital therapeutics for rehabilitation of urinary incontinence. Methods:Seven electronic databases were searched for randomized controlled studies investigating the effectiveness of digital therapeutics on urinary incontinence, reporting outcomes on urinary incontinence severity, adherence, the patient global impression of improvement (PGI-I), quality of life, and pelvic floor muscle function. The literature was reviewed, and the risk of bias was assessed. Meta-analysis was then conducted for each outcome using RevMan 5.4 and Stata 18.0. Results:A total of 18 studies were included, involving 2308 individuals with urinary incontinence. Meta-analysis showed significant difference in urinary incontinence severity (SMD = -0.30, 95%CI: -0.53 to -0.07, P = 0.010), adherence (SMD = 1.79, 95%CI: 0.74-2.84, P = 0.0008), and PGI-I (RR = 1.70, 95%CI: 1.12-2.58, P = 0.010) between digital therapeutics compared with any type of control. However, the results showed no significant difference in quality of life and pelvic floor muscle function (all P > 0.05). Conclusion:This review suggests that digital therapeutics-based interventions may be significantly more effective than controls in alleviating urinary incontinence severity, enhancing adherence and improving PGI-I. However, due to the evidence quality, confidence in these findings is low. Therefore, future research should generate more robust evidence to validate the effectiveness of digital therapeutics on rehabilitation of urinary incontinence.

Background: Der(1;7)(q10;p10)[der(1;7)] as a recurrent unbalanced translocation in MDS has steadily gained attention. The direct consequence of this karyotype alteration is +1q and 7q-;however, accumulating evidence supports that der(1;7) is distinct from 7q- in clinical and molecular features, representing a unique MDS subtype. However, the transcriptomic features of these patients remain largely unknown. Although previous bulk-RNA seq results have revealed dysregulated oncogene and tumor suppressor gene expression due to dosage effects in der(1;7) MDS, the limitations of bulk sequencing technology prevent direct association of these findings with der(1;7)-aberrant cells. In this study, we applied scRNA-seq in der(1;7) MDS to perform in-depth analysis at single-cell resolution, providing novel insights into der(1;7) hematopoietic development, disease progression mechanisms, and key molecular pathways. Methods: This study analyzed bone marrow mononuclear cells (BMMCs) using bulk RNA-seq and 10X scRNA-seq approaches. Bulk RNA-seq was performed on 156 MDS patients, including 7 cases with der(1;7), while scRNA-seq was conducted on 4 der(1;7) MDS cases, 2 secondary acute myeloid leukemia (sAML) cases with der(1;7), 3 healthy donors, and 2 MDS patients with normal karyotypes as controls. We utilized the CopyKat algorithm to identify cells harboring der(1;7) and CellChat was used to characterize the intercellular communication networks. Results: Principal component analysis (PCA) of transcriptomic data from MDS patients with different karyotypes revealed that der(1;7) MDS patients clustered more tightly, indicating relatively reduced internal heterogeneity and distinct gene expression patterns. Enrichment analysis of the top 100 genes with the most negative loadings on PC1 revealed that inflammatory activation and immune dysregulation are characteristic changes in der(1;7) MDS. At single-cell resolution, we observed that overexpressed genes in most der(1;7) positive cell subsets were enriched in multiple inflammation- and immune-related pathways, with interferon-mediated inflammatory pathways being particularly prominent. Notably, we observed similar results in CNV neutral cells[der(1;7) WT], suggesting that inflammatory pathway activation may result from bone marrow microenvironment remodeling mediated by pro-inflammatory factors such as IFN and IL-6. Given the importance of IFN-γ and IL-6 in der(1;7) MDS, we identified IFN-γ primarily originated from CD8+ effector T cells in der(1;7) MDS, and the EGR1+ ACB as the main cell subset with detectable IL-6 expression. Similar to recent findings in iMCD, we discovered that monocytes in der(1;7) MDS, particularly der(1;7)-positive subsets, receive IL-6 signals from B cells and IFN-γ signals from T cells, with higher IL-6 and IFN-γ response pathway activities accompanied by elevated cytokine production and inflammatory pathway scores. 1q gain played a crucial role in this process, not only enhancing sensitivity to pro-inflammatory signals through upregulation of IL-6R (1q21) expression but also further amplifying pro-inflammatory effects through upregulation of S100A family genes expression(1q21). The stability of gene dosage effects caused by der(1;7) karyotype during progression implies that advancement is not driven by additional cytogenetic evolution, but by the amplification of effects under selective pressure. The anti-apoptotic gene MCL1 located on 1q showed upregulation compared to CNV neutral cells across different stages in der(1;7) patients, suggesting that these anti-apoptotic properties conferred by 1q gain may be important intrinsic factors for der(1;7) cells competitive advantage in the inflammatory microenvironment. Conclusion: This study, our comprehensive analysis reveals the critical role of IFNG/IL-6-mediated inflammation in der(1;7) MDS and identifies a special pro-inflammatory network in BM microenvironment remodeling. Additionally, we demonstrate the importance of 1q gain in maintaining der(1;7) clonal dominance, which represents a potential therapeutic vulnerability.

BACKGROUND:Global aging is a significant public health challenge. Social determinants of health are crucial in shaping healthy aging trajectories by influencing intrinsic capacity, a key indicator of functional ability and well-being in older adults. However, the association between social determinants of health and intrinsic capacity trajectories remains underexplored. This study examines the associations between social determinants of health and intrinsic capacity trajectories among Chinese community-dwelling older adults. PARTICIPANTS AND SETTING:Community-dwelling adults aged ≥60 years from the China Health and Retirement Longitudinal Study (2011-2015). METHODS:Bifactor models of intrinsic capacity were constructed. Multigroup confirmatory factor analysis was used to test the longitudinal measurement invariance of intrinsic capacity. Growth mixture modeling was performed to identify distinct intrinsic capacity trajectory classes, and multivariate logistic regression was employed to determine the social determinants of health associated with these classes. RESULTS:A total of 5798 community-dwelling older adults were included. Four distinct intrinsic capacity trajectory classes were identified: high-increasing (20.6 %), medium-maintaining (37.1 %), medium-decreasing (29.0 %), and low-decreasing (13.3 %). Compared with the high-increasing trajectory, illiteracy, low-middle income, no social activities, being separated/divorced/widowed/never married, smoking, non-drinking, low physical activity, rural residence, non-age-friendly home environment, and no health insurance were associated with a higher likelihood of belonging to the low-decreasing trajectory. CONCLUSIONS:These findings provide evidence for the early identification of heterogeneous intrinsic capacity trajectories and support the implementation of stratified intervention strategies.

Background: In patients with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), the presence of a complex karyotype (CK) consistently indicates a poor prognosis, a low response rate to treatment, a high risk of transition to relapse or refractory disease, and an urgent need for more effective therapeutic options. When TP53 mutations are present in conjunction with CK, the prognosis is further worsened, and treatment becomes more challenging. Consequently, could MDS and AML with complex karyotypes and TP53 mutations be classified into a single category for clinical diagnosis, treatment, and management? Methods: The clinical characteristics and survival outcomes of 151 patients with MDS or AML with CK who were first diagnosed in our center from January 2021 to December 2022 were collected. Overall survival (OS) was calculated from the date of diagnosis to the date of death or the last date of follow-up. Next generation sequencing (NGS) was used to detect gene mutations. TP53 mutations were considered to be multi-hit if either 2 different TP53 mutations, a single TP53 mutation with VAF≥50%, or a single TP53 mutation with -17/17p- on karyotype were present. Results: A total of 151 patients with complex karyotypes were included in the study, including 82 MDS and 69 AML. Compared with AML, MDS patients had lower hemoglobin (69.5 g/L vs 75.0 g/L, P=0.012) and higher absolute neutrophil count (1.09×10e9/L vs 0.72×10e9/L, P=0.007). Age and sex ratio were not significantly different between MDS and AML subgroups. Also, there was no significant difference in OS between MDS and AML in the context of complex karyotype. TP53 mutations were detected in 69.5% (105/151) of the patients, with a median VAF value of 46.1%; The median VAF of TP53 in MDS patients was significantly lower from that in AML patients (43.1% vs 58.1%, P=0.017). However, as for TP53 mutation types, there was no significant difference between MDS and AML (P=0.58). Also, there was no significant difference in OS between MDS and AML in TP53 mutations (MT) (8.8 months vs 4.6 months, P=0.06) or in TP53 wild type (WT) (21.7 months vs NR, P=0.20). However, both the presence of TP53 mutations significantly shortened OS than TP53 WT in MDS and AML patient (MDS: 21.7 months vs 8.8 months, P=0.002; AML: NR vs 4.6 months, P<0.0001). Furthermore, among MDS and AML with CK, there was no statistical difference in OS among the groups according to the proportion of bone marrow (BM) blasts 0-9%, 10-19%, 20-29%, and ≥30% (P=0.07), which indicated that the impact of BM blasts on prognosis would be less important when CK combined with TP53 mutation. COX multivariate regression analysis included age, gender, TP53 mutation, hemoglobin, absolute neutrophil count, platelet, BM blasts, and myelofibrosis as research variables. Results showed that only TP53 mutation was an independent adverse prognostic factor (P＜0.001, HR 4.58, 95% CI 2.24-9.3). These results suggest that patients with TP53 mutations have a worse prognosis in both MDS and AML with complex karyotypes. Moreover, we compared TP53 mono-hit with multi-hit, and the results showed that the OS of TP53 multi-hit was significantly worse than that of TP53 WT in both MDS and AML (21.7 months vs 8.0 months, P<0.0001; NR vs 5.5 months, P<0.0001). Of note, OS of TP53 mono-hit was not significantly different from that of TP53 WT in MDS (21.7 months vs 12.2 months, P=0.08), while in AML were significantly worse than TP53 WT (NR vs 2.4 months, P=0.0002). This suggests that although patients with TP53 mutations have a poor prognosis for both MDS and AML, TP53 mono-hit has limited prognostic impact in MDS patients. Conclusions: Our study shows that in the context of complex karyotypes, the presence of TP53 mutations (especially TP53 multi-hit) could distinguish a class of highly homogenous myeloid neoplasms in which the proportion of BM blasts is no longer an independent prognostic factor. This discovery might define a novel category of disease entities that could more precisely guide treatment options.

Objective To compare the effects of exercise-based interventions on cardiometabolic health and fatigue in men with prostate cancer receiving androgen deprivation therapy (ADT). Methods A comprehensive search for Randomized controlled studies (RCTs) was performed in Pubmed, Embase, EBSCO, Web of science, Scopus, Cochrane library, Wanfang database, China National Knowledge Infrastructure (CNKI), VIP from their inception to May 2025. Meta-analysis and network meta-analysis was then conducted for each outcome using RevMan 5.4 and R 4.5.1. Results A total of 22 RCTs were included, involving 1579 patients with prostate cancer receiving ADT. The results of the meta-analysis indicated that exercise can significantly enhance cardiometabolic health and alleviate fatigue in men with prostate cancer receiving ADT. And the network meta-analysis showed that RET (Resistance Exercise Training) (SUCRA: 75.21%, 83.60%) was the most effective exercise for improving the whole-body fat mass and whole-body fat percentage; Home-based AET (Aerobic Exercise Training) + RET (SUCRA: 94.46%) were the most effective exercise in alleviating fatigue. Moreover, improvements in whole-body fat mass and whole-body fat percentage were proportional to the duration of the intervention. However, the optimal duration and frequency for improving fatigue still require further exploration. Conclusions Network meta-analysis results show that the optimal exercises for improving cardiometabolic health and alleviating fatigue are RET and Home-based AET + RET. However, the certainty of this evidence is very low; further studies are required to identify the optimal type, duration, and frequency of exercise for improving cardiometabolic outcomes and fatigue in men with prostate cancer receiving ADT. Systematic review registration PROSPERO (CRD420251047818).

Auriculotherapy has become a promising complementary therapy and is widely used to manage various symptoms and diseases. However, little is known about patients’ knowledge and attitudes. This study aimed to identify and synthesize the factors that influence acceptance and adherence related to auriculotherapy from patients’ perspectives. The thematic synthesis developed by Thomas and Harden was applied to guide this review. Six common English databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, and PsycINFO) and four common Chinese databases (CNKI, VIP, WangFang, and Sinomed) were searched in December 2023. The quality of the included studies was assessed using the Critical Appraisal Skills Programme. Data synthesis was conducted using the theoretical domains framework. Ten studies with eleven publications were included. Twenty-four barriers and fourteen facilitators on patients’ acceptance and adherence to auriculotherapy were identified under nine of the theoretical domains framework domains. Among these domains, “knowledge (n = 2)”, “memory, attention and decision processes (n = 2)”, and “environmental context and resources (n = 5)” reported only barriers. Besides, the most frequently mentioned domains in the included studies were “beliefs about consequences (n = 10)” and “emotions (n = 6)”. Our findings provide a comprehensive overview of the factors affecting the patients’ behavior in receiving and complying with auriculotherapy, which may help healthcare professionals deeply understand the factors that influence patients’ intentions to use auriculotherapy and better interact with them. Further research that addresses these modifiable factors and develops relevant interventions may aid in meeting the growing use of auriculotherapy by patients. This study was registered with PROSPERO in Dec 2023 (Registration number: CRD42023488856).

To identify and quantify the influence factors of fear of cancer recurrence among prostate cancer patients through meta-analysis. A systematic review and meta-analysis followed by the PRISMA2020 checklist. We searched PubMed, Web of Science, Cochrane Library, Embase, CNKI, CMAPH, VIP, and Wanfang databases, along with manual retrieval, to identify relevant studies published from 1981 to November 2023. Two independent reviewers screened the literature, extracted data, and assessed study quality. Meta-analysis was conducted using R 4.2.3 software. A total of 5031 studies were identified through database searches and manual retrieval. After removing duplicates and screening titles, abstracts, and full texts, 19 studies met the inclusion criteria and were included in the final analysis. The meta-analysis revealed a significant association between fear of cancer recurrence among prostate cancer patients and age (odds ratio = 0.9084), partnership (1.0462), income (0.9076), employment status (1.0799), education (0.8146), treatment (2.0567), time since diagnosis (1.5252), stage of disease (1.6895), biochemical recurrence (3.2214), hormone function (0.8042), urinary function (1.1271), Gleason score (2.9419), quality of life (0.5704), self-rated health (0.6711), social support (1.2149), anxiety (2.1002), depression (2.8319), negative emotion (2.0835), and hope level (1.2363). Our findings considerably enhance the understanding of the influencing factors of fear of cancer recurrence of patients with prostate cancer. The insights this study provides can enable health-care providers to apply quick and effective assessment tools to identify high-risk patients with fear of cancer recurrence early and thereby support the personalized interventions to reduce it, promoting overall health.

Objective To explore Fear of cancer recurrence (FCR) profiles in prostate cancer survivors, identify heterogeneous subgroups, and examine influencing factors to provide a reference for improving mental well-being and overall quality of life. Methods A convenience sample of 389 patients completed a questionnaire that assessed general and disease-related data, including the Fear of Progression Questionnaire-Short Form, Perceived Social Support Scale, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Statistical analysis involved latent profile analysis (LPA), Bolck-Croon-Hagenaars methods and multinomial logistic regression. Results Three FCR profiles were identified: “Adapted” (25.7%), “Struggling” (42.2%), and “Dysregulated” (32.1%). Compared to the Adapted group, factors associated with the Struggling group included age, social support, and employment status, while factors associated with the Dysregulated group included age, social support, and time since diagnosis. From Adapted to Dysregulated, physical, cognitive, emotional, and social function declined, while dyspnea, insomnia, and financial difficulties increased. Conclusions The psychological problems caused by the FCR in patients with prostate cancer seriously affect their physical, emotional, cognitive and social functions. Targeted intervention strategies should be developed for different categories of patients with prostate cancer to improve the FCR and promote the health-related quality of life.

BACKGROUND:Artificial intelligence-based conversational agents (CAs) have shown transformative potential in healthcare, yet their application in cancer health education has remained underexplored, particularly regarding usability and patients' experiences. Existing reviews lack a dedicated focus on user perspectives, limiting insights into how CAs can be optimised for patient needs. AIM:To explore the usability and experience of artificial intelligence-based conversational agents in health education for cancer from the user perspective. DESIGN:A scoping review was conducted with the Joanna Briggs Institute Scoping Reviews conduct guidance and reported according to the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist. METHODS:A search was performed in PubMed, Embase, CINAHL, Web of Science, PsycINFO, IEEE Xplore Digital Library and ACM Digital Library from their inception to March 6, 2024. The references to the articles included were also searched. The Pillar Integration Process was employed to chart data. RESULTS:A total of 12 studies were included in this scoping review, which revealed that CAs supported diverse educational contexts, including cancer-related knowledge (41.7%), pretest genetics (33.3%), self-management (16.7%) and psychological skills (8.3%). Three studies reported that patients preferred interactions with multiple options or 'read more' functions. Patients were generally optimistic about the CAs and reported that CAs provided informational, physical, and psychological support for them. However, limitations such as insufficient customisation, lack of empathy, and defects in understanding free-input questions were noted. CONCLUSION:This review demonstrated that CAs are promising complementary tools in cancer education, alleviating healthcare burdens while enhancing patient engagement, which was particularly critical in resource-limited settings. However, clinical implementation requires more rigorous validation of safety protocols and high-quality original studies. RELEVANCE TO CLINICAL PRACTICE:Nurses and policymakers should consider CAs valuable tools to enhance cancer health education, provided that they align with patient needs and institutional safety standards.

To evaluate the effectiveness of a proactive health intervention in reducing symptoms, enhancing self-efficacy, and improving self-management capabilities in prostate cancer survivors. A single-blind randomized controlled trial was conducted with 200 prostate cancer survivors at a tertiary hospital in Zhejiang Province. Participants were randomly assigned to either the intervention group (n = 95), which received a 3-month proactive health management program based on five health modules with online and telephone follow-up, or the control group (n = 97), which received routine telephone follow-up care. Outcomes were assessed at baseline, 1 month, and 3 months post-discharge, focusing on prostate cancer symptoms, self-care ability, self-efficacy, and psychological well-being. Compared to the control group, the intervention group showed significant improvements in prostate cancer symptoms (95

To evaluate the effect of middle meningeal artery embolization (MMAE) on chronic subdural hematoma (CSDH). The authors enrolled consecutive patients with CSDH who underwent burr hole craniostomy (BHC) between January 2020 and February 2023. The primary outcome was recurrence rate, defined as an increase of hematoma width on imaging compared with the immediate postoperative imaging at a 3-month follow-up. Secondary outcomes included the rate of complications and adverse prognosis. Cohorts were balanced using 1:2 propensity score matching (PSM). A total of 271 patients were eligible for this study and divided into the MMAE group (n=23) and the BHC group (n=205). Compared with the BHC group, there was more use of anticoagulant or antiplatelet medication (47.8% vs 22.4%, P=0.008), bilateral hematoma (19.5% vs 19.5%, P=0.043), and hematoma with septations (47.8% vs 21.5%, P=0.005) in the MMAE group. After PSM, 64 cases were finally successfully matched. The logistic analysis result showed that MMAE was associated with the decreased recurrence rate of CSDH in the cohort after PSM (OR 0.072, 95% CI: 0.322~0.746, P=0.028) but not with the improved clinical prognosis (OR 0.065, 95% CI: 0.533~4.786, P=0.562). MAAE has a positive therapeutic effect on reducing the recurrence rate of CSDHs as an adjunct postoperative treatment after burr hole surgery.

Introduction Prostate cancer is the most common malignant disease within the male genitourinary system. Advances in cancer screening and treatment have significantly ameliorated the survival rates of patients with prostate cancer. Nonetheless, prostate cancer survivors report various degrees of cancer-related symptoms. These symptoms cause physiological and psychological suffering, leading to a deterioration of quality of life. Web-based interventions may facilitate the management of symptoms due to their flexibility, accessibility and convenience. However, the efficacy of web-based interventions in reducing symptom burden remains to be confirmed. Consequently, this systematic review and meta-analysis aims to comprehensively synthesise existing evidence, evaluate the effectiveness of web-based interventions in reducing symptom burden among patients and furnish a reference for clinical practice.Methods and analysis This protocol strictly adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol guidelines. We will comprehensively search six databases (PubMed, Web of Science, Cochrane, Embase, CINAHL and PsycINFO) from their inception to March 2024 in order to identify clinical trials on the efficacy of web-based interventions for prostate cancer survivors. Two reviewers will independently conduct study selection, data extraction and quality assessment. The risk bias of included studies will be assessed using the Cochrane Risk of Bias Tool for randomised trials 2.0, and the strength of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) guideline. Meta-analysis will be performed using STATA V.16.0, and the effect size will be calculated using the standardised mean difference and its 95% CI. Heterogeneity will be assessed using Cochran’s Q statics and inconsistency will be measured using the I2 statistics. Potential sources of bias will be evaluated.Ethics and dissemination Ethics approval is not required for this review as no human participants will be involved. The results will be disseminated via a peer-reviewed journal or an academic conference.PROSPERO registration number CRD42023457718.

PURPOSE:To evaluate the available evidence regarding the quality of life (QoL) in patients with acromegaly, by synthesizing the psychosocial factors of QoL, QoL measures, and complementary interventions targeting QoL. METHODS:A scoping review was conducted using the PRISMA-ScR guideline. We searched six English databases (PubMed, Embase, CINAHL, Scopus, Web of Science, and the Cochrane Library) from the inception to August 21, 2023. We included observational studies involving psychosocial factors and complementary interventions targeting QoL (concept) in patients with acromegaly (population) in any setting (context). The design characteristics, psychosocial factors, measures, details of interventions, and outcomes of included studies were described in detail. RESULTS:Twenty-one studies were identified, including sixteen cross-sectional studies and five interventional studies. Ten categories of psychosocial factors that are associated with QoL in acromegaly. Depression and anxiety were the most frequent psychosocial factors. Seven different validated QoL measures were used. AcroQoL was the most common measure. Two categories of complementary interventions targeting QoL were identified including psychological and exercise interventions. CONCLUSIONS:Our scoping review provides a reasonably clear picture of the current research status of QoL in acromegaly. However, this review also highlights the need to deepen understanding of QoL and psychosocial factors in the future, as well as conduct longitudinal research and qualitative research to clarify the changing trends of psychosocial factors and specific experiences of patients. Further, more potential clinical complementary interventions are needed to improve QoL for patients with acromegaly.

Abstract Objective: Patients undergoing surgery are at high risk of developing venous thromboembolism (VTE). This study aimed to determine the predictive value of risk factors for VTE in surgical patients and to develop a prediction model by integrating independent predictors. Methods: A total of 1,111 patients who underwent surgery at clinical departments in a tertiary general hospital were recruited between May and July 2021. Clinical data including patient-related, surgery-related, and laboratory parameters were extracted from the hospital information system and electronic medical records. A VTE prediction model incorporating ten risk variables was constructed using artificial neural networks (ANNs). Results: Ten independent factors (X1: age, X2: alcohol consumption, X3: hypertension, X4: bleeding, X5: blood transfusions, X6: general anesthesia, X7: intrathecal anesthesia, X8: D-dimer, X9: C-reactive protein, and X10: lymphocyte percentage) were identified as associated with an increased risk of VTE. Ten-fold cross validation results showed that the ANN model was capable of predicting VTE in surgical patients, with an area under the curve (AUC) of 0.89, a Brier score of 0.01, an accuracy of 0.96, and a F1 score of 0.92. The ANN model slightly outperformed the logistic regression model and the Caprini model, but a DeLong test showed that the statistical difference in the AUCs of the ANN and logistic regression models was insignificant (P>0.05). Conclusion: Ten statistical indicators relevant to VTE risk prediction for surgical patients were identified, and ANN and logistic regression both showed promising results as decision-supporting tools for VTE prediction.