Prostate androgen receptor: immunohistological localization and mRNA characterization

Four androgen receptor (AR) specific monoclonal antibodies were used for the immunohistochemical localization of AR in the human prostate tissue. The prostate tissue consisted of alveoli embedded in fibromuscular stroma and lined with a single layer of columnar secretory epithelial cells. The immunoreactive ARs were found predominantly in the nuclei of epithelial cell, suggesting ARs, like estrogen receptors and progesterone receptors, are mainly nuclear proteins. Northern blot hybridization showed that AR mRNA is about 9 kilobases (kb) and relative abundant in the androgen-sensitive organs, such as ventral prostate, dorsolateral prostate and seminal vesicle.

Response to high-dose interferon-alpha after failure of standard therapy in MPGN associated with hepatitis C virus infection

A 42-year-old man developed mixed cryoglobulinemia secondary to hepatitis C virus (HCV) infection with hypocomplementemia and nephrotic syndrome. His renal biopsy showed membranoproliferative glomerulonephritis type I (MPGN). Despite treatment with interferon-alpha, three million units three times a week for a total of 6 months, the patient continued to have hypocomplementemia, cryoglobulinemia, and nephrosis. After a course of high-dose interferon-alpha treatment consisting of ten million units daily for 2 weeks followed by 10 million units three times per week for an additional 6 weeks, HCV RNA and cryoglobulin testing became negative, complement levels increased to normal levels, and nephrotic syndrome remitted. This case confirms an association between HCV infection and MPGN and suggests a role for high-dose interferon-alpha treatment when conventional interferon therapy fails.

Regulation of MMP 2 and MMP 9 expressions modulated by AP-1 (c-jun) in wound healing: improving role of Lucilia sericata in diabetic rats

AIMS

Lucilia sericata larvae have been successfully used on healing of wounds in the diabetics. However, the involvement of the extraction/secretion (ES) products of larvae in the treatment of diabetic wounds is still unknown. Activator protein-1 (AP-1) transcription, composed of c-jun and c-Fos proteins, has been shown to be the principal regulator of multiple MMP transcriptions under a variety of conditions, also in diabetic wounds. Specifically, MMP-2 and MMP-9's transcriptions are known to be modulated by AP-1. c-jun has been demonstrated to be a repressor of p53 in immortalized fibroblasts. The aim of the present study is to investigate the effects of L. sericata ES on the expression of AP-1 (c-jun), p53, MMP-2, and MMP-9 in wound biopsies dissected from streptozotocin induced diabetic rats.

METHODS

The expression levels of MMP-2, MMP-9, c-jun and p53 in dermal tissues were determined at days 0, 3, 7 and 14 after wounding, using immunohistochemical analysis and quantitative real-time PCR.

RESULTS

The treatment with ES significantly decreased through inflammation-based induction of MMP-2 and MMP-9 expression levels in the wounds of diabetic groups, compared to control groups at the third day of wound healing. At the 14th day, there were dramatic decreases in expression of c-jun, MMP-9, and p53 in ES-treated groups, compared to the diabetic group (P < 0.001, P < 0.05 and P < 0.01, respectively).

CONCLUSION

ES products of L. sericata may enhance the process of wound healing in phases of inflammation, proliferation, and re-epithelization, essentially via regulating c-jun expression and modulating MMP-2 and MMP-9 expressions.

Anti-cancer effect of metformin on the metastasis and invasion of primary breast cancer cells through mediating NF-kB activity

Current evidence strongly suggests that aberrant activation of the nuclear factor kappa B (NF-kB) signaling cascade is connected to carcinogenesis. The matrix metalloproteinases (MMP) which are also the key agents for tumor metastasis may be potent candidates for tumor diagnosis in clinics. In this in vitro study, we hypothesized that metformin with an effective dose can inhibit tumor cell proliferation and metastasis by modulating the expressions of MMP-2 and -9 and interfering with NF-kB signaling in primary breast cancer cells (PBCCs). 300 000 cells per ml were obtained from biopsies of breast tumors from five human donors. The cell viability and proliferation were tested. Immunocytochemistry was performed for MMP-2, MMP-9, and NF-kB, and enzyme-linked immunosorbent assay for NF-kB activity, quantitative real-time PCR for RELA/p65, IkBα, MMP-2, and MMP-9. Three different doses of metformin (5, 10, and 25 mM) (Met) reduced the viability and proliferation of PBCCs in a dose-dependent manner, maximum inhibition was observed at 25 mM Met. The expression of RELA/p65 was not affected by 25 mM Met. Nuclear immunoreactivity and activity of NF-kB reduced while cytoplasmic NF-kB (p65) elevated by 25 mM Met compared to non-treatment (P <  0.05). The expression and immunoreactivity of MMP-9 but not MMP-2 were decreased by 25 mM Met treatment, compared with the non-treatment (P <  0.05). Metformin may have an essential antitumor role in the invasion and metastasis pathways of PBCCs by downregulating the MMP-9 expression blocking both the activity and nuclear translocation of NF-kB.

Alexithymia in Diabetes Mellitus

Background

Diabetes mellitus is a chronic, progressive disease with complex therapy protocols requiring major coping efforts from patients to achieve and maintain glycaemic control in order to reduce risk of diabetic complications. Disease coping strategies including good knowledge of diabetes and high ability of self-care have been reported to be impaired by alexithymic features. Alexithymia is a psychological construct characterised by inability to express emotions verbally, poor imagination and operational thinking, leading to failure in psychological self-regulation.

Objective

To compare prevalence of alexithymia and mean Toronto Alexithymia Scale-26 (TAS-26) scores in diabetic patients with non-diabetic controls; to investigate the association of alexithymia with glycemic control in diabetes.

Method

In this cross- sectional study, TAS-26 scores of 193 diabetic patients and 49 non-diabetic controls were compared. Disease related factors were obtained from patient records. Alexithymia was used as a continuous (mean TAS-26 scores) and semi-quantitative (dichotomised into non-alexithymic 11>TAS-26 scores>11 and alexithymic individuals) variable. Descriptive data are presented as mean±SD, median (range) or %. Differences in means were compared via Independent-Samples T Test and One-Way ANOVA. Proportions were analysed with chi-square test and odds ratios (OR) were calculated via cross tabulation with a confidence interval (CI) of 95%. P<0.05 was considered statistically significant.

Results

The control group was similar with respect to age, gender and education with the diabetic group. In the diabetic study population (n=193, male/female: 42/58%, age 54.2±14.0 years, median diabetes duration 7 years (1-32 years), postprandial blood glucose (PBG) 243±110 mg/dl, HbA1c 7.3±3.6%) prevalence of alexithymia was significantly higher than in the control group (65 % in diabetics vs. 45 % in controls, p=0.011; mean TAS-26 score 12.3±3.7 vs. 10.6±3.6, p=0.004, respectively). Poor postprandial glycaemic control (p=0.002), female gender (p=0.026), combination therapy (p=0.037) and poor educational level (p=0.005) were positively associated with TAS-26 scores in diabetic individuals. Alexithymic diabetic patients were less educated (OR=1.2, p=0.046) and under worse glycaemic control (OR=2.4, p=0.005) compared to their non-alexithymic counterparts.

Chronic regulation of transepithelial Na+ transport by the rate of apical Na+ entry

In several settings in vivo, prolonged inhibition of apical Na+ entry reduces and prolonged stimulation of apical entry enhances the ability of renal epithelial cells to reabsorb Na+, an important feature of the load-dependent regulation of renal tubular Na+ transport. To model this load dependency, apical Na+ entry was inhibited or stimulated for 18 h in A6 cells and vectorial transport was measured as short-circuit current (Isc) across monolayers on filter-bottom structures. Basal amiloride-sensitive Isc represents the activity of apical Na+ channels, whereas Isc after permeabilization of the apical membrane to cations with nystatin represents maximal activity of the basolateral Na(+)-K(+)-ATPase. Chronic inhibition of apical Na+ entry by 18-h apical exposure to amiloride or replacement of apical Na+ with tetramethylammonium (TMA+), followed by washing and restoration of normal apical medium, revealed a persistent decrease in Isc that remained despite exposure to nystatin. Both basal and nystatin-stimulated Isc recovered progressively after restoration of normal apical medium. In contrast, chronic stimulation of apical Na+ entry by short circuiting the epithelium increased Isc in the absence and presence of nystatin, indicating upregulation of both apical Na+ channels and basolateral Na(+)-K(+)-ATPase. Basolateral equilibrium [3H]ouabain binding was reduced to 67 +/- 5% in TMA+ vs. control cells, whereas values in 18-h short-circuited cells increased by 42 +/- 19%. The results demonstrate that load dependency of tubular Na+ transport can be modeled in vitro and indicate that the regulation of Na(+)-K(+)-ATPase observed in these studies occurs in part by changes in the density of functional transporter proteins within the basolateral membrane.

Lumbosacral plexopathy after dual kidney transplantation

A 58-year-old man underwent dual kidney transplantation. He was unable to move his right leg after surgery. This was caused by extensive lumbosacral plexopathy on the side of surgery. Lumbosacral plexopathy after kidney transplantation is uncommon, because the plexus has rich anastomotic blood supply, and ischemic injury is unlikely. However, isolated femoral neuropathy after renal transplantation has been reported, as the distal portion of this nerve is supplied by branches of internal iliac artery only and is more prone to ischemic injury during surgery. Dual-kidney transplantation involves a larger dissection, and the procedure takes 60 to 90 minutes longer than single-kidney transplantation. It involves more vascular reconstruction. This may predispose the lumbosacral plexus to ischemic injury. To the best of our knowledge, this is the first reported case of lumbosacral plexopathy after a dual kidney transplantation, and this may be seen more frequently because this procedure is becoming more common.

Prognostic factors in 161 patients with mucosal melanoma: a study of German Central Malignant Melanoma Registry

BACKGROUND

Mucosal melanoma is a rare malignancy which represents approximately 1% of all melanomas. It is shown that mucosal melanomas have a different biology and less favourable prognosis than its cutaneous counterpart.

OBJECTIVES

Predictive and prognostic factors of survival for mucosal melanoma have not yet been elucidated. The aim of this study was to investigate risk factors affecting the course of mucosal melanoma patients followed in our clinic.

METHODS

One hundred and sixty-one patients with mucosal melanoma prospectively documented in the German Central Malignant Melanoma Registry (CMMR) were included in this study. Gender, age, localization, stage at first medical examination, tumour thickness and mutational status were documented. The American Joint Committee on Cancer (AJCC), 7th edition was used to define tumour stage. Kaplan-Meier survival curves were evaluated compared with the log-rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors.

RESULTS

According to the localization, patients were categorized in 44.7% oral-nasal, 28.6% genital, 20.5% anorectal and 6.2% visceral. Genital mucosal melanomas had the most favourable 5-year OS rate (58.6%) followed by visceral (58.3%) and oral-nasal (39.3%). Anorectal melanomas had the worst OS time (median: 21 ± 4.8 months) and 5-year survival rate (22.7%). Patients <60 years had a better survival than the older group (P = 0.013). Tumour stage at the time of the first medical examination was also a significant factor for survival (P = 0.001). Gender and mutational status were found to have no effect on survival. Age (<60 years vs. ≥60 years; HR = 2.1) and stage at first medical examination (Stage I vs. Stage IV; HR = 8.2) are shown to be significant independent prognostic factors on multivariate Cox regression analysis, but not localization.

CONCLUSION

In this study, we observed that older age and advanced stage have significant negative effects on the survival of mucosal melanoma. Thus, the AJCC staging system is applicable for mucosal melanoma.

Metformin reverses the effects of high glucose on human dermal fibroblasts of aged skin via downregulating RELA/p65 expression

Metformin has been successfully used as an anti-aging agent but exact molecular mechanisms of metformin in anti-aging remain unknown. Hyperglycemia during skin aging not only causes oxidative damage to cellular macromolecules, like dermal collagen, but also modulates the activation of transcription factor nuclear factor kappa B (NF-kB). We aimed to investigate in vitro effects of high glucose (HG) and metformin treatment on proliferation and apoptosis of human primary dermal fibroblasts (HDFs), and the expression of COL1A1, COL3A1, and RELA/p65 genes. Effects of normal glucose (5.5 mM) and HG concentration (50 mM HG) on HDFs, with two doses of metformin (50 μM and 500 μM), were investigated by immunostaining. Apoptotic levels were analyzed by flow cytometry. Expression of COL1A1, COL3A1, and RELA/p65 genes was measured by quantitative real-time PCR. The proliferation of HDFs was decreased significantly (P < 0.01) and expression of COL1A1 was downregulated by HG without metformin, whereas proliferation was elevated and expression was upregulated with 500 μM metformin + HG compared to 5.5 mM glucose (P < 0.05). The expression of COL3A1 and RELA/p65 were upregulated (P < 0.01 for COL3A1), and percentage of late apoptotic cells increased significantly by HG without metformin (P < 0.001) while it decreased in two concentrations of metformin dramatically compared with 5.5 mM glucose (P < 0.01 for expressions and < 0.001 for apoptosis). Metformin not only significantly downregulated RELA/p65 expression, but also inhibited the apoptosis of HDFs from aged human skin at toxic glucose concentrations which could be inversely mediated via COL1A1 and COL3A1 expression.

Metformin suppresses the proliferation and invasion through NF-kB and MMPs in MCF-7 cell line

Objective

MCF-7 cells, a breast cancer cell line, are used for experiments of estrogen receptor (ER)-positive breast cancer and many sub-clones representing different classes of ER-positive tumors. We aimed to determine the efficacy of metformin, a potential anti-cancer agent, on the cell proliferation, and the expressions of NF-kB (p65), MMP-2 and MMP-9 in MCF-7 cell line.

Materials and methods

MCF-7 cells (human breast adenocarcinoma) were treated with elevating doses of metformin (0–50 mM) for 24 h. The anti-proliferative effect of metformin was studied by BrdU proliferation assay, and the expression levels of NF-kB (p65), MMP-2 and MMP-9 were analyzed by immunocytochemical staining.

Results

The percentage of cell proliferation was reduced significantly by 10 and 50 mM doses of metformin (p < 0.001). The expression levels of nuclear NF-kB (p65), MMP-9 and MMP-2 were considerably reduced in 50 mM metformin treated cells while the expression of cytoplasmic NF-kB (p65) elevated compared to control group (p < 0.05). Ten millimolar metformin also reduced expression of MMP-9 significantly (p < 0.05).

Conclusion

Metformin may act on the proliferation, and the processes of invasion and metastasis of MCF-7 cells through blocking NF-kB, which is intensely expressed in breast cancer cells, and through diminishing the expression of MMP-2 and MMP-9 significantly.

Clinical and molecular evaluation of MEFV gene variants in the Turkish population: a study by the National Genetics Consortium

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease.

D-dimer levels decline after immunosuppressive treatment rather than anticoagulant treatment in severe autoimmune chronic spontaneous urticaria

Summary

Chronic spontaneous urticaria (CSU) is a common dermatological condition presenting with wheals and/or angioedema for more than 6 weeks. The role of autoimmunity and inflammation in the pathogenesis of CSU have been studied, but the precise mechanism remains unknown. Association with coagulation cascade has been suggested based on the observations of increased coagulation indicators such as serum D-dimer levels. We report an omalizumab refractory case of severe CSU with high D-Dimer levels that declined only after disease remission with cyclosporine treatment but not with anticoagulation. Activation of coagulation cascade occurs secondary to the pro-inflammatory state in CSU patients and the correlation between D-dimer levels and disease activity may indicate the need for more studies to better understand the relationship of D-dimer levels and Omalizumab resistance. Clinicians should consider this relationship in CSU patients with significant D-dimer levels before considering treatment with anticoagulants.

Late recurrence of melanoma after 10 years - Is the course of the disease different from early recurrences?

BACKGROUND

It is known that melanoma can metastasize and recur many years after the first diagnosis. Although predictive and prognostic factors for melanoma are well defined, there is still insufficient information about the factors affecting the recurrence period and the effect of the recurrence time to survival.

OBJECTIVES

This study investigates the course of melanoma to show prognostic factors comparing early and late recurrence patients. The main objective is to uncover the effect of the recurrence time on the progression of the disease.

METHODS

In this retrospective study, late recurrence (LR) was defined as melanoma recurrence 10 years after the first diagnosis and early recurrence (ER) was defined as recurrence within 10 years. Gender, age, localization of primary tumour, time to first metastasis, survival rates, histological subtype, stage, tumour thickness, invasion level, ulceration and regression of the primary melanoma were documented. Survival curves were evaluated using the Kaplan-Meier and compared with the log-rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors for melanoma-specific survival (MSS).

RESULTS

A total of 1537 melanoma patients were analysed. Early metastasis was developed in 1438 patients (93.6%), and 99 patients (6.4%) developed late metastasis. Late recurrence patients were younger (P < 0.001) and had fewer ulcerated (P = 0.005), fewer head/neck localized (P = 0.009) and thinner (P < 0.001) melanomas than ER patients. The MSS time (mean ± SD) was nearly identical for LR (31 ± 4.4 months 95% CI [22.3-39.7]) and ER (32 ± 1.9 months [28.3-35.7]). Multivariate regression analysis revealed male gender (hazard ratio [HR = 1.4, P < 0.001), truncal tumour localization (HR = 1.7, P < 0.001), tumour thickness (HR = 1.4, P < 0.045) and ulceration (HR = 1.3, P < 0.008) as significant independent prognostic factors for MSS.

CONCLUSION

Although ER and LR patients are found to have different clinicopathologic features, the time of the first recurrence after diagnosis do not seem to have an effect on the survival.

Pregnancy in infertile PCOD patients. Complications and outcome

OBJECTIVE

To evaluate the complications and outcome of pregnancy in women with polycystic ovary disease (PCOD).

STUDY DESIGN

The course and outcome of 47 singleton pregnancies in women with well-documented PCOD were compared with those in 100 healthy controls.

RESULTS

Women with PCOD had a significantly higher body mass index as compared to the control group (P < .05); however, the proportion of lean versus obese subjects in the two groups was similar. The incidence of an abnormal glucose challenge test, gestational diabetes mellitus and pregnancy-induced hypertension was significantly increased in pregnant women with PCOD (P < .05). When lean PCOD subjects were compared with lean control subjects, the difference in the incidence of the above complications was still significant (P < .05). The incidence of pregnancy complications was similar when obese PCOD subjects were compared with obese controls.

CONCLUSION

Women with PCOD were at increased risk of gestational diabetes and pregnancy-induced hypertension, and this risk appeared to be independent of body mass index.

The effect of epilepsy self-management on productivity at work

BACKGROUND

Epilepsy is a significant public health concern and the most common neurological disorder. Lack of understanding of the disease may magnify the challenges faced by employees with epilepsy, including effective management of symptoms, and full participation in workplace and work productivity.

AIM

Study aimed to evaluate epilepsy self-management skills of working individuals with epilepsy and to determine the impact of it on productivity at work.

METHODS

The study adopted a cross-sectional design and involved 111 individuals with epilepsy. Data collection was carried out using a socio-demographic characteristics form, the "Epilepsy Self-Management Scale" and the "Endikot Work Productivity Scale."

RESULTS

The average age was 35.76 ± 3.39 in the study. The majority of the participants (57.7 %) were women. Additionally, 33.3 % were private sector employee, and 39.6 % held a bachelor's degree. The mean score of the Epilepsy Self Management Scale was 3.91 ± 0.15, the total score of Endikot Work Productivity Scale was 39.84 ± 6.33. A negative significant correlation was observed between epilepsy self management and work productivity. Moreover, women (3.94 ± 0.17) and healthcare workers (3.97 ± 0.06) had higher scores of epilepsy self management. While men (40.43 ± 0.15) demonstrated higher productivity scores, public servants (35.61 ± 0.34) had lower scores compared to others (p < 0.05).

CONCLUSIONS

The findings of this study suggest that improved self-management of epilepsy among working individuals leads to increased work productivity. The epilepsy-management skills of women and healthcare workers was higher. Furthermore, men exhibited lower productivity levels, while woman and public servants displayed higher.

Metformin represses the carcinogenesis potentially induced by 50 Hz magnetic fields in aged mouse fibroblasts via inhibition of NF-kB

Aging is a risk factor for various human disorders, including cancer. Current literature advocates that the primary principles of aging depend on the endogenous stress-induced DNA damage caused by reactive oxygen species 50 Hz low-frequency magnetic field was suggested to induce DNA damage and chromosomal instability. NF-kB, activated by DNA damage, is upregulated in age-related cancers and inhibition of NF-kB results in aging-related delayed pathologies. Metformin (Met), an NF-kB inhibitor, significantly reduces both NF-kB activation and expression in aging and cancer. This in vitro study, therefore, was set out to assess the effects of 5mT MF in 50 Hz frequency and Met treatment on the viability and proliferation of aged mouse NIH/3T3 fibroblasts and expression of RELA/p65, matrix metalloproteinases MMP2 and MMP9, and E-cadherin (CDH1) genes. The trypan blue exclusion assay was used to determine cell viability and the BrdU incorporation assay to determine cell proliferation. The MMP-2/9 protein analysis was carried out by immunocytochemistry, NF-kB activity by ELISA and the expressions of targeted genes by qRT-PCR methods. Four doses of Met (500 uM, 1 mM, 2 mM and 10 mM) suppressed both the proliferation and viability of fibroblasts exposed to the MF in a dose-dependent pattern, and the peak inhibition was recorded at the 10 mM dose. Met reduced the expression of NF-kB, and MMP2/9, elevated CDH1 expression and suppressed NF-kB activity. These findings suggest that Met treatment suppresses the carcinogenic potential of 50 Hz MFs in aged mouse fibroblasts, possibly through modulation of NF-kB activation and epithelial-mesenchymal transition modulation.

Evaluation of the mental health of COVID-19 patients discharged from the intensive care unit

In this editorial, I address the mental health status of patients who have been discharged from intensive care units (ICUs) after battling coronavirus disease 2019 (COVID-19). An ICU admission is generally a stressful experience, and for severe COVID-19 survivors prolonged treatment in the ICU can lead to significant psychological consequences. These individuals may experience psychiatric distress, including symptoms such as insomnia, anxiety, depression, and even post-traumatic psychological issues. Research indicates that during the first 6 months to 1 year following an ICU stay, nearly one-third of survivors exhibit symptoms similar to those of depression and post-traumatic stress disorder. Several factors may have contributed to the development of depressive and anxious symptoms during the COVID-19 pandemic, particularly for those who underwent an ICU stay. The ICU environment itself is inherently stressful, filled with the constant noise of various medical devices. Studies have provided strong evidence that the prolonged need for ventilation support and the loss of freedom of movement are key factors in the development of psychological problems among COVID-19 patients who had been treated in the ICU.

Gender-based economic violence and the exploitation of women: A deep dive

Economic violence is a form of domestic violence that extends beyond physical harm, affecting victims' economic stability and independence. This situation perpetuates gender inequality and also reinforces the cycle of gender-based violence. With definitions of economic violence broadening to encompass a range of coercive and manipulative behaviors - from financial abuse in domestic violence scenarios to the economic harassment faced by stay-at-home moms - understanding this form of exploitation is crucial for crafting effective interventions. This article aims to delve into various facets of economic violence, including its definition, prevalence, and the stark realities it creates for its victims. Following the search of international databases: Social Work Abstracts (EBSCO), Psychology Abstracts, Family and Women Studies Worldwide, Psychiatry Online, Psych INFO (including Psych ARTICLES), PubMed, Wiley, and Scopus, 60 peer-reviewed articles that met all inclusion criteria were included in the paper. Our review clarifies that looking forward, the call for a comprehensive understanding of economic violence, enhanced legal frameworks, and the strengthening of supportive networks underscore the multidisciplinary approach required to combat this issue effectively.

Impact of parenting styles on preschoolers' behaviors

In this editorial, I comment on the article "Association of preschool children behavior and emotional problems with the parenting behavior of both parents" which was published in the latest issue of "World Journal of Clinical Cases" that demonstrates the prevalence of behavioral disorders in preschool children. Therefore I am focused on parenting which is the most effective factor shown to affect the development and continuity of these behaviors. The management of child behavior problems is crucial. Children in early ages, especially preschoolers who are in the first 5 years of life, are influenced by dramatic changes in various aspects of development, such as social, emotional, and physical. Also, children experience many changes linked to different developmental tasks, such as discovering themselves, getting new friendships, and adapting to a new environment. In this period, parents have a critical role in supporting child development. If parents do not manage and overcome their child's misbehavior, it could be transformed into psychosocial problems in adulthood. Parenting is the most powerful predictor in the social development of preschool children. Several studies have shown that to reduce the child's emotional and behavioral problems, a warm relationship between parents and children is needed. In addition, recent studies have demonstrated significant relationships between family regulation factors and parenting, as well as with child behaviors.

Development and Validation of Information Technology Scale in Nursing

BACKGROUND

 The implementation of information technology (IT) in patient care is on the rise. The nursing workforce should be prepared for using such technology to support the delivery of patient-centered care. The integration of informatics into nursing practice has been progressing at a slower rate than the development of advancements and in which areas nurses use IT is still not clear.

OBJECTIVE

 Our objective was to develop a new instrument to determine the usage of IT in nursing practice.

METHODS

 A methodological study was conducted with factor analyses. A total of 498 registered nurses in a university hospital (n = 374) and primary care centers (n = 124) participated in the study. A questionnaire consisting demographic characteristics and an item pool with 50 statements were used to collect data. The validity and reliability of the instrument were statistically tested by computing the Keiser-Meier-Olkin (KMO) and Bartlett tests, an exploratory factor analysis, descriptive statistics, Cronbach's α, and a confirmatory factor analysis.

RESULTS

 The instrument extracted eight factors comprising 39 items that explained 55% of the variance: professional autonomy(α = 0.82), data sharing/communication(α = 0.80), data management (α = 0.79), professional development (α = 0.71), administration (α = 0.76), research (α = 0.76), informing (α = 0.68), and classification of interventions (α = 0.75). Total reliability was 0.936. KMO index and a measure of sampling adequacy were high (0.936); the Bartlett test of sphericity was significant (p < 0.005).

CONCLUSION

 Study provided the evidence for the factor structure, internal consistency, reliability, and responsiveness of the 39-item "The Information Technology Scale in Nursing." Further testing of the developed instrument with a larger number of nurses from various backgrounds and different settings is recommended.

Relationship between the use of smart medical services and mental health status

In this editorial, I comment on the article by Zhang et al. To emphasize the importance of the topic, I discuss the relationship between the use of smart medical devices and mental health. Smart medical services have the potential to positively influence mental health by providing monitoring, insights, and interventions. However, they also come with challenges that need to be addressed. Understanding the primary purpose for which individuals use these smart technologies is essential to tailoring them to specific mental health needs and preferences.

A cultural adaptation study of nursing informatics competency scale

OBJECTIVE

The objective of this study is to examine the factor structure, internal consistency reliability and responsiveness of an instrument related to the informatics competency of nurses.

BACKGROUND

Informatics is a scientific discipline that needs to be integrated into nursing practice. There is no current and valid tool to measure the informatics competency of nurses in Turkey.

DESIGN

This study has a methodological design.

METHODS

The Self-Assessment of Nursing Informatics Competency Scale-18 was used to collect data. The original scale was translated into Turkish in a process of forward and back-translation. Data were collected in a setting of 190 respondents with a random subsample in a hospital. Internal reliability was tested using Cronbach's alpha. The factor structure of the instrument was determined through exploratory factor analysis. Factorial invariance was tested in a multi-group confirmatory factor analysis.

RESULTS

Exploratory analysis with varimax rotation extracted three factors comprising 18 items that explained 62.1 % of the variance: applied computer skills (α=.91), role (α=.67) and basic computer skills (α=.77).

CONCLUSION

The current version of the instrument is well grounded in the theoretical framework of informatics competence in nursing practice.