bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health and resilience quotient of patients in primary care units during the widespread COVID-19 pandemic in Thailand: a cross-sectional study
Authors: Sanphiboon Tanyalak , Buathong Napakkawat , Chootong Rattanaporn
Published: February 2024

Background

The coronavirus disease 2019 pandemic impacted both the physical and mental health of individuals. The resilience quotient (RQ) is an important factor that decreases mental health problems. This study aimed to explore mental health problems and RQ in patients who visit Primary Care Units (PCU).

Methods

A cross-sectional study was conducted on participants aged 18 to 60 years who visited the PCU of Songklanagarind Hospital from May 1, 2022, to June 31, 2022. Participants completed a self-administered questionnaire on baseline characteristics and the Primary Care Assessment, Personal Resource Questionnaire, satisfaction with life scale, Thai RQ, PHQ-9, and GAD-7, and the results were analyzed by descriptive, logistic regression, and Spearman’s rank correlation.

Results

Among the 216 participants, 72.2% were female, and the median age was 39 (24,51) years old. Most of them had normal RQ levels (61.1%). Of these, 4.2% and 12.1% exhibited moderate to high levels of depression and anxiety, respectively. This study found that sex (OOR 1.93; 95% CI 1.01–3.74), age (OOR 1.03; 95% CI 1.01–1.06), moderate and high social support levels (OOR 9.51; 95% CI 3.36–28.85), and a high life satisfaction level (OOR 4.67; 95%CI 1.75–13.25) were associated with RQ. Moreover, the results showed that ≥ 3 times visiting PCU (β 1.73; 95% CI 0.39–3.08), BMI (β 0.13; 95% CI 0.04–0.23) and experiencing stressful events (β 2.34; 95% CI 1.32–3.36) were positively associated with depression. Finally, experiencing stressful events (OR 4.1; 95% CI 1.09–15.47) significantly affected anxiety, however, moderate and high life satisfaction levels acted as a protective factor against anxiety (OR 0.19; 95% CI 0.07–0.54 and OR 0.03; 95% CI 0.01–0.16, respectively).

Conclusion

Although there were a few patients with moderate to severe levels of depression and anxiety, most of them had normal RQ levels. However, there were some patients with low RQ levels which correlated to a high risk of psychiatric diseases such as depression and anxiety. Healthcare providers should focus on interventions that enhance resilience in both proactive and defensive strategies to reduce negative mental problems during these formidable times.
Distinct uric acid trajectories are associated with incident cardiac conduction block
Authors: Li Na , Cui Liufu , Shu Rong , Song Haicheng , Wang Jierui , Chen Shuohua , Tse Gary , Zhang Nan , Yang Xuemei , Xu Wenqi , Wu Shouling , Liu Tong
Published: February 2024

Background

The association of longitudinal uric acid (UA) changes with cardiac conduction block risk is unclear. We aimed to identify the trajectories of UA and explore its association with cardiac conduction block.

Methods

A total of 67,095 participants with a mean age of 53.12 years were included from the Kailuan cohort in Tangshan, China, who were free of cardiac conduction block and with repeated measurements of UA from 2006 to 2012. UA trajectories during 2006 to 2012 were identified by group-based trajectory modeling. Cox proportional hazard regression models were used to assess the association of UA trajectories with cardiac conduction block.

Results

We categorized three observed discrete trajectories of UA during 2006–2012 period: low-stable, moderate-stable, and high-stable. Over a median follow-up of 6.19 years, we identified 1405 (2.09%) incident cardiac conduction block. Compared to those in the low-stable trajectory, the adjusted hazard ratios (HRs) (95% confidence interval [CI]) of cardiac conduction block in the moderate-stable and high-stable trajectory were 1.30 (1.16–1.47) and 1.86 (1.56–2.22), and HRs of atrioventricular block were 1.39 (1.12–1.72) and 2.90 (2.19–3.83), and HRs of bundle branch blocks were 1.27 (1.10–1.47) and 1.43 (1.13–1.79). Notably, although the average UA level in the moderate-stable UA trajectory group is within the normal range, the risk of cardiac conduction block has increased.

Conclusions

The moderate-stable and high-stable trajectories are associated with increased risk for new-onset cardiac conduction block. Monitoring UA trajectories may assist in identifying subpopulations at higher risk for cardiac conduction block.
Machine learning prediction of future amyloid beta positivity in amyloid-negative individuals
Authors: Moradi Elaheh , Prakash Mithilesh , Hall Anette , Solomon Alina , Strange Bryan , Tohka Jussi ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: February 2024

Background

The pathophysiology of Alzheimer’s disease (AD) involves $$\beta$$
β
-amyloid (A$$\beta$$
β
) accumulation. Early identification of individuals with abnormal $$\beta$$
β
-amyloid levels is crucial, but A$$\beta$$
β
quantification with positron emission tomography (PET) and cerebrospinal fluid (CSF) is invasive and expensive.

Methods

We propose a machine learning framework using standard non-invasive (MRI, demographics, APOE, neuropsychology) measures to predict future A$$\beta$$
β
-positivity in A$$\beta$$
β
-negative individuals. We separately study A$$\beta$$
β
-positivity defined by PET and CSF.

Results

Cross-validated AUC for 4-year A$$\beta$$
β
conversion prediction was 0.78 for the CSF-based and 0.68 for the PET-based A$$\beta$$
β
definitions. Although not trained for the clinical status-change prediction, the CSF-based model excelled in predicting future mild cognitive impairment (MCI)/dementia conversion in cognitively normal/MCI individuals (AUCs, respectively, 0.76 and 0.89 with a separate dataset).

Conclusion

Standard measures have potential in detecting future A$$\beta$$
β
-positivity and assessing conversion risk, even in cognitively normal individuals. The CSF-based definition led to better predictions than the PET-based definition.
Computed tomography-based body composition parameters can predict short-term prognosis in ulcerative colitis patients
Authors: Lu Jun , Xu Hui , Shi Haiyun , Zheng Jing , Cheng Tianxin , Zhou Minsi , Han Xinjun , Wang Yuxin , Meng Xuxu , Li Xiaoyang , Jiang Jiahui , Li Peng , Yang Zhenghan , Xu Lixue
Published: February 2024

Objectives

Emerging evidence suggests a potential relationship between body composition and short-term prognosis of ulcerative colitis (UC). Early and accurate assessment of rapid remission based on conventional therapy via abdominal computed tomography (CT) images has rarely been investigated. This study aimed to build a prediction model using CT-based body composition parameters for UC risk stratification.

Methods

In total, 138 patients with abdominal CT images were enrolled. Eleven quantitative parameters related to body composition involving skeletal muscle mass, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured and calculated using a semi-automated segmentation method. A prediction model was established with significant parameters using a multivariable logistic regression. The receiver operating characteristic (ROC) curve was plotted to evaluate prediction performance. Subgroup analyses were implemented to evaluate the diagnostic efficiency of the prediction model between different disease locations, centers, and CT scanners. The Delong test was used for statistical comparison of ROC curves.

Results

VAT density, SAT density, gender, and visceral obesity were significantly statistically different between remission and invalidation groups (all p < 0.05). The accuracy, sensitivity, specificity, and area under the ROC curve (AUC) of the prediction model were 82.61%, 95.45%, 69.89%, and 0.855 (0.792–0.917), respectively. The positive predictive value and negative predictive value were 70.79% and 93.88%, respectively. No significant differences in the AUC of the prediction model were found in different subgroups (all p > 0.05).

Conclusions

The predicting model constructed with CT-based body composition parameters is a potential non-invasive approach for short-term prognosis identification and risk stratification. Additionally, VAT density was an independent predictor for escalating therapeutic regimens in UC cohorts.

Critical relevance statement

The CT images were used for evaluating body composition and risk stratification of ulcerative colitis patients, and a potential non-invasive prediction model was constructed to identify non-responders with conventional therapy for making therapeutic regimens timely and accurately.

Key points

• CT-based prediction models help divide patients into invalidation and remission groups in UC.

• Results of the subgroup analysis confirmed the stability of the prediction model with a high AUC (all > 0.820).

• The visceral adipose tissue density was an independent predictor of bad short-term prognosis in UC.

Graphical Abstract
Liver imaging and pregnancy: what to expect when your patient is expecting
Authors: Porrello Giorgia , Cannella Roberto , Bernuau Jacques , Agman Antoine , Brancatelli Giuseppe , Dioguardi Burgio Marco , Vilgrain Valérie
Published: February 2024

Liver diseases in pregnancy can be specific to gestation or only coincidental. In the latter case, the diagnosis can be difficult. Rapid diagnosis of maternal-fetal emergencies and situations requiring specialized interventions are crucial to preserve the maternal liver and guarantee materno-fetal survival. While detailed questioning of the patient and a clinical examination are highly important, imaging is often essential to reach a diagnosis of these liver diseases and lesions. Three groups of liver diseases may be observed during pregnancy: (1) diseases related to pregnancy: intrahepatic cholestasis of pregnancy, pre-eclampsia, eclampsia, hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, and acute fatty liver of pregnancy; (2) liver diseases that are more frequent during or exacerbated by pregnancy: acute herpes simplex hepatitis, Budd-Chiari syndrome, hemorrhagic hereditary telangiectasia, hepatocellular adenoma, portal vein thrombosis, and cholelithiasis; (3) coincidental conditions, including acute hepatitis, incidental focal liver lesions, metabolic dysfunction–associated steatotic liver disease, cirrhosis, hepatocellular carcinoma, liver abscesses and parasitosis, and liver transplantation. Specific knowledge of the main imaging findings is required to reach an early diagnosis, for adequate follow-up, and to avoid adverse consequences in both the mother and the fetus.

Critical relevance statement Pregnancy-related liver diseases are the most important cause of liver dysfunction in pregnant patients and, in pregnancy, even common liver conditions can have an unexpected turn. Fear of radiations should never delay necessary imaging studies in pregnancy.

Key points

• Pregnancy-related liver diseases are the most frequent cause of liver dysfunction during gestation.

• Fear of radiation should never delay necessary imaging studies.

• Liver imaging is important to assess liver emergencies and for the diagnosis and follow-up of any other liver diseases.

• Common liver conditions and lesions may take an unexpected turn during pregnancy.

• Pregnancy-specific diseases such as pre-eclampsia and HELLP syndrome must be rapidly identified. However, imaging should never delay delivery when it is considered to be urgent for maternal-fetal survival.

Graphical Abstract
Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents
Authors: Dekker Helena M. , Stroomberg Gerard J. , Van der Molen Aart J. , Prokop Mathias
Published: February 2024

Gadolinium-based contrast agents (GBCA) are essential for diagnostic MRI examinations. GBCA are only used in small quantities on a per-patient basis; however, the acquisition of contrast-enhanced MRI examinations worldwide results in the use of many thousands of litres of GBCA per year. Data shows that these GBCA are present in sewage water, surface water, and drinking water in many regions of the world. Therefore, there is growing concern regarding the environmental impact of GBCA because of their ubiquitous presence in the aquatic environment. To address the problem of GBCA in the water system as a whole, collaboration is necessary between all stakeholders, including the producers of GBCA, medical professionals and importantly, the consumers of drinking water, i.e. the patients. This paper aims to make healthcare professionals aware of the opportunity to take the lead in making informed decisions about the use of GBCA and provides an overview of the different options for action.

In this paper, we first provide a summary on the metabolism and clinical use of GBCA, then the environmental fate and observations of GBCA, followed by measures to reduce the use of GBCA. The environmental impact of GBCA can be reduced by (1) measures focusing on the application of GBCA by means of weight-based contrast volume reduction, GBCA with higher relaxivity per mmol of Gd, contrast-enhancing sequences, and post-processing; and (2) measures that reduce the waste of GBCA, including the use of bulk packaging and collecting residues of GBCA at the point of application.

Critical relevance statement This review aims to make healthcare professionals aware of the environmental impact of GBCA and the opportunity for them to take the lead in making informed decisions about GBCA use and the different options to reduce its environmental burden.

Key points

• Gadolinium-based contrast agents are found in sources of drinking water and constitute an environmental risk.

• Radiologists have a wide spectrum of options to reduce GBCA use without compromising diagnostic quality.

• Radiology can become more sustainable by adopting such measures in clinical practice.

Graphical Abstract
The value of periportal hyperintensity sign from gadobenate dimeglumine-enhanced hepatobiliary phase MRI for predicting clinical outcomes in patients with decompensated cirrhosis
Authors: Cong Lanqing , Deng Yan , Cai Shuo , Wang Gongzheng , Zhao Xinya , He Jingzhen , Zhao Songbo , Wang Li
Published: February 2024

Objectives

To determine the value of periportal hyperintensity sign from gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatobiliary phase (HBP) magnetic resonance imaging (MRI) for predicting clinical outcomes in patients with decompensated cirrhosis.

Methods

A total of 199 cirrhotic patients who underwent Gd-BOPTA-enhanced MRI were divided into control group (n  =  56) and decompensated cirrhosis group (n  =  143). The presence of periportal hyperintensity sign on HBP MRI was recorded. The Cox regression model was used to investigate the association between periportal hyperintensity sign and clinical outcomes.

Results

There was a significant difference in the frequency of periportal hyperintensity sign on HBP between compensated and decompensated cirrhotic patients (p  <  0.05). After a median follow-up of 29.0 months (range, 1.0–90.0 months), nine out of 143 patients (6.2%) with decompensated cirrhosis died. Periportal hyperintensity sign on HBP MRI was a significant risk factor for death (hazard ratio (HR)  =  23.677; 95% confidence interval (CI)  =  4.759–117.788; p  =  0.0001), with an area under the curve (AUC) of 0.844 (95% CI  =  0.774–0.899). Thirty patients (20.9%) developed further decompensation. Periportal hyperintensity sign on HBP MRI was also a significant risk factor for further decompensation (HR  =  2.594; 95% CI  =  1.140–5.903; p  =  0.023).

Conclusions

Periportal hyperintensity sign from Gd-BOPTA-enhanced HBP MRI is valuable for predicting clinical outcomes in patients with decompensated cirrhosis.

Critical relevance statement

Periportal hyperintensity sign from gadobenate dimeglumine-enhanced hepatobiliary phase magnetic resonance imaging is a new noninvasive method to predict clinical outcomes in patients with decompensated cirrhosis.

Key points

• There was a significant difference in the frequency of periportal hyperintensity sign on HBP between compensated and decompensated cirrhotic patients.

• Periportal hyperintensity sign on the hepatobiliary phase was a significant risk factor for death in patients with decompensated cirrhosis.

• Periportal hyperintensity sign on the hepatobiliary phase was a significant risk factor for further decompensation in patients with decompensated cirrhosis.

Graphical Abstract
Azathioprine and hydroxychloroquine overdose in Sjögren’s syndrome patient with hypocalcemia: a case report
Authors: Kooshki Alireza , Mehrpour Omid , Nakhaee Samaneh
Published: February 2024

Introduction

Hydroxychloroquine and azathioprine have been routinely used to control and treat primary and secondary Sjögren’s syndrome, which potentially triggered some overdoses by these drugs. Toxicity from hydroxychloroquine and azathioprine manifests in the form of cardiac conduction abnormalities, nausea, vomiting, and muscle weakness. Recognizing these unique drug overdoses and management of these toxicities is important. This case report aims to expand our current understanding of these drug overdoses and their management and also underscores the importance of anticipating and identifying fewer common complications, such as hypocalcemia.

Case report

A 34-year-old Persian woman with a history of Sjögren’s syndrome presented to the emergency department 3.5–4 hours after an intentional overdose of hydroxychloroquine and azathioprine and severe hypotension and loss of consciousness. Although the patient was regularly taking other medications, such as fluoxetine, naproxen, and prednisolone, she explicitly clarified that these were not the substances involved in her overdose. Early investigations showed hypokalemia (2.4 mEq/L), hypocalcemia (7.5 mg/dL), and hypoglycemia (65 mg/dL). She was also diagnosed with metabolic acidosis and respiratory alkalosis. The electrocardiogram showed changes in favor of hypokalemia; other lab tests were run on the patient. Supportive treatments were applied, including rapid intravenous fluid dextrose 5%, normal saline, potassium chloride 30 mEq, and calcium gluconate 100 mg. The patient was managed and monitored overnight in the emergency room and recovered without residual side effects.

Conclusion

Hydroxychloroquine and azathioprine toxicity are considered rare, but it is likely to increase in frequency given the prevalence and increase in autoimmune diseases and the increasing usage of these drugs in treating such diseases. We found hypocalcemia as the presentation to this patient, which needs further investigation into the probable mechanism. Clinicians need to consider the unique effects of hydroxychloroquine and azathioprine poisoning and initiate appropriate emergency interventions to improve the outcomes in similar patients.
Oxidized SOD1 accelerates cellular senescence in neural stem cells
Authors: Guan Teng , Guo Ying , Zhou Ting , Yu Qiang , Sun Jingyi , Sun Baoliang , Zhang Guohui , Kong Jiming
Published: February 2024

Background

Neural stem cells (NSCs), especially human NSCs, undergo cellular senescence characterized by an irreversible proliferation arrest and loss of stemness after prolonged culture. While compelling correlative data have been generated to support the oxidative stress theory as one of the primary determinants of cellular senescence of NSCs, a direct cause-and-effect relationship between the accumulation of oxidation-mediated damage and cellular senescence of NSCs has yet to be firmly established. Human SOD1 (hSOD1) is susceptible to oxidation. Once oxidized, it undergoes aberrant misfolding and gains toxic properties associated with age-related neurodegenerative disorders. The present study aims to examine the role of oxidized hSOD1 in the senescence of NSCs.

Methods

NSCs prepared from transgenic mice expressing the wild-type hSOD1 gene were maintained in culture through repeated passages. Extracellular vesicles (EVs) were isolated from culture media at each passage. To selectively knock down oxidized SOD1 in NSCs and EVs, we used a peptide-directed chaperone-mediated protein degradation system named CT4 that we developed recently.

Results

In NSCs expressing the hSOD1 from passage 5, we detected a significant increase of oxidized hSOD1 and an increased expression of biomarkers of cellular senescence, including upregulation of P53 and SA-β-Gal and cytoplasmic translocation of HMGB1. The removal of oxidized SOD1 remarkably increased the proliferation and stemness of the NSCs. Meanwhile, EVs derived from senescent NSCs carrying the wild-type hSOD1 contained high levels of oxidized hSOD1, which could accelerate the senescence of young NSCs and induce the death of cultured neurons. The removal of oxidized hSOD1 from the EVs abolished their senescence-inducing activity. Blocking oxidized SOD1 on EVs with the SOD1 binding domain of the CT4 peptide mitigated its toxicity to neurons.

Conclusion

Oxidized hSOD1 is a causal factor in the cellular senescence of NSCs. The removal of oxidized hSOD1 is a strategy to rejuvenate NSCs and to improve the quality of EVs derived from senescent cells.
“When everyone is responsible, no one takes responsibility”: exploring pediatric physiotherapy services in Israel
Authors: Waiserberg Nilly , Horev Tuvia , Feder-Bubis Paula
Published: February 2024

Background

According to Israel's National Health Insurance Law (1994), the Ministry of Health is responsible for the provision of health services in the country including physiotherapy services; moreover, the Special Education Law (1988), stipulates that physiotherapy services for children with motor disabilities, as well as other allied health services, are provided by the Ministry of Education in educational settings. Thus, children with motor disabilities are entitled PT services under two different laws by two different ministries.

Method

To describe the physiotherapy services for children with motor disabilities and examine how policymakers view these services, we conducted a qualitative study including in-depth semi-structured interviews with 10 policymakers from the Ministry of Health and the Ministry of Education, and the national directors of physiotherapy services from three of the four health maintenance organizations in Israel.

Results

Study results indicate that there is an array of physiotherapy services and providers. Despite the regulation of these services for children with motor disabilities, uncertainty and lack of knowledge were found about various issues. Therefore, the thematic analysis was structured around four descriptive questions: Where do the children receive physiotherapy? Who is eligible for physiotherapy treatment and who receives treatment? What interventions do children with motor disabilities receive? Who provides therapy for children with motor disabilities?

Conclusions

Policymakers are dubious regarding the provision of these services, questioning whether children with motor disabilities receive physiotherapy services according to their needs. In addition, the abundance of suppliers does not necessarily improve the quality of services provided to children with motor disabilities, which may ultimately harm their developmental potential.
Some existence results for a differential equation and an inclusion of fractional order via (convex) F-contraction mapping
Authors: Roomi Vahid , Afshari Hojjat , Kalantari Sabileh
Published: February 2024

The existence of solutions for a class of μ-Caputo fractional differential equations and an inclusion problem equipped with nonlocal μ-integral boundary conditions are investigated. We use F-contraction, convex F-contraction, and some consequences to achieve the desired goals. Finally, some examples are provided to illustrate the results.
Therapeutics for neurodegenerative diseases by targeting the gut microbiome: from bench to bedside
Authors: Ma Yuan-Yuan , Li Xin , Yu Jin-Tai , Wang Yan-Jiang
Published: February 2024

The aetiologies and origins of neurodegenerative diseases, such as Alzheimer’s disease (AD), Parkinson’s disease (PD), amyotrophic lateral sclerosis (ALS) and Huntington’s disease (HD), are complex and multifaceted. A growing body of evidence suggests that the gut microbiome plays crucial roles in the development and progression of neurodegenerative diseases. Clinicians have come to realize that therapeutics targeting the gut microbiome have the potential to halt the progression of neurodegenerative diseases. This narrative review examines the alterations in the gut microbiome in AD, PD, ALS and HD, highlighting the close relationship between the gut microbiome and the brain in neurodegenerative diseases. Processes that mediate the gut microbiome–brain communication in neurodegenerative diseases, including the immunological, vagus nerve and circulatory pathways, are evaluated. Furthermore, we summarize potential therapeutics for neurodegenerative diseases that modify the gut microbiome and its metabolites, including diets, probiotics and prebiotics, microbial metabolites, antibacterials and faecal microbiome transplantation. Finally, current challenges and future directions are discussed.
Hydrogen partitioning between stishovite and hydrous phase δ: implications for water cycle and distribution in the lower mantle
Authors: Ishii Takayuki , Criniti Giacomo , Purevjav Narangoo , Katsura Tomoo , Ohtani Eiji
Published: February 2024

Water is transported into the deep mantle by subducting slabs, playing important roles in mantle dynamics and evolution. An aluminous hydrous mineral, phase δ with a main component of AlOOH, has been considered an important water carrier in the lower mantle. Recent studies reported that SiO2 stishovite can accommodate weight percent levels of water, indicating another important water carrier in the lower mantle. However, which mineral can mainly carry water is not clear yet. Recent hydrous phase relation studies reported that stishovite is depleted in alumina when coexisting with hydrous phase δ, in which water content of stishovite was not investigated. In this study, we investigated hydrogen partitioning between stishovite and hydrous phase δ at 24–28 GPa and 1000–1200 °C by means of Kawai-type multi-anvil press in combination with Fourier-transform infrared spectroscopy at ambient conditions on recovered samples. Fourier-transform infrared spectra of recovered stishovites showed that water contents of stishovite coexisting with hydrous phase δ were limited to up to ~ 500 ppm. This indicates that coexisting hydrous phase δ causes not only depletion in alumina but also in hydrogen in stishovite and therefore mainly transports water in a cold subducting slab. Once hydrous phase δ becomes thermally unstable, alumina and water contents in silica minerals are increased by the chemical reaction between SiO2 and AlOOH, and aluminous silica minerals such as stishovite and CaCl2-type phase will be a main water carrier in the lower mantle. Presence of small-scale seismic scatterers observed around 1900 km depth, which was considered to be caused by a transition from almost pure SiO2 stishovite to CaCl2-type phase, might also be able to be explained by the phase transition of stishovite coexisting with hydrous phase δ.
Effects of employee engagement on organizational performance: case of public universities in Ethiopia
Authors: Gede Dawit Udessa , Huluka Admassu Tesso
Published: February 2024

The objective of this research is to examine the impact of Employee Engagement on Organizational Performance within Public Universities in Ethiopia. It aims to explore the relationship between employee engagement and the overall performance of these institutions, specifically focusing on public universities. By providing significant insights and recommendations, this research will contribute towards the development of strategies that can enhance employee engagement and improve the overall performance of Ethiopian public universities. The study utilized both quantitative and qualitative approaches, employing descriptive and explanatory research designs. To gather data, three Ethiopian universities were selected based on their establishment date, and a random selection technique was used to include 365 personnel in the sample. Descriptive statistical tools like mean and standard deviation were employed, while structural equation models were utilized for confirmatory factor analysis and path analysis. The study's findings indicate that vigor, dedication, and absorption all have a significant and favorable impact on organizational performance in higher education. The study findings also indicate that the performance of study institutions differs based on the extent of employee involvement. This research introduces a fresh perspective of the relationship between employee engagement and organizational performance by concentrating specifically on the context of public universities in Ethiopia. This sheds light on the distinctive dynamics and obstacles encountered by these institutions. Furthermore, the study adds to the current body of knowledge by exploring the relationship between employee engagement and organizational performance, offering valuable insights and suggestions to enhance performance in the setting of Ethiopian public universities.
Striving for a life out of shadows: informal entrepreneurial dynamics in time of crisis
Authors: Yana Mbena Jacques , Yeboah Kwabena Obiri
Published: February 2024

Motivated by the unique opportunity that a crisis period provides for capturing and reassessing specific entrepreneurial behaviors, this paper takes on the debate about the entrepreneurial attributes of informal ventures “IVent” and their endeavor to formalize. In doing so, Cronbach’s alpha rationales and contingency analysis are applied to quantitative data from street vendors of the main markets of Cameroon to investigate informal entrepreneurial behavioral dynamics and their impact on a hypothetical willingness for change during the COVID-19 pandemic. It was uncovered that IVent have activated entrepreneurial attributes of resilience, intention and orientation. Also, specific composites or variables of entrepreneurial orientation and resilience have been found more supportive of IVent’s endeavor to formalize than others. The novelties in that regard are: (1) While most of the variables related to the composite of innovativeness reinforce the desire to formalize, the variable of “routine” plays a hindering role. (2) The composite of proactiveness is not significantly related to the willingness to formalize. (3) The composite of risk-taking has proven significant to IVent’s transformation aims. And (4) contrary to all other variables of the attribute of resilience and self-efficacy, the variable of behavior control appears to hamper the aim to move out of the shadows. It is argued that facilitating Ivent’s dynamics and aspiration to formalize necessitates policymakers to advance policies that support the development of the uncovered determining composites. Furthermore, academia should undertake an extensive investigation into the role that the captured non-significant variables, attributes, and composites may play in fostering IVent's shadowed business lifecycle.

Graphical abstract
Ties that bind: exploring corporate networks, decision-making dynamics in the financial market, labor-management relations, and organizational performance
Authors: da Silva Emerson Jorge , Ramos Fernando Maciel , Cembranel Priscila , Witt Cleonice
Published: February 2024

Corporate governance relies significantly on the board of directors, who act as custodians of shareholders' interests. The dynamics of social connections between Chief Executive Officers (CEOs) and board members form a critical element that influences information exchange within this vital governance structure. This study seeks to assess the impact of these social connections on organizational performance. We conducted a comprehensive analysis of the professional backgrounds of CEOs and board members to measure the extent of their social connections. Employing multiple regression analysis with robust error corrections, we considered essential economic and financial metrics, including Return on Assets (ROA), Return on Equity (ROE), and Earnings before Interest, Taxes, Depreciation, and Amortization (EBITDA). Our findings reveal that professional social connections have a positive influence on ROA (β = 0.0230|p-value ≤ 0.05) and EBITDA (β = 420,517,1|p-value ≤ 0.05), while educational connections exhibited no significant effect, and familial connections were found to adversely affect EBITDA (β = − 516,307,0|p-value ≤ 0.05). This study highlights the real influence of social connections on firm performance, shedding light on the complex interplay between social dynamics and corporate success. These insights contribute to a more comprehensive understanding of corporate governance and the factors driving organizational performance.

Graphical abstract
Understanding the impact of human capital on radical and incremental innovation: the role of entrepreneurial passion and alertness
Authors: Rafique Tayyaba , Mohsin Muhammad , Abid Muhammad Adeel , Ashrif Ali Noman , Anwar Saliah
Published: February 2024

Purpose

The present study sought to comprehend the impact of human capital on radical and incremental innovation, with a focus on examining the mediating effects of entrepreneurial passion and entrepreneurial alertness.

Design/methodology/approach

The study employed a purposive sampling technique for collecting data from entrepreneurs in from different sectors of Pakistan. A sample of 382 entrepreneurs completed the survey. Data were analyzed using SPSS and AMOS. Reliability, discriminant, and convergent validity tests were conducted, and structural equation modeling was used to test the hypotheses.

Findings

It was revealed that human capital has a significant impact on radical and incremental innovation. Furthermore, entrepreneurial passion and alertness significantly mediates the relationship between human capital and innovation.

Originality/value

The study contributes to the emerging research on innovation in entrepreneurship. There is limited research on types of innovation and entrepreneurial alertness in Pakistan; therefore, the study adds value to the scarce empirical research on innovation and entrepreneurial alertness and passion.
Glucocorticoid use in psoriatic arthritis and treatment outcomes: does the gender have a role?
Authors: Bayrak Esra Dilsat , Aktas Ilknur
Published: February 2024

Background

Systemic glucocorticoids are commonly used in practice in the treatment of psoriatic arthritis. However, authorities advise against prescribing it, primarily because of the risk of psoriasis flare-ups. The authors aimed to assess the glucocorticoid use in psoriatic arthritis (PsA), factors associated with the use of glucocorticoids and to uncover whether gender has an impact on glucocorticoid use and treatment responses. Disease-modifying antirheumatic drug (DMARD)-naive PsA patients were included in this cross-sectional study. Baseline clinical and demographic characteristics were recorded. After starting DMARD treatment, patients were followed for 2 years. The number of patients who started glucocorticoids, the clinical demographics of these patients, the duration of glucocorticoid administration, and the dose for administration were recorded. Patient outcomes and gender differences were analyzed. Disease activity was measured using the Disease Activity Scale 28 (DAS28-CRP) and the Disease Activity Index for Psoriatic Arthritis (DAPSA).

Results

Fifty-five of the 141 patients (39%) received glucocorticoids at the 2-year follow-up. There was no difference between the sexes who are in remission-low disease activity (LDA) on cDMARD monotherapy (p = 0.300). Glucocorticoid usage (p = 0.660), dose (p = 0.054), and duration (p = 0.159) did not differ between male and female patients. Higher glucocorticoid doses were associated with dactylitis, higher CRP levels, higher DAS-28 and DAPSA scores, and longer (> 3 months) glucocorticoid administration. Glucocorticoid duration was longer in patients with higher TJS, SJS, serum CRP, higher DAS-28 and DAPSA scores, and higher glucocorticoid doses. Sustained remission-LDA was achieved in 16 of 55 patients after cessation of glucocorticoids and no sex difference was observed.

Conclusion

Systemic glucocorticoids are commonly prescribed in PsA, and when added to treatment even for short periods and in low doses, they help achieve significant disease control. Except for axial involvement, there is no difference in treatment responses between male and female patients, making it unnecessary to make a gender distinction in the treatment algorithm. Given these findings, prospective studies are needed to evaluate glucocorticoids as a bridging treatment in PsA, such as rheumatoid arthritis.
Topical Diclofenac for Prevention of Capecitabine-Associated Hand-Foot Syndrome: A Double-Blind Randomized Controlled Trial
Authors: Santhosh Akhil , Sharma Atul , Bakhshi Sameer , Kumar Akash , Sharma Vinod , Malik Prabhat Singh , Pramanik Raja , Gogia Ajay , Prasad Chandra Prakash , Sehgal Tushar , Gund Sneha , Dev Arundhathi , Cheung Winson Y. , Pandey R.M. , Kumar Saran , Gupta Ishaan , Batra Atul ,   on behalf of the D-TORCH Trial Investigators
Published: February 2024

PURPOSE

Hand-foot syndrome (HFS) is a dose-limiting side effect of capecitabine. Celecoxib prevents HFS by inhibiting cyclooxygenase-2 (COX-2) that is upregulated because of the underlying associated inflammation. However, systemic side effects of celecoxib have limited routine prescription. Topical diclofenac inhibits COX-2 locally with minimal risk of systemic adverse events. Therefore, we conducted this study to assess the efficacy of topical diclofenac in the prevention of capecitabine-induced HFS.

METHODS

In this single-site phase III randomized double-blind trial, we enrolled patients with breast or GI cancer who were planned to receive capecitabine-based treatment. Participants were randomly assigned in a 1:1 ratio to receive topical diclofenac or placebo gel for 12 weeks or until the development of HFS, whichever occurred earlier. The primary end point was the incidence of grade 2 or 3 HFS (Common Terminology Criteria for Adverse Events version 5), which was compared between the two groups using simple logistic regression.

RESULTS

In total, 264 patients were randomly assigned to receive topical diclofenac gel (n = 131) or placebo (n = 133). Grade 2 or 3 HFS was observed in 3.8% of participants in the diclofenac group compared with 15.0% in the placebo group (absolute difference, 11.2%; 95% CI, 4.3 to 18.1; P = .003). Grade 1-3 HFS was lower in the diclofenac group than in the placebo group (6.1% v 18.1%; absolute risk difference, 11.9%; 95% CI, 4.1 to 19.6). Capecitabine dose reductions because of HFS were less frequent in the diclofenac group (3.8%) than in the placebo group (13.5%; absolute risk difference, 9.7%; 95% CI, 3.0 to 16.4).

CONCLUSION

Topical diclofenac prevented HFS in patients receiving capecitabine. This trial supports the use of topical diclofenac to prevent capecitabine-associated HFS.
Circulating Tumor DNA Dynamics Fail to Predict Efficacy of Poly(ADP-ribose) Polymerase/VEGFR Inhibition in Patients With Heavily Pretreated Advanced Solid Tumors
Authors: Hu Yiduo , Narayan Azeet , Xu Yunshan , Wolfe Julia , Vu Dennis , Trinh Thi , Kantak Chaitanya , Ivy S. Percy , Eder Joseph Paul , Deng Yanhong , LoRusso Patricia , Kim Joseph W. , Patel Abhijit A.
Published: February 2024

PURPOSE

Cell-free circulating tumor DNA (ctDNA) has shown its potential as a quantitative biomarker for longitudinal monitoring of response to anticancer therapies. However, ctDNA dynamics have not been studied in patients with heavily pretreated, advanced solid tumors, for whom therapeutic responses can be weak. We investigated whether changes in ctDNA could predict clinical outcomes in such a cohort treated with combined poly(ADP-ribose) polymerase/vascular endothelial growth factor receptor inhibitor therapy.

MATERIALS AND METHODS

Patients with metastatic pancreatic ductal adenocarcinoma (PDAC), triple-negative breast cancer (TNBC), small-cell lung cancer (SCLC), or non–small-cell lung cancer (NSCLC) received up to 7 days of cediranib 30 mg orally once daily monotherapy lead-in followed by addition of olaparib 200 mg orally twice daily. Patients had progressed on a median of three previous lines of therapy. Plasma samples were collected before and after cediranib monotherapy lead-in and on combination therapy at 7 days, 28 days, and every 28 days thereafter. ctDNA was quantified from plasma samples using a multigene mutation–based assay. Radiographic assessment was performed every 8 weeks.

RESULTS

ctDNA measurements were evaluable in 63 patients. The median baseline ctDNA variant allele fractions (VAFs) were 20%, 28%, 27%, and 34% for PDAC, TNBC, SCLC, and NSCLC, respectively. No association was observed between baseline VAF and radiographic response, progression-free survival, or overall survival (OS). Similarly, no association was found between ctDNA decline and radiographic response or survival. However, an increase in ctDNA at 56 days of combination therapy was associated with disease progression and inferior OS in a landmark analysis.

CONCLUSION

ctDNA levels or dynamics did not correlate with radiographic response or survival outcomes in patients with advanced metastatic malignancies treated with olaparib and cediranib.
Incorporating Genetic Risk Into Prostate Cancer Care: Implications for Early Detection and Precision Oncology
Authors: Amini Andrew E. , Salari Keyan
Published: February 2024

The availability and cost of germline and somatic genetic testing have dramatically improved over the past two decades, enabling precision medicine approaches in oncology, with significant implications for prostate cancer (PCa) care. Roughly 12% of individuals with advanced disease are carriers of rare pathogenic germline variants that predispose to particularly aggressive and earlier-onset disease. Several of these variants are already established as clinically actionable by modern precision oncology therapeutics, while others may come to aid the selection of active surveillance, definitive local therapies, and systemic therapies. Concurrently, the number of common variants (ie, incorporated into polygenic risk scores) associated with PCa risk has continued to grow, but with several important considerations both at the intersection of race and ancestry and for early detection of aggressive disease. Family history has historically been used as a proxy for this inherited genetic risk of PCa, but recently emerging evidence examining this relation has shifted our understanding of how best to leverage this tool in PCa care. This review seeks to clarify and contextualize the existing and emerging precision oncology paradigms that use inherited genetic risk in PCa care, for both early detection and localized disease management.
All-Cause Mortality Differentials by Diabetes Status and Serum Neurofilament Light-Chain Levels in US General Adults
Authors: Cai Yingyuan , Wei Qian , Wang Shan , Lu Xiaowei
Published: February 2024

Context

Neurofilament light chains (sNFLs) increase in patients with diabetes (DM) and are associated with death.

Objective

This work aimed to examine whether sNFL mediates associations of DM with all-cause mortality and the extent of interaction or joint relations of sNFL and DM with mortality.

Methods

This population-based cohort study was conducted using the 2013 to 2014 cycle of the National Health and Nutrition Examination Survey. A total of 2071 adults aged 20 to 75 years with sNFL measurements were included. sNFL was lg-transformed (LgNfl). Participants were included whose LgNfl was higher than 1.48 pg/mL or who were diagnosed with DM. All-cause mortality was the primary outcome obtained through linkage to registries.

Results

During a median follow-up of 6.1years, 85 participants died. Incidence rates (per 1000 person-years [95% CI]) of all-cause mortality were 27.78 (19.98∼35.58) in adults with LgNfl greater than 1.48 pg/mL and DM, 9.01 (1.99∼16.03) in adults with LgNfl greater than 1.48 pg/mL but no DM, 3.07 (1.01∼5.13) in adults with DM and LgNfl less than or equal to 1.48 pg/mL, and 2.21 (1.15∼3.27) in adults without DM and LgNfl less than or equal to 1.48 pg/mL. Significant interaction but not mediation was observed between LgNfl and DM. Compared with adults without DM and LgNfl less than or equal to 1.48 pg/mL, those with DM and LgNfl greater than 1.48 pg/mL had higher risks of all-cause mortality (hazard ratio; 95% CI, 7.06; 3.52∼14.16).

Conclusion

In general US adults with DM, elevated sNFLs were associated with higher all-cause mortality specifically, supporting an important role of sNFLs in predicting health outcome in individuals with DM.
Continuous Glucose Monitoring Profiles and Health Outcomes After Dapagliflozin Plus Saxagliptin vs Insulin Glargine
Authors: Simonson Donald C , Testa Marcia A , Ekholm Ella , Su Maxwell , Vilsbøll Tina , Jabbour Serge A , Lind Marcus
Published: February 2024

Context

Glycemic variability and hypoglycemia during diabetes treatment may impact therapeutic effectiveness and safety, even when glycated hemoglobin (HbA1c) reduction is comparable between therapies.

Objective

We employed masked continuous glucose monitoring (CGM) during a randomized trial of dapagliflozin plus saxagliptin (DAPA + SAXA) vs insulin glargine (INS) to compare glucose variability and patient-reported outcomes (PROs).

Design

24-week substudy of a randomized, open-label, 2-arm, parallel-group, phase 3b study.

Setting

Multicenter study (112 centers in 11 countries).

Patients

283 adults with type 2 diabetes (T2D) inadequately controlled with metformin ± sulfonylurea.

Interventions

DAPA + SAXA vs INS.

Main outcome measures

Changes in CGM profiles, HbA1c, and PROs.

Results

Changes from baseline in HbA1c with DAPA + SAXA were similar to those observed with INS, with mean difference [95% confidence interval] between decreases of −0.12% [−0.37 to 0.12%], P = .33. CGM analytics were more favorable for DAPA + SAXA, including greater percent time in range (> 3.9 and ≤ 10 mmol/L; 34.3 ± 1.9 vs 28.5 ± 1.9%, P = .033), lower percent time with nocturnal hypoglycemia (area under the curve ≤ 3.9 mmol/L; 0.6 ± 0.5 vs 2.7 ± 0.5%, P = .007), and smaller mean amplitude of glycemic excursions (−0.7 ± 0.1 vs −0.3 ± 0.1 mmol/L, P = .017). Improvements in CGM were associated with greater satisfaction, better body weight image, less weight interference, and improved mental and emotional well-being.

Conclusion

DAPA + SAXA and INS were equally effective in reducing HbA1c at 24 weeks, but people with T2D treated with DAPA + SAXA achieved greater time in range, greater reductions in glycemic excursions and variability, less time with hypoglycemia, and improved patient-reported health outcomes.