Demographic Age Research Articles

Charting a new course for nurse education: Adapting to the evolving demands of healthcare

How we educate nurses in modern America is at a crucial juncture as healthcare evolves, demographics shift and technological advancements reshape the landscape. In this paper, we advocate for a fundamental shift in how nurse candidates are enrolled and trained, emphasising collaboration among educators, employers and policymakers. Addressing systemic challenges in nurse education, we examine the impact of ageing demographics, increasing diversity and the rise of nontraditional learners. Proposing alternative pathways for enrolment and leveraging technology for personalised learning experiences, we argue for inclusivity, diversity and adaptability in nurse education. Through effective collaboration between stakeholders, we envision a future where nurse education meets the demands of a changing healthcare industry. Our goal is to inspire transformative action, foster innovation and promote equitable access to quality education for all who want to become a nurse. This paper aims to spark discussions and guide stakeholders towards developing a resilient, adaptable and community-connected nursing workforce.

Clear cell sarcoma in Japan: an analysis of the population-based cancer registry in Japan.

Clear cell sarcoma is rare, so no reports have previously characterized its national profiles. We examined the nationwide epidemiology and clinical outcomes of patients with clear cell sarcoma based on the National Cancer Registry in Japan. Overall, 23 522 patients with soft tissue sarcoma-entered in the National Cancer Registry in 2016-2019 using the International Classification of Diseases for Oncology, Third Edition cancer topography and morphology codes-were enrolled in either the clear cell or the non-clear cell sarcoma group. Data extracted included: demographics (sex and age), tumor details (reason for diagnosis, tumor location, histology and stage), hospital volume and facility type, treatment and prognosis for each patient. Of 23 522 soft tissue sarcoma patients, 122 were enrolled in the clear cell sarcoma group and 23 400 in the non-clear cell sarcoma group. The incidence of clear cell sarcoma was 0.52% of all soft tissue sarcoma, with an age-adjusted incidence of 0.024/100 000/year. The age at diagnosis was significantly younger, and more tumors were at the localized stage in the clear cell than the non-clear cell sarcoma group. In addition, the overall survival in the clear cell group was worse than in the non-clear cell group (P<0.001). Of 122 patients with clear cell sarcoma, the localized stage, surgical treatment and treatment without chemotherapy were associated with better overall survival in the univariate analyses. The present study is the first to have clarified the epidemiology, clinical features, treatment, prognosis and significant factors affecting the prognosis of patients with clear cell sarcoma in Japan.

Analyzing the Prevalence of Depression and Its Influencing Factors in Elderly Patients With Obstructive Sleep Apnea: A Machine Learning Approach.

Objective: Depressive symptoms are prevalent and detrimental in elderly patients with obstructive sleep apnea (OSA). Understanding the factors influencing these symptoms is crucial. This study aims to use machine learning algorithms to identify the contributing factors in this population. Method: The National Health and Nutrition Examination Survey database provided the data for this study. The study includes elderly patients who are eligible for diagnostic evaluation for OSA. Logistic regression was used to screen their influencing factors, and random forest (RF), extreme gradient boosting (XGB), artificial neural network (ANN), and support vector machine (SVM) were utilized to 4 algorithms were used to construct depressive symptoms classification models, and the best model performance was selected for feature importance ranking. Influential factors included demographics (age, gender, education, etc.), chronic disease status (diabetes, hypertension, etc.), and laboratory findings (white blood cells, C-reactive protein, cholesterol, etc.). Result: Ultimately, we chose 1538 elderly OSA patients for the study, out of which 528 (34.4%) suffered from depressive symptoms. Logistic regression initially identified 17 influencing factors and then constructed classification models based on those 17 using RF, XGB, ANN, and SVM. We selected the best-performing SVM model [area under the curve (AUC) = 0.746] based on the AUC values of 0.73, 0.735, 0.742, and 0.746 for the 4 models. We ranked the variables in order of importance: General health status, sleep disorders, gender, frequency of urinary incontinence, liver disease, physical activity limitations, education, moisture, eosinophils, erythrocyte distribution width, and hearing loss. Conclusion: Elderly OSA patients experience a high incidence of depressive symptoms, influenced by various objective and subjective factors. The situation is troubling, and healthcare institutions and policymakers must prioritize their mental health. We should implement targeted initiatives to improve the mental health of high-risk groups in multiple dimensions.

Geographic Variation of Prevalence of Alzheimer's Disease and Related Dementias in Central Appalachia.

Alzheimer's disease and related dementias (ADRD) prevalence varies geographically in the United States. To assess whether the geographic variation of ADRD in Central Appalachia is explained by county-level sociodemographics or access to care. Centers for Medicare and Medicaid Services Public Use Files from 2015- 2018 were used to estimate county-level ADRD prevalence among all fee-for-service (FFS) beneficiaries with≥1 inpatient, skilled nursing facility, home health agency, hospital outpatient or Carrier claim with a valid ADRD ICD-9/10 code over three-years in Central Appalachia (Kentucky, North Carolina, Ohio, Tennessee, Virginia, and West Virginia). Negative binomial regression was used to estimate prevalence overall, by Appalachian/non-Appalachian designation, and by rural/urban classification. Models were then adjusted for county-level: 1) FFS demographics (age, gender, and Medicaid eligibility), comorbidities; 2) population sociodemographics (race/ethnicity, education, aging population distribution, and renter-occupied housing); and 3) diagnostic access (PCP visits, neurology visits, and imaging scans). Across the 591 counties in the Central Appalachian region, the average prevalence of ADRD from 2015- 2018 was 11.8%. ADRD prevalence was modestly higher for Appalachian counties both overall (PR: 1.03; 95% CI: 1.02, 1.04) and after adjustment (PR: 1.02; 95% CI: 1.00, 1.03) compared to non-Appalachian counties. This difference was similar among rural and urban counties (p = 0.326) but varied by state (p = 0.004). The relative variation in ADRD prevalence in the Appalachian region was smaller than hypothesized. The case mixture of the dual eligible population, accuracy of the outcome measurement, and impact of educational attainment in this region may contribute to this observation.

Mortality from prostate cancer in the years 2007–2021 in North Rhine-Westphalia, Germany

BackgroundThe crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany.MethodsBased on the cause of death statistics and data from the NRW State Cancer Registry on 45,300 deaths in the years 2007–2021, mortality rates, the lifetime mortality risk from prostate cancer, median age at death and years of life lost are presented. Additionally, the 15 most frequent causes of death of 95,013 patients diagnosed with prostate cancer are reported.ResultsWith a stable lifetime mortality risk from prostate cancer, age-standardised mortality and years of life lost per capita are decreasing while crude mortality and median age at death are increasing in NRW. Less than half of the patients die from their prostate cancer. Cancers of the urinary bladder and other urinary organs also occur more frequently as a cause of death than it would be expected based on the age-specific risk in the total population.ConclusionsMore people in North Rhine-Westphalia are dying of prostate cancer over time due to demographic ageing alone. At the same time, the age-specific mortality risk has not increased and when patients die of prostate cancer, it is at an increasingly older age. However, there is a statistical association with deaths from cancers of the lower urinary tract in patients diagnosed with prostate cancer, which demands further evaluation.

Quality of Life and Attachments to Rural Settlements: The Basis for Regeneration and Socio-Economic Sustainability

Balanced territorial development and improving living conditions have become the focus of rural development policies. As the number of young people moving to cities or other countries is increasing, rural settlements face serious demographic disbalances and aging societies. Quality of life and place attachment are both key variables in enhancing the social and economic capacities of rural and undeveloped communities and reducing youth out-migration. However, this topic remains underexplored, especially among younger generations, who are critical for further socio-economic sustainability. Thus, the main goal of this study was to explore young residents’ perceptions about quality of life, level of attachment to their rural homes, and their interrelationship. This study was conducted among 299 participants in rural areas of Serbia and Croatia. The results identified two quality of life factors: (1) satisfaction with the quality of infrastructure and (2) satisfaction with culture and education. Three attachment factors were extracted, among which place identity was the strongest. Additionally, the influence of quality of life and socio-demographic characteristics on place attachment was confirmed. These results provide new insights that could be very useful in creating strategies and initiatives for rural planning and strengthening rural areas’ social, economic, and environmental sustainability.

Understanding the Associations between Executive Function and Psychological Variables in Fibromyalgia Syndrome: A Network Analysis Approach.

The aim of this study was to quantify the multivariate relationships between clinical, cognitive performance, executive functioning, and psychological outcomes in women with fibromyalgia (FMS) using network analyses. Demographic (age, height, weight), clinical (pain history, pain intensity, and related disability), neurocognitive (D2 Attention test, Rey-Osterrieth Complex Figure for visual perception, "Digits D/R/I" tests of the WAIS-IV battery for working memory, the 5-Digit Test for mental inhibition, the Symbol Search for processing speed and the Zoo Test for planning/decision making) and psychological (depressive symptoms, anxiety levels, sleep quality, pain hypervigilance) variables were collected in 129 women with FMS and 111 healthy women. Network analyses were conducted separately for each group to quantify the adjusted correlations between the modeled variables and to assess their centrality indices (i.e., connectivity with other symptoms in the network and their importance in the network). The network identified 74 associations in FMS women and 46 associations in controls with small differences. The strongest correlations in both groups were found between different attention variables: d2_CON with d2_C, d2_O with d_2TR, and d2_CON with d2_TA. The most central variables were d2_TA, d2_C, and d2_CON (highest strength centrality in both groups) and anxiety levels and pain hypervigilance (highest harmonic centrality in FMS women). The strength centrality of the network was stable for women with FMS (CScor0.7: 0.68) but not for healthy women (CScor0.7: 0.28). This study found that attention variables are most relevant within a neurocognitive network and that psychological variables are most important for the treatment of women with FMS. The clinical implications of the current findings, such as the development of treatments targeting these variables, are discussed.

Individualized Treatment of Polycystic Ovary Syndrome Based on Symptom Profile and Patient Characteristics

This study investigated Polycystic Ovary Syndrome (PCOD) treatment strategies by analyzing data from 156 patients. The Patient data has been collected from Nangal, Punjab. The collected data included patient demographics (age and gender), cause (if known), and a range of symptoms. Statistical analysis explored relationships between age, gender, and the reported symptoms. The findings from the statistical analysis served as the foundation for proposing a groundbreaking approach to PCOD treatment – tailoring interventions based on the unique symptom profile of each patient. Based on these findings, the study proposes a novel approach to PCOD treatment – tailoring interventions based on the specific symptom profile of each patient. This personalized approach has the potential to improve treatment efficacy and patient outcomes. This research represents a significant step towards individualizing PCOD treatment. By analyzing patient data and proposing a symptom-based treatment, the study has the potential to revolutionize the management of this complex condition.

The disease burden and its distribution characteristics of clonorchiasis in Guangdong Province, Southern China

BackgroundClonorchiasis has significant socioeconomic importance in endemic areas; however, studies investigating the disease burden in specific sub-regions are lacking. This study aims to address the gap by quantifying the current disease burden caused by clonorchiasis in Guangdong province and assessing its distribution characteristics.MethodsComprehensive measures, including prevalence rates, disability-adjusted life years (DALYs), and direct medical costs, were used to assess the disease burden of clonorchiasis. To estimate the prevalence rate, the number of infections was divided by the examined population, based on the annual surveillance data on clonorchiasis cases during 2016–2021. The calculation of DALYs was based on the epidemiological parameters according to the definition issued by the World Health Organization. Cost data of clonorchiasis were utilized to quantify the direct medical costs. The distribution characteristics of disease burden were assessed through comparisons of groups of population defined by geographic area, time, and characteristics of people.ResultsIn 2021, clonorchiasis posed a significant disease burden in Guangdong Province. The prevalence rate was found to be 4.25% [95% CI (4.02%, 4.49%)], with an associated burden of DALYs of 406,802.29 [95% CI (329,275.33, 49,215,163.78)] person-years. The per-case direct medical costs of patients with clonorchiasis were estimated to be CNY 7907.2 (SD = 5154.4). Notably, while the prevalence rate and DALYs showed a steady decrease from 2016 to 2020, there was a rising trend in 2021. Spatial clustering of clonorchiasis cases and DALYs was also observed, particularly along the Pearl River and Han River. This suggests a concentration of the disease in these regions. Furthermore, significant differences in prevalence rates were found among various demographic groups, including sex, age, occupation, and education level. Additionally, patients with longer hospital stays were more likely to incur higher direct medical costs.ConclusionsThe burden of clonorchiasis in Guangdong Province remains high, despite significant progress achieved through the implementation of the prevention and control programs. It is suggested that measures should be taken based on the distribution characteristics to maximize the effectiveness of prevention and control, with a primary focus on key populations and areas.Graphical

Prediction of Gestational Diabetes Mellitus Risk in Early Pregnancy Using Antenatal Screening Biomarkers

Aim: In this study, we aimed to compare their success in predicting the risk of Gestational Diabetes Mellitus (GDM) using demographic (age, gravidity, parity), body mass index (BMI), first-trimester fasting blood glucose (FBG), thyroid-stimulating hormone (TSH), and antenatal screening biomarkers (dual and quadruple tests). Materials and Methods: In this study, 800 pregnant women who underwent a one-step 75 g Oral Glucose Tolerance Test (OGTT) and antenatal screening tests at a tertiary hospital between January 2017 and June 2020 were retrospectively investigated. After patients were divided into two groups based on their GDM screening test results, the examined parameters were compared between the GDM-Positive and GDM-Negative groups. Once the parameters significantly associated with GDM were determined, their clinical utility in the early diagnosis of GDM was investigated. Results: GDM was diagnosed in 159 (19.8%) of 800 patients. The GDM-Positive group had a higher age, gravidity, parity, BMI, and first-trimester serum FBG levels, as well as lower serum PAPP-A MoM levels than the GDM-Negative group (P

A review of digital maternal health promotion to optimise access and utilization of care services in sub-Saharan Africa

In sub-Saharan Africa, maternal mortality rates remains high among women as the vulnerable demographics of reproductive age and breastfeeding mothers compared to other parts of the world. The situation is exacerbated by the region’s underperforming healthcare systems. Although digital health interventions have increased since the emergence of COVID-19 pandemic to enhance health promotion in terms of maternal health vulnerability, the access to and utilization of care services, the record of positive impacts remains limited. The objective of this paper was to analyse the status of digital maternal health promotion in supporting female of reproductive age, first-time and nursing mothers to access and utilise maternal healthcare services during their perinatal and postpartum periods in underserved settings of sub-Saharan Africa. A literature review of peer-reviewed publications between 2020 and 2023 was conducted by searching online databases using keywords and filtering the results using a set of inclusion and exclusion criteria. Findings indicate that digital maternal health promotion is increasingly enabling access to hard-to-reach populations, but the utilization of associated care services remains relatively low. Particularly, mHealth and asynchronous audio-visual digital media are critical for delivering maternal health educational content to the targeted populations, including their partners, and are most likely to increase utilization of maternal care services. Digital promotion of maternal health requires multi-stakeholder collaboration to address the limiting socio-economic, cultural and technical factors that determine access to and utilization of care services during the perinatal and postpartum period, if mortality rates are to be reduced towards the sustainable development goal for good health and well-being.

Outcomes After Implementation of a Fragility Fracture Pathway in Ground Level Falls

IntroductionFragility fractures occur due to low energy mechanisms and result in significant morbidity and mortality. This study reviews the implementation of a fragility fracture program at a level I trauma center. In this pathway, trauma surgery provides clearance followed by admission and management with medical service and orthopedic consultation for injuries which meet fragility fracture criteria. MethodsThis pathway, implemented in July 2021, includes patients with isolated fractures secondary to a low energy mechanism. We compared cohorts 2-ys before (PRE) and after (POS) pathway implementation. Demographics (age, sex, fracture location, injury severity score, American Society of Anesthesiologists score) and outcome data were collected and analyzed using between-subjects analyses. Measured outcomes included deep vein thrombosis/pulmonary embolism, hospital mortality, disposition to hospice, nonoperative rate, unplanned intensive care unit admission, time to surgery (TTS), and length of stay (LOS). ResultsThe study included n = 1137 patients (n = 564 PRE and n = 573 POS). POS patients had a higher injury severity score (P = 0.003) and different fracture location (P = 0.017), but no other demographics were different. Trauma admission decreased after implementation (P < 0.001; PRE: 21.5%, POS: 1.8%) with no differences in outcomes except increases in LOS (P < 0.001; PRE: 114 h, POS: 124 h) and TTS (P < 0.001; PRE: 15 h, POS: 18 h). ConclusionsMorbidity and mortality did not correlate with pathway implementation; however, TTS and LOS increased. Although TTS increased, it remained under the American Academy of Orthopedic Surgery 48-h recommendation. The TTS and LOS increases were potentially from COVID-19 or cohort demographic differences. Decreased trauma as admitting service demonstrates pathway adherence. These findings highlight the need for investigation to better understand fragility fracture pathways.

The Influence of Social Media Influencer Endorsement on Purchase Intention with the Mediating Roles of Parasocial Interaction and Possession Envy

This study investigates the impact of social media influencer endorsements on purchase intention while examining the mediating roles of parasocial interaction, possession envy, brand credibility, and brand attractiveness. The research employs surveys targeting social media users experienced in influencer endorsements who regularly purchase influencer-recommended products or services. The sample includes diverse respondents across age groups and demographics. SEM-PLS with SmartPLS software is utilized for data analysis. Findings reveal that social media influencer endorsements significantly enhance purchase intention. Parasocial interaction is identified as a mediator in the relationship between influencer endorsements and purchase intention. However, possession envy does not serve as a mediator for social media interactions' influence on purchase intention. In essence, perceived interactions with influencers and feelings of possession envy play pivotal roles in explaining the link between influencer endorsements and purchase intention. Additionally, brand attractiveness and brand credibility act as intermediaries in the impact of social media interactions on purchase intention. This study contributes valuable insights into the dynamics of influencer marketing and its effects on consumer behavior

An Approach to Analyzing Migration Flow and House Price Data: Exploring Spatial Linkages between Flow, Price, Distance, Age at the Local Level

This paper is intended to elucidate the efficacy of employing a Geographic Information Systems (GIS) methodology to investigate the spatial interrelations among migration flows, housing prices, age demographics, and geographical distances. Utilizing data on migration flows and housing prices from Greater Manchester, UK, in 2011, in this study, we performed statistical analyses and generated a suite of visual mappings to illustrate the spatial dynamics between migration patterns, distances, age brackets, and the segmentation of migration destinations by housing price tiers. The findings reveal pronounced spatial associations among migration destinations, underscored by the interplay of housing price levels with age categories, distance intervals, or the origination points tied to specific housing price ranges. This GIS-based analytical framework offers policy-makers and urban planners a powerful tool for discerning distinct migration trends and locales, thereby facilitating more informed decision-making processes.

Comparison of Continuous Thoracic Epidural Analgesia Versus Bilateral Erector Spinae Plane Block for Pain Management in Coronary Bypass Surgery.

Background Effective pain control is vital for patients undergoing heart surgery. Utilizing a multimodal approach to analgesia is essential, as poor pain management can result in hemodynamic and systemic complications. This study aimed to compare perioperative pain management techniques in patients undergoing coronary artery bypass grafting (CABG), specifically evaluating continuous thoracic epidural analgesia and ultrasound-guided bilateral erector spinae block. Methods This randomized comparative study was conducted at a tertiary care centreover a period of six months, with approval from the institute's ethics committee. A total of 24 patients undergoing CABG under general anesthesia participated in the study. They were randomly assigned to either the continuous thoracic epidural analgesia (TEA) group (Group A) or the ultrasound-guided bilateral erector spinae plane (ESP) block group (Group B) using a simple randomization method. The study assessed intraoperative intravenous opioid requirements for maintaining stable hemodynamics, as well as postoperative resting and coughing Visual Analog Scale (VAS) scores and peak inspiratory spirometry. Results Twelve patients from each group completed the study, with comparable demographics (age, gender). Both groups exhibited similar resting and coughing VAS scores at 0, 3, 6, and 12 hours postoperatively (p > 0.05). However, at 24, 36, and 48 hours, Group A had significantly higher VAS scores compared to Group B (p < 0.05). Group A maintained an overall mean VAS score of 4 or less during rest and coughing. Peak inspiratory spirometry results were consistent between both groups (p > 0.05). Conclusion The ultrasound-guided bilateral erector spinae block provided pain control comparable to thoracic epidural analgesia, making it a viable alternative for perioperative pain management. This is particularly beneficial for CABG patients where early postoperative anticoagulant therapy is crucial for graft patency. Effective pain management also contributes to faster recovery in coronary artery bypass grafting.

Family Caregivers of Persons with Bipolar Disorder: Caregiver Demographics and Need and Preference for Intervention

The unpredictability of bipolar disorder is highly distressing for family caregivers, who differ in their needs and preferences for stress-reducing or educational interventions. Applying Ryan and Sawin’s model, this study examined associations between caregiver demographics (age, gender, and race) as contextual factors and caregiver needs and preferences for three interventions as process factors within a preliminary descriptive analysis of 306 family caregivers from a randomized clinical trial. Caregiver needs for education about bipolar disorder, biofeedback, and Resourcefulness Training© were determined by established cut scores on validated measures of bipolar knowledge, heart rate variability, and resourcefulness. Frequencies for need and preference for intervention were compared by caregiver age, gender, and race. Discrepancies between caregiver need and preference for interventions were analyzed. Non-White caregivers showed greater need for education (X 2=33.68, p < 0.001). Middle-aged caregivers showed greatest need for biofeedback (X 2=19.58, p < 0.001). Need for Resourcefulness Training© was similar across age, gender, and race. We found 58% needed biofeedback, 34% education, and 18% Resourcefulness Training©; 46% of those in the preference group chose Resourcefulness Training©. Further caregiver intervention research should consider the effect of caregiver needs and preferences on their health. The findings support the essentiality of assessing caregiver demographics, needs, and preferences before implementing interventions.

Comprehensive Clinical Profile and Hemodialysis Outcomes in Patients Attending a Tertiary Care Hospital.

Background Chronic kidney disease (CKD) can lead to serious conditions such as anemia and cardiovascular disease, posing a growing global health challenge. End-stage renal disease (ESRD) requires treatments such as dialysis or kidney transplantation. Despite the widespread impact and rising prevalence of CKD and ESRD, comprehensive data remains limited in India. This study seeks to investigate the clinical, socio-demographic, and etiological profiles of CKD patients undergoing hemodialysis at a tertiary care hospital, with the goal of enhancing understanding and improving patient care. Methodology This retrospective cohort study, conducted at a tertiary care center, included 500 CKD patients undergoing hemodialysis, with comprehensive medical records. Data collected covered demographics (age, sex, education, and occupation), CKD etiology, disease duration, hemodialysis duration, viral marker status, blood transfusions, and vascular access details. With continuous variables reported as mean ± standard deviation (SD) and categorical variables as counts (percentages), statistical analysis was carried out using SPSS version 21 (IBM Corp., Armonk, New York, USA). The connections were examined using the Pearson Chi-square test, with P≤0.05 being deemed significant. Results The study revealed that hypertension was the primary cause of CKD in 58% of patients, followed by diabetes mellitus in 13%. A significant 93% of patients tested negative for viral markers such as human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen (HBsAg). Hemodialysis duration varied, with 68% of patients undergoing dialysis for one to five years. Most patients had two (40%) or three (58%) dialysis sessions per week, and 84% had only one arteriovenous (AV) fistula surgery. Blood transfusions were common, with 62% of patients receiving between one and five transfusions. The gender distribution showed more males (372) than females (201), and the majority of patients were aged between 41 and 60 years. Conclusion This study highlights the importance of early detection and management of CKD, emphasizing preventive health measures, enhanced diagnostic capabilities, and sufficient resource allocation to reduce the disease burden. It also calls for further research into unknown CKD causes and strategies to improve patient care and outcomes.

Exploring Teacher Awareness of Artificial Intelligence in Education: A Case Study from Northern Cyprus.

This study investigates the level of awareness among teachers regarding the use of artificial intelligence (AI) in education, focusing on whether this awareness varies according to socio-demographic characteristics, access to technology, and specific knowledge and beliefs about AI. Conducted in Northern Cyprus during the 2023-2024 academic year, this study employed a survey model with purposive and snowball sampling methods, involving 164 teachers. Teachers at different levels, namely, primary school, secondary school, high school, and university, were included in this study. The "Artificial Intelligence Awareness Scale", developed by Ferikoğlu and Akgün (2022), was used to measure AI awareness. Data normality was verified through skewness and kurtosis values, allowing for parametric statistical tests such as t-tests, one-way ANOVA, logistic regression, and chi-square analysis. This study explored the distribution of AI use across different school types and educational levels and assessed the impact of sub-dimensions of AI awareness on its application in teaching. Findings revealed no significant influence of teacher demographics (age, gender, education level, type of school, institution level, and monthly income) on AI awareness. However, usage patterns indicated that university lecturers were more likely to incorporate AI in their teaching, followed by primary and high school teachers, with secondary school teachers using it the least. A Multilayer Neural Network Analysis identified practical knowledge as the most critical factor influencing the use of AI in teaching (importance weight of 0.450), followed by beliefs and attitudes (0.298), relatability (0.148), and theoretical knowledge (0.104). These results highlight the importance of practical knowledge for fostering AI integration in educational practices, underscoring significant implications for teacher training and professional development programs.

Establishment and validation of a nomogram for dropout intention in Chinese early year medical undergraduates

BackgroundThe attrition rate of Chinese medical students is high. This study utilizes a nomogram technique to develop a predictive model for dropout intention among Chinese medical undergraduates based on 19 individual and work-related characteristics.MethodA repeated cross-sectional study was conducted, enrolling 3536 medical undergraduates in T1 (August 2020-April 2021) and 969 participants in T2 (October 2022) through snowball sampling. Demographics (age, sex, study phase, income, relationship status, history of mental illness) and mental health factors (including depression, anxiety, stress, burnout, alcohol use disorder, sleepiness, quality of life, fatigue, history of suicidal attempts (SA), and somatic symptoms), as well as work-related variables (career choice regret and reasons, workplace violence experience, and overall satisfaction with the Chinese healthcare environment), were gathered via questionnaires. Data from T1 was split into a training cohort and an internal validation cohort, while T2 data served as an external validation cohort. The nomogram’s performance was evaluated for discrimination, calibration, clinical applicability, and generalization using receiver operating characteristic curves (ROC), area under the curve (AUC), calibration curves, and decision curve analysis (DCA).ResultFrom 19 individual and work-related factors, five were identified as significant predictors for the construction of the nomogram: history of SA, career choice regret, experience of workplace violence, depressive symptoms, and burnout. The AUC values for the training, internal validation, and external validation cohorts were 0.762, 0.761, and 0.817, respectively. The nomogram demonstrated reliable prediction and discrimination, with adequate calibration and generalization across both the training and validation cohorts.ConclusionThis nomogram exhibits reasonable accuracy in foreseeing dropout intentions among Chinese medical undergraduates. It could guide colleges, hospitals, and policymakers in pinpointing students at risk, thus informing targeted interventions. Addressing underlying factors such as depressive symptoms, burnout, career choice regret, and workplace violence may help reduce the attrition of medical undergraduates.Trial registrationThis is an observational study. There is no Clinical Trial Number associated with this manuscript.

Characterizing the Links Between Systemic Sclerosis and Breast Cancer.

Systemic sclerosis (SSc) is a complex, autoimmune connective tissue disease that affects multiple organs in the body, culminating in a variance of severity and a reduced quality of life. Breast cancer (BC) also affects patients with SSc, and these two conditions affect a similar demographic. With this systematic review, we aim to characterize the links between SSc and BC. Characterizing possible links between SSc and breast malignancies is important for advancing the understanding of SSc management and comorbidities. In this systematic meta-analysis, a comprehensive literature search was conducted in PubMed using relevant keywords and MeSH terms. The inclusion criteria included an English-language retrospective analysis that characterized patients with SSc with or without BC. Two independent reviewers assessed the study's eligibility based on predetermined criteria. Data extraction included patient antibody measurements, demographics (age and gender), family history, social behaviors (alcohol use and smoking history), concurrent condition treatments, and adverse effects following treatment. Thirteen articles were identified in the literature with relevant data on SSc and BC patients. Studies encompassed research about SSc patients with or without BC and relevant risk factors being measured. SSc was found to have a link to antibodies widely associated with cancer. Adverse treatment outcomes and concurrent conditions of BC were found when patients had a family history of SSc, BC, or an alcohol or smoking history. Our results suggest that the presence of antinuclear antibodies, anti-centromere antibodies, or anti-topoisomerase antibodies in SSc patients is correlated with BC. Out of the three antibodies, ATA seemed to be found more commonly in patients with SSc and malignancy across the studies. This systematic review discusses the link between SSc and BC through patients with relevant clinical markers, medical histories, and treatments. However, further research is necessary to advance the linkage between SSc and BC and determine whether management of one condition may prevent or alleviate the other.