Research Evidence Research Articles

Acupuncture for patients with Alzheimer's disease: An evidence map of randomized controlled trials, systematic reviews, and meta-analysis.

Background: Acupuncture is an effective complementary treatment for Alzheimer's disease (AD). This review aims to summarize the available evidence provided by randomized controlled trials (RCTs) and systematic reviews (SRs) or meta-analyses (MAs) on the effect of acupuncture on AD. Objective: To systematically summarize and combine clinical research evidence on AD distribution. Methods: We conducted a comprehensive search of various databases, including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wan Fang Data, Chinese BioMedical Literature Database (CBM) and Chonqing VIP (CQVIP), from their inception to September 2023. Relevant literature about acupuncture for AD was included, and the characteristics of the evidence map were presented through charts and textual analyses. Results: In total, 117 RCTs and 17 SRs or MAs were included. The results were divided into three categories: basic characteristics of the included literature, clinical characteristics and quality assessment of the included RCTs, and clinical characteristics and quality assessment of the included SRs and MAs. Conclusions: Acupuncture as a therapeutic measure for AD has some advantages in improving cognition and quality of life; thus, it is imperative to conduct multi-center, large-scale RCTs to enhance the evidence supporting the use of acupuncture in AD. This is the first evidence map exploring acupuncture treatment for AD, providing insights into the current clinical research landscape on acupuncture treatment for AD. Furthermore, the findings of this study highlight research gaps in this field and serve as a valuable reference for guiding the planning and selection of topics for future research.

The importance of incorporation of real-world evidence into the guidelines on the pharmacological treatment of schizophrenia.

The quantity and quality of real-world data and real-world evidence in schizophrenia research are at a high level. However, these results are not included in the grading systems used to develop treatment guidelines for schizophrenia. A meta-analysis and a network meta-analysis have independently provided evidence that the results of randomized clinical trials in schizophrenia adequately translate to real-world settings. The authors propose the incorporation of a synthesis of evidence derived from analyses of randomized controlled trials and real-world data as a novel and highest level of evidence in grading instruments used to develop treatment guidelines for schizophrenia.

Abstract 4117868: The Mediation Effect of Self-care Self-efficacy between Illness Perceptions and Self-care Behaviors among People with Heart Failure

Introduction: Heart failure (HF) self-care behaviors are related to patient outcomes. The Common-sense Model of Self-Regulation indicates that illness perceptions and self-care self-efficacy are crucial predictors of self-care behaviors. However, research evidence is limited on these relationships. Aims: To explore the associations among illness perceptions, self-care self-efficacy, and self-care behaviors in people with HF. Methods: A cross-sectional study design was adopted. People with HF were recruited from a tertiary hospital between February and April 2023 in China. All the participants were assessed for illness perceptions, self-care self-efficacy, and self-care behaviors. Data were analyzed using Pearson correlation and mediation analyses. The study was reported following the STROBE checklist. Results: A total of 164 people with HF were enrolled. Pearson analysis reported the negative correlations between the scores of illness perceptions and the scores of self-care maintenance (r=-0.344, p<0.001), symptom perception (r=-0.352, p<0.001), and self-care management (r=-0.519, p<0.001), as well as the positive associations between the scores of self-care self-efficacy and the scores of self-care maintenance (r=0.689, p<0.001), symptom perception (r=0.697, p<0.001), and self-care management (r=0.771, p<0.001). Moreover, a significant negative relationship between the scores of illness perceptions and the scores of self-care self-efficacy was observed (r=-0.527, p<0.001). Mediation analysis reported that the scores of self-care self-efficacy completely mediated the negative relationships between the scores of illness perceptions and the scores of self-care maintenance, symptom perception, and self-care management, and the mediation effect accounted for 71.4%, 72.5%, and 88.2% of the total effect, respectively. Conclusions: Among people with HF, self-care self-efficacy completely mediated the relationships between illness perceptions and self-care behaviors. Interventions targeting improving illness perceptions and self-care self-efficacy may enhance HF self-care behaviors.

Swipe, view, engage: the interplay of athlete social media content and viewer attitudes on sports perception and interest

PurposeInfluencers in physical activity and sports have gained significant prominence in promoting health and well-being via digital social networks. This research investigates the impact of athlete influencers on sports perceptions, with a focus on korfball. Using korfball as a representative sport minimizes biases, allowing a nuanced exploration of athlete-generated content’s direct influence on viewer attitudes.Design/methodology/approachA questionnaire survey with 319 respondents explores variables like athlete attitude, attractive appearance, social media profile attitude, emotional engagement toward korfball, korfball perception, korfball interest and general sports attitude. Structural equation modeling analysis examines relationships among these variables.FindingsThe study delves into the complex interplay among athlete attitude, social media attitude and emotional engagement toward sports, emphasizing the pivotal role of authenticity in fostering deeper connections. Contrary to expectations, athlete attractiveness did not significantly influence viewer priorities, signaling a notable shift towards valuing authenticity and performance. Furthermore, the research explores how general sports attitudes moderate relationships between sports perceptions and interest, offering critical insights for sports sociology and marketing.Originality/valueThis study innovates by focusing on korfball, emphasizing authenticity over attractiveness and providing insights into the evolving dynamics of sports marketing and consumer behavior in the digital age. This research evidences the profound impact of the digital age on sports engagement, laying a foundation for future studies and practical applications in sports sociology, marketing and consumer behavior.

Interventional Strategies for Children with Progressive Pulmonary Hypertension Despite Optimal Therapy. An Official American Thoracic Society Clinical Practice Guideline.

Pulmonary hypertension in children often progresses despite optimal therapy. This document provides an evidence-based clinical practice guideline for the management of children with progressive pulmonary hypertension despite optimal therapy. A multidisciplinary panel identified pertinent questions regarding the management of children with pulmonary hypertension that has progressed despite optimal therapy, conducted systematic reviews of the relevant literature, and applied the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach to develop clinical recommendations. After reviewing the research evidence, the panel considered the balance of desirable (benefits) and undesirable (harms and burdens) effects of the interventions in each proposed question. Valuation of our main outcomes was also considered, along with resources required, equity, acceptability, and feasibility. Recommendations were developed for or against interventional strategies specific to children with pulmonary hypertension that has progressed despite optimal therapy. Although there is a growing population of children with pulmonary hypertension, there is a striking lack of empirical evidence regarding management of those whose disease has progressed despite optimal pharmacotherapy. The panel formulated and provided the rationale for clinical recommendations for or against interventional strategies based on this limited empirical evidence, coupled with expert opinion, to aid clinicians in the management of these complex pediatric patients. In addition, we identified important areas for future research.

Ergonomics in Management of Stress amongst the Night Shift Workers: A Preliminary Review

Working on night shift is basically going against the circadian rhythm. Biological clock inside the human insists to fixed working status on daytime and rest/sleep at night. Ergonomics deals with providing a healthy relation between man machine and environment, where man fits to the job generates ultimate productivity. People in the east who are compromised to adjust in low to middle income are the main sufferers of not having optimum sleep. The population of security services, drivers, loco-pilots, nurses, tele-sales, IT professionals, various millworkers etc. often have shift based jobs and tries to accustom in it by compromising the biological clock. Many research evidences have been showed that alterations in biological clock lead to cause severe insomnia & shift work sleep disorder leading in disturbing occupational health as well as safety. Even sudden alterations in the biological clock lead cause accident, injuries alike from common health distresses. Alteration in the work rest cycle, taking sufficient rest in between the works, getting sufficient scopes in changing postures by arrangements of refreshments in the work place can help in optimizing productivity in the work place. Rotational shift with dynamic posture based work may lower the tendencies of accident and risk associated with night shift based work.

AI-Assisted Pedagogies

This paper advocates using large language models (LLMs) to enhance students' open-ended mathematical problem-solving skills. The literature review reveals that using large language models (LLMs) in educational settings is an emerging field with limited research evidence. Much of the existing literature focuses on the perceptions of educators and other stakeholders and evaluations of LLM model accuracy rather than their potentially transformative impact on educational outcomes or personalised learning in mathematics. This paper reports on the ongoing development of a study to provide such evidence. It presents expected results derived from our preliminary development work, which suggests that teaching students to utilise LLMs like ChatGPT effectively can enhance their critical thinking and analytical skills in mathematical problem-solving. Initial observations and iterative refinements inform these anticipated outcomes during the pilot phase of our research.

A Systematic Review of Isotopically Measured Iron Absorption in Infants and Children Under 2 Years

Background: Iron is an essential element for critical biological functions, with iron deficiency negatively affecting growth and brain development and iron excess associated with adverse effects. The goal of this review is to provide a comprehensive assessment of up-to-date evidence on iron absorption measured isotopically in children, preterm infants, and full-term infants, up to 24 months of age. Methods: Search databases included Pubmed, Cochrane, Web of Science, and Scopus from a date range of 1 January 1953 to 22 July 2024. The included articles were experimental studies with iron absorption outcomes measured by isotopic techniques. The risk of bias was assessed using the Cochrane Risk of Bias Tool. Results: A total of 1594 records were identified from databases, and 37 studies were included in the quality review with a total of 1531 participants. Article results were grouped by study commonality: absorption and red blood cell incorporation, type of milk feedings, additives to improve absorption, how and when to supplement with iron, and iron forms and complimentary foods. Conclusions: The results from this review support the current recommendations of oral iron supplementation. Iron from breast milk has high bioavailability, and unmodified cow’s milk reduces iron absorption. Supplemental iron is required at 4–6 months for healthy, full-term infants and sooner for preterm infants. Ascorbic acid increases iron absorption in full-term infants and children. Lactoferrin and prebiotics are promising candidates for enhancing iron absorption, but they require further investigation. Research evidence of iron absorption mechanisms and modulating factors in preterm infants is limited and should be a research priority.

Initiatives on Education Diplomacy/Linkages: The Chequered Experience in Nigeria

Purpose of the study: The study provided clear indications from the studies of comparative education that Nigeria’s educational system is not highly rated when compared to many other educational systems around the globe. Research evidences are also rife on the use of education diplomacy and international linkages for bridging the gaps of educational inequalities between developed and developing nations. Methodology: As a qualitative study, the paper adopted historical research design, relying on documentary analysis to establish the tenets of education diplomacy/ linkages are not only capable of improving Nigeria’s educational system, but can equally be used to elevate it to a point of global relevance and reference. Main Findings: Revealed in the study are the four major purposive initiatives that are corollaries of education diplomacy/ linkages are depicted in the praxes associated with Foreign Aid packages, Technical Aids Corps, Foreign Studentship schemes and Internalization programme in higher education. The treatise critical appraises the exploration and use of these initiatives for educational image-making and cautious integration of the country’s educational system with global best practices. Despite the chequered experiences identifiable with the initiatives, the inherent derivatives of these initiatives are extremely gainful to the overall development of education in Nigeria. Novelty/Originality of this study: Finally, the paper strongly advocated that Nigeria needs to carefully re-engage and follow through the gains in these initiatives, so as to unlock and tap from the intrinsic benefits and humongous opportunities derivable from the thrusts of education diplomacy linkages.

BARRIERS, KNOWLEDGE AND FACILITATORS OF EVIDENCE BASED PHYSIOTHERAPY PRACTICE IN INDIA.

Background: Evidence based practice is a method to improve patient outcome by replacing the outdated practice with scientifically validated methods. Barriers, knowledge and facilitator influence evidence-based physiotherapy practice worldwide. Objective: This study was to explore the barriers, knowledge and facilitator of Evidence Based Practice (EBP) among physiotherapist in India Methods: A survey was conducted using a structured questionnaire among 50 physiotherapists, 42 responses were collected. Result: Respondents concurred that EBP is essential for practice, and it is helpful in both decision making and improving patient care. The most common barriers were time and workload constraints, lack of desire, financial incentives, weakness in English, difficulty in access to search engines, Inability to apply evidence. The facilitator includes targeting funding, access to remote, supportive staff and leadership committed to innovation and skills in EBP. The knowledge is limited to a few key terms. Conclusion: Physiotherapists in India have a positive attitude towards EBP, and it is necessary to move towards minimizing the existing barriers at the individual level by adopting effective multilateral policies. Attention is needed to improve EBP knowledge. Implication: EBP is the integration of best research evidence with clinical expertise and patient values. It provides open and thoughtful clinical decision making about physiotherapy management of patients.

Potential Role of Soundscape and Music Interventions in post-Intensive Care Rehabilitation

Background Post Intensive Care Unit (ICU) survivors face physical, psychological, and cognitive impairments during their recovery phase, adversely affecting their quality of life. Given the scarcity and barriers to access to post-ICU care worldwide, patient-centered adjuncts are worth exploring. Although music interventions have gained recognition as non-pharmacological approaches in the acute phase of critical illness; exploration of their potential benefits in the post-ICU is scarce. Objective This paper examines the potential of sound and music interventions as an adjunct therapeutic modality to improve the well-being of adults post-ICU patients, through a narrative overview of published research evidence regarding post-ICU recovery and other relevant post-acute conditions, such as post-traumatic disorder and anxiety. Results The effectiveness of sound/ music interventions on several key outcomes including reduced anxiety, stress, pain, and PTSD, improved sleep, and enhanced mood and emotional well-being have been studied. Research indicates that music-based approaches to physical and psychological well-being reduce emotional distress, foster connectedness, and improve overall well-being. The importance of tailoring sound and music interventions to the individual needs and preferences of post-ICU patients is emphasized. Conclusion The potential benefits of sound and music interventions, both in terms of physiological and psychological well-being, encourage further investigation into their potential application and implementation into post-ICU care and rehabilitation. Ultimately, this therapeutic approach could contribute to enhancing the overall quality of life and empowerment of post-ICU patients on their path to recovery.

Evidence use in higher education decision-making and policy: a scoping review of empirical studies from 2010 to 2022

In this article, we review empirical studies on the use of evidence in higher education decision-making and policy from 2010 to 2022. In our scoping review, we identify 77 studies in English or German, of which 69 meet minimum quality standards. We map the current state of knowledge on the use of data and research evidence in higher education and research institutions, and higher education and research policy, using qualitative coding. The results depict a growing, US-dominated, research field characterised by a large variety of methodological approaches, influenced by heterogeneous sets of paradigms and shaped by professional publications. We compare studies on evidence use in higher education and research institutions, and higher education and research policy, and find conceptual and empirical differences regarding the studied dimensions of evidence use, the types of evidence taken into account, and factors influencing evidence use. Our review highlights the need for comparative organisational research on evidence use, further research on mechanisms and pathways of evidence uses and a closer linkage between concepts and empirical findings.

Three-dimensional finite element analysis of occlusal stress on maxillary first molars with different marginal morphologies restored with occlusal veneers

BackgroundThere are differences in the research results regarding which edge design of occlusal veneers can achieve the best long-term success rate as a relatively new fixed prosthesis restoration method. Further research is needed. The three-dimensional finite element method was used to conduct stress analysis on occlusal veneers of maxillary first permanent molars with different thicknesses and margin preparation designs. The aim of this study was to provide mechanical research evidence and a reference for exploring standardized clinical protocols for the design of occlusal veneer restorations of maxillary first molars.MethodA 3Shape (Intraoral Scanner) was used to scan the maxillary first molar teeth in vitro, after which 3D printing was carried out. Three different edge designs were applied to identical teeth: straight-beveled finishing line(SFL), chamfer finishing line(CFL), and standard cuspal inclination(SCI). Preparation was carried out with a thickness of 0.5 mm. Using the surface deformation feature, the occlusal veneer was thickened to 0.5 mm and 1.0 mm, and periodontal ligaments were added. They were then placed into the upper and lower jaws and dental arches. Finite element analysis was performed after applying bite force dispersion to the loading area on the mandible following dynamic contact.Results(1) As the thickness increased, the maximum Von Mises stress in the occlusal veneers SFL and CFL also increased, while the SCI exhibited the opposite trend. (2). The trend of the maximum Von Mises stress in the adhesive layer decrease gradually with increasing thickness of the occlusal veneer. The stresses of the SFL and CFL is concentrated primarily at the edge position below the functional cusp, resulting in relatively low adhesive stress. However, in the SCI group, the maximum stress at the edge of the adhesive layer exceeds the maximum shear strength of commonly used adhesives.ConclusionsUnder the experimental conditions, the mechanical properties of the maximum Von Mises stress in the SFL, CFL, and SCI occlusal veneers meet clinical needs. Incorporating the minimally invasive concept of tooth preservation, a thickness of 1.0 mm are optimal for glass ceramic occlusal veneers on maxillary first molars.

Digital Contact Tracing Implementation Among Leaders and Health Care Workers in a Pediatric Hospital During the COVID-19 Pandemic: Qualitative Interview Study.

Health systems had to rapidly implement infection control strategies to sustain their workforces during the COVID-19 pandemic. Various outbreak response tools, such as digital contact tracing (DCT), have been developed to monitor exposures and symptoms of health care workers (HCWs). Limited research evidence exists on the experiences with these technologies and the impacts of DCT innovations from the perspective of stakeholders in health care environments. This study aims to identify the factors influencing the adoption of DCT, highlight variations in perspectives across 3 key stakeholder groups concerning the impact of DCT, and provide benchmarking evidence for future pandemic preparedness. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, we conducted an exploratory qualitative study to investigate the implementation and impact of DCT at the Children's Hospital of Eastern Ontario between December 2022 and April 2023. We conducted 21 semistructured interviews with key stakeholders, including health care administrators (6/21, 29%), occupational health and safety specialists (8/21, 38%), and HCWs (7/21, 33%). Stakeholders were asked about the factors influencing engagement with the DCT tool, organizational-level uptake, the implementation process, long-term use and sustainability of DCT, and unintended consequences. Verbatim transcripts were subject to thematic analysis using NVivo (QSR International). The implementation of DCT was viable and well received. End users indicated that their engagement with the DCT tool was facilitated by its perceived ease of use and the ability to gain awareness of probable COVID-19 exposures; however, risk assessment consequences and access concerns were reported as barriers (reach). Participants commonly agreed that the DCT technology had a positive influence on the hospital's capacity to meet the demands of COVID-19 (effectiveness). Implementors and occupational specialists referred to negative staffing impacts and the loss of nuanced information as unintended consequences (effectiveness). Safety-focused communication strategies and having a DCT tool that was human-centered were crucial factors driving staff adoption of the technology. Conversely, adoption was challenged by the misaligned delivery of the DCT tool with HCWs' standard practices, alongside the evolving perceived threat of COVID-19. Stakeholders collectively agreed on the viability of DCT and its applicability to infectious disease practices (maintenance). Hospital stakeholders were highly satisfied with DCT technology and it was perceived as feasible, efficient, and having a positive impact on organizational safety. Challenges related to the alignment and delivery of DCT, alongside the evolving perspectives on COVID-19, posed obstacles to continued adoption by HCWs. Our findings contribute to evidence-based practices and present benchmarks that can inform preparedness for future pandemics and infectious disease outbreaks and help other organizations implement similar technologies.

Local Perception of The Effects of Climate Uncertainty on Cattle Farming in Burkina Faso: A Case Study of The Mouhoun Province

Climate change represents a threat to pastoralists in the Mouhoun Province, whose main source of income is the exploitation of natural and animal resources. The problem of this study is based on the good perception of breeders which was necessary for them to adapt to the climatic crises that have already occurred. The objective of this study is to analyze the perception of the effects of climate uncertainty on ruminant breeding in the Mouhoun province. For this purpose, 286 breeders, including agro-breeders and agro-breeders, or 22 breeders per village, were surveyed. In addition, a focus group was organized in each village, for a total of thirteen (13). Phinks software was used to process the individual survey data. The results indicate a deterioration in the forage supply of natural rangelands (100%), an increase in the mobility of animals (69.31%), an increase in morbidity (69.3%) and a drop in the frequency of twin births (56.0%). In summary, it appears that the population has a good perception of the effects of the local climate on animals and forage resources. Furthermore, although it is difficult to integrate research evidence into development policies and practices, the results of this research could guide policy decision-making. This study leads to the conclusion that the changes perceived by breeders are relevant for the development of adaptation strategies to climate change.

Toward evidence-informed policymaking in Nigeria? A systematic review of agricultural evidence syntheses

This article studies the body of agriculture evidence synthesis in Nigeria as a basis for evidence-informed policymaking (EIPM). EIPM is seen by its advocates as an objective way of identifying problems and proffering solutions that work, given its potential to offer sound bases for choices, helping with more effective decisions, and preventing detrimental policy outcomes. Yet, according to the EIPM literature, policymakers hardly use evidence or use it to justify pre-existing beliefs. At the same time, EIPM is often criticized as being susceptible to bias, especially given the large volumes of research being published that may arrive at different conclusions. One tool that could address these challenges is research evidence syntheses, known to be objective and rigorous, although there is a gap in knowledge on whether they are produced in ways that make them easily usable by decision makers. To bridge this knowledge gap, this study develops an analytical framework from the literature on facilitators and barriers of scientific evidence use to analyze existing agriculture-based evidence syntheses in Nigeria. The analytical framework was used to analyse and identify gaps in these syntheses that may limit their use by decision makers. Based on pre-defined search criteria, we find 19 relevant syntheses which are more qualitative and useful in defining policy-relevant problems; however, they mostly do not provide quotable economic statistics, solutions to address the problems identified, or implementation strategies. Given the currently limited number of evidence syntheses, especially those evaluating effectiveness of policy solutions, stakeholders interested in strengthening EIPM in Nigeria could facilitate collaborations between policymakers and researchers to popularize policy-relevant evidence synthesis and ensure such are made available and accessible to users in timely and usable formats.

Platelet count has a U-shaped association with mortality in hemodialysis patients

Our previous manuscript showed that thrombocytopenia predicts all-cause mortality in Chinese hemodialysis (HD) patients. Based on the role of platelets in coagulation, clot formation, and systemic inflammation, we speculate that high platelets increase risk of thrombo-embolic events, hence the mortality. However, research evidence is currently lacking. Therefore, we utilized data from a very large international cohort study to explore the association of platelet counts with mortality and cardiovascular (CV) death in hemodialysis (HD) patients. International data from 396 facilities enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 5 (2012–2015) were analyzed. Participants were divided into 3 groups according to their platelet counts (low: <100, normal: 100–300, high: >300*109). Associations between platelet counts and all-cause and CV mortality were analyzed using Cox regression, adjusted for confounders. There were 13,631 patients with median age of 65 years old. Males accounted for 61.2%. Mean platelet count was 205*109/L overall and ranged from 173 *109/L in China to 227 *109/L in Sweden. Overall, 2,348 (17.2%) patients died and 1017 (7.5%) died from CV disease. Both low (HR:1.48, 95% CI 1.21–1.80, p < 0.001) and high (HR:1.17, 95% CI 1.00- 1.35, p = 0.044) platelet counts were associated with higher all-cause mortality after adjustment for covariates; results for CV death were consistent. Platelet count has a U-shaped association with all-cause and CV mortality in HD patients, and thus may be used as an outcome predictor that is readily available among HD patients.

A mixed-methods survey and focus group study to understand researcher and clinician preferences for a Journal transparency Tool

Transparency within biomedical research is essential for research integrity, credibility, and reproducibility. To increase adherence to optimal scientific practices and enhance transparency, we propose the creation of a journal transparency tool (JTT) that will allow users to obtain information about a given scholarly journal’s operations and transparency policies. This study is part of a program of research to obtain user preferences to inform the proposed JTT. Here, we report on our consultation with clinicians and researchers. This mixed-methods study was conducted in two parts. The first part involved a cross-sectional survey conducted on a random sample of authors from biomedical journals. The survey asked clinicians and researchers about the inclusion of a series of potential scholarly metrics and user features in the proposed JTT. Quantitative survey items were summarized with descriptive statistics. Thematic content analysis was employed to analyze text-based responses. Subsequent focus groups used survey responses to further explore the inclusion of items in the JTT. Items with less than 70% agreement were used to structure discussion points during these sessions. Participants voted on the use of user features and metrics to be considered within the journal tool after each discussion. Thematic content analysis was conducted on interview transcripts to identify the core themes discussed. A total of 632 participants (5.5% response rate) took part in the survey. A collective total of 74.7% of respondents found it either ‘occasionally, ‘often’, or ‘almost always’ difficult to determine if health information online is based on reliable research evidence. Twenty-two participants took part in the focus groups. Three user features and five journal tool metrics were major discussion points during these sessions. Thematic analysis of interview transcripts resulted in six themes. The use of registration was the only item to not meet the 70% threshold after both the survey and focus groups. Participants demonstrated low scholarly communication literacy when discussing tool metric suggestions. Our findings suggest that the JTT would be valuable for both researchers and clinicians. The outcomes of this research will contribute to developing and refining the tool in accordance with researchers and clinicians.

PhD-DNP Collaboration: An Integrative Review of Scholarly Partnerships in Nursing.

Nurses holding terminal degrees, Doctor of Philosophy (PhD), Doctor of Nursing Science (DNS), and Doctor of Nursing Practice (DNP), fulfill different roles in nursing. The continued growth of nursing science and practice is dependent on alliances between these nurses that produce state-of-the-art knowledge and support the translation of evidence to practice. This integrative review described characteristics of scholarly collaborations between nurses holding a research-focused degree, the PhD, and those holding a practice-focused degree, the DNP. Five major nursing, medicine, and education databases were searched for peer-reviewed, original articles addressing or describing the characteristics of PhD-DNP scholarly collaborations, published through March 2023. In total, 15 articles met the inclusion criteria, and an integrative synthesis was conducted using constant comparison and thematic analysis. Findings included one overarching theme, Role Clarification, as well as four subthemes that emerged across the sample, describing key characteristics of collaborative PhD-DNP scholarship: (1) Mutual understanding and appreciation of strengths; (2) Strategic project planning and team building; (3) Clear organizational/administrative directives and guidance; and (4) Shared goals for the nursing profession. Articles describing the collaboration between nurses holding doctoral degrees are limited and provide primarily lower-level research evidence and evidence-based practice outcomes. Despite efforts to foster scholarly collaborations among nurses holding terminal degrees, more research is needed to clarify individual roles, offer tangible strategies for collaboration, and measure outcomes of collaboration benefitting healthcare systems, patient outcomes, and the nursing profession. This integrative review involved only the review of the extant literature.

Construction of a prognostic model based on cuproptosis-related patterns for predicting survival, immune infiltration, and immunotherapy efficacy in breast cancer: Cuproptosis-based prognostic modeling in breast cancer.

Breast cancer is the most common and lethal malignancy among women worldwide. Cuproptosis, a newly identified copper-dependent cell death, is closely associated with cancer development. However, its regulatory mechanisms in breast cancer are not well studied. This study aims to establish a prognostic model for breast cancer to improve risk stratification. The mRNA expression data was downloaded from The Cancer Genome Atlas and Gene Expression Omnibus databases. Consensus clustering identified patterns based on cuproptosis-related genes. Key genes were screened using Weighted Gene Co-Expression Network Analysis and differentially expressed gene analysis. A prognostic model was constructed using Cox regression and evaluated with time-dependent receiver operating characteristic and Kaplan-Meier analyses. Functional pathways, immune cell infiltration, and other tumor characteristics were also analyzed. Two distinct cuproptosis patterns were identified. The top 21 differentially expressed genes, significantly associated with survival, were used to construct the prognostic model. The risk score has a negative correlation with survival. Enrichment analysis showed immune-related pathways enriched in the low-risk group, which also had more immune cell infiltration, higher stromal component, lower tumor purity, and lower tumor heterogeneity. Finally, significant differences of half maximal inhibitory concentration were also observed between patients in high- and low-risk groups who received chemotherapy and targeted therapy drugs. These findings in our study may provide evidence for further research and individualized management of breast cancer.