Expectation Scores Research Articles

Acceptability, User Satisfaction, and Feasibility of an App-Based Support Service During the COVID-19 Pandemic in a Psychiatric Outpatient Setting: Prospective Longitudinal Observational Study.

Patients with mental disorders often have difficulties maintaining a daily routine, which can lead to exacerbated symptoms. It is known that apps can help manage mental health in a low-threshold way and can be used in therapeutic settings to complement existing therapies. The aim of this study was to evaluate the acceptability, usability, and feasibility of an app-based support service specifically developed for outpatients with severe mental disorders in addition to regular face-to-face therapy during the COVID-19 pandemic. Patients in a psychiatric outpatient department at a German university hospital were invited to use an app-based support service designed transdiagnostically for mental disorders for 4 weeks. The app included 7 relaxation modules, consisting of video, audio, and psychoeducational text; ecological momentary assessment-like questionnaires on daily mood answered via a visual smiley-face scale; and an activity button to record and encourage daily activities. Standardized questionnaires at baseline (T0; preintervention time point) and after 4 weeks (T2; postintervention time point) were analyzed. Feedback via the smiley-face scale was provided after using the app components (T1; during the intervention). Measures included depressive symptoms, quality of life, treatment credibility and expectancy, and satisfaction. Furthermore, participation rates, use of app modules and the activity button, and daily mood and the provided feedback were analyzed (T2). In total, 57 patients participated in the study, and the data of 38 (67%) were analyzed; 17 (30%) dropped out. Satisfaction with the app was high, with 53% (30/57) of the participants stating being rather satisfied or satisfied. Furthermore, 79% (30/38) of completers stated they would be more likely or were definitely likely to use an app-based support service again and recommend it. Feasibility and acceptability were high, with nearly half (18/38, 47%) of the completers trying relaxation modules and 71% (27/38) regularly responding to the ecological momentary assessment-like questionnaire between 15 and 28 times (mean 19.91, SD 7.57 times). The activity button was used on average 12 (SD 15.72) times per completer, and 58% (22/38) felt "definitely" or "rather" encouraged to perform the corresponding activities. Depressive symptomatology improved significantly at the postintervention time point (P=.02). Quality of life showed a nonsignificant increase in the physical, psychological, and social domains (P=.59, P=.06, and P=.42, respectively) and a significant improvement in the environment domain (P=.004). Treatment credibility and expectancy scores were moderate and significantly decreased at T2 (P=.02 and P<.001, respectively). Posttreatment expectancy scores were negatively associated with posttreatment depressive symptomatology (r=-0.36; P=.03). App-based programs seem to be an accessible tool for stabilizing patients with severe mental disorders, supporting them in maintaining a daily routine, complementing existing face-to-face treatments, and overall helping respond to challenging situations such as the COVID-19 pandemic.

Service quality evaluation of county-level public hospitals in Chongqing under smart healthcare

BackgroundThis study explores patients' perceptions and expectations of smart healthcare services from the perspective of patient experience.The aim is to provide insights for the development of smart healthcare services in hospitals.MethodsA cluster sampling method was used to select 10 public county-level hospitals from October to November 2021 in a municipality in southwestern China. Patient expectations and perceptions about smart healthcare services were assessed using SERVQUAL scale, which included 24 items across four dimensions: ability, application, platform, and effectiveness. The perception-expectation gap was calculated, and factors influencing this gap were analyzed. The Importance-Performance Analysis (IPA) model was then applied to evaluate the results.ResultsA total of 915 patients from outpatient and inpatient departments participated in the study. The average perception score was 3.86, while the average expectation score was 4.44, resulting in a gap of -0.58. Paired sample t-tests revealed significant differences between patients' perceptions and expectations across the 24 items (P < 0.05). IPA quadrant analysis identified 5 items in quadrant IV. A generalized linear model indicated that patients with a college degree, income between 2001 ~ 3500RMB, and income between 3501 ~ 5000RMB were associated with differences in service quality evaluation. Patients covered by urban and rural residents' medical insurance also showed variations in their evaluations.ConclusionsThe study highlights that smart healthcare services in public county-level hospitals fall short of meeting patients' expectations. It emphasizes the importance of addressing individualized medical needs and improving aspects such as cost control, system design, technology-human care balance, and operational efficiency.

ANALISIS PENGARUH KUALITAS PELAYANAN BERBASIS BUDAYA ORGANISASI TERHADAP KEPUASAN PENGGUNA JASA FASILITAS KAWASAN BERIKAT PADA BEA CUKAI MAGELANG

The aim of the research is to examine, determine and analyze the influence of service quality based on organizational culture on the satisfaction of users of Bonded Zone facility services at Magelang Customs. The method used is a quantitative method with a descriptive statistical approach. Research data at Magelang Customs. was obtained using a questionnaire and a sample of 49 respondents. The data analysis carried out in the research is statistical and mathematical methods through GAP Analysis, Customer Satisfaction Index (CSI), and Importance-Performance Analysis (IPA) measurements. The results of research on Service Quality calculations using GAP Analysis show that there are indicators from statement items that have negative values from the GAP Analysis calculations for each dimension of service quality with the total score obtained being -0.20. This value shows that the expectation score is greater than the performance score. Data analysis using the Customer Satisfaction Index (CSI) at Magelang Customs showed that 89.12% were very satisfied. The overall level of customer satisfaction by looking at the level of performance and level of importance of product or service attributes as measured using the Customer Satisfaction Index (CSI) at the Magelang Customs, overall expectations and performance are very good. Then, the results of the Importance-Performance Analysis (IPA) measurement show improvements in service quality which are focused on 5 indicators that are included in important services, but satisfaction is still low.

Expectation, perception, and satisfaction of antenatal care services among pregnant women attending health facilities of Lumbini province, Nepal: a cross-sectional study

Background: Antenatal care (ANC) plays a crucial role in ensuring the health and well-being of pregnant women by providing regular checkups to identify potential complications and deliver important guidance on pregnancy and childbirth. While the expectations surrounding ANC services are shaped by user's individual needs and preferences, the quality of care experienced is largely determined by the service providers. The level of service quality significantly influences the utilization of ANC service, as women are more likely to use services that satisfied their expectations. This study aimed to assess the expectations, perceptions, and satisfaction levels of pregnant women concerning the ANC services offered by health institutions in Lumbini Province. Methods: An institution-based cross-sectional analytical study was carried out involving 2,986 pregnant women, selected through multistage cluster sampling. Quantitative analysis was carried out to calculate the perception, expectation, and satisfaction score. The SERVQUAL tool was utilized to measure expectation, perception and service quality gap. Results: The study involved 2,986 pregnant women, the majority of whom (76.7%) were aged 20-30 years, 38.5% were Janajati, most of them (32.5%) had a secondary level of education, and 78.8% were housewives. The expectation score was higher than the perception. Overall, only 67% of pregnant women were satisfied with the services. Conclusions: Significant disparities exist between the expectations and actual perceptions of ANC users, indicating a lower level of satisfaction among mothers with the ANC services. The study concluded that decreased satisfaction with the service is likely to reduce the trend of service utilization.

Characterizing Treatment Credibility, Treatment Expectancy, and Symptom Expectancy in Patients Before Nonoperative Treatment for Degenerative Meniscal Tears.

The role of nonspecific factors, such as treatment credibility, treatment expectancy, and symptom expectancy, may shape the outcomes of the nonoperative treatment of degenerative meniscal tears (DMTs). The purpose of this study was to characterize treatment credibility and expectancy, symptom expectancy, and patient and clinical correlates of these factors among participants before undergoing 4 nonoperative treatment programs for DMTs. It was hypothesized that (1) treatment credibility scores would be similar across patient and baseline clinical subgroups and (2) treatment expectancy and symptom expectancy scores would be lower in older patients and among those reporting a longer pain duration or greater pain intensity. Cohort study; Level of evidence, 3. In 126 participants, validated scales were administered before treatment to assess the credibility of the assigned treatment (possible score of 1-9) as well as the expectations of treatment outcomes (0-100) and symptom improvement (1-5). Patient and clinical characteristics associated with these variables were examined. On average, participants (mean age, 58 years [range, 45-75 years]; 51% female; 94% White) expected the treatment to improve their symptoms by a mean of 68% and expected their symptoms to be "very likely" to improve. Participants with a body mass index (BMI) ≥30 kg/m2 had lower mean treatment credibility (6.09 ± 1.81) and treatment expectancy (64.53 ± 25.16) scores on bivariate analyses than those with a BMI <30 kg/m2 (6.73 ± 1.69 [P = .045] and 72.86 ± 19.20 [P = .039], respectively). Participants reporting a pain duration ≥3 months also had lower mean treatment expectancy (63.85 ± 23.83) and symptom expectancy (3.70 ± 0.85) scores compared to those reporting a pain duration <3 months (75.52 ± 18.93 [P = .003] and 4.16 ± 0.67 [P = .001], respectively). Most patients about to undergo physical therapy for DMTs considered it to be between "somewhat" and "very" credible and believed that their symptoms, on average, were "very likely" to improve. Although not supported by most evidence, patients with a BMI ≥30 kg/m2 believed physical therapy to be less credible and had lower treatment and symptom expectations, and those with symptoms present for ≥3 months had lower treatment and symptom expectations as well. Whether these nonspecific factors influence outcomes should be considered for further research.

Total Knee Replacement as Treatment for Hemophilic Arthropathy: A Case Series.

Background and objectives Hemophilic arthropathy is a known complication of patients with hemophilia, with the knee as the commonest joint affected. Patients with this condition have severe pain and restricted joint mobility, affecting their activities of daily living. Total knee replacement can increase these patients' quality of life. Nevertheless, this surgery has a high risk of complications due to the nature of the underlying hemophilia. In this study, we present the short-term outcome of a case series of six patients with hemophilic arthropathy who underwent total knee replacement at a hospital with hematology support performed by an experienced arthroplasty surgeon. Patients and method This study reviewed and included eight consecutive total knee replacements in six patients with hemophilic arthropathy performed by a single board-certified arthroplasty surgeon from 2019 to 2023. The demographic profile of the patients, pre- and postoperative range of movement, and short-term outcome scores were summarized. Results The mean preoperative flexion contracture was 10.6° (range: 5°-30°), and it was 0.7° (range: 0°-5°) postoperatively. The mean preoperative flexion of the knee was 78.1° (range: 45°-110°) and 98.8° postoperatively. At six-month follow-up, the average Knee Society Score expectation, satisfaction, and functional scores had improved from 8.3 to 13.8 points, 20 to 38.5 points, and 42.8 to 80.5 points, respectively. Conclusion This study suggests that short-term results of total knee replacement in patients with hemophilic arthropathy are favorable, with increased range of movement and quality of life. We also conclude that surgery should be performed by an experienced surgeon with the support of a dedicated hematology unit.

Smoking-Related Increases in Alcohol Outcomes and Preliminary Evidence for the Protective Effect of a Functional Nicotine Receptor Gene (CHRNA5) Variant on Alcohol Consumption in Individuals Without Alcohol Use Disorder.

Alcohol and nicotine interact with the nicotinic acetylcholine receptor system to alter reward-related responses, thereby contributing to the co-use and misuse of these drugs. A missense polymorphism rs16969968 (G>A) in the CHRNA5 gene has shown a strong association with nicotine-related phenotypes. However, less is known about the impact of this variant on alcohol-related phenotypes. We assessed the main and interactive effect of smoking and rs16969968 polymorphism on alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT), Timeline Follow Back (TLFB), and Lifetime Drinking History (LDH) in 980 healthy adults without alcohol use disorder. We further examined the effect of the rs16969968 polymorphism on acute alcohol consumption using a free-access i.v. alcohol self-administration (IV-ASA) human laboratory paradigm in a subset of 153 nonsmoking participants. Subjective alcohol responses, alcohol sensitivity, and expectancy measures were compared between genotype groups (GG; AA/AG). We observed a significant association of smoking with AUDIT, TLFB, and LDH measures across genotype groups, with smokers showing higher scores compared with nonsmokers. Additionally, we found an association between genotype and TLFB-total drinks in the IV-ASA subset, with the GG group showing higher scores than AA/AG group. Relatedly, the alcohol negative expectancy score was significantly lower in the GG group than the AA/AG group. Our findings underscore the association of smoking with alcohol measures. We found preliminary evidence for the protective effect of the functional CHRNA5 polymorphism on alcohol consumption and its association with increased negative alcohol expectancies, which highlights the substantial heterogeneity in alcohol responses.

ANALISIS KUALITAS PELAYANAN SISTEM X-RAY PADA PT PELINDO CABANG BENOA

This study aims to assess the service quality of the X-ray system at Benoa Port and provide recommendations for improving service quality at Benoa Port. The analysis methods used are the Service Quality (Servqual) method to identify gaps between the perceptions and expectations of passengers regarding service quality at Benoa Port and the Importance Performance Analysis (IPA) method to determine service improvement priorities. The sample of this study consisted of 96 cruise passengers in 2024. The result of the research using the servqual method indicate that there are gaps in all dimensions. The highest gap is in the tangible dimension with -0,49 and the lowest gap is in the assurance dimension with a gap of -0,24. Overall the average perception score is 3,80 and the average expectation score is 4,19, resulting in a gap of -0,39 and an average Q score of 0,91 indicating that the service quality provided almost meets the passengers expectations but is not yet perfect. The analysis result using Importance Performance Analysis (IPA) methode show a conformity rate (TKi) between importance and performance of 93,65%, indicating that the quality of the X-ray service system at Benoa Port meets the passengers expectations but still requires improvements. Based on the Cartesian Diagram, there are 5 attributes located in quadrant I, which means that improvements are necessary, consisting of the dimensions of tangibles, responsiveness, and empathy

Association of parent-child discrepancies in educational aspirations with physical fitness, quality of life and school adaptation among adolescents: a multiple mediation model

BackgroundThe global public health issue of diminishing physical fitness among adolescents has gained increasing attention. The impact of parents’ negative emotions or pressure regarding adolescents’ educational aspirations may have a passive impact on the quality of life and adaptation of adolescents in and out of school, and ultimately harm their physical health. This study aims to explore whether parent-child discrepancies in educational aspirations influence physical fitness in adolescents through school adaptation and quality of life.MethodsParticipants consisted of 9,768 students, males 4,753(48.7%), females 5,015(51.3%), aged 11–19 years, males 14.3 ± 1.92, females 14.4 ± 1.93. The educational aspirations were gauged using a six-point scale for expectation scores. Physical fitness assessments were based on criteria from the National Student Physical Fitness and Health Survey. School adaptation was evaluated using the School Social Behaviors Scale-2. Quality of life for adolescents was measured using Chinese version of the Quality of Life Scale for Children and Adolescents. To analyze the multiple mediating effects, structural equation models were used, and 95% confidence intervals were determined through bootstrap methods.ResultsThe results illustrated that school adaptation and quality of life played a significant mediating role in the effect of parent-child discrepancies in educational aspirations and physical fitness. There were three intermediary paths were confirmed: (1) discrepancies in educational aspirations → school adaptation → physical fitness (β=-0.088 SE = 0.021; p<0.01; 95% CI: -0.135, -0.05); (2) discrepancies in educational aspirations → quality of life → physical fitness (β=-0.025; SE = 0.011; p = 0.010; 95% CI: -0.050, -0.006); (3) discrepancies in educational aspirations → school adaptation→ quality of life → physical fitness (β=-0.032; SE = 0.014; p = 0.011; 95% CI: -0.061, -0.007).ConclusionThis study suggests that parents should reduce negative emotions and pressure regarding adolescents’ academic aspirations may help their children get better physical fitness.

Determination of the Ideas and Expectations of the Students Taking the Laboratory Animal Breed-ing Course towards their Clinical Skills Acquisition and their Achievements and Anxiety Levels at the end of the Application

This study aimed to determine the thoughts and expectations of the students who took laboratory animal breeding courses about clinical skill acquisition and their achievements and anxiety levels at the end of the application with a survey study. One hundred thirtyeight students participated in the survey. The questionnaire method was applied to the propositions and questions created using the State-Trait Anxiety Scale and the literature. A statistically significant difference (P&amp;lt;0.05) was found between the students' total scores of opinions and expectations towards the practice before and after the practice course. The total score of opinion and expectation towards the application after the application lesson was found to be higher (P&amp;lt;0.01) than the total score of opinion and expectation towards the application before the application lesson. State anxiety (P&amp;lt;0.05) and trait anxiety total score (P&amp;lt;0.01) were lower after the applica-tion lesson than before the application lesson. It was concluded that the applied education made a difference in the students' clinical skill acquisition and positively affected their mood.

Assessing Quality of In-Patient Care and Patients's Expectations Using A SERVQUAL Approach in A Tertiary Care Hospital in India

Background: Patient satisfaction is a key indicator of healthcare service quality and has implications for the growth and success of healthcare organizations. However, there is often a gap between patients’ expectations and perceptions of service quality, which can vary depending on various sociodemographic factors. This study aimed to assess the expectations, perceptions and service quality gap in a tertiary care hospital using SERVQUAL model. Materials and Methods: A cross-sectional study was conducted among 120 adult inpatients using a semi-structured questionnaire based on the five dimensions of the SERVQUAL model. The quality gap was calculated as the difference between perception and expectation scores. Results: The study found a significant negative quality gap across all five dimensions, with the largest gaps observed in reliability and responsiveness. The study also revealed that gender, age, and education influenced patients’ perception of service quality, while type of specialty, residence, monthly income, and occupation did not have a significant effect. Conclusion: The study highlighted the need for improving the service quality in the tertiary care hospital, especially in terms of reliability and responsiveness. The study also suggested that healthcare managers and providers should consider the diverse expectations and needs of patients based on their sociodemographic characteristics.

Heterosexual couples' initial role and outcome expectations as predictors of the therapeutic alliance and relationship satisfaction prior to the fourth session.

We sampled routinely collected measures of role and outcome expectations, the expanded therapeutic alliance, and relationship satisfaction completed by 253 heterosexual couples seen by 35 therapists in the Marriage and Family Research Practice Network (Johnson et al., 2017) and investigated these variables as interdependent dyadic processes using the latent congruence model (Cheung, 2009) and the mediated actor-partner interdependence model (Ledermann et al., 2011). Taken together, we found a direct association between a couple's mean role and outcome expectation scores at Session 1 and individual partners' alliance perceptions at Session 3. Further, men rated the alliance more favorably when their outcome expectations were higher and the partners' outcome expectations were less discrepant. In terms of role expectations, both men and women began therapy expecting to be more actively engaged in the process than their partner. Whereas women rated the alliance more favorably when they had high role expectations for their partner as well as themselves, men rated the alliance more favorably when they had high expectations for their female partner's engagement in the therapy. Notably, alliance at Session 3 did not mediate the association between initial expectations and Session 4 relationship satisfaction due to a strong association (r = 0.85) between relationship satisfaction rated prior to Sessions 1 and 4. In other words, although the best predictor of relationship status before the fourth session was how the relationship was perceived before couple therapy began, men's and women's initial role and outcome expectations were important contributors to the early alliance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Intraoperative lateral laxity greater than 4° is associated with inferior functional improvement in posterior-stabilised total knee arthroplasty.

The study aimed to determine the impact of intraoperative lateral laxity at extension on clinical and functional outcomes 1 year after posterior-stabilised total knee arthroplasty (PS-TKA). In total, 91 varus-type osteoarthritic knees that underwent PS-TKA using the medial preservation gap technique were included. After the femoral trial component placement and patellofemoral joint reduction, the soft-tissue balance was assessed using an offset-type tensor with a 40-lb joint-distraction force. Patients were divided into the following three groups according to the intraoperative lateral laxity at extension (i.e., varus ligament balance) using the mean ± 1 standard deviation: Groups A, ≤0°; B, 0-4°; and C, >4°. The 2011 Knee Society Score (KSS) and 3-m timed up-and-go test (TUG) time 1-year postoperatively, and their improvements were compared among the groups. While significant improvements were observed in all subscales of the 2011 KSS and TUG post-TKA (p < 0.05), the improvement of functional activities and TUG time were significantly lower in Group C than in Group B (p < 0.05). However, no significant differences were observed in symptom improvement, patient satisfaction or patient expectation scores among the groups. An excessive lateral laxity (varus angle) >4° at extension was associated with lower improvement in functional ability 1-year postoperatively. Therefore, excessive intraoperative lateral laxity should be avoided in PS-TKA. Level IV.

Treatment expectations and clinical outcomes following repetitive transcranial magnetic stimulation for treatment-resistant depression

BackgroundPatient expectations, including both positive (placebo) and negative (nocebo) effects, influence treatment outcomes, yet their impact on acute repetitive transcranial magnetic stimulation (rTMS) for treatment-resistant depression (TRD) is unclear. MethodsIn this single-center retrospective chart review, 208 TRD patients completed the Stanford Expectation of Treatment Scale (SETS) before starting open-label rTMS treatment. Patients were offered two excitatory rTMS protocols (deep TMS or intermittent theta-burst stimulation), which stimulated the left dorsolateral prefrontal cortex. A minimum of 20 once daily treatments were provided, delivered over 4–6 weeks. Primary outcomes were 1) remission, measured by a post-treatment score of <8 on the Hamilton Depression Rating Scale (HAMD-17), and 2) premature discontinuation. The change in HAMD-17 scores over time was used as a secondary outcome. Physicians were blinded to SETS scores. Logistic and linear regression, adjusting for covariates, assessed SETS and HAMD-17 relationships. ResultsOf 208 patients, 177 had baseline and covariate data available. The mean positivity bias score (positive expectancy minus negative expectancy subscale averages) was 0.48 ± 2.21, indicating the cohort was neutral regarding the expectations of their treatment on average. Higher positive expectancy scores were significantly associated with greater odds of remission (OR = 1.90, p = 0.003) and greater reduction in HAMD-17 scores (β = 1.30, p = 0.005) at the end of acute treatment, after adjusting for covariates. Negative expectancy was not associated with decreased odds of remission (p = 0.2) or treatment discontinuation (p = 0.8). ConclusionsHigher pre-treatment positive expectations were associated with greater remission rates with open-label rTMS in a naturalistic cohort of patients with TRD.

Exploring physicians’ expectations of telehealth services implementation in primary care: An application of the social cognitive theory

ABSTRACT Background: Understanding healthcare professionals’ expectations in telehealth is crucial for successful implementation. The present study used an adaptation of the antecedents-expectations model, supported by the social cognitive theory to evaluate physicians’ expectations regarding the implementation of telehealth in primary healthcare (PHC) and to investigate the potential influence, on expectations, of a prior telehealth experience (antecedents) during the Coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: A questionnaire-based survey was conducted online, targeting PHC physicians. Expectations covered four telehealth performance domains including public health and health promotion, Care Quality and Workflow Organization, Patient’s Convenience and Engagement and Providers’ Value and Training. Antecedents included six domains including gain in self-efficacy, gain in knowledge, gain in participation/engagement, gain in experience, enjoyment and satisfaction. Stepwise linear regression was performed to analyse the effect of antecedents on overall expectations. Results: A total of 54 physicians participated in the study. The mean expectation score was 114.15/154 (SD = 28.26), with highest expectations concerning cost-effectiveness, care timeliness and patients’ convenience. A previous experience with smart apps and dedicated telehealth platforms was associated with lower expectations scores. Expectations scores were positively correlated with antecedents scores; however, satisfaction was the sole independent factor of overall expectations (regression coefficient B = 4.40, 95%CI: 3.11–5.68). Conclusion: The findings highlight the significance of previous experience and various antecedents in shaping physicians’ expectations about telehealth. These insights can inform the development of strategies and interventions to enhance healthcare professionals’ expectations and facilitate the successful implementation of telehealth services.

Examination of undergraduate students’ physics expectations

A body of beliefs based on previous knowledge, attitudes, and experiences creates physics expectations of students about what they will learn and which skills they will use in physics lessons. Previous research indicated these views about knowledge and learning influenced physics learning by affecting their learning approaches. This research aims to investigate the physics expectations of undergraduate engineering and education students, who take various and different numbers of physics courses in Türkiye. The physics expectations of students were examined due to certain variables and they were compared with experts' ideas. In the study, the Turkish version of the Maryland Physics Expectations Survey II (MPEX II) was given to 831 engineering and education students in different universities. The results indicated the statistical differences in the physics expectations scores according to the department that was registered, the number of physics courses taken, and the reading of popular physics books. However, no significant difference was observed in the physics expectations scores according to gender, being an engineering student or education student, the year of the program, and the instructional approach of physics courses. The mean of the percentages of students who thought like experts in item by item was around 2/5; however, when expert-like thinking was considered for the overall scores, almost 12% of students answered at least half of the items like experts.

Identifying Suitable Patients for Overcoming Androgen Deprivation Monotherapy in De Novo Metastatic Hormone-Sensitive Prostate Cancer.

Although metastatic hormone-sensitive prostate cancer (mHSPC) treatments have evolved, androgen deprivation therapy (ADT) remains a widely used regimen. Therefore, this study sought patients who did not progress to castration-resistant prostate cancer (CRPC) but received ADT monotherapy and factors affecting overall survival (OS) in de novo mHSPC. De novo mHSPC patients who received ADT treatment were included. ADT included luteinizing hormone-releasing hormone agonists with or without anti-androgen. The total cohort was divided into two groups relative to CRPC progression within two years. Logistic analysis was used to identify factors that did not progress CRPC within two years. Cox regression was used to assess the independent predictors for OS. The total cohort was divided into the no-CRPC within two years group (n = 135) and the CRPC within two years group (n = 126). Through multivariate logistic analysis, the life expectancy (odds ratio [OR] 0.95, 95% CI 0.91-0.99, p = 0.014) and Gleason scores (≥9 vs. ≤8; OR 0.43, 95% CI 0.24-0.75, p = 0.003) were associated with the group without castration-resistant prostate cancer progression within two years. The multivariate Cox model revealed that life expectancy (hazard ratio [HR] 0.951, 95% CI 0.904-0.999, p = 0.0491), BMI (HR 0.870, 95% CI 0.783-0.967, p = 0.0101), and CCI (≥2 vs. <2; HR 2.018, 95% CI 1.103-3.693, p = 0.0227) were significant predictive factors for OS. Patients with long life expectancy and a Gleason score of 9 or more were more likely to develop mCRPC while alive. Patients with short life expectancy, low BMI, and worsening comorbidity were more likely to die before progressing to CRPC. Although intensified treatment is essential for oncologic outcomes in mHSPC, shared decision making is integral for patients who may not benefit from this treatment.

Preoperative expectations of patients with degenerative cervical myelopathy: an observational study from the Canadian Spine Outcomes and Research Network

BACKGROUNDDespite an abundance of literature on degenerative cervical myelopathy (DCM), little is known about preoperative expectations of these patients. PURPOSEThe primary objective was to describe patient preoperative expectations. Secondary objectives included identifying patient characteristics associated with high preoperative expectations and to determine if expectations varied depending on myelopathy severity. STUDY DESIGNThis was a retrospective study of a prospective multicenter, observational cohort of patients with DCM. PATIENT SAMPLEPatients who consented to undergo surgical treatment between January 2019 and September 2022 were included. OUTCOMES MEASURESAn 11-domain expectation questionnaire was completed preoperatively whereby patients quantified the expected change in each domain. METHODSThe most important expected change was captured. A standardized expectation score was calculated as the sum of each expectation divided by the maximal possible score. The high expectation group was defined by patients who had an expectation score above the 75th percentile. Predictors of patients with high expectations were determined using multivariable logistic regression models. RESULTSThere were 262 patients included. The most important patient expectation was preventing neurological worsening (40.8%) followed by improving balance when standing or walking (14.5%), improving independence in everyday activities (10.3%), and relieving arm tingling, burning and numbness (10%). Patients with mild myelopathy were more likely to select no worsening as the most important expected change compared to patients with severe myelopathy (p<.01). Predictors of high patient expectations were: having fewer comorbidities (OR -0.30 for every added comorbidity, 95% CI -0.59 to -0.10, p=.01), a shorter duration of symptoms (OR 0.92, 95% CI 0.35–1.19, p=.02), no contribution from “failure of other treatments” on the decision to undergo surgery (OR 1.49, 95% CI 0.56–2.71, p=.02) and more severe neck pain (OR 0.19 for 1 point increase, 95% CI 0.05–0.37, p=.01). CONCLUSIONSMost patients undergoing surgery for DCM expect prevention of neurological decline, better functional status, and improvement in their myelopathic symptoms. Stopping neurological deterioration is the most important expected outcomes by patients.

Associations between autistic traits, depression, social anxiety and social rejection in autistic and non-autistic adults

Autistic people frequently experience negative judgements from non-autistic people, often fuelled by misconceptions that autistic people lack empathy. Understanding responses to negative social judgement among autistic people is crucial because of the potential negative impact on wellbeing and future interactions. We investigated the role of autistic traits, social anxiety, and depression on behavioural indices of social rejection in 20 autistic (AUT; 11 males) and 40 non-autistic (N-AUT; 21 males) university students. Participants completed the Social Judgement Task (SJT) where they predicted whether they were liked by another person, then received feedback on whether those evaluations were correct. Participants also completed an Age Judgement Task (AJT) where they estimated the age of the pictured person. The AUT group had lower positive expectation scores, meaning less tendency to predict being liked. Across the whole sample, higher social anxiety predicted greater tendency to anticipate rejection from others, not autistic traits. These findings suggest early experiences of rejection might lead to a negative self-bias in autistic people and emphasise the importance of using a transdiagnostic approach by showing that social anxiety rather than autistic traits is associated with expectation of social rejection.

Identification of watermelon genes involved in the ZYMV interaction through a miRNA bio-informatics analysis and characterization of ATRIP and RBOHB

Our objective was to identify differentially expressed watermelon genes in its interaction with ZYMV through a bioinformatics analysis of differentially expressed miRNAs. Small RNAseq data analysis of healthy and ZYMV-infected watermelon (21 dpi) identified 353 miRNAs from which 22 known and 331 new miRNAs. Important information about their precursors, their length, the loci of which they originated on watermelon genome are provided. The ZYMV genome could be a target for mir396a-3p, miR8706a, and miR1886i-5p from the miRbase, but none of them was identified in the watermelon miRNAome. Furthermore, watermelon miRNAome does not contain a miRNA targeting ZYMV genome with an expectation score ≤3.5. In healthy watermelon bioinformatically predicted targets of 32 miRNAs were 34 resistance genes, as CC-NBS-LRR, TIR-NBS-LRR, TIR-NBS. For nine differentially expressed miRNAs the respective target genes (10 in total) were bioinformatically predicted. For cla-new_miR307 (upregulated upon ZYMV infection) and cla-miR166h-3p (downregulated upon ZYMV infection) the targets were predicted to be ClaATRIP and ClaRBOHB, respectively, with ClaATRIP downregulated and ClaRBOHB upregulated upon ZYMV infection. ALSV-mediated VIGS of ClaATRIP rendered watermelon plants more resistant to ZYMV, whereas VIGS of ClaRBOHB resulted in higher levels of ZYMV titer in watermelon. These data suggest that ClaATRIP and ClaRBOHB are a susceptibility and resistant gene, respectively. Our results provide new insights in watermelon miRNAome and could propose new strategies for generating resistant watermelon to ZYMV.