Related Factors Research Articles

Antioxidants, Hormetic Nutrition, and Autism.

Autism spectrum disorder (ASD) includes a heterogeneous group of complex neurodevelopmental disorders characterized by atypical behaviors with two core pathological manifestations: deficits in social interaction/communication and repetitive behaviors, which are associated with disturbed redox homeostasis. Modulation of cellular resilience mechanisms induced by low levels of stressors represents a novel approach for the development of therapeutic strategies, and in this context, neuroprotective effects of a wide range of polyphenol compounds have been demonstrated in several in vitro and in vivo studies and thoroughly reviewed. Mushrooms have been used in traditional medicine for many years and have been associated with a long list of therapeutic properties, including antitumor, immunomodulatory, antioxidant, antiviral, antibacterial, and hepatoprotective effects. Our recent studies have strikingly indicated the presence of polyphenols in nutritional mushrooms and demonstrated their protective effects in different models of neurodegenerative disorders in humans and rats. Although their therapeutic effects are exerted through multiple mechanisms, increasing attention is focusing on their capacity to induce endogenous defense systems by modulating cellular signaling processes such as nuclear factor erythroid 2 related factor 2 (Nrf2) and nuclear factor-kappa B (NF-κB) pathways. Here we discuss the protective role of hormesis and its modulation by hormetic nutrients in ASD.

Knowledge of tuberculosis among physicians working at community health stations in Vietnam

Tuberculosis (TB) remains a significant health problem worldwide, including in Vietnam, where around 174,000 newly diagnosed cases and 13,200 patients died in 2018. There are challenges in the diagnostic process, treatment, and follow-up. The physicians with knowledge of TB working at commune health stations play an essential role in this struggle. The primary purpose of this study was to evaluate knowledge of TB and related factors among physicians working at community health stations in the Northern provinces of Vietnam. A cross-sectional survey was implemented on 335 physicians working at community health stations in 5 Northern provinces in Vietnam from September 2019 to October 2020. The result showed that the TB knowledge of physicians was not good. There were some severe knowledge gaps concerning at-risk groups, the main symptoms of TB, sputum tests for both diagnosis and follow-up and management of attack therapy. The TB training participants had better TB knowledge than others (aOR=1.68; 95%CI: 1.047-2.712). This study underlines the importance of clinical experience and TB training to TB knowledge. We suggest that a TB training plan is required for physicians. Our survey results could inform the process of defining the physicians who work at community health stations' role in TB management in the future.

The psychological impact of the COVID-19 epidemic among healthcare workers at the grassroots level in Vietnam

The COVID-19 pandemic has significantly affected the mental health of healthcare workers (HCWs). Therefore, an immediate priority is to monitor rates of mental health issues to understand related factors and inform interventions. The main purpose of this study was to evaluate the psychological and mental health impact of COVID-19 and some related factors among HCWs at the grassroots level in Vietnam. A cross-sectional study was conducted on 675 HCWs working at health facilities through questionnaires. The finding showed the rate of HCWs who were psychologically affected by the COVID-19 pandemic was 37.2%, of which 64.1% of HCWs were afraid to tell their families about the risk of exposure to COVID-19 at work. The 31.0% of HCWs had difficulty sleeping deeply/insomnia due to the COVID-19 epidemic. No statistically significant differences were found in the psychological impact of COVID-19 between HCW groups by age, gender, seniority, and professional qualifications. Some groups of HCWs were found to have poor psychological health. Our research suggests that during the COVID-19 pandemic, HCWs working in healthcare facilities experienced an increased psychological burden; psychological interventions for those at high risk and with common mental disorders should be included to reduce this burden and protect HCWs' mental health.

Bone mineral density and osteoporosis related risk factors in type 2 diabetes mellitus

Diabetes mellitus negatively affects bone tissue and unfavourably impacts bone mineral density (BMD), therfore increasing the probability of fractures through pathological mechanisms. This study aimed to explore the factors associated with BMD and osteoporosis risk in individuals with a diagnosis of type 2 diabetes mellitus (T2DM). An investigation was undertaken involving 49 patients diagnosed with T2DM who fulfilled the specified criteria. These individuals underwent BMD assessment as part of a cross-sectional study. The analysis encompassed both univariate and bivariate approaches, utilizing the Chi-square test (X2) and binary logistic regression methods. A total of 30 participants (61%) have decreased BMD. Among the participants aged 60 years and above, 83.4% exhibited a decreased BMD status (osteopenia and osteoporosis), in contrast to the under 60 years age group, in which 40% displayed decreased BMD status. Older age (>60 years) is a risk factor for decreasing bone density onset of diabetes mellitus (DM) diagnosis, duration of DM, glycemic control, body mass index (BMI), use of thiazolidinediones (TZD) drugs, kidney function, were not associated with lower BMD in T2DM patients.

A qualitative study on redefining normality in relatives of patients with advanced cancer.

To obtain insight into adaptation processes of redefining normality and its influencing factors in relatives of patients with advanced cancer. An exploratory qualitative study among relatives of patients with advanced cancer was conducted. Participants were purposively recruited. Ten in-depth individual (relative only) and 16 dyad (relative and patient together) interviews were conducted, transcribed verbatim, and analyzed by means of thematic analysis, drawing on elements of grounded theory, combining both inductive and deductive elements. Two adaptation processes of (redefining) normality were identified: assimilation and accommodation. The latter was found to be the main way of adapting to new events. Assimilative coping strategies entailed "continuing to do the same activities as done before the disease," "difficulty accepting the situation," "avoiding to think about the disease," and "living in the short term." Accommodative strategies involved "arranging practical matters," "thinking about the future," "doing what is feasible," "engaging in new activities," "accepting the situation," "seeking distraction," "living in the short term," and "focusing on what truly matters in life." The interplay between the diagnosis and treatment of cancer, a deteriorating disease status, and the accompanying uncertainty about the future was of influence on the relatives' coping strategies. When the new situation is too divergent to assimilate, accommodation may be necessary for relatives to cope with the growing complexity of the consequences of their loved one's illness. Accommodative coping then involves accepting the changing reality and actively making the necessary adjustments to build resilience and cope with the new circumstances.

Health-related quality of life and related factors in patients with colorectal cancer in Iran: a systematic review.

This systematic review aims to examine the health-related quality of life (QOL) in Iranian patients with colorectal cancer (CRC) and its related factors. A thorough, systematic search was conducted in different international electronic databases, including Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords such as "Colorectal neoplasm", "Colorectal tumors", "Colorectal cancer", "Quality of life", and "Life quality" from the earliest to 17 October 2022. The quality of the studies included in this systematic review was evaluated using the appraisal tool for cross-sectional studies (AXIS tool). There were 820 CRC patients in the five cross-sectional studies that made up this systematic review. The mean score of QOL in patients with CRC was 61.99 (SD=15.87) out of 100 based on EORTC-QLQ-C30, which indicates a moderate to good level of QOL. Factors such as age, gender, living conditions, level of education, occupation, monthly income, health insurance, physical activity, performance status, and comorbidities had a significant relationship with QOL in patients with CRC. In sum, the findings of the five studies that were a part of this systematic review revealed that Iranian patients with CRC had a moderate to good QOL. Therefore, managers and health policymakers can create psychological counseling programs with an emphasis on the factors affecting the QOL of patients in light of how crucial it is to raise patients' understanding of the long-term impacts of CRC and how they affect their QOL.

Physical Activity Levels, Correlates, and All-Cause Mortality Risk in People Living With Different Health Conditions.

To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between physical activity and all-cause mortality. We used a subsample (n = 88,659) of the Lifelines cohort study from the Netherlands. For people living with and without 20 different self-reported health conditions, we studied the aforementioned factors in relation to physical activity. Physical activity was assessed with the Short Questionnaire to Assess Health-Enhancing Physical Activity Questionnaire, and mortality data were obtained from the Dutch death register. People with a reported health condition were less likely to meet physical activity guidelines than people without a reported health condition (odds ratios ranging from 0.55 to 0.89). Higher body mass index and sitting time, and lower self-rated health, physical functioning, and education levels were associated with lower odds of meeting physical activity guidelines across most health conditions. Finally, we found a protective association between physical activity and all-cause mortality in both people living with and without different health conditions. People living with different health conditions are generally less physically active compared with people living without a health condition. Both people living with and without self-reported health conditions share a number of key factors associated with physical activity levels. We also observed the expected protective association between physical activity and all-cause mortality.

Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kızıltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

Analysis of Factors Affecting the Implementation of Sustainable Building Projects

Abstract: Sustainability concept can be defined as “meeting the needs of the present without compromising the needs of the future” [7]. Conventional buildings approximately consumes more than 30% of energy while utilising around 40% of resources while also simultaneously generating 40% of wastes and 35% of harmful green-house gases [8]. The sustainable building construction approach has the potential to make a significant contribution to sustainable development, especially considering the building industry’s considerable influence. Based on our literature assessment, we discovered that multiple research reveal a general lack of consistency across outcomes in different geographical locations regarding factors impacting the implementation of sustainable building projects. Therefore this study is based on the analysis of factors that impact the implementation of sustainable building projects and the effects of sustainable building projects on various critical factors. For the result of the research analysis, the Reliability analysis which was conducted based on Cronbach's Alpha Coefficient for the factors affecting the implementation of sustainable building projects were found to be 0.76658442 which can conclude that the reliability level of the questionnaires responses was good while based on Relative Importance Index (RII) analysis factors affecting the implementation of sustainable building projects were ranked, with material related factors being the most significant (RII 0.705) among other factors. Additionally, the impact of implementing sustainable building projects on different critical factors was determined, with RII analysis indicating that the most significant impact will occur in terms of economic benefits (RII 0.767). Overall, the study tried fulfilling all the objectives which were stated.

Forecasting individual bids in real electricity markets through machine learning framework

With the increasing uncertainty caused by the complexity of the world’s energy environment and the increasing penetration rate of renewable energy, it is significant to estimate the future operation of power markets in advance. Forecasting individual bids in spot electricity markets is a promising new method for achieving so, but it has not been fully studied due to the difficulty of forecasting a bid function. The idealization of existing optimization-based models decreases their practical effects in real markets. Thus, we propose a scalable forecasting framework that incorporates several customized state-of-art machine learning methods according to the characteristics of the bidding data. First, several low-rank approximation algorithms are customized to encode the high-dimensional bidding curves into low-dimensional feature spaces and reconstruct them from the predicted feature space. Second, a transformer-based multidimensional time series prediction algorithm is proposed to predict the bidding feature based on both related factors and historical bidding records. To appropriately evaluate the performances of the forecasting methods, we introduce a dynamic criterion based on the economic implications of bids. The comprehensive framework is tested based on actual market data from the Australian national electricity market, and in the empirical example, the feasibility and effectiveness of the proposed framework are demonstrated.

Eucalyptol regulates Nrf2 and NF-kB signaling and alleviates gentamicin-induced kidney injury in rats by downregulating oxidative stress, oxidative DNA damage, inflammation, and apoptosis

Gentamicin, an aminoglycoside antibiotic, is nowadays widely used in the treatment of gram-negative microorganisms. The antimicrobial, anti-inflammatory, and antioxidant activities of eucalyptol, a type of saturated monoterpene, have been reported in many studies. The aim of this study was to examine the possible effects of eucalyptol on gentamicin-induced renal toxicity. A total of 32 rats were divided into 4 groups; Control (C), Eucalyptol (EUC), Gentamicin (GEN), and Gentamicin + Eucalyptol (GEN + EUC). In order to induce renal toxicity, 100 mg/kg gentamicin was administered intraperitoneally (i.p.) for 10 consecutive days in the GEN and GEN + EUC groups. EUC and GEN + EUC groups were given 100 mg/kg orally of eucalyptol for 10 consecutive days. Afterwards, rats were euthanized and samples were taken and subjected to histopathological, biochemical, immunohistochemical, and real-time PCR examinations. The blood urea nitrogen (BUN) and creatinine (CRE) levels were significantly decreased in the GEN + EUC group (0.76 and 0.69-fold, respectively) compared to the GEN group. The glutathione peroxidase (GPx) and catalase (CAT) activities were significantly increased in the GEN + EUC group (1.35 and 2.67-fold, respectively) compared to the GEN group. In GEN group, Nuclear factor kappa B (NF-kB), Interleukin 1-beta (IL-1β), Inducible nitric oxide synthase (iNOS), Tumor necrosis factor-α (TNF-α), Caspase-3, 8-Hydroxy-2′-deoxyguanosine (8-OHdG) and Nuclear factor erythroid 2–related factor (Nrf2) expression levels were found to be quite irregular. GEN + EUC group decreased the expressions of NF-kB, IL-1β, iNOS, TNF-α, Caspase-3, and 8-OHdG (0.55, 0.67, 0.54, 0.54, 0.63 and 0.67-fold, respectively), while it caused increased expression of Nrf2 (3.1 fold). In addition, eucalyptol treatment ameliorated the histopathological changes that occurred with gentamicin. The results of our study show that eucalyptol has anti-inflammatory, antioxidative, antiapoptotic, nephroprotective, and curative effects on gentamicin-induced nephrotoxicity.

Nursing applicants’ desire to work in nursing and related factors: a cross-sectional study

Background The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants’ or students’ desire to work in nursing. Aims The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing. Design A cross-sectional study design. Methods The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes. Results A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire. Conclusions The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

Kinesophobia and its related factors in patients after percutaneous coronary intervention: A cross-sectional study.

To explore the postoperative kinesophobia of patients after percutaneous coronary intervention (PCI) and its related factors. Percutaneous coronary intervention is an effective method to treat coronary heart disease (CHD), and cardiac rehabilitation is an important auxiliary method after PCI. However, the compliance of patients with cardiac rehabilitation after PCI is not good, among which kinesophobia is an important influencing factor. A descriptive cross-sectional design was implemented, and the high-quality reporting of the study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology Statement. In total, 351 inpatients who underwent PCI in three tertiary grade-A hospitals in China were selected by convenient sampling method. We use one-way ANOVA and multiple linear regression analysis to determine the relevant related factors. The kinesophobia of patients after PCI was negatively correlated with chronic illness resource utilization and sense of personal mastery, and positively correlated with illness perception. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery entered the regression equation, which could explain 78.1% of the total variation. The level of kinesiophobia of patients after PCI is high. Education level, clinical classification of CHD, exercise habits, chronic illness resource utilization, illness perception and sense of personal mastery are the related factors of kinesiophobia of patients after PCI. By reducing the level of exercise fear of patients after PCI, patients are more likely to accept and adhere to the cardiac rehabilitation plan, thus improving their prognosis and improving their quality of life. The patient underwent PCI in the research hospital. Researchers screen them according to the inclusion criteria and invite them to participate in this study. If they meet the requirements, participants will answer the research questionnaire face to face after signing the informed consent form.

Intestinal tissue-resident memory T cells maintain distinct identity from circulating memory T cells after in vitro restimulation.

Resident memory T (TRM) cells have been recently established as an important subset of memory T cells that provide early and essential protection against reinfection in the absence of circulating memory T cells. Recent findings showing that TRM expand in vivo after repeated antigenic stimulation indicate that these memory T cells are not terminally differentiated. This suggests an opportunity for in vitro TRM expansion to apply in an immunotherapy setting. However, it has also been shown that TRM may not maintain their identity and form circulating memory T cells after in vivo restimulation. Therefore, we set out to determine how TRM respond to antigenic activation in culture. Using Listeria monocytogenes and LCMV infection models, we found that TRM from the intraepithelial compartment of the small intestine expand in vitro after antigenic stimulation and subsequent resting in homeostatic cytokines. A large fraction of the expanded TRM retained their phenotype, including the expression of key TRM markers CD69 and CD103 (ITGAE). The optimal culture of TRM required low O2 pressure to maintain the expression of these and other TRM-associated molecules. Expanded TRM retained their effector capacity to produce cytokines after restimulation, but did not acquire a highly glycolytic profile indicative of effector T cells. The proteomic analysis confirmed TRM profile retention, including expression of TRM-related transcription factors, tissue retention factors, adhesion molecules, and enzymes involved in fatty acid metabolism. Collectively, our data indicate that limiting oxygen conditions supports in vitro expansion of TRM cells that maintain their TRM phenotype, at least in part, suggesting an opportunity for therapeutic strategies that require in vitro expansion of TRM.

PAK1 Promotes Inflammation Induced by Sepsis through the Snail/CXCL2 Signaling Pathway.

Sepsis is a severe syndrome characterized by organ dysfunction, resulting from a systemic imbalance in response to infection. PAK1 plays a critical role in various diseases. The present study aimed to explore and delineate the mechanism of PAK1 in inflammation induced by sepsis. Bioinformatics analysis was performed to assess PAK1, snail, and CXCL2 expression in the whole blood of septic patients and the pathways enriched with PAK1. To simulate the sepsis model, THP-1 cells were stimulated with lipopolysaccharide. Gene expression was evaluated using qRT-PCR, while cell viability was assessed using CCK-8 assay. Cell apoptosis was tested with flow cytometry. Expression of inflammatory factors in cells following different treatments was analyzed using the enzyme linked immunosorbent assay (ELISA). Dual-luciferase and chromatin immunoprecipitation assays were conducted to verify the binding relationship between PAK1 and the snail. Mouse models of cecal ligation and puncture were established, and hematoxylin and eosin staining and ELISA were employed to detect the infiltration levels of inflammatory cells and the expression of related protective factors in lung, liver, and kidney tissues. The results demonstrated upregulation of PAK1, snail, and CXCL2 in the whole blood of septic patients, with PAK1 being enriched in the chemokine-related pathway. Knockdown of PAK1 significantly promoted the apoptosis of LPS-stimulated THP-1 cells and inhibited the expression of inflammatory factors. PAK1 upregulated the expression of the snail, which in turn promoted the expression of CXCL2. Thus, PAK1 mediated the sepsis-induced inflammatory response through the snail/CXCL2 pathway. In conclusion, PAK1 played a role in promoting inflammation induced by sepsis through the snail/CXCL2 axis, thereby providing a potential therapeutic target for the management of sepsis.

Driving STEM learning effectiveness: dropout prediction and intervention in MOOCs based on one novel behavioral data analysis approach

AbstractWith the full application of MOOCs online learning, STEM multidisciplinary and knowledge structures have been achieved, but it has also resulted in a massive number of dropouts, seriously affected the learning sustainability of STEM education concepts, and made it difficult to achieve learning effectiveness. Based on the massive STEM learning behavior instances generated by MOOCs, as well as the entire learning periods, this study considers some key explicit and implicit features associated with learning behavior, and achieves the fusion of convolutional neural network and recurrent neural network through data-driven approaches, incorporates long short-term memory mechanism to develop dropout prediction methods and models. Based on the experimental results, we also discuss the relevant problems of dropouts related to STEM learning behavior, explore the key dropout temporal sequences of the learning process, identify related factors that have key impacts on learning behavior, and deduce intervention measures and early warning suggestions. The entire study can provide effective methods and decisions for researching the STEM learning behavior of MOOCs and has strong research feasibility and urgency.

Identification of Factors of Low Grades and Academic Failure of Medical Students

Background: Students are human capital and future of all countries, several factors affect students’ academic status leading to academic burnout and possibly academic failure, academic failure can delay finding a job and lead to frustration, loss of morale, and ultimately result in a large cost. Several factors may lead to academic failure, such as age, gender, scientific background, motivation and interest in the field, marital status, occupation status, place of residence, parental employment and education level, financial ability and others. Academic failure of students is not a personal problem, but rather a social issue; therefore, fundamental steps must be taken toward addressing the issue. Aim: The aim of study to Determine academic failure and related factors among medical students of Tikrit university college of medicine. Subject and methods: The current study is cross section study type was carried out in medical students from 21th of November 2022 to the 5th of March 2023.The study design was by convenient sampling, from medical students .The Exclusion criteria of participants was all students with a good academic level, while all other students were included in the study.The data was collected using Google form Questinaire. Results: The total samples of study was (202), the bad time management is the most factors affecting on students with low grades (93%), work while studying (49%), family responsibility (25%), Psychological problems (10.4%), pathological problems (6%), Low economic state (5.4%). the students with second trial had highest bad time management (35.4%), work while studying (25.8%). The poor teaching quality is the highest percentage (50%) of evaluation, moderate (32%), good (14%), (4%) excellent. the students satisfaction with effective teaching methods is moderate (44%), poor (36%), good (17%) and excellent (3%). Conclusions: The bad time management is the most factors affecting on students with low grades.

Juvenil İdiyopatik Artrit Tanılı Çocuklarda 25 Hidroksivitamin D Düzey Takibinin Önemi

Objective: In patients with juvenile idiopathic arthritis (JIA), bone metabolism may be negatively affected due to both the activity of the disease and the medications used. Our study aimed to investigate the necessity of evaluating 25 hydroxyvitamin D (25 (OH) Vit D), calcium (Ca), phosphorus (P), alkaline phosphatase (ALP) levels and possible related factors in the follow-up of patients diagnosed with JIA.
 Method: The records of 68 patients with JIA were retrospectively evaluated. Disease subtypes, medications used, and whether they were in remission or active disease were reviewed.
 Results: 25 OH Vit D levels were low in 14.7% of patients with JIA compared to the control group. 66.6% of the patients with systemic arthritis had high ALP levels. 25 OH Vit D level was low in 16.6% of steroid users, and Vitamin D level was low in 55.5% of the patients in the active disease group. It was determined that patients in the active disease group had the highest ALP and lowest vitamin D levels compared to patients in remission with and without medication.
 Conclusion: Bone metabolism in patients with JIA is negatively affected. Since vitamin D plays a crucial role in bone metabolism, it was emphasized that vitamin D levels should be evaluated especially during active disease and supplements should be provided for patients with low vitamin D levels.

G6PD gene detection in neonatal hyperbilirubinemia and analysis of related risk factors.

Hyperbilirubinemia is a common disorder in neonates, with premature infants at higher risk of developing the disorder. Glucose-6-phosphate dehydrogenase (G6PD) gene detection was used to determine the incidence of G6PD deficiency and analyze the etiologies of G6PD deficiency in neonates with hyperbilirubinemia in the Zunyi region with the aim of providing scientific evidence for the clinical diagnosis and treatment. For the gene detection, 64 neonates with hyperbilirubinemia were selected as the observation group and 30 normal neonates were selected as the control group, and the risk factors for hyperbilirubinemia were investigated by using multivariate logistic regression analysis. Among the neonates in the observation group, 59 cases had the G1388A mutation (92.19%) and 5 cases had the G1376T mutation (7.81%). No mutation was detected in the control group. In the observation group, the proportion of neonates who were born prematurely, with artificial feeding, with the age of starting feeding of more than 24 h, the time of first bowel movement of more than 24 h, premature rupture of membranes, infection, scalp hematoma, and perinatal asphyxia was higher than that in the control group, and the difference was statistically significant (p< 0.05). Multivariate logistic regression analysis showed that prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding of more than 24 h, and the time of first bowel movement over 24 h were risk factors for the development of neonatal hyperbilirubinemia (p< 0.05). The G1338A and G1376T mutations were important features of the genetics of neonatal hyperbilirubinemia, and genetic detection together with the prevention of prematurity, infection, scalp hematoma, perinatal asphyxia, the age of starting feeding, and the time of first bowel movement would help reduce the incidence of this disease.

Knowledge, Attitude, and Practice (KAP) Status toward Clinical Reasoning and Evidence-Based Medicine among the Medical Interns and Gynecology Residents of Iran University of Medical Sciences.

Clinical reasoning and evidence-based medicine (EBM) are important concepts in modern medicine. We performed this study to investigate the knowledge, attitude, and practice (KAP) status toward clinical reasoning and EBM among the medical interns and gynecology resident physicians of Iran University of Medical Sciences and related factors. A cross-sectional study (Tehran, Iran, first half of 2022) was conducted based on two researcher-made questionnaires consisting of three components for each including clinical reasoning attitude (CR-A), clinical reasoning knowledge (CR-K), clinical reasoning practice (CR-P), EBM attitude (EBM-A), EBM knowledge (EBM-K), and EBM practice (EBM-P). The related factors were age, gender, educational level, score of general practice education, having research experience, and general practice experience. A total of 60 individuals participated. The mean score was good for CR-A, moderate for CR-K, moderate for CR-P, good for EBM-A, moderate for EBM-K, and moderate for EBM-P. The total score was moderate in both clinical reasoning and EBM. Among the related factors, CR-P was associated with higher educational levels and having experience in general practice (P < 0.05). Research experience was associated with better CR-K and all KAP components for EBM (P < 0.05). The total score and many of the KAP components had moderate status for clinical reasoning and EBM. Planning on the associated factors should be regarded in the future. Such questionnaires are suggested to be validated for use in quasi-experimental studies.