Individual Management Research Articles

STATUS SOSIAL KELUARGA, LITERASI KEUANGAN TERHADAP MANAJEMEN KEUANGAN INDIVIDU DAN LIFESTYLE

The social status of a family plays a crucial role in shaping a student's ultimate career aspirations as an individual, as does financial literacy, which an individual acquires from their parents or through learning and experience. A family's social status naturally influences whether a child, as an individual, has better access to financial education or otherwise. Families with a higher social status will certainly provide different opportunities compared to those of lower economic standing. Similarly, strong financial literacy can help individuals manage their personal finances effectively. In this era of disruptive technology, a family's socioeconomic status, financial literacy, and individual financial management models can all impact one's lifestyle. This study aims to analyze the influence of a family's socioeconomic status, financial literacy, and individual financial management on lifestyle. The respondents of this study numbered 123. The results indicate that family social status affects individual financial management, financial literacy affects individual financial management, family social status affects lifestyle, financial literacy affects lifestyle, and individual financial management affects lifestyle. Additionally, individual financial management mediates the relationship between family social status and lifestyle, as well as between financial literacy and lifestyle. Keywords: Family social status, Financial literacy, Individual financial management, Lifestyle

The Association of Sociodemographic Factors and Utilization of Diabetes Technologies with Diabetes Management: An Investigation in Children and Adolescents with Type 1 Diabetes.

We aimed to investigate the relationship between sociodemographic and clinical characteristics, as well as the utilization of diabetes technologies, with diabetes management in individuals with type 1 diabetes (T1D). Our study included 134 cases diagnosed with T1D who were followed for at least 1 year with T1D. Of the cases, 67.2% were using insulin pens as their insulin regimen, while 37.8% were using insulin pumps. The rate of continuous glucose monitoring (CGM) usage was 29.9%. The rate of CGM usage was 5% in families with low income levels. Glycosylated hemoglobin A1c(HbA1c) level of children with working mothers was found to be higher compared to those with non-working mothers (median 9.2% vs. 8%; P = .009). Cases with 3 or more siblings had higher HbA1c levels compared to those with 2 or fewer siblings (median 8.7% vs. 8.1%; P = .044).The median HbA1c was 8.7% in cases using insulin pens and checking fingerstick blood glucose (SMBG); 8.3% in cases using insulin pumps and SMBG; 7.6% in cases using insulin pens with CGM, and 7.5% in cases using insulin pumps with CGM (P = .003). The utilization of insulin pumps with CGM in T1D cases exhibited lower HbA1clevels. Similarly, even the usage of insulin pens with CGM demonstrated improved diabetes management. Maternal employment and having a higher number of siblings may negatively affect diabetes management due to increased caregiver burden. We believe that personalized healthcare delivery tailored to the individual needs of T1D patients based on family and clinical characteristics could have positive effects on diabetes management.

Predicting the effect of climate change and management on net carbon sequestration in the forest ecosystems of the European part of Russia with the complex of models

The objectives of sustainable development require the ability to estimate potential changes in net carbon sequestration in forest ecosystems (including changes in biomass, mortmass, and soil organic matter) under possible climate change and different forest management strategies. Such estimates require consideration of different ecosystem components and processes. To achieve this goal, we have integrated several ecological models (dynamic stand model FORRUS-S, soil organic matter model Romul_Hum, statistical climate generator SCLISS and process-based forest ecosystem model EFIMOD3) to simulate the ecosystem dynamics at the regional level in several study areas within the forest zone of the European part of Russia. The simulation results reflected both the direct effects of climate change and forest management actions on ecosystem carbon pools, and the indirect effects through changes in species composition. The simulation experiments were spatially detailed at the level of individual forest management units, thereby revealing the influence of habitat conditions on the rate of carbon sequestration under the influence of environmental factors. We found that net carbon sequestration in all major ecosystem pools was mostly positive, ranging between 0 and 1.45 t ha year−1 depending on study area and simulation scenario. Higher accumulation was typically observed in medium-rich and rich habitat types with mesic moistening. In the long term, the effect of climate change was found to be comparable to the effect of management interventions.

Genomic testing for differences of sex development: Practices and perceptions of clinicians.

To investigate the approach taken by clinicians involved in the diagnosis and management of individuals with Differences of Sex Development (DSD), particularly with regard to genomic testing, and identify perceived gaps/strengths/barriers in current practice. An anonymous online survey was developed, with questions exploring demographics, perceptions of genomic testing, availability of genetics services and opinions on the role and utility of genomic testing in DSD. All responses were anonymous. Clinicians involved in the diagnosis and management of individuals with DSD were recruited from relevant societies and departments across Australia and New Zealand. 79 eligible clinicians commenced the survey, with 63 completing it and 16 providing a partial response. The perceived benefit of having a genetic diagnosis for DSD was almost unanimous (97%). Almost half (48%) of respondents reported barriers in genomic testing. 81% of respondents reported they order genomic tests currently. Approaches to genomic testing when faced with four different clinical scenarios varied across respondents. Clinicians perceived genomic testing to be underutilised (median 36 on sliding scale from 0 to 100). Despite 97% of respondents reporting benefit of a genetic diagnosis for individuals with DSD, this was not reflected throughout the survey with regard to clinical implementation. When faced with clinical scenarios, the recommendations for genomic testing from respondents was much lower, indicating the discrepancy between perception and clinical practice. Genomic testing in the context of DSD is seen as both beneficial and desired, yet there are multiple barriers impacting its integration into standard clinical care.

Research priorities for diagnosis, prognosis, and rehabilitation following concussion: results from a national survey of Australian health professionals

Purpose Recently, the Concussion James Lind Alliance Priority Setting Partnership (JLAPSP) (Canada) identified serious research gaps regarding diagnosis, management, and access to effective rehabilitation for concussion/mild traumatic brain injury (mTBI). Our aim was to determine if the same research priorities are important to Australian health professionals working in the concussion/mTBI field. Materials and methods A survey was distributed via professional networks, social media, professional group listservs, a research project noticeboard, and at conferences. It comprised of 25 of the highest ranked concussion research questions from the JLAPSP. We examined how professionals ranked the research questions and analyzed variation in ranking by clinical role and concussion/mTBI work experience. Results Our sample of 187 participants included medical and allied health professionals. Most participants were occupational therapists (22%), physiotherapists (18%), neuropsychologists (17%), and worked in Victoria (47%), New South Whales (18%), or Queensland (15%) in metropolitan areas. Health professionals ranked three research questions highest: identifying methods to predict prolonged recovery; effectiveness of early referral and treatment by a specialized concussion/mTBI team; and implementation studies on upskilling healthcare workers. Conclusions The research priorities identified can guide research efforts to improve the assessment, management, and rehabilitation of individuals with concussion/mTBI in Australia.

Rethinking inter-firm dynamics from a small firm perspective: the case for inter-organizational bullying

PurposeThis paper aims to explain how the dynamics of inter-firm relations between small and large firms can, in the case of some behaviours, be interpreted as inter-organizational bullying.Design/methodology/approachThis paper draws on a qualitative approach adopting the critical incident method to explore the subjective experiences of 13 individual managers and owners of small service businesses in dealing with the representatives/executives of the large corporations they serviced. The method facilitated an investigation of the significant occurrences identified by the small-firm respondents about the undue advantage taken by the large firms. This was found to be more than simple occasional opportunistic or unfair business practices perpetrated by representatives of the large firms but, instead, involved bullying.FindingsThe results revealed that large corporations actively, though covertly, sought to take advantage of their small service providers by resorting to bullying practices. Intimidation, opportunism, use of deceitful or unfair business practices, as well as abuse of power, were manifestations of inter-organizational bullying committed by the large and powerful corporations. The contrasting characteristics of size, access to resources, economic and market power were identified as strong impediments against building effective ethical relational exchanges between the large corporations and their small service providers.Research limitations/implicationsThe study's findings provide valuable insights into the root causes and consequences of inter-organizational bullying. However, it is crucial to interpret these results in the context of this specific study. It is worth nothing that these findings primarily represent the self-perception of inter-organizational bullying among small service providers and may not capture other viewpoints or aspects of the industrial sector. Replicating this study in different sectors could enhance the generalizability of the conclusions drawn.Practical implicationsThis analysis is valuable in understanding what constitutes the phenomenon referred to as inter-organizational bullying. It also assists to understand the conditions when large firms exhibit such behaviours and their implications on the well-being of relevant stakeholders.Social implicationsFirstly, the business partners should maintain a healthy relationship if they want to avoid incidents of bullying, which can harm the performance of the relationship. In doing so, they need to reduce the level of uncertainty in their business relationships through the transparent information exchange, formulating commonly agreeable contracts and enhancing communication procedures. They also need to put aside their self-interest, but rather strive for achieving results that will be beneficial to both parties.Originality/valueThis exploratory study offers a novel and unexplored way of theorizing inter-organizational bullying, as well as uncovering its antecedents and impacts on the welfare of small businesses, particularly small service providers.

Innovation in Protein Therapy for Atherosclerosis——Application of ApoA1

Atherosclerosis is still the basic cause of metabolic diseases, namely the adnormal lipid metabolism and cholesterol accumulation. As more and more in-depth clinical investigations are being conducted, modulation the high-density lipoprotein (HDL) pathway, particularly the ApoA1, has been particularly attracted attention. Until now, to use these biotechnological functions properly and in management of individuals still poses a challenge. This essay will range from the introduction and discussion on the working and significance of both ApoA1 mimetics and genetically engineered ApoA1, focusing majorly on their functions which involve in enhancing cholesterol efflux and providing anti-inflammatory benefits. Consequently, they as a whole play a role in improving cardiovascular health. The results suggest that novel therapies could just be the epiphany for atherosclerosis cure or reversal. The study delineates the emphasis on protein-based treatments as a move for the future in the management of cardiovascular diseases, which serves as the architecture of subsequent research. However, as time goes on, matching treatment by patients’ genetic and environmental considerations stays to be a roadblock. Next research is set to target unsuitable combinations and those effective and possible in different groups for the development of such strategies.

Gender disparities in utilization of statins for low density lipoprotein management across the spectrum of atherosclerotic cardiovascular disease: Insights from the houston methodist cardiovascular disease learning health system registry

IntroductionLower statin utilization is reported among women compared to men, however large-scale studies evaluating gender disparities in LDL-C management in individuals with ASCVD and its subtypes remain limited, particularly across age and racial/ethnic subgroups. In this study, we address this knowledge gap using data from a large US healthcare system. MethodsAll adult patients with established ASCVD in the Houston Methodist Learning Health System Registry during 2016–2022 were included. Statin use and dose were extracted from the database. The association between gender and statin utilization was evaluated using multivariate logistic regression analyses in patients with ASCVD overall, across ASCVD subtypes, and by age, racial/ethnic subgroups, and socioeconomic risk factors. ResultsA total of 97,819 patients with prevalent ASCVD were included. Women with ASCVD had lower utilization of any statin (64.3% vs 72.6 %; p < 0.001) and high-intensity statin (29.8% vs 42.5 % p < 0.001) compared with men. In fully adjusted models, women had 40 % lower odds of any (adjusted odds ratio [aOR]:0.58, 95 % CI 0.57–0.60) and high-intensity statin use (aOR:0.59, 0.57–0.61) relative to men. Women were also less likely to have guideline-recommended LDL-C < 70 mg/dL (30.2% vs 42.7 %; p < 0.01). These differences persisted across age, racial/ethnic and socioeconomic subgroups. ConclusionSignificant gender disparities exist in contemporary lipid management among patients with ASCVD, with women being less likely to receive any and high-intensity statin and achieving guideline defined LDL-C goal compared with men across age and racial/ethnic subgroups. These disparities underscore the need to further understand potential socioeconomic drivers of the observed lower statin uptake in women.

Individual supported work placements (ReISE) for improving sustained return to work in unemployed people with persistent pain: an internal pilot study of a cohort randomised controlled approach

BackgroundPersistent pain is a frequent cause of sick leave and work disability in Norway. A return-to-work intervention featuring supported work placements, developed in the UK, demonstrated feasibility, and a return-to-work rate of 20% within 6 months was observed in the sample. We sought to adapt the intervention for delivery in Norway and to confirm feasibility prior to a full-scale trial.MethodsIn this internal pilot, we used a pragmatic cohort randomised controlled approach with national recruitment in Norway. We recruited people who were unemployed (for at least 1 month), having persistent pain (for at least 3 months), aged between 18 and 64, and wanting to return to work. We initially recruited people to an observational cohort study of the impact of being unemployed with persistent pain. After baseline measurement, we randomly sub-sampled participants to whom we offered the intervention, which featured individual case management and support, work-familiarisation sessions, and the offer of a 6-week part-time unpaid work placement. We assessed recruitment rates (aiming to recruit 66, and sub-sample 17 within 6 months); optimal recruitment pathways; intervention acceptance rates; the feasibility of data collection; using video links for work-familiarisation sessions and remote case manager support.ResultsThe pilot ran from June to November 2022. Of 168 people expressing interest, 94 consented. Recruitment posts on Facebook yielded the most ‘expressions of interest’ (66%, n = 111). After screening for eligibility, we included 55 participants. Of these, 19 were randomised to be offered the intervention. Of these, less than half (n = 8) consented to intervention participation. Remote case manager and work-familiarisation sessions appeared feasible. Following a delay in identifying placements, three participants received offers of work placements, with one starting and completing during the pilot period. Data collection methods were feasible, and no adverse events were reported.ConclusionsRecruitment and logistical processes, such as remote management by video link, are feasible. However, delivery of the intervention is challenging. In particular, sourcing placements and the time required for identifying appropriate placements was more challenging than anticipated. A full-scale trial is feasible but will require improvements to the placement identification processes.Trial registrationISRCTN85437524 (Referring to the ReISE trial, of which this internal pilot was a part), Registered 31 of May 2022 https://doi.org/10.1186/ISRCTN85437524Trial fundingNorwegian Research Council.

Modeling platform to assess the effectiveness of single and integrated Ixodes scapularis tick control methods

BackgroundLyme disease continues to expand in Canada and the USA and no single intervention is likely to curb the epidemic.MethodsWe propose a platform to quantitatively assess the effectiveness of a subset of Ixodes scapularis tick management approaches. The platform allows us to assess the impact of different control treatments, conducted either individually (single interventions) or in combination (combined efforts), with varying timings and durations. Interventions include three low environmental toxicity measures in differing combinations, namely reductions in white-tailed deer (Odocoileus virginianus) populations, broadcast area-application of the entomopathogenic fungus Metarhizium anisopliae, and fipronil-based rodent-targeted bait boxes. To assess the impact of these control efforts, we calibrated a process-based mathematical model to data collected from residential properties in the town of Redding, southwestern Connecticut, where an integrated tick management program to reduce I.xodes scapularis nymphs was conducted from 2013 through 2016. We estimated parameters mechanistically for each of the three treatments, simulated multiple combinations and timings of interventions, and computed the resulting percent reduction of the nymphal peak and of the area under the phenology curve.ResultsSimulation outputs suggest that the three-treatment combination and the bait boxes–deer reduction combination had the overall highest impacts on suppressing I. scapularis nymphs. All (single or combined) interventions were more efficacious when implemented for a higher number of years. When implemented for at least 4 years, most interventions (except the single application of the entomopathogenic fungus) were predicted to strongly reduce the nymphal peak compared with the no intervention scenario. Finally, we determined the optimal period to apply the entomopathogenic fungus in residential yards, depending on the number of applications.ConclusionsComputer simulation is a powerful tool to identify the optimal deployment of individual and combined tick management approaches, which can synergistically contribute to short-to-long-term, costeffective, and sustainable control of tick-borne diseases in integrated tick management (ITM) interventions.Graphical

Retinitis Pigmentosa and Therapeutic Approaches: A Systematic Review.

Background: Retinitis pigmentosa (RP) is a group of hereditary retinal dystrophies characterized by progressive degeneration of photoreceptor cells, which results in debilitating visual impairment. This systematic review aims to evaluate the efficacy and safety of emerging treatment modalities for RP, including gene therapy, mesenchymal-cell-based approaches, and supplementary interventions. Methods: A comprehensive search of electronic databases was conducted to identify relevant studies published up to February 2024. Studies reporting outcomes of treatment interventions for RP, including randomized controlled trials, non-randomized studies, and case series, were included. Data extraction and synthesis were performed according to predefined criteria, focusing on assessing the quality of evidence and summarizing key findings. Results: The search yielded 13 studies meeting inclusion criteria, encompassing diverse treatment modalities and study designs. Gene therapy emerged as a promising therapeutic approach, with several studies reporting favorable outcomes regarding visual function preservation and disease stabilization. Mesenchymal-cell-based therapies also demonstrated potential benefits, although evidence remains limited and heterogeneous. Supplementary interventions, including nutritional supplements and neuroprotective agents, exhibited variable efficacy, with conflicting findings across studies. Conclusions: Despite the lack of definitive curative treatments, emerging therapeutic modalities promise to slow disease progression and preserve visual function in individuals with RP. However, substantial gaps in evidence and heterogeneity in study methodologies underscore the need for further research to elucidate optimal treatment strategies, refine patient selection criteria, and enhance long-term outcomes. This systematic review provides a comprehensive synthesis of current evidence and highlights directions for future research to advance the care and management of individuals with RP.

AF among Nurses Working in Neonatal and Paediatric Intensive Care Units: A Cross-Sectional Study.

Aim: This research study aims to determine nurses' alarm fatigue (AF) levels in paediatric critical care units in two governmental hospitals and to examine the significant differences in the mean between nurses' attributes, nurses' working environment, and nurses' alarm management with the level of fatigue caused by the alarm. Background: In recent years, AF has become a significant and growing concern among nurses. However, in the Saudi Arabian paediatrics context, the impact of AF on nurses working in intensive care units remains unexplored. Method: A descriptive cross-sectional survey was conducted using a non-probability purposive sampling method. Data were collected from 216 nurses in two governmental hospitals through self-administered questionnaires comprised of four sections: individual attributes, work environment, alarm management, and AF scale. Data analysis: The Statistical Package of Social Science (SPSS) was used to analyse the data, and ANOVA was utilised to describe the sample's demographic characteristics and determine any differences. Results: Most participants were female, held a bachelor's degree, and were aged 31 to 35. Of the participants, 62.5% reported experiencing a medium level of AF, 29.2% reported a low level, and 8.3% reported a high level. Participants expressed that recurrent false alarms disrupt patient care and decrease trust in alarm systems. Significant differences in AF levels were observed based on marital status and the percentage of non-actionable alarms. Conclusions: Nurses working in paediatric critical units with high rates of false alarms, the frequent de-activation of alarms, and decreased trust in alarm systems are more likely to experience AF. Addressing AF is crucial for patient safety; nurse training on alarm management, the collaboration between biomedical and nursing staff, and technological advancements can help mitigate this issue. Implications for Practice: To minimise the adverse effects of AF, policymakers, biomedical experts, and nursing administrators must establish comprehensive policies and protocols concerning alarms. These measures aim to ensure secure and efficient care for the well-being of patients and nurses.

Development of preoperative nomograms to predict the risk of overall and multifocal positive surgical margin after radical prostatectomy

ObjectiveTo develop preoperative nomograms using risk factors based on clinicopathological and MRI for predicting the risk of positive surgical margin (PSM) after radical prostatectomy (RP).Patients and methodsThis study retrospectively enrolled patients who underwent prostate MRI before RP at our center between January 2015 and November 2022. Preoperative clinicopathological factors and MRI-based features were recorded for analysis. The presence of PSM (overall PSM [oPSM]) at pathology and the multifocality of PSM (mPSM) were evaluated. LASSO regression was employed for variable selection. For the final model construction, logistic regression was applied combined with the bootstrap method for internal verification. The risk probability of individual patients was visualized using a nomogram.ResultsIn all, 259 patients were included in this study, and 76 (29.3%) patients had PSM, including 40 patients with mPSM. Final multivariate logistic regression revealed that the independent risk factors for oPSM were tumor diameter, frank extraprostatic extension, and annual surgery volume (all p < 0.05), and the nomogram for oPSM reached an area under the curve (AUC) of 0.717 in development and 0.716 in internal verification. The independent risk factors for mPSM included the percentage of positive cores, tumor diameter, apex depth, and annual surgery volume (all p < 0.05), and the AUC of the nomogram for mPSM was 0.790 in both development and internal verification. The calibration curve analysis showed that these nomograms were well-calibrated for both oPSM and mPSM.ConclusionsThe proposed nomograms showed good performance and were feasible in predicting oPSM and mPSM, which might facilitate more individualized management of prostate cancer patients who are candidates for surgery.

Oral hygiene changes & compliance with telemonitoring device in individuals with intellectual/developmental disabilities: a randomized controlled crossover trial.

Advances in mobile technology are helping with health management practices, and smart toothbrushes provide proper dental care by collecting and analyzing users' toothbrushing data. The purpose of this study is to assess the effect of a telemonitoring device on oral hygiene management in individuals with intellectual or developmental disabilities and its role in promoting oral health. Participants were split into two groups: one initially using the telemonitoring device (telemonitoring device/manual toothbrush) and the other using it later (manual toothbrush/telemonitoring device), with a one-month washout period. The study compared plaque index, halitosis, changes in oral microbiota, and guardian questionnaire responses between the groups. In period 1, the QHI index score significantly decreased from 1.93 to 0.83 in the group using the remote monitoring device, compared to an increase from 1.75 to 2.01 in the manual toothbrush group. Additionally, toothbrushing frequency, time, and cooperation increased by 0.82 ± 0.60, 0.82 ± 1.16, and 1.09 ± 0.94, respectively, with initial telemonitoring device use. However, these measures decreased by -1.45 ± 0.68, -1.09 ± 0.70, and - 1.00 ± 1.00 after switching to a manual toothbrush, and decreased by -0.64 ± 0.67, -0.27 ± 1.19, and 0.09 ± 0.94 overall, respectively. However, there were no significant differences in oral microbiota between the groups at these different time points. The study shows that telemonitoring devices effectively reduce plaque index and improve toothbrushing frequency, time, and cooperation. However, these benefits decrease after switching to a manual toothbrush. Follow-up is needed to assess satisfaction and compliance with telemonitoring device use. Using telemonitoring devices in the oral health management of individuals with intellectual and developmental disabilities can improve their oral health quality.

The future of education in Preventive Cardiology. A Statement of the European Association of Preventive Cardiology (EAPC) of the ESC.

In recent years, major advances in our understanding of risk factors implicated in the development of cardiovascular disease (CVD), in available tools for early detection of CVD, and in effective interventions to prevent subclinical or clinically manifest disease, have led to an increasing appreciation of prevention as a major pillar of cardiovascular medicine. Preventive cardiology has evolved into a dynamic sub-specialty focused on the promotion of cardiovascular health through all stages of life, and on the management of individuals at risk of developing CVD or experiencing recurrent cardiovascular events, through interdisciplinary care in different settings. As the level of knowledge, specialized skills, experience, and committed attitudes related to cardiovascular prevention has exceeded core cardiology training, the European Association of Preventive Cardiology (EAPC) has placed major emphasis on continuous education and training of physicians and allied professionals involved in cardiovascular prevention, with the aim of setting standards for practice and improving quality of care. The EAPC recognizes the need for comprehensive educational offer across different levels of training (from core cardiology to sub-specialty to expert training) as well as the need for interdisciplinary approaches that will promote synergies among allied professionals involved in cardiovascular prevention. This statement by the EAPC aims to highlight current gaps and unmet needs, and to describe the framework to help standardize, structure, and deliver comprehensive, up-to-date, interactive, high-quality education using a combination of traditional and novel educational tools. The document aims to form the basis for ongoing refinements of the EAPC educational offer, with the ultimate goal to ensure that new evidence in the field will translate to better cardiovascular practice and improved outcomes for our patients.

Unveiling an anoikis-related risk model and the role of RAD9A in colon cancer

ObjectiveColorectal cancer (CRC), specifically colon adenocarcinoma, is the third most prevalent and the second most lethal form of cancer. Anoikis is found to be specialized form of programmed cell death (PCD), which plays a pivotal role in tumor progression. This study aimed to investigate the role of the anoikis related genes (ARGs) in colon cancer. MethodsConsensus unsupervised clustering, differential expression analysis, tumor mutational burden analysis, and analysis of immune cell infiltration were utilized in the study. For the analysis of RNA sequences and clinical data of COAD patients, data from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) were obtained. A prognostic scoring system for overall survival (OS) prediction was developed using Cox regression and LASSO regression analysis. Furthermore, loss-of-function assay was utilized to explore the role of RAD9A played in the progression of colon cancer. ResultsThe prognostic value of a risk score composed of NTRK2, EPHA2, RAD9A, CDC25C, and SNAI1 genes was significant. Furthermore, these findings suggested potential mechanisms that may influence prognosis, supporting the development of individualized treatment plans and management of patient outcomes. Further experiments confirmed that RAD9A could promote proliferation and metastasis of colon cancer cells. These effects may be achieved by affecting the phosphorylation of AKT. ConclusionDifferences in survival time and the tumor immune microenvironment (TIME) were observed between two gene clusters associated with ARGs. In addition, a prognostic risk model was established and confirmed as an independent risk factor. Furthermore, our data indicated that RAD9A promoted tumorigenicityby activating AKT in colon cancer.

Role of ventral tegmental area dopamine neurons in fear memory retention in post-traumatic stress disorder model rats

Ventral tegmental area (VTA) dopamine (DA) neurons have been found to substantially associate with post-traumatic stress disorder (PTSD) pathology, however, whether and how these DA neurons affect fear memory management in PTSD individuals remains largely unknown. In this study, we utilized auditory conditioned foot-shock to evaluate the fear memory retrieval and retention characteristics in a single prolonged stress-induced PTSD rat model. We employed chemogenetic technology to specifically activate VTA DA neurons to examine the freezing behaviors responding to the conditioned stimuli. In vivo extracellular electrophysiological analyses were used to identify VTA DA neuronal firing alterations due to the chemogenetic activation. The results demonstrated that PTSD model rats showed comparable fear memory retrieval (Day 2 after the conditioned foot-shock), but significant enhancements in fear memory retention (Day 8 after the conditioned foot-shock), compared to normal control rats. Chemogenetic activation of VTA DA neurons markedly diminished the retention of fear memory in PTSD model rats, which appeared concomitantly with increases in the firing activities of the DA neurons. These findings revealed that PTSD induced the persistence of fear memory, which could be attenuated by activation of VTA DA neurons. It is presumed that VTA dopaminergic signals may serve as a prospective option for PTSD treatment.

A high hospital frailty risk score indicates an increased risk for complications following surgical treatment of proximal humerus fractures

BackgroundApproximately 70 % of proximal humerus fractures (PHF) occur after the age of 60. High complication rates have been described in correlation with the treatment of PHF. Major risk factors for the outcome might be frailty, mobility and comorbidities of patients at the time of hospital admission. The aim of this study was to create risk adjusted quality indicators for surgical treatment of proximal humerus fractures based on German claims data and to evaluate the impact of the Hospital Frailty Risk Score (HFRS) on risk adjustment. MethodsRetrospective claims data (2015–2021) were used to create risk adjusted quality indicators for eight outcomes by clustered multivariable logistic regression. The comparison of different risk adjustment model performances was done by ROC-AUC and Standardized Mortality/Morbidity Ratios. ResultsIn total, N = 34,912 patients (median age 75 years, 80.3 % female) were included. The most common surgical procedure was open reduction and internal fixation with plate osteosynthesis with 39.7 %, followed by reverse shoulder arthroplasty with 25.3 %. The most influential risk factor for all outcomes was a high HFRS with an Odds Ratio of 2.0 (95 %-Confidence Interval 1.8–2.3) for any secondary surgery (365 days) up to an Odds Ratio of 17.6 (95 %-Confidence Interval 14.9–20.8) for general complications during the index stay. ConclusionComparative quality reporting for the surgical treatment of PHF appears feasible with the developed models for risk adjustment using claims data. Preoperative evaluation of HFRS in PHF can contribute to risk assessment, and individual patient management. It therefore enables personalized treatment decisions.

Communication Strategies Used during a Crisis in the Tourism and Hospitality Industry in Naivasha Sub-County

Purpose: Since tourism is highly susceptible to shocks, and effects of crises in the industry can lead to several direct and indirect repercussions, appropriate communication techniques and strategies are needed to proactively overcome or prevent crises. However, in Kenya, assessment of the same is glaringly insufficient, hence, the need for the current study. The study objective was guided by a research question; What are the during-crisis communication strategies used in crises preparedness in the tourism and hospitality industry in Naivasha Sub-county? Methodology: The study was conducted among hotels in Naivasha Sub-County of Nakuru County of Kenya using a mixed research methodology. Using a sample of 362 employees through multi-stage and purposive sampling techniques, questionnaires were used to collect data among employees while 28 key informant interviews were used among the hotel managers. Descriptive and inferential statistics were used to analyze quantitative data. Findings: The study concluded that during crisis communication strategies featured issuance of accurate and consistent messages, giving precautions, dissemination of information on how to cope physically as well as information on prioritizing self-protection. The communication strategies during the crisis influenced the preparedness in small and insignificant amounts (sig. = .968). The results showed that communicating on precautions during a crisis was a special way and strategy to contain the effect of the crisis. The study found that more than half of the hotel staff 175(59.5%) agreed that their organizations give accurate and consistent messages on crisis preparedness. Unique Contribution to Theory, Practice and Policy: The study recommends that the Cabinet secretary in the Ministry of Tourism develop policies that spell and guide crisis management plans that acknowledge effective crisis communication strategies in hotels in the country. For individual hotel operators and managers in Naivasha subcounty, provision of regular information on crisis, and having a crisis communication plan in the precrisis stage will educate and sensitize the employees of the possible risks and how to handle them. This study findings will inform academia and be a base for scholars in mass communication in carrying out further studies in communicative strategies used in crises preparedness. The study findings inform development and roll out of policies that guide crisis management plans in tourism and hotel industry.

Thermal ablation for Bethesda III and IV thyroid nodules: current diagnosis and management.

The diagnosis and management of Bethesda III and IV thyroid nodules remain clinical dilemmas. Current guidelines from academic societies suggest active surveillance or diagnostic lobectomy. However, the extent of surgery is often inappropriate, and a considerable percentage of patients experience under- or over-treatment. Thermal ablation has gained popularity as a safe and effective alternative treatment option for benign thyroid nodules. This review explores the feasibility of thermal ablation for Bethesda III or IV thyroid nodules, aiming to preserve the thyroid organ and avoid unnecessary surgery. It emphasizes individualized management, the need to consider factors including malignancy risk, clinical characteristics, and sonographic features, and the importance of supplemental tests such as repeat fine needle aspiration cytology, core needle biopsy, molecular testing, and radioisotope imaging.