Negative Outcomes Research Articles

Sex-related differences in vitamin D testing in the Veneto Region, Italy: a retrospective analysis from 2005 to 2016

SummaryA retrospective analysis was performed to evaluate the frequency of vitamin D blood testing in individuals from the Padua province, Veneto, Italy from 2005 to 2016. A significant increase in the frequency of vitamin D blood tests, particularly in females was observed and in individuals with severe vitamin D deficiency (Class I).PurposeVitamin D deficiency has been linked to negative health outcomes that extend beyond bone-related conditions. The frequency of vitamin D blood testing in residents from the Padua province, (Veneto, Italy) from 2005 to 2016 was evaluated.MethodsData were retrospectively retrieved from blood test databases (Laboratory Medicine Unit, Padua University Hospital) and information on number of vitamin D blood tests performed on residents from 2005 to 2016 was collected. Data were stratified by sex and ten birth cohorts from 1901 to 2016. Blood tests were classified into five vitamin D classes: I < 50 nmol/L, II 50–74.9 nmol/L, III 75–149 nmol/L, IV 150–250 nmol/L, and V > 250–1000 nmol/L. Blood test trends were analyzed as blood test rate and vitamin D class rate/resident population. Population analysis was analyzed by incidence rates and stratified by vitamin D class.Results293,013 vitamin D blood tests were conducted between 2005 and 2016 across 10 birth cohorts. Females accounted for 75% of tests and fewer were conducted in the youngest and oldest birth cohorts. Sex differences in vitamin D blood test frequency were observed; adjusted rates ranging from 1.7 to 35.6% for males and 8 to 81% for females from 2005 to 2016. Crude incidence rates (per 1000 from 2005 to 2016) varied from 1.5 to 10.8‰ for males and 7 to 19.4‰ for females. Crude blood test rates for vitamin D deficiency (Class I) increased from 1.1 to 9.9‰ in 2016 for males and 5 to 17.3‰ for females. Crude incidence rates (from 2005 to 2016) for Class I were 9.7–57.1‰ in males and 43.6–92.4‰ in females.ConclusionsThese findings highlight sex-related differences in vitamin D testing, providing valuable insight for healthcare planning.

The Relationship Between Feelings of Emptiness and Self-Harm Among Thai Patients Exhibiting Borderline Personality Disorder Symptoms: The Mediating Role of the Inner Strengths

Background and Objectives: Fifty percent of individuals with borderline personality disorder (BPD) experience self-harm. One of the crucial factors related to self-harm is feelings of emptiness. While inner strengths, such as the Five Precepts, meditation, and equanimity, have been identified as potential buffers against negative mental health outcomes in BPD, their role in mediating the relationship between feelings of emptiness and self-harm is not well-documented. This study aimed to explore how these inner strengths mediate the relationship between feelings of emptiness and self-harm in individuals exhibiting BPD symptoms. Materials and Methods: A total of 302 Thai participants exhibiting BPD symptoms completed several assessments: the SCID-II Personality Disorder Questionnaire for BPD to assess feelings of emptiness and self-harm, the Inner-Strength-Based Inventory (i-SBI) to evaluate the Five Precepts, meditation, and equanimity, and the Outcome Inventory Depression (OI-Depression) to assess depression. Mean and standard deviation were used for continuous variables, such as age and OI-Depression. A t-test assessed mean differences in continuous variables between the self-harm group and the non-self-harm group. Chi-square tests examined differences in categorical variables with three or more levels, such as education. Pearson’s correlation and linear regression analyzed relationships between continuous variables, including i-SBI and OI-Depression scores. Mediation analysis was performed using IBM SPSS and AMOS, with self-harm as the outcome variable, feelings of emptiness as the predictor, and inner strengths as mediators. Results: The participants had a mean age of 36.56, with 65.4% being female. The analysis showed that the Five Precepts, meditation, and equanimity significantly mediated the relationship between feelings of emptiness and self-harm, with a standardized coefficient of β = 0.534 (95% CI = 0.417 to 0.647, p &lt; 0.001). The indirect effect of feelings of emptiness through these inner strengths was significant (β = 0.034, 95% CI = 0.009 to 0.075, p = 0.005). The mediation model explained 38% of the variance in self-harm with a 3% increase, albeit small but significant. Conclusions: This study highlights that inner strengths negatively mediate the relationship between feelings of emptiness and self-harm, indicating that as these inner strengths increase, the direct impact of feelings of emptiness on self-harm decreases. These findings suggest that targeting inner strengths as protective factors could be a valuable strategy in developing interventions aimed at reducing self-harm by addressing the underlying emotional challenges associated with BPD.

Connecting the dots: A narrative review of the relationship between heart failure and cognitive impairment.

Large clinical data underscore that heart failure is independently associated to an increased risk of negative cognitive outcome and dementia. Emerging evidence suggests that cerebral hypoperfusion, stemming from reduced cardiac output and vascular pathology, may contribute to the largely overlapping vascular dementia and Alzheimer's disease. Despite these insights, cognitive outcomes remain largely overlooked in heart failure management. This narrative review outlines the prevalence and risk of cognitive impairment in heart failure patients, exploring potential shared pathophysiological mechanisms and examining the impact of heart failure therapy on cognitive deficits. Additionally, it discusses clinical implications and suggests future treatment approaches targeting therapeutic outcomes. Cognitive impairment is prevalent among individuals with heart failure, with reported rates varying widely depending on assessment methods. Shared pathological pathways and risk factors, including atrial fibrillation (AF), hypertension, obesity and type 2 diabetes mellitus, suggest a causal link. Mechanisms such as poor perfusion, microembolic events, ischaemic syndromes and cerebral inflammation contribute to this relationship. Moreover, heart failure itself may exacerbate cognitive dysfunction. This emerging understanding posits that vascular dementia and Alzheimer's disease may represent a pathophysiological continuum, driven by both the accumulation of misfolded proteins and cerebrovascular pathology due to cardiovascular dysfunction. Understanding these links is crucial for developing effective treatment strategies. The complex interplay between heart failure and cognitive impairment underscores the necessity for a holistic patient care approach. Both conditions share analogous disease processes, influencing self-management and independence in patients. Prioritizing brain health in heart failure management is essential to enhance patient prognosis and general well-being.

An Examination of Underlying Domains in Childhood Adversity: A Scoping Review of Studies Conducting Factor Analyses on Adverse Childhood Experiences

There is an abundance of research linking experiences of childhood adversity to negative physical and mental health outcomes. Areas that remain to be explored and expanded upon include the ideal set of events for inclusion in measures of childhood adversity and testing the models of risk (e.g., cumulative, specificity, dimensional). In the current paper, we performed a scoping review to develop a comprehensive list of studies that conducted factor analyses of childhood adversity measures. There were 89 articles that met the inclusion criteria; trends in the underlying factor structures are reported. Highly associated yet distinct constructs of adversity have demonstrated empirical utility in predicting outcomes in dozens of studies, with consensus that physical abuse, emotional abuse, sexual abuse, physical and emotional neglect, and household dysfunction offer important predictive value to understanding developmental mechanisms of change. We endorse revisions to one commonly used scale that could offer researchers a consistent and psychometrically robust measure of adversity.

Exploring Inpatient Unit Nurses’ Experience with Emergency Department Crowding, Access and Flow, and Associated Patient Outcomes

Background: Emergency department crowding and hospital access and flow are complex and long standing issues that negatively impact healthcare delivery. This study aims to address these issues through the perspectives of inpatient unit nurses. Strategies to alleviate ED crowding are supported by research exploring ED staff perspectives; however, a paucity of research exists addressing the perceptions of inpatient unit nurses and other key stakeholders. Methods: The research aims were addressed using qualitative method. Semi-structured virtual interviews were completed with eleven inpatient unit registered nurses from two hospital sites. A 17-question interview tool facilitated the collection of data. Results: Three main themes emerged from the data analysis. Inpatient unit nurses identified ED crowding, hospital access and flow, and site congestion as key areas of concern. In addition, the influence of understaffing was viewed as a contributor to ED crowding, resulting in negative outcomes for patient care. Conclusion: This study is the initial step to understanding different experiences, perceptions and knowledge on emergency department crowding and access and flow processes. Further research exploring diverse viewpoints on this topic is necessary given the interconnected organizational structure of healthcare today and how key stakeholders, outside of the emergency department, strongly influence access block and ED outflow.

A systematic review of surgical and interventional radiology procedures for pediatric idiopathic intracranial hypertension.

Idiopathic intracranial hypertension (IIH) is defined as elevated intracranial pressure and consequent symptoms (mainly headache and visual deterioration) occurring in the absence of secondary causes. Surgical and interventional radiology procedures should be considered for refractory IIH and mainly include cerebrospinal fluid (CSF) diversion techniques, optic nerve sheath fenestration (ONSF), and venous sinus stenting (VSS). Our study aims to review the current literature on the application of these techniques in clinical practice. A systematic literature review on the surgical and interventional radiology treatment of IIH was conducted, focusing on ONSF, VSS, and CSF diversion techniques. According to PRISMA guidelines, all reports published in PubMed in the last 30 years (1993-2023) were considered, and among 722 papers, 48 were included in the present study, resulting in a total study population of 454 children or adolescents (11 months-17 years old). Among 454 patients, 193 underwent an invasive approach, divided into CSF diversion (115/193), ONSF (65/193), VSS (11/193), cranial subtemporal decompression (8/193), and internal cranial expansion (9/193). Sixteen of the 193 patients (8%) required reintervention due to relapsing symptoms or surgical complications, particularly those who underwent CSF diversion. Furthermore, 9/115 required shunt revision due to shunt obstruction or malfunction. We extracted data on the outcome of each procedure: of the 193 patients, 71 experienced a positive outcome with symptom resolution or improvement, while 27 demonstrated a negative outcome. Severe and refractory cases of IIH are eligible for invasive treatments. CSF diversion is the most frequently used technique, despite its high failure risk and need for reintervention. ONSF has shown good results in terms of outcome and safety, particularly in children with visual symptoms. VSS is the most recent approach, indicated in children with stenosis of the venous sinus. In our study population, VSS demonstrated good results in terms of symptom resolution and need for reintervention, but its use remains limited to a few centers. https://www.crd.york.ac.uk/, PROSPERO (CRD42024504244).

Longitudinal transcriptional changes reveal genes from the natural killer cell-mediated cytotoxicity pathway as critical players underlying COVID-19 progression

Patients present a wide range of clinical severities in response severe acute respiratory syndrome coronavirus 2 infection, but the underlying molecular and cellular reasons why clinical outcomes vary so greatly within the population remains unknown. Here, we report that negative clinical outcomes in severely ill patients were associated with divergent RNA transcriptome profiles in peripheral immune cells compared with mild cases during the first weeks after disease onset. Protein–protein interaction analysis indicated that early-responding cytotoxic natural killer cells were associated with an effective clearance of the virus and a less severe outcome. This innate immune response was associated with the activation of select cytokine–cytokine receptor pathways and robust Th1/Th2 cell differentiation profiles. In contrast, severely ill patients exhibited a dysregulation between innate and adaptive responses affiliated with divergent Th1/Th2 profiles and negative outcomes. This knowledge forms the basis of clinical triage that may be used to preemptively detect high-risk patients before life-threatening outcomes ensue.

Longitudinal transcriptional changes reveal genes from the natural killer cell-mediated cytotoxicity pathway as critical players underlying COVID-19 progression.

Patients present a wide range of clinical severities in response severe acute respiratory syndrome coronavirus 2 infection, but the underlying molecular and cellular reasons why clinical outcomes vary so greatly within the population remains unknown. Here, we report that negative clinical outcomes in severely ill patients were associated with divergent RNA transcriptome profiles in peripheral immune cells compared with mild cases during the first weeks after disease onset. Protein-protein interaction analysis indicated that early-responding cytotoxic natural killer cells were associated with an effective clearance of the virus and a less severe outcome. This innate immune response was associated with the activation of select cytokine-cytokine receptor pathways and robust Th1/Th2 cell differentiation profiles. In contrast, severely ill patients exhibited a dysregulation between innate and adaptive responses affiliated with divergent Th1/Th2 profiles and negative outcomes. This knowledge forms the basis of clinical triage that may be used to preemptively detect high-risk patients before life-threatening outcomes ensue.

Gendered socio-economic and mental health effects of the COVID-19 pandemic among adults living in selected informal settlements in Kenya: an intersectional analysis.

COVID-19 pandemic had devastating socio-economic and health effects, including mental health. This study examines the intersectionality between gender and mental health outcomes among Kenyan adults in informal settlements of Nairobi, Kisumu, and Kilifi Counties during the COVID-19 crisis. This is necessary to inform mental health response in case of another pandemic. We analyzed data collected in a longitudinal survey between July 2020 (fourth round) and February 2021 (fifth round). The data covered COVID-19-related effects on job loss, food insecurity, access to health services, and mental health. Participants were randomly sampled from existing cohorts at the Population Council. The outcomes of interest were depressive and anxiety disorders, combined into a binary composite outcome variable. Descriptive statistics included means for continuous variables and frequencies and proportions for categorical variables. Chi-square tests were used to examine the differences between groups. The relationship between the gendered COVID-19 socio-economic effects and participants' mental health was examined using modified Poisson regression. A total of 4,050 participants were interviewed, 66% female and median age 38 [interquartile range (IQR): 29-46]. Complete income loss was strongly associated with negative mental health outcomes in multiple intersections with varied magnitudes. The association was larger among older females (≥50 years) (PR = 1.33, 95% CI = 1.17-1.51, p < 0.001) than older males (PR = 1.22, 95% CI = 1.17-1.27, p < 0.001). Partial loss of income was protective against negative mental health outcomes among young males (18-29 years) (PR = 0.81, 95% CI = 0.76-0.87, p < 0.001) but linked to negative outcomes among middle-aged males (30-49 years old) (PR = 1.14, 95% CI = 1.12-1.16, p < 0.001). Skipping meals was associated with negative mental health outcomes for both genders particularly the married (married male: PR = 1.49, 95% CI = 1.22-1.83, p < 0.001; married female: PR = 1.42, 95% CI = 1.26-1.60, p < 0.001). We observed significant gender differences in the prevalence of depressive symptoms and anxiety disorders during the COVID-19 pandemic, underscoring the importance of socio-economic factors and health services access in shaping mental health outcomes. Interventions targeting pandemic-related mental health issues should be gender-sensitive and address economic vulnerabilities such as job losses and food insecurity. Policies to mitigate these effects, especially for at-risk groups are crucial for reducing mental health burden in future crises.

Pants on fire: Risks for and outcomes of atypical lying

AbstractIntroductionMost people are generally honest, but around 5% of individuals are prolific liars, some of whom lie for fun or no reason. However, developmental research on atypical lying features (e.g., motives, attitudes, inclinations for dishonesty) and the associated traits and negative outcomes is lacking. We examined how psychopathic traits are related to the development of lying trajectories and whether exhibiting atypical lying features during a developmental period when lies tend to decrease in frequency (i.e., adolescence to adulthood) increases the risk for adulthood antisocial behaviors.MethodsData come from the multisite Pathways to Desistance project, a longitudinal study of serious juvenile offenders in the United States who were interviewed across 11 time points over 7 years from 2000 to 2010. Age‐based trajectory analyses modeled self‐reported atypical lying features from ages 14 to 26 for male participants (N = 1170; 42.1% Black, 34.0% Hispanic, 19.2% White, 4.6% Other), and examined how subscales from the Youth Psychopathy Inventory predicted lying trajectory classes and whether those classes differed in adulthood offending and substance use.ResultsAround 5% of the sample maintained elevated atypical lying features in adolescence and into adulthood. These individuals were more manipulative, remorseless, impulsive, and irresponsible in adolescence, and were more likely to offend and use substances in adulthood.ConclusionsFindings highlight how atypical lying features during the normative developmental desistance period of lying may be elevated for prolific liars and how traits can be used to identify at‐risk individuals. This information will help to inform intervention and prevention programs targeting externalizing behaviors.

Real-World Study of US Adults with Paroxysmal Nocturnal Hemoglobinuria Treated with Pegcetacoplan

Background: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired, life-threatening disease characterized by complement-mediated hemolysis. OPERA is the first US longitudinal real-world study on C3 inhibitor therapy, known as pegcetacoplan. Methods: OPERA enrolled US patients with PNH, age ≥18, who were prescribed pegcetacoplan, and data were collected from routine care. Hemoglobin was reported by patients during regular follow-up (censored from transfusions). The Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue (0–52 score) and Patient-Reported Outcomes Measurement Information System scale for Cognitive Function Abilities (PROMIS-CF; 23.27–67.09 t-score) were completed electronically (low score = negative outcome). Patients self-reported incidence of healthcare resource utilization (HCRU). Results: By January 2024, 70 patients (mean age 44.6 years; 57.1% female) reported up to 9 months of pegcetacoplan treatment, with a median [IQR] follow-up of 6.6 [3.8] months. The latest reported hemoglobin levels improved by a mean (SD) of 2.6 (1.9) g/dL from baseline. At 3, 6 and 9 months, patients reported clinically meaningful improvements (≥5 points) in FACIT-F (53.3–69.0%) and (≥2 points) PROMIS-CF (46.7–55.2%). Patients reported a &lt;10% incidence rate per person month of all HCRU events. Conclusions: This first longitudinal real-world US study indicates a positive trend in Hb, fatigue, and cognition with limited HCRU during pegcetacoplan treatment in adults with PNH.

Need Frustration and E-Cigarette Use and Dependence Among College Students: The Mediating Role of Ruminative Thinking

Background: The prevalence and dependence of e-cigarettes have increased among young adult college students in recent years. Though several independent risk factors for e-cigarette use and dependence have been identified, research employing theory-informed models to predict e-cigarette use and dependence is limited. Objectives: Using Self Determination Theory (SDT), e-cigarette use and dependence may be understood as stemming from need frustration that impairs autonomy, competence, and relatedness, which increases vulnerability for negative health outcomes, including e-cigarette use. Further, need frustration may relate to more e-cigarette use and dependence via higher ruminative thinking, which is known to relate to both need frustration and tobacco use. Method: This study tested this path model (i.e., SDT need frustration components [autonomy, relatedness, competency]→rumination facets [problem-focused thoughts, counterfactual thinking, repetitive thinking, anticipatory thoughts]→e-cigarette use frequency and dependence outcomes) among 1001 college students (75.3% female; 60.4% White, non-Hispanic; 52% first-year students) who endorsed past-month e-cigarette use. Results: Within our path model, we found significant indirect effects via problem-focused thoughts on e-cigarette use frequency and e-cigarette dependence. Specifically, higher scores on SDT autonomy, competence, and relatedness frustration were associated with greater problem-focused thoughts, which was associated with higher e-cigarette use frequency and e-cigarette dependence scores. Conclusions/Importance: Results highlight the importance of distinguishing between the unique facets of rumination in understanding relations with e-cigarette use. Further intervention research targeting need frustration and ruminative thinking (particularly problem-focused thoughts) among college student e-cigarette-dependent users is needed.

Medication Management in Portuguese Long-Term Care Facilities: A Preliminary Cross-Sectional Study.

Population ageing has been a pressing global issue for decades. Older adults, especially those residing in long-term care facilities (LTCFs), often experience frailty and polypharmacy, which can lead to negative clinical outcomes. In Portugal, LTCFs provide essential care for individuals aged 65 or older, offering temporary or permanent accommodation. These facilities are not considered healthcare providers, and as a result, pharmaceutical services are not mandatory. This study aimed to evaluate medication management practices in Portuguese LTCFs, identify which professionals are responsible for managing medications, and identify potential gaps in safety and efficacy. A cross-sectional electronic questionnaire was sent by email to 2552 Portuguese LTCFs from the Portuguese "Carta Social" database. Data collection took place between 20 July and 2 August 2023, yielding a response rate of 15.4% (392 institutions). Most LTCFs (94.39%) oversee their resident's medication, with 75.95% using the same pharmacy. Individualised medication packaging is used by 57.84% of facilities, and 97.84% provide medication reconciliation and review, mainly conducted by physicians and nurses. Medication is often stored in nursing offices (81.12%) but also in kitchens or dining rooms. Nurses are responsible for medication storage (87.50%) and preparation (81.89%), although non-nursing staff are also involved. In 63.27% of LTCFs, the same individual is responsible for both the preparation and verification of medication. Assistants are involved in both the checking (30.56%) and administering (45.66%) of medication. The results presented illustrate the current status of LTCFs in Portugal. Medication management presents a significant challenge, and it is notable that the role of the pharmacist in this process is not as prominent as it is in other countries.

Adoption is History: Enhancing Counselor Awareness of Adoption as a Legal and Sociocultural Practice

Understanding cultural history is essential to becoming a culturally responsive counselor. Despite adoptees’ increased risks for negative mental health outcomes, the history of adoption as a cultural and legal practice has been underemphasized in counseling scholarship. This overview of adoption practices from Ancient Babylon through the mid-1970s highlights lasting historical influences on modern adoption practice and the lingering threats to adoptees’ mental health from systemic legal and sociocultural inequities.

How do different game genres impact adolescent players’ problematic game use?

This study investigates the influence of video game genres on adolescent behavior, focusing on tolerance, withdrawal symptoms, and impaired control. With the increasing prevalence of gaming among adolescents, understanding the specific impacts of game genres becomes crucial. This research aims to identify how different genres affect adolescent gamers and to provide insights for educators, parents, and policymakers on managing gaming-related behaviors. Using ANOVA and Sidak post-hoc test to analyze responses from a sample size of 60,029 adolescents, the study found significant differences in tolerance, withdrawal symptoms, and impaired control across various game genres. RPG and AOS games were associated with higher levels of tolerance and withdrawal symptoms compared to sports and casual games, suggesting a genre-specific influence on these behaviors. The findings underscore the need for targeted strategies in educational and parental guidance to address game genre-related issues among adolescents. The implications of this research are vital for developing effective interventions and supports that cater to the specific needs of adolescent gamers, aiming to foster healthier gaming habits and mitigate potential negative outcomes.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

The Role of the Plasminogen Activator Inhibitor 1 (PAI1) in Ovarian Cancer: Mechanisms and Therapeutic Implications

AbstractOvarian cancer (OC) is one among most significantly fatal gynecological cancers, with late-stage detection and an inadequate prognosis. Plasminogen activator inhibitor-1 (PAI1) gene anticipates negative outcomes in many different kinds of malignancies. Several research investigations are currently being done to examine the biological role of PAI1 in OC and the possible benefits of targeted pharmacotherapies. The PAI1 gene has been linked to the emergence and development of cancer in the ovary. PAI1, an inhibitor of serine protease, influences the fibrinolysis and extracellular matrix remodeling, both of which are crucial for tumor expansion and metastatic growth. PAI1 levels have been discovered to be subsequently more elevated in malignant ovarian tissues than in usual ovarian tissue, demonstrating a potential connection among PAI1 overexpression and OC development. PAI1 promotes tumor cell proliferation, movement, and an invasion by influencing the urokinase-plasminogen activators and through interactions with cell surface receptors. In addition, PAI1 gene contributes to angiogenesis and apoptotic cell death, which contribute to the more hostile phenotypes of OC. The prognostic and therapeutic consequences of focusing on PAI1 in OC are explored, demonstrating PAI1's potential to be a biomarker and emphasizing for novel treatment approaches. The PAI1 gene possesses several functions in OC, affecting tumor development, an invasion, and metastatic growth. Comprehending the complicated interactions and mechanisms that regulate PAI1 in OC may lead to more efficient evaluation and treatment strategies and ultimately enhance patient outcomes.

Social dynamics of luxury customization: The unique impact of name personalization

AbstractAs customized luxury becomes increasingly mainstream, adhering to a uniform treatment of all types of customization falls short of the nuanced insight needed. Our research focuses on the effects of a prevalent form of customization—name personalization—on the perceived “social cost” associated with luxury items from a potential buyer's point of view. Despite most luxury brands offering consumers the option to imprint their names on products for a personalized touch, concerns arise about being perceived to be “showing off.” Our four experimental studies demonstrate that adding one's name to luxury goods heightens apprehensions about the social cost, specifically diminishing metaperceptions of warmth due to impression management (Study 1). This phenomenon applies to both the imprinting of one's full first name, and only their initials (Study 2). However, luxury consumers with a lower social‐adjustive (i.e., less driven by the desire for social approval) show an elevated concern over the social cost of name personalization (Studies 3 and 4). As the trend of customizing luxury items rises, our findings emphasize the significance of luxury researchers and practitioners to discern both the positive and negative outcomes associated with various forms of luxury customization.

Revision open reduction in developmental dysplasia of the hip.

Re-dislocation after open reduction remains a challenge in the treatment of developmental dysplasia of the hip (DDH). Few geographically and temporally diverse reports exist on the topic. The aim of this study was to uncover the outcome in a group of DDH patients who underwent repeat open reduction. All patients who had DDH surgery were screened at one hospital, spanning a ten-year period. Patients who underwent repeat open reduction for re-dislocation were included. Clinical data and radiographic parameters were obtained. This is a retrospective cohort study. Twenty-three revision open reductions were included. The median age (interquartile range) was 40 (26-61) months and the median follow-up duration was 26 (14-55.50) months. Fifteen revisions (65%) had at least one notable complication. Recurrent instability was found in nine revisions (39%), and other complications included avascular necrosis, stiffness and leg length discrepancy in 12 revisions (52%). Although it did not reach statistical significance (p = 0.13), all hips with pre-revision international hip dysplasia institute grade III (n = 4), compared to grade IV, remained stable after the re-operation. There is a substantial risk of dismal prognosis after repeat open reduction. Moreover, every precaution should be taken during the first surgery to reduce the risk of re-operation. Findings from this study may help inform surgeons and caregivers about the probable negative outcome when contemplating repeat open reduction.

Limited critical and communicative health literacy is related to poorer health among older adults

Abstract Background Health literacy-related challenges are expected to increase with age due to a discrepancy between individual capacity and health care demands. Knowledge about associations between health literacy and age-related health outcomes among older adults is scarce. This is important to address and promote optimal health in older adults. The study aims to investigate the association between health literacy and health status among older adults and explore differences between the younger old and the oldest old adults. Methods Cross-sectional study using SWEOLD population-based data from 2022, a national representative sample of people 77+ years in Sweden. Univariate and multivariate logistic regression analysis assessed associations between communicative- and critical health literacy and health outcomes. Models were adjusted for age, sex, and socioeconomic status, and stratified by age. Results Significant adjusted associations were found between inadequate and problematic health literacy and less than good self-rated health (OR 2.64, 95%CI: 1.61-4.33; 2.11, 95%CI: 1.40.3.17), and requiring assistance with medicine management (OR 5.26, 95%CI: 2.67-10.38, 2.14, 95%CI 1.08-4.22). Among the younger old (77-84 years) inadequate and problematic HL was associated with having lifestyle-related conditions (OR 1.77, 95%CI: 1.07-2.93, 2.75, 95%CI: 1.33-2.71). Among the oldest old (85+), inadequate health literacy was associated with higher likelihood of poor activities of daily living (ADL) (OR 4.48, 95%CI: 1.99-10.07) and frailty (OR 3.51, 95%CI: 1.43-8.47). Level of frailty increases earlier in age for individuals with limited HL than among those with sufficient HL. Conclusions Limited health literacy is a prevalent issue in the older population and is associated with negative health-related outcomes. To mitigate development of poor health and frailty and to promote healthy ageing, care organisations need to meet the needs of this population in a health literacy friendly way. Key messages • Limited health literacy among the older population is associated with several negative health-related outcomes. • Care organisations need to work actively to mitigate the development of poor health while promoting healthy aging among the older population in a health literacy-friendly and age sensitive manner.