Predictors Of Effectiveness Research Articles

Learning methods and entrepreneurial effectiveness of women-owned agri-small and medium enterprises: the mediating effect of entrepreneurial knowledge

PurposeThe purpose of this study is to establish the mediating effect of entrepreneurial knowledge in the relationship between learning methods and entrepreneurial effectiveness of women-owned agricultural small and medium enterprises (SMEs) in Uganda.Design/methodology/approachThis study is cross-sectional and correlational in nature and used a quantitative approach. A self-administered questionnaire was used to gather data from 380 women-owned agri-SMEs in Central Uganda. Statistical Package for the Social Sciences (SPSS.25) and Medgraph (Excel Version) were used to support data analysis.FindingsStudy findings revealed that learning methods and entrepreneurial knowledge are significant predictors of entrepreneurial effectiveness. In addition, entrepreneurial knowledge significantly mediates the association between learning methods and entrepreneurial effectiveness of women-owned agricultural SMEs in Uganda.Originality/valueThe study confirmed that entrepreneurial knowledge significantly mediates the relationship between learning methods and entrepreneurial effectiveness of women-owned agricultural SMEs, unlike previous studies that focused on the direct relationship between the study variables in predicting the study phenomenon.

Anti‑CGRP monoclonal antibodies in resistant migraine: preliminary real-world effectiveness and clinical predictors of response at twoyears.

Monoclonal antibodies targeting calcitonin gene-related peptide (anti-CGRP mAbs) have shown clinical effectiveness and safety in randomized clinical studies. However, long-term studies in clinical practice remain limited. To assess the long-term effectiveness, clinical predictors and safety of three anti-CGRP mAbs (erenumab, galcanezumab, fremanezumab) in resistant migraine patients. A single-center retrospective study was conducted from December 2019 to June 2023 involving 120 resistant migraine patients who received at least a month of anti-CGRP mAbs treatment. Patients completed a headache diary that included monthly acute medication intake (MAM), monthly migraine days (MMD), adverse events as well as completed Patient-Reported Outcome questionnaires (MIDAS [Migraine Disability Assessment] and Headache Impact Test 6 [HIT-6]). The number of patients achieving a ≥ 50% reduction in monthly migraine days was determined and classified as ≥ 50% responders, and baseline parameters and logistic regression between responders and non-responders were analyzed to identify potential predictors of response. Adverse events were registered in every follow-up. Treatment with anti-CGRP mAbs led to reductions in MIDAS, HIT-6, MMD and MAM from baseline to 6-24months. At 6-12months, responders (61% and 57%, respectively) exhibited lower baseline MMD and MAM. Medication overuse was associated with non-responders from 6 to 24months and it was identified as a negative predictor of treatment effectiveness (OR 0.23, 95% CI 0.07-0.74; p = 0.014). Anti-CGRP mAbs prove effectiveness and safety over a 24-month period in a RM population. Patients with no medication overuse and lower basal MMDs and MAM may respond better to anti-CGRP mAbs.

Plasma Cytokines for the Prediction of the Effectiveness of TNFα Inhibitors Etanercept, Infliximab, and Adalimumab in the Treatment of Psoriasis.

Background/Objectives: Psoriasis is a chronic, inflammatory, immuno-mediated cutaneous disease characterized by a prominent TNFα-IL23/IL17 immune axis. In recent years, targeted therapies have become standard practice for managing moderate-to-severe psoriasis and have demonstrated efficacy. At the same time, identifying factors associated with the success or failure of TNFα inhibitor therapy remains one of the most difficult aspects in psoriasis treatment. Methods: A clinical, non-randomized study was conducted to evaluate the impact of TNFα inhibitors on the plasma cytokine profiles in patients with moderate-to-severe psoriasis vulgaris (ICD-10 code L40.0). The patients were treated with either etanercept, adalimumab, or infliximab for 16 weeks. Plasma cytokine profiles were assessed using a BioPlex200 System. Results: By the 16th week of therapy, a positive treatment response (PASI ≥ 75) was observed in 51 patients (63%), while 30 patients (37%) showed no response (PASI ≤ 50). When using etanercept, a positive effect was observed in 11 patients (41%), in 14 patients (52%) using adalimumab, and in 26 patients (96%) using infliximab. Analysis of the baseline cytokine levels revealed no differences between the "positive effect" and "no effect" groups, except for IL20, which was 2.61 times higher in the "positive effect" group compared to the "no effect" group, suggesting its potential predictive role in the effectiveness of therapy with TNFα inhibitors. Treatment led to a decrease in IL17F, IL31, sCD40L, and VEGF for all patients, and in IL20 for the "positive effect" group. The increase in ICAM1 in the "no effect" group suggests the possible retention of active migration and the fixation of T cells in the affected skin in these patients. No significant difference in cytokine levels was observed when categorizing patients into subgroups based on the effectiveness of therapy with etanercept, infliximab, and adalimumab; only a pre- and post-treatment difference in the whole cohort was noted. A random forest model showed the importance of VEGF, sCD40L, and ICAM1. Conclusions: The baseline levels of VEGF, sCD40L, and ICAM1, as well as IL20, could serve as potential predictors of treatment effectiveness using TNFa inhibitors. However, this hypothesis requires confirmation with a larger patient population.

Outcomes and Baseline Predictors of Failure in Primary Standalone Xen45 Gel Stent versus Trabeculectomy for Glaucoma

PurposeTo compare safety, effectiveness and baseline predictors of failure in standalone primary Xen45 gel stent (Xen) vs trabeculectomy (Trab) in glaucoma. DesignRetrospective study SubjectsSubjects that underwent primary Xen or Trab augmented by mitomycin-C with at least 12 months follow-up. MethodsMultinational observational study of eyes in the Fight Glaucoma Blindness international registry Main outcome measuresThe primary outcome was success at 12 months defined by IOP reduction ≥ 20% from baseline and ≤ threshold IOPs of 15mmHg, 18mmHg and 21mmHg with (qualified) or without (complete) medications and without secondary glaucoma surgery. Multivariable mixed effects cox regression models were used to identify risk factors for failure in each cohort. Results701 eyes (Xen, 308; Trab, 393) of 596 subjects were included with baseline IOP being significantly higher (22.4 vs 19.9 mmHg, p < 0.001) and baseline medications significantly lower in the Xen vs the Trab group (2.9 vs 3.4, p <0.001). Baseline visual field (VF) mean deviation (MD) was less severe in the Xen group (-9.47 vs -13.04 dB, p < 0.001). The proportion of complete surgical success was significantly lower in the Xen vs Trab group across the three upper IOP limits at 12 months; 32% vs 52% at 15mmHg, 37% vs 54% at 18mmHg, and 39% vs 55% at 21mmHg (p < 0.001). The incidence of post-operative numerical and symptomatic hypotony was lower in the Xen vs Trab group. In the Xen cohort, a higher failure rate was associated with Asian ethnicity (HR, 1.97; 95% CI, 1.03-3.79) and use of oral acetazolamide at baseline (HR, 1.74; 1.13-2.70), while a lower failure rate was associated with diagnosis of ocular hypertension/open angle glaucoma suspect (HR, 0.52; 0.28-0.94) and secondary open angle glaucoma (HR, 0.45; 0.25-0.8). Exposure to prostaglandin analogue was associated with greater failure in the Trab group (HR, 2.66; 1.18-6.01). ConclusionsThere was significantly greater complete success at 12 months across all complete success definitions for Trab compared to Xen, while the rate of post-operative hypotony was significantly lower in Xen group. Asian ethnicity and use of oral acetazolamide at baseline were associated with greater failure in Xen, while exposure to prostaglandin analogue was associated with greater failure in Trab patients. Such baseline predictors of success and failure may help guide patient selection for subconjunctival minimally invasive glaucoma surgery in patients undergoing surgical intervention.

Predictors of EFL Teacher Effectiveness in their Online Classes

Introduction: Online education has been used more widely after COVID-19. This calls for teachers’ familiarity with technological tools and pushes them toward gaining computer literacy to improve their efficacy. Moreover, there is a growing recognition of the need to redefine professional identities in this context. This study was an attempt to investigate the relationships between EFL teachers’ professional identity and computer self-efficacy with their effectiveness in online classes. Methodology: To conduct the study, 100 EFL teachers from English language Institutes and schools in Bojnourd, Iran, participated in the study. They completed three questionnaires, namely, professional identity, computer self-efficacy, and online EFL teacher effectiveness. The obtained data were analyzed using two Spearman correlation coefficients and one regression analysis. Results: The findings indicated significant relationships between professional identity and computer self-efficacy with teacher effectiveness in online classes. Moreover, it was found that computer self-efficacy was a better predictor of online EFL teacher effectiveness. Conclusion: The findings indicated that teaching effectiveness is a crucial aspect of professional development in online education. This highlights the importance of educators possessing strong computer skills and actively reshaping their professional identities. By doing so, teachers can significantly enhance the success and practicality of their online classes, benefiting both students and the educational system as a whole.

Impact Analysis of Sustainable Financial Reporting and Environmental Regulatory Compliance on Decision Making Effectiveness in Bandung Manufacturing Industry

This research investigates the impact of sustainable financial reporting and compliance with environmental regulations on decision-making effectiveness within the Bandung manufacturing industry. A quantitative analysis was conducted using survey data collected from manufacturing firms in Bandung, Indonesia. Descriptive statistics, correlation analysis, and multiple regression analysis were employed to examine the relationships between sustainable financial reporting, environmental regulations compliance, and decision-making effectiveness. The results reveal significant positive correlations between sustainable financial reporting, environmental regulations compliance, and decision-making effectiveness. Regression analysis demonstrates that both sustainable financial reporting and environmental regulations compliance are significant predictors of decision-making effectiveness, even after controlling for relevant covariates. These findings underscore the importance of integrating sustainability principles and regulatory compliance into organizational decision-making processes to enhance performance outcomes and stakeholder value within the manufacturing sector.

Exploring Socio-Economic and Socio-Psychological Factors as A Predictor of Self-Help Groups Dynamics Effectiveness in Debre Birhan, Ethiopia

The study intended to address a knowledge gap by examining the group dynamics effectiveness of Self Help Groups in the Ethiopian context. A correlational design was applied and 372 Self Help Groups members were selected from 60 SHGs through simple random sampling. The main data analysis methods used were Pearson's product-moment correlation and multiple regression. The result indicated that the attitude (r=.667, p&lt;001), extension contact (r=.534, p&lt;001), socioeconomic profile (r=.593, p&lt;001), and social participation (r=.400, p&lt;001) of SHG members had a statistically significant positive relationship with the group’s performance. The model (attitude, social participation, socioeconomic profile, and extension contact) significantly predicted and explained 59.3% of the variance in self-help group dynamics effectiveness. Attitude was the strongest predictor (β = .512, p &lt; .001) &amp; uniquely explained 18.5% of the variance in group dynamics effectiveness, while the socioeconomic profile of self-help group members was the least predictor (β = .106, P &lt; .005) with 0.5% of unique contribution in the explanation of group dynamics. The findings further revealed striking similarities with studies in Asia, suggesting that the potential universalities and the function of self-help group dynamics may transcend regional boundaries.

Clinical and biological predictors of Cladribine effectiveness in Multiple Sclerosis: A real-world, single Centre study considering a two-year interval from year-2 dosing

ObjectivesCladribine tablets (CLAD) for adult patients with highly active relapsing multiple sclerosis (RMS) have been available in Italy since 2018. We aimed to assess predictors of no-evidence-of-disease-activity-3 (NEDA-3) status after 24 months of the last dose of CLAD. ResultsWe included 88 patients (70.5% female, mean age at CLAD start 35.4 ± 11.4). Eighteen patients were treatment naïve, 48 switched to CLAD from a First line Disease Modifying Drug (DMD), and 22 from Second line DMDs. All patients were observed for a median follow-up time of 2.4 (1–4) years after the last dose of CLAD. Forty-nine patients (55.7%) showed NEDA at the last available follow-up. Naïve patients (p = 0.001), those with a lower number of previous DMDs (p < 0.001) and, even though not significantly, those switching from first line DMDs (p = 0.069) were more likely NEDA3 at the last available follow-up. In a subgroup of 30 patients (34%), Serum Light Neurofilaments (sNFL) levels showed a decrease from baseline to the 24 months of follow-up, statistically significant from baseline to the sixth month, and from the first to the second year detection. sNFL levels at 12th month showed a strong inverse correlation with the time to NEDA3 loss. ConclusionsOur experience provides information for the 2-years after the last dose of CLAD, confirming a higher effectiveness of CLAD when placed early in the treatment algorithm. Given the ongoing expansion of the therapeutic landscape in MS, sNfL could support individualized decision-making, used as blood-based biomarker for CLAD responses in clinical practice.

Study of lncRNAs expression profile in the response to biological drugs in Psoriatic Arthritis: MEG3 could be a potential genomic biomarker of therapy efficacy

We aimed to identify an expression profile of lncRNAs potentially related to treatment response in Psoriatic arthritis (PsA) patients, to be used as potential genomic biomarkers predictors of drug treatment effectiveness. In addition, we evaluated a possible association between lncRNAs genetic variants and the response to therapy using the clinical parameter of Disease Activity Index. For the expression study, we collected 48 treated PsA patients, monitoring the treatment response for 12 months. We initially used PCR Array and, then, we validated the results with qRT-PCR. We also retrospectively genotyped 163 treated PsA patients. Firstly, we observed a significant difference in the expression level between Responder and non-Responder patients, of 4 lncRNAs in the group of PsA patients treated with TNFi and of 3 lncRNAs in the group of patients treated with IL17i. Then, we confirmed a significant decrease of MEG3 expression in non-Responder patients compared to Responders, also considering separately the single groups of patients treated with TNFi and IL17i. In addition, our results seem to highlight a potential dose-dependent effect of rs941576 (MEG3) variant allele on Disease Activity Index. Our study suggests a possible role of the lncRNA MEG3 in the treatment response to biological drugs.

Political Skill of B to B Sales Team as a Dynamic Capability: A Strategic Resource Perspective

ABSTRACT Purpose To identify the key internal and external collective conditions and determinants for sales managers in the B to B context, which would allow the articulation of Team Political Skill as a firm’s dynamic capability at organizational and strategical level. Methodology/approach This study employs qualitative methods based on grounded theory, with an exploratory discovery, which jointly used in-depth interviews and online focus groups targeting sales management positions (Sales managers, sales supervisors) and CEOs of 24 B to B different firms in Chile and Peru. Findings The study reports that the political skill of B to B sales teams is articulated as a dynamic capacity when it is capable of generating organizational co-creation routines and an identification culture based on innovation, which translates into intrafirm collaborative organizational learning, strengthening its strategic intelligence, customer orientation and providing a distinctive and differentiating seal in the market at organizational level. Research implications This research suggests from the perspective of resource-based theory that B to B salespeople team political skills not only is a tactical resource to achieve sales results but also becomes an active differentiator of high strategic value for B to B firms in their organizational performance. Therefore, the sales team acts as a key predictor of higher social effectiveness and work performance. Additionally, this study highlights the pivotal role of the sales supervision role and competitive environment in the evolution of individual salespersons’ political skills toward group consolidation. Practical implications The current work offers initial strategies regarding for B to B sales managers can establish political skill development plans in their salespeople and to incorporate innovative supervision and supporting mechanisms that bolster the B to B sales team as a strategic resource in an ever-increasing competitive and complex environment, as seen in the recent post pandemic environment. Originality/value/contribution of the paper To identify unexplored dimensions and collaborative processes in B to B salespersons’ individual and collective team political skills and how these potentially consolidate themselves as a distinctive firm’s dynamic capability in their sales performance.

Comparing quality and engagement in face‐to‐face and online teacher professional development

AbstractIn order for teachers to successfully gain new knowledge during professional development (PD), courses must be of high quality and stimulate active involvement from participants. More and more PD courses are taking place online, without clear evidence of whether face‐to‐face and online courses differ in terms of their quality or level of participants' engagement. The present study investigates differences between face‐to‐face and online PD with respect to certain quality characteristics: clarity and structure, cognitive activation, collaboration and practical relevance, as well as participants' behavioural, cognitive and affective engagement. The study is based on 2210 teachers from Germany who participated in 1 of 137 face‐to‐face or 54 online PD courses. Although participants rated face‐to‐face and online courses very positively regarding all quality characteristics and engagement dimensions, they evaluated online courses slightly less favourably compared to face‐to‐face courses. Implications for practice and research are derived to help ensure high‐quality PD offerings in the future. Practitioner notesWhat is already known about this topic Face‐to‐face and online PD have the potential to be similarly effective. PD quality and participants' engagement can be assumed to be predictors of PD effectiveness. PD quality contains clarity and structure, cognitive activation, collaboration and practical relevance. Engagement is a three‐dimensional construct composed of behavioural, cognitive and affective components. What this paper adds PD quality was rated very positively for online and face‐to‐face courses. Participants rated the quality of online PD lower compared to face‐to‐face PD. Participants rated their engagement in online PD lower compared to face‐to‐face PD. Implications for practice and/or policy PD format should always be chosen with which a higher benefit can be achieved. Quality assurance should take place before PD is conducted.

The Predictors of Early Treatment Effectiveness of Intravitreal Bevacizumab Application in Patients with Diabetic Macular Edema.

The aim of this study was to establish whether multiple blood parameters might predict an early treatment response to intravitreal bevacizumab injections in patients with diabetic macular edema (DME). Seventy-eight patients with non-proliferative diabetic retinopathy (NPDR) and DME were included. The treatment response was evaluated with central macular thickness decrease and best corrected visual acuity increase one month after the last bevacizumab injection. Parameters of interest were the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), vitamin D, and apolipoprotein B to A-I ratio (ApoB/ApoA-I). The NLR (2.03 ± 0.70 vs. 2.80 ± 1.08; p < 0.001), MLR (0.23 ± 0.06 vs. 0.28 ± 0.10; p = 0.011), PLR (107.4 ± 37.3 vs. 135.8 ± 58.0; p = 0.013), and SII (445.3 ± 166.3 vs. 675.3 ± 334.0; p < 0.001) were significantly different between responder and non-responder groups. Receiver operator characteristics analysis showed the NLR (AUC 0.778; 95% CI 0.669-0.864), PLR (AUC 0.628; 95% CI 0.511-0.735), MLR (AUC 0.653; 95% CI 0.536-0.757), and SII (AUC 0.709; 95% CI 0.595-0.806) could be predictors of response to bevacizumab in patients with DME and NPDR. Patients with severe NPDR had a significantly higher ApoB/ApoA-I ratio (0.70 (0.57-0.87) vs. 0.61 (0.49-0.72), p = 0.049) and lower vitamin D (52.45 (43.10-70.60) ng/mL vs. 40.05 (25.95-55.30) ng/mL, p = 0.025). Alterations in the NLR, PLR, MLR, and SII seem to provide prognostic information regarding the response to bevacizumab in patients with DME, whilst vitamin D deficiency and the ApoB/ApoA-I ratio could contribute to better staging.

Abstract PO2-06-06: Effectiveness and prognostic predictors of primary systemic therapy for de-novo Stage IV breast cancer - Supplementary analysis of JCOG1017 PRIM-BC

Abstract Background The optimal choice of drug is important in treating metastatic breast cancer, and the efficacy of the drug should be determined early, especially in cases of progression. On the other hand, untreated de novo Stage IV (dnST-IV) patients are expected to be more sensitive to drugs, but no detailed data are available. In JCOG1017 (Randomized trial of primary tumor resection in dnST-IV), dnST-IV patients were treated with primary systemic therapy for 3 months according to breast cancer subtypes before randomization. We already presented the results of primary endpoint. Primary tumor resection (PTR) could not significantly prolong the overall survival of de-novo stage IV breast cancer patients with sensitivity to primary systemic therapy. We conducted the supplementary analysis of JCOG1017 to clarify the efficacy of primary systemic therapy for dnST-IV and develop optimal treatment strategies for dnST-IV breast cancer. Methods In JCOG1017, systemic therapy was performed for each subtype/metastatic status as follows; 1) hormone therapy: ER+ HER2- and no life-threatening metastases, 2) weekly PTX therapy: life-threatening metastases, or ER-HER2-, 3) trastuzumab + pertuzumab + docetaxel (HPD) therapy OR trastuzumab + paclitaxel (HPTX) therapy: ER-HER2+. 4) hormone therapy: ER+HER2+ and no life-threatening metastases. The non-PD rate (no increase of more than 10% of the sum of the diameters of the target lesions compared before systemic therapy), the responses rate (cCR or cPR), and overall survival (OS) of responder (cCR or cPR)/non-responder (cSD or cPD) and PD/non-PD were examined. Results Among 569 patients who received primary systemic therapy in JCOG 1017, the non-PD rate was 77.2% and the response rate was 29.0% after 3 months of systemic therapy. By subtype, the non-PD rate was 78.2% for ER-HER2-, 75.4% for ER+HER2-, 92.9% for ER-HER2+, and 66.7% for ER+HER2+. The response rate was 36.4% for ER-HER2-, 13.4% for ER+HER2-, 81.0% for ER-HER2+, and 40.3% for ER+HER2+. In multivariable analysis, the non-PD rate was higher in postmenopausal (odds ratio [OR] 1.673, p=0.0240) and PgR-positive (OR 2.391, p= 0.0019) patients besides subtypes. Analysis results by drug were as follows; 1) hormone therapy (non-PD rate: 72.9%) was more effective for PgR-positive (OR 3.258, p&amp;lt; 0.0001), less effective for patients with visceral metastasis (OR 0.605, p=0.0334) and HER2-positive (OR 0.365, p=0.0016), 2) wPTX (non-PD rate: 76.1%) was no significant predictors of efficacy, 3) HPD/HPTX (non-PD rate: 92.7%) was more effective in patients with visceral metastasis (OR 15.818, p=0.0030). PD patients had much worse OS (hazard ratio [HR] 0.501, p&amp;lt; 0.0001) compared to non-PD, whereas responders had a little worse OS (HR 0.788, p=0.0538) compared to non-responders. Similar tendency was observed in any drug. Discussion Predictors of response to primary systemic therapy differed by subtype, with the need for treatment strategies tailored to PgR, HER2 expression, and the status of visceral metastasis. In the ER+HER2+ group, the efficacy of hormonal therapy alone was low, and combination therapy with molecular-targeted agents was considered necessary. The non-PD rate reflected prognosis in determining the efficacy of primary systemic therapy for dnST-IV. Citation Format: Tadahiko Shien, Akihiko Shimomura, Makoto Ishitobi, Kiyo Tanaka, Takahiro Tsukioki, Takashi Yamanaka, Fumitaka Hara, Kenjiro Aogi, Yasuhiro Yanagita, Michiko Tsuneizumi, Naohito Yamamoto, Hiroshi Matsumoto, Akihiko Suto, Ken-ichi Watanabe, Michiko Harao, Chizuko Kanbayashi, Mitsuya Ito, Keisei Anan, Shigeto Maeda, Keita Sasaki, Gakuto Ogawa, Haruhiko Fukuda, Hiroji Iwata. Effectiveness and prognostic predictors of primary systemic therapy for de-novo Stage IV breast cancer - Supplementary analysis of JCOG1017 PRIM-BC [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-06-06.

Analysis of the Role of Policy Socialization, Asset Management, and Performance Management in Improving the Effectiveness of Public Services in West Java

This research paper investigates the role of policy socialization, asset management, and performance management in enhancing the effectiveness of public services in West Java, Indonesia. Through a quantitative analysis, data was collected from public service providers and users in the region using structured surveys. Statistical techniques including regression analysis and correlation analysis were employed to analyze the data. The findings revealed significant positive correlations between policy socialization, asset management, performance management, and public service effectiveness. Regression analysis further demonstrated that these variables were significant predictors of public service effectiveness, with performance management exhibiting the strongest predictive power. These results underscore the importance of integrated governance approaches in optimizing public service delivery and promoting socio-economic development in West Java.

Relationship between the efficacy of sulfonylurea therapy and structural variants of the ABCC8 (rs757110) and KCNJ11 (rs5219) genes in patients with type 2 diabetes mellitus with different phenotypes

Recently, a large number of studies have been conducted to investigate the variability of response in the treatment of diabetes mellitus (T2DM), which make personalized medicine possible. However, the available data are insufficient to decide on the choice of sugar-lowering drugs in T2DM. The search for phenotypic and clinical factors of pharmacogenetic response to therapy continues. Aim of the study was to investigate the relationship between the effectiveness of sulfonylurea therapy and structural variants of the ABCC8 (rs757110) and KCNJ11 (rs5219) genes in T2DM patients with clinical phenotypes. Material and methods. A cross-sectional clinical and pharmacogenetic study of 1271 patients with T2DM receiving sulfonylurea monotherapy (SU) or in combination with metformin and divided into three clinical phenotypes: with insulin deficiency (insulinopenic phenotype), with obesity and moderate insulin resistance (classical phenotype) and with severe insulin resistance (insulin-resistant phenotype) was performed. A glycated hemoglobin content of less than 7% was considered as a good response to SU therapy. Results. Patients with a good response to SU therapy with a classic phenotype had a longer duration of diabetes compared to patients with absence of good response (5.68 ± 5.22 vs 9.12 ± 6.10 years, respectively, p &lt; 0.001) and a later age at diagnosis of T2DM (54.05 ± 7.18 vs 49.37 ± 7.65 years, respectively, p &lt; 0.001); patients with an insulin-resistant phenotype had T2DM established at an older age (54.35 ± 7.91 vs 50.10 ± 7.51 years, respectively, p = 0.001). Logistic regression analysis did not reveal a statistically significant association of the genotype of the structural variant of the ABCC8 gene (rs757110) with the effectiveness of SU in clinical phenotypes. The T/T genotype of the KCNJ11 gene (rs5219) was associated with a better response to SU therapy only in the group of T2DM patients with the classic phenotype (odds ratio 1.85, 95% confidence interval 1.05–3.25, p = 0.041). Conclusions. In patients with type 2 diabetes, predictors of a good response to SU with a classic phenotype were a later age of T2DM diagnosis, a shorter duration of diabetes, and the presence of the T/T genotype of the structural variant of the KCNJ11 gene (rs5219); with an insulin-resistant phenotype, a later age of T2DM diagnosis; with the insulinopenic phenotype no clinical and genetic predictors of the SU effectiveness were identified.

A retrospective analysis of iv ketamine outcome on hospitalisations in an unselected psychiatric sample.

This study aims to explore the outcome with iv ketamine treatment in a real-world clinical setting, primarily measured as posttreatment days hospitalised. The psychiatric medical records of 46 patients having received iv ketamine on a psychiatric treatment indication between 2015 and 2018 were retrospectively examined. Analysis comparing the number and duration of hospital admissions before and after ketamine treatment as well as logistic regression analysis to investigate clinical predictors of effectiveness, were performed. To assess patients' severity of depressed symptoms records were screened for MADRS-S scores. No significant difference between pre- and posttreatment hospital days (p = 0.170), or number of hospitalisations (p = 0.740) were found. The response rate was 31% and remission rate 21%. None of the predictors showed statistical significance in the logistic model. Iv ketamine treatment showed effectiveness in reducing depressive symptoms even with complex patients in a real-world clinical setting. However, this did not translate to a reduction in hospitalisation. Highlighting the multifaceted challenges posed when implementing iv ketamine treatment in clinical practice.

Real-world data of 5-aminolaevulinic acid-mediated photodynamic therapy for Bowen disease: a 10-year retrospective study in patients with darker-coloured skin (2011-2021).

Photodynamic therapy (PDT) has been strongly recommended as an excellent alternative treatment for Bowen disease (BD). However, reported data on 5-aminolaevulinic acid-mediated PDT (ALA-PDT) with red-light irradiation are limited and the long-term effectiveness remains to be determined, especially in dark-skinned populations. We aimed to review routine clinical practice in the field of BD treatment with ALA-PDT over an extended study period (2011-2021), calculate the overall clearance rate, and explore and evaluate factors that might affect the effectiveness of therapy in a real-world setting. The medical records of patients with BD who received ALA-PDT with red-light irradiation between February 2011 and June 2021 were reviewed and summarized. Univariate and multivariate analyses of clinically relevant variables that may affect treatment outcomes were conducted to identify risk predictors. The overall clearance rate of 122 BD lesions was 89.3% with a median follow-up time of 36 months. The correlation between the effectiveness and fluorescence intensity of pre-PDT or PDT sessions was statistically significant after eliminating the interference of confounding factors. All recurrences occurred in the first 2 years following ALA-PDT. ALA-PDT is an effective treatment for BD in patients with darker-coloured skin. Well-executed operations and effective pretreatment are the determinants of effectiveness. Fluorescence intensity of pre-PDT appeared to be a significant predictor of final effectiveness. In addition, 2 years of follow-up is necessary following ALA-PDT.

Strategic Communication Effectiveness in the Ugandan Health Sector: Do Relational Cohesion and Interaction Quality Matter?

ABSTRACT A strategic approach to communication streamlines the communication processes of an organization. In a setting of a wide range of stakeholders like the healthcare system, it is important to focus communication efforts to reach the different stakeholder groups and ensure common understanding and willingness to act by all the groups in order to achieve the organization mission. This study tested the effects of relational cohesion and interaction quality on strategic communication effectiveness in the Ugandan health sector. This study is premised on the commitment-trust theory to explain the relational bonds that are embedded in interactions that drive the audience to implement the action points in the messages received. The study adopted a cross-sectional survey with mixed methods, including triangulated quantitative data collected from 381 health organizations’ audiences and qualitative data collected from 12 key informants. The results revealed that relational cohesion is a significant predictor of strategic communication effectiveness. The results further indicated that interaction quality is a partial mediator between relational cohesion and strategic communication effectiveness. Theoretical and policy implications are provided, and direct interactions like dialogues and one-on-one communication formats are recommended as the best communication strategies to achieve the organization mission.

Modulation index predicts the effect of ethosuximide on developmental and epileptic encephalopathy with spike-and-wave activation in sleep

PurposeIn developmental and epileptic encephalopathy with spike-and-wave activation in sleep (DEE-SWAS), the thalamocortical network is suggested to play an important role in the pathophysiology of the progression from focal epilepsy to DEE-SWAS. Ethosuximide (ESM) exerts effects by blocking T-type calcium channels in thalamic neurons. With the thalamocortical network in mind, we studied the prediction of ESM effectiveness in DEE-SWAS treatment using phase-amplitude coupling (PAC) analysis. MethodsWe retrospectively enrolled children with DEE-SWAS who had an electroencephalogram (EEG) recorded between January 2009 and September 2022 and were prescribed ESM at Okayama University Hospital. Only patients whose EEG showed continuous spike-and-wave during sleep were included. We extracted 5-min non-rapid eye movement sleep stage N2 segments from EEG recorded before starting ESM. We calculated the modulation index (MI) as the measure of PAC in pair combination comprising one of two fast oscillation types (gamma, 40–80 Hz; ripples, 80–150 Hz) and one of five slow-wave bands (delta, 0.5–1, 1–2, 2–3, and 3–4 Hz; theta, 4–8 Hz), and compared it between ESM responders and non-responders. ResultsWe identified 20 children with a diagnosis of DEE-SWAS who took ESM. Fifteen were ESM responders. Regarding gamma oscillations, significant differences were seen only in MI with 0.5–1 Hz slow waves in the frontal pole and occipital regions. Regarding ripples, ESM responders had significantly higher MI in coupling with all slow waves in the frontal pole region, 0.5–1, 3–4, and 4–8 Hz slow waves in the frontal region, 3–4 Hz slow waves in the parietal region, 0.5–1, 2–3, 3–4, and 4–8 Hz slow waves in the occipital region, and 3–4 Hz slow waves in the anterior-temporal region. SignificanceHigh MI in a wider area of the brain may represent the epileptic network mediated by the thalamus in DEE-SWAS and may be a predictor of ESM effectiveness.

Influencing Physical Therapist's Self-efficacy for Musculoskeletal Ultrasound Through Blended Learning: A Mixed Methods Study.

With the growing interest for physical therapists to incorporate musculoskeletal (MSK) ultrasound comes a need to understand how to organize training to promote the transfer of training to clinical practice. A common training strategy blends asynchronous learning through online modules and virtual simulations with synchronous practice on live simulated participants. However, few physical therapists who attend MSK ultrasound continuing education courses integrate ultrasound into clinical practice. Self-efficacy is a significant predictor of training transfer effectiveness. This study describes to what degree and how a blended learning strategy influenced participants' self-efficacy for MSK ultrasound and transfer of training to clinical practice. Twenty-one outpatient physical therapists with no previous MSK ultrasound training. Twenty-one participants assessed their self-efficacy using a 26-item self-efficacy questionnaire at 3 intervals: before asynchronous, before synchronous training, and before returning to clinical practice. Participants were interviewed within 1 week of training using a semi-structured interview guide. Quantitative analysis included descriptive statistics and repeated-measures ANOVA. Thematic analysis was used to examine participants' experiences, and "following the thread" was used to integrate findings. Self-efficacy questionnaire mean scores increased significantly across the 3- time points ( F [2, 40] = 172.7, P < .001, η 2 = 0.896). Thematic analysis indicated that asynchronous activities scaffolded participants' knowledge, enhanced their self-efficacy, and prepared them for synchronous learning; however, it did not replicate the challenges of MSK ultrasound. Synchronous activities further improved self-efficacy and helped participants better calibrate their self-judgments of their abilities and readiness to integrate MSK ultrasound training into clinical practice. Despite individual-level improvements in self-efficacy, interviewees recognized their limitations and a need for longitudinal training in a clinical environment. A blended learning approach positively affects participants' self-efficacy for MSK ultrasound; however, future training designs should provide learners with additional support during the transition phase.