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PloS One 2024During the Omicron pandemic, clinical first-line nurses played a crucial role in healthcare. Their innovative behavior enhanced the quality of nursing and served as a...
Innovative behavior and organizational innovation climate among the Chinese clinical first-line nurses during the Omicron pandemic: The mediating roles of self-transcendence.
BACKGROUND
During the Omicron pandemic, clinical first-line nurses played a crucial role in healthcare. Their innovative behavior enhanced the quality of nursing and served as a vital factor in driving the sustainable development of the nursing discipline and healthcare industry. Many previous studies have confirmed the significance of nurses' innovative behavior worldwide. However, the correlations among innovative behaviors, organizational innovation climate, self-transcendence, and their mediating roles in Chinese clinical first-line nurses need further research.
METHODS
A cross-sectional study was conducted, and the quality reporting conformed to the STROBE Checklist. From March 2022 to February 2023, a convenience sample of 1,058 Chinese clinical first-line nurses was recruited from seven tertiary grade-A hospitals of Tianjin city in Northern China. The Demographic Characteristics Questionnaire, Nurse Innovative Behavior Scale (NIBS), Nurse Organizational Innovation Climate Scale, and the Self-Transcendence Scale were used. The data was analyzed using descriptive statistics, correlation, and process plug-in mediation effect analyses.
RESULTS
The total scores of innovative behavior, organizational innovation climate, and self-transcendence were 33.19 ± 6.71, 68.88 ± 12.76, and 41.25 ± 7.83, respectively. Innovative behavior was positively correlated with the organizational innovation climate (r = 0.583, p < 0.01) and self-transcendence (r = 0.635, p < 0.01). Self-transcendence partially mediated mediating role between innovative behavior and organizational innovation climate, accounting for 41.7%.
CONCLUSION
The innovative behavior, organizational innovation climate, and self-transcendence among the first-line nurses during the Omicron pandemic were relatively moderate, which needs improving. Organizational innovation climate can directly affect the innovative behavior among Chinese clinical first-line nurses and indirectly through the mediating role of self-transcendence. It is recommended that nursing managers adjust their management strategies and techniques based on the unique characteristics of nurses during the pandemic. This includes fostering a positive and inclusive environment for organizational innovation, nurturing nurses' motivation and awareness for innovation, enhancing their ability to gather information effectively, overcoming negative emotions resulting from the pandemic, and promoting personal growth. These efforts will ultimately enhance nursing quality and satisfaction during the Omicron pandemic.
Topics: Humans; COVID-19; China; Cross-Sectional Studies; Adult; Female; Male; Organizational Innovation; Surveys and Questionnaires; Pandemics; Nurses; SARS-CoV-2; Organizational Culture; Middle Aged; East Asian People
PubMed: 38941294
DOI: 10.1371/journal.pone.0306109 -
PloS One 2024Drawing on the diffusion of innovation theory, we argue that the development of digital economy has a positive effect on urban economic resilience. Using panel data from...
Drawing on the diffusion of innovation theory, we argue that the development of digital economy has a positive effect on urban economic resilience. Using panel data from 284 cities in China from 2011 to 2018, we empirically examine the relationship between digital economy and urban economic resilience. We find a positive and significant link between them, mediated by technological innovation and entrepreneurial vitality. Moreover, the heterogeneity analysis shows that the impact of digital economy is most pronounced in smaller cities, with its effects diminishing in larger cities and megacities. Our results underscore the importance and the direction of fostering digital economy development.
Topics: Cities; Humans; Inventions; Entrepreneurship; China; Economic Development
PubMed: 38941292
DOI: 10.1371/journal.pone.0303782 -
PloS One 2024Although infant deaths worldwide have reduced, many children die before their first birthday. Infant deaths are widespread in low-income countries, and information about...
BACKGROUND
Although infant deaths worldwide have reduced, many children die before their first birthday. Infant deaths are widespread in low-income countries, and information about the cause of death is limited. In Ethiopia, 53% of infants' deaths occurred in their neonatal period, and 174 infants' deaths occurred from 3684 births. Hence, this study aimed to assess mothers' experiences with infant death and its predictors in Ethiopia.
METHODS
A total of 1730 weighted samples of mothers from the 2019 EDHS dataset, which was collected across the regions of Ethiopia, were included for analysis. A two-stage cluster sampling technique with a cross-sectional study design was used. All mothers whose children were under the age of 0-12 months were included in this study. Six count regression models were considered and compared using Akaike's information criteria and Bayesian information criterion with STATA version 15 software. The strength of the association between the number of infant deaths and possible predictors was determined at a P-value less than 0.05, with a 95% confidence interval. The findings were interpreted by using the incident rate ratio.
RESULTS
A total of 46.3% of mothers had lost at least one infant by death in the last five years before the 2019 EDHS survey was held. The mean and variance of infant deaths were 2.55 and 5.58, respectively. The histogram was extremely picked at the beginning, indicating that a large number of mothers did not lose their infants by death, and that shows the data had positive skewness. Mothers under 25-29 years of age (IRR: 1.75, 95% CI:1.48, 2.24), and 30-34 years of age (IRR: 1.42, 95% CI: 1.12, 2.82), Somali (IRR: 1.47, 95% CI: 1.02, 3.57), Gambela (IRR: 1.33, 95% CI: 1.10, 2.61), and Harari (IRR: 1.39, 95% CI: 1.02, 2.63) regions, rural resident mothers (IRR: 1.68, 95% CI: 1.09, 1.91, and Protestant (IRR = 1.43, 95% CI: 1.14, 2.96), and Muslim (IRR = 1.59, 95% CI: 1.07, 2.62) religion fellow of mothers were associated with a high risk of infants' deaths. Whereas, being rich IRR: 0.37, 95% CI: .27, .81) and adequate ANC visits (IRR: 0.28, 95% CI: .25, .83) were associated with a low risk of infant death.
CONCLUSION
Many mothers have experienced infant deaths, and the majority of infants' deaths occur after the first month of birth. Encouraging mothers to attend antenatal care visits, creating mothers' awareness about childcare, and ensuring equal health services distribution and utilization to rural residents are essential to minimize infant death. Educating lower-aged reproductive mothers would be a necessary intervention to prevent and control infant deaths.
Topics: Humans; Ethiopia; Mothers; Female; Infant; Adult; Infant, Newborn; Cross-Sectional Studies; Infant Mortality; Young Adult; Adolescent; Infant Death; Male; Rural Population; Bayes Theorem
PubMed: 38941290
DOI: 10.1371/journal.pone.0303358 -
PloS One 2024Hepatitis C virus (HCV) infection remains a major cause of liver related morbidity and mortality worldwide. Epidemiologic data on seroprevalence, viremia prevalence and...
Hepatitis C virus (HCV) infection remains a major cause of liver related morbidity and mortality worldwide. Epidemiologic data on seroprevalence, viremia prevalence and risk factors remain limited in sub-Saharan Africa. In Ghana, HCV-related deaths are estimated to have increased since 2015. Risk factors associated with HCV infection in Ghana are not well described. The aim of this study was to determine the prevalence of, and risk factors associated with hepatitis C virus infection in the Upper East Region located in the northern part of Ghana. A community-based cross-sectional study was conducted in 9 communities in the Upper East region of Ghana. A total of 1,769 participants aged ≥12 years were screened for HCV antibody (anti-HCV) using rapid diagnostic testing (RDT). Seventy-four participants undertook HCV RNA testing after a positive anti-HCV result. Multivariate logistic regression was used to determine risk factors associated with HCV seropositivity. The anti-HCV prevalence was 8.4%, with 149 out of 1,769 testing anti-HCV positive. Mean age (±SD) of seropositive persons was 45.4 (±16.3) years. The highest anti-HCV seroprevalence was amongst persons aged 60 years and above. Forty-four out of 74 (59.5%) seropositive cases had viremic infection and the estimated viremic prevalence in the screened population was 5.0%. Predictors of HCV seropositivity were age (OR 1.03 95% CI 1.01-1.04), history of female genital mutilation or circumcision (OR 1.63 95% CI 1.04-2.55), sexual activity (OR 2.57 95% CI 1.38-4.79), positive maternal HCV status (OR 10.38 95% CI 4.13-26.05) and positive HIV status (OR 4.03 95% CI 1.35-12.05). In conclusion, the Upper East Region demonstrates a high Hepatitis C antibody prevalence. Almost 60% of individuals have viremic infection, however the cost of RNA testing is a barrier to virological diagnosis. There is a need to educate the population about HCV-associated risk factors to reduce HCV transmission and burden of disease.
Topics: Humans; Ghana; Female; Male; Middle Aged; Cross-Sectional Studies; Risk Factors; Adult; Hepatitis C; Prevalence; Hepacivirus; Young Adult; Seroepidemiologic Studies; Adolescent; Hepatitis C Antibodies; Aged; Child
PubMed: 38941280
DOI: 10.1371/journal.pone.0306292 -
ELife Jun 2024Genetic diversity is a hallmark of RNA viruses and the basis for their evolutionary success. Taking advantage of the uniquely large genomic database of SARS-CoV-2, we...
Genetic diversity is a hallmark of RNA viruses and the basis for their evolutionary success. Taking advantage of the uniquely large genomic database of SARS-CoV-2, we examine the impact of mutations across the spectrum of viable amino acid sequences on the biophysical phenotypes of the highly expressed and multifunctional nucleocapsid protein. We find variation in the physicochemical parameters of its extended intrinsically disordered regions (IDRs) sufficient to allow local plasticity, but also observe functional constraints that similarly occur in related coronaviruses. In biophysical experiments with several N-protein species carrying mutations associated with major variants, we find that point mutations in the IDRs can have nonlocal impact and modulate thermodynamic stability, secondary structure, protein oligomeric state, particle formation, and liquid-liquid phase separation. In the Omicron variant, distant mutations in different IDRs have compensatory effects in shifting a delicate balance of interactions controlling protein assembly properties, and include the creation of a new protein-protein interaction interface in the N-terminal IDR through the defining P13L mutation. A picture emerges where genetic diversity is accompanied by significant variation in biophysical characteristics of functional N-protein species, in particular in the IDRs.
Topics: SARS-CoV-2; Coronavirus Nucleocapsid Proteins; Mutation; COVID-19; Humans; Intrinsically Disordered Proteins; Phosphoproteins; Nucleocapsid Proteins; Thermodynamics; Protein Stability
PubMed: 38941236
DOI: 10.7554/eLife.94836 -
JAMA Network Open Jun 2024While most patients with acute pancreatitis (AP) fulfill diagnostic criteria with characteristic abdominal pain and serum lipase levels of at least 3 times the upper...
IMPORTANCE
While most patients with acute pancreatitis (AP) fulfill diagnostic criteria with characteristic abdominal pain and serum lipase levels of at least 3 times the upper limit of normal (reference range) at presentation, early imaging is often used for confirmation. A prior prediction model and corresponding point-based score were developed using nonimaging parameters to diagnose AP in patients presenting to the emergency department (ED).
OBJECTIVE
To evaluate the performance of the prediction model to diagnose AP in a prospective patient cohort.
DESIGN, SETTING, AND PARTICIPANTS
This prospective diagnostic study included consecutive adult patients presenting to the ED between January 1, 2020, and March 9, 2021, at 2 large academic medical centers in the northeastern US with serum lipase levels at least 3 times the upper limit of normal. Patients transferred from outside institutions or with malignant disease and established intra-abdominal metastases, acute trauma, or altered mentation were excluded. Data were analyzed from October 15 to October 23, 2023.
EXPOSURES
Participants were assigned scores for initial serum lipase level, number of prior AP episodes, prior cholelithiasis, abdominal surgery within 2 months, presence of epigastric pain, pain of worsening severity, duration from pain onset to presentation, and pain level at ED presentation.
MAIN OUTCOME AND MEASURES
A final diagnosis of AP, established by expert review of hospitalization records.
RESULTS
Prospective scores in 349 participants (mean [SD] age, 53.0 [18.8] years; 184 women [52.7%]; 66 Black [18.9%]; 199 White [57.0%]) demonstrated an area under the receiver operating characteristics curve of 0.91. A score of at least 6 points achieved highest accuracy (F score, 82.0), corresponding to a sensitivity of 81.5%, specificity of 85.9%, positive predictive value of 82.6%, and negative predictive value of 85.1% for AP diagnosis. Early computed tomography or magnetic resonance imaging was performed more often in participants predicted to have AP (116 of 155 [74.8%] with a score ≥6 vs 111 of 194 [57.2%] with a score <6; P < .001). Early imaging revealed an alternative diagnosis in 8 of 116 participants (6.9%) with scores of at least 6 points, 1 of 93 (1.1%) with scores of at least 7 points, and 1 of 73 (1.4%) with scores of at least 8 points.
CONCLUSIONS AND RELEVANCE
In this multicenter diagnostic study, the prediction model demonstrated excellent AP diagnostic accuracy. Its application may be used to avoid unnecessary confirmatory imaging.
Topics: Humans; Pancreatitis; Female; Male; Prospective Studies; Middle Aged; Adult; Lipase; Emergency Service, Hospital; Aged; Predictive Value of Tests; Acute Disease; Abdominal Pain
PubMed: 38941094
DOI: 10.1001/jamanetworkopen.2024.19014 -
Oncology and Therapy Jun 2024Breast cancer presents diverse molecular subtypes affecting treatment strategies. Human epidermal growth factor receptor 2 (HER2)-low, hormone receptor-positive (HR+)...
BACKGROUND
Breast cancer presents diverse molecular subtypes affecting treatment strategies. Human epidermal growth factor receptor 2 (HER2)-low, hormone receptor-positive (HR+) breast cancer poses a challenge due to limited targeted therapies. Current neoadjuvant treatment primarily utilizes chemotherapy, with conflicting results regarding efficacy in patients with HER2-low breast cancer. Trastuzumab deruxtecan (T-DXd) shows promise in HER2-low metastatic disease, and preliminary evidence suggests synergy with endocrine therapy.
OBJECTIVE
This editorial explores the hypothesis that neoadjuvant T-DXd with or without endocrine therapy offers efficacy in the clinical management of HR+/HER2-low breast cancer.
METHODS
We propose a phase II study with two treatment arms: T-DXd + letrozole and T-DXd alone. The primary endpoint is the radiological complete response rate. Secondary endpoints include pathological complete response rate, safety, event-free survival, and overall survival. Exploratory analyses will compare the arms to identify potential for optimizing treatment efficacy and minimizing side effects.
CONCLUSIONS
This study design allows for initial assessment of T-DXd with or without endocrine therapy in the treatment of HER2-low breast cancer. The findings may pave the way for personalized treatment strategies and inform future research, potentially leading to a chemotherapy-sparing approach.
PubMed: 38941050
DOI: 10.1007/s40487-024-00286-3 -
Alternative Therapies in Health and... Jun 2024To evaluate the effectiveness of FLS model nursing in the rehabilitation of elderly patients after femoral neck fracture surgery.
OBJECTIVE
To evaluate the effectiveness of FLS model nursing in the rehabilitation of elderly patients after femoral neck fracture surgery.
METHODS
We retrospectively analyzed data from 89 elderly patients treated surgically for femoral neck fractures, comparing outcomes between those receiving routine nursing (control group, n=44) and FLS model nursing interventions (observation group, n=45). Key metrics included rehabilitation process indicators, hip joint function, self-efficacy, perceived burden, limb stability, and adverse reactions.
RESULTS
The observation group showed significantly shorter first out-of-bed time, time for pain disappearance, and length of hospital stay compared to the control group. The observation group also exhibited significantly higher scores in pain, gait, functional activities, and deformity/mobility assessments after the intervention compared to the control group. The GSES score was significantly higher and the SPB score was significantly lower in the observation group after the intervention compared to the control group. The observation group demonstrated significantly higher levels of dynamic balance ability, lower limb muscle strength, and mobile walking ability than the control group. The incidence of adverse reactions was significantly lower in the observation group (8.89%) compared to the control group (36.36%).
CONCLUSION
FLS model nursing intervention has a significant positive effect on the rehabilitation of elderly patients undergoing surgery for femoral neck fractures. Compared to routine nursing intervention, the FLS model nursing intervention can further promote postoperative recovery of hip joint function, improve self-efficacy, alleviate the self-perceived burden, shorten the rehabilitation process, and reduce the risk of adverse postoperative reactions. These findings suggest the FLS model nursing approach holds promise for broader clinical adoption and implementation.
PubMed: 38940811
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024This meta-analysis evaluates the diagnostic value of echocardiography for Acute Heart Failure (AHF) and its utility in urgent clinical situations, emphasizing its...
OBJECTIVE
This meta-analysis evaluates the diagnostic value of echocardiography for Acute Heart Failure (AHF) and its utility in urgent clinical situations, emphasizing its significance for accurate and timely diagnosis in critical care.
METHODS
Relevant studies from databases like PubMed and Embase were selected using terms such as 'Ultrasound' and 'acute heart failure'. Inclusion criteria focused on studies evaluating echocardiographic diagnosis in adult patients presenting with symptoms suggestive of AHF. Quality assessment was performed using RevMan 5.3 and QUADAS. Key metrics like sensitivity, specificity, and likelihood ratios were analyzed using STATA 15.1. The types of echocardiography assessed included transthoracic and focused cardiac ultrasound.
RESULTS
Eighteen articles were included, indicating echocardiography's high sensitivity (0.92) and specificity (0.96) in diagnosing AHF. The combined positive likelihood ratio of 23.2 suggests that patients with AHF are over 23 times more likely to have a positive echocardiography result than those without AHF, greatly influencing clinical decision-making toward confirming the diagnosis. The AUC of the SROC curve was 0.98, indicating excellent overall accuracy.
CONCLUSION
Echocardiography is highly accurate in diagnosing AHF, underscored by its critical role in early treatment decisions and potential integration into standard care protocols, thereby preventing adverse outcomes and improving patient management.
PubMed: 38940797
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024This study aims to investigate the correlation between breast cancer and autoimmune thyroid diseases.
OBJECTIVE
This study aims to investigate the correlation between breast cancer and autoimmune thyroid diseases.
METHODS
A cross-sectional observational study enrolled 100 breast cancer patients at Zhongshan Hospital of Xiamen University from March 2020 to October 2021. Patients were categorized into benign and malignant groups based on tumor pathology. Additionally, 100 healthy female participants underwent physical examinations at the hospital's outpatient center during the same period as controls. The incidence of autoimmune thyroid diseases was assessed via B-type ultrasound, thyroxine level examination, and biopsy. Statistical analyses explored the relationship between autoimmune thyroid diseases and breast cancer.
RESULTS
The pathological type of the malignant group was more severe than that of the healthy group. Although the levels of triiodothyronine (T3), thyroxine (T4), and free thyroxine (FT4) in the malignant group fell within the normal range, the concentrations of T3 and T4 in the malignant group were significantly lower than those in the benign and healthy groups. Additionally, the levels of FT4 and antibodies (anti-thyroid peroxidase [anti-TPO] and anti-thyroglobulin [anti-TG]) were significantly higher in the malignant group compared to the benign and healthy groups, demonstrating statistical significance (P < .05). Conversely, the concentrations of free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) in the malignant group showed no statistical significance (P > .05). Furthermore, the levels of T3 and T4 did not correlate with the expression of estrogen receptor (ER) and progesterone receptor (PR) in the study group (P > .05). However, both hormone levels were lower in patients with negative HER-2 expression and those with lymph node metastasis (P > .05).
CONCLUSION
Autoimmune thyroid disease correlates with breast cancer occurrence. Thyroid hormone and autoantibody levels aid clinical monitoring and prognosis. Positive anti-TG and anti-TPO expressions, along with T3, T4, and FT4 alterations, impact patients.
PubMed: 38940788
DOI: No ID Found