Conectar
by Ama Gyesiwaa Quansah, Helena Baffoe, Solomon Eshun
This study examined how cancer-related beliefs, information-seeking behaviors, and discussions about health with family or friends relate to depressive symptoms (PHQ-2 ≥ 3) among U.S. adults, using data from the 2024 Health Information National Trends Survey (HINTS 7; unweighted N = 6,826). Associations were estimated using survey-weighted logistic regression with jackknife replicate weights, adjusting for sociodemographic factors and personal or family cancer history; results are reported as adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Weighted estimates indicate that approximately 15.5% of respondents screened positive for depression. Fatalistic beliefs, particularly the views that everything causes cancer (OR = 1.86; 95% CI: 1.39–2.48), prevention is not possible (OR = 1.69; 95% CI: 1.25–2.28), and cancer automatically means death (OR = 1.75; 95% CI: 1.31–2.34), were significantly associated with higher odds of screening positive for depression. In contrast, neither cancer information seeking (OR = 1.12; 95% CI: 0.83–1.51) nor discussions about health with family or friends (OR = 0.90; 95% CI: 0.62–1.30) showed a significant independent association with depression. In moderation analyses, discussions about health with family or friends weakened the positive association between each fatalistic belief and depression, but these interaction effects were not statistically significant. Sensitivity analyses using multiple imputation for missing data and restricting the analyses to respondents without a personal cancer history produced consistent results. Theoretical and practical implications of these findings are discussed.Nanocrystalline silver dressings are increasingly used as alternatives to silver sulfadiazine dressings in burn management, but comparative evidence remains inconclusive. This meta-analysis aimed to compare the efficacy and safety of nanocrystalline silver dressings versus silver sulfadiazine dressings in burn patients.
Systematic review and meta-analysis following PRISMA guidelines. The review was registered with PROSPERO (CRD420251060978).
PubMed, Embase, Cochrane Library and Web of Science were searched from inception through April 2025.
Randomized controlled trials comparing nanocrystalline silver dressings with silver sulfadiazine dressings in burn patients were included. Primary outcomes were wound healing time and adverse events. Secondary outcomes included complete re-epithelialization rates and dressing change frequency. Risk of bias was assessed using the Cochrane risk of bias tool. Evidence certainty was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations framework. Meta-analysis was performed using Review Manager 5.4.
Eight randomized controlled trials (724 patients) were included. Nanocrystalline silver dressings significantly reduced wound healing time (mean difference [MD] = −3.29 days, 95% confidence interval [CI]: −3.82 to −2.76; p < 0.00001; I 2 = 0%) and dressing change frequency (MD = −8.76, 95% CI: −12.68 to −4.85; p < 0.00001; I 2 = 94%). No significant differences were found in re-epithelialization rates (odds ratio = 1.08, p = 0.80) or adverse events (risk difference = −0.00, p = 0.99). Evidence certainty was low to very low across all outcomes.
Nanocrystalline silver dressings may offer advantages over silver sulfadiazine dressings in reducing wound healing time and dressing change frequency in burn patients, but the overall certainty of evidence is low to very low. Future well-powered, multicenter trials with standardized outcomes and extended follow-up are needed.
These findings support the consideration of nanocrystalline silver dressings for burn wound management, particularly for reducing wound healing time and nursing workload associated with dressing changes. However, dressing selection should be guided by burn depth, infection risk, patient-specific factors, and resource availability.
We have adhered to relevant EQUATOR guidelines, particularly the PRISMA checklist.
No patient or public contribution.
PROSPERO CRD420251060978.
To evaluate the association between non-steroidal anti-inflammatory drugs (NSAIDs) and miscarriage, which remains elusive in the actual literature, using modelling approaches to mitigate time-related bias.
Nationwide, population-based retrospective cohort study.
The study used data from the French National Mother-Child Register (EPI-MERES), developed from the French National Health Data System containing the health information (hospital admissions, drug dispensing, comorbidities, etc.) of about 99% French population.
4 857 907 pregnancies ended in a live birth, a stillbirth or a miscarriage from 2013 to 2019.
Exposure to NSAIDs from 2 weeks before conception to the 20th week of pregnancy.
Miscarriage (ie, spontaneous abortion before the 20th week of pregnancy) from the sixth week of pregnancy. The Cox regression with a time-dependent exposure that incorporated a 3-day lag was used to estimate HRs and their 95% CIs adjusted for maternal characteristics. The 3-day lag period allows for addressing protopathic bias.
In total, there were 163 666 (3,37%) miscarriage cases, and 349 294 (7.19%) pregnancies were exposed to NSAIDs. Unexposed pregnancies were used as the reference category in all analyses. In the main analysis, exposure to NSAIDs increased the risk of miscarriage (HR, 1.83; 95% CI 1.81 to 1.86). The effect of individual drugs was heterogeneous, with 7 of the 19 drugs evaluated shown to increase the risk (flurbiprofen had the highest risk (HR, 3.28; 95% CI 3.15 to 3.41) and naproxen the lowest (HR, 1.09; 95% CI 1.01 to 1.18)). In the sensitivity analyses, increasing the lag time decreased the estimated HR (from HR, 2.25; 95% CI 2.21 to 2.28 with no lag to HR, 1.56; 95% CI 1.54 to 1.59 with a 7-day lag). Overall, the risk of miscarriage remained statistically significant in all the analyses.
Our study found that early exposure to NSAIDs could increase the risk of miscarriage. This finding contributes to the body of evidence on their safety profile and may help inform future recommendations for their use in pregnant women.
Skin-to-Skin Contact or Kangaroo Mother Care is an evidence-based intervention proven to enhance breastfeeding rates, improve cardiorespiratory stability and promote neurodevelopment in neonates. While established as a standard of care for stable term infants and increasingly recognised for preterm infants, the implementation of sustained skin-to-skin contact faces significant systemic and clinical challenges, particularly within the intensive care environment. This editorial argues that the focus must shift from when skin-to-skin contact is permitted to how sustained skin-to-skin contact can be universally integrated as a non-negotiable core practice, even for extremely preterm infants. Addressing practical barriers, such as staff training, equipment design, parental support and perceived clinical instability, is essential to realise the full potential of sustained skin-to-skin contact to optimise neurodevelopmental and physiological outcomes for all neonates, closing the gap between compelling evidence and inconsistent global practice.
by Peiling Zuo, Huanhuan Zhu, Chunying Sun, Xiaohan Ma, Sheng Chen, Rong Tang, Tong Wu, Ding Zhang, Xiao Tang, Wenquan Lv, Wenzhong Chen, Xiawei Wei, Encun Hou, Minsheng Wu, Minghe Jiang
BackgroundEvidence indicates that the Endothelial Activation and Stress Index (EASIX) is a predictor of mortality in endothelium-related conditions; however, its association with mortality risk in atrial fibrillation (AF) remains uncertain. Accordingly, this study examines the relationship between EASIX and mortality risk among patients with AF.
MethodsThis retrospective analysis utilized data from the Medical Information Marketplace in Intensive Care IV (MIMIC-IV) database, which includes critically ill patients diagnosed with AF. To examine the association between EASIX scores and mortality, Kaplan–Meier survival analysis, Cox proportional hazards models, and restricted cubic spline regression were applied to evaluate the relationship between EASIX and all-cause mortality. Subgroup analyses were conducted to explore potential interactions with key patient characteristics, and sensitivity analyses were performed to further confirm the robustness of the results.
ResultsA total of 3,193 patients were included in the analysis. KM survival analysis showed that elevated EASIX levels were associated with a higher risk of both in-hospital and ICU mortality. After adjusting for potential confounders, increased EASIX levels remained significantly associated with in-hospital mortality [HR, 1.09 (95% CI 1.03, 1.15), P = 0.0002] and ICU mortality [HR, 1.10 (95% CI 1.04, 1.17), P = 0.0002]. Stratified analyses revealed a significant interaction between sepsis, respiratory failure, and EASIX in relation to both in-hospital and ICU mortality. To evaluate the robustness of the findings, a sensitivity analysis was performed. After additionally adjusting for metoprolol and heparin as covariates, patients in the highest EASIX group continued to demonstrate the greatest mortality risk: the HR for in-hospital death was 2.08 (95% CI: 1.51–2.85), and the HR for ICU death was 1.83 (95% CI: 1.21–2.65).
ConclusionElevated EASIX levels correlate with higher mortality rates, underscoring its potential as an accessible tool for identifying high-risk patients and informing clinical decisions. However, further studies are needed to explore the underlying mechanisms and validate its applicability across diverse patient populations.
by Dandan Feng, Yakun Song, Zuqi Wu, Wuruo Liu, Yuting Pu, Yangcan Gao, Yuying Sun, Jiquan Zhang
Trypsin, a canonical serine protease in crustaceans, plays a crucial role in ontogeny and antibacterial defense. Whether these biological functions correlate with its catalytic characteristics remains unresolved in the freshwater shrimp Neocaridina denticulata sinensis. To address this gap, we characterized a trypsin gene from N. denticulata sinensis (NdTryp) and assessed both its biological roles and its prospective utility. NdTryp was predominantly expressed in the hepatopancreas, where it localized to storage cells (R-cells) and tubule-lining epithelial cells (ECTs). Across development, NdTryp transcripts were essentially absent during early embryogenesis but rose sharply at late stages, temporally coincident with hatching and the onset of feeding. After a challenge with Vibrio parahaemolyticus, the expression of NdTryp was induced, with the expression level significantly increased relative to the baseline expression level. RNA interference-mediated knockdown rendered shrimp more susceptible to infection and was accompanied by extensive hepatopancreatic injury, including epithelial detachment and disruption of the basement membrane. Biochemically, recombinant NdTryp (rNdTryp) displayed proteolytic activity over a broad temperature and pH span. Activity was differentially tuned by metal ions, with several divalent cations producing marked enhancement, whereas ferric iron exerted strong inhibition. Overall, our results showed that NdTryp functions as a multifunctional protease involved in both late embryonic development and innate antimicrobial defense. Furthermore, the robust stability of rNdTryp underscores its potential as an aquafeed additive and candidate for enzymatic biotransformation.Parkinson’s disease (PD) is a common neurodegenerative disorder characterised by high prevalence and disability rates, severely impairing patients’ quality of life and imposing a substantial societal burden. Rehabilitation interventions are an essential component of PD management; however, conventional face-to-face rehabilitation is constrained by limited resources and poor adherence. In recent years, the integration of artificial intelligence (AI) with wearable technologies has offered new avenues for rehabilitation, enabling continuous monitoring, objective assessment and personalised feedback. Although relevant studies have emerged, most are limited by small sample sizes, short-term designs and a lack of comprehensive synthesis. This study aims to conduct a scoping review to summarise the current applications of AI-driven wearable technologies in PD rehabilitation and functional assessment, and to identify existing research gaps.
This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines and employ the Joanna Briggs Institute three-step search strategy. After an initial pilot search, a comprehensive search strategy will be developed to systematically search 10 databases (CNKI, Wanfang Data Knowledge Service Platform, SinoMed, the Cochrane Library, PubMed, Web of Science, CINAHL, Scopus, Embase and the IEEE Xplore Digital Library). One researcher will independently perform data extraction, and another will independently verify the extracted data. Eligible studies will include original research articles, dissertations and conference papers published after 2020, involving PD patients and using AI-driven wearable devices for rehabilitation or functional assessment. Data will be synthesised narratively and presented using tables and figures.
This study involves only publicly available published data and therefore does not require ethical approval. Findings will be disseminated through peer-reviewed journal publications and presentations at academic conferences.
by Alyssa Howren, Quan L. Tran, Sadaf Sediqi, Saadiya Hawa, Douglas K. Owens, Eleni Linos, Titilola O. Falasinnu, Yashaar Chaichian, Julia F. Simard
BackgroundSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune rheumatic disease whose epidemiology and clinical prognosis vary by race and sex. Observed disparities in SLE may be partly attributable to cognitive processes in clinical decision-making, which can influence diagnostic accuracy and clinical management. We aimed to examine variation in primary care physicians’ (PCP) diagnosis and management of SLE when all content of a clinical case is identical, apart from race and sex.
MethodsWe distributed an online randomized factorial survey from 04/11/2024–06/10/2024 to PCPs across the US. Participants were presented with one of four possible SLE vignettes – Black female, White female, Black male, White male – for which all other clinical content was identical. Block randomization was used to randomly modify the race (Black/White) and sex (female/male) of the SLE “case”. Primary outcomes were correct text-based responses for SLE diagnosis at initial case presentation and after reviewing additional lab results. Secondary outcomes were participants’ review time and planned next steps (treatment, referral, tests) as a proxy for cognitive bias and certainty, respectively. We calculated descriptive statistics for all outcomes stratified by assigned randomized factor and used chi-square tests to evaluate between-group differences.
Results1031 PCPs (42.7% women, mean age 52.1 ± 12.1 years) completed the case. At initial presentation, 63.9% of participants correctly identified SLE as a differential diagnosis. An initial diagnosis of SLE significantly differed by the race and sex of the case (p Conclusion
A patient’s race and sex may influence diagnostic accuracy and clinical decision-making for SLE in primary care. The observed variation in diagnostic accuracy, which aligns with the descriptive epidemiology of SLE, highlights the need for targeted interventions to ensure equitable diagnostic processes.
by Li Dong, Changkun Ma, Wanghai Tao, Quanjiu Wang
The flow characteristics of water and gas are closely linked to pore structure of porous media, which is of critical importance across various scientific and industrial fields. In this study, synthetic porous media with varying grain sizes and porosity were generated, and their corresponding pore structures were characterized using pore network modeling. Furthermore, the intrinsic permeability, water retention curve, water-gas relative permeability and relative gas diffusivity of the synthetic porous media were simulated via pore network modeling. The results demonstrate that the pore networks extracted from images can effectively distinguish pore structural characteristics. Specifically, the mean pore diameter, throat diameter, and throat length were larger in coarse-grained media compared to fine-grained media of the same porosity. In contrast, fine-grained media exhibited higher values for pore number, throat number, and coordination number. Additionally, the distributions of pore diameter, throat diameter, throat length and coordination were found to follow a lognormal distribution. Porous media with coarse grains and larger porosity exhibit greater intrinsic permeability and relative gas diffusivity compared to media composed of finer grains or lower porosity. The water-retention curves were fitting by van Genuchten model, revealing an exponential relationship between parameter α and throat diameter (or pore diameter). But the parameter n did not show a clear trend across various synthetic porous media, which is attributed to the relatively narrow range of pore size distribution. Similarly, for water-gas relative permeability, the critical water saturation did not vary significantly across different porous media. A strong correlation was observed among the pore structural parameters, irrespective of grain shape and size. Both intrinsic permeability and relative gas diffusivity exhibited a power-law relation with the porosity as well as with pore or throat radius. Moreover, the relationship between intrinsic permeability and relative gas diffusivity can be expressed as k = 166.51(Dp/D0)0.98, which provides a direct means of estimating relative gas diffusion from intrinsic permeability directly.by Nguyen Thien Duc, Nguyen An Ninh, Nguyen Phi Trinh, Le Quang Tuyen, Nguyen Van Hung, Dinh Hoang Khanh, Nguyen Van Luat, Nguyen Huu Phuc Dai, Tran Duc Huy, Chu Duc Hoa, Tran Vuong The Vinh
PurposesAnatomy is fundamental in medical education, yet cadaveric dissection faces challenges including limited specimens, high costs, and chemical hazards. Interactive anatomy tables such as the Pirogov system offer innovative alternatives, but evidence from Southeast Asia is limited.
MethodsIn a prospective cohort, 188 medical students (139 in Y1 and 49 in Y2) were randomly assigned to the Pirogov table group (Group A, n = 99) or the cadaveric dissection group (Group B, n = 89). Knowledge acquisition was measured using a validated 20-item multiple-choice test before and after the intervention. Student perceptions were evaluated with a 10-item Likert-scale questionnaire covering four domains: knowledge and understanding, spatial visualization and relationships, learning experience and engagement, and effectiveness and practical value. Data were analyzed using paired and independent t-tests and Welch’s t-test.
ResultsBoth groups showed significant knowledge gains (Group A: 4.3 ± 1.65 to 5.2 ± 1.75, p Conclusion
The Pirogov table and cadaveric dissection were associated with similar short-term improvements in anatomy knowledge. Students valued the Pirogov table for visualization and engagement. These findings support integrating digital tools with cadaveric dissection to enhance anatomy education, particularly in resource-limited contexts.
To examine the relationship among leadership, clinical teaching competencies, and structural empowerment of nursing clinical instructors in China.
A cross-sectional study.
A total of 152 nurses who come from three Grade A tertiary hospitals located in Beijing, Kunming, and Liaoning Province, China, completed an online questionnaire that included general information, clinical teaching information, the Conditions of Work Effectiveness Questionnaire-II, nurse leadership, and structural empowerment. SPSS 26.0 and AMOS 26.0 were used for normality test, descriptive statistics, correlation analysis, regression analysis, and structural equation model.
The study revealed that nurse leadership (r = 0.402) and structural empowerment (r = 0.568) both positively correlated with clinical teaching competencies. Specifically, the level of nurse leadership exhibited a low but direct positive effect on these competencies (β = 0.22), while the level of structural empowerment demonstrated a moderate direct positive effect (β = 0.56).
Enhancing nurse leadership and structural empowerment positively influence the clinical teaching competencies of nursing instructors.
Constructing a structural equation model to describe the relationship between leadership, structural empowerment, and teaching ability can provide the most intuitive direction for future research, so as to better improve the teaching ability of clinical nursing teachers.
No patient or public contribution.
by Quynh Anh Tran, Hien Duy Pham, Dung Boi Ly, Minh Quang Ngo, Nhung Thi Nguyen, Liem Thanh Nguyen, Quang Thanh Nguyen
BackgroundEarly definitive surgery for Hirschsprung disease (HD) in neonates is increasingly adopted to reduce preoperative morbidity and preserve long term bowel function. However, comparative data across minimally invasive approaches in neonates with short segment disease remain limited. This study compared outcomes of single incision laparoscopic assisted endorectal pull through (SILEP), conventional laparoscopic assisted endorectal pull through (CLEP), and complete transanal endorectal pull through (TERPT) for rectosigmoid HD.
MethodsWe conducted a retrospective cohort study of 55 neonates who underwent one stage definitive surgery before 28 days of age at a high volume center between January 2019 and December 2021. The primary outcome was long term bowel function assessed using the Rintala Bowel Function Score (BFS) after a minimum of 4 years of follow up. Secondary outcomes included operative parameters, postoperative complications (Clavien Dindo classification), and cosmetic outcomes using the Manchester Scar Scale (MSS) in the laparoscopic groups.
ResultsAll patients successfully underwent surgery at a mean age of 22.4 ± 4.3 days. Operative time differed across approaches and was shorter for SILEP (53.8 ± 11.9 minutes) and TERPT (52.1 ± 18.3 minutes) than for CLEP (70.2 ± 22.5 minutes, p = 0.036). At follow up (mean 54.0 ± 7.7 months), the overall BFS was 17.5 ± 2.5 with no significant differences among groups (p = 0.32). MSS was numerically lower for SILEP than for CLEP (6.2 ± 1.1 vs 6.8 ± 1.9, p = 0.53). Complications were infrequent, with 14 minor and 7 major events, and there was no mortality or Clavien Dindo grade IV or V morbidity.
ConclusionSILEP, CLEP, and TERPT are feasible one stage options for neonates with rectosigmoid HD, with comparable long term bowel function and low rates of major complications. SILEP and TERPT were associated with shorter operative times, and SILEP showed a trend toward improved cosmetic scores compared with CLEP. These findings support an individualized approach to technique selection based on intraoperative requirements and institutional expertise.
by Thanh Luan Nguyen, Thanh Khoi Tu, Thien-Vy Phan, Chanh M. Nguyen, Khoa D. Nguyen, Minh Quan Pham, Hai Ha Pham Thi
Cyperus amuricus (Cyperaceae) has exhibited potential anticancer activity against hepatocellular carcinoma (HCC), yet its molecular mechanisms and phytoconstituent interactions with oncogenic pathways remain underexplored. This study integrates in vitro cytotoxicity assays and molecular docking to evaluate the effects of C. amuricus fractionated extracts on HCC, focusing on PI3K/AKT/mTOR signaling axis. The ethyl acetate (EA) fraction selectively inhibited HepG2 cell proliferation (IC50 = 159.76 µg/mL) with minimal toxicity to normal fibroblasts. Apoptotic features—cell shrinkage, membrane blebbing, nuclear condensation, and DNA fragmentation—were confirmed through DAPI staining and gel electrophoresis. Western blot analysis revealed dose-dependent suppression of phosphorylated Akt and p70S6K, indicating pathway inhibition. Molecular docking identified strong binding affinities between Cyperaceae-derived compounds and PI3K/AKT/mTOR targets, with luteolin 7-O-β-D-glucuronopyranoside-6″-methyl ester blocked PI3K activation, vitexin bound AKT’s allosteric site, and digitoxin targeted mTOR’s ATP-binding pocket, showing comparable binding energies to reference ligands. These findings suggest C. amuricus as a promising candidate for natural product-based HCC therapy.by Nguyen Hong Tan, Tran Manh Tuan, Pham Minh Chuan, Nguyen Duc Hoang, Le Quang Thanh, Le Hoang Son
Artificial Intelligence (AI) has been dramatically applied to healthcare in various tasks to support clinicians in disease diagnosis and prognosis. It has been known that accurate diagnosis must be drawn from multiple evidence, namely clinical records, X-Ray images, IoT data, etc called the multi-modal data. Despite the existence of various approaches for multi-modal medical data fusion, the development of comprehensive systems capable of integrating data from multiple sources and modalities remains a considerable challenge. Besides, many machine learning models face difficulties in representation and computation due to the uncertainty and diversity of medical data. This study proposes a novel multi-modal fuzzy knowledge graph framework, called FKG-MM, which integrates multi-modal medical data from multiple sources, offering enhanced computational performance compared to unimodal data. In addition, the FKG-MM framework is based on the fuzzy knowledge graph model, one of the models that represent and compute effectively with medical data in tabular form. Through some experiment scenarios utilizing the well-known BRSET dataset on multi-modal diabetic retinopathy, it has been experimentally validated that the feature selection method, when combining image features with tabular medical data features, gives the highest reliability results among 5 methods including Feature Selection Method, Tensor Product, Hadamard Product, Filter Selection, and Wrapper Selection. In addition, the experiment also confirms that the accuracy of FKG-MM increases by 12–14% when combining image data with tabular medical data than the related methods diagnosing only on tabular data.by Phi Ngoc Quang Tran, Anh Hoang Cu, Minh Ngoc Thuy Tran, Vy Ngoc Thuy Tran
BackgroundSkeletal Class III malocclusion is a severe dentofacial deformity that often requires surgical correction, but the associated risks have increased interest in non-surgical alternatives. The multiloop edgewise archwire (MEAW) technique has been used as a conservative option. The aim of this study was to investigate the dentoskeletal changes associated with the MEAW technique in treating skeletal Class III malocclusion, with a particular focus on improvements in anteroposterior bimaxillary relationships and comparison with surgical outcomes.
MethodsThis retrospective study included 60 patients with skeletal Class III malocclusion, comprising 30 treated with the MEAW technique and 30 matched patients who underwent orthognathic surgery. Dentoskeletal parameters were assessed on pre- and post-treatment lateral cephalograms. Pearson’s correlation analysis and multiple linear regression were performed to identify factors associated with improvements in anteroposterior relationships.
ResultsSignificant dental and skeletal changes were observed, including alterations in incisor inclination and bimaxillary measurements (p Conclusions
Although the effect is less pronounced than in the case of surgical intervention, the MEAW technique effectively improves anteroposterior bimaxillary relationships in skeletal Class III malocclusion. These findings suggest that MEAW is a valuable non-surgical alternative for selected skeletal Class III patients.
by Weiheng Chen, Shouxi Zhu, Kequan Shao, Kejia Liang
To examine the impact of work-family conflict on occupational burnout among pilots following the COVID-19 pandemic, this study employed the Maslach Burnout Inventory-General Survey and the Zhao Xinyuan Bi-directional Scale of Work-Family Conflict as research instruments. The data were analyzed using correlation analysis and Structural Equation Modeling (SEM) to explore the relationship between work-family conflict and burnout. The results indicate a significant correlation between work-family conflict and burnout, as well as the three dimensions of burnout. Specifically, the correlation coefficients between work interfering with family (WIF) and family interfering with work (FIW) with occupational burnout were found to be 0.737 and 0.496, respectively. In the path analysis of the SEM, the estimated effects of WIF and FIW on burnout were both 0.49. Mediation analysis revealed that WIF indirectly influences burnout through FIW, with a mediation effect value of 0.117. Additionally, while pilot-related factors did not significantly affect burnout, they were found to have a notable impact on work-family conflict. These findings underscore the significant role of work-family conflict in contributing to burnout and provide a theoretical foundation for targeted interventions aimed at mitigating burnout among pilots.by Thomas C. Scheier, Richard Whitlock, Mark Loeb, Philip James Devereaux, Andre Lamy, Michael McGillion, MacKenzie Quantz, Ingrid Copland, Shun-Fu Lee, Dominik Mertz
Sternal surgical site infections after cardiac surgery can lead to significant morbidity, mortality, and cost. The effects of negative pressure wound management and adding vancomycin as perioperative antimicrobial prophylaxis are unknown. The PICS-PREVENA pilot/vanguard trial, a 2x2 factorial, open label, cluster-randomized crossover trial with 4 periods, was conducted at two major cardiac surgery hospitals in Ontario, Canada. Sites were randomized to one of eight sequences of the four study arms (Cefazolin or Cefazolin + Vancomycin (not analyzed) and standard wound dressing or a negative pressure 3M Prevena incision management system (Prevena). Only diabetic or obese patients were eligible for the latter comparison. This trial investigated feasability including adherence to protocol of each intervention (goal: > 90% each) and loss to follow-up (goal:This study sought to explore decision making among caregivers of children with cancer in Pakistan, one of the largest lower middle-income countries in the world.
Cross-sectional survey study
This study was conducted in Pakistan at Indus Hospital and Health Network in Karachi and Children’s Hospital of Lahore. Children’s Hospital of Lahore is a public sector hospital, and Indus Hospital has a foundation-based funding structure. Both are larger tertiary care centers. Over 2,500 new patients are seen at these centers annually, this accounts for almost 50% of all children with cancer in Pakistan
Eligible participants included bedside caregivers, defined as a parent or family member involved in communication with the medical team, of children with cancer (
Primary outcome measures included caregiver priorities and experiences related to communication including decision-making role, involvement of the paediatric patient and decisional regret.
Participants included 200 caregivers of children
Findings from this study highlight the importance of exploring preferences for decision making and empowering bedside caregivers while respecting cultural norms. In the Pakistani context, it may be specifically important to consider gender roles and the inclusion of extended family members. Future work should investigate paediatric patient involvement in diverse settings.
FreshRSS 