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Effect of evidence-based nursing practices on individualised care: A cross-sectional descriptive study
No full textAim: This study was conducted to determine the effect of nurses' attitudes towards evidence-based practices on individualised nursing care. Methods: This study is a cross-sectional descriptive trial. The descriptive analysis included 200 clinical nurses working in a private hospital between April and September 2022. Data were collected with a personal information form, Individualised Care Scale (A-Nurse Version), and Evidence-Based Nursing Attitude Questionnaire. The relationship between the scales and effect was examined by Pearson correlation and linear regression analyses. T-test, one-way analysis of variance (ANOVA), and post hoc (Tukey, LSD) analysis were used in the statistical analysis of nurses according to their descriptive characteristics. This study has adhered to the STROBE checklist for reporting. Results: They had high mean scores on Individualised Care Scale total (3.68 ± 1.25) and from Clinical Situation (3.78 ± 1.30) and Decisional Control (3.82 ± 1.35) subscales and average score from the Personal Life (3.32 ± 1.29) subscale. Their mean score from the Evidence-Based Nursing Attitude Questionnaire was average (47.64 ± 10.99). There was a positive moderate (r = 0.50, p = 0.000 < 0.05) significant correlation between the scales. Conclusion: Positive attitude towards evidence-based nursing practices positively affects individualised care. Variables such as professional experience positively affect nurses' attitudes towards evidence-based nursing. A positive and significant relationship was found between nurses' attitudes towards evidence-based practice and their attitudes towards individualised care
Distinctive delta and theta responses in deductive and probabilistic reasoning
No full textIntroduction: The neural substrates of reasoning, a cognitive ability we use constantly in daily life, are still unclear. Reasoning can be divided into two types according to how the inference process works and the certainty of the conclusions. In deductive reasoning, certain conclusions are drawn from premises by applying the rules of logic. On the other hand, in probabilistic reasoning, possible conclusions are drawn by interpreting the semantic content of arguments. Methods: We examined event-related oscillations associated with deductive and probabilistic reasoning. To better represent the natural use of reasoning, we adopted a design that required participants to choose what type of reasoning they would use. Twenty healthy participants judged the truth values of alternative conclusion propositions following two premises while the EEG was being recorded. We then analyzed event-related delta and theta power and phase-locking induced under two different conditions. Results: We found that the reaction time was shorter and the accuracy rate was higher in deductive reasoning than in probabilistic reasoning. High delta and theta power in the temporoparietal, parietal, and occipital regions of the brain were observed in deductive reasoning. As for the probabilistic reasoning, prolonged delta response in the right hemisphere and high frontal theta phase-locking were noted. Conclusion: Our results suggest that the electrophysiological signatures of the two types of reasoning have distinct characteristics. There are significant differences in the delta and theta responses that are associated with deductive and probabilistic reasoning. Although our findings suggest that deductive and probabilistic reasoning have different neural substrates, consistent with most of the studies in the literature, there is not yet enough evidence to make a comprehensive claim on the subject. There is a need to diversify the growing literature on deductive and probabilistic reasoning with different methods and experimental paradigms
A novel approach to prioritizing health technology investments using integrated ai-based ranking model
No full textPurpose – Health technologies are an issue that directly affectsthe sustainability and quality of health services. Due to budget constraints, it is not financially possible for businesses to apply comprehensive improvement strategies to all these criteria. In this case, it is possible for businesses to implement more priority strategies. Accordingly, the main purpose of this study is to evaluate the important performance indicators of health technology investments.
Design/methodology/approach – Firstly, with the help of the artificial intelligence system, a decision matrix is established. Secondly, spherical fuzzy total order of preference decision-making trial and evaluation laboratory methodology istaken into consideration for weighting the criteria. Thirdly, emerging seven countries are ranked by using spherical fuzzy MultiAtributive Ideal-Real Comparative Analysis (MAIRCA). Findings – The findings demonstrate that the criteria of health policies and research and development are defined as the most significant factor in this regard. China and Turkey are also found to be the most successful emerging countries with respect to the performance of health technology investments. Originality/value – The main contribution of this study is that a novel decision-making model is generated by integrating artificial methodology into the spherical fuzzy sets
Is aspirin an effective prophylaxis against venous thromboembolism in patients undergoing routine total knee or total hip arthroplasty?
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Medication-related osteonecrosis of the jaw: bibliometric analysis from 2003 to 2023
No full textMedication-related osteonecrosis of the jaw (MRONJ) is a serious condition associated with the use of antiresorptive and antiangiogenic medications. Despite extensive research, the pathophysiology of MRONJ remains poorly understood. Bibliometric analysis provides insights into the academic impact of research, helping identify influential works and emerging trends in this field. This study employed a bibliometric analysis of MRONJ publications indexed in Web of Science from 2003 to 2023. The analysis included English-language articles and utilized the VOSviewer, R Studio Bibliometrix package, and Graphpad to evaluate citation counts, publication trends, and collaboration patterns. This study unveils the current situation of the MRONJ research, addressing well-recognized safety issues of antiresorptive and antiangiogenic agents. Our findings may suggest that the overall trend of the MRONJ research continues to evolve and is not likely to reach its peak or plateau yet. We believe that our work will help to identify gaps in the literature and future research directions, contributing to a better understanding of MRONJ management
Original vs. generic plerixafor for the mobilization of stem cells in multiple myeloma patients
No full textThis study investigates the efficacy and safety of generic plerixafor (Pleksor – Gen Pharma) compared to the original plerixafor (Mozobil - Sanofi) in patients with multiple myeloma undergoing ASCT. A total of 59 patients from three centers, who underwent ASCT between 2018 and 2023, were included and divided into two groups: Mozobil (M) group (n = 32) and Pleksor (P) group (n = 27). Plerixafor was administered as a just-in-time approach with granulocyte-colony stimulating factor (G-CSF) alone or with cyclophosphamide (Cy) + G-CSF mobilization. The study aimed to assess mobilization success and engraftment kinetics. There was no statistically significant difference between the two groups in terms of age, gender, RT history, previous lines of treatment, pretransplant lenalidomide cycles (p = 0.778, 0.165, 0.520, 0.094, 0.530, respectively). However, lenalidomide exposure was significantly higher in P group (18,8% vs. 81,5%, p < 0.001). Both groups achieved a similar total yield of CD34 + cells, and no serious side effects related to plerixafor were noted. Median platelet engraftment time was longer in P group, while neutrophil engraftment time was similar in both groups. This study demonstrates the comparable efficacy of generic plerixafor in myeloma patients, suggesting that it can be a cost-effective alternative with a similar safety profile. These findings contribute to the body of evidence on the use of generic plerixafor in specific patient cohorts, emphasizing its efficacy and safety for ASCT in a sole multiple myeloma patient cohort
Offending and clinical characteristics of adults with autism spectrum disorder: Experience at forensic psychiatry center in Türkiye between 2012 and 2022
No full textThe forensic and clinical need for better understanding of criminal offending in adults with ASD is increasingly recognized. To date, few studies have examined the differences and similarities between criminal offenders with and without ASD with respect to demographics, offending profiles, and clinical characteristics. This study, conducted in Turkey, is the first to conduct such as comparison using a national database of forensic files. Computerized search of the forensic records of 11,853 adults assessed between January 1, 2012, and January 1, 2022, for criminal responsibility by the Turkish Council of Forensic Medicine found 74 adults diagnosed with ASD; they ranged in age from 18 to 40. [Correction added after first online publication on 04 December 2024. The value 11,583 has been revised to 11,853.] The demographic, clinical, and offending characteristics of these adults were compared to 100 adults without ASD selected from the remaining 11,779 records based on age (18–40 years) and year of assessment (10 from each year). The ASD group was younger, more likely to be unemployed and not living on their own. The ASD group was more likely to have co-morbid intellectual disability, ADHD, and OCD, while the non-ASD group was more likely to have co-morbid personality disorders, The ASD group was more likely to commit unplanned simple (non-penetrative) sexual and violent offenses against strangers; the non-ASD group was more likely to commit planned, qualified (penetrative) crimes against known persons. Impulsivity and manipulability were more often contributory in persons with ASD; revenge was more often contributory in persons without ASD. Adults with ASD were more likely to commit crimes on social media. In conclusion, this study found that adult offenders with and without ASD differed in demographics, psychiatric co-morbidities, and types of offending behaviors. These differences may have implications for the prevention of criminal offending in persons with ASD and addressing their needs once they are in the criminal justice system.Turkish Ministry of Justice, Council of Forensic Medicin
Brain microRNA profiles after exposure to heroin in rats
No full textHeroin addiction is one of the neuropsychiatric burdens that affects many genetic and epigenetic systems. While it is known that heroin may change the expressions of some genes in the brain during dependence, there is no detailed study related to which gene are mostly affected. Therefore, in the current study, we aimed to determine alterations in the miRNA profiles of rats’ brains for providing a detailed analysis of molecular mechanisms in heroin addiction-related toxicology. Next generation global miRNA sequencing was used to predict potential miRNAs in prefrontal cortex (PC), hippocampus, ventral tegmental area (VTA), striatum, and Nucleus accumbens (NA) of rats that exposed to heroin by intravenous injections. The total daily dose was started with 2 mg/kg and ended with 10 mg/kg on the 10th day. In the striatum, miR-18a, miR-17-5p, miR-20a-5p, miR-106a, miR-301a-3p, miR872-5p, miR-15a-5p, miR-500-3p, and miR-339-5p expressions were upregulated by nearly 2-to-4 times with heroin. The expressions of hippocampal miR-153-3p, miR-130a-3p, miR-204-5p, miR-15b-5p, and miR-137-3p and the expressions of miR-872, miR-183-5p, miR-20a-5p, miR-325-5p, miR-379-5p, and miR-340-5p in the VTA were 2-times higher in the heroin-addicted rats. While there was nearly 2-times increase in the miR-129-1-3p and miR-3068-3p expressions in the NA, no change was noted in the PC due to heroin. The only heroin-dependent downregulation was observed in the expressions of striatal miR-450b-3p and miR-103-1-5p of VTA. These results suggested that heroin addiction might give harm to brain by altering cytokine balance and increasing neuroinflammation and apoptosis. In addition, neurons also try to compensate these abnormalities by enhancing neurogenesis and angiogenesis through several miRNAs in the different brain regions. In conclusion, the present study may provide a more integrated view of the molecular mechanism and a potential biomarker that will aid in clinical diagnosis and treatment of heroin-dependence.TÜBİTA
First-drug efficacy and drug-resistant epilepsy rates in children with new-onset epilepsies: a multicenter large cohort study
No full textObjective: This study aimed to assess the first-drug efficacy rate in newly diagnosed children with epilepsies treated with antiseizure medications. Methods: This retrospective study was conducted on 1003 children (age range: 3-10 years, and the mean duration of follow-up: 22 ± 13 months) with newly diagnosed epilepsy. The following parameters were evaluated: first-drug efficacy rate, first-drug-failure rate, and drug resistance rate in the cohort. Results: The first-drug-failure rate was defined in 335/1003 (33%) of the patients, no seizure control in 315 (31%), and drug withdrawal in 20 (2%). There was no significant difference between the group with focal-onset seizures and the group with generalized onset seizures. The first-drug efficacy rate was 67% in children with focal-onset seizures and 66% in children with generalized-onset seizures. Adjunctive antiseizure medication therapy was initiated in 335 patients—dual therapy with 180 patients (18%) and polytherapy with 155 (15%). Drug-resistant epilepsy was defined as 15% in the follow-up period. Etiology-specific diagnoses of the cohort were structural (n = 165, 17%), genetic (n = 25, 3%), metabolic (n = 15%), immune-infectious (n = 17 (2%), and unknown (n = 781, 77%). With a comparison of the 2 most common etiology subgroups (structural versus unknown), a first-drug efficacy rate of 53% and a higher prevalence of drug-resistant epilepsy at 30% were observed in children with structural etiology. First-drug efficacy was statistically lower in children without well-defined epilepsy syndromes (65%) compared with the rate of those with well-defined epilepsy syndrome (79%). Conclusion: This study revealed a first-drug failure rate (33%) in the presented cohort with a drug-resistance epilepsy rate (15%)
Multi-omics characterization of improved cognitive functions in Parkinson’s disease patients after the combined metabolic activator treatment: a randomized, double-blinded, placebo-controlled phase II trial
No full textParkinson’s disease is primarily marked by mitochondrial dysfunction and metabolic abnormalities. We recently reported that the combined metabolic activators improved the immunohistochemical parameters and behavioural functions in Parkinson’s disease and Alzheimer’s disease animal models and the cognitive functions in Alzheimer’s disease patients. These metabolic activators serve as the precursors of nicotinamide adenine dinucleotide and glutathione, and they can be used to activate mitochondrial metabolism and eventually treat mitochondrial dysfunction. Here, we designed a randomized, double-blinded, placebo-controlled phase II study in Parkinson’s disease patients with 84 days combined metabolic activator administration. A single dose of combined metabolic activator contains L-serine (12.35 g), N-acetyl-L-cysteine (2.55 g), nicotinamide riboside (1 g) and L-carnitine tartrate (3.73 g). Patients were administered either one dose of combined metabolic activator or a placebo daily for the initial 28 days, followed by twice-daily dosing for the next 56 days. The main goal of the study was to evaluate the clinical impact on motor functions using the Unified Parkinson’s Disease Rating Scale and to determine the safety and tolerability of combined metabolic activator. A secondary objective was to assess cognitive functions utilizing the Montreal Cognitive Assessment and to analyse brain activity through functional MRI. We also performed comprehensive plasma metabolomics and proteomics analysis for detailed characterization of Parkinson’s disease patients who participated in the study. Although no improvement in motor functions was observed, cognitive function was shown to be significantly improved (P 0.05). Moreover, a significant reduction (P = 0.001) in Montreal Cognitive Assessment scores was observed in the combined metabolic activator group, with no decline (P > 0.05) in the placebo group among severe Parkinson’s disease patients with lower baseline Montreal Cognitive Assessment scores. We showed that improvement in cognition was associated with critical brain network alterations based on functional MRI analysis, especially relevant to areas with cognitive functions in the brain. Finally, through a comprehensive multi-omics analysis, we elucidated the molecular mechanisms underlying cognitive improvements observed in Parkinson’s disease patients. Our results show that combined metabolic activator administration leads to enhanced cognitive function and improved metabolic health in Parkinson’s disease patients as recently shown in Alzheimer’s disease patients.ScandiBio Therapeutics ; Swedish National Infrastructure for Computing (SNIC) at UPPMAX ; Swedish Research Council Instituto Politecnico Nacional - Mexic