Tag: pubmed

Adv Health Sci Educ Theory Pract. 2023 Nov 9. doi: 10.1007/s10459-023-10292-1. Online ahead of print.

ABSTRACT

Research has demonstrated erosion of empathy in students during medical education. Particularly, U.S. studies have demonstrated empathy declines during clinical training in the third and fourth year of traditional medical programs. Yet, studies conducted outside the U.S. have not confirmed this trend. Timing and extent of patient interactions have been identified as empathy-protective factors. The need to examine empathy within different learning contexts has been noted, as has the need for longitudinal and time-series research designs to analyze trajectories. Between fall 2010 and spring 2019, we assessed empathy longitudinally among six student cohorts (N = 493) at a U.S. medical school, where patient interaction occurs early and throughout an integrated curriculum. Empathy levels of students in each cohort were assessed at five time points utilizing the Jefferson Scale of Physician Empathy-Student version. We hypothesized empathy levels will not degrade by program end, and trajectories will not show patterns of decline in Years Three and Four. Analysis of Variance (ANOVA) and Linear Mixed Model (LMM) analyses were used to analyze differences at baseline and changes in empathy trajectories. ANOVA analyses revealed statistically significant differences at baseline by class cohort (F(5, 487) = [23.28], p < 0.001). LMM analyses indicated empathy was either significantly higher or not different at the end of the program (F(19, 1676) = [13.97], p < 0.001). Empathy trajectories varied among cohorts; yet, none resulted in an overall empathy decline by the end of the program. Findings demonstrate empathy in U.S. medical students can be unchanged or higher by the end of medical education. Outcomes are consistent with reports of non-declining medical student empathy outside the U.S. and support the notion of context-specificity. Results further support recent research, suggesting decreases in empathy during training can stabilize or increase by program end. These findings have important implications for future empathy research context and design considerations, as well as program planning.

PMID:37946064 | DOI:10.1007/s10459-023-10292-1

Int Orthop. 2023 Nov 9. doi: 10.1007/s00264-023-06031-1. Online ahead of print.

ABSTRACT

PURPOSE: Joint line (JL) position change in total knee arthroplasty (TKA) may alter knee biomechanics and impact function. The purpose of this study was to compare the change in JL position between robotic-assisted TKA (RA-TKA) and conventional TKA (C-TKA).

METHODS: A retrospective, radiographic analysis was conducted of patients who underwent RA-TKA and C-TKA to compare JL position change. JL position was measured in consecutive RA-TKAs and C-TKAs performed by four fellowship-trained arthroplasty surgeons. Statistical analysis was done utilizing t-tests and Mann Whitney U tests, with statistical significance being defined as a p value < 0.05.

RESULTS: Six hundred total RA-TKAs and 400 total C-TKAs were included in the analysis. There were no significant differences in patient baseline characteristics such as body mass index, range of motion, and tibiofemoral coronal alignment. RA-TKAs were associated with an average of 0.04 (2.2) mm JL position change, and C-TKAs were associated with an average 0.5 (3.2) mm JL position change (p = 0.030). There were inter-surgeon differences when comparing the change in JL position for RA-TKAs and C-TKAs between the four participating surgeons.

CONCLUSION: RA-TKA leads to better preservation of the JL position than C-TKA, and this seems to be dependent on the arthroplasty surgeon’s preferences and techniques during TKA. Whether this statistically significant difference is clinically relevant needs to be further investigated.

PMID:37946052 | DOI:10.1007/s00264-023-06031-1

Nat Aging. 2023 Nov 9. doi: 10.1038/s43587-023-00513-y. Online ahead of print.

ABSTRACT

Tissues within an organism and even cell types within a tissue can age with different velocities. However, it is unclear whether cells of one type experience different aging trajectories within a tissue depending on their spatial location. Here, we used spatial transcriptomics in combination with single-cell ATAC-seq and RNA-seq, lipidomics and functional assays to address how cells in the male murine liver are affected by age-related changes in the microenvironment. Integration of the datasets revealed zonation-specific and age-related changes in metabolic states, the epigenome and transcriptome. The epigenome changed in a zonation-dependent manner and functionally, periportal hepatocytes were characterized by decreased mitochondrial fitness, whereas pericentral hepatocytes accumulated large lipid droplets. Together, we provide evidence that changing microenvironments within a tissue exert strong influences on their resident cells that can shape epigenetic, metabolic and phenotypic outputs.

PMID:37946043 | DOI:10.1038/s43587-023-00513-y

J Behav Med. 2023 Nov 9. doi: 10.1007/s10865-023-00456-0. Online ahead of print.

ABSTRACT

Metabolic syndrome is associated with increased risk for negative health events, decrements in quality of life, and greater health costs. The current study sought to identify whether the ratio of social support to social demands across multiple relationship types (spouse, friends, children, or other family members) were associated with concurrent metabolic syndrome in a nationally representative sample of US adults ages 32-40. Results indicate that the ratio of total social support to social demands was associated with a greater likelihood of meeting criteria for metabolic syndrome, even after statistically controlling for the effects of race, ethnicity, sex, age, income, and prior metabolic syndrome. When considering the relative contributions of each relationship type, greater support relative to demands from friends was the only relationship type that was significantly independently associated with lower likelihood of metabolic syndrome. Although not statistically significant, a trend-level negative association with spousal support/demands emerged, as did a trend-level positive association with support/demands from children. Taken together, the current study reaffirms the relevance of considering social support and demands with regards to metabolic syndrome and highlights the ways in which specific relationships may differentially relate to health risk.

PMID:37946025 | DOI:10.1007/s10865-023-00456-0

Acta Diabetol. 2023 Nov 9. doi: 10.1007/s00592-023-02203-y. Online ahead of print.

ABSTRACT

AIMS: To assess body composition by means of BOD POD in the large cohort of Italian Olympic athletes of many sport disciplines (studied at the same time), and to provide possible reference values for body composition in elite athletes.

METHODS: 1556 elite athletes, who took part in the selection procedure for the 2016 Rio Olympic Games for the National Italian Olympic Committee (CONI), were retrospectively studied. Body composition was determined using air plethysmography-based BOD POD.

RESULTS: We observed that Fat Mass (FM) and Fat-free Mass (FFM) should be considered as two mutually independent domains in elite athletes. By performing Principal Component Analysis, we defined two independent main domains (respectively, representing FM and FFM), which presented different trends according to gender and static or dynamic exercise load. Lastly, we reported possible reference values for FM index and FFM index, respectively, representing the largest contributors to FM domain and FFM domain, and calculated as FM or FFM (kg)/height (m²).

CONCLUSIONS: Our findings might provide a basis to optimize the practical approach to body composition in athletes, highlighting the importance of considering indicators of fat mass and lean mass “simultaneously” and not specularly, according to different sport disciplines as well. Moreover, these data might contribute to standardize reference values for body composition in elite athletes, with a view to potentially helping to monitor and guide training regimens, prevent related detrimental practices and plan cardiometabolic prevention and rehabilitation programs.

PMID:37945991 | DOI:10.1007/s00592-023-02203-y

Environ Sci Pollut Res Int. 2023 Nov 10. doi: 10.1007/s11356-023-30779-z. Online ahead of print.

ABSTRACT

The measurement of performance within the water industry holds significant importance for policymakers, as it can help guide decision-making for future development and management initiatives. In this study, we apply data envelopment analysis (DEA) cross-efficiency techniques to evaluate the productivity change of the Chilean water industry during the years 2010-2018. Water leakage and unplanned interruptions are included in the analysis as quality of service variables. Moreover, we use cluster analysis and regression techniques to better understand what drives productivity change of water companies. The results indicate that the Chilean water industry is characterized by considerable high levels of inefficiency and low levels of productivity change. This is due to the existence of technical regress whereas gains in efficiency were small. Concessionary water companies were found to be more productive than full private and public water companies. Best and worst performers need to make efforts to reduce production costs and improve service quality. Other factors such as customer density and ownership type statistically affect productivity.

PMID:37945962 | DOI:10.1007/s11356-023-30779-z

Environ Sci Pollut Res Int. 2023 Nov 9. doi: 10.1007/s11356-023-30660-z. Online ahead of print.

ABSTRACT

The reduction of haze and carbon emissions is extremely important for promoting sustainable development, improving air quality, enhancing health, and mitigating climate change. However, there is not enough research available on the impact of fiscal decentralization in China on the management of carbon and haze reduction. In order to thoroughly examine the effects of Chinese-style fiscal decentralization on the synergy between haze reduction and carbon reduction in different provinces, this study utilizes a dynamic spatial panel Durbin model using Han-Phillips Generalized Method of Moments (GMM) estimation and a multi-scale geographically and temporally weighted regression model. Our findings indicate that the eastern region consistently takes the lead in reducing haze and achieving carbon synergy. Fiscal technology decentralization has a direct positive impact and spatial spillover effect on carbon haze synergy with significant inverted U-shaped characteristics. These effects primarily arise from the promotion of technological innovation through fiscal technology decentralization. Furthermore, the influence of decentralizing fiscal technology expenditures on the degree of synergy between haze mitigation and carbon reduction varies significantly across China’s provinces, both spatially and temporally. This entails promoting coordination between fiscal decentralization and policies related to haze and carbon emission reduction and encouraging information sharing, technology exchange, and collaborative projects between different regions to create a synergistic linkage effect. This will help achieve joint development and environmental protection goals in all regions. The discoveries carry significant consequences for directing the synchronized administration of haze and carbon and can serve as a solid basis for governmental decision-making aimed at enhancing air quality and attaining carbon neutrality through collaborative actions and policies.

PMID:37945950 | DOI:10.1007/s11356-023-30660-z

Environ Sci Pollut Res Int. 2023 Nov 9. doi: 10.1007/s11356-023-30673-8. Online ahead of print.

ABSTRACT

A comprehensive understanding of carbon emission reduction and decoupling in urban agglomerations of the Yellow River Basin (YRB) has significant theoretical and practical value for formulating precise carbon reduction policies and achieving ecological conservation and high-quality development in the region. This study utilized a generalized Divisia index decomposition model to identify the primary driving factors behind carbon emission changes in urban agglomerations of the YRB. Based on this, a model measuring decoupling efforts was constructed to systematically investigate the decoupling relationship between carbon emissions. The research findings indicate that technological progress and output scale are two primary drivers of carbon emission increases in the YRB and its urban agglomerations, whereas technological carbon intensity, output carbon intensity, and energy carbon intensity play key roles in reducing carbon emissions. Except for a few years, the YRB and Jiziwan metropolitan area (JWMA) did not exhibit decoupling effects on carbon emissions. The Shandong Peninsula Urban Agglomeration (SPUA) and Central Plains Urban Agglomeration (CPUA) showed strong decoupling effects from 2016 to 2019. The Guanzhong Plain Urban Agglomeration (GPUA) demonstrated a strong decoupling effect from 2013 to 2019 (except from 2016 to 2017). The Lanxi Urban Agglomeration (LXUA) exhibited a strong decoupling effect from 2014 to 2019. Technological carbon intensity plays a decisive role in the transition from non-decoupling to decoupling. Therefore, the government must increase investments in green and low-carbon technologies and strictly implement carbon reduction measures. Thus, the YRB and its urban agglomerations have considerable potential for carbon emission reduction and strong decoupling effects.

PMID:37945949 | DOI:10.1007/s11356-023-30673-8

Support Care Cancer. 2023 Nov 10;31(12):684. doi: 10.1007/s00520-023-08158-8.

ABSTRACT

PURPOSE: To examine the relationship between self-disclosure, coping styles, and benefit finding (BF) among caregivers of cancer patients. The study also aimed to identify the factors influencing BF and the impact of coping styles on the relationship between self-disclosure and BF.

METHODS: Convenience sampling was used to select 300 caregivers of cancer patients aged greater than 18 years from October 2022 to April 2023 in Chengdu, China. The demographic and clinical characteristics questionnaire, the Benefit Finding Scale (BFS), the Distress Disclosure Index Scale (DDI), and the Simple Coping Style Scale (SCSQ) for caregivers were included in this study. Descriptive statistics, t-tests, one-way analysis of variance, Pearson’s correlation analyses, and multiple linear regression models were used. The effect of mediation was tested by the PROCESS macro (Model 4) for SPSS 26.0 by Hayes using 5000 bootstrap samples.

RESULTS: There were 292 valid questionnaires (effective response rate 97.33%). The total scores of BF, self-disclosure, negative coping style, and positive coping style of caregivers were 67.77 ± 14.78, 38.23 ± 8.59, 19.68 ± 5.98, and 9.88 ± 4.18, respectively; Pearson’s correlation analysis showed that BF was positively correlated with self-disclosure, positive coping, and negatively correlated with negative coping; multiple linear regression analysis showed that self-disclosure, positive coping, and negative coping were influential factors of BF. The results revealed that the effect of self-disclosure on BF was partly mediated by coping styles. It also confirmed that the mediation effect accounted for 54.03% of the total effect.

CONCLUSION: The BF of caregivers is at a moderate level. Self-disclosure may influence BF partly because of coping styles.

PMID:37945919 | DOI:10.1007/s00520-023-08158-8

Nat Genet. 2023 Nov 9. doi: 10.1038/s41588-023-01534-4. Online ahead of print.

ABSTRACT

The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups.

PMID:37945903 | DOI:10.1038/s41588-023-01534-4