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Biologics are widely used to treat moderate-to-severe psoriasis. However, we have unmet needs for predicting individual patient responses to biologics before starting psoriasis treatment. We investigate a reliable platform and biomarkers for predicting individual patient responses to biologics. In a cohort study between 2018 and 2023 from a referral center in Taiwan, twenty psoriasis patients with or without psoriatic arthritis who had ever experienced two or more biologics were enrolled. Peripheral blood mononuclear cells obtained from these patients were treated with Streptococcus pyogenes and different biologics. The PASI reduction rate was strongly correlated with the reduction rate in the IL-13 level (p = 0.001) and the ratios of IFN-γ to IL-13 (p < 0.001), IFN-γ to IL-4 (p = 0.019), and IL-17A to IL-13 (p = 0.001). The PASI reduction difference was strongly correlated with the difference in the IFN-γ level (p = 0.002), the difference in the ratios of IFN-γ to IL-4 (p = 0.041), the difference in the ratios of IFN-γ to IL-13 (p = 0.006), the difference in the ratios of IL-17A to IL-4 (p = 0.011), and the difference in the ratios of IL-17A to IL-13 (p = 0.029). The biomarkers IFN-γ, IL-13, IFN-γ/IL4, IFN-γ/IL13, IL-17A/IL-4, and IL-17A/IL-13 are representative of the effectiveness of psoriasis treatment. [ABSTRACT FROM AUTHOR]

Simple Summary: Patients with severe diseases at the end-of-life stage are mostly hospitalized and may receive care from a hospitalist in the current healthcare system. In this study, we found that hospitalist care may enhance palliative care and reduce unnecessary aggressive life-sustaining treatment, such as mechanical ventilation, tracheostomy, surgery, and intensive care unit transfer before death. Although the benefit of hospitalist care at the end-of-life stage requires further validation, it potentially improves care for terminally ill patients in the hospital, especially when palliative care services are scarce. Background: Information on the use of palliative care and aggressive treatments for terminally ill patients who receive care from hospitalists is limited. Methods: This three-year, retrospective, case-control study was conducted at an academic medical center in Taiwan. Among 7037 patients who died in the hospital, 41.7% had a primary diagnosis of cancer. A total of 815 deceased patients who received hospitalist care before death were compared with 3260 patients who received non-hospitalist care after matching for age, gender, catastrophic illness, and Charlson comorbidity score. Regression models with generalized estimating equations were performed. Results: Patients who received hospitalist care before death, compared to those who did not, had a higher probability of palliative care consultation (odds ratio (OR) = 3.41, 95% confidence interval (CI): 2.63–4.41), and a lower probability to undergo invasive mechanical ventilation (OR = 0.13, 95% CI: 0.10–0.17), tracheostomy (OR = 0.14, 95% CI: 0.06–0.31), hemodialysis (OR = 0.70, 95% CI: 0.55–0.89), surgery (OR = 0.25, 95% CI: 0.19–0.31), and intensive care unit admission (OR = 0.11, 95% CI: 0.08–0.14). Hospitalist care was associated with reductions in length of stay (coefficient (B) = −0.54, 95% CI: −0.62–−0.46) and daily medical costs. Conclusions: Hospitalist care is associated with an improved palliative consultation rate and reduced life-sustaining treatments before death. [ABSTRACT FROM AUTHOR]

Aim We explored the impact of job content and stress on anxiety, depressive symptoms and self-perceived health status among nurse practitioners ( NPs). Background Taiwan's NP roles vary between hospitals as a result of the diverse demands and complex tasks that cause job-related stress, potentially affecting the health of the NP. Methods This study utilised a cross-sectional descriptive design with 161 NPs from regional hospitals participating. Data collection involved demographics, the Taiwan Nurse Stress Checklist, the Job Content Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, a General Health Status Checklist and salivary cortisol tests. Results NPs reported moderate job stress, similar job control to nurses, mild anxiety and depression, and below-average self-perceived health. Being a licensed NP, personal response, competence, and incompleteness of the personal arrangements subscales of job stress, and anxiety predicted self-perceived health after adjusting for other covariates. Conclusions Job stress and anxiety affect NP health. Implications for Nursing Management NPs are a valuable resource, and the healthcare system demand is growing. Reasonable NP staffing, working hours, proper promotion systems, the causes of job stress, job content clarification and practical work shift scheduling need to be considered. The occupational safety and physical and psychological health of NPs are strongly associated with the quality of patient care. [ABSTRACT FROM AUTHOR]