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Abstract Background Social consensus in the nursing industry is that the job is accompanied by dirtiness. It is generally accepted that negative cognition about a career is an important determinant in reducing nursing students’ professional commitment. However, the impact of nursing students’ perceived work dirtiness on professional commitment and its mechanism remains unclear. This study aimed to analyze the association between perceived work dirtiness and professional commitment and to examine the mediating role of career adaptability and the moderating role of social support among nursing students in mainland China. Methods A cross-sectional online study was conducted among 341 nursing students from three medical universities in Henan, China. The participants’ perceived work dirtiness, career adaptability, professional commitment, and social support were obtained. SPSS 26.0 and Amos 23.0 software were used for the statistical analysis. Results Perceived work dirtiness was negatively related to career adaptability and professional commitment (P

IntroductionOvarian cancer is one of the most common cancer among women in Malaysia. Patients with ovarian cancer are often diagnosed at an advanced stage. Despite initial response to surgery and chemotherapy, most patients will experience a relapse. Olaparib has been reported have promising effects among BRCA mutated ovarian cancer patients. This study aimed to evaluate the cost-effectiveness of olaparib as a maintenance therapy for BRCA ovarian cancer in Malaysia.MethodsWe developed a four-state partitioned survival model which compared treatment with olaparib versus routine surveillance (RS) from a Malaysian healthcare perspective. Mature overall survival (OS) data from the SOLO-1 study were used and extrapolated using parametric models. Medication costs and healthcare resource usage costs were derived from local inputs and publications. Deterministic and probabilistic sensitivity analyses (PSA) were performed to explore uncertainties.ResultsIn Malaysia, treating patients with olaparib was found to be more costly compared to RS, with an incremental cost of RM149,858 (USD 33,213). Patients treated with olaparib increased life years by 3.05 years and increased quality adjusted life years (QALY) by 2.76 (9.45 years vs 6.40 years; 7.62 vs 4.86 QALY). This translated to an incremental cost-effectiveness ratio (ICER) of RM 49,159 (USD10,895) per life year gained and RM54,357 (USD 12,047) per QALY gained, respectively. ICERs were most sensitive to time horizon of treatment, discount rate for outcomes, cost of treatment and health state costs, but was above the RM53,770/QALY threshold.ConclusionThe use of olaparib is currently not a cost-effective strategy compared to routine surveillance based upon the current price in Malaysia for people with ovarian cancer with BRCA mutation, despite the improvement in overall survival.

The Ministry of Health Malaysia aims to fully replace liquid-based cytology (LBC) with Human Papillomavirus (HPV) tests and increase the screening coverage from a baseline of 25% to 40% by 2023, followed by a 10% yearly increment until 70% coverage. This transition requires proper planning, including the number of tests needed and budget allocation. This study aims to simulate different transition strategies involving the shift from LBC to HPV testing with expanded screening coverage to predict their impact on cervical cancer elimination in Malaysia. A system dynamics model was developed to simulate the transition from LBC to HPV testing and HPV vaccination coverage in Malaysia. The dynamic model utilised local epidemiological data, published research, and expert opinion when data was unavailable. The simulation showed that a combination of high HPV vaccination coverage and transitioning fully to five-yearly HPV testing by 2030, coupled with a 70% screening uptake by 2040, would accelerate cancer elimination in Malaysia by 18 years with an estimated screening cost of MYR1.81 billion equivalent to USD 411 millions compared to the baseline of using LBC as the primary screening method (MYR1.39 billion, USD 315 millions). Sustained, it would lead to averting 6,000 new cancer cases by 2070. Alternatively, conducting HPV screenings twice before age 50 would advance cervical cancer elimination by 14 years and prevent approximately 1000 new cases by 2070, with an estimated cost of MYR1.13 billion equivalent to USD 257 millions. A delay in achieving the full transition prolonged the elimination more than a delay in increasing the screening coverage. In all scenarios, yearly vaccination of 90% of girls age 13 is crucial to achieving elimination. In the Malaysian context, where HPV vaccination coverage has reached considerable levels, the evidence advocates for a full transition from LBC to HPV testing, ideally by 2030. While expanding screening coverage remains a critical factor in this endeavour, the findings unequivocally endorse prioritising the transition process. Trial registration: Trial registration number: NMRR ID-22-00187-DJU.

Total leaf area per shoot (AT) can reflect the photosynthetic capacity of a shoot. A prior study hypothesized that AT is proportional to the product of the sum of the individual leaf widths per shoot (LKS) and the maximum individual leaf length per shoot (WKS), referred to as the Montgomery–Koyama–Smith equation (MKSE). However, empirical evidence does not support such a proportional relationship hypothesis, as AT was found to allometrically scale with LKSWKS, i.e., A T ∝ L K S W K S α , where α ≠ 1 , referred to as the power law equation (PLE). Given that there is variation in the total number of leaves per shoot (n), little is known about whether the leaf area distribution has an explicit mathematical link with the sorted leaf area sequence per shoot, and it is unknown whether the mathematical link can affect the prediction accuracy of the MKSE and PLE. In the present study, the leaves of 500 shoots of a dwarf bamboo (Sasaella kongosanensis 'Aureostriatus') were scanned, and the leaf area, length, and width values were obtained by digitizing the leaf images. We selected the shoots with n ranging from 3 to 10, which accounted for 76.6% of the totally sampled shoots (388 out of 500 shoots). We used the formula for the sum of the first j terms (j ranging from 1 to n) of a geometric series (GS), with the mean of the quotients of any adjacent two terms (denoted as q ¯ A ) per shoot as the common ratio of the GS, to fit the cumulative leaf area observations. Mean absolute percentage error (MAPE) was used to measure the goodness of fit of the GS. We found that there were 367 out of 388 shoots (94.6%) where 1 < q ¯ A < 1.618 and MAPE < 15%, and these 367 shoots were defined as valid samples. The GS hypothesis for leaf area distribution was supported by the result that the MAPE values for most valid samples (349 out of 367, i.e., 95.1%) were smaller than 5%. Here, we provide a theoretical basis using the GS hypothesis to demonstrate the validity of the MKSE and PLE. The MAPE values for the two equations to predict AT were smaller than 5%. This work demonstrates that the leaf area sequence per shoot follows a GS and provides a useful tool for the calculation of total leaf area per shoot, which is helpful to assess the photosynthetic capacity of plants. [ABSTRACT FROM AUTHOR]

(1) Background: Pasteurellosis is a global zoonotic bacterial disease, which has caused significant economic impacts in animal husbandry. Nevertheless, there is limited understanding of the immune response between goat peripheral blood lymphocytes (PBLs) and goat-derived Pasteurella multocida (P. multocida). (2) Methods: To investigate the immune response of host PBLs during infection with P. multocida type D, we established an in vitro cell model utilizing isolated primary goat PBLs. Utilizing this in vitro infection model, we employed an enzyme-linked immunosorbent assay (ELISA) to assess the cytokine profile variation in goat PBLs following infection. Meanwhile, RNA sequencing and quantitative PCR (qPCR) methods were employed to analyze the gene expression profile. (3) Results: The ELISA test results indicated that the expression levels of pro-inflammatory cytokines, such as IL-6, IFN-γ, CXCL10, and IL-17A, were significantly elevated within 12 h after infection with P. multocida. In contrast, the levels of the anti-inflammatory cytokine IL-10 were found to be reduced. RNA sequencing and functional enrichment analysis identified 2114 differentially expressed genes (DEGs) that were primarily associated with cytokine-cytokine receptor interactions, viral protein-cytokine interactions, and the IL-17 signaling pathway. Furthermore, protein-protein interaction (PPI) network analysis and qPCR highlighted CD86, CCL5, CD8A, CXCL8, CTLA4, TNF, CD274, IL-10, IL-6, CXCL10, IFNG, and IL-17A that were crucial for the response of PBLs to P. multocida infection. (4) Conclusions: This study systematically revealed the characteristics of PBLs in goats following infection with goat-derived P. multocida type D through the analysis of cytokines and gene expression, providing important theoretical insights for a deeper understanding of the defense mechanisms in goats against P. multocida. [ABSTRACT FROM AUTHOR]

Background: With rising global diabetes prevalence, precise early identification and management of diabetes risk are critical research areas. The metabolic score for insulin resistance (METS-IR), a novel non-insulin-based tool, is gaining attention for quantifying insulin resistance using multiple metabolic parameters. Despite its potential in predicting diabetes and its precursors, evidence on its specific relationship with diabetes is limited, especially in large-scale population validation and mechanistic exploration. Objective: This study aims to analyze the association between METS-IR and type 2 diabetes (T2DM) in American adults. Methods: We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2009 to 2018. Participants aged 20 years and above were included, excluding individuals with missing data on BMI, fasting blood glucose, high-density lipoprotein cholesterol glycated hemoglobin and diabetes status. Logistic regression analysis, subgroup analysis, and restricted cubic spline analysis were used to assess the association between METS-IR and T2DM, controlling for potential confounding factors. Results: After adjusting for age, gender, race, education level, smoking status, drinking habits, depression, physical activity, hypertension, and hyperlipidemia, we found a positive association between METS-IR and the risk of T2DM. Specifically, each unit increase in METS-IR was associated with a 7% increase in the risk of T2DM (OR = 1.07, 95% CI: 1.06, 1.08). Subgroup analysis showed that the association between METS-IR and T2DM incidence was significantly positive in the highest quartile group, particularly among Mexican Americans over 40 years old and those diagnosed with depression, hypertension, or hyperlipidemia. Conclusion: Our study revealed a significant positive association between METS-IR and the prevalence of T2DM, indicating that this relationship persists even after controlling for various confounding factors. Therefore, monitoring METS-IR may provide a valuable tool for the early identification of individuals at risk of glucose metabolism disorders. Further research should focus on the applicability of METS-IR in different populations and its potential impact on clinical practice. [ABSTRACT FROM AUTHOR]