Spousal Involvement in the Workplace of Doctors: What Is Defined as Appropriate or Inappropriate

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.

Corrigendum:Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease

https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on pages 1602-1607,Issue 7,Volume 19 of Neural Regeneration Research(Zhao et al.,2024),the first author’s affiliations were incorrectly tagged.

Determinants of Occipital Involvement in Males and Females with Pattern Hair Loss: A Retrospective Study

Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is often used as a donor site for hair transplantation procedures. However, evidence suggests that the occipital region may also be affected by PHL, although to a lesser extent compared to the frontal and vertex regions. Objective: To assess the levels and determinants of occipital involvement in PHL, focusing on gender and disease severity. Such data would enhance the comprehensive understanding of PHL progression and inform development of improved treatment strategies. Methods: This retrospective study involved 1993 adults (1000 males, 993 females) following for PHL at a specialized hair clinic in Jeddah, Saudi Arabia. Any patient who had hair transplantation in the past and any male who had balding areas (Hamilton-Norwood scales 4 to 7) at the initial consultation was excluded. The primary outcome was occipital involvement, defined as >10% thin hairs in the trichometry assessments of the occipital region. Additional data included patients age, treatment status, disease severity, and other trichometry parameters. Results: The prevalence of occipital involvement was found to be 23.8% overall, significantly more frequent in females (35.6%) than males with early PHL (Hamilton-Norwood scales 2 and 3) (12.1%) (p Conclusion: This study underscored the relevance of gender and disease severity in occipital involvement in PHL. Females had significantly higher rates of occipital involvement, suggesting that gender differences are critical in understanding PHL progression. Future research should aim to validate these findings, with an aim to refine therapeutic and surgical approaches to improve patient outcomes.

The burden of upper motor neuron involvement is correlated with the bilateral limb involvement interval in patients with amyotrophic lateral sclerosis:a retrospective observational study

Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.

How Sense of Ritual in Tourism Impacts Tourists’Co-Creation of Tourism Experience Values:A Study Based on the Theory of Value Co-Creation

Establishing a sense of ritual within tourism consumption scenarios offers tourists the opportunity for interactive engagement.Drawing upon the value co-creation theory,this study constructed an influence mechanism model to examine tourists'active engagement in the process of co-creating tourism experience values.It employed Partial Least Squares Structural Equation Modeling(PLS-SEM)to empirically test the proposed hypotheses.The findings demonstrate that the model constructed in the present study exhibits robust reliability,validity,and explanatory power.The perception of the sense of ritual in tourism exerts a significant positive influence on tourists’co-creation of tourism experience values,thereby significantly enhancing both the communitas and flow experienced by tourists during their travels.Moreover,such communitas and flow can mediate the influence of the sense of ritual in tourism on tourists’co-creation of tourism experience values.This study contributes to advancing the current research on tourists’co-creation of tourism experience values and the sense of ritual in tourism,thereby providing theoretical foundations for cultivating a sense of ritual within tourism consumption scenarios.

Experienced Involvement (ExIn) in Social-Psychiatric Care of Germany-Challenges and Chances

This study explores the integration of Experienced Involvement(ExIn)in social-psychiatric care in Germany,emphasizing both the challenges and opportunities it presents.The European Leonardo da Vinci Project(2005-2007)established a curriculum for ExIn,promoting participatory structures in psychiatric services.While peer support is well-established in other European countries,Germany’s experience is still developing.This research uses a mixed methods design,combining quantitative surveys and qualitative interviews,to investigate the professional experiences of ExIn recovery companions and team colleagues in German clinics and support services.The findings reveal numerous benefits:for social-psychiatric services,ExIn enhances service quality,inclusivity,and accessibility;for team colleagues,it fosters reflexivity,hope,and trust,and improves self-care;for service users,it provides empowerment,easy access to support,trust,and hope,and offers credible role models.Despite these benefits,challenges such as stigmatization,lack of recognition,and financial constraints remain and require to be addressed.The study highlights the need and provides implications for a dedicated and inclusive approach to effectively implementing ExIn,ultimately enriching psychiatric care through experiential knowledge and reducing prejudice within mental health services.

Retraction:Macrophage involvement in the pathological evolution of ulcerative colitis-associated colon cancer and progress of related traditional Chinese medicine drug interventions

Traditional Medicine Research has retracted this article upon the request of the editor-in-chief and academic committee.On June 5,2023,we received a complaint regarding possible picture plagiarism within the article,which promoted the decision to retract this article.Following a comprehensive examination,it was determined that the content depicted in this article's pictures was identical to that found in another published paper.Consequently,the editorial office determined that retracting the article was necessary.

Current guidelines for diagnosis and management of hepatic involvement in hereditary hemorrhagic teleangiectasia

Hereditary hemorrhagic teleangiectasia(HHT),also known as Rendu-Osler-Weber syndrome,is the most common cause of hepatic vascular malformations in adults.Different vascular shunts(arteriovenous,arterioportal or portovenous)lead to different clinical manifestations.Even though no hepatic-related symptoms are reported in the majority of cases,the severity of liver disease could lead to refractory medical conditions,in some cases requiring liver transplantation.The aim of this manuscript is to provide an updated overview of the current evidence regarding the diagnosis and treatment of HHT liver involvement and liver-related complications.

Male Involvement in the Maternal Health Care: Expectations of Pregnant Women in Bolgatanga Municipality in the Upper East Region of Ghana

Background: Male involvement during pregnancy and childbirth is very important as it has been shown to increase the number of times a pregnant woman undertakes antenatal care visits before delivery. The purpose of this study was to determine whether there is a relationship between the background characteristics of participants and their male partners’ involvement in maternal health care in the Bolgatanga Municipality of Upper East Region. Methods: The study design employed was a facility-based cross-sectional study design in 9 health facilities in the Bolgatanga municipality. The study populations for this study consisted of pregnant women using antenatal services in the health facilities before the commencement of this current study and are residents of the Bolgatanga municipality. A multistage sampling strategy was used in the sampling of participants for this study with an estimated sample size of 422. Results: Findings show that the majority of 403 (95.5%) of the participants expect their male partner accompanies them during the antenatal care clinic. The chi-square test revealed that marital status had a significant influence on male partners’ support in house chore and support in antenatal care service (P-value of 0.001 and 0.002, Conclusion: This study’s findings showed that pregnant women always want their male partners to accompany them to antenatal care and during labour and delivery. The pregnant women expected their male partners to be educated on the effects of pregnancy, how to take care of a pregnant woman, how to tolerate their partners, Sex during pregnancy, and how to prepare for emergencies (blood donation, transportation and finance).

Variant of Guillain-Barrésyndrome with anti-sulfatide antibody positivity and spinal cord involvement:A case report

BACKGROUND Guillain-Barrésyndrome(GBS)is an acute autoimmune-mediated polyneuropathy.Studies have increasingly reported the presence of anti-sulfatide antibody positivity with varying clinical symptoms in patients with GBS.However,spinal cord involvement is relatively rare in these cases.CASE SUMMARY A 68-year-old woman was admitted to the hospital with weakness of the limb for more than 3 d.Additional symptoms included neck pain,progressive numbness in the distal extremities,urinary and fecal retention,and reduced perception of temperature.She was diagnosed with an anti-sulfatide antibody-positive GBS variant and discharged after treatment with methylprednisolone and intravenous human immunoglobulin pulse therapy.Unlike common cases of anti-sulfatide antibody-positive GBS,this patient had atypical clinical symptoms of spinal cord involvement.No similar cases have previously been reported in China.CONCLUSION Although GBS is associated with a poor prognosis,a prompt diagnosis allows early administration of combined intravenous human immunoglobulin and methylprednisolone pulse therapy.

Acute flare of systemic lupus erythematosus with extensive gastrointestinal involvement: A case report and review of literature

BACKGROUND Lupus mesenteric vasculitis(LMV)is a serious condition that may occur as an acute manifestation of gastrointestinal(GI)involvement and is not easily diagnosed by physicians.Delayed diagnosis and treatment of LMV may lead to rapid disease progression and can be life threatening.CASE SUMMARY A previously healthy 27-year-old woman presented with abdominal pain following a history of fatigue and consumption of cold water.Laboratory invest-igations,physical examinations,and enhanced abdominal computed tomography(CT)suggested systemic lupus erythematosus complicated by LMV.She received treatments,such as GI decompression,somatostatin,glucocorticoids,and immu-nosuppressants,and was evaluated using color ultrasonography.Twenty days later,the patient reported no stomach discomfort and was able to consume semi-liquid food.Laboratory investigations showed that inflammatory factors decreased to normal levels and complement levels increased slightly.One year after discharged,she recovered with methylprednisolone being tapered to 4 mg per day,mycophenolate mofetil to 0.75 g bid,and hydroxychloroquine to 0.2 g bid;however,only C3 complement level was slightly below the normal level.CONCLUSION Early diagnosis of LMV is essential for successful treatment;this depends on a combination of clinical manifestations,laboratory investigations,and imaging findings.Enhanced CT is preferred,but ultrasonography can be used for prompt screening and follow-up.

Infrequent organ involvement in immunoglobulin G4-related prostate disease: A case report

BACKGROUND Immunoglobulin G4-related prostate disease(IgG4-RPD)characterized by a high count of IgG4-positive plasma cells has distinctive serological and radiological findings.Here we report a case of a patient who was successfully treated for IgG4-RPD,which manifested as frequent micturition,dysuric,and systemic lymphadenopathy.CASE SUMMARY The patient was a 33-year-old man who was referred to our hospital because of urinary tract symptoms that had persisted for 4 years.A physical examination revealed systemic lymphadenopathy and blood tests showed hyperglobulinemia with an IgG level of 18.90 g/L and an IgG4 level of 18.40 g/L.Computed tomography(CT)revealed bilateral lacrimal gland,right parotid gland and prostatic enlargement.Based on these findings,IgG4-RD was suspected,and further pathological examination and follow-up results showed expected results.Finally,the patient was diagnosed with IgG4-RPD based on clinical symptoms,pathological examination,therapeutic effects,and follow-up results.He received 50 mg oral prednisolone(the dose was gradually reduced and a low dose was used for long-term maintenance)in combination with cyclophosphamide 1.0 g via an intravenous drip for 6 mo.One year after the treatment was initiated,he was free of urinary or other complaints and his serum IgG4 level normalized.CONCLUSION In IgG4-RPD with severe urinary tract symptoms,radiological findings should be carefully examined.IgG4-RPD prognosis is good because the disease responds well to glucocorticoids.Furthermore,it is urgent for clinicians and pathologists to improve their understanding of IgG4-RPD.

Asian variant intravascular large B-cell lymphoma with highly suspected central nervous system involvement:A case report

BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare subtype of extranodal lymphoma.In particular,the Asian variant of IVLBCL is characterized by hemophagocytic lymphohistiocytosis along with bone marrow involvement.However,central nervous system(CNS)involvement is uncommon in this variant compared to the Western variant.Here,we report a case of typical Asian variant IVLBCL with highly suspected CNS involvement and discuss the nature of the disease and its genetic aberration.CASE SUMMARY A 67-year-old female patient complained of gradually worsening cognitive impairment.While hospitalized,she developed a high fever and showed marked bicytopenia.Intracranial imaging revealed a suspected leptomeningeal disease.Although no malignant cells were found in the cerebrospinal fluid(CSF),the protein and lactate dehydrogenase levels in CSF were increased.Bone marrow examination revealed an increased number of hemophagocytic histiocytes,and 18F-fluorodeoxyglucose(FDG)positron emission tomography with computerized tomography scan revealed increased FDG uptake in both adrenal glands,the liver,and the right ethmoid sinus.A tissue biopsy showed atypical large lymphoid cells with prominent nucleoli in the vessels,and the tumor cells were positive for CD20,BCL2,BCL6,and IRF4/MUM1.In addition,targeted sequencing identified MYD88,TET2,and PIM1 mutations.Consequently,we diagnosed the patient with the Asian variant of IVLBCL with highly suspected CNS involvement.CONCLUSION Suspicion of IVLBCL and immediate diagnosis lead to timely treatment.Moreover,careful CNS examination at diagnosis is recommended.

The Mediating Effect of Social Media on the Relationship Between Travel Preference and Tourist Behavior of Local Tourists in Davao City

This paper aims to determine the mediating effect of social media on the relationship between travel behavior and tourist preference.This paper utilized the mediation analysis design to determine whether social media significantly affects the independent and dependent variables.For the statistical tools,the proponents of the study utilized descriptive statistics,Sobel’s test,mean and standard deviation.Also,the proponents of the study utilized data from questionnaires gathered through an online google form.Most of the respondents are single females,college-level,and use Facebook most of the time.Therefore,this is the social media platform that the majority utilize.It has been revealed in the study the three sets of correlated variables:Travel behavior vs.tourist behavior,travel preference vs.social media,and social media vs.tourist behavior,have a strong positive linear relationship between the two quantitative variables.Thus,the study proponents concluded that there is an indirect effect between the travel preference and tourist behavior of local tourists in Davao City via social media.Lastly,the study’s findings reveal the fundamentals of how visitors make decisions,which are essential for enhancing the competitive advantages of cultural destinations.Significant findings from the study are beneficial to the growth of cultural tourism in Davao City.

Fifth Definition for Strategic HRM:HRM Involvement

This study aims to contribute to development of SHRM field.Because personnel management and human resource management are in practice by firms,however,firms do not apply strategic HRM yet.There are four definitions of SHRM so far.This study presents a new approach for the development of the field.It is HRM involvement.HRM involvement is related to appointment of managers and board of directors.Because board of directors appoints managers in firms,HR must be member of board of directors.Because managers achieve firm performance(market share and profit),and Board of Directors appoints managers.Therefore,HRM manager must be involved with board of directors to affect appointments.This study uses semantic content analysis and systematic review methods as a research methodology.To conclude,organizations may apply strategic HRM through strategic HR Directors at top level,appointment of C-level Executives and HRM involvement.

Tourists’Willingness to Pay for Recreation Services in Nyerere National Park,Tanzania:Are We Overvaluing or Undervaluing Our Nature Recreation Resources?

This study estimated tourists’Willingness to Pay(WTP)per day for recreation services in Nyerere National Park(NNP)and compared these values with daily travel costs that are incurred by tourists to visit NNP in order to inform whether recreation resources in the park are overvalued or undervalued.The study revealed that tourists’WTP per day for recreation services was estimated at$237.4 and$1521 for resident and non-resident tourists,respectively.The estimated tourists’WTP values exceed the daily travel costs currently incurred by tourists,which are$201.04 and$1517.97 for resident and non-resident tourists,respectively.This indicates that tourists are willing to spend more to enjoy recreation services in NNP,which signifies that recreation resources in NNP are slightly undervalued.In addi­tion,the findings disclosed that the largest share of tourist daily travel expenses is allocated to transportation services,and very little is paid to the park as a conservation fee.It was revealed that out of the daily travel expenses incurred by non-resident and resident tourists,only 4.62%and 2.23%are respectively paid directly to NNP as conservation fees.This study considers that allocation is not very fair;thus,NNP,in collaboration with TANAPA,needs to adjust the current entrance or conservation fee and reduce the transportation costs charged by tourist companies.The travel costs incurred by tourists,age,education,monthly income,site visited,substitute site,and quality of park were identified as significant factors in influencing tourists’WTP for recreation services in NNP.Thus,policies oriented to reduce tour­ists’transportation costs and improve the quality of national parks would attract more tourists to NNP.

Return of Chinese Tourists

South Africa on 29 March received the first group of 13 tourists from China over the past three years.The tourists,taking a flight from Air China,landed at O.R.Tambo International Airport in Johannesburg and were welcomed by people from different walks of life.

从“媒体出圈”到“价值共创”:非传统旅游城市目的地品牌生态圈塑造研究

社交媒体平台的兴起催生了“网红打卡”式新兴旅游方式,带火了一批“网红城市”。对于知名度低、传统旅游吸引物匮乏的非传统旅游城市来说,媒体“出圈”容易,却难以形成持续稳定的目的地品牌形象。基于品牌生态圈理论,通过梳理“淄博烧烤”现象的关键事件,探索从单一网红要素到目的地品牌生态圈塑造的经验模式。研究发现,非传统旅游城市品牌生态圈塑造分四个阶段:聚焦“有效治理”的品牌生态圈前期阶段、聚焦“核心IP打造”的品牌核心圈塑造阶段、聚焦“价值共创”的品牌生态圈初步形成阶段和聚焦“适应性演化能力”的城市品牌生态圈可持续发展阶段,不同阶段分别受市场契合性、感官真实性、互动参与性、多主体联动性和情感体验性因素驱动。本研究为非传统旅游城市打造从媒体出圈到目的地品牌可持续发展模式提供了有益借鉴及参考。

原发性干燥综合征合并神经系统病变患者32例临床分析

目的了解原发性干燥综合征(pSS)合并神经系统病变患者的临床特征。方法回顾分析2013年3月至2022年1月诊断为pSS合并神经系统病变的32例患者的临床资料,并进一步分析定性诊断为脱髓鞘疾病及血管性疾病患者的临床特征。结果pSS合并神经系统病变发生率11.1%(32/287),以神经系统为首发表现的有56.3%(18/32)。pSS合并神经系统病变患者临床表现多样,单纯中枢神经系统病变27例(84.4%),单纯周围神经受累2例(6.3%),中枢神经系统合并周围神经系统病变2例(6.3%),神经-肌肉接头病变1例(3.1%)。32例患者中,脱髓鞘性疾病13例,血管性疾病13例,感染性病变3例,肌紧张性头痛2例,重症肌无力1例,比较脱髓鞘性疾病、血管性疾病患者的临床指标,结果发现脱髓鞘性疾病患者外周血淋巴细胞数量、血清IgM水平均高于血管性疾病患者[1.98(1.39,2.77)×10^(9)·L^(-1) vs.1.30(1.07,1.77)×10^(9)·L^(-1),P=0.005;1.31(1.12,1.88)g/L vs.0.98(0.74,1.18)g/L,P=0.009]。结论pSS合并神经系统病变发生率不低,临床表现多样复杂,脱髓鞘疾病、血管性疾病多见,目前发病机制不明,淋巴细胞活化、免疫系统激活与泛化可能在发病、疾病演变过程中发挥作用。

嗜酸性肉芽肿性多血管炎心脏受累的临床特征分析

目的分析嗜酸性肉芽肿性血管炎(EGPA)患者心脏受累的临床特点。方法回顾性分析2005年5月至2021年12月于首都医科大学附属北京朝阳医院收治的确诊EGPA患者的临床资料,比较心脏受累组和非心脏受累组患者的差异,并随访两组的预后。结果104例EGPA患者中,男性55例,女性49例,确诊时中位年龄56(46,65)岁,其中20例(19.2%)患者ANCA阳性。心脏受累组50例(48.1%),非心脏受累组54例(51.9%)。心脏受累组中16例(32.0%)患者有心脏受累相关症状,25例(50%)心电图异常,34例(68%)心脏超声检查异常。6例行心脏增强核磁检查,5例发现心脏受累,其中2例为隐匿性心脏受累。心脏受累组中老年患者、基础疾病合并高血压病患者明显高于非心脏受累组(P<0.05)。两组之间嗜酸粒细胞计数及ANCA阳性率无明显差异(P>0.05)。平均随访中位时间41(19,59)月,6例患者死亡,均有心脏受累患者,其中3例死于心功能衰竭,另外3例分别死于脑梗死合并肺部感染、侵袭性肺曲霉菌病及肺恶性肿瘤。结论EGPA患者中心脏受累比例高,临床表现缺乏特异性。心脏MRI有利于发现隐性的心脏受累。心脏受累与嗜酸性粒细胞计数及ANCA无明显相关性。心脏受累是疾病死亡的危险因素。