New calcimimetics for secondary hyperparathyroidism in CKD G5D: do they offer advantages?

Secondary hyperparathyroidism is one of the most frequent metabolic abnormalities found in patients with chronic kidney disease. The calcium-sensing receptor senses extracellular calcium and is the principal regulator of parathyroid hormone secretion. Cloning of the calcium-sensing receptor led to the development of calcimimetics, drugs that decrease parathyroid hormone secretion through the positive allosteric modulation of this receptor. Cinacalcet was the first oral calcimimetic approved by the US Food and Drug Administration (FDA) in 2004 for the treatment of secondary hyperparathyroidism in adult patients on dialysis. Although cinacalcet has demonstrated safety and effectiveness, it has two main problems: gastrointestinal side effects that result in poor adherence, and the inhibitory action on CYP2D6 with the possibility of interactions with commonly used medications. To address the problem of oral compliance, Etelcalcetide, a small synthetic polycationic peptide IV calcimimetic was introduced in 2017. This drug showed a 10% greater decrease in serum parathyroid hormone values compared to cinacalcet but no better gastrointestinal tolerance, with greater risk of hypocalcemia. Several structural modifications were introduced in cinacalcet to produce a new compound called evocalcet. This drug, which was introduced in Japan in 2018, has considerably enhanced bioavailability and decreased both the inhibitory effect on CYP2D6 and half of the gastrointestinal side effects of cinacalcet. Finally, a novel non-peptidic injectable calcimimetic agent, upacicalcet, became available in Japan in 2021. This agent has greater clearance by hemodialysis and shows no effect on gastric emptying. More studies are needed comparing the old calcimimetics to the new ones to establish their future role in the treatment of secondary hyperparathyroidism in chronic kidney disease (CKD) G5D.

The influence of positivity and self-efficacy beliefs on family functioning among young adults in Italy and Colombia.

Background: Research suggests that positivity and self-efficacy beliefs may impact adaptive behavior and developmental outcomes, such as social adjustment and subjective wellbeing. The present study explored the effect of positive dimensions (positivity and self-efficacy beliefs) and individual characteristics (gender, type of country, age, and sexual orientation) on family cohesion and flexibility in a group of Colombian and Italian young adults. Method: An online survey was administered to 949 Colombian and 2,073 Italian people aged between 18 and 40 years (M age = 24.3; SDage = 4.5; 67% women). A mediational model was performed to test the influence of positivity on family functioning via the mediational role of self-efficacy beliefs, analyzing the moderated effects of gender, type of country, sexual orientation, and age. Results: Filial self-efficacy mediated the effect of positivity on family functioning, showing stronger paths in men and Colombian participants than in women and Italian counterparts. Regulatory self-efficacy mediated the associations between positivity and family functioning for both genders and types of countries. Conclusion: The results suggest that positivity and self-efficacy beliefs may allow families to engage in more adaptive family functioning across countries and genders. Further research should focus on implications from a cross-national perspective to examine other culture-specific factors that may impact family adjustment.

Perceived Emotional Self-Efficacy and Life Satisfaction of Elementary School Children on the US-Mexico Border.

Objectives. It has been established that an adult's perceived ability to effectively address negative emotions predicts their life satisfaction. To increase the understanding of ethnic minority children's mental health and quality of life, this study examined the relationship between perceived emotional self-efficacy and life satisfaction of Hispanic children. Methods. Using the nonexperimental-correlational research design and the convenience sampling method, a total of 176 fourth-, fifth-, and sixth-grade students (73 boys, 103 girls; 88% Hispanic) in one public elementary school on the US-Mexico border were recruited to participate in this study. Emotional self-efficacy was measured using the emotional subscale of the Self-Efficacy Questionnaire for Children and subjective well-being was measured using the Student Life Satisfaction Scale. Spearman correlation and ordinal regression analyses were used to test the study hypotheses. Results. Consistent with findings from the current literature, emotional self-efficacy was positively associated with subjective well-being. Children in lower elementary grades were more likely to report higher emotional self-efficacy than those in higher elementary grades. Boys were more likely to report higher life satisfaction than girls. Conclusions and Relevance. Using a sample of elementary school children with Hispanic backgrounds on the US-Mexico border, this study attested to the empirical link between emotional self-efficacy and life satisfaction. Our study findings stress the importance of early identification of students with low emotional self-efficacious beliefs and the early introduction of social-emotional learning programs in elementary schools to enhance students' emotional self-efficacy. This study contributes to positive psychology literature and provides insights for future school-based mental health practice and research.

Interaction effect of self-efficacy and joint problems on hearing aid abandonment among older adults.

OBJECTIVE: We assessed the interaction between self-efficacy and joint problems and self-efficacy and visual problems on the risk of hearing aid abandonment in older adults. DESIGN: A retrospective cohort study comprising older adults who received hearing aids in Chile was conducted. Hearing aid self-efficacy was measured using the S-MARS-HA questionnaire, while joint and visual problems were assessed through self-reported questions. Survival regression models were conducted to investigate the interaction between self-efficacy and joint problems, as well as self-efficacy and visual problems. STUDY SAMPLE: The study included 355 older adults who received hearing aids through the Chilean public health sector. RESULTS: A significant interaction effect indicated that the relationship between self-efficacy and the risk abandonment was influenced by joint problems (p < 0.05). In the subpopulation with joint problems, self-efficacy was associated with a reduced risk of hearing aid abandonment (HR = 0.81), whereas in the subpopulation without joint problems, the protective effect was more pronounced (HR = 0.52). The interaction between self-efficacy and visual problems was not significant. CONCLUSIONS: The interaction between self-efficacy and joint problems was associated with the risk of abandonment. Addressing limitations associated with joint problems and individuals' confidence in using their hearing aids could reduce the abandonment.

Efficacy of prophylactic antibiotics in the adjuvant treatment of alcohol-related liver disease (ALD): A systematic review and meta-analysisProphylactic antibiotics in ALD.

INTRODUCTION AND OBJECTIVES: This research aims to evaluate the efficacy and safety of prophylactic antibiotics in patients with alcohol-related liver disease (ALD). MATERIALS AND METHODS: We systematically searched databases including PubMed, Embase, Cochrane, and Web of Science up to October 2023. Our scope encompassed the influence of prophylactic antibiotics on all-cause mortality, infection, variceal bleeding, hepatic encephalopathy (HE), hepatorenal syndrome (HRS), adverse events (AE), fungal infection, clostridioides difficile infection (CDI), and multidrug-resistant (MDR) bacterial infection. Additionally, total bilirubin, creatinine, platelet counts, and plasma endotoxin levels were also analyzed. RESULTS: After comprehensive selection, 10 studies with 974 participants were included for further analysis. The study demonstrated that prophylactic antibiotic therapy was associated with reductions in infection rates, HE incidence, variceal bleeding, and all-cause mortality. The treatment did not increase the incidence of AE, fungal infection, and CDI, but it did raise the MDR bacteria infection rate. The analysis revealed no significant protective effect of antibiotic prophylaxis on total bilirubin and creatinine levels. Furthermore, the administration of antibiotics led to marginal increases in platelet counts, a minor reduction in endotoxin concentrations, and a subtle enhancement in HRS; however, these changes did not reach statistical significance. CONCLUSIONS: Prophylactic antibiotic therapy was an effective and safe treatment for advanced ALD. To mitigate the risk of MDR bacterial infections, a strategy of selective intestinal decontamination could be advisable. Future investigations should prioritize varied ALD patient populations with extended follow-up periods and assorted antibiotic regimens to solidify the efficacy and safety of ALD treatments.

Parental Self-Efficacy and Personal Time Help Explain Impact of Parent-Staff Interactions on Parental Distress and Bonding in the Neonatal Intensive Care Unit.

OBJECTIVES: To identify factors that help explain associations between parent-staff interactions and: (1) parental depression, anxiety, and post-traumatic stress; and (2) parent-child bonding in the neonatal intensive care unit. STUDY DESIGN: Our cross-sectional mixed methods survey investigated the ways in which parental-staff interactions relate to parental distress and parent-child bonding. Parents with babies in the neonatal intensive care unit (n = 165) completed validated measures and open-ended questions about their experiences with staff. Using a sequential explanatory approach, we examined: (1) whether and how parental self-efficacy and personal time mediated parent-staff interactions on distress and bonding; and (2) parental written accounts of experiences with staff. RESULTS: Multiple mediation analyses revealed that parent-staff interactions exhibited an: (1) indirect effect on parental depression (b = -0.05, SE = 0.02, CI [-0.10, -0.01]), anxiety (b = -0.08, SE = 0.04, CI [-0.16, -0.02]), and parent-child bonding (b = -0.26, SE = 0.08, CI [-0.43, -0.11]) through parental self-efficacy; and (2) indirect effect on parental post-traumatic stress (b = -0.08, SE = 0.04, CI [-0.17, -0.00], completely standardized indirect effect = -0.06) through parental personal time. Thematic analyses revealed that emotional and instructional support from staff helped build parental self-efficacy. Trust with staff helped parents feel comfortable leaving the bedside and engage in basic needs (eg, eat, sleep). CONCLUSIONS: Family-staff dynamics are the foundation for high quality family-centered care. Staff who empower parents to participate in care, engage in parenting tasks, and take care of themselves may reduce their distress and improve relationships among staff, parents, and babies.

Laboratory and physiological aspects of substitute metazoan models for in vivo pharmacotoxicological analysis.

New methods are essential to characterize the performance of substitute procedures for detecting therapeutic action(s) of a chemical or key signal of toxicological events. Herein, it was discussed the applications and advantages of using arthropods, worms, and fishes in pharmacological and/or toxicology assessments. First of all, the illusion of similarity covers many differences between humans and mice, remarkably about liver injury and metabolism of xenobiotics. Using invertebrates, especially earthworms (Eisenia fetida), brine shrimps (Artemia salina, Daphnia magna), and insects (Drosophila melanogaster) and vertebrates as small fishes (Oryzias latipes, Pimephales promelas, Danio rerio) has countless advantages, including fewer ethical conflicts, short life cycle, high reproduction rate, simpler to handle, and less complex anatomy. They can be used to find contaminants in organic matters and water and are easier genetically engineered with orthologous-mutated genes to explore specific proteins involved in proliferative and hormonal disturbances, chemotherapy multidrug resistance, and carcinogenicity. As multicellular embryos, larvae, and mature organisms, they can be tested in bigger-sized replication platforms with 24-, 96-, or 384-multiwell plates as cheaper and faster ways to select hit compounds from drug-like libraries to predict acute, subacute or chronic toxicity, pharmacokinetics, and efficacy parameters of pharmaceutical, cosmetic, and personal care products. Meanwhile, sublethal exposures are designed to identify changes in reproduction, body weight, DNA damages, oxidation, and immune defense responses in earthworms and zebrafishes, and swimming behaviors in A. salina and D. rerio. Behavioral parameters also give specificities on sublethal effects that would not be detected in zebrafishes by OECD protocols.

Effectiveness of Lemon Verbena (Cymbopogon citratus) in Oral Candidiasis: A Systematic Review.

The rise of phytotherapy has enabled the utilization of various plant species for medicinal purposes, such as Cymbopogon citratus (C. citratus), providing solutions for oral pathologies, such as oral candidiasis. The PubMed, Web of Science, Scopus, and SciELO databases were searched. In vivo and in vitro studies on the action of C. citratus against oral candidiasis were included, and ROBINS-I was used to determine study quality and risk of bias. The search yielded 1922 articles, of which 10 met the inclusion criteria. Limited scientific evidence exists regarding the use of C. citratus for oral candidiasis. However, studies have indicated its potent antifungal effects. Further studies, preferably clinical trials, are necessary to confirm this effect and to enable its clinical use as a therapeutic option.

Fulvestrant en la práctica clínica: análisis de efectividad en pacientes uruguayas con cáncer de mama HR+/HER2. / Fulvestrant in clinical practice: Effectiveness analysis in Uruguayan patients with HR+/HER2- breast cancer.

Introduction: Fulvestrant demonstrated benefits in overall survival and progression-free survival in patients with advanced breast cancer, who are hormone receptor-positive and human epidermal growth factor receptor 2 negative. The characteristics, evolution, and survival of patients with hormone receptor-positive, HER2-negative breast cancer treated with fulvestrant were evaluated according to the national treatment coverage protocols of the National Resources Fund, with the aim of understanding the efficacy of fulvestrant in patients treated in usual clinical practice and comparing our results with those from pivotal studies. Methods: A database from the National Resources Fund covering the period from 2009 to 2022 was used. Survival curves were assessed using the Kaplan-Meier method, and differences were analyzed using the Log-Rank test. Results: A total of 1085 patients with an average age of 63,66 years were included. Following a follow-up of 14 months, the median overall survival was 16 months, and the median progression-free survival was 6 months. The presence of liver and bone metastases was associated with a shorter overall survival. Patients from the public sector and those with a better performance status experienced longer overall survival. Conclusions: Our findings provide a valuable perspective for treatment management in a context of limited resources. Overall survival and progression-free survival were somewhat lower than those reported in pivotal clinical trials. The presence of liver and bone metastases was associated with worse prognosis and survival; additionally, patients with worse performance status had shorter overall survival. These findings underscore the need for personalized therapies, opening new lines of future research.

Introducción: Fulvestrant demostró beneficio en sobrevida global y sobrevida libre de progresión en pacientes con cáncer de mama avanzado, con receptores hormonales positivos y receptor de factor de crecimiento epidérmico humano 2 negativo. Se evaluaron las características, la evolución y la sobrevida de pacientes con cáncer de mama receptor hormonal positivo, HER2 negativo, tratadas con fulvestrant, de acuerdo con los protocolos nacionales de cobertura de tratamiento del Fondo Nacional de Recursos. Su objetivo fue conocer la eficacia de fulvestrant en pacientes tratados en la práctica clínica habitual. Se compararon los resultados obtenidos en el presente trabajo con los resultados de los estudios pivotales. Métodos: Se utilizó la base de datos del Fondo Nacional de Recursos, que abarca el período de 2009 a 2022. La evaluación de las curvas de sobrevida se realizó mediante el método Kaplan-Meier y las diferencias se analizaron utilizando el test de Log-Rank. Resultados: Se incluyeron 1085 pacientes con una edad media de 63,66 años. Tras un seguimiento de 14 meses, la mediana de la sobrevida global fue de 16 meses y la de la sobrevida libre de progresión de 6 meses. La presencia de metástasis hepáticas y óseas se asoció con una menor sobrevida global. Los pacientes del sector público y aquellos con una mejor escala de estado funcional experimentaron una mayor sobrevida global. Conclusiones: Los resultados obtenidos ofrecen una perspectiva valiosa para la gestión de tratamientos en un contexto de recursos limitados. La sobrevida global y la sobrevida libre de progresión fueron algo inferiores a los reportados en los ensayos clínicos pivotales. La presencia de metástasis hepáticas y óseas se asoció a un peor pronóstico y una peor sobrevida. Además, los pacientes con peor escala de estado funcional tuvieron una menor sobrevida global. Estos hallazgos subrayan la necesidad de terapias personalizadas, abriendo nuevas líneas de investigación futura.

Clinical Validation of the Nursing Diagnosis 'Inadequate Health Self-Efficacy' in People With Hypertension.

AIMS: To test the clinical validity of clinical indicators and causal relationships of aetiological factors of the new nursing diagnosis of inadequate health self-efficacy in people with hypertension. BACKGROUND: The diagnosis of inadequate health self-efficacy has both theoretical and content validity. However, a clinical validation study is needed to establish an appropriate framework for distinguishing individuals who manifest this unique human response. DESIGN: The study adopts a cross-sectional clinical validation approach, adhering strictly to the STROBE guidelines throughout its design and implementation. METHODS: Naturalistic sampling was used to identify 302 adults diagnosed with hypertension. Their data were subjected to latent class analysis, which facilitated the identification of a comprehensive set of clinical indicators that demonstrated better diagnostic accuracy and established posterior probabilities to guide the inference of inadequate health self-efficacy. In addition, logistic regression analysis was used to assess the magnitude of the impact of aetiological factors. RESULTS: The prevalence of inadequate health self-efficacy was 76.61%. Among the 13 indicators examined, seven demonstrated notable sensitivity: 'risk-prone health behaviour', 'failure to take action that prevents health problems', 'inadequate self-control', 'avoidance behaviours', 'negative health self-perception', 'inadequate health-related quality of life' and 'difficulty feeling good about adopting a healthy lifestyle'. Additionally, two indicators showed high specificity: 'difficulty feeling good about adopting a healthy lifestyle' and 'inadequate adherence to treatment regimen'. Notably, 15 aetiological factors were identified as significantly associated with an increased risk of inadequate health self-efficacy. CONCLUSIONS: A clinical framework consisting of eight clinical indicators and 15 aetiological factors was developed to characterise inadequate health self-efficacy in individuals with hypertension. RELEVANCE TO PRACTICE: Clinical validation provides insight into the precision of clinical indicators and the magnitude of the effect of putative causal elements, thereby facilitating identification and tailored intervention for individuals with hypertension and inadequate health self-efficacy.

The efficacy and safety of neoadjuvant immunochemotherapy in resectable stage I-III non-small cell lung cancer: a systematic review and network meta-analysis.

BACKGROUND: Neoadjuvant immunochemotherapy (NICT) is a new treatment method for resectable non-small-cell lung cancer (NSCLC). Network meta-analysis assessed efficacy, safety, and optimal treatment. METHODS: We searched for randomized controlled trials (RCTs) comparing NICT with neoadjuvant chemotherapy (NCT) in PubMed, Embase, Web of Science, Cochrane Library, and international conferences. Outcomes were surgical resection rate, pathological complete response(pCR),event-free survival (EFS), and Grade 3-5 treatment-related adverse events (TRAEs). RESULTS: RCTs of 3,387 patients, six treatment combinations, and two modalities were included. Meta-analysis showed that NICT yielded higher pCR and EFS rates than NCT. The toripalimab-chemotherapy combination had the highest surgical resection rate (OR = 1.68, 95% CI: 1.05-2.73), pCR (OR = 38.84, 95% CI: 11.05-268.19) and EFS (HR = 0.40, 95% CI: 0.28-0.58).This regimen worked well for patients with low programmed death-ligand 1 (PD-L1) expression or squamous cell pathology. For high PD-L1 expression and patients with NSCLC, neoadjuvant nivolumab with chemotherapy had the most efficacy. The incidence of treatment-related adverse events increased with longer treatment cycles, with perioperative nivolumab combined with chemotherapy showing the worst safety profile (RR = 1.32, 95% CI: 1.00-1.76), while neoadjuvant nivolumab combined with chemotherapy alone had the best safety profile (RR = 0.91, 95% CI: 0.68-1.21). Indirect comparison showed no survival benefit for neoadjuvant-adjuvant immunotherapy (HR = 0.93, 95% CI: 0.65-1.35). In the indirect comparison between the two immune checkpoint inhibitors(ICIs), although there was no significant difference in EFS (HR = 0.81, 95% CI: 0.61-1.08), PD-1 inhibitors may still be the most effective treatment option. CONCLUSIONS: NICT effectively and safely treats resectable NSCLC. The optimal treatment combination is typically toripalimab and chemotherapy. Treatment based on PD-L1 expression and pathological type is recommended.

Unravelling the differences between observation and active participation in simulation-based education.

BACKGROUND: In simulation-based education, the effectiveness of observation or active participation on the retention of knowledge and skills is uncertain. The aim of the study was to investigate knowledge retention, technical and non-technical skills and self-efficacy among observers and active participants in a simulated palliative extubation. METHOD: We included medical and nursing undergraduates and residents. On the first day, participants were divided into observers and active participants, each with one participant from medical and nursing backgrounds. We presented a recorded lecture, followed by knowledge and self-efficacy tests for all participants before and after the simulation. After fourteen days, both groups actively participated in the scenario, without observers. We assessed technical and non-technical skills during the simulation and repeated the knowledge and self-efficacy tests after the training. RESULTS: Forty-four individuals participated in this study, half from each training programme. Knowledge improved after the first training in both groups, with a significant drop only for active participants after 14 days. Self-efficacy increased in both groups, being higher for the active participants. After 14 days, active participants performed better in technical skills compared to observers, but it was similar in both groups for non-technical skills. CONCLUSIONS: Active participation seems superior to observation in the development of self-efficacy and the retention of technical skills. Observation may be superior to active participation in knowledge retention. Retention of non-technical skills appears to be similar with both observation and active participation. The findings have important implications for current simulation-based education, but further research is recommended.

Efficacy and safety of camrelizumab combined with chemotherapy in the treatment of advanced biliary malignancy and associations between peripheral blood lymphocyte subsets and clinical outcomes.

BACKGROUND: Biliary tract cancer (BTC) is a highly heterogeneous aggressive tumor, and advanced patients have poor prognosis. This work aimed to evaluate the efficacy and safety of camrelizumab combined with chemotherapy in treating advanced BTC, and to explore predictive biomarkers for distinguishing effective population. METHODS: 183 advanced BTC patients admitted from September 2018 to September 2021 were retrospectively selected. 93 patients were treated with camrelizumab combined with chemotherapy (C+C group) and 90 patients were treated with chemotherapy alone (C group). Objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), and median overall survival (mOS) were analyzed between two groups. Peripheral blood lymphocyte subsets were assessed by flow cytometry pre- and post-treatment. RESULTS: The mPFS (6.9 months) and mOS (12.1 months) in the C+C group were significantly longer than those in the C group, which were 5.2 months and 9.8 months respectively (HR 0.46, 95% CI 0.38-0.54, p=0.017; HR 0.39, 95% CI 0.32-0.47, p=0.033). The percentage of Total T, CD4+T, natural killer (NK) cells, lymphocyte, and CD4+/CD8+ cell ratios were significantly increased in effective patients after C+C treatment, but didn't increase in progressive disease (PD) patients. Higher percentage of Total T, CD4+T, and higher CD4+/CD8+ cell ratios post-treatment were associated with longer OS. CONCLUSIONS: Camrelizumab combining chemotherapy significantly prolonged the mPFS and mOS of advanced BTC patients. Immunotherapy may improve the immune status of advanced patients, and immunotherapy efficacy might be predicted based on the peripheral blood lymphocyte subsets.

Educational Intervention to Promote Parent/Caregiver Self-Efficacy in the Management and Control of Childhood Asthma: A Randomized Clinical Trial.

BACKGROUND: Asthma is a leading cause of pediatric hospitalization and morbidity, necessitating the development of educational interventions for its management and control. OBJECTIVE: To evaluate the effectiveness of an educational intervention in promoting parent/caregiver self-efficacy in the management and control of their children's asthma. METHODS: A clinical trial was conducted in Fortaleza, Ceará, Brazil, involving two randomized groups of parents/caregivers of children: the comparison group (CG) (n = 42) and the intervention group (IG) (n = 42). Data collection took place in two phases: the first included face-to-face sessions followed by the educational intervention in the IG, and the second included telephone follow-up. The educational intervention included the use of an educational booklet and a brief motivational interview. RESULTS: The groups were homogeneous at baseline. After the intervention, the mean self-efficacy scores of the IG were significantly higher than those of the CG (p < 0.05), and children whose parents/caregivers were in the CG were 1.43 times more likely to experience an asthma crisis than those in the IG. CONCLUSIONS: The educational intervention proved effective in increasing parent/caregiver self-efficacy in asthma management and control. Furthermore, children whose parents/caregivers did not receive the educational intervention were more likely to experience an asthma crisis.

Design, development and preclinical assessment of MENAVip-ICP, a new snake antivenom with potential coverage of species in the Middle East and North Africa regions.

Snakebite in the Middle East and North Africa (MENA) is a public health problem whose magnitude is not fully known. Several antivenoms are available in these regions, but these formulations are designed for restricted geographical settings. Many countries do not have local production of antivenoms and must access products whose clinical performance has not been demonstrated. We hypothesize that it is possible to unify the treatment for viperid snakebites of MENA in a single antivenom formulation. Hereby we describe the design, development and preclinical evaluation of an antivenom of broad geographical coverage for this region (MENAVip-ICP). We produced this antivenom from the plasma of horses immunized with eight medically important venoms of viperid snake species from MENA. For this, we used a strategy based on two stages: first, immunization of horses with North African (NA) venoms, followed by a second immunization stage, on the same horses, with MENA venoms. We purified antivenoms from both stages: the Anti-NA and the final product Anti-MENA (MENAVip-ICP). Anti-NA was considered as intermediate formulation and was purified with the intention to study the progression of the immunoglobulin immune response of the horses. Antivenoms from both stages neutralized lethal, hemorrhagic, and procoagulant activities of homologous venoms. Compared to Anti-NA, MENAVip-ICP improved the neutralization profile of intravenous lethality and in vitro procoagulant activities of venoms. A notable finding was the difference in the neutralization of lethality when MENAVip-ICP was assessed intraperitoneally versus intravenously in the murine model. Intraperitoneally, MENAVip-ICP appears more effective in neutralizing the lethality of all venoms. Furthermore, MENAVip-ICP neutralized the lethal activity of venoms of species from other regions of MENA, Central/East Asia, and Sub-Saharan Africa that were not included in the immunization protocol. Our results showed that MENAVip-ICP neutralizes the main toxic activities induced by viperid MENA venoms at the preclinical level. Consequently, it is a promising product that could be clinically assessed for the treatment of snakebite envenomings in this region.

Mediating role of digital skills and mobile self-efficacy in the stress and academic engagement of Peruvian university students in postpandemic virtual environments.

BACKGROUND: Remote education emerged as an option during the COVID-19 pandemic; however, this modality continues to be used by various universities around the world in the postpandemic context. The aim of this study was to determine the mediating role of digital skills and mobile self-efficacy in the influence of stress on the academic engagement of Peruvian university students during remote teaching by COVID-19 using structural equation modeling (SEM). METHOD: This study involved 1,468 students from nine public and private universities in northern Peru who had undergraduate and graduate distance learning programs. RESULTS: The results showed that stress negatively influenced academic engagement (ß=-0.107*) and digital skills (ß=-0.328***). In addition, digital skills (ß = 0.470**) and mobile self-efficacy (ß = 0.684***) positively influence academic engagement. Similarly, digital skills mediate the relationship between stress and academic engagement (ß=-0.154**), and both variables act as sequential mediators in this relationship (ß=-0.348***). CONCLUSION: This study provides a deeper understanding of the factors that influence academic engagement during Remote education and lays the groundwork for the development of interventions and training programs tailored to hybrid learning contexts that promote the well-being and academic success of college students in postpandemic times.

Validity and reliability of the Chinese version of human-robot interaction self-efficacy scale in Chinese adults.

BACKGROUND: With the fast-paced advancements of robot technology, human-robot interaction (HRI) has become increasingly popular and complex, and self-efficacy in HRI has received extensive attention. Despite its popularity, this topic remains understudied in China. OBJECTIVE: In order to provide a psychometrically sound instrument in China, this study aimed to translate and validate the Self-Efficacy in Human-Robot Interaction Scale (SE-HRI) in two Chinese adult samples (N1 = 300, N2 = 500). METHODS: The data was analyzed by SPSS 26.0 and Amos 24.0. Item analysis and exploratory factor analysis were conducted using Sample 1 data. Confirmatory factor analysis, criterion-related validity analysis, and reliability analysis were then performed using Sample 2 data. RESULTS: The results revealed that the Chinese SE-HRI scale consisted of 13 items in a two-factor model, suggesting a good model fit. Moreover, general self-efficacy and willingness to accept the use of artificial intelligence (AI) were both positively correlated with self-efficacy in HRI, while negative attitudes toward robots showed an inverse correlation, proving the Chinese SE-HRI scale exhibited excellent criterion-related validity. CONCLUSION: The Chinese SE-HRI scale is a reliable assessment tool for evaluating self-efficacy in HRI in China. The study discussed implications and limitations, and suggested future directions.

[Perceived self-efficacy scale on shared care planning (ACP-SEs) Argentina]. / Escala autoeficacia percibida sobre planificación compartida de la atención (ACP-SEs) Argentina.

INTRODUCTION: Shared care planning (ACP) is a reflective, deliberative and structured process involving the sick person and his or her caring environment. Health professionals recognize barriers to initiating ACP.Perceived self-efficacy is one of the main predictors of success in learning processes. OBJECTIVES: 1) To crossculturally adapt the ACP self-efficacy scale in Spanish for Argentina (ACP-SEs); 2) To explore the reliability and validity of the scale; and 3) To explore self-efficacy in ACP in Argentinean professionals. METHOD: Exploratory instrumental study carried out on health professionals who assist patients with advanced chronic diseases, interdisciplinary through a comprehension test of the ACP-SEs instrument and psychometric validation in a purposive sample of professionals. Sociodemographic variables and previous experience were analyzed. RESULTS: After the comprehension test and linguistic adaptation of the scale through cognitive testing with eight professionals with experience with advanced chronic patients, the ACP-SEs Ar version of the scale was achieved. 236 professionals participated in the exploration, 83% attended patients with advanced chronic disease, 52.9 % were physicians, 52% received informal training in ACP, and 11% had a personal advance directive document. The scale's internal consistency was high (Cronbach's alpha = 0.89). Questions about prognosis, treatment options, goals, treatment preferences, and reassessment of goals of care showed significant differences between physicians and nonphysicians. CONCLUSION: We explored PCA self-efficacy in health professionals with the ACP-SEs Ar scale validated for the first time in Argentina.

Introducción: La planificación compartida de la atención (PCA) es un proceso reflexivo, deliberativo y estructurado. Involucra a la persona enferma y su entorno afectivo. Los profesionales sanitarios reconocen barreras para iniciar la PCA. La autoeficacia percibida es un principal predictor del éxito en los procesos de aprendizaje. Objetivos: 1) Adaptar transculturalmente la escala de autoeficacia percibida en PCA en español para Argentina (ACP-SEs); 2) Explorar la confiabilidad y la validez de la escala y 3) Explorar la autoeficacia en PCA en profesionales argentinos. Métodos: Estudio instrumental exploratorio realizado a profesionales de la salud que asisten pacientes con enfermedades crónicas avanzadas, interdisciplinarios, a través de una prueba de comprensión del instrumento ACP-SEs y la validación psicométrica en una muestra intencional de profesionales. Se analizaron variables sociodemográficas y la experiencia previa. Resultados: Luego de la prueba de comprensión y adaptación lingüística de la escala a través de un test cognitivo con 8 profesionales con experiencia con pacientes crónicos avanzados se logró la versión de la escala ACP-SEs Ar. Participaron en la exploración 236 profesionales, el 83% asistía pacientes con enfermedad crónica avanzada; el 52.9% médicos; 52% recibió formación informal en PCA y 11% tenía un documento de directivas anticipadas personal. La consistencia interna de la escala fue alta (alfa de Cronbach = 0.89). Las preguntas sobre pronóstico, objetivos y preferencias de tratamiento, y reevaluación de los objetivos de cuidados mostraron diferencias significativas entre médicos y no médicos. Conclusión: La escala ACP-SEs Ar demostró propiedades psicométricas adecuadas.

Assessment of the psychometric properties of the traditional Chinese version of the cancer survivors' self-efficacy scale.

BACKGROUND: The reliability and validity of the traditional Chinese version of the Cancer Survivors' Self-Efficacy Scale (CS-SES-TC) has not been assessed. OBJECTIVE: To assess the psychometric properties of the Traditional Chinese version of the CS-SES-TC. METHODS: Participants were recruited from the outpatient departments of a hospital in Taiwan. A single questionnaire was administered to 300 genitourinary cancer survivors. The scales included in the initial questionnaire were the CS-SES-TC, the General Self-Efficacy Scale, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Functional Assessment of Cancer Therapy-General scale (FACT-G). Data obtained from 300 survivors were used to confirm the structure through confirmatory factor analysis (CFA). RESULTS: The CFA results indicate that the 11-item CS-SES-TC is consistent with the original scale. Furthermore, it was identified as a unidimensional scale, with the model showing acceptable goodness-of-fit (CFI = 0.99, TLI = 0.97). The factor loading of each item in the CS-SES-TC was above 0.6 and had convergent validity. Based on multiple-group CFA testing, the change (ΔCFI) between the unconstrained and constrained models was ≤ 0.01, indicating that measurement invariance holds for gender. The participants' CS-SES-TC scores were positively correlated with their FACT-G scores and negatively correlated with their CES-D scores. The scales exhibited concurrent validity and discriminant validity. The CS-SES-TC had a Cronbach's α in the range of .97-.98. CONCLUSION: The CS-SES-TC had acceptable reliability and validity. Healthcare workers can use this scale for ongoing assessment of the cancer-related self-efficacy of cancer survivors.

Relationships between Resilience and Self-Efficacy in the Prosocial Behavior of Chilean Elementary School Teachers.

Teachers' actions go beyond instruction, as their personal traits influence their teaching methods, problem-solving skills, and the quality of their relationships with students. Among these attributes, their prosocial competencies stand out for contributing to school, community, and social coexistence. Furthermore, the connection they have to resilience and self-efficacy promotes increased effectiveness in meeting the demands of an ever-more challenging work environment. This research aimed to analyze the effect of the relationship between self-efficacy and resilience on the prosocial behavior of Chilean elementary school teachers. The sample consisted of 1426 teachers (77.2% women) working in public and subsidized Chilean schools. Structural equation modeling (SEM) explored the relationships between self-efficacy, resilience, and prosocial behavior. The findings indicate that self-efficacy and resilience directly and positively affect the prosocial behavior of elementary school teachers. It is suggested that resilience, self-efficacy, and prosociality among teachers are promoted due to their synergistic effects and, consequently, the benefits for school children, especially those from vulnerable social contexts.