Educational interventions for imposter phenomenon in healthcare: a scoping review.

BACKGROUND: Imposter Phenomenon (IP) is a subjective feeling of intellectual fraudulence and self-doubt experienced by individuals in goal-orientated high-achieving professions. The impact of IP within healthcare has been associated with individual physical and mental health and concerns around training, career progression and DEI at an institutional level. To effectively address IP in healthcare, this scoping review aims to explore educational interventions designed to empower high-achieving individuals with the tools needed to confront and overcome IP. METHODS: The scoping review adhered to a predetermined protocol informed by the JBI methodology and PRISMA-ScR guidelines in order to identify educational interventions addressing IP in high-achieving industries. Articles were searched across multiple databases, including MEDLINE (Ovid), PsychINFO, SCOPUS, and Web of Science, alongside grey literature, without imposing any time constraints. A systematic approach including a thematic analysis allowed for a nuanced exploration and interpretation of the identified educational interventions and their impact on addressing IP. RESULTS: Seventeen articles were incorporated into the review, with the majority originating from the USA and majority being published since 2020. Ten studies targeted healthcare professionals, undergraduate and postgraduate healthcare students. Majority of studies aimed at addressing IP, featured a larger number of female participants than males. Workshops with self-reflection and group-guided exercises to overcome IP were the most popular educational interventions. Coaching and structured supervision were also suggested. Across all papers, three themes emerged for coping strategies: individual, peer-to-peer, and institutional. CONCLUSIONS: This scoping review suggests how group and individual interventions such as workshops, small group discussions and coaching can be used to overcome IP in healthcare. Institutional changes like diversity promotion, supervisor education, and support networks are crucial in addressing IP. Further long term and speciality specific assessments are needed to measure impact. Overall, the review highlights how educational awareness and a variety of strategies can be implemented to create a supportive environment for professionals dealing with IP, promoting their well-being and success.

Root Canal Treatment Survival Analysis in National Dental PBRN Practices.

Few studies have examined the longevity of endodontically treated teeth in nonacademic clinical settings where most of the population receives its care. This study aimed to quantify the longevity of teeth treated endodontically in general dentistry practices and test the hypothesis that longevity significantly differed by the patient's age, gender, dental insurance, geographic region, and placement of a crown and/or other restoration soon after root canal treatment (RCT). This retrospective study used deidentified data of patients who underwent RCT of permanent teeth through October 2015 in 99 general dentistry practices in the National Dental Practice-Based Research Network (Network). The data set included 46,702 patients and 71,283 RCT permanent teeth. The Kaplan-Meier (product limit) estimator was performed to estimate survival rate after the first RCT performed on a specific tooth. The Cox proportional hazards model was done to account for patient- and tooth-specific covariates. The overall median survival time was 11.1 y; 26% of RCT teeth survived beyond 20 y. Tooth type, presence of dental insurance any time during dental care, placement of crown and/or receiving a filling soon after RCT, and Network region were significant predictors of survival time (P < 0.0001). Gender and age were not statistically significant predictors in univariable analysis, but in multivariable analyses, gender was significant after accounting for other variables. This study of Network practices geographically distributed across the United States observed shorter longevity of endodontically treated permanent teeth than in previous community-based studies. Also, having a crown placed following an RCT was associated with 5.3 y longer median survival time. Teeth that received a filling soon after the RCT before the crown was placed had a median survival time of 20.1 y compared to RCT teeth with only a crown (11.4 y), only a filling (11.2 y), or no filling and no crown (6.5 y).

Allergic rhinitis: diagnosis and management.

Allergic rhinitis affects 20% of the population of the UK. It confers a significant health burden upon the individual as it affects the patient's quality of life and is associated with serious comorbidities including asthma, sinusitis and conjunctivitis. Owing to its prevalence, it has a significant economic impact through its effects on education, productivity and use of healthcare resources. This review focuses on the management of allergic rhinitis and potential future treatments, because of the lack of clear national guidelines and because this illness is often misdiagnosed and mismanaged. The article provides a comprehensive overview of allergic rhinitis and illustrates the assessment criteria for various subcategories.

Sustainable effect of a symbiotic nitrogen-fixing bacterium Sinorhizobium meliloti on nodulation and photosynthetic traits of four leguminous plants under low moisture stress environment.

Sustainable effect of a nitrogen-fixing bacterium Sinorhizobium meliloti on nodulation and photosynthetic traits (phenomenological fluxes) in four leguminous plants species under low moisture stress (20-25% soil moisture content) environment was studied. Sinorhizobium meliloti was isolated from fenugreek (Trigonella foenum-graecum) root nodules, and later, it was cultured and purified. Nodulation and photosynthetic ability in the presence of S. meliloti were tested in four leguminous plant species, that is, kidney bean (cv. lobia-2000), black bean (cv. NM-97), mung bean (cv. NM-2006) and chickpea (cv. Pb-2008). Plants of each species were grown in sterilized soil that was previously treated with 25 ml suspension containing S. meliloti at 41 × 106  CFU ml-1  kg-1 pot. One-month-old plants were subjected to low soil moisture stress conditions for 15 days, and soil moisture contents were maintained to 20-25% throughout the experimental period. The ability to fix nitrogen, nodule formation, and their subsequent effect on phenomenological fluxes in low moisture treated legumes were studied.

Synergic effects of cancer stem cells markers, CD44 and embryonic stem cell transcription factor Nanog, on bladder cancer prognosis.

Background: Therapy that targets cancer stem cells has the potential to eradicate cancer and prevent tumour recurrence. Therefore, we hypothesized the combined prognostic significance of stem cell markers CD44 (prevalent in basal layer of urothelial carcinoma) and Nanog (embryonic stem cell transcription factor) in bladder cancer.Material and Methods: CD44 and Nanog expression were determined by immunohistochemistry in 112 bladder cancer cases of which 79 were non-muscle invasive and 33 muscle invasive.Results: A significant correlation was found between CD44 and Nanog expression (r = 0.41, p < 0.001). The bladder cancer patients with high CD44 and Nanog expression had poor recurrence-free survival and poor overall survival (all p < 0.01). Multivariate Cox regression analysis identified lymph node positivity (hazard ratio; HR 3.81, 95% confidence interval; CI 1.66-8.75), CD44 (HR/95%CI 7.03 [3.04-16.22]) and Nanog (HR/95%CI 2.89 [1.23-6.77]) as independent prognostic biomarkers for recurrence-free survival, whilst a combined index of CD44 and Nanog expression (high expression group; HR/95%CI 25.45 [6.71-96.50] for recurrence-free survival) and lymph node positivity (HR/95%CI 3.68 [1.63-8.33] for recurrence-free survival) were independent prognostic biomarkers for recurrence-free survival and overall survival (all p < 0.001).Conclusions: A combined index of CD44 and Nanog expression is a promising prognostic predictor of recurrence-free survival and overall survival in bladder cancer. It may help identification of patients who will benefit from intensive treatment.

Leveraging Electronic Dental Record Data to Classify Patients Based on Their Smoking Intensity.

BACKGROUND: Smoking is an established risk factor for oral diseases and, therefore, dental clinicians routinely assess and record their patients' detailed smoking status. Researchers have successfully extracted smoking history from electronic health records (EHRs) using text mining methods. However, they could not retrieve patients' smoking intensity due to its limited availability in the EHR. The presence of detailed smoking information in the electronic dental record (EDR) often under a separate section allows retrieving this information with less preprocessing. OBJECTIVE: To determine patients' detailed smoking status based on smoking intensity from the EDR. METHODS: First, the authors created a reference standard of 3,296 unique patients' smoking histories from the EDR that classified patients based on their smoking intensity. Next, they trained three machine learning classifiers (support vector machine, random forest, and naïve Bayes) using the training set (2,176) and evaluated performances on test set (1,120) using precision (P), recall (R), and F-measure (F). Finally, they applied the best classifier to classify smoking status from an additional 3,114 patients' smoking histories. RESULTS: Support vector machine performed best to classify patients into smokers, nonsmokers, and unknowns (P, R, F: 98%); intermittent smoker (P: 95%, R: 98%, F: 96%); past smoker (P, R, F: 89%); light smoker (P, R, F: 87%); smokers with unknown intensity (P: 76%, R: 86%, F: 81%), and intermediate smoker (P: 90%, R: 88%, F: 89%). It performed moderately to differentiate heavy smokers (P: 90%, R: 44%, F: 60%). EDR could be a valuable source for obtaining patients' detailed smoking information. CONCLUSION: EDR data could serve as a valuable source for obtaining patients' detailed smoking information based on their smoking intensity that may not be readily available in the EHR.

A comparative study of hepatitis B virus X protein mutants K130M, V131I and KV130/131MI to investigate their roles in fibrosis, cirrhosis and hepatocellular carcinoma.

Hepatitis B virus (HBV) genomic mutations A1762T, G1764A and AG1762/1764TA cause production of HBV X protein (HBx) mutants, namely K130M, V131I and KV130/131MI. These mutations are important biomarkers for the development of cirrhosis and hepatocellular carcinoma (HCC) in chronic HBV patients. This study comparatively analyses the impact of intracellular expression of HBx mutants on HCC cell line Huh7. It was found that expression of KV130/131MI induced: cell proliferation, altered expression of cell cycle regulatory genes in favour of cell proliferation, intracellular reactive oxygen species (ROS) production and mitochondrial depolarization. KV130/131MI may be directly involved in host cell proliferation and hepatocarcinogenesis via altering expression of cell cycle regulatory genes. KV130/131MI may also play pivotal roles in fibrosis and cirrhosis via inducing ROS production and mitochondrial depolarization. Furthermore, these might be the possible reasons for higher occurrence of AG1762/1764TA as compared to A1762T and G1764A in cirrhosis and HCC patients.

Enhanced MAPK signaling is essential for CSF3R-induced leukemia.

Both membrane-proximal and truncation mutations in CSF3R have recently been reported to drive the onset of chronic neutrophilic leukemia (CNL). Here we show that although truncation mutation alone cannot induce leukemia, both proximal and compound mutations (proximal and truncation mutations on same allele) are leukemogenic with a disease latency of 90 and 23 days, respectively. Comparative whole-genome expression profiling and biochemical experiments revealed that induced expression of Mapk adaptor protein Ksr1 and enhanced Mapk signaling are crucial to leukemogenesis by CSF3R proximal and compound mutants. Moreover, inhibition of Mek1/2 by trametinib alone is sufficient to suppress leukemia induced by both CSF3R proximal and ruxolitinib-resistant compound mutations. Together, these findings elucidate a Mapk-dependent mechanism of CSF3R-induced pathogenesis, and they establish the rationale for clinical evaluation of MEK1/2 inhibition in CNL.

Evaluation of TH agglutinin titres of Widal test in the diagnosis of typhoid fever.

This prospective study was evaluated the role of TH agglutinins and reevaluate the diagnostic value of Widal test in the diagnosis of typhoid fever by identifying the S. typhi specific antibody. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July 2010 and June 2011, including 200 individuals of different ages and sexes. Widal test and blood culture were performed for each of the cases and controls. Among 150 blood samples from the suspected cases, 23(15.3%) were culture positive for S. typhi and 67(44.7%) had high titres of ≥1:160 for 'O' or 'H' or both agglutinins. Out of 23 culture positive cases, 3(13%) had TO ≥:160, 5(21.7%) had significant TH ≥1:160. Based on the above findings, it was concluded that judicious interpretation of Widal test play an essential role in diagnosis of typhoid fever, especially in the resource poor countries like Bangladesh.

Road rage and road traffic accidents among commercial vehicle drivers in Lahore, Pakistan.

Road rage and road traffic accidents increase the burden of morbidity and mortality in a population. A cross-sectional survey with convenience sampling was conducted among commercial vehicle drivers in Lahore, Pakistan (n = 901) to record their behaviours/experiences regarding road rage and road traffic accidents. Respondents were asked about incidents of shouting/cursing/rude gestures or threats to physically hurt the person/vehicle, by others or themselves, in the previous 24 hours or 3 months, and their involvement in road traffic accidents in the previous 12 months. Auto-rickshaw drivers were significantly more likely to report various road rage experiences/behaviours and involvement in accidents compared with bus and wagon drivers. A total of 112 respondents (12.4%) reported being involved in a road traffic accident in the previous 12 months but traffic police did not record the accident in 52.7% of cases. The results of this study underline the need to improve road safety in Pakistan.

Road rage and road traffic accidents among commercial vehicle drivers in Lahore, Pakistan

Road rage and road traffic accidents increase the burden of morbidity and mortality in a population. A cross-sectional survey with convenience sampling was conducted among commercial vehicle drivers in Lahore, Pakistan [N= 901] to record their behaviours/experiences regarding road rage and road traffic accidents. Respondents were asked about incidents of shouting/cursing/rude gestures or threats to physically hurt the person/vehicle, by others or themselves, in the previous 24 hours or 3 months, and their involvement in road traffic accidents in the previous 12 months. Auto-rickshaw drivers were significantly more likely to report various road rage experiences/ behaviours and involvement in accidents compared with bus and wagon drivers. A total of 112 respondents [12.4%] reported being involved in a road traffic accident in the previous 12 months but traffic police did not record the accident in 52.7% of cases. The results of this study underline the need to improve road safety in Pakistan

Road rage behaviour and experiences of rickshaw drivers in Rawalpindi, Pakistan.

A cross-sectional survey with convenience sampling was conducted among rickshaw drivers in Rawalpindi, Pakistan to study their road rage behaviour and experiences. Cumulatively 318 male drivers participated in this study. The most common forms of road rage reported were: having been shouted at; and having experienced rude gestures from other drivers (78.9% each). Least common forms of road rage reported were: threats of physical hurt or having actually been physically hurt ( < or = 3% each). Rickshaw drivers with shorter driving time (< or = 10 years) had significantly more road rage experiences than those who had been driving for more than 10 years (P < 0.01). There is a need for nationally representative surveys to study road age in commercial vehicle drivers so as to improve road safety in Pakistan.

Road rage behaviour and experiences of rickshaw drivers in Rawalpindi, Pakistan

A cross-sectional survey with convenience sampling was conducted among rickshaw drivers in Rawalpindi, Pakistan to study their road rage behaviour and experiences. Cumulatively 318 male drivers participated in this study. The most common forms of road rage reported were: having been shouted at; and having experienced rude gestures from other drivers [78.9% each]. Least common forms of road rage reported were: threats of physical hurt or having actually been physically hurt [</= 3% each]. Rickshaw drivers with shorter driving time [</=10 years] had significantly more road rage experiences than those who had been driving for more than 10 years [P < 0.01]. There is a need for nationally representative surveys to study road age in commercial vehicle drivers so as to improve road safety in Pakistan

Detection of MEF-1 laboratory reference strain of poliovirus type 2 in children with poliomyelitis in India in 2002 & 2003.

BACKGROUND & OBJECTIVES: Significant progress has been made towards eradication of poliomyelitis in India. Surveillance for acute flaccid paralysis (AFP) has reached high standards. Among the 3 types of polioviruses, type 2 had been eliminated in India and eradicated globally as of October 1999. However, we isolated wild poliovirus type 2 from a small number of polio cases in northern India in 2000 and again during December 2002 to February 2003. Using molecular tools the origin, of the wild type 2 poliovirus was investigated. METHODS: Polioviruses isolated from stool samples collected from patients with AFP were differentiated as wild virus or Sabin vaccine-like by ELISA and probe hybridization assays. Complete VP1 gene nucleotide sequences of the wild type 2 poliovirus isolates were determined by reverse transcriptase polymerase chain reaction (RT-PCR), followed by cycle sequencing. VP1 nucleotide sequences were compared with those of wild type 2 polioviruses that were indigenous in India in the past as well as prototype/laboratory strains and the GenBank database. RESULTS: Wild poliovirus type 2 was detected in stool samples from 6 patients with AFP in western Uttar Pradesh and 1 in Gujarat. In addition, the virus was isolated from one healthy contact child and from environmental sewage sample in Moradabad where three of these patients were reported. These isolates were identified as genetically closely related to laboratory reference strain MEF-1. Molecular characterization of the isolates confirmed that there was no evidence of extensive person-to-person transmission of the virus in the community. INTERPRETATION & CONCLUSION: Laboratory reference strain (MEF-1) of poliovirus type 2 caused paralytic poliomyelitis in 10 patients in September 2000 and November 2002 to February 2003. The origin of the virus was some laboratory as yet not identified. This episode highlights the urgent need for stringent containment of wild poliovirus containing materials in the laboratories across the country in order to prevent recurrence of such incidents.

Effects of rhizobacteria and root symbionts on the reproduction of Meloidogyne javanica and growth of chickpea.

The effects of rhizobacteria, i.e. Pseudomonas fluorescens, Azotobacter chyroococcum and Azospirillum brasilense, alone and in combination with root symbionts, Rhizobium sp. and Glomus mosseae, on the growth of chickpea, Cicer arietinum, and reproduction of Meloidogyne jaranica were studied. When added alone G. mosseae was better at improving plant growth and reducing galling and nematode reproduction than any other tested organism. Application of P. fluorescens caused an almost similar increase in plant growth to that caused by Rhizobium sp., while use of A. chroococcum was better than A. brasilense in improving growth of nematode --infected plants. Combined use of P. fluorescens with G. mosseae was better at improving plant growth and reducing galling and nematode multiplication than any other combined treatment.

C. elegans KLP-11/OSM-3/KAP-1: orthologs of the sea urchin kinesin-II, and mouse KIF3A/KIFB/KAP3 kinesin complexes.

Kinesins are intracellular multimeric transport motor proteins that move cellular cargo on microtubule tracks. It has been shown that the sea urchin KRP85/95 holoenzyme associates with a KAP115 non-motor protein, forming a heterotrimeric complex in vitro, called the Kinesin-II. Here we describe isolation of a cDNA clone corresponding to the klp-11 kinesin in C. elegans. Our sequence analysis of the encoded KLP-11 shows that it shares high homology with the OSM-3 kinesin. We also describe a nematode cDNA encoding KAP-1 that shares extensive homology with the sea urchin KAP115 kinesin associated protein. Sequence-based structural analysis of the OSM-3, KLP-11, and KAP-1, presented here suggests that these may form a heterotrimeric complex. We also describe the presence of a Drosophila armadillo consensus motif in CeKAP-1, first found in spKAP115, that suggests a possible role for the KAP-1 in signal transduction.

A novel C-terminal kinesin subfamily may be involved in chromosomal movement in caenorhabditis elegans.

C-terminal kinesin motor proteins, such as the Drosophila NCD and yeast KAR3, are involved in chromosomal segregation. Previously we have described two orthologs of NCD in Caenorhabditis elegans, KLP-3 and KLP-17, which also participate in chromosome movement. Here we report cDNA cloning of klp-15 and klp-16, and the expression pattern of the genes encoding C-terminal motor kinesins including klp-15 and klp-16. Interestingly KLP-15 and KLP-16 form a unique class of C-terminal kinesins, distinct from the previously known C-terminal motors in other organisms. Using in situ hybridization and RNA interference assay, we show that although all of these motors mediate chromosome segregation, they do so in a combination of unique and overlapping manners, suggesting a complex hierarchy of kinesin motor function in metazoans.