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Hedysari Radix Praeparata Cum Melle (HRPCM) and Astragali Radix Praeparata Cum Melle (ARPCM) are used interchangeably in clinics to treat spleen-qi deficiency (SQD) symptom mainly including gastrointestinal dysfunction and decreased immunity, which has unknown differences in efficacy. To investigate the differences between HRPCM and ARPCM on intervening gastrointestinal- and immune-function with SQD syndrome. After the SQD model was established, the Sprague-Dawley (SD) rats were randomly divided into nine groups (n = 10): normal; model; Bu-Zhong-Yi-Qi Pills; 18.9, 12.6 and 6.3 g/kg dose groups of HRPCM and ARPCM. Gastrointestinal function including d-xylose, gastrin, amylase vasoactive intestinal peptide, motilin, pepsin, H + /K + -ATPase, Na + /K + -ATPase, sodium-glucose cotransporter 1 (SGLT1), glucose transporter 2 (GLUT2) and immune function including spleen and thymus index, blood routine, interleukin (IL)-2, IL-6, interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), immunoglobulin (Ig) M, IgA, IgG and delayed-type hypersensitivity (DTH) were detected. Finally, the efficacy differences were analysed comprehensively by the fuzzy matter-element method. In regulating immune, the doses differences in efficacy between HRPCM and ARPCM showed in the high-dose (18.9 g/kg), but there were no differences in the middle- and low- dose (12.6 and 6.3 g/kg); the efficacy differences were primarily reflected in levels of IL-6, IFN-γ, TNF-α and IgM in serum, and the mRNA expression of IL-6 and IFN-γ in the spleen. In regulating gastrointestinal, the efficacy differences were primarily reflected in the levels of D-xylose, MTL, and GAS in serum, and the mRNA and protein expression of SGLT1 and GLUT2 in jejunum and ileum. HRPCM is more effective than ARPCM on regulating gastrointestinal function and immune function with SQD syndrome. Therefore, we propose that HRPCM should be mainly used to treat SQD syndrome in the future.

PD-1 inhibitors are first-line treatments for recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). However, previous trials included few participants from mainland China and other Asian regions and differed from real-world practice. PD-L1 expression alone has limited predictive value. This study aimed to systematically evaluate efficacy and survival differences in diverse clinical scenarios and identify associated peripheral blood markers (PBMs). Data were retrospectively collected from 105 R/M HNSCC patients treated with first-line immunotherapy alone or in combination across 3 hospitals in China (2020.01-2022.12). Primary endpoints were overall survival (OS) and progression-free survival (PFS). We assessed efficacy, survival, and safety, and developed predictive models. Data analyses were performed using SPSS 26.0 and GraphPad Prism 8.0.1. The median follow-up was 21 months. The objective response rate was 37.14%. Median OS was 21 months (1-year OS: 81.02%), and median PFS was 11 months (1-year PFS: 39.47%). Immunotherapy was more effective for distant metastasis (DM) than local recurrence (LR). For patients with LR, DM, or both, median PFS was 12, 14, and 7.5 months, respectively (P = 0.0029). Higher combined positive score (CPS) predicted better outcomes. Median OS for CPS ≥ 20, 1 ≤ CPS < 20, and CPS < 1 was 32, 20, and 12 months, respectively (P = 0.0008). In the comparison of combination versus single-agent immunotherapy, median PFS was 12 versus 9 months (P = 0.0044). Combining taxanes with immunotherapy yielded favorable results, with a median OS of 27 months. No survival difference was found between domestic and imported PD-1 inhibitors. Secondary radiotherapy did not improve survival. Increased peripheral blood lymphocyte subsets and decreased peripheral blood inflammatory markers were associated with superior immunotherapy outcomes. Key predictive PBMs included baseline CD8 T cells, CD3 T cells at 12 weeks post-treatment (12w pt), CD4 T cells at 6w pt, and CD8 T cells at 12w pt. This study focused on evaluating immunotherapy efficacy and survival differences in R/M HNSCC patients across various clinical background. Dynamic PBMs correlated closely with immunotherapy response and survival prognosis. These findings expanded treatment options and supported personalized decisions. R/M HNSCC, Immunotherapy, Real-world study, Efficacy and survival differences, Predictive markers.

Burnout syndrome, characterised by exhaustion, cynicism, and reduced professional efficacy, is a growing concern in contemporary fast-paced workplaces. In Croatia, research has mostly concentrated on helping professions, rarely focusing on the business sector. This study aims to assess the extent of work-related burnout among Croatian corporate employees and examine whether individual and occupational characteristics are associated with significant differences across the three core burnout dimensions: exhaustion, cynicism, and professional efficacy. Using t-tests and one-way analysis of variance (ANOVA), burnout dimensions were compared across groups defined by gender, age, education, position, working hours, department, company size, and industry. Although most employees did not exhibit severe manifestations of burnout, the findings indicate moderate levels of exhaustion, suggesting early signs of strain. Overall, respondents display patterns consistent with a mildly overextended profile, although threshold values for high burnout are not reached. Differences across groups were observed, with higher exhaustion reported among employees working longer hours and in larger companies, and differences in cynicism and professional efficacy across gender and job positions. The results highlight the importance of recognising early signs of burnout and understanding how burnout-related dimensions vary across employee groups. Such insights may support the design of more targeted organisational practices to promote employee well-being in the Croatian business sector.

The explosion in Internet usage and huge government funding initiatives in digital libraries have drawn attention to research on digital libraries. Whereas the traditional focus of digital library research has been on the technological development, there is now a call for user-focused research. Although millions of dollars have been spent on building \"usable\" systems, research on digital libraries has shown that potential users may not use the systems in spite of their availability. There is a need for research to identify the factors that determine users' adoption of digital libraries. Using the technology acceptance model (TAM) as a theoretical framework, this study investigates the effect of a set of individual differences (computer self-efficacy and knowledge of search domain) and system characteristics (relevance, terminology, and screen design) on intention to use digital libraries. Based on a sample of 585 users of a university's award-winning digital library, the results strongly support the utilization of TAM in predicting users' intention to adopt digital libraries, and demonstrate the effects of critical external variables on behavior intention through perceived ease of use and perceived usefulness. All of the individual differences and system characteristics have significant effects on perceived ease of use of digital libraries. In addition, relevance has the strongest effect on perceived usefulness of digital libraries.

The considerable interindividual differences in efficacy and side effects of commonly used medications in Crohn's disease are partly owing to genetic polymorphisms. Many genetic variants have been studied in genes possibly involved in the metabolism or mechanism of action of therapeutic agents such as glucocorticosteroids, azathioprine/6-mercaptopurine, methotrexate, calcineurin inhibitors or anti-TNF agents. However, the only test translated into clinical practice is thiopurine S-methyltransferase (TPMT) genotyping for hematological toxicity of thiopurine treatment. To date, there are no other meaningful applications for pharmacogenomics in clinical practice of Crohn's disease. In the future, designed therapeutic trials should possibly permit the development of predictive models including genotypic markers, such as that proposed for the clinical outcome after infliximab therapy, which includes an apoptotic pharmacogenetic index. The recent identification of new susceptibility genes provides additional candidate markers that have possible effects on the outcomes of therapies, and prioritizes new therapeutic targets, such as the IL-23 pathway. Further innovative approaches might be relevant for the pharmacogenetic investigation of gene variants implied in innate immune pattern recognition and autophagy.

Rubrics are widely used as instructional and learning instrument. Though they have been claimed to have positive effects on students’ learning, these effects have not been meta-analyzed. Our aim was to synthesize the effects of rubrics on academic performance, self-regulated learning, and self-efficacy. The moderator effect of the following variables was also investigated: year of publication, gender, mean age, educational level, type of educational level (compulsory vs. higher education), number of sessions, number of assessment criteria, number of performance levels, use of self and peer assessment, research design, and empirical quality of the study. Standardized mean differences (for the three outcomes) and standardized mean changes (SMC; for academic performance) were calculated from the retrieved studies. After correcting for publication bias, a moderate and positive effect was found in favor of rubrics on academic performance (g = 0.45, k = 21, m = 54, 95% CI [0.312, 0.831]; SMC = 0.38, 95% CI [0.02, 0.75], k = 12, m = 30), whereas a small pooled effect was observed for self-regulated learning (g = 0.23, k = 5, m = 17, 95% CI [-0.15, 0.60]) and for self-efficacy (g = 0.18, k = 3, m = 5, 95% CI [-0.81, 0.91]). Most of the moderator variables were not significant. Importantly, to improve the quality of future reports on the effects of rubrics, we provide an instrument to be filled out for rubric scholars in forthcoming studies.

Previous research has largely failed to separate the between- and within-person effects in the longitudinal associations between academic stress, academic self-efficacy, and psychological distress (symptoms of anxiety and depression). Filling this research gap, this study investigated if academic self-efficacy mediated the relationship between academic stress and psychological distress at the intraindividual level during 3 years of upper secondary school. Gender moderation was also examined in the hypothesised model. The present sample consisted of 1508 Norwegian adolescents (baseline M age = 16.42; 52.9% high perceived family wealth; 70.6% Norwegian-born). The random intercept cross-lagged panel model results indicated (1) positive and time-invariant direct effects from academic stress to psychological distress, (2) academic self-efficacy partially mediated these effects, and (3) psychological distress impacted later academic stress. Academic stress was more strongly related to academic self-efficacy and psychological distress at the interpersonal level for boys, while the intraindividual impact of academic stress on psychological distress was stronger for girls. The study findings might have implications for school-based implementation strategies and theoretical development.

This study examined the relationships among exercise motivation, exercise self-efficacy, and physical activity rating, as well as the role of exercise self-efficacy in the above relationship. A survey was conducted among 362 college students (aged 19.0 ± 0.8 years, 185 males and 177 females) from a Chinese college using exercise motivation, self-efficacy, and physical activity assessment scales. The results revealed significant sex differences in exercise motivation, self-efficacy, and physical activity scores. Structural equation analysis revealed that ability motivation had a direct effect, accounting for 41.5% of the total effect, while the mediating effect of exercise self-efficacy accounted for 58.5%. Exercise self-efficacy has been proven to be a key predictor of physical activity in both general analysis and gender stratification analysis. From the results of path analysis, in the overall sample and the male group, the influence intensity of each variable on physical activity is the direct effect of exercise self-efficacy, the mediating effect of exercise self-efficacy and the direct effect of ability motivation. However, different influence patterns were observed in female groups: the direct effect of exercise self-efficacy still ranked first, followed by the direct effect of ability motivation, and finally, the mediating effect of exercise self-efficacy. This finding suggests that gender may be an important variable regulating the relationship between exercise self-efficacy and physical activity. Based on the above findings, this study emphasizes that gender-specific strategies should be adopted when formulating intervention programs for physical activity promotion: for male groups, it should focus on strengthening the cultivation of exercise self-efficacy, while for female groups, it should also focus on the improvement of ability motivation and the establishment of self-efficacy. This study provides an important empirical basis for improving the theory of health behavior promotion.