Shu-Te University

ObjectiveThis study aimed to compare the risk of developing systemic autoimmune diseases (SADs) among pediatric patients with juvenile idiopathic arthritis (JIA) treated with tumor necrosis factor inhibitors (TNFi) versus interleukin-6 inhibitors (IL-6i), based on real-world data.MethodsWe conducted a retrospective real-world cohort study using the TriNetX Research Network, which contains data from over 122 million patients. Individuals ≤18 years of age with a diagnosis of JIA who initiated TNFi or IL-6i therapy between January 1, 2013, and December 31, 2024, were included. Propensity score matching (1:1) was performed to balance baseline characteristics. The primary outcome was the incidence of SADs. Hazard ratios (HRs) were estimated using Cox proportional hazards models, and subgroup and sensitivity analyses were conducted to assess robustness.ResultsAfter matching, 1,192 patients were included in each cohort. The TNFi group demonstrated a significantly lower incidence of SADs than the IL-6i group (17 vs. 45 events; HR = 0.37, 95% CI: 0.20–0.63). Subgroup analyses showed consistent protective effects of TNFi across age, sex, and concomitant medication strata. Sensitivity analyses across three adjusted models confirmed the robustness of the findings, yielding HRs ranging from 0.28 to 0.46.ConclusionAmong pediatric patients with JIA, TNF inhibitor therapy was associated with a substantially lower risk of developing systemic autoimmune diseases compared with IL-6 inhibitor therapy. These findings may inform biologic selection and long-term safety considerations in pediatric rheumatologic practice.

Suy giảm cơ ở người cao tuổi (NCT) ảnh hưởng đáng kể đến chất lượng sống, nhưng tại huyện Tân PhúĐông vấn đề này chưa được quan tâm đúng mức. Nghiên cứu này nhằm đánh giá tỷ lệ NCT có nguy cơsuy giảm cơ và xác định một số yếu tố liên quan đến tỉ lệ suy giảm cơ của NCT tại huyện Tân Phú Đôngnăm 2023. Thiết kế cắt ngang trên 352 NCT từ 12/2022 đến 06/2023, sử dụng công cụ SARC-CalF. Kếtquả: Tỷ lệ NCT có nguy cơ suy giảm cơ là 36,1% (127/352). Các yếu tố liên quan gồm: tuổi ≥ 70 có nguycơ cao gấp 8,11 lần so với 60 - 69 (KTC 95%: 3,95 - 16,64); không đạt mức hoạt động thể lực khuyếnnghị tăng nguy cơ 8,67 lần (KTC 95%: 4,62 - 16,24); Suy dinh dưỡng hoặc có nguy cơ suy dinh dưỡnglàm tăng nguy cơ 3,01 lần (KTC 95%: 1,39 - 6,49); và bệnh mạn tính tăng nguy cơ 3,71 lần (KTC 95%:1,23 - 11,20). Giới tính, học vấn và sống cùng người thân không có ý nghĩa thống kê sau hiệu chỉnh (p >0,05). Tỷ lệ suy giảm cơ ở NCT tại Tân Phú Đông còn cao, nhấn mạnh sự cần thiết của sàng lọc và pháthiện sớm trong cộng đồng.

Mutu pelayanan dalam sebuah rumah sakit sangat dipengaruhi oleh pelayanan bidang keperawatan. Hal ini menjadi perhatian pihak manajemen dalam menjaga kualitas dan mutu pelayanan keperawatan di rumah sakit. Salah satu indicator mutu pelayanan rumah sakit adalah kepuasan pasien. Kepuasan yang dirasakan pasien merupakan bentuk cerminan dari baik dan buruknya pelayanan keperawatan yang telah diberikan. Kepuasan pasien dalam pelayanan keperawatan dapat dipengaruhi oleh jaminan kesehatan seperti BPJS kesehatan. Tujuan penelitian ini adalah untuk mengetahui hubungan mutu pelayanan peserta BPJS dengan tingkat kepuasan pasien di ruang rawat inap RSUD Tengku Rafian. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan cross sectional. Penelitian ini dilakukan di ruang rawat inap RSUD Tengku Rafian dengan populasi sebanyak 910 orang. Adapun teknik pengambilan sampel yaitu menggunakan purposive sampling yaitu 100 orang dengan kriteria inklusi: pasien rawat inap selain ICU dan Perinatologi yang menggunakan jaminan kesehatan BPJS, pasien yang telah menjalani hari rawatan minimal 3 hari. Alat pengumpulan data dalam penelitian ini menggunakan kuisioner dan hasil penelitian diolah menggunakan Chi-square test. Adapun hasil dalam penelitian ini didapatkan bahwa terdapat hubungan yang signifikan antara mutu pelayanan kesehatan dengan tingkat kepuasan pasien di ruang rawat inap RSUD Tengku Rafian (p-value = 0,000). Terdapat hubungan yang signifikan antara mutu pelayanan peserta BPJS dengan tingkat kepuasan pasien di ruang rawat inap RSUD Tengku Rafian.

Rheumatoid arthritis (RA) significantly impacts bone health, leading to osteoporosis and increased fracture risks. This study aims to compare the effects of TNF-α and IL-6 inhibitors on the incidence of fractures, osteoporosis, and mortality among RA patients. We conducted a retrospective cohort study using the TriNetX database, spanning from January 1, 2015, to December 31, 2022. The adult patients diagnosed with Rheumatoid Arthritis (RA) were identified and divided into two groups of new users of TNF-α and IL-6 inhibitors. Patients with prior fractures or who switched treatments post-index were excluded. Patients baseline characteristics were adjusted with propensity score matching (PSM). We compared TNF-α and IL-6 inhibitor cohorts in terms of fracture and osteoporosis incidence, and mortality employing Cox proportional hazards models for risk assessment, adjusting for potential confounders. The study included 2158 RA patients each in the TNF-α and IL-6 cohorts after PSM. Both cohorts had 71 osteoporosis/fractures during a 1-year follow-up. The adjusted HR (95% CI) was 0.987 (0.711-1.372) comparing TNFi versus IL-6is initiators. Similar results were shown stratified by age, sex, and steroid usage. However, all-cause mortality was significantly lower in the TNF-α cohort with an adjusted HR (95% CI) of 0.247 (0.114-0.536). Subgroup analyses showed the TNF-α cohort was associated with lower all-cause mortality among patients older than 65, male patients, and steroid users. TNF-α and IL-6 inhibitors exhibit comparable effects on the risk of osteoporosis and fractures among RA patients. Notably, TNF-α inhibitors may offer advantages in reducing all-cause mortality, warranting further investigation.

In efforts to fulfill the research objectives of this study, we analyzed the influences between human resource management practices and employees' corporate social responsibility (CSR) attitude, and the influences of employees' CSR attitude on Environmental, Social, Governance (ESG) and CSR practices, as well as the mediating effect of employees' CSR attitude on the relationship between human resource management practices, ESG and CSR practices. This study utilized a number of social platforms, such as FaceBook, LINE, and Instagram, and employed the convenience sampling method to select employees in the hotel and catering service industries. Electronic questionnaires were distributed to collect data, and 284 valid copies of questionnaires were recovered. According to the research results, the following three findings were revealed. 1.CSRaFac2 and CSRaFac3 have partial mediating effects on the relationships between HRMp and the dependent variables CSRpC and CSRpS. 2. CSRaFac2 and CSRaFac3have partial mediating effects on the relationships between HRMp and the dependent variables ESGe and ESGs. 3.CSRaFac2 and CSRaFac4 have full mediating effects on the relationships between HRMp and the dependent variable ESGg. Facing the shortage of human resources in the service industry, it is recommended that hotel and catering enterprises should not only pay more attention to actual CSR practices but also invest in ESG progressively.