Advances in the ecological validity of research on social cognition in schizophrenia: A systematic review of the literature.

Introduction: Ecologically valid assessments need to require tasks representative of real, everyday interactions between people in a social environment (i.e., verisimilitude) and to predict aspects of real-life performance in those same interactions (i.e., veridicality). To determine how researchers interested in social cognition among people with schizophrenia currently understand and apply ecological validity in their work, we conducted a systematic review of studies that had the ecological validity of their results as an explicit objective. Methods: We performed the described systematic review following PRISMA guidelines. Results: Of the 18 studies reviewed, only two defined ecological validity, 15 incorporated modifications to improve their verisimilitude, eight proposed analyses to examine their veridicality, and seven aimed to achieve both objectives. Conclusions: Our systematic review suggests that very few published studies on social cognition among people with schizophrenia have explicitly defined ecological validity, and most have focused only on the verisimilitude of the tasks required while neglecting the veridicality of the results.

Postoperative laboratory testing in the era of outpatient total joint arthroplasty: Targeted patient selection and associated cost savings.

Background: With the advent of outpatient total joint arthroplasty (TJA), the days of routinely drawing postoperative labs (complete blood counts [CBCs] and metabolic panels [CMPs/BMPs]) to monitor for complications are behind us. However, there does exist a subset of at-risk patients that may benefit from diligent postoperative monitoring, though the circumstances under which labs should be ordered remains unclear and subject to surgeon discretion. A systematic review of the literature was therefore conducted to evaluate the utility of postoperative laboratory testing, approaches to targeted patient selection and associated cost-savings. Methods: The PubMed, MEDLINE, EBSCOhost, and Google Scholar electronic databases were searched on August 17, 2023, to identify all studies published since January 1, 2000, that evaluated the role of postoperative lab testing in TJA. (PROSPERO study protocol registration: CRD42023437334). Articles were included if a full-text English manuscript was available and the study assessed the utility of routine postoperative labs in TJA. 19 studies were included comprising 34,166 procedures. The mean Methodological index for Nonrandomized Studies score was 18.2 ± 1.5. Results: Abnormal postoperative lab results were common and infrequently required clinical intervention. Among several identified risk factors for patients that may benefit from postoperative laboratory monitoring, preoperative lab values proved excellent discriminators of transfusion requirement and metabolite-associated intervention. Selective testing demonstrated the ability to generate substantial cost-savings. Conclusion: Routine postoperative laboratory testing offers little clinical utility and produces unnecessary expenditures. Preoperative lab values offer the greatest predictive utility for postoperative transfusion requirement and metabolite-associated clinical intervention, with a preoperative hemoglobin threshold of 111.5 g/L offering an area under the curve (AUC) of 0.93 for predicting postoperative transfusion. Further investigations are needed for metabolic panel predictive models and should incorporate preoperative lab values. The refinement of such models can enable targeted patient selection to avoid unnecessary labs and generate substantial cost savings without compromising patient safety.

Efecto de la sintomatología ansiosa y depresiva sobre los estilos de alimentación de la población chilena / Effect of anxious and depressive symptomatology on eating styles in the chilean population

Resumen Antecedentes: existe una estrecha relación entre salud mental y estilos de alimentación. Indicadores de salud mental como sintomatología ansiosa y depresiva han reportado efectos directos sobre estilos de alimentación que promueven la malnutrición por exceso como la alimentación emocional o restrictiva. Se analizó el efecto de la sintomatología ansiosa y depresiva sobre los estilos de alimentación en mujeres y hombres del norte y centro de Chile. Método: participaron 910 adultos residentes en el norte y centro de Chile; se aplicó el Cuestionario Holandés de Conducta Alimentaria (DEBQ), así como el Inventario de Ansiedad de Beck (BAI) y el Inventario de Depresión de Beck-II (BDI-II). El análisis del modelo global de la relación entre variables se realizó mediante modelos de ecuaciones estructurales. Resultados: el modelo global presentó adecuados indicadores de bondad de ajuste; la sintomatología ansiosa tuvo un efecto directo y significativo sobre la alimentación emocional, alimentación externa y alimentación restrictiva. Por su parte, la sintomatología depresiva no presentó efectos significativos sobre ningún estilo de alimentación. Conclusiones: a medida que aumentan los niveles de ansiedad, aumentan los niveles de todos los estilos de alimentación. La depresión podría interactuar mediando la relación por el contexto emocional que genera la sintomatología depresiva.

Abstract Introduction: There is a close relationship between mental health and eating styles. Mental health indicators such as anxious and depressive symptomatology have reported direct effects on eating styles that promote excess malnutrition such as emotional or restrictive eating. The aim was to analyze the effect of anxious and depressive symptomatology on eating styles in women and men from northern and central Chile. Method: Nine hundred and ten adults living in northern and central Chile participated in the study. The Dutch Eating Behavior Questionnaire (DEBQ), the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) were administered. The analysis of the global model of the relationship between variables was carried out using structural equation modeling. Results: The structural model presented adequate goodness-of-fit indicators, anxious symptomatology had a direct and significant effect on emotional eating, external eating and restrictive eating. On the other hand, depressive symptomatology, did not present significant effects on any eating style. Conclusions: As anxiety levels increase, levels of all eating styles increase. Depression, could interact mediating the relationship by the emotional context that generates the depressive symptomatology.

Documenting adaptations to an evidence-based intervention in 58 resource-variable pediatric oncology hospitals across implementation phases.

BACKGROUND: Adaptation of evidence-based interventions (EBIs) often occurs when implemented in new local contexts and settings. It is unclear, however, during which phase of implementation adaptations are most frequently made and how these changes may impact the fidelity, effectiveness, and sustainability of the EBI. Pediatric Early Warning Systems (PEWS) are EBIs for early identification of deterioration in hospitalized children with cancer. This study evaluates adaptations of PEWS made among resource-variable pediatric oncology hospitals in Latin America implementing and sustaining PEWS. METHODS: We conducted a cross-sectional survey among pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), a collaborative to implement PEWS. Adaptations to PEWS were assessed via 3 multiple choice and 1 free text question administered as part of a larger study of PEWS sustainability. Descriptive statistics quantitatively described what, when, and why adaptations were made. Qualitative analysis of free text responses applied the Framework for Reporting Adaptations and Modifications Expanded (FRAME) to describe respondent perspectives on PEWS adaptations. RESULTS: We analyzed 2,094 responses from 58 pediatric oncology centers across 19 countries in Latin America. Participants were predominantly female (82.5%), consisting of nurses (57.4%) and physicians (38.2%) who were PEWS implementation leaders (22.1%) or clinical staff (69.1%). Respondents described multiple PEWS adaptations across all implementation phases, with most occurring during the planning and piloting of EBIs. Adaptations included changes to PEWS content (algorithm, scoring tool, terminology, and use frequency) and context (personnel delivering or population). Respondents felt adaptations streamlined monitoring, enhanced effectiveness, improved workflow, increased comprehension, and addressed local resource limitations. Qualitative analysis indicated that most adaptations were categorized as fidelity consistent and planned; fidelity inconsistent adaptations were unplanned responses to unanticipated challenges. CONCLUSION: Adaptations made to PEWS across implementation phases demonstrate how EBIs are adapted to fit dynamic, real-world clinical settings. This research advances implementation science by highlighting EBI adaptation as a potential strategy to promote widespread implementation and sustainability in hospitals of all resource levels.

The Potential of Gingival Crevicular Fluid as a Tool for Molecular Diagnosis: A Systematic Review.

A biomarker is defined as a characteristic that is measured as an indicator of a normal biological or pathological process, a response to an exposure or intervention. Biomarkers with a diagnostic approach must identify not only the presence but also the absence of the disease with high precision, so having the biological source of the said marker is of vital importance to ensure precision and accuracy; the aim was to carry out a review of its diagnostic potential. The search strategy was carried out in three databases: PubMed, ScienceDirect, and Scopus. The keywords that were used were as follows: "gingival crevicular fluid", "Biomarker", and "Diagnosis", using the Boolean operator "AND". The filter was used at 10 years. Within the type of molecules most studied, the cytokine family was the most abundant with 25.42% of the studies, followed by metalloproteinases and proteins with 16.9% each one. Studies that included RNA-type genetic material were less frequently found. As has been demonstrated, the use of GCF as a source of biomolecules for diagnostic use has been increasing, both for oral diseases, which reflects the local conditions of the disease; it also has the ability to reflect the development of distant diseases; and this is because GCF is a blood ultrafiltrate.

Multicenter Study Examining Temporal Trends in Traumatic Intracranial Hemorrhage Over Six Years Using Joinpoint Regression.

The aging US population has altered the epidemiology of traumatic injury, but there are few studies examining changing patterns of traumatic intracranial hemorrhage (tICH). We examined temporal changes in incidence, demographics, severity, management, and outcomes of tICH among trauma admissions at six US Level I trauma centers over 6 years (July 1, 2016-June 30, 2022). Patients with tICH (subdural, epidural, subarachnoid, and intracerebral hemorrhage) were identified by 10th revision of the International Statistical Classification of Diseases diagnosis codes. Temporal trends were examined over 12 six-month intervals using joinpoint regression and reported as biannual percent change (BPC); models without joinpoints are described as linear trends over time. There were 67,514 trauma admissions over 6 years and 11,935 (17.7%) patients had a tICH. The proportion of tICH injuries significantly increased 2.6% biannually from July 2016 to July 2019 (BPC = 2.6, p = 0.04), then leveled off through June 2022 (BPC = -0.9, p = 0.19). Similarly, the proportion of geriatric patients (≥65 years old) increased 2.4% biannually from July 2016 to July 2019 (BPC = 2.4, p = 0.001) as did injuries due to falls (BPC = 2.2, p = 0.01). Three of the four most prevalent comorbidities significantly increased: hypertension linearly increased 2.1% biannually, functional dependence increased 25.5% biannually through June 2019, and chronic anticoagulant use increased 19.0% biannually through June 2019 and then 3.1% thereafter. There were no trends in the rates of neurosurgical intervention (BPC = -0.89, p = 0.40), ED Glasgow coma score 3-8 (BPC = -0.4, p = 0.77), or presence of severe extracranial injuries (BPC = -0.7, p = 0.45). In-hospital mortality linearly declined 2.6% biannually (BPC = 2.6, p = 0.05); however, there was a 10.3% biannual linear increase in discharge to hospice care (BPC = 10.3, p < 0.001). These results demonstrate the incidence of tICH admissions is temporally increasing, and the population is growing older with more comorbidities and injuries from falls. Yet, traumatic brain injury severity and neurosurgical management are unchanged. The shift from in-patient death to hospice care suggests an increased need for palliative care services.

Massive pulmonary thromboembolism in an adolescent with SARS-CoV-2 infection. / Tromboembolismo pulmonar masivo en adolescente con infección por SARS­CoV-2.

Thromboembolic events incidence is low in pediatrics; high suspicion and explicit management algorithms are essential. We present a 12-year-old female patient with two weeks of dyspnea, orthopnea, and ankle edema. Tests showed metabolic acidosis, hyperlactatemia, elevated D-dimer, and positive SARS-CoV-2 CRP. The echocardiogram showed severe right ventricular dysfunction and supra-systemic pulmonary hypertension. Chest CT angiography showed extensive bilateral pulmonary thromboembolism. Anticoagulant therapy was started. She presented with hemodynamic instability. Adrenaline, norepinephrine, milrinone, and nitric oxide were started. The clinical picture was extremely severe in the first 24 hours. It was decided to perform systemic thrombolysis with alteplase, which led to an improvement. Cardiorespiratory stabilization and anticoagulation are the mainstays of therapy in massive pulmonary thromboembolism. Fibrinolytic therapy is used in selected high-risk cases. In this patient, systemic reperfusion therapy with alteplase was performed with no significant complications.

La incidencia de eventos tromboembólicos es baja en pediatría; es importante la alta sospecha y algoritmos claros de manejo. Presentamos una paciente de 12 años, con 2 semanas de disnea, ortopnea y edema de tobillos. Exámenes evidenciaron acidosis metabólica, hiperlactatemia, dímero D elevado y PCR SARS-CoV-2 positiva. Ecocardiograma con disfunción grave de ventrículo derecho e hipertensión pulmonar suprasistémica. Angio-TAC de tórax mostró extenso tromboembolismo pulmonar bilateral. Se inició terapia anticoagulante. Evolucionó con inestabilidad hemodinámica. Inició adrenalina, norepinefrina, milrinona y óxido nítrico. Primeras 24 horas de extrema gravedad. Se decidió realización de trombólisis sistémica con alteplasa, y evolucionó con progresión a la mejoría. Los pilares de terapia en tromboembolismo pulmonar (TEP) masivo son la estabilización cardiorrespiratoria y la anticoagulación. En casos seleccionados como de alto riesgo, se utiliza terapia fibrinolítica. En esta paciente, se realizó terapia de reperfusión sistémica con alteplasa, sin complicaciones de importancia en el procedimiento.

EPHA2 Regulates SOX2 during Esophageal Development.

The human esophagus, derived from the anterior foregut endoderm, requires proper dorsal-ventral patterning for development. The transcription factor SOX2, crucial in this process, when dysregulated, leads to congenital esophageal abnormalities. EPHA2, a receptor tyrosine kinase, is vital in various developmental processes and cancer models, where it activates SOX2. This study demonstrates that EPHA2 regulates SOX2 expression during esophageal development using human iPSCs and iPSC-derived human esophageal organoids (HEO). Inhibition of EPHA2 decreased iPSC-derived HEO formation and SOX2 expression. These findings provide evidence of EPHA2 as being a key regulator of SOX2 signaling in early esophageal development. Highlights: SOX2 is crucial for proper esophageal development.EPHA2 is a receptor tyrosine kinase involved in various developmental processes.EPHA2 activates SOX2.Inhibition of EPHA2 decreased SOX2 expression and human esophageal organoid formation.

Unveiling the Wing Shape Variation in Northern Altiplano Ecosystems: The Example of the Butterfly Phulia nymphula Using Geometric Morphometrics.

The Andean Altiplano, characterized by its extreme climatic conditions and high levels of biodiversity, provides a unique environment for studying ecological and evolutionary adaptations in insect morphology. Butterflies, due their large wing surface compared to body surface, and wide distribution among a geographical area given the flight capabilities provided by their wings, constitute a good biological model to study morphological adaptations following extreme weathers. This study focuses on Phulia nymphula, a butterfly species widely distributed in the Andes, to evaluate wing shape variation across six localities in the Northern Chilean Altiplano. The geometric morphometrics analysis of 77 specimens from six locations from the Chilean Altiplano (Caquena, Sorapata Lake, Chungará, Casiri Macho Lake, Surire Salt Flat, and Visviri) revealed significant differences in wing shape among populations. According to the presented results, variations are likely influenced by local environmental conditions and selective pressures, suggesting specific adaptations to the microhabitats of the Altiplano. The first three principal components represented 60.92% of the total wing shape variation. The detected morphological differences indicate adaptive divergence among populations, reflecting evolutionary responses to the extreme and fragmented conditions of the Altiplano. This study gives insights into the understanding of how high-altitude species can diversify and adapt through morphological variation, providing evidence of ecological and evolutionary processes shaping biodiversity in extreme environments.

Quality of life and unmet needs in patients with fabry disease: a qualitative study.

BACKGROUND: Patients with Fabry disease (FD) consider their quality of life to be significantly affected. The majority of studies evaluate the quality of life using quantitative measures and standardised scales that offer relevant information about experience with the disease in multiple aspects. The main objective of the research was to examine in depth the quality of life and unmet needs of patients diagnosed with FD in relation to their disease and treatment. A qualitative and transversal study was carried out in two stages: (a) nine semi-structured qualitative interviews with patients and one representative of the patient association, conducted individually by phone; (b) a focus group was set up with three patients diagnosed with FD and one relative. A deductive, thematic analysis approach was used for data coding and analysis. RESULTS: The analysis of the interviews revealed various relevant themes: experience with the disease, impact on daily activities, experience of the family and work environment, experience related to treatment and healthcare professionals, and unmet support needs. Diagnosis has a significant impact on both those suffering from the disease and on the family environment. The symptoms and evolution of the disease are highly variable among the patients interviewed and depend on the years diagnosed as well as the time taken to receive the diagnosis. The families of the interviewees have to go through an adjustment process in light of the significant psychological impact brought about by the disease. Patients show various unmet needs. The need mentioned most is to have more information, support, and understanding from people around them and society, improving empathy and raising awareness about the difficulties faced by people with FD while giving the disease visibility. A lack of social understanding is highlighted as one of the main challenges, as this does not only affect the emotional management of the disease but also has repercussions on working life and social relationships. CONCLUSIONS: It seems necessary to define possible strategies that help to improve the quality of life of patients and their experience with the disease. Some recommendations obtained from the study include: facilitate access to mental health professionals for patients and their families; improve training for specialists and coordination among them; and carry out actions to raise awareness of the disease that are aimed at the general public, the patients themselves, and the people around them.

Exploring of Chemical Profile and Biological Activities of Three Ocimum Species From Comoros Islands: A Combination of In Vitro and In Silico Insights.

Ocimum species have a great interest in different traditional medicinal systems. This study examined the chemical composition, antioxidant properties, enzyme inhibitory effects, and antibacterial and antifungal activities of the aerial parts of Ocimum gratissimum, Ocimum americanum, and Ocimum basilicum from the Comoros Islands. The extracts were analyzed using high-performance liquid chromatography-mass spectrometry (HPLC-MS) to determine their chemical composition. Antioxidant activity was assessed using 2,2-Diphenyl-1-picrylhydrazyl (DPPH), 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), cupric reducing antioxidant capacity (CUPRAC), ferric reducing antioxidant power (FRAP), chelating ability, and phosphomolybdenum radical scavenging assays. Enzyme inhibitory activities against acetylcholinesterase (AChE), butrylcholinesterase (BChE), tyrosinase, amylase, and glucosidase were evaluated using spectrophotometric methods. Antibacterial and antifungal activities were tested using the broth microdilution method against selected pathogenic microorganisms. The selected enzymes and proteins were evaluated using in silico methods with biomolecules from these plants. In addition, 111 different metabolites were identified in the tested extracts using advanced HPLC/MS techniques. The most significant number of detected compounds were derivatives of hydroxycinnamic acids, followed by flavonoid glycosides and aglycones and derivatives of hydroxybenzoic acids. All three Ocimum species exhibited significant antioxidant activities, O. gratissimum exhibited the best-reducing abilities in CUPRAC and FRAP assays. In addition, enzyme inhibitory assays revealed that O. americanum had the most potent inhibitory effect on tyrosinase (48.01 ± 3.89 mg kojic acid equivalent [KAE]/g), and amylase (1.08 ± 0.02 mmol acarbose equivalent [ACAE]/g). Antibacterial and antifungal tests demonstrated that the extracts possess broad-spectrum activity. Molecular docking results showed that compounds exhibited remarkable binding energies with target enzymes and proteins. The molecular dynamics simulations identified chicoric acid with MurE of Staphylococcus aureus complex as the most promising drug candidate. These findings support their traditional medical and nutraceutical uses and suggest possibilities for natural functional applications.

Optical Extinction-Based 3D Nano-Imaging of WS2 on Gold.

Broadband nanoextinction images recorded in tip-enhanced optical spectroscopy geometry track the 3D topography of a single layer of WS2 on Au substrate. The described nano-optical method is complementary to conventional atomic force microscopy and offers additional information about the buried material-metal interface that is not accessible using conventional topographic imaging. Beyond 3D optical imaging, we observe large variations in the junction plasmon resonance on the nanoscale. The latter is important to understand and account for in tip-enhanced Raman and photoluminescence studies that target low-dimensional materials specifically. Our observations and (coherent) optical scattering-based method are also relevant to emerging efforts aimed at exploring strong coupling and Fano interferences in hybrid plasmonic-low dimensional quantum material systems.

Fetal Diagnosis of a Ductus Arteriosus Aneurysm: A Case Report.

The ductus arteriosus aneurysm (DAA) is considered a rare anatomical alteration that consists of a dilation of this vascular structure. It has been reported that the DAA can resolve in the immediate postnatal stage and do not generate any consequences for the neonate. However, have been described some cases in which the DAA is complicated due to thromboembolic events, rupture of the lesion, respiratory symptoms, and even death. We present a case report of aneurysm of the ductus arteriosus diagnosed at 24 weeks of gestation with detailed imaging study. Also, we highlight the importance of the use of fundamental tools in the diagnosis: 3D ultrasound, multiplanar reconstruction, spatio-temporal image correlation (STIC), and omniview.

Creating and validating a neurosurgical intervention rule-out tool for patients with mild traumatic brain injury and isolated subdural hematoma: a 5-year, six-center retrospective cohort study.

OBJECTIVE: Because there is no reliable method on admission to predict whether a patient will require neurosurgical intervention in the future, the general approach remains to treat each patient with mild traumatic brain injury (mTBI) and subdural hematoma (SDH) as if they will require such an intervention. Consequently, there is a growing population of patients with mTBI and SDH that is overtriaged despite having a low probability of needing neurosurgical intervention. This study aimed to train and validate a predictive rule-out tool for neurosurgical intervention in patients with mTBI and SDH. METHODS: This was a retrospective cohort study of all trauma patients admitted to six level I trauma centers in three states. Patients were included if they met the following criteria: admitted between 2016 and 2020, ≥ 18 years of age, ICD-10 diagnosis of isolated SDH, initial head imaging available, initial Glasgow Coma Scale score of 13-15, and arrived within 48 hours of injury. Exclusion criteria included skull fracture, intracranial hemorrhage other than an SDH, and no neurosurgical consultation. Prediction variables included 34 demographic, clinical, and radiographic variables. The study outcome was neurosurgical intervention within 48 hours of hospital admission. Seventy-five percent of the data were used for training, and 25% for testing. Multivariable logistic regression with fivefold cross-validation was used on the training set to identify covariates with the highest specificity while holding sensitivity at 100%. Results were validated on the testing set. RESULTS: In total, 1000 patients were in the training set and 333 in the testing set. The overall neurosurgical intervention rate was 8.8%. For the fivefold cross-validation process, three variables were selected that maximized specificity while holding sensitivity at 100%: maximum hematoma thickness, initial Glasgow Coma Scale score, and preinjury antithrombotic use (sensitivity 100%, specificity 56%, area under the receiver operating characteristic curve 0.94). With a cutoff probability of neurosurgical intervention set at 1.88%, the final model was validated to predict neurosurgical intervention with a sensitivity of 100% (95% CI 88.4%-100%) and specificity of 55.1% (95% CI 49.3%-60.8%). CONCLUSIONS: In this study, the largest of its kind to date, the authors successfully developed and validated a new tool for ruling out the necessity of neurosurgical intervention in patients with mTBI and isolated SDH. By successfully identifying more than half of patients who are unlikely to require neurosurgery within the first 2 days of admission, this tool can be used to improve treatment efficiency and provide patients and clinicians with valuable prognostic information.

pH-Responsive Alginate/Chitosan Gel Films: An Alternative for Removing Cadmium and Lead from Water.

Biosorption, a non-expensive and easy method for removing potentially toxic metal ions from water, has been the subject of extensive research. In this context, this study introduces a novel approach using sodium alginate and chitosan, versatile biopolymers that have shown excellent results as biosorbents. The challenge of maintaining high efficiencies and reuse is addressed by developing alginate/chitosan-based films. These films, prepared using solvent casting and crosslinking methods, form a hydrogel network. The alginate/chitosan-based films, obtained using the eco-friendly polyelectrolyte complex method, were characterized by FTIR, SEM, TGA, and DSC. The study of their swelling pH response, adsorption, and desorption behavior revealed promising results. The adsorption of Pb was significantly enhanced by the presence of both biopolymers (98%) in a shorter time (15 min) at pH = 6.5. The adsorption of both ions followed a pseudo-second-order kinetic and the Langmuir isotherm model. The desorption efficiencies for Cd and Pb were 98.8% and 77.6% after five adsorption/desorption cycles, respectively. In conclusion, the alginate/chitosan-based films present a highly effective and novel approach for removing Cd and Pb from water, with a promising potential for reuse, demonstrating their strong potential in potentially toxic metal removal.

Integrating an antimicrobial nanocomposite to bioactive electrospun fibers for improved wound dressing materials.

This study investigates the fabrication and characterization of electrospun poly (ε-caprolactone)/poly (vinyl pyrrolidone) (PCL/PVP) fibers integrated with a nanocomposite of chitosan, silver nanocrystals, and graphene oxide (ChAgG), aimed at developing advanced wound dressing materials. The ChAgG nanocomposite, recognized for its antimicrobial and biocompatible properties, was incorporated into PCL/PVP fibers through electrospinning techniques. We assessed the resultant fibers' morphological, physicochemical, and mechanical properties, which exhibited significant enhancements in mechanical strength and demonstrated effective antimicrobial activity against common bacterial pathogens. The findings suggest that the PCL/PVP-ChAgG fibers maintain biocompatibility and facilitate controlled therapeutic delivery, positioning them as a promising solution for managing chronic and burn-related wounds. This study underscores the potential of these advanced materials to improve healing outcomes cost-effectively, particularly in settings plagued by high incidences of burn injuries. Further clinical investigations are recommended to explore these innovative fibers' full potential and real-world applicability.

Perceptions and attitudes about the contribution of the environment to childhood cancer: a pilot study in a medical guild and undergraduate students.

BACKGROUND: Identifying and recognizing environmental risk factors for childhood cancer is crucial to prevent it. Medical guild are the first contact to monitor children's health. Therefore, courses about the contribution of chemical toxins in the environment and health outcomes such as cancer should be included in their professional training. This study aimed to evaluate the perceptions and attitudes of a medical guild and undergraduate students in health sciences about the contribution of the environment to childhood cancer. METHODS: A pilot study was conducted, an online survey including thirteen questions was shared among medical guild members and undergraduate students in health sciences. Frequencies, percentages, and chi-square homogeneity tests were calculated to compare groups. RESULTS: Genetic factors ranked as the first possible cause of childhood cancer (88.2% medical guild and 97.7% undergraduate students). However, 70.6% of medical guild and 64.6% of undergraduate students reported that they have ever suspected that childhood cancer could be related to the environmental conditions in which children live. More than 95% of the participants reported that they would find it useful to have more knowledge about environmental risks and cancer. When data were analyzed by profession (medical guild) and academic year (undergraduate students), no significant differences were observed. Nonetheless, comparisons by academic discipline between undergraduate students, showed that a higher percentage of medicine and environmental sciences and health (over 98%) reported environmental exposure as risk factors associated with childhood cancer compared to 75% from physiotherapy, (p = 0.001). CONCLUSIONS: In this study, the environmental contribution to childhood cancer is not clear among the medical guild and undergraduate students. They should be trained on the topic of cancer and the environment.

Long-Acting Reversible Contraception (LARC) and Early Childbearing Revisited: Births and Birth Intendedness After LARC Removal in a State Medicaid Population (2012-2020).

Objectives. To analyze births and birth intendedness after long-acting reversible contraception (LARC) removal among Medicaid-insured women. Methods. We linked all Delaware women with a Medicaid-covered LARC removal in 2012 to 2020 (n = 8047) to birth records and to Pregnancy Risk Assessment Monitoring System (PRAMS) pregnancy intendedness survey responses (n = 241). Results. Births within 3 years of a Medicaid-covered LARC removal were much more likely to be to women in their 20s compared with all Medicaid births (63.5% vs 53.4%; P < .001). The intended proportion for births within 3 years of Medicaid-covered LARC removal (65.2%) was higher than for all Medicaid-covered births (58.8%; P = .08) and was consistently above 60% across all age groups younger than 30 years. Conclusions. A state Medicaid-insured population's use of highly effective reversible contraception was associated with births being concentrated among women in their 20s and with consistently high fractions of intended births across younger ages at birth. Public Health Implications. Programs and policies may consider LARC access for its potential to increase low-income women's reproductive autonomy by enhancing their ability to achieve births at the age of their choosing. (Am J Public Health. Published online ahead of print October 10, 2024:e1-e8. https://doi.org/10.2105/AJPH.2024.307844).

Assessing Patient Satisfaction With Metacognitive Training (MCT) for Psychosis: A Systematic Review of Randomized Clinical Trials.

OBJECTIVES: Metacognitive training (MCT) for psychosis is a group intervention that combines cognitive-behavioural therapy and psychoeducation. It has proven efficacy in reducing psychotic symptoms and correcting cognitive biases implicated in the development and maintenance of psychotic symptoms. However, other outcomes, such as patient satisfaction with the intervention, have not been well studied despite their importance for adherence and overall success. A systematic review of randomized clinical trials was conducted to assess satisfaction with MCT among adults with psychotic spectrum disorders. METHODS: The search was conducted in Ovid Embase, Ovid MEDLINE, PsycINFO and Cochrane Central Register of Controlled Trials (CENTRAL). PRISMA guidelines and the Cochrane Risk of Bias Tool were followed, and certainty of evidence was ascertained using the Grading of Recommendations Assessment, Development and Evaluation framework. The study is registered with PROSPERO (CRD42023418097). RESULTS: Patient satisfaction was considered the primary outcome in 3 of the 10 studies reviewed. Four studies compared MCT with other psychosocial interventions (a newspaper discussion group, cognitive remediation and supportive therapy), two of which found significantly higher satisfaction with MCT. A high percentage of all patients found MCT comprehensible and considered it an important part of their treatment; they would recommend the training to others and found the group setting advantageous. Most participants expressed high subjective satisfaction or acceptance of MCT. CONCLUSIONS: The authors found evidence that MCT may be associated with high levels of satisfaction in clinical trials whose main objective is to assess patient satisfaction, but more research is needed to consolidate the findings, especially for the extended version of MCT.