Inclusion of Trainee Stakeholders Is Necessary for Effective Change in Health-Service-Psychology Internship Training.

In a recent call to action, we described pressing issues in the health-service-psychology (HSP) internship from the perspective of interns. In our article, we sought to initiate a dialogue that would include trainees and bring about concrete changes. The commentaries on our article are a testament to the readiness of the field to engage in such a dialogue, and we applaud the actionable recommendations that they make. In our response to these commentaries, we seek to move the conversation further forward. We observe two themes that cut across these responses: the impetus to gather novel data on training (the "need to know") and the importance of taking action (the "need to act"). We emphasize that in new efforts to gather data and take policy-level action, the inclusion of trainee stakeholders (as well as others involved in and affected by HSP training) is a crucial ingredient for sustainable and equitable change.

Pulmonary cryptococcosis in chronic kidney disease.

Pulmonary cryptococcosis is a fungal infection caused by Cryptococcus species, with Cryptococcus neoformans being the most common agent, affecting the lungs. While it commonly occurs in immunocompromised individuals, such as those with HIV/AIDS or undergoing immunosuppressive therapy, its presentation in patients with chronic kidney disease (CKD) is relatively rare. However, it should be considered in the differential diagnosis of respiratory infections in patients with CKD, particularly in the context of immunosuppression.

Severity of papular urticaria in children is associated with specific IgG4 anti-salivary gland antigens from Aedes aegypti.

Summary: Background. Papular Urticaria (PU) is a cutaneous hypersensitivity disorder triggered by hematophagous arthropod bites. Despite being a common condition, especially in tropical environments, many knowledge gaps are observed for this disease. The main objective of this study was to investigate the patterns of humoral immune response to mosquito antigens in children with PU and establish a correlation between this response and the severity of clinical symptoms. Methods. An analytical cross-sectional observational study was carried out. Clinical and sociodemographic data and children's blood samples were collected to measure the specific antibodies from: 1. A. aegypti salivary gland antigens; 2. A. aegypti whole body antigens (both produced in the laboratory of the Center for Health Sciences at the Federal University of Rio de Janeiro). A PU severity score based on clinical data is proposed to correlate disease severity with antibody reactivity signatures. Results. According to the clinical data, 58.9% of children received high severity scores. A significant statistical correlation was found between patients with high PU severity score and the development of symptoms before the age of two (p = 0.0326) and high IgG4 anti-salivary gland antigens concentration (p less than 0.05). Conclusion. It is suggested that PU severity in children is associated with a high concentration of IgG4 anti-salivary gland antigens from Aedes aegypti. Further studies are recommended to deepen the understanding of the mechanisms involved.

[Study of the growth temperature of ocular surface microorganisms in norm and in infectious keratitis]. / Izuchenie temperaturnykh uslovii rosta mikroorganizmov glaznoi poverkhnosti v norme i pri infektsionnykh keratitakh.

Standard bacteriological examinations, which involve culturing microorganisms at 37 °C, are commonly used in clinical practice for diagnosing infectious diseases. However, the growth temperature of microorganisms on the ocular surface (OS) during infectious keratitis (IK) may not coincide with the laboratory standard, which is due to the characteristic features of heat exchange in the eye. PURPOSE: This exploratory study examines the distribution and properties of OS microorganisms isolated under different temperature cultivation conditions in patients with IK and healthy volunteers without ophthalmic pathology. MATERIAL AND METHODS: Fifteen participants were divided into two groups. Group 1 (n=10) consisted of patients with signs of unilateral infectious keratitis, while group 2 (n=5) served as the control group. A novel microbiological method was employed to isolate pure cultures of microorganisms. This method involved cultivating microorganisms at two temperature regimes (37 °C and 24 °C) and subsequently identifying them using biochemical, immunological, and physicochemical techniques, including mass spectrometry. Scanning electron microscopy (SEM) with lanthanide staining used as the reference method. The temperature status of the ocular surface was assessed using non-contact infrared thermography. RESULTS: The study demonstrated the presence of psychrotolerant microorganisms on the ocular surface, which exhibited growth at a relatively low temperature of 24 °C. These psychrotolerant microorganisms were found to be isolated from the ocular surface displaying signs of temperature dysregulation. Among such microorganisms are Acinetobacter lwoffii, Achromobacter xylosoxidans, Bacillus licheniformis, Enterococcus faecalis, Klebsiella oxytoca, Klebsiella pneumoniae, Micrococcus luteus, Pseudomonas luteola, Streptococcus spp. CONCLUSION: When identifying the causative agent of infectious keratitis, it is crucial to consider the divergence of growth temperature of ocular surface microorganisms. The presence of psychrotolerant microorganisms on the ocular surface, which can effectively grow at room temperature, should be taken into account, especially in cases of temperature dysregulation.

mRNA-lncRNA gene expression signature in HPV-associated neoplasia and cervical cancer.

Cervical cancer is one of the most frequent cancers in women and is associated with human papillomavirus (HPV) in 70 % of cases. Cervical cancer occurs because of progression of low-differentiated cervical intraepithelial neoplasia through grade 2 and 3 lesions. Along with the protein-coding genes, long noncoding RNAs (lncRNAs) play an important role in the development of malignant cell transformation. Although human papillomavirus is widespread, there is currently no well-characterized transcriptomic signature to predict whether this tumor will develop in the presence of HPV-associated neoplastic changes in the cervical epithelium. Changes in gene activity in tumors reflect the biological diversity of cellular phenotype and physiological functions and can be an important diagnostic marker. We performed comparative transcriptome analysis using open RNA sequencing data to assess differentially expressed genes between normal tissue, neoplastic epithelium, and cervical cancer. Raw data were preprocessed using the Galaxy platform. Batch effect correction, identification of differentially expressed genes, and gene set enrichment analysis (GSEA) were performed using R programming language packages. Subcellular localization of lncRNA was analyzed using Locate-R and iLoc-LncRNA 2.0 web services. 1,572 differentially expressed genes (DEGs) were recorded in the "cancer vs. control" comparison, and 1,260 DEGs were recorded in the "cancer vs. neoplasia" comparison. Only two genes were observed to be differentially expressed in the "neoplasia vs. control" comparison. The search for common genes among the most strongly differentially expressed genes among all comparison groups resulted in the identification of an expression signature consisting of the CCL20, CDKN2A, CTCFL, piR-55219, TRH, SLC27A6 and EPHA5 genes. The transcription level of the CCL20 and CDKN2A genes becomes increased at the stage of neoplastic epithelial changes and stays so in cervical cancer. Validation on an independent microarray dataset showed that the differential expression patterns of the CDKN2A and SLC27A6 genes were conserved in the respective gene expression comparisons between groups.

Search for Baryon Number Violation in Top Quark Production and Decay Using Proton-Proton Collisions at sqrt[s]=13 TeV.

A search is presented for baryon number violating interactions in top quark production and decay. The analysis uses data from proton-proton collisions at a center-of-mass energy of 13 TeV, collected with the CMS detector at the LHC with an integrated luminosity of 138 fb^{-1}. Candidate events are selected by requiring two oppositely charged leptons (electrons or muons) and exactly one jet identified as originating from a bottom quark. Multivariate discriminants are used to separate the signal from the background. No significant deviation from the standard model prediction is observed. Upper limits are placed on the strength of baryon number violating couplings. For the first time the production of single top quarks via baryon number violating interactions is studied. This allows the search to set the most stringent constraints to date on the branching fraction of the top quark decay to a lepton, an up-type quark (u or c), and a down-type quark (d, s, or b). The results improve the previous bounds by 3 to 6 orders of magnitude based on the fermion flavor combination of the baryon number violating interactions.

Female Psammomys obesus Are Protected from Circadian Disruption-Induced Glucose Intolerance, Cardiac Fibrosis and Adipocyte Dysfunction.

Circadian disruption increases the development of cardiovascular disease and diabetes. We found that circadian disruption causes glucose intolerance, cardiac fibrosis and adipocyte tissue dysfunction in male sand rats, Psammomys obesus. Whether these effects occur in female P. obesus is unknown. Male and female P. obesus were fed a high energy diet and exposed to a neutral (12 light:12 dark, control) or short (5 light:19 dark, circadian disruption) photoperiod for 20 weeks. Circadian disruption impaired glucose tolerance in males but not females. It also increased cardiac perivascular fibrosis and cardiac expression of inflammatory marker Ccl2 in males, with no effect in females. Females had reduced proapoptotic Bax mRNA and cardiac Myh7:Myh6 hypertrophy ratio. Cardiac protection in females occurred despite reductions in the clock gene Per2. Circadian disruption increased adipocyte hypertrophy in both males and females. This was concomitant with a reduction in adipocyte differentiation markers Pparg and Cebpa in males and females, respectively. Circadian disruption increased visceral adipose expression of inflammatory mediators Ccl2, Tgfb1 and Cd68 and reduced browning marker Ucp1 in males. However, these changes were not observed in females. Collectively, our study show that sex differentially influences the effects of circadian disruption on glucose tolerance, cardiac function and adipose tissue dysfunction.

Performance Assessment of Object Detection Models Trained with Synthetic Data: A Case Study on Electrical Equipment Detection.

This paper explores a data augmentation approach for images of rigid bodies, particularly focusing on electrical equipment and analogous industrial objects. By leveraging manufacturer-provided datasheets containing precise equipment dimensions, we employed straightforward algorithms to generate synthetic images, permitting the expansion of the training dataset from a potentially unlimited viewpoint. In scenarios lacking genuine target images, we conducted a case study using two well-known detectors, representing two machine-learning paradigms: the Viola-Jones (VJ) and You Only Look Once (YOLO) detectors, trained exclusively on datasets featuring synthetic images as the positive examples of the target equipment, namely lightning rods and potential transformers. Performances of both detectors were assessed using real images in both visible and infrared spectra. YOLO consistently demonstrates F1 scores below 26% in both spectra, while VJ's scores lie in the interval from 38% to 61%. This performance discrepancy is discussed in view of paradigms' strengths and weaknesses, whereas the relatively high scores of at least one detector are taken as empirical evidence in favor of the proposed data augmentation approach.

Position paper on perioperative management and surgical risk in the patient with cirrhosis.

INTRODUCTION: Management of the patient with cirrhosis of the liver that requires surgical treatment has been relatively unexplored. In Mexico, there is currently no formal stance or expert recommendations to guide clinical decision-making in this context. AIMS: The present position paper reviews the existing evidence on risks, prognoses, precautions, special care, and specific management or procedures for patients with cirrhosis that require surgical interventions or invasive procedures. Our aim is to provide recommendations by an expert panel, based on the best published evidence, and consequently ensure timely, quality, efficient, and low-risk care for this specific group of patients. RESULTS: Twenty-seven recommendations were developed that address preoperative considerations, intraoperative settings, and postoperative follow-up and care. CONCLUSIONS: The assessment and care of patients with cirrhosis that require major surgical or invasive procedures should be overseen by a multidisciplinary team that includes the anesthesiologist, hepatologist, gastroenterologist, and clinical nutritionist. With respect to decompensated patients, a nephrology specialist may be required, given that kidney function is also a parameter involved in the prognosis of these patients.

Modulation of aryl hydrocarbon receptor activity by tyrosine kinase inhibitors (ponatinib and tofacitinib).

Ponatinib and tofacitinib, established kinase inhibitors and FDA-approved for chronic myeloid leukemia and rheumatoid arthritis, are recently undergoing investigation in diverse clinical trials for potential repurposing. The aryl hydrocarbon receptor (AhR), a transcription factor influencing a spectrum of physiological and pathophysiological activities, stands as a therapeutic target for numerous diseases. This study employs molecular modelling tools and in vitro assays to identify ponatinib and tofacitinib as AhR ligands, elucidating their binding and molecular interactions in the AhR PAS-B domain. Molecular docking analyses revealed that ponatinib and tofacitinib occupy the central pocket within the primary cavity, similar to AhR agonists 2,3,7,8-tetrachlorodibenzodioxin (TCDD) and (benzo[a]pyrene) B[a]P. Our simulations also showed that these compounds exhibit good stability, stabilizing many hot spots within the PAS-B domain, including the Dα-Eα loop, which serves as a regulatory element for the binding pocket. Binding energy calculations highlighted ponatinib's superior predicted affinity, revealing F295 as a crucial residue in maintaining strong interaction with the two compounds. Our in vitro data suggest that ponatinib functions as an AhR antagonist, blocking the downstream signaling of AhR pathway induced by TCDD and B[a]P. Additionally, both tofacitinib and ponatinib cause impairment in AhR-regulated CYP1A1 enzyme activity induced by potent AhR agonists. This study unveils ponatinib and tofacitinib as potential modulators of AhR, providing valuable insights into their therapeutic roles in AhR-associated diseases and enhancing our understanding of the intricate relationship between kinase inhibitors and AhR.

Comparison of low versus high (standard) intraabdominal pressure during laparoscopic colorectal surgery: systematic review and meta-analysis.

BACKGROUND: To evaluate outcomes of low with high intraabdominal pressure during laparoscopic colorectal resection surgery. METHODS: A systematic search of multiple electronic data sources was conducted, and all studies comparing low with high (standard) intraabdominal pressures were included. Our primary outcomes were post-operative ileus occurrence and return of bowel movement/flatus. The evaluated secondary outcomes included: total operative time, post-operative haemorrhage, anastomotic leak, pneumonia, surgical site infection, overall post-operative complications (categorised by Clavien-Dindo grading), and length of hospital stay. Revman 5.4 was used for data analysis. RESULTS: Six randomised controlled trials (RCTs) and one observational study with a total of 771 patients (370 surgery at low intraabdominal pressure and 401 at high pressures) were included. There was no statistically significant difference in all the measured outcomes; post-operative ileus [OR 0.80; CI (0.42, 1.52), P = 0.50], time-to-pass flatus [OR -4.31; CI (-12.12, 3.50), P = 0.28], total operative time [OR 0.40; CI (-10.19, 11.00), P = 0.94], post-operative haemorrhage [OR 1.51; CI (0.41, 5.58, P = 0.53], anastomotic leak [OR 1.14; CI (0.26, 4.91), P = 0.86], pneumonia [OR 1.15; CI (0.22, 6.09), P = 0.87], SSI [OR 0.69; CI (0.19, 2.47), P = 0.57], overall post-operative complications [OR 0.82; CI (0.52, 1.30), P = 0.40], Clavien-Dindo grade ≥ 3 [OR 1.27; CI (0.59, 2.77), P = 0.54], and length of hospital stay [OR -0.68; CI (-1.61, 0.24), P = 0.15]. CONCLUSION: Low intraabdominal pressure is safe and feasible approach to laparoscopic colorectal resection surgery with non-inferior outcomes to standard or high pressures. More robust and well-powered RCTs are needed to consolidate the potential benefits of low over high pressure intra-abdominal surgery.

Formulation of silver phosphate/graphene/silica nanocomposite for enhancing the photocatalytic degradation of trypan blue dye in aqueous solution.

Photocatalytic degradation of several harmful organic compounds has been presented as a potential approach to detoxify water in recent decades. Trypan Blue (TB) is an acidic azo dye used to distinguish live cells from dead ones and it's classified as a carcinogenic dye. In this study, silver phosphate (Ag3PO4) nanoparticles and novel Ag3PO4/graphene/SiO2 nanocomposite have been successfully prepared via simple precipitation method. Afterward, their physical properties, chemical composition, and morphology have been characterized using SEM, EDS, TEM, SAED, BET, XRD, FTIR and UV-VIS spectroscopy. The specific surface area of Ag3PO4 and Ag3PO4/G/SiO2 nanocomposite were reported to be 1.53 and 84.97 m2/g, respectively. The band gap energy of Ag3PO4 and Ag3PO4/G/SiO2 nanocomposite was measured to be 2.4 and 2.307 eV, respectively. Photocatalytic degradation of Trypan blue (TB) was studied at different parameters such as pH, catalyst dosage, initial concentration, and contact time. The results showed that, at initial dye concentration of 20 ppm, pH = 2, and using 0.03 g of Ag3PO4/G/SiO2 as a photocatalyst, the degradation percent of TB dye in the aqueous solution was 98.7% within 10 min of light exposure. Several adsorption isotherms such as Langmuir, Freundlich, and Temkin adsorption isotherms have been tested in addition to the photocatalytic degradation kinetics. Both catalysts were found to follow the Langmuir isotherm model and pseudo-second-order kinetic model. Finally, the possible photocatalytic performance mechanism of Ag3PO4/G/SiO2 was proposed.

From political priority to service delivery: Complexities to real-life priority of abortion services in Ethiopia.

Improving access to abortion services has been coined a high priority by the Ethiopian Federal Ministry of Health. Nevertheless, many women are still struggling to access abortion services. The dedicated commitment to expanding abortion services by central authorities and the difficulties in further improving access to the services make for an interesting case to explore the real-life complexities of health priority setting. This article thus explores what it means to make abortion services a priority by drawing on in-depth interviews with healthcare bureaucrats and key stakeholders working closely with abortion service policy and implementation. Data was collected from February to April 2022. Health bureaucrats from nine of the twelve regional states in Ethiopia and the Federal Ministry of Health were interviewed in addition to key stakeholders from professional organizations and NGOs. The study found that political will and priority to abortion services by central authorities were not necessarily enough to ensure access to the service across the health sector. At the regional and local level, there were considerable challenges with a lack of funding, equipment, and human resources for implementing and expanding access to abortion services. The inadequacy of indicators and reporting systems hindered accountability and made it difficult to give priority to abortion services among the series of health programs and priorities that local health authorities had to implement. The situation was further challenged by the contested nature of the abortion issue itself, both in the general population, but also amongst health bureaucrats and hospital leaders. This study casts a light on the complex and entangled processes of turning national-level priorities into on-the-ground practice and highlights the real-life challenges of setting and implementing health priorities.

The impact of the COVID-19 pandemic on adult bronchiectasis patients and the relationship between clinical parameters and bronchiectasis severity.

OBJECTIVE: Viral infections are an important cause of exacerbation in bronchiectasis patients. We aimed to determine the influence of the COVID-19 pandemic on adult bronchiectasis patients and whether there was a relationship between the clinical parameters and the COVID-19 infection. PATIENTS AND METHODS: In this retrospective observational study, 547 bronchiectasis patients were included. Demographic characteristics, vaccination status, Bronchiectasis Severity Index (BSI), FACED and Reiff scores, and clinical and laboratory parameters during COVID-19 infection were evaluated. RESULTS: The median age was 56, and 49.2% of the patients were male. The COVID-19 infection rate was 27.6%. 431 (78.8%) patients had at least one dose of the COVID-19 vaccine. The patients were divided into two groups according to their COVID-19 infection status. Emergency admission was significantly higher in the COVID-19-infected group. There was no statistical difference with other clinical factors. The COVID-19-infected patients were divided into home treatment and hospital/intensive care unit (ICU) treatment groups. There was a statistically significant difference between the two groups regarding advanced age, male gender, presence of asthma, long-term oxygen therapy (LTOT) and non-invasive mechanic ventilator (NIMV) usage, sputum culture positivity, BSI and FACED scores, and multiple laboratory parameters (ferritin, C-reactive protein, eosinophil). In logistic regression analysis, BSI was found as a risk factor [OR 1.252 (1.077-1.456), p=0.004] and eosinophilia as a protective factor [OR 0.986 (0.973-0.999), p=0.030] for hospital/ICU admission. CONCLUSIONS: Frequent emergency visits might increase the risk of COVID-19 infection in bronchiectasis patients. BSI was found to be an independent risk factor, and blood eosinophilia could play a protective role in hospital/ICU admission for COVID-19 infection.

Absence of effects of widespread badger culling on tuberculosis in cattle.

Government policy in England aims for the elimination of bovine tuberculosis (bTB). This policy includes culling of European badger (Meles meles) to reduce cattle TB incidence. The rationale is based on a field trial, the Randomised Badger Culling Trial (RBCT) 1998-2005, which reported a substantial decrease in bTB herd incidence where badger culling had been implemented, in comparison to untreated control areas. The RBCT was undertaken because previous studies of reductions in badgers by culling, reported a possible association between bTB in badger and cattle, but none could directly show causation. The effect of intensive widespread (proactive) culling in the RBCT was reported in 2006 in the journal Nature. Analysis of an extensive badger removal programme in England since 2013 has raised concerns that culling has not reduced bTB herd incidence. The present study re-examined RBCT data using a range of statistical models. Most analytical options showed no evidence to support an effect of badger culling on bTB herd incidence 'confirmed' by visible lesions and/or bacterial culture post mortem following a comparative intradermal skin test (SICCT). However, the statistical model chosen by the RBCT study was one of the few models that showed an effect. Various criteria suggest that this was not an optimal model, compared to other analytical options available. The most likely explanation is that the RBCT proactive cull analysis over-fitted the data with a non-standard method to control for exposure giving it a poor predictive value. Fresh appraisal shows that there was insufficient evidence to conclude RBCT proactive badger culling affected bTB breakdown incidence. The RBCT found no evidence of an effect of culling on 'total' herd incidence rates. Total herd incidences include those confirmed as bTB at necropsy and those herds where there was at least one animal animal positive to the comparative intradermal skin test, the standard diagnostic test used for routine surveillance, but not confirmed at necropsy. This was also the case using the more suitable statistical models. Use only of 'confirmed' herd incidence data, together with a more recent (2013) published perception that RBCT data presented 'a strong evidence base….with appropriate detailed statistical or other quantitative analysis' should be reconsidered. The results of the present report are consistent with other analyses that were unable to detect any disease control benefits from badger culling in England (2013-2019). This study demonstrates one form of potential driver to the reproducibility crisis, in this case with disease control management in an increasingly intensified livestock industry.

Effect of gamma irradiation on properties of the synthesized PANI-Cu nanoparticles assimilated into PS polymer for electromagnetic interference shielding application.

Conductive polymer nanocomposites for electromagnetic interference (EMI) shielding are important materials that can be combat the increasingly dangerous radiation pollution arising from electronic equipment and our surrounding environment. In this work, we have synthesized polyaniline-copper nanoparticles (PANI-Cu NPs) by the copper salt based oxidative polymerization method at room temperature and then added with different concentration (0, 1, 3 and 5 wt%) in polystyrene polymer forming PS/ PANI-Cu nanocomposites films by means of the traditional solution casting technique. The formed PANI-Cu NPs were investigated by UV/Vis spectroscopy, X-ray diffraction (XRD), transmission electron microscopy (TEM) and SEM/EDX elemental mapping techniques. On the other hand, the prepared PS/PANI-Cu nanocomposites films were evaluated by UV and SEM, the mechanical properties of the nanocomposites films were evaluated and showed an improvement by added PANI-Cu NPs up to 3 wt% and 50 kGy gamma exposure dose. The PS/PANI-Cu nanocomposites films were examined as electromagnetic interference shielding material. Electromagnetic shielding effectiveness of the produced nanocomposites were tested in the X-band of the radio frequency range namely from 8 to 12 GHz using the vector network analyzer (VNA) and a proper wave guide. All samples were studied before and after 50 kGy gamma-ray irradiation under the same condition of pressure and temperature. The results showed that the nanocomposites have improved shielding properties.

Quantum engineering of the radiative properties of a nanoscale mesoscopic system.

Despite the recent advances in quantum technology, the problem of controlling the light emission properties of quantum emitters used in numerous applications remains: a large spectral width, low intensity, blinking, photodegradation, biocompatibility, etc. In this work, we present the theoretical and experimental investigation of quantum light sources - mesoscopic systems consisting of fluorescent molecules in a thin polydopamine layer coupled with metallic or dielectric nanoparticles. Polydopamines possess many attractive adhesive and optical properties that promise their use as host media for dye molecules. However, numerous attempts to incorporate fluorescent molecules into polydopamines have failed, as polydopamine has been shown to be a very efficient fluorescence quencher through Förster resonance energy transfer and/or photoinduced electron transfer. Using the system as an example, we demonstrate new insights into the interactions between molecules and electromagnetic fields by carefully shaping its energy levels through strong matter-wave coupling of molecules to metallic nanoparticles. We show that the strong coupling effectively suppresses the quenching of fluorescent molecules in polydopamine, opening new possibilities for imaging.

Ka Malu a Wa'ahila: Cultivating cultural safety for Native Hawaiian students in university behavioral health.

Ka Malu a Wa'ahila, an Indigenous-centered and student-informed program, was established in 2022 to meet the growing behavioral health needs of Native Hawaiian college students at the University of Hawai'i at Manoa. Utilizing a cultural safety foundation and relying on the wisdom of community voices articulated by the Pilinaha framework, clinicians provide prevention, direct intervention, and outreach services. As the program continues to evolve, future plans include expanding to other Pacific Islanders and developing an additional layer of systemic change through building an Indigenous behavioral health training pathway and training curriculum for clinicians serving Native Hawaiian and Pacific Islander (NHPI) communities.