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Black girls in the United States are disproportionately diagnosed with sexually transmitted infections (STIs), which can increase the risk of contracting HIV (human immunodeficiency virus), compared to adolescent girls of other races. Therefore, this study was designed to understand barriers to impactful HIV/STI and substance use prevention programmes for Black girls. Data was collected between October 2021 and June 2022 from twelve focus groups which included (N = 62) participants who identified as Black and female between the ages of 13 and 18 years old. Using intersectionality theory as a guiding framework, the data were analysed thematically. The analysis revealed three themes: 1) need for parent-child discussions on sex; 2) stigma in schools; 3) suggestions for Black girl-centred prevention programming. Participants described minimal discussion about sex in their household as well as STI/HIV and substance abuse stigma as barriers to impactful sex education. They also indicated that current substance use and STI/HIV prevention interventions are not tailored to the experience of Black girls and offered suggestions for improvement. In sum, participants pointed out several barriers to existing sex education and substance abuse prevention programs. Findings revealed that HIV and drug use prevention information and knowledge may be best received from older peers in small private settings that can allow for intimate discussion and sharing of reliable information on HIV education, aetiology, and safer sexual practices. In addition, the study findings support the need to develop a racial and gender-specific prevention programming that fosters peer relationships, social support, and empowerment-based principles.

Abstract Background Self-Directed Learning (SDL) is a theory of andragogy in which adult learners take their own initiative to identify and tailor their individual learning process and outcomes. In undergraduate medical education, SDL aims to develop medical students into lifelong learners. This study aims to estimate the overall effectiveness of self-directed learning compared to traditional didactic learning (TDL). Methods We performed a systematic review and meta-analysis according to the PRISMA statement. A systematic search was used across PubMed, Scopus, Embase and Google Scholar to identify peer-reviewed articles spanning from January 1, 2014, to May 30, 2024. Key words used were “self-directed learning” AND “undergraduate medical education.” Forest plots were generated with the Open Meta-analyst Software, comparing SDL and TDL. Results A total of 2,955 titles and abstracts were screened for eligibility, of which 95 articles met the eligibility criteria for full-text review. Following a more detailed screening, 19 articles met the criteria for inclusion in the systematic review and 14 articles met the criteria for inclusion in the meta-analysis. The systematic review included 2,098 students while the meta-analysis included 1,792 students. The overall mean difference for all studies was 2.399, 95% CI [0.121–4.678], and I2 = 98.56%. Conclusion Self-directed learning compared to traditional didactic learning is an effective learning strategy in medical undergraduate education and has the potential to aid in students’ learning and improve their cognitive performance. Moreover, SDL nurtures qualities such as autonomy, curiosity, and self-regulation, which are essential for success in the ever-evolving field of medicine.

Large waders including herons and egrets are important ecological wetland health indicators since these species are sensitive to a complex set of environmental factors. Anthropogenic factors are driving major changes in coastal and inland wetlands. We investigated the relationship between environmental variables, productivity, fish diversity and large waders in southwestern India. These variables cover climatic variables (rainfall), sediment variables (salinity, pH, organic carbon, nitrogen, phosphorus), water variables (Salinity, pH, temperature, nitrate, phosphate), primary productivity (Chlorophyll-a) and prey availability (mean fish stock availability). Densities of all the studied wader species decreased significantly from 2010 to 2019, with highest densities in agroecosystems or estuarine habitats and in post-monsoon seasons but lowest in mudflats and in monsoon seasons. Structural equational modelling revealed that rainfall and organic carbon positively affected the primary productivity, whereas water variables (nitrate, salinity and phosphate) positively affected the fish stock availability. This in turn positively affected the density of large wading birds. The decreasing trend of water nitrate negatively affected the primary productivity and density of waterbirds while rainfall negatively affected fish stock availability and waterbird density. Sediment phosphorous adversely affected both the biotic variables and the density of waterbirds. Sediment variables (salinity, pH, and phosphorus) increased over years, whereas organic carbon and nitrogen in the sediment decreased significantly. Salinity, water temperature, pH, and phosphate showed a significant increase while water nitrate, and chlorophyll-a decreased over the period of study. Significant decline in fish stock availability and altered environmental variables resulted in long term decline in the abundance of wading birds. Thus, large waders have adapted to these long-term, anthropogenically driven, environmental changes by shifting to agroecosystems and estuaries as their alternate foraging habitats. These population declines indicate consistent decline in ecosystem health of wetlands. Strategies need to be formulated to mitigate declines and restore ecosystem health.

Background Neurohormonal blocking drugs, like beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs), are recommended for treating anthracycline-induced left ventricular dysfunction (AILVD). However, there is limited evidence supporting their benefit. Therefore, this study evaluated associations of neurohormonal blockers and other clinical factors with recovery of left ventricular ejection fraction (LVEF) in patients with AILVD. Methods This retrospective chart review assessed patients treated with at least one dose of anthracycline, then had ≥10% LVEF reduction or post-anthracycline LVEF value

Summary: Genetic factors related to pregnancy-related traits are understudied, especially in ancestrally diverse cohorts. To assess maternal contributions to hypertensive disorders of pregnancy (HDP), we performed a multi-ancestry genome-wide association study (GWAS) of HDP in data from the North Carolina-based Personalized Environment and Genes Study (PEGS) cohort with validation in the UK Biobank (UKBB). The GWAS revealed two maternal loci associated with HDP at the genome-wide significance level. The lead independent variants were rs114954125 on chromosome 2 (near LRP1B; odds ratio [OR] [95% confidence interval {CI}]): 2.96 [2.02–4.34]; p = 2.82 × 10−8) and rs61176331 on chromosome 3 (on RARB; OR (95% CI): 3.08 (2.12–4.48); p = 3.52 × 10−9). We validated the associations near RARB with a meta-analysis of PEGS and the UKBB. We also identified cis-expression quantitative trait loci in the candidate region associated with decreased RARB expression in macrophage cells exposed to Salmonella. Chromatin mapping in FUMA identified a significant interaction within chromosome 3’s enhancer and open chromatin regions, with strong effects observed for RARB and H3P10 gene regulation in mesendoderm cells, mesenchymal stem cells, and trophoblast-like stem cells. We applied existing polygenic scores (PGS) for preeclampsia and gestational hypertension and found that the scores were significantly associated with HDP in PEGS. The findings demonstrate the power of multi-ancestry studies for genetic discovery and highlight the relationship between immune response, regulation, and HDP and the utility of PGS for risk prediction. (PEGS is registered at ClinicalTrials.gov: NCT00341237.)

As educational justice scholarship addressing racial oppression continues to name the role of the spirit, there is a need for Black and Brown Christian educators and researchers to locate ourselves as grounded in the epistemologies and pedagogies of Christ as our spiritual home. This paper brings together eight Black and Brown Christian educators and researchers to grapple with what it means to be Christians committed to racial justice in education against the backdrop of centuries of religious corruption. Through collaborative autoethnography, we turn to our spiritual and religious lives situated within our racialized identities to challenge the disciplinary and material boundaries of what critical qualitative research counts as "knowing." In doing this, we give ourselves, and all educators and researchers, permission to make evident the unseen forces that shape our ways of being in research and teaching.

This paper examines the official pedagogic discourse communicating the explicit inclusion of Mental Health (MH) education in Singapore's revised 2021 Character and Citizenship (CCE2021) curriculum within Singapore's state-driven educational context of decentralised centralism. By adapting Basil Bernstein's theoretical work on pedagogic discourse -- using William Tyler's typology of Bernstein's 'Pedagogic Codes' and 'Official Pedagogic Identities' -- our findings reveal how MH in CCE2021 projects different, simultaneous student identities. These include retrospective identities of students as resilient, community-minded citizens; prospective identities of students as vulnerable cyber users requiring explicit guidance for their future-readiness; de-centred therapeutic identities of students as reflective, self-actualising students requiring psychological safety; and de-centred market identities of students as trained advocates and community first responders. Together, they generate a tension where therapeutic identities are positioned as prerequisite to the other identities, subsuming individual well-being within community well-being, and conflating the intrinsic good of personal resilience with instrumental notions of future-readiness. This expresses a paradox where state-student social relations are both transformed and continued, as concerns of student confidentiality and efficacy of help-seeking efforts persist. Overall, we contend the educational reform of MH in CCE2021 accommodates rather than reconciles progressive concerns of youth mental health with neoliberal state imperatives.

Bacteroides are often the most abundant, commensal species in the gut microbiome of industrialized human populations. One of the most commonly detected species is Bacteroides ovatus. It has been linked to benefits like the suppression of intestinal inflammation but is also correlated with some autoimmune disorders, for example irritable bowel disorder (IBD). Bacterial cell surface carbohydrates, like capsular polysaccharides (CPS), may play a role in modulating these varied host interactions. Recent studies have begun to explore the diversity of CPS loci in Bacteroides; however, there is still much unknown. Here, we present structural and functional characterization of a putative polysaccharide deacetylase from Bacteroides ovatus (BoPDA) encoded in a CPS biosynthetic locus. We solved four high resolution crystal structures (1.36-1.56 Å) of the enzyme bound to divalent cations Co2+, Ni2+, Cu2+, or Zn2+ and performed carbohydrate binding and deacetylase activity assays. Structural analysis of BoPDA revealed an atypical domain architecture that is unique to this enzyme, with a carbohydrate esterase 4 (CE4) superfamily catalytic domain inserted into a carbohydrate binding module (CBM). Additionally, BoPDA lacks the canonical CE4 His-His-Asp metal binding motif and our structures show it utilizes a noncanonical His-Asp dyad to bind metal ions. BoPDA is the first protein involved in CPS biosynthesis from B. ovatus to be characterized, furthering our understanding of significant biosynthetic processes in this medically relevant gut microbe.