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Background: Marginalized mothers are disproportionately impacted by depression and face barriers in accessing mental health treatment. Recent efforts have focused on building capacity to address maternal depression in Head Start; however, it is unclear if mental health inequities can be addressed by two-generation programs in Head Start settings. Therefore, this study examined the implementation outcomes and processes of a two-generation program called "Healthy Moms, Healthy Kids" (HMHK) that provided an evidence-based depression treatment to ethnic minority Head Start mothers. Method: Quantitative and qualitative data were collected and merged in a convergent mixed method design in accordance with the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) framework. Qualitative data included interviews with 52 key stakeholders, including intervention participants and staff members, and 176 sets of meeting minutes from the implementation period. Quantitative data included intervention study data and administrative data. Results: It was difficult for HMHK to reach the target population, with only 16.8% of eligible mothers choosing to participate. However, mothers who participated experienced reductions in depressive symptoms and parenting stress and shared a variety of positive impacts in interviews. The program was also more successful in enrolling Latinx mothers who were Spanish-speaking or bilingual rather than English-speaking and Black/African American mothers, limiting its reach. Conclusion: Providing IPT therapy groups was effective in reducing maternal depressive symptoms and stress for those who enrolled, but additional work should focus on reducing barriers to participation, considering other delivery models to meet participants' needs, and identifying culturally relevant ways to meet the needs of Black mothers.

Background Since its academic inception in the 1960s, Germany’s general practice has seen numerous dissertations, many of which are housed in the ‘Archive of German language General Practice’ (ADAM).Aim This study aims to provide the first comprehensive overview of dissertation topics from the discipline of general- and family medicine in Germany, establishing a foundation for advancing research.Method We employed a systematic review approach, examining 801 dissertations from both ADAM and online sources. Each topic was identified, categorized, and finalized through consensus by two independent reviewers.Results Our analysis encompassed 486 dissertations from ADAM, 176 from the German national library, and 139 from university libraries. A total of 167 unique research topics were identified. The predominant themes included medical education (n = 49), medication orders (n = 39), frequent consultation issues (n = 33), complementary medicine (n = 32), and screening measures (n = 29). The use of qualitative methods was constantly rising, from no qualitative methods used from 1965–1974, up to 22% of dissertations in recent years.Conclusion The diversity of 167 research topics underscores the vastness and complexity of general practice in Germany. This structured overview is pivotal for facilitating focused and interconnected research endeavors in the field.

Weed control and replenishing soil moisture and fertility are important areas in fruit production. The number of studies focused to determine whether living mulches in tree rows can fulfil these tasks increases recently. In the paper the results of an 11-year experiment on the effect of two such mulches (Trifolium repens L. and Agrostis capillaris L.) on the growth, yield, and fruit quality of three pear cultivars ('Alfa', 'Dolores', 'Amfora') in relation to herbicide fallow are presented. In the experiment, a single sowing of covering plants without additional treatments was used. A statistically significant reduction in yield (20-22%) was found for both mulches used, which was related to weakening the vegetative growth of trees. The average fruit mass did not change significantly, but the percent share of large fruits increased significantly (about 17%) in the A. capillaris mulch. Fruits from trees growing in T. repens contained significantly more soluble solids and Ca. However, that mulch became heavily infested with weeds after a few years. The obtained results allow us to recommend the use of the living mulch A. capillaris in the tree rows of a commercial pear orchard. The 'Dolores' and 'Amfora' cvs are particularly recommended.

In this work, we report the set-up and results of the Liver Tumor Segmentation Benchmark (LiTS), which was organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI) 2017 and the International Conferences on Medical Image Computing and Computer-Assisted Intervention (MICCAI) 2017 and 2018. The image dataset is diverse and contains primary and secondary tumors with varied sizes and appearances with various lesion-to-background levels (hyper-/hypo-dense), created in collaboration with seven hospitals and research institutions. Seventy-five submitted liver and liver tumor segmentation algorithms were trained on a set of 131 computed tomography (CT) volumes and were tested on 70 unseen test images acquired from different patients. We found that not a single algorithm performed best for both liver and liver tumors in the three events. The best liver segmentation algorithm achieved a Dice score of 0.963, whereas, for tumor segmentation, the best algorithms achieved Dices scores of 0.674 (ISBI 2017), 0.702 (MICCAI 2017), and 0.739 (MICCAI 2018). Retrospectively, we performed additional analysis on liver tumor detection and revealed that not all top-performing segmentation algorithms worked well for tumor detection. The best liver tumor detection method achieved a lesion-wise recall of 0.458 (ISBI 2017), 0.515 (MICCAI 2017), and 0.554 (MICCAI 2018), indicating the need for further research. LiTS remains an active benchmark and resource for research, e.g., contributing the liver-related segmentation tasks in http://medicaldecathlon.com/. In addition, both data and online evaluation are accessible via https://competitions.codalab.org/competitions/17094.

Background: Weight stigma and bias are present in education, employment, and health care institutions, and have increased in recent years. College students in pre-health majors have been documented to hold weight biases, and interventions to mitigate these beliefs have had varying results. Objectives: This study's purpose was to assess the impact of a pedagogical intervention regarding weight stigma outcomes among first-year students. Method: Three instructors of lower-division health and social science courses implemented a 3-module lecture series on weight stigma, the environmental sources of weight variability, and body appreciation. Participants (N = 81; 48 from intervention (INT) classrooms, 33 from comparison [COM] classrooms) completed an end-of-semester survey regarding their anti-fat biases, fat phobia, and body appreciation, and a subset (n = 13) participated in a semi-structured interview about their experiences. Results: Results revealed no outcome differences between the treatment versus comparison groups, although self-reported body mass index (BMI) was a significant covariate (p = 0.008). A significant correlation emerged between BMI and fear of fat scores for COM (r = 0.52, p < 0.01) but not for INT students (r = 0.28, p > 0.05), suggesting the intervention may have impacted how students form their anti-fat biases in relation to their BMI. Qualitative findings yielded five themes -- connected course material with personal experiences; learned about weight stigma; shifted perspective on weight stigma; recognised application of weight stigma; material to future career; and valued learning about weight stigma -- that provided insight into how the intervention positively affected students. Conclusion: Informed by the findings from this study, future interventions should take a more immersive pedagogical approach.

Background: The liver and lungs are the most common sites of colorectal cancer (CRC) metastases. Their involvement can take five different clinical scenarios: lung metastases only, liver metastases only, lung metastases before liver metastases, liver metastases before lung metastases and simultaneous lung and liver metastases. Using clinical and morphological data we studied the clonal trajectory of these scenarios. Materials and methods: A total of 465 (CRC) patients with 7952 liver and 6406 lung metastases were evaluated. Metastases clinical route was deciphered from metastases number, timing, and linear/parallel ratio (LPR)- a computerized parameter used for deducing clonal trajectories. LPR of +1 suggest pure linear dissemination and −1 pure parallel. Results: Lung-only metastases: high percentage of metachronous disease with a long lead time and a low LPR suggest parallel dissemination. Liver-only metastases: Rare metachronous disease with a short lead time, and a high LPR suggest linear spread. Lung-before-liver metastases: rare solitary metastasis, a median gap of 21 months between the organs, high lung and low liver LPRs suggest linear progression to the lungs and parallel dissemination to the liver. Liver-before-lung metastases: low liver and high lung LPRs and a median gap of 16.5 months between the organs suggest parallel dissemination to the liver and linear spread from the liver to the lungs. Simultaneous liver and lung metastases: rare solitary metastasis and similar and high LPRs suggest simultaneous linear progression to both organs. Conclusions: CRC metastases have different dissemination trajectories in different clinical scenarios. This information can potentially impact on clinical management.

Lopinavir (LPV) and ritonavir (RTV) are two of the essential antiretroviral active pharmaceutical ingredients (APIs) characterized by poor solubility. Hence, attempts have been made to improve both their solubility and dissolution rate. One of the most effective approaches used for this purpose is to prepare amorphous solid dispersions (ASDs). To our best knowledge, this is the first attempt aimed at developing ASDs via the electrospinning technique in the form of fibers containing LPV and RTV. In particular, the impact of the various polymeric carriers, i.e., Kollidon K30 (PVP), Kollidon VA64 (KVA), and Eudragit® E100 (E100), as well as the drug content as a result of the LPV and RTV amorphization were investigated. The characterization of the electrospun fibers included microscopic, DSC, and XRD analyses, the assessment of their wettability, and equilibrium solubility and dissolution studies. The application of the electrospinning process led to the full amorphization of both the APIs, regardless of the drug content and the type of polymer matrix used. The utilization of E100 as a polymeric carrier for LPV and KVA for RTV, despite the beads-on-string morphology, had a favorable impact on the equilibrium solubility and dissolution rate. The results showed that the electrospinning method can be successfully used to manufacture ASDs with poorly soluble APIs.

BackgroundLength of hospital stay (LOS) is one of the essential indicators for evaluating the efficiency and the quality-of-care service delivered. predicting LOS is critical for resource allocation, decision-making, lowering neonatal morbidity and death, enhancing clinical outcomes and parent counseling. In addition, extended hospital stays (long LOS_NICU) place a burden on the healthcare systems decreasing bed turnover rates as well as their financial stand and the mental stress on families. In Ethiopia, there is limited evidence on the determinant factors that influence on LOS.ObjectivesTo determine factors affecting neonatal intensive care unit length of stay for all preterm newborns who were discharged alive.MethodThe study used a secondary data source, was collected for the Study of Illness in Preterm (SIP) infants project. The research study was a multicenter, cross-sectional, observational clinical study that took place in five Ethiopia hospitals from July 1, 2016, to May 31, 2018. The predictors of LOS were determined using Fine-Gray's competing risk analysis.ResultsFor this study 3,511 preterm infants admitted to the NICU were analyzed. About 28.8% of the preterm infants died during their time in neonatal care while 66.6% were discharged alive. At the end of the study 4.6% babies were still in the NICU. The overall median LOS (death or discharge) was 7 days, with an interquartile range of 8 days. The cumulative incidence of discharge rose with increasing in gestational age and birth weight, on the contrary, the rate of discharge was decreased by 45.7% with the development of RDS (SDH ratio: 0.543), by 75.9% with the development of apnea (SDH ratio: 0.241), by 36.2% with sepsis, and by 43.6% with pneumonia (SDH ratio: 0.564).ConclusionsPreterm newborns with a low gestational age and birth weight have a greater probability of having a prolonged LOS. Complications of the medical conditions RDS, apnea, sepsis, pneumonia, anemia, asphyxia, and NEC substantially raise LOS considerably.

Antibodies against Aß amyloid are indispensable research tools and potential therapeutics for Alzheimer's disease. They display several unusual properties, such as specificity for aggregated forms of the peptide, the ability to distinguish polymorphic aggregate structures, and the ability to recognize generic aggregation-related epitopes formed by unrelated amyloid sequences. Understanding the mechanisms underlying these unusual properties and the structures of their corresponding epitopes is crucial for the understanding why antibodies display different therapeutic activities and for the development of more effective therapeutic agents. Here we employed a novel "epitomic" approach to map the fine structure of the epitopes of 28 monoclonal antibodies against amyloid-beta using immunoselection of random sequences from a phage display library, deep sequencing, and pattern analysis to define the critical sequence elements recognized by the antibodies. Although most of the antibodies map to major linear epitopes in the amino terminal 1 to 14 residues of Aß, the antibodies display differences in the target sequence residues that are critical for binding and in their individual preferences for nontarget residues, indicating that the antibodies bind to alternative conformations of the sequence by different mechanisms. Epitomic analysis also identifies discontinuous, nonoverlapping sequence Aß segments that may constitute the conformational epitopes that underlie the aggregation specificity of antibodies. Aggregation-specific antibodies recognize sequences that display a significantly higher predicted propensity for forming amyloid than antibodies that recognize the monomer, indicating that the ability of random sequences to aggregate into amyloid is a critical element of their binding mechanism.

Antibodies against Aß amyloid are indispensable research tools and potential therapeutics for Alzheimer's disease. They display several unusual properties, such as specificity for aggregated forms of the peptide, the ability to distinguish polymorphic aggregate structures, and the ability to recognize generic aggregation-related epitopes formed by unrelated amyloid sequences. Understanding the mechanisms underlying these unusual properties and the structures of their corresponding epitopes is crucial for the understanding why antibodies display different therapeutic activities and for the development of more effective therapeutic agents. Here we employed a novel "epitomic" approach to map the fine structure of the epitopes of 28 monoclonal antibodies against amyloid-beta using immunoselection of random sequences from a phage display library, deep sequencing, and pattern analysis to define the critical sequence elements recognized by the antibodies. Although most of the antibodies map to major linear epitopes in the amino terminal 1 to 14 residues of Aß, the antibodies display differences in the target sequence residues that are critical for binding and in their individual preferences for nontarget residues, indicating that the antibodies bind to alternative conformations of the sequence by different mechanisms. Epitomic analysis also identifies discontinuous, nonoverlapping sequence Aß segments that may constitute the conformational epitopes that underlie the aggregation specificity of antibodies. Aggregation-specific antibodies recognize sequences that display a significantly higher predicted propensity for forming amyloid than antibodies that recognize the monomer, indicating that the ability of random sequences to aggregate into amyloid is a critical element of their binding mechanism.

Key points CT justification practices vary across Europe. Less than half of respondents reported advance justification of CT examinations. Imaging referral guidelines are widely available but not in daily use. CT for health screening is not widely used in Europe at present.

Heart tumors are a rare oncological problem. Nevertheless, they are an important element of cardio-oncology that should not be forgotten. The development of imaging techniques has made it possible to increase the probability of making a diagnosis in a non-invasive way. Despite the development of techniques such as computed tomography, magnetic resonance imaging or positron emission tomography, histopathological examination still remains the gold standard for making the final diagnosis and determining the appropriate therapeutic procedure. This paper is a summary of the available knowledge on the symptoms, diagnosis and treatment options of cardiac tumors. Data were obtained from PubMed and Google Scholar.

Crohn's disease is a chronic disease. It most often begins between the ages of 15 and 35 and lasts a lifetime. The earliest radiographic findings are aphthous ulcers. It can cause mouth-to-anal lesions and extra-intestinal complications. Typical symptoms are diarrhoea, abdominal pain, rectal bleeding, fever, weight loss and fatigue. Many different tests, including laboratory tests, are important in the diagnosis of the disease. Fecal calprotection is a direct marker of inflammation in the intestinal mucosa. Endoscopic examination remains the basic diagnostic method of Crohn's disease. In order to assess the small intestine, MRI or CT should be performed. In the case of acute disease progression, ileocolonoscopy should be the examination. The disease requires long-term treatment, both pharmacological and often surgical.

Pregnancy is a state of emergency for most women and is usually a great happiness. Twin pregnancy should bring double happiness. Unfortunately, it often means more problems, more research, more worries. TTTS is a twin-to-twin transfusion syndrome that carries many complications.It occurs in 5-25% of monochorionic twin pregnancies. The severity of the disease is determined using the Quintero scale. The methods of treatment include fetoscopic laser photocoagulation, expectant management, amnioreduction, termination of pregnancy, usually when the fetal lungs are mature. The prognosis depends on many factors, including the type of vascular anastomoses. There are two types of TTTS: acute and chronic.

Cardiovascular diseases, in particular ischemic heart disease, are the leading cause of death worldwide. According to the current guidelines of scientific societies, the most important target group, in which preventive actions play a key role, are e.g. patients with ischemic heart disease. The actions taken aimed at slowing down the progression of the disease, optimizing therapy, including its individualization, education and counseling in the field of pro-health behaviors. Preventive measures are also cost-effective in relation to the costs incurred for a number of measures taken in the event of an acute cardiovascular event. As a result, comprehensive care programs with secondary prevention as the primary objective are now considered the standard of care, particularly in patients with acute coronary artery disease (ACS).

Introduction: Atrial fibrillation (AF) is the most common supraventricular arrhythmia in clinical practice. The percentage of people with AF increases with age. The currently implemented procedure for detecting modifiable risk factors allows for early implementation of a therapeutic plan in primary and secondary prevention. The following work deals with the occurrence of atrial fibrillation, risk factors and ways of coping with the disease in patients undergoing coronary artery bypass grafting (CABG). Materials and methods: The literature available on PubMed and Google Scholar was reviewed using the words „atrial fibrillation”, „coronary artery bypass grafting”. Summary: Patients undergoing coronary artery bypass surgery are at risk of developing postoperative atrial fibrillation. This is especially true for older patients with additional burdens, such as past arrhythmia episodes, hypertension, critical stenosis of the right coronary artery.

With attention to the increasing onset of disease, the number of typical diseases of old age is also increasing. Osteoarthritis is one of the most common diseases that affect elderly people. It forces to introduce various methods of treatment, support the improvement of the benefits and quality of life of patients. If the disease is severely advanced, an effective treatment is to replace the joint which is destroy. The results of the study is a retrospective analysis of patients who underwent hip arthroplasty in the first age of 2023.

Cervical cancer is now a common occurrence in both non-pregnant and pregnant women. The sooner cancer is diagnosed, the greater the chance of cure and better prognosis for the future. Treatment is used if it is supported by a multidisciplinary team including doctors, midwives, psychologists, psychotherapists, physiotherapists. Diagnostics and methods of treatment of pregnant women for a complex process. These methods must be carefully analyzed and applied in accordance with the guidelines and the implementation of treatment and diagnostics in the event of damage to toxicity and risk to the mother and fetus. Matrials and methods: The literature available on PubMed and Google Scholar was reviewed using the words: „cancer and pregnancy”, „cervical cancer”

Cancer in pregnancy is a rare phenomenon. Pregnancy is a period when a number of tests are performed, thanks to which irregularities can be quickly diagnosed. The most common cancers during pregnancy are breast cancer and cervical cancer. Particular care should be taken in the diagnosis and treatment, as the teratogenicity of some of these methods must be taken into account. Treatment is used if it is supported by a multidisciplinary team consisting of doctors, midwives, psychologists, psychotherapists and physiotherapists. Materials and methods: The literature available on PubMed and Google Scholar was reviewed using the worlds „Gynecologic cancers in pregnancy”, „pregnancy”, „cancer”

Brugada syndrome (BrS) is a rare congenital arrhythmia syndrome. BrS is characterized by a tendency to syncope, ventricular arrhythmias and sudden cardiac death. These symptoms occur mainly at night and can occur spontaneously or as a result of provocation by, for example, fever, stress or medication. Based on the differences in electrocardiography, three types were distinguished. Genetic studies are being conducted, which have shown a significant defect of the SCN5A gene, which in turn leads to disturbances in the functioning of the sodium channel NaV1.5 has a negative impact on the course of depolarization of myocardial cells. Patients with symptoms of the disease are subjected to implantation of a cardioverter-defibrillator, which protects them against sudden death. Data was obtained from the PubMed and Google Scholar platforms.