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Training programs focused on developing the next generation of scholars with expertise in HIV and mental health are crucial for advancing health equity and cultivating a diverse workforce by supporting individuals with lived experience and a strong commitment to serving underserved communities. However, disparities persist in the workforce, particularly in the inclusion of professionals typically underrepresented in research. The aim of this commentary is to explore the strengths and challenges of a NIMH-funded training program (T32), Culturally focused HIV Advancements through the Next Generation for Equity (CHANGE), at the University of Miami, with the goal of providing a series of general recommendations. The program excels in leveraging Miami’s unique context, recruiting a cohort of trainees committed to addressing HIV and mental health inequities, delivering a tailored curriculum, and providing strong leadership and mentorship networks to trainees. Additional opportunities for training programs that attract minoritized scholars to realize their vision include further increasing underrepresented scholars in health research, expanding federal funding and institutional investment in training programs, continuing to combat systemic inequities, fostering culturally-sensitive mentorship training, and building upon existing resources to provide trauma-informed support that acknowledges and addresses the unique, intersectional, and historical trauma experienced by trainees. We close with calls to action spanning institutional, community, and policy levels, urging scientists and decision-makers to actively address disparities in diversifying the HIV workforce, fostering equity, and creating inclusive training environments.

Objective: B-HOLISTIC was a real-world retrospective study of treatment patterns and clinical outcomes in Hodgkin lymphoma (HL) in regions outside Europe and North America. This subgroup analysis reports findings from Saudi Arabia, Türkiye, and South Africa. Materials and Methods: Patients aged ≥18 years and diagnosed with stage IIB-IV classical HL receiving frontline chemotherapy (frontline cHL) and/or with relapsed/refractory HL (RRHL) from January 2010 to December 2013 were assessed. The primary endpoint was progressionfree survival (PFS) in patients with RRHL. Results: Overall, 694 patients (RRHL: n=178; frontline cHL: n=653) were enrolled. Among patients with RRHL, >80% received first salvage chemotherapy. The most common first salvage regimens were etoposide, methylprednisolone, cytarabine, and cisplatin in Saudi Arabia (78.3%) and dexamethasone, cytarabine, and cisplatin in Türkiye (36.1%) and South Africa (40%). Median PFS (95% confidence interval [CI]) in the RRHL group was 5.1 (3.0-15.9), 19.7 (7.5-not reached), and 5.2 (1.1-10.1) months in Saudi Arabia, Türkiye, and South Africa, respectively. The 5-year PFS and overall survival (95% CI) rates in patients with RRHL were 33.2% (21.6-45.2) and 78.2% (65.9-86.5) in Saudi Arabia, 42.5% (29.5-54.9) and 79.4% (67.2-87.5) in Türkiye, and 13.1% (4.2-27.0) and 53% (35.5-67.8) in South Africa, respectively. Conclusion: This study showed that the clinical outcomes in Türkiye and Saudi Arabia were generally comparable with those of Western countries during the study period, although Saudi Arabia had lower PFS rates. Conversely, the clinical outcomes in South Africa were suboptimal, emphasizing the need for novel therapies and improved progression to stem cell transplantation. These data may serve as a control group for future studies in these countries and inform clinical decision-making.

SETTING: An established response to an outbreak of drug-resistant TB (DR-TB) on Daru Island, South Fly District (SFD), Western Province, Papua New Guinea (PNG). OBJECTIVE: To describe and evaluate the trends in TB case notification disaggregated by demographic and clinical characteristics, programmatic interventions for TB and COVID-19 and treatment outcomes in 2017–2022. DESIGN: A cohort study of routinely collected programmatic data of all patients registered for TB treatment in SFD comparing pre-COVID (2017–2019) to COVID (2020–2022) periods. RESULTS: Of the 3,751 TB cases registered, 19.6% had DR-TB, and the case notification rate was 1,792/100,000 for Daru and 623/100,000 for SFD. There was a 29.2% reduction in case notifications from 2019 to 2021, with recovery in 2022. During COVID, the healthcare workforce was adversely impacted, and active TB case-finding was stopped. During COVID, compared to pre-COVID, bacteriological confirmation increased (62.3% to 71.9%), whereas rates of child TB notifications (11.6% to 9.1%), pulmonary TB (60.8% to 57.4%) and DR-TB (20.7% to 18.6%) decreased. High rates of treatment success were maintained for both drug-susceptible (86.5%) and DR-TB (83.6%). CONCLUSION: Health systems strengthening and community engagement before COVID likely contributed to resilience and mitigated potential impacts on TB in this remote and resource-limited setting. Case notifications remain very high, and additional interventions are needed to interrupt transmission.

SETTING: Linezolid (LZD) has emerged as a critical agent and core component of regimens to treat drug-resistant TB (DR-TB); however, there are ongoing uncertainties regarding its safety and the optimal dosing approach. Since 2016, linezolid has been used in the treatment of patients diagnosed with DR-TB at Daru Provincial Hospital, PNG. OBJECTIVE: To describe the patient characteristics, treatment outcomes, and tolerability of linezolid-containing regimens used to treat DR-TB in Daru, Western Province. DESIGN: This was a retrospective analysis of programmatic data. RESULTS: A total of 632 eligible patients were diagnosed with DR-TB during the study period. Of these, 580 (91.8%) were commenced on a LZD-containing regimen. Among patients with baseline haemoglobin results available (380/632, 60.1%), the median value was 10.1 g/dL, with a mean corpuscular volume of 70.7 fL, 78.1% of those with haemoglobin results were anaemic at baseline. Despite this, 242/580 (41.7%) patients were able to complete the full LZD course of treatment (typically 18 months) without dose reduction or interruption. Treatment success was observed in 87.9% of the cohort. Neurotoxicity was not commonly reported, but adverse events were likely under-reported. CONCLUSION: In this cohort, with high rates of baseline anaemia, prolonged therapy with LZD was relatively well tolerated.

Early diagnosis is extremely important for children with autism spectrum disorder (ASD), as other children having developmental disabilities. In early diagnosis, which is one of the most important elements of the treatment process, parents have a special place with different factors. Considering the importance of parents in early diagnosis, the aim of the study is to examine the opinions of the mother on early developmental differences in children with autism. The research is a case study designed in a qualitative research model. Accordingly, an interview form was developed by the researchers and data were collected in the scanning model in the first step of the study. In the second step of the study, data were obtained by using the semi-structured interview method, which is one of the qualitative research methods. In the study group of the research, 110 mothers were interviewed, whom were selected via purposeful sampling, and 87 mothers, who gave full answers to the questions, were included in the study. The data obtained were subjected to descriptive and thematic analysis. As a result of the study, it was found that children diagnosed with autism and children with development showed similar developmental characteristics during pregnancy and after birth. It was observed that mothers with a child diagnosed with autism have the awareness on the suspicion of autism in their children when they are between 18 and 24 months and 31 and 36 months, and they experienced problems in breast-feeding and falling asleep.

SETTING: Daru Island in Papua New Guinea (PNG) has a high prevalence of TB and multidrug-resistant TB (MDR-TB). OBJECTIVE: To evaluate the early implementation of a community-wide project to detect and treat TB disease and infection, outline the decision-making processes, and change the model of care. DESIGN: A continuous quality improvement (CQI) initiative used a plan-do-study-act (PDSA) framework for prospective implementation. Care cascades were analysed for case detection, treatment, and TB preventive treatment (TPT) initiation. RESULTS: Of 3,263 people screened for TB between June and December 2023, 13.7% (447/3,263) screened positive (CAD4TB or symptoms), 77.9% (348/447) had Xpert Ultra testing, 6.9% (24/348) were diagnosed with TB and all initiated treatment. For 5–34-year-olds without active TB (n = 1,928), 82.0% (1,581/1,928) had tuberculin skin testing (TST), 96.1% (1,519/1,581) had TST read, 23.0% (350/1,519) were TST-positive, 95.4% (334/350) were TPT eligible, and 78.7% (263/334) initiated TPT. Three PDSA review cycles informed adjustments to the model of care, including CAD4TB threshold and TPT criteria. Key challenges identified were meeting screening targets, sputum unavailability from asymptomatic individuals with high CAD4TB scores, and consumable stock-outs. CONCLUSION: CQI improved project implementation by increasing the detection of TB disease and infection and accelerating the pace of screening needed to achieve timely community-wide coverage.

Beam-down solar towers are presented as an alternative to conventional solar towers that allow modular design, easily adaptable to industrial environments. Secondary reflectors are a key component in this type of configuration, due to the high concentration of radiation received from the solar field. The results of a technical and economic study of new secondary reflectors, based on a polished stainless-steel substrate with silver PVD coating and a system of protective layers, are presented and compared with aluminum reflectors, currently used in such configurations. For this, twelve different designs, grouped in three cases are simulated using ray tracing and finite elements. The results show that the steel reflectors reach lower temperatures compared to aluminum reflectors, allowing for greater durability. Additionally, the optical efficiency of the plant was determined, and it was estimated that steel reflectors can reduce the LCOH of the plant by approximately 3.5%.

Abstract Background In low and middle-income countries like Kenya, critical care facilities are limited, meaning acutely ill patients are managed in the general wards. Nurses in these wards are expected to detect and respond to patient deterioration to prevent cardiac arrest or death. This study examined nurses' vital signs documentation practices during clinical deterioration and explored factors influencing their ability to detect and respond to deterioration. Methods This convergent parallel mixed methods study was conducted in the general medical and surgical wards of three hospitals in Kenya's coastal region. Quantitative data on the extent to which the nurses monitored and documented the vital signs 24 h before a cardiac arrest (death) occurred was retrieved from patients' medical records. In-depth, semi-structured interviews were conducted with twenty-four purposefully drawn registered nurses working in the three hospitals' adult medical and surgical wards. Results This study reviewed 405 patient records and found most of the documentation of the vital signs was done in the nursing notes and not the vital signs observation chart. During the 24 h prior to death, respiratory rate was documented the least in only 1.2% of the records. Only a very small percentage of patients had any vital event documented for all six-time points, i.e. four hourly. Thematic analysis of the interview data identified five broad themes related to detecting and responding promptly to deterioration. These were insufficient monitoring of vital signs linked to limited availability of equipment and supplies, staffing conditions and workload, lack of training and guidelines, and communication and teamwork constraints among healthcare workers. Conclusion The study showed that nurses did not consistently monitor and record vital signs in the general wards. They also worked in suboptimal ward environments that do not support their ability to promptly detect and respond to clinical deterioration. The findings illustrate the importance of implementation of standardised systems for patient assessment and alert mechanisms for deterioration response. Furthermore, creating a supportive work environment is imperative in empowering nurses to identify and respond to patient deterioration. Addressing these issues is not only beneficial for the nurses but, more importantly, for the well-being of the patients they serve.

ABSTRACT This study was conducted to investigate the influence of two different production systems on the welfare of a new Turkish egg-laying hybrid known as Akbay. A total of 180 Akbay hens at the 80th week of production either reared in a free-range system or conventional cages were used. Live body weight at the 80th week of production was recorded, as well as the weight of immune organs and liver. Plumage damage, foot lesions, stress, and fear were examined. It was observed that the live body weight at the 80th week of production was significantly (p

Various emotion elicitation methods are used in many studies assessing the interaction of emotion and cognition. However, most of the experimental and meta-analysis studies comparing emotion elicitation methods have examined the success of emotion evoking in terms of valence and arousal. There are few experimental studies dealing with comparisons within discrete emotion approach. The present study was mainly aimed to determine the most effective emotion elicitation method for discrete emotions. Therefore, three emotion elicitation methods (film, IAPS, imagery) used to evoke three discrete emotions (fear, disgust, happiness) were examined in the framework of discrete, dimensional, and response component model of emotion. Within-subject design was used to examine the coherence of emotional response components such as subjective experience, facial expression, and physiological responses. The results suggested that film was the most effective among all emotion elicitation methods. All emotions elicited using the film method were accompanied not only by intense subjective experiences but also by physiological responses. IAPS and imagination methods successfully elicited subjective experiences of all emotions, except for fear - IAPS condition. Besides all, there was a lack of coherence between the components of emotional responses, and the most explicit results were obtained from subjective experiences., Author(s): Merve Boga [sup.1] , Mehmet Koyuncu [sup.1] , Gülin Kaça [sup.1] , Turan Onur Bayazit [sup.2] Author Affiliations: (1) grid.8302.9, 0000 0001 1092 2592, Department of Psychology, Ege University, [...]

After smallpox was eradicated worldwide in 1980 and routine smallpox vaccination subsequently ceased, monkeypox virus (MPXV) emerged as the most consequential orthopoxvirus for public health (1). The genetic clades of [...]

Background: Recurrences due to discontinuity in ablation lines are substantial after pulmonary vein isolation (PVI) with radiofrequency ablation for atrial fibrillation. Data are scarce regarding the durability predictors for very high-power short-duration (vHPSD, 90 W/4 s) ablation. Methods: A total of 20 patients were enrolled, who underwent 90 W PVI and a mandatory remapping procedure at 3 months. First-pass isolation (FPI) gaps, and acute pulmonary vein reconnection (PVR) sites were identified at the index procedure; and chronic PVR sites were identified at the repeated procedure. We analyzed parameters of ablation points (n = 1357), and evaluated their roles in predicting a composite endpoint of FPI gaps, acute and chronic PVR. Results: In total, 45 initial ablation points corresponding to gaps in the ablation lines were analyzed. Parameters associated with gaps were interlesion distance (ILD), baseline generator impedance, mean current, total charge, and loss of catheter–tissue contact. The optimal ILD cut-off for predicting gaps was 3.5 mm anteriorly, and 4 mm posteriorly. Conclusions: Biophysical characteristics dependent on generator impedance could affect the efficacy of vHPSD PVI. The use of smaller ILDs is required for effective and durable PVI with vHPSD compared to the consensus targets with lower power ablation, and lower ILDs for anterior applications seem necessary compared to posterior points.

High-level delafloxacin-resistant (H-L DLX-R) Staphylococcus aureus isolates (minimum inhibitory concentration ≥1 mg/L) associated with mutations affecting position 84 of ParC have emerged. We aimed to elucidate the role of these mutations as a mechanism of H-L DLX resistance in methicillin-resistant S. aureus (MRSA) isolates recovered from blood cultures. Susceptibility to DLX was determined in 75 MRSA isolates by E-test, and an rt-PCR was developed to detect mutations affecting position 84 of ParC to screen a further 185 MRSA isolates. The genomes of 48 isolates, including all DLX-R isolates or with alterations at position 84, and also a subset of DLX-susceptible isolates were analyzed. Among the 75 isolates studied, 77.34% were DLX-susceptible and only 4 H-L DLX-R isolates were found. Seven (3.8%) isolates with alterations at position 84 of ParC were detected by rt-PCR. Genomic analysis showed that 89.9% (8/9) of isolates with the substitution E84K/G in ParC, together with other mutations in gyrA and parC, were H-L DLX-R. However, the E84K substitution in ParC alone or with other alterations was found in two isolates without H-L DLX-R. Alterations at position 84 of ParC are rare but play a key role in H-L DLX resistance in MRSA but only when other alterations in GyrA are present.

Objective:Breast cancer (BC) is the most common cancer type in women and may be inherited, mostly in an autosomal dominant pattern. The clinical diagnosis of BC relies on the published diagnostic criteria, and analysis of two genes, BRCA1 and BRCA2, which are strongly associated with BC, are included in these criteria. The aim of this study was to compare BC index cases with non-BC individuals in terms of genotype and diagnostic features to investigate the genotype/demographic information association.Materials and Methods:Mutational analyses for the BRCA1/BRCA2 genes was performed in 2475 individuals between 2013-2022 from collaborative centers across Turkey, of whom 1444 with BC were designated as index cases.Results:Overall, mutations were identified in 17% (421/2475), while the percentage of mutation carriers in cases of BC was similar, 16.6% (239/1444). BRCA1/BRCA2 gene mutations were detected in 17.8% (131/737) of familial cases and 12% (78/549) of sporadic cases. Mutations in BRCA1 were found in 4.9%, whereas 12% were in BRCA2 (p

When a monkeypox virus outbreak began in several parts of the world in May 2022, timely and accurate diagnosis became mandatory. In our laboratory, a real-time quantitative PCR was designed and evaluated in several patient samples and compared with isolation results. Genomic viral load was related to virus viability.