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Abstract Objective To determine the prevalence of mitochondrial diseases (MD) in Hong Kong (HK) and to evaluate the clinical characteristics and genetic landscape of MD patients in the region. Methods This study retrospectively reviewed the phenotypic and molecular characteristics of MD patients from participating public hospitals in HK between January 1985 to October 2020. Molecularly and/or enzymatically confirmed MD cases of any age were recruited via the Clinical Analysis and Reporting System (CDARS) using relevant keywords and/or International Classification of Disease (ICD) codes under the HK Hospital Authority or through the personal recollection of treating clinicians among the investigators. Results A total of 119 MD patients were recruited and analyzed in the study. The point prevalence of MD in HK was 1.02 in 100,000 people (95% confidence interval 0.81–1.28 in 100,000). 110 patients had molecularly proven MD and the other nine were diagnosed by OXPHOS enzymology analysis or mitochondrial DNA depletion analysis with unknown molecular basis. Pathogenic variants in the mitochondrial genome (72 patients) were more prevalent than those in the nuclear genome (38 patients) in our cohort. The most commonly involved organ system at disease onset was the neurological system, in which developmental delay, seizures or epilepsy, and stroke-like episodes were the most frequently reported presentations. The mortality rate in our cohort was 37%. Conclusion This study is a territory-wide overview of the clinical and genetic characteristics of MD patients in a Chinese population, providing the first available prevalence rate of MD in Hong Kong. The findings of this study aim to facilitate future in-depth evaluation of MD and lay the foundation to establish a local MD registry.

El Monasterio de las Descalzas Reales de Madrid se convirtió en uno de los centros religiosos más importantes del Madrid del Antiguo Régimen. Su vinculación con la familia Real desde el momento de su fundación, junto con la profesión de destacadas mujeres tanto de la familia Real como de importantes familias nobles de la época, le permitió adquirir dicha relevancia en celebraciones religiosas al igual que en diferentes eventos civiles. En este ámbito, resulta de gran interés conocer las religiosas que fueron miembros de esta comunidad. El propósito de este estudio es, reconstruir la relación de las monjas que profesaron en el cenobio clariano desde sus inicios a los primeros años del siglo XX, a través de nuevas fuentes archivísticas.

Background: Clinical studies have implicated the cerebellum in the pathogenesis of essential tremor (ET), and recent postmortem studies have identified structural changes in the ET cerebellum. While the basal ganglia have traditionally been implicated in dystonia, cerebellar involvement has been suggested as well, and a recent study showed Purkinje cell (PC) loss. We conducted a detailed postmortem examination of the brain in four individuals with clinical diagnoses of ET and dystonia, and hypothesized that pathological changes in the cerebellum would be greater in these four ET cases than in published ET cases without dystonia.Methods: After a complete neuropathological assessment, a standard parasagittal neocerebellar tissue block was harvested in each brain. One 7-µm thick section was stained with luxol fast blue/hematoxylin and eosin, and one section with the Bielschowsky method. We quantified PCs, torpedoes, heterotopic PCs, PC dendritic swellings, and basket cell changes.Results: Two ET+dystonia cases had more microscopic changes in the cerebellum than published ET cases; the other two cases had similar changes to published ET cases.Discussion: This is the first report that uses human autopsy tissue to study patients with both ET and dystonia. The findings were heterogeneous. Additional studies, with larger samples, are needed.

Macroautophagy is a cellular mechanism for the clearance of protein aggregates and damaged organelles. Impaired macroautophagy has been observed in neurodegenerative disorders. We investigated the macroautophagy pathway in essential tremor (ET) cases compared to age-matched controls. We analyzed microtubule-associated protein light chain 3-II (LC3-II), S6K, phosphorylated S6K, beclin-1, and mitochondrial membrane proteins levels by Western blot in the post-mortem cerebellum of 10 ET cases and 11 controls. We also performed immunohistochemistry in 12 ET cases and 13 controls to quantify LC3 clustering in Purkinje cells (PCs). LC3-II protein levels were significantly lower in ET cases vs. controls on Western blot (0.84 ± 0.14 vs. 1.00 ± 0.14, p = 0.02), and LC3-II clustering in PCs by immunohistochemistry was significantly lower in ET cases vs. controls (2.03 ± 3.45 vs. 8.80 ± 9.81, p = 0.03). In ET cases, disease duration was inversely correlated with LC3-II protein level (r = -0.64, p = 0.046). We found that mitochondrial membrane proteins were accumulated in ET (TIM23: 1.36 ± 0.11 in ET cases vs. 1.00 ± 0.08 in controls, p = 0.02; TOMM20: 1.63 ± 0.87 in ET cases vs. 1.00 ± 0.14 in controls, p = 0.03). Beclin-1, which is involved in macroautophagy, was strikingly deficient in ET (0.42 ± 0.13 vs. 1.00 ± 0.35, p

As the attention for climate change has grown in recent years, the topic of biodiversity loss has become increasingly relevant. The importance of biodiversity is reflected in the requirements stated in the Corporate Sustainability Reporting Directive (2022). 2024 is the year in which CSRD and ESRS are effective, implying that the first reports that must be compliant (by large listed companies) will be published in 2025. This article reflects on how and to what extent Dutch large listed companies already address the topic of biodiversity in their annual reports one year before they must comply with the CSRD (2024). Our research shows that many companies are aware of biodiversity issues. However, many companies have to further specify their policy, strategy, actions and targets by next year.

Abstract Assessment of immune correlates of severe COVID-19 has been hampered by the low numbers of severe cases in COVID-19 vaccine efficacy (VE) trials. We assess neutralizing and binding antibody levels at 4 weeks post-Ad26.COV2.S vaccination as correlates of risk and of protection against severe-critical COVID-19 through 220 days post-vaccination in the ENSEMBLE trial (NCT04505722), constituting ~4.5 months longer follow-up than our previous correlates analysis and enabling inclusion of 42 severe-critical vaccine-breakthrough cases. Neutralizing antibody titer is a strong inverse correlate of severe-critical COVID-19, with estimated hazard ratio (HR) per 10-fold increase 0.35 (95% CI: 0.13, 0.90). In a multivariable model, HRs are 0.31 (0.11, 0.89) for neutralizing antibody titer and 1.22 (0.49, 3.02) for anti-Spike binding antibody concentration. VE against severe-critical COVID-19 rises with neutralizing antibody titer: 63.1% (95% CI: 40.0%, 77.3%) at unquantifiable [

Abstract Background Sacituzumab govitecan is an antibody-drug conjugate that is FDA approved for refractory metastatic triple-negative breast cancer. It targets the human trophoblastic cell-surface antigen 2 (Trop-2) with SN-38, a topoisomerase I inhibitor, attached to the antibody [1]. SN-38 breaks DNA strands and induces tumor apoptosis [2]. Acute kidney injury (AKI) is one of its adverse effects mainly prerenal due to gastrointestinal toxicity, but it has not been reported to cause acute tubulointerstitial nephritis (ATIN). Case Presentation This report describes a rare adverse effect of sacituzumab govitecan, the approach to diagnosing the etiology of the patient’s AKI, and the mechanism by which sacituzumab govitecan causes ATIN. A woman with metastatic ER positive, PR positive, HER2 negative breast cancer who was initiated on sacituzumab govitecan presents with vomiting and diarrhea, and findings of nephrotic-range proteinuria, negative anti-PLA2R antibody, and severe AKI requiring hemodialysis. She underwent kidney biopsy and pathology showed ATIN characterized by patchy interstitial inflammation alongside tubular injury without glomerular and vascular involvement. With intermittent renal replacement therapy, furosemide challenge, and a course of prednisone, the patient’s kidney function recovered. Conclusions Sacituzumab has a high affinity for Trop-2 protein which is also expressed within the collecting ducts, and to a lesser extent, the proximal tubule. Individuals, such as this patient, who express a homozygous genotype for UGT1A1*28 allele are at increased risk for AKI from sacituzumab govitecan due to decreased glucuronidation of SN-38.

Abstract In this study, we focused on calcification and diffusion restriction, which sometimes appear around the resection cavity or periventricular white matter in patients with high-grade glioma (HGG) treated with bevacizumab (BVZ), as candidate imaging biomarkers for BVZ treatment efficacy. We investigated the timing of the appearance of diffusion restriction and calcification using magnetic resonance imaging and computed tomography in 35 patients with newly diagnosed or recurrent HGG treated with BVZ. In 17 (48.6%) patients, calcification was identified around the resection cavity or periventricular white matter at a median of 12 months after the initiation of BVZ treatment. Patients with calcification had significantly longer progression-free survival (16 vs. 7 months; p = 0.0023) and overall survival (36 vs. 12 months; p = 0.0006) than those without calcification. Histopathological examination revealed the presence of scattered microcalcifications within areas of necrosis, which suggested dystrophic calcification induced by BVZ. Diffusion-restricted lesions that appeared in patients with calcification had significantly lower apparent diffusion coefficients than those in patients without calcifications, indicating the presence of treatment-related necrosis but not hypercellularity. In conclusion, the radiological finding of diffusion restriction followed by calcification could be a potential imaging biomarker for favorable clinical course in patients with HGG treated with BVZ.

We recently expanded the viral genomic surveillance program in Minnesota, USA, to include human respiratory syncytial virus. We performed whole-genome sequencing of 575 specimens collected at Minnesota healthcare facilities during July 2023–February 2024. Subgroups A and B differed in their genomic landscapes, and we identified 23 clusters of genetically identical genomes.

Abstract Genetic testing for Parkinson’s disease (PD) is infrequently performed due to perceptions of low utility. We investigated the personal utility in PD GENEration and how results lead to enrollment in additional research studies. Participants (n = 972) underwent genetic testing, results disclosure, genetic counseling, and completed a survey examining the perceived personal utility of their results and interest in participating in additional studies. Most participants found their genetic test results useful, including satisfying curiosity (81%), feeling good about helping the medical community (80%), and having information to share with family (77%). There were no significant differences in responses based on result type. Forty-five percent of participants expressed interest in participating in research studies; whereas 16% of participants confirmed enrollment. Our results suggest that participants find personal utility in genetic testing regardless of results. Although participants may be interested in enrolling in additional research, they may need support and resources.

Abstract Metabolic dysfunction-associated steatohepatitis (MASH) is a rising global disease signaling the urgent need for non-invasive tests (NITs). Recent work demonstrated that dynamic 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging can identify MASH by measuring liver glucose transport rate, K1, and liver CT attenuation. By combining dynamic PET/CT with the serum-based fibrosis-4 (FIB-4) test, we were able to better distinguish clinical MASH from fibrotic subtypes, enabling determination of the core tenets of MASH: steatosis, inflammation, and fibrosis. Future studies using FDG-PET technology can further enable concomitant prediction of MASH severity and extrahepatic comorbidities such as cardiovascular disease.

Abstract In the phase 3 Coronavirus Efficacy (COVE) trial (NCT04470427), post-dose two Ancestral Spike-specific binding (bAb) and neutralizing (nAb) antibodies were shown to be correlates of risk (CoR) and of protection against Ancestral-lineage COVID-19 in SARS-CoV-2 naive participants. In the SARS-CoV-2 Omicron era, Omicron subvariants with varying degrees of immune escape now dominate, seropositivity rates are high, and booster doses are administered, raising questions on whether and how these developments affect the bAb and nAb correlates. To address these questions, we assess post-boost BA.1 Spike-specific bAbs and nAbs as CoRs and as correlates of booster efficacy in COVE. For naive individuals, bAbs and nAbs inversely correlate with Omicron COVID-19: hazard ratios (HR) per 10-fold marker increase (95% confidence interval) are 0.16 (0.03, 0.79) and 0.31 (0.10, 0.96), respectively. In non-naive individuals the analogous results are similar: 0.15 (0.04, 0.63) and 0.28 (0.07, 1.08). For naive individuals, three vs two-dose booster efficacy correlates with predicted nAb titer at exposure, with estimates -8% (-126%, 48%), 50% (25%, 67%), and 74% (49%, 87%), at 56, 251, and 891 Arbitrary Units/ml. These results support the continued use of antibody as a surrogate endpoint.

Abstract Background In Australia, university clinical programs rely heavily on external healthcare professionals to provide a range of authentic clinical training and professional development opportunities for students. There is, however, a limited understanding of the factors that motivate these professionals to be educators and whether this varies across different healthcare disciplines within Australia. As the demand for clinical placements continues to increase, it is critical for the ongoing success of these programs that universities identify both the barriers associated with teaching and the benefits that enhance job satisfaction. Methods A two-part questionnaire was emailed to 849 external healthcare educators teaching predominantly in Medicine, Medical Imaging, and Optometry programs at Deakin University. Part-one surveyed the socio-demographics, perceived benefits, and barriers to teaching, plus the utilisation of entitlements offered by the university. Part-two was modelled on Dybowski and Harendza’s validated Physician Teaching Motivation Questionnaire (PTMQ) and adapted to an Australian audience. Results Overall, 776 out of the 849 questionnaires were considered in the final participant pool. The response rate for part-one was 19.7% (n = 153/776) and 18.3% (n = 142/776) for part-two. Across all professions, altruism was the primary source of motivation for teaching in Deakin University’s healthcare programs. Medical Imaging educators placed a higher value on career-related teaching aspects compared to those in Medicine and Optometry (p

Abstract Background Interprofessional education (IPE) has the potential to shape students’ collaboration perception and interprofessional identity but remains understudied. This study aims to understand the effects of the IPE program as a contextual trigger to promote collaboration perception change and interprofessional identity formation among healthcare professional students. Methods Using concurrent triangulation mixed-methods, we examined the relationship between collaboration perception and interprofessional identity change among health profession students (N = 263), and explored their perspectives on how their IPE experiences influenced their perception and identity. Participants completed the Interdisciplinary Education Perception Scale and Extended Professional Identity Scale and responded to open-ended questions before and after the IPE intervention. Pearson’s correlation, t-tests, regression (quantitative), and thematic analysis (qualitative) were conducted. Results Teams with initially lower collaboration perception (M = 3.59) and lower interprofessional identity (M = 3.59) showed a significant increase in collaboration perception (M = 3.76, t = 2.63; p = .02) and interprofessional identity (M = 3.97, t = 4.86; p

El objetivo del artículo es explorar la interacción entre la pandemia y las manifestaciones culturales, utilizando un enfoque cualitativo de los datos bibliográficos. El marco analítico se basa en suposiciones metodológicasde Marc Bloch (2001) para apoyar el análisis bibliográfico de las manifestaciones culturales y el impacto pan-démico de Covid-19. La globalización se analiza como un factor que intensifica el mercado de la información y tiene un gran impacto en las identidades culturales. Bauman (2007) reflexiona sobre la sociedad contempo-ránea y sus características fluidas y efímeras, que influyen en las manifestaciones culturales. El tema de la into-lerancia religiosa (Nogueira, 2020) también se aborda en el contexto de la pandemia, destacando los cambios en las formas de manifestación a lo largo de la historia. La investigación analiza las manifestaciones culturales como una forma de resistencia (Bhabha, 2007), donde aún con el impacto directo de la pandemia, se buscaron alternativas para continuar con sus festividades, y cómo estos elementos interculturales (Candau, 2016) abar-can la identidad de un pueblo, además de romper fronteras simbólicas impuestas por no aceptar al "otro".

Abstract Background In 2015, the results of the ‘Small bites versus large bites for closure of abdominal midline incisions (STITCH) Trial’ were published in The Lancet. This demonstrated the superiority of small bite laparotomy closure over mass closure for the reduction of incisional hernias; despite this most surgeons have not changed their practice. Previous research has shown the time taken for the implementation of evidenced based practise within medicine takes an average of 17 years. This study aims to understand the reasons why surgeons have and have not changed their practice with regards to closure of midline laparotomy. Methods Semi-structured interviews were completed with surgical consultants and registrars at a single institution in South West England. The interview topic guide was informed by a review of the published literature, which identified barriers to adopting evidence into surgical practice. Interview transcripts underwent thematic analysis with themes identified following discussions within the research team, exploring views on published data and clinical practise. Results Nine interviews with general surgical and urological consultants as well as registrars in training were performed. Three themes were identified; ‘Trusting the Evidence & Critical Appraisal’, ‘Surgical Attitude to Risk’ and ‘Adopting Evidence in Practise’, that reflected barriers to the introduction of evidenced based practise to clinical work. Conclusion Identification of the themes highlights possible areas for intervention to decrease the adoption time for evidence, for example from randomised controlled trials. The continued updating of clinical practise allows clinicians to provide best evidenced based care for patients and improve their outcomes.

Abstract This study aimed to assess retinal alterations following membrane peeling procedures using novel ILM Forceps with laser ablated surface with the help of intraoperative optical coherence tomography (iOCT). A post-hoc analysis was performed to evaluate iOCT findings in eyes that underwent membrane peeling procedures with the novel ILM Forceps. Pre-peel and post-peel iOCT videos and images were evaluated for each eye to assess for post-peel anatomic alterations. Surgical video/iOCT scan correlation was conducted to evaluate the etiology of anatomic alterations. Thirty-two eyes were included in the analysis. Three eyes (9%) had focal full thickness retinal elevations identified on iOCT following tissue-instrument interaction with the ILM Forceps. Two eyes (6%) had focal inner retinal elevations and one eye (3%) had a full-thickness retinal elevation that were not related to direct tissue-instrument interaction but rather indirect peeling forces. iOCT-identified architectural alterations related to direct-tissue instrument interaction were relatively infrequent (

Abstract The diversity in genome resources is fundamental to designing genomic strategies for local breed improvement and utilisation. These resources also support gene discovery and enhance our understanding of the mechanisms of resilience with applications beyond local breeds. Here, we report the genome sequences of 555 cattle (208 of which comprise new data) and high-density (HD) array genotyping of 1,082 samples (537 new samples) from indigenous African cattle populations. The new sequences have an average genome coverage of ~30X, three times higher than the average (~10X) of the over 300 sequences already in the public domain. Following variant quality checks, we identified approximately 32.3 million sequence variants and 661,943 HD autosomal variants mapped to the Bos taurus reference genome (ARS-UCD1.2). The new datasets were generated as part of the Centre for Tropical Livestock Genetics and Health (CTLGH) Genomic Reference Resource for African Cattle (GRRFAC) initiative, which aspires to facilitate the generation of this livestock resource and hopes for its utilisation for complete indigenous breed characterisation and sustainable global livestock improvement.

Background: Rural US regions experience lower naloxone dispensing rates compared to urban counterparts, particularly in Alabama. In light of this, strategies to enhance opioid counseling and naloxone services (OCN) in rural community pharmacies are critical. However, organizational readiness to implement OCN in rural versus urban contexts where resource networks may differ is not well understood. Objectives: The purpose of this study was to explore organizational readiness and identify factors associated with implementation of OCN in rural versus urban Alabama community pharmacies. Methods: Alabama community pharmacists and technicians were recruited to participate in an anonymous online cross-sectional survey via email. The survey instrument was adapted from the Organizational Readiness to Change Assessment (ORCA). Primary outcome measures included 3 overarching ORCA domains (Evidence, Context, and Facilitation) with 19 subscales regarding OCN implementation readiness, measured via 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree). Secondarily, pharmacy OCN implementation status (implementer, non-implementer, or in-development) was measured via multiple-choice (1-item). Differences in mean domain and subscale scores between rural and urban pharmacies were evaluated using Mann-Whitney U tests and influential factors affecting OCN implementation status were assessed via logistic regression (alpha = 0.05). Results: Of 171 respondents, the majority were pharmacists (78.6 %) in urban locations (57.1 %). Mean[SD] clinical experience evidence (Evidence) (3.98[0.69] vs 3.74[0.71]; p = 0.029), staff culture (Context) (4.04[0.66] vs 3.85[0.76]; p = 0.047), service measurement goals (Context) (3.92[0.77] vs 3.66[0.79]; p = 0.034), and senior management characteristics (Facilitation) (3.87[0.72] vs 3.71[0.66]; p = 0.045) subscales were higher in urban versus rural pharmacies. Notably, 66.7 % of pharmacies were current OCN implementers, and pharmacies with higher ORCA context domain scores had 3.230 greater odds of implementing or being in the process of developing OCN (95 % CI = 1.116–9.350; p = 0.031). Conclusion: Organizational readiness to implement OCN was higher among urban versus rural pharmacies in terms of perceived strength of clinical evidence, staff culture, service measurement goals, and senior management characteristics. Future research may leverage key contextual factors to enhance OCN implementation.

Summary: Background: Adolescent pregnancies pose a risk to young mothers and their babies. In Zambia, one third of 18-year-old girls have given birth. Poverty, low secondary school enrolment, misinformation, and community norms contribute to early childbearing. We assessed the effectiveness of economic support alone and combined with comprehensive sexuality education (CSE) and community dialogue on childbearing and sitting for grade nine exams among girls. Methods: This cluster randomised trial had one control and two intervention arms. In 2016, 157 rural schools (units of randomisation) were included, and girls in grade seven were eligible. After recruitment, schools were stratified by district and randomised (ratio 31:63:63). In one arm, girls and their guardians were offered economic support. Another arm combined CSE and community dialogues with the economic support. The interventions were implemented for 27 months, and the participants were followed for another 2 years. The primary outcomes were birth within 8 months of the end of the intervention period, birth before the 18th birthday, and sitting for grade nine exams. The trial is registered with ISRCTN (ISRCTN12727868). Findings: Between 3rd March and 15th July 2016, 4922 girls were recruited, with 999 randomised to the control, 2004 to the economic and 1919 to the combined arm. The combined support gave a moderate reduction in the incidence of birth within eight months of the intervention period's end (risk difference (RD) −0.042 (95% CI −0.084, −0.0003), possibly a minimal reduction in birth before the 18th birthday (RD −0.010 (95% CI −0.053, 0.032), and a substantial increase in sitting for grade nine exams (RD 0.17 (95% CI 0.11, 0.22). The economic support alone tended to give slightly smaller effects. Interpretation: Our findings suggest that a combination of economic support, CSE and community dialogue may give small reductions in adolescent childbearing. The same interventions can increase completion of basic education. Funding: The Research Council of Norway, the University of Bergen and the Swedish International Development Cooperation Agency (SIDA).

Aim: This study aimed to conduct a global assessment of swallow function (GASF) using a range of swallow outcome tools, in a cohort of patients pre- and post-treatment with image-guided volumetric modulated arc therapy (VMAT) radiotherapy. Materials and methods: All patients receiving radical (chemo)radiation for SCC of the larynx, oro-, hypo- or nasopharynx between October 2016 – 2021 were eligible for inclusion.Patients were treated with VMAT radiotherapy according to institutional and national protocols.Patients underwent GASF pre- and 6 months post-treatment. Data were collated from the MD Anderson Dysphagia Inventory (MDADI), the Functional Oral Intake Scale (FOIS), the Performance Status Scale-Head and Neck: Normalcy of Diet scale (PSS-NoD), the 100 ml water swallow test (WST) for capacity and maximal interincisal opening (MIO). Results: One hundred and seventy-five patients were included. 55.2 % of patients experienced a fall in MDADI-Composite score greater than the published meaningful clinical important difference (MCID).A trend for a decrease in FOIS score reflects a decrease in range of diet textures and increase in reliance on enteral feeding at 6 months post-treatment.Mean PSS-NoD score decreased reflecting increased restriction in diet textures.20 patients’ WST capacity improved by the minimal clinically important difference of > 4mls whilst 37 % of patients experienced a decrease in WST capacity of 4mls or more. 12.6 % of patients developed trismus following radiotherapy. Conclusions: This paper adds new detail to the understanding of the decline in measured eating, drinking and swallowing function that patients treated with VMAT radiotherapyexperience at 6 months post treatment. However, gaps are highlighted in the evidence base in terms of interpretation of swallow outcomes tool scores; future research in HNC should include ongoing discussion and development around robust outcomes tools and data collection.

Introduction Routine collection of patient-reported outcome measures (PROMs) has the potential to inform and improve cancer care. It is now feasible for patients to complete PROMs electronically (ePROMs) providing information about their current levels of symptoms, side effects of treatment and other concerns. PROM scores can be tracked over time allowing more timely identification of problems and more appropriate intervention. Studies have reported clear benefits in patient–clinician communication when PROMs are used and trials in the USA and France found patients randomised to complete regular ePROMs reported better health-related quality of life, had fewer unplanned hospital visits and, importantly, significantly better survival than those randomised to usual care. However, information about the effects on health outcomes and, particularly, the cost-effectiveness of incorporating this information into practice is limited.Methods and analysis PROMISE (Patient Reported Outcome Measures in cancer care: a hybrid effectiveness-Implementation trial to optimise Symptom control and health service Experience) is a multicentre, randomised hybrid effectiveness/implementation trial to evaluate the clinical and cost-effectiveness of using ePROMs in routine cancer care to improve patient outcomes. Participants (target sample=572; randomised 1:1 to intervention and control) are adults aged 18 years or older diagnosed with a solid cancer and starting treatment at one of the four study hospitals. The primary outcomes are unplanned hospital presentations and physical/functional well-being at 6 months. We hypothesise that, compared with usual care, patients randomised to use an ePROM tool will have fewer unplanned hospital presentations, report better health-related quality of life and greater satisfaction with their care and that the ePROM tool will be cost-effective. We will also assess implementation and process outcomes consistent with the RE-AIM (Reach Effectiveness Adoption Implementation Maintenance) Framework.Ethics and dissemination This trial has been approved by the Metro South Human Research Ethics Committee (HREC/2020/QMS/67441). Participants provide written informed consent, including consent for record linkage, prior to completing the baseline questionnaire. Study results will be disseminated via peer-reviewed journals and presentations at scientific conferences and clinical meetings.Trial registration number ACTRN12620001290987.

The sudden shift to remote learning during the Covid-19 pandemic has brought much distress to teachers. Since the teachers are considered as the major force that facilitates the learning process, their well-being should be given importance. The study used a survey research design to determine the level of distress among private school teachers in San Pablo City, Philippines, using the Covid-19 Peritraumatic Distress Index (CPDI). It also analyzed the sources of distress and examined the different coping strategies the teachers are using to mitigate the distress related to remote learning. Results show that the majority of the respondents are experiencing distress, with most having mild-moderate distress, followed by severe distress. Preparation of learning materials, internet connectivity problems, limited teacher-student interaction, assessment of student's learning, tracking student's progress, inconducive working environment, and inadequate technical skills were identified as sources of distress. Most respondents prefer coping strategies that would promote their overall wellness and those activities that avoid the source of distress. These findings have implications for school owners and administrators, policymakers, and curriculum developers in addressing the needs of teachers by providing programs that would help them cope with the distress related to remote learning.

As experiências vivenciadas por licenciandos em Física ganham destaque na medida em que se compreende que estes retroalimentarão a educação básica. No entanto, pesquisas têm mostrado pouca ênfase em discussões sobre as aprendizagens de conceitos e fenômenos abordados pela Física Moderna e Contemporânea (FMC). Por isso, implementamos a técnica da Revisão Sistemática de Literatura (RSL) de Kitchenham e Charters (2007), cujo corpus é constituído de teses disponibilizadas no período de 1987 a 2021 no contexto do ensino de Física em cursos de licenciatura, a fim de analisar os caminhos tomados pelos pesquisadores: teorias e avaliação da aprendizagem, recursos didáticos, estratégias de ensino e conteúdos abordados. A partir da leitura das 6 teses selecionadas, concluímos que apesar das práticas apresentarem propostas para melhorias do ensino de FMC nos cursos de licenciatura, suas possibilidades educacionais não foram significativamente exploradas, principalmente nas discussões de transposição didática e dificuldades de aprendizagem.

Abstract Background Globally, the counting of deaths based on gender identity and sexual orientation has been a challenge for health systems. In most cases, non-governmental organizations have dedicated themselves to this work. Despite these efforts in generating information, the scarcity of official data presents significant limitations in policy formulation and actions guided by population needs. Therefore, this manuscript aims to evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to gender identity and sexual orientation in the State of Rio de Janeiro. Methods This study evaluated the accuracy of the probabilistic record linkage to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy. Results The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother’s name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs. Conclusion With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and gender markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBTQ + population more closely reflects the reality experienced by these population groups.

Abstract Background The problem of mental ill-health in doctors is complex, accentuated by the COVID-19 pandemic, and impacts on healthcare provision and broader organisational performance. There are many interventions to address the problem but currently no systematic way to categorise them, which makes it hard to describe and compare interventions. As a result, implementation tends to be unfocussed and fall short of the standards developed for implementing complex healthcare interventions. This study aims to develop: 1) a conceptual typology of workplace mental health and wellbeing interventions and 2) a mapping tool to apply the typology within research and practice. Methods Typology development was based on iterative cycles of analysis of published and in-practice interventions, incorporation of relevant theories and frameworks, and team and stakeholder group discussions. Results The newly developed typology and mapping tool enable interventions to be conceptualised and/or mapped into different categories, for example whether they are designed to be largely preventative (by either improving the workplace or increasing personal resources) or to resolve problems after they have arisen. Interventions may be mapped across more than one category to reflect the nuance and complexity in many mental health and wellbeing interventions. Mapping of interventions indicated that most publications have not clarified their underlying assumptions about what causes outcomes or the theoretical basis for the intervention. Conclusion The conceptual typology and mapping tool aims to raise the quality of future research and promote clear thinking about the nature and purpose of interventions, In doing so it aims to support future research and practice in planning interventions to improve the mental health and wellbeing of doctors.

El agua envasada ―o embotellada― es una fuente vital de hidratación en favor de la salud. Las empresas de agua embotellada gestionan los recursos responsablemente y tienen como gran reto invertir en ciencia, tecnología, innovación e investigación, y prácticas que mejoran la calidad y conservación del agua. En Colombia, el mercado del agua embotellada se lo disputan cerca de 800 compañías, las cuales parten del agua potable, y le suman tratamientos de microfiltración, nanofiltración, ozonización, ósmosis inversa, luz ultravioleta y pasteurización, entre otros. El objetivo del presente estudio fue evaluar la presencia de aerobios mesófilos, coliformes, Pseudomonas aeruginosa y Salmonella spp. en agua potable tratada envasada producida por empresas de San José de Cúcuta, y comercializada en los municipios de Los Patios, Villa del Rosario y Cúcuta, Colombia. Se recolectaron 50 muestras en diez empresas y se analizaron siguiendo metodologías establecidas en las normas técnicas colombianas. Se determinó la presencia de aerobios mesófilos en un 76 % del total de muestras, coliformes totales en 36 %, coliformes fecales en 28 %, Pseudomonas aeruginosa en 12 % y Salmonella spp. en 0 %, resultados que superan los valores permitidos de acuerdo con lo expuesto por el Ministerio de Salud (1991), en la resolución 12186 de 1991, razón por la cual se debe hacer un seguimiento y control exhaustivo en las etapas del procesamiento y distribución del agua potable tratada envasada, a fin de establecer las medidas correctivas necesarias que aseguren la calidad y reduzcan el riesgo potencial para la salud de los consumidores.

Beyond the challenges presented by obesity itself, a considerable portion of the population encounters prejudice and discriminatory behavior based on their weight and size. This phenomenon, termed weight stigma and weight bias, appears to be perpetuated not only by the broader society but also by healthcare providers, leading to distrust and alienation among individuals with obesity, thereby exacerbating a global issue. Recognizing weight stigma as a violation of human rights and its association with declining health outcomes, there is a pressing need to explore evidence-based strategies for mitigating it within healthcare. This is especially crucial at the early stages of professional development. Methodology: A randomized controlled trial employing a 60 min lecture experimental design was conducted to evaluate changes in conceptions, beliefs, and prejudices toward obesity among healthcare undergraduates (n = 242). Results: Semantic network analysis revealed participants’ conceptualization of obesity as a condition closely linked to diet and sedentary habits. Moreover, three out of four healthcare students considered obesity a disease for which the individual is responsible. While individuals with obesity were described as weak, lazy, and having a high affinity for food, these prejudices decreased following the educational intervention. Conclusion: Following an educational intervention based on the multifactorial nature of obesity and weight stigma, it was possible to modify prejudices and conceptions about obesity among future healthcare professionals.

Summary: In African American adults, the strongest genetic predictor of pneumonia appears to be the A allele of rs334, a variant in the β-globin gene, which in homozygous form causes sickle cell disease (SCD). No comparable studies have been done in African American children. We performed genome-wide association analyses of 482 African American children with documented pneumonia and 2,048 African American control individuals using genotypes imputed from two reference panels: 1000 Genomes (1KG) (which contains rs334) and TOPMed (does not contain rs334). Using 1KG imputed genotypes, the most significant variant was rs334 (A allele; odds ratio [OR] = 2.76; 95% CI, 2.21–3.74; p = 5.9 × 10−19); using TOPMed imputed genotypes the most significant variant was rs2226952, found in the β-globin locus control region (G allele; OR = 2.14; 95% CI, 1.78–2.57; p = 5.1 × 10−16). After conditioning on rs334, the most strongly associated variant in the β-globin locus, rs33930165 (T allele, 1KG: OR = 4.09; 95% CI, 2.29–7.29; p = 1.7 × 10−6; TOPMed: OR = 3.58; 95% CI, 2.18–5.90; p = 4.7 × 10−7), which as a compound heterozygote with rs334 A allele, can cause SCD. To compare the power of different sample sets we developed a way to estimate the power of sample sets with different sample sizes, genotype arrays, and imputation platforms. Our results suggest that, in African American children, the strongest genetic determinants of pneumonia are those that increase the risk of SCD.