Group Therapy Research Articles

Emotional loneliness, perceived stress, and academic burnout of medical students after the COVID-19 pandemic.

In recent times, emotional loneliness has been increasing among young people, despite their intense social interaction via virtual platforms and in real life. Their social-emotional development seems to be interrupted due to high levels of psychological stress, and it probably results in significant academic problems. This study aimed to investigate the relationships between loneliness, perceived stress, and academic burnout among medical students after the COVID-19 pandemic. Datasets were collected from 630 medical students (51.7% women, with the mean age of 21.31 and the standard deviation of 2.14) by using scales for emotional and social loneliness, psychological stress, and academic burnout in January 2023. After verifying normality, a t-test and ANOVA were used to compare groups. Pearson's correlation coefficient and path analyses were also utilized for data analysis. In terms of loneliness, there were significant differences between genders in preclinical and clinical term groups, and stress levels were also significantly different between the two term groups. Men were found to be more emotionally lonely than women. No significant difference was observed for academic burnout across gender and term groups. Perceived stress played a mediator role between emotional loneliness and academic burnout, while social loneliness had almost no effect on either stress or academic burnout. Stress increased significantly as educational levels increased. According to the results, emotional loneliness and stress increase academic burnout. To alleviate burnout, emotional loneliness and stress should be decreased through various psychosocial interventions, such as group therapies. Addressing the psychological issues and improving the psychological resilience of medical students can also help.

Anomaly detection in the veterinary antibiotic prescription surveillance system (IS ABV)

Antibiotic resistance is one of the major concerns in veterinary and human medicine and poses a considerable threat to both human and animal health. It has been shown that over- or misuse of antibiotics is one of the primary drivers of antibiotic resistance. To develop the surveillance of antibiotic use, Switzerland introduced the "Informationssystem Antibiotika in der Veterinärmedizin" (IS ABV) in 2019, mandating electronic registration of antibiotic prescriptions by all veterinarians in Switzerland. However, initial data analysis revealed a considerable amount of implausible data entries, potentially compromising data quality and reliability. These anomalies may be caused by input errors, inaccuracies, incorrect or aberrant master data or data transmission and make analysis impossible. To address this issue efficiently, we propose a two-stage anomaly detection framework utilizing machine learning algorithms. In this study, our primary focus was on cattle treatments with either single or group therapy, as they were the species with the highest prescription volume. However, not all outliers are necessarily incorrect; some may be legitimate but unusual antibiotic treatments. Thus, expert review plays a crucial role in distinguishing outliers, that are correct from actual errors. Initially, relevant prescription variables were extracted and pre-processed with a custom-built scaler. A set of unsupervised algorithms calculated the probability of each data point and identified the most likely outliers. In collaboration with experts, we annotated anomalies and established anomaly thresholds for each production type and active substance. These expert-annotated labels were then used to fine-tune the final supervised classification algorithms. With this methodology, we identified 22,816 anomalies from a total of 1,994,170 prescriptions in cattle (1.1 %). Cattle with no further specified production type had the most (2 %) anomalies with 7758 out of 379,995. The anomalies were consistently identified and comprised prescriptions with too high and too low dosages. Random Forest achieved a ROC-AUC score of 0.994, (95 % CI: 0.992, 0.995) and a F1-Score of 0.962 (95 % CI: 0.958, 0.966) for single treatments. The versatility of this framework allows its adaptation to other species within IS ABV and potentially to other prescription-based surveillance systems. If applied regularly to uploaded prescriptions, it should reduce input errors over time, improving the validity of the data in the long term.

The Impact of Emotional Responses on Female Reproduction: Fibrinolysis in the Spotlight.

Fibrinolytic enzymes modify various substrates required for tissue remodeling, playing a crucial role in mechanisms underlying resilience, reward processing, ovulation, embryo implantation, and placentation. Individuals with low resilience and reduced reward responsiveness, when exposed to chronic stress, are at increased risk of experiencing a range of negative emotions. Chronic anxiety and melancholia are examples of negative emotions associated with hypercortisolism, while fear and atypical depression are characterized by systemic inflammation. Both cortisol and inflammatory cytokines stimulate the production of plasminogen activator inhibitor-1 (PAI-1), a potent fibrinolysis inhibitor. Chronic anxiety, fear, and depression are among the many hypofibrinolytic conditions increasing the risk of oligo-anovulation, miscarriage, fetal growth restriction, and preeclampsia. Although significant, the impact of negative emotions on implantation is not as obvious as on ovulation or placentation. Other hypofibrinolytic conditions that may affect female reproduction through mechanisms dependent or independent of PAI-1 include metabolic disturbances (e.g., due to consumption of highly palatable foods, often used to alleviate negative affect), inflammation, hyperhomocysteinemia, hypothyroidism, hypercortisolism, antiphospholipid antibodies, and the 4G allele of the PAI-1 gene. Benzodiazepines and antidepressants should be used with caution in the first trimester as this combination may cause malformations. Also, selective serotonin reuptake inhibitors have fibrinolytic properties that increase the risk of bleeding after surgical procedures. Psychological interventions, especially group therapy, are effective in the prevention of reproductive disorders. Controlled trials are needed to test the hypothesis that female reproductive health depends on psychological well-being, a balanced diet and physical activity, suppression of inflammation and autoantibodies, and homocysteine and hormonal homeostasis.

Comparing the effectiveness of behavioral activation in group vs. self-help format for reducing depression, repetitive thoughts, and enhancing performance of patients with major depressive disorder: a randomized clinical trial

BackgroundBehavioral activation has gained increasing attention as an effective treatment for depression. However, the effectiveness of Behavioral Activation Group Therapy (BAGT) in controlled conditions compared to its self-help programs requires more investigation. The present study aimed to compare their effectiveness on depressive symptoms, repetitive negative thinking (RNT), and performance in patients with major depressive disorder (MDD).MethodsIn this randomized clinical trial, 40 patients diagnosed with Major Depressive Disorder (MDD) were recruited based on a structured clinical interview for DSM-5 (SCID-5). Participants were allocated to BAGT (n = 20) and self-help behavioral activation (SBA; n = 20) groups. BAGT received ten weekly sessions (90 min), while the SBA group followed the same protocol as the self-help intervention. Participants were evaluated at pre-treatment, post-treatment, and the 2-month follow-up using the Beck Depression Inventory-II (BDI-II), repetitive thinking questionnaire (RTQ-31), and work and social adjustment scale (WSAS).ResultsThe results of a Mixed ANOVA analysis revealed that participants who underwent BAGT showed significant improvement in depression, rumination, work, and social functioning post-treatment and at the 2-month follow-up. However, the SBA group did not show significant changes in any outcome. The study also found that, based on clinical significance, 68% of the BAGT participants were responsive to treatment, and 31% achieved a high final performance status at the 2-month follow-up.DiscussionBAGT was more effective than SBA in MDD patients. Participants’ engagement with self-help treatment is discussed.Trial registrationThe present trial has been registered in the Iranian Registry of Clinical Trials Center (IRCT ID: IRCT20181128041782N1|| http://www.irct.ir/) (Registration Date: 04/03/2019).

A Systematic Review of Emotion Focused Group Therapy Using Quality Indicators

Emotion-focused group therapy (EFGT) is regarded as a helpful approach for clients; however, there remains a lack of comprehensive understanding pertaining to its application and efficacy. This article reviews the evidence for the quality of EFGT studies. Out of 288 articles, fifteen relevant studies were selected based on the review criteria. Descriptive analyses and quality indicators were used to analyze the selected articles. Despite emerging supportive evidence for EFGT, study results showed quality indicator categories were insufficient to guarantee research quality and key EFT task usage. These findings suggest further research and rigorous implementation of EFGT to enhance the effectiveness of mental health service delivery.

Racial and ethnic disparities in access to total neoadjuvant therapy for rectal cancer

BackgroundTotal neoadjuvant therapy has revolutionized the treatment of locally advanced rectal cancer and quickly become the new standard of care. Whether patients from all racial and ethnic groups have had equal access to these potential benefits, however, remains unknown. MethodsWe identified all adults diagnosed with locally advanced rectal cancer in California who underwent neoadjuvant chemotherapy and radiation from 2010 to 2020 using the California Cancer Registry. We used logistic regression to estimate the predicted probability of receiving total neoadjuvant therapy as opposed to traditional chemoradiotherapy for each racial and ethnic group and used a time–race interaction to evaluate trends in access to total neoadjuvant therapy over time. We also compared survival by racial and ethnic group and total neoadjuvant therapy status using Kaplan-Meier plots and Cox proportional hazards models. ResultsIn total, 6,856 patients met inclusion criteria. Overall, 36.6% of patients received total neoadjuvant therapy in 2010 compared with 66.3% in 2020. Latino patients were significantly less likely than non-Latino White patients to undergo total neoadjuvant therapy ; however, there was no difference in the rate of growth in total neoadjuvant therapy over time between racial and ethnic groups. Non-Latino Black patients appeared to have lower risk-adjusted survival compared with non-Latino White patients, although not among patients who underwent total neoadjuvant therapy . ConclusionAccess to total neoadjuvant therapy has increased significantly over time in California with no apparent difference in the rate of growth between racial and ethnic groups. We found no evidence of racial or ethnic disparities in survival among patients treated with total neoadjuvant therapy, suggesting that increasing access to high-quality cancer care may also improve health equity.

A person-centered, transdiagnostic schema and mode profile approach to predict outcome in time-limited schema group therapy

Objective This study employs a person-centered transdiagnostic approach to examine how schema and mode profiles predict symptom severity reduction in schema group therapy for patients with personality disorders and enduring clinical syndromes. Method We analyzed symptom reduction in 248 patients across three formats of manualized, time-limited schema group therapy. Latent profile analysis and mixed multilevel modeling were used to determine the extent to which schema/mode classes predict symptom reduction, and whether the inclusion of individual schemas and modes enhances these predictions. Results No significant differences in treatment outcomes were found across the group modalities. A three latent profile solution for schemas and modes showed external validity with clinical variables and demonstrated that declines in symptom severity varied by schema and mode class, even after adjusting for baseline symptom severity. Adding the Vulnerability to Harm schema and Vulnerable Child mode to the model increased the explained variance. Conclusion Patients with more severe personality problems show more substantial symptom reduction. Both schema and mode profiles significantly contribute to predicting post-treatment symptom levels. Understanding these profiles may help therapists tailor interventions more effectively, consistent with Young’s theoretical model. Trial registration: ISRCTN.org identifier: ISRCTN17262253.

US Military Veteran Perspectives on Eating Disorder Screening, Diagnosis, and Treatment: A Qualitative Study.

We aimed to explore US veteran perspectives on eating disorder screening, diagnosis, patient-provider conversations, and care in the Veterans Health Administration (VHA). Rapid qualitative analysis of 30-45 min phone interviews with 16 (N = 16) veterans with an electronic health record ICD-10 eating disorder diagnosis, who received care at one of two VHA healthcare systems in Connecticut or California. Topics covered included: conversations with providers about eating disorder symptoms, diagnosis, and referral to treatment; feedback about an eating disorder screener, and; reflections on eating disorders among veterans and VHA's effort to address them. Most veterans reported difficulty understanding and defining the problems they were experiencing and self-diagnosed their eating disorder before discussing it with a provider. Treatment referrals were almost universally for being overweight rather than for an eating disorder, often leading veterans to feel misunderstood or marginalized. Overall, veterans were enthusiastic about the screener, preferred screening to be conducted by primary care providers, and noted that conversations needed to be non-stigmatizing. There was consensus that VHA is not doing enough to address this issue, that group support and therapy could be beneficial, and that resources needed to be centralized and accessible. For the most part, veterans felt that, at best, eating disorders and disordered eating are overlooked, and at worst, conflated with overweight. The majority of veterans got referred for weight loss or weight management services but would welcome the opportunity to be screened for, and referred to, eating disorder treatment.

Emotional Dysregulation in Anorexia Nervosa: Scoping Review of Psychological Treatments.

Eating disorders are complex psychiatric disorders characterized by compensatory and restrictive behavior and a preoccupation with one's body. Eating and purging behaviors are considered dysfunctional emotional regulation strategies. Therefore, psychological treatment is essential. The most common psychological interventions are dialectical behavior therapy (DBT), cognitive-behavioral therapy (CBT), family therapy (FBT), multi-family group therapy (MFTG) and mentalization-based treatment (MBT). The aim of this study was to summarize the current evidence on the impact of psychological treatments on emotional regulation difficulties and psychological symptoms in patients with eating disorders, especially anorexia nervosa. A search was conducted on PubMed and Web of Science using the terms "anorexia nervosa" and "emotion dysregulation". Of the 278 initial articles, we included 15 publications. The results indicate that the acquisition of coping strategies, through DBT, leads to an improvement in anxiety and alexithymia. DBT, CBT and MBT lead to a reduction in the use of dysfunctional emotional regulation strategies too. Eating disorders involve both physical and mental health; therefore, it is desirable for future research to focus on the mutual synergy between the mental and physical components by evaluating various factors, such as biomarkers and the most appropriate therapeutic approach, with respect to the treatment setting.

Effectiveness of residential versus outpatient therapy for smoking cessation: The START randomized clinical trial.

Tobacco smoking represents a major cause for preventable death and morbidity. Results from non-randomized studies suggest that smoking cessation therapy in a residential setting might be a new viable way to facilitate smoking abstinence. We aimed to test the effects of residential multicomponent group therapy for smoking cessation compared with outpatient group therapy. Prospective parallel-group open-label randomized superiority trial, with assessments at baseline, 6 and 12 months. Recruitment throughout Germany via media advertisements. Adult smokers (≥10 cigarettes/day) randomly assigned to residential (n = 157) or outpatient (n = 158) therapy. 51.8% female; mean age 53.2 years; mean years of smoking 34.4. Residential 9-day smoking cessation group therapy comprising six daily therapy sessions and supportive interventions for cessation and daily structure embedded in the routines of a somatic rehabilitation center, compared with weekly outpatient smoking cessation group therapy (3-7weeks) provided in routine care courses close to the participants' places of residence, both including at least 9h of behavioral therapy. Co-primary outcomes were self-reported continuous 6- and 12-month abstinence (hierarchically ordered). Primary analyses were conducted in the therapy-uptake population including participants who started therapy with sensitivity analyses in the intention-to-treat population of all randomized participants. Intervention uptake rates were 87.3% (n = 137) in the residential and 60.1% (n = 95) in the outpatient group. In the therapy-uptake population, abstinence rates were 46.7% in the residential versus 26.3% in the outpatient group at 6 months (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.39-4.33, P = 0.0019) and 39.4% versus 24.2% at 12 months (OR = 2.04, 95% CI = 1.14-3.64, P = 0.017). Biochemically validated abstinence rates at 12 months were 33.1% in the residential versus 17.4% in the outpatient group (OR = 2.35, 95% CI = 1.22-4.51, P = 0.011). In the intention-to-treat population, self-reported and biochemically validated abstinence rates at 12 months were 34.4% in the residential versus 14.6% in the outpatient group (OR = 3.08, 95% CI = 1.77-5.34, P < 0.0001) and 28.6% versus 10.3% (OR = 3.48, 95% CI = 1.85-6.52, P = 0.0001), respectively. Residential therapy exclusively for smoking cessation is feasible and effective and could be a beneficial new treatment for smokers.

Acupuncture ameliorates depression-like behavior of poststroke depression model rats through the regulation of gut microbiota and NLRP3 inflammasome in the colon.

This study was conducted to examine the effects of acupuncture on gut microbiota and expression of NLRP3 inflammasome in the colon in poststroke depression (PSD) model rats. Sprague-Dawley male rats were randomized into four groups: sham surgery group, poststroke depression group, acupuncture group, and probiotics group. Acupuncture therapy at Baihui (GV20), Shenting (GV24), bilateral Zusanli (ST36) acupoints in the acupuncture group and probiotic gavage therapy in the probiotics group were performed once per day for 2 weeks. Behaviors of depression were assessed by using weight measurements, sucrose preference test, open field test, and forced swimming test. Histopathological alterations in the colon were determined by hematoxylin-eosin staining, the expression of NLRP3/ASC/caspase-1 pathway-related proteins was analyzed by western blotting. Serum levels of IL-1β and IL-18 were derived from ELISA. The 16S rRNA gene sequencing was performed to examine and analyze the differences of gut microbiota of rats among all groups. Acupuncture was effective to increase weight and ameliorate depressive-like behaviors in PSD rats. Acupuncture increased the diversity of gut microbiota, upregulated the abundance of Bifidobacteriaceae and Lactobacillaceae, and decreased the relative abundance of Peptostreptococcaceae, Rikenellaceae, Eggerthellaceae, and Streptococcaceae at family level. Acupuncture effectively improved the pathological changes in the colon. Meanwhile, acupuncture reduced NLRP3, ASC, caspase-1 protein expressions in the colon, and serum levels of IL-18 and IL-1β. Acupuncture may reduce depressive-like behaviors of PSD by regulating the gut microbiota and suppressing hyperactivation of NLRP3 inflammasome in the colon. Microbiota-gut-brain axis may be an effective target pathway for acupuncture treatment of PSD.

The investigative learning and its daily applicability

This paper compares the effectiveness of collaborative teaching methods with traditional expository approaches in high school physics classes. Through bibliographical review, it discusses the definitions and differences between collaboration and cooperation to establish clear terminology. Initially, the paper examines the limitations of expository teaching methods and the benefits of collaborative teaching, drawing on Vygotsky’s concepts such as the Zone of Proximal Development (ZPD) and the idea of the most capable pair. It also looks at how these concepts are recommended for classroom use according to official Brazilian documents, like the National Common Core Curriculum (BNCC) and the Law of Guidelines and Bases of National Education (LDB 9394/96). Collaborative teaching through investigative methods significantly improves learning quality and helps students become more employable. Lastly, the paper compares investigative methodologies with approaches from other fields, such as group therapy and pair programming, to highlight their advantages and applicability.

How does group music therapy help in combating the anxiety and depression of dementia patients? A quasi-experimental investigation

This study looked at the effect of group music therapy on dementia patients' levels of feelings of depression and anxiety. Quasi-experiment was carried out (N = 121) in which patients were randomly divided into a control (N = 61) and an experimental group (N = 60). Following a six-weeks, twelve-sessions trial involving both passive and active music therapy, it was discovered that the music group therapy intervention decreased the anxiety and depression levels of dementia patients in the experimental group as compared to the control group, which did not receive any music therapy. It was also noted that after three months of follow-up, participants in the experimental group still maintained a low level of anxiety and depression, but the control group's level remained high, therefore, substantiating the effect of music in lowering anxiety and depression among older ones. We urge the nursing descipline, medical professionals, carers, and care homes to include music therapy in the care they provide for patients with dementia.

Online Group Psychotherapy: A Systematic Review.

There is a need within counselling and psychotherapy to ensure their ability to respond to endemic presences such as the COVID-19 pandemic, by utilising rapid technological advances without compromising effectiveness. To do so, existing research about online group therapy must be built upon to provide a comprehensive understanding of the efficacious delivery of this therapy modality. Thus, a systematic review was conducted to collate what is currently known in the published and grey literature on online group therapy, using the PRISMA framework. Thirty-three articles were identified as including information regarding facilitating group therapy online. After appraising each article using appropriate quality appraisal tools, a thematic analysis was conducted on the papers, arriving at seven main themes summarising the main findings regarding online versus in-person groups, group planning, counselling micro skills, group processes, ethics, technology, and unique online therapy issues. There is a growing but incomplete body of knowledge that informs the group therapist regarding the ethical delivery of groups online. A more comprehensive review can enable group therapists to feel confident they are across best practice guidelines. Limitations and research implications are considered.

Sexual Assault Survivors’ Individual and Group Therapy Experiences at Rape Crisis Center

Survivors of sexual violence often experience short-and long-term mental and physical health conditions due to the victimization. Rape Crisis Centers are community-based advocacy organizations that provide free supportive services to survivors of sexual assault, such as 24-hour crisis hotlines, medical advocacy, individual and group therapeutic services, and victim advocacy services for those with cases within the criminal justice system. However, the efficacy of these services in assisting survivors is not well known, often due to researchers’ lack of access to clients. In this paper, we investigate the experiences of survivors directly from the survivors receiving psychotherapy services from a Rape Crisis Center in an urban jurisdiction in the Midwestern United States. We qualitatively interviewed nine survivors who attended individual and/or group therapy. In-depth analysis showed that four themes emerged regarding their experiences. Two themes pertain to positive outcomes—emotional processing and group therapy dynamics. One theme concerns obstacles. The final theme relates to suggestions for service improvement. The discussion includes summaries of the reflective findings and recommendations for future practice. This research contributes to informing and improving practices and policies to better serve survivors of sexual assault.

Direct retrospective measurement of therapeutic changes: an example using the Czech version of the Questionnaire of Personal Changes (Q-PC)

Objective: The study aimed to test the psychometric properties of the Czech translation of the Questionnaire of Personal Changes (Q-PC), a measure designed for retrospective (direct) measurement of change in psychotherapy. Methods: A sample of group psychotherapy clients (N = 222) and a nonclinical sample (N = 167) sample were used. Clients in the clinical sample were administered the Q-PC in addition to several pre–post outcome measures. Confirmatory factor analysis, correlational analysis, and structural equation modeling were used to test the Q-PC’s factor structure, longitudinal measurement invariance, reliability, convergent validity, sensitivity to change, and other psychometric properties. Results: The Q-PC demonstrated a unidimensional structure that was strictly invariant between two follow-up measurement waves. The measure also demonstrated excellent reliability and sensitivity to change and good convergent validity. Furthermore, it demonstrated a similar relationship to baseline severity as the pre–post outcome measures. Conclusions: The retrospective measurement of change is a promising approach that has the potential to complement the traditional pre–post measurement of change.

Race/ethnicity-based discrimination, depressive symptoms, and smoking-related variables among people with HIV participating in a randomized clinical trial for cigarette smoking cessation

ABSTRACT People with HIV smoke cigarettes at a high prevalence, and it is important to identify modifiable variables related to smoking in this population. Race/ethnicity-based discrimination is common among people with HIV from minoritized racial and ethnic groups and results in significant adverse effects. The goal of this study was to examine the relationship between race/ethnicity-based discrimination, depression, and smoking-related variables among people with HIV who smoke. This was a secondary analysis of data from a prospective, randomized controlled smoking cessation trial for people with HIV. Participants were recruited from three HIV clinical care sites and randomly assigned to an HIV-tailored group therapy intervention or a control condition. Participants completed measures of demographics, smoking-related variables, race/ethnicity-based discrimination, and depressive symptoms at baseline and were followed up 3- and 6-months after study completion. Depressive symptoms had an indirect effect on the relationship between race/ethnicity-based discrimination and self-efficacy to quit smoking at 3-month follow-up. Depressive symptoms mediated the relationship between race/ethnicity-based discrimination and both nicotine dependence and self-efficacy to quit smoking at 6-month follow-up. Findings highlight the importance of considering race/ethnicity-based discrimination and depressive symptoms in the development and implementation of smoking cessation treatment interventions for people with HIV.

P-385 Personalized immunotherapy in RIF patients with different endometrial immune profiles

Abstract Study question Does immunotherapy effective in patients with recurrent implantation failure (RIF) according to the type of endometrial immune profile? Summary answer Immunotherapy based on the profile of the endometrial immune system has significant results in increasing the pregnancy rate and live birth rate. What is known already Personalized medicine in the area of infertility is in its early stages, and considering the promising results of personalization of treatment in other disorders, including cancer, it is expected to have acceptable results in infertility as well. Given that one of the key factors that affects the infertility of RIF patients is the imbalance of the endometrial immune system, efforts have been made to correct this disorder to increase the chances of fertility. Studies have classified RIF patients into different groups based on endometrial immune system profiles: Balanced, High, Low, and Mixed endometrial immune system activity. Study design, size, duration The study selected 267 RIF patients who were referred to Valiasr Hospital in Tabriz from Aug 2020-Sep 2023, and divided them into five groups: unclassified RIF patients (n = 89), patients with normal and balanced endometrial immune system profile (n = 63), and patients with high (n = 53), low (n = 38) and mixed (n = 24) profiles of endometrial immune system. Based on type of disorder identified, the appropriate immunotherapy was suggested for each group, including vaginal probiotics, lymphocyte therapy and Tacrolimus. Participants/materials, setting, methods The study classified RIF patients based on the endometrial immune system profiles, by the gene expression level of IL-18, IL-15, TWEAK, Fn-14, and CD56. The study included a group of unclassified RIF patients, who underwent routine IVF/ET cycles without immunotherapy. The Balanced group received no immunotherapy. For the Low endometrial immune group, probiotics and lymphocyte therapy were used. High group received probiotics and Tacrolimus, and for Mixed group, probiotics, Tacrolimus, and lymphocyte therapy were used. Main results and the role of chance The primary and secondary endpoints of this study were clinical pregnancy and delivery of a live born infant, respectively. The results showed that RIF patients without classification based on the profile of the endometrial immune system who went through the routine process of IVF/ET cycles had a 25.8% and 23.5% pregnancy and live birth rates, respectively. The pregnancy and live birth rates of the Balanced group was 28.5% and 25.3% (P=NS) while it was significantly higher in the High (56.6%, 54.7%), Low (47.3%, 44.7%) and Mixed groups (37.5%, 29.1%), respectively. According to the obtained results, it was found that the appropriate immunotherapy treatment based on the endometrial immune activity profiles in RIF patients has significantly increased the effective implantation rate in the IVF/ET cycles (P &amp;lt; 0.05). Limitations, reasons for caution It is necessary to examine a larger number of patients. Further work is needed to explore other parameters that are affected by endometrial immune system disorder and that can help classify RIF patients and recommend the most effective treatment. Wider implications of the findings For RIF patients, accurate identification of the cause of the disorder can be very effective for choosing the best treatment method. Personalized immunotherapy for RIF patients with immunologically abnormalities can lead to very promising and acceptable results while having few complications. Trial registration number Not Applicable

Collective Trauma and Political Activism: Learning from the Bereaved Families of Shot Down Ukrainian Airline Flight 752

ABSTRACT On January 8, 2020, Ukraine Airline Flight 752 was shot down minutes after taking off from Tehran, Iran, by an Iranian surface-to-air missile. This happened hours after Iran had launched missiles at US targets in Iraq. Amongst the 176 people killed in this tragedy, many of them children, were 85 Iranian-Canadians who had traveled to visit their relatives in Iran. Over the past two years, families of the victims have struggled to find some healing from this trauma amidst political pressures in their fight to get accountability, transparency and justice for their loved ones. This paper is an account of group therapy sessions conducted over two years with these bereaved families, mostly mothers. I provide a detailed account of how relational psychoanalytic principles were utilized to develop a group psychotherapy model for dealing with this novice complex situation where the trauma is as individual as it is collective. For these families, grief and trauma is complicated by the sociopolitical issues surrounding the incident, including lack of transparency, dishonesty, insensitivity and absence of any attempts at reparations or reconciliation by the Iranian government in the aftermath of this tragedy. I examine how these political moments has come to inform psychological challenges of the group, including their emotions, dreams and fantasies. I further elaborate on how these experiences have transformed these individuals into political activists as observed not only in their individual and collective identities but also in their actual participation in the political arena.

Investigating the Effect of Phototherapy on Expression of CXCR3-B Gene in Vitiligo

Abstract Background Vitiligo is acquired depigmentary disorder characterized by destruction of the epidermal melanocytes leading to the loss of the skin color. Oxidative stress, genetic susceptibility together with autoimmunity are the main players of melanocytic destruction aetiopathogenesis. Aim of the Work The primary aim of the work was to investigate the effect of phototherapy (NBUVB and excimer laser) on CXCR3B expression in vitiligo. The secondary aim was to confirm the claim of causal relationship between CXCR3B levels and vitiligo in an attempt to evaluate CXCR3B role in the pathogenesis of vitiligo. Patients and Methods A prospective cohort study in department of Dermatology, Venereology and Andrology Ain Shams University, (El Demerdash and Al-Haud Al-Marsoud) vitiligo clinics and Biochemistry Department Ain Shams University between 2020 - 2022. In our study we measured CXCR3B mRNA expression in skin of vitiligo patients before and after generalized ‘NBUVB’ and targeted ‘Excimer laser’ phototherapy. Our study was conducted on 25 patients suffering from non-segmental vitiligo. All biopsies were stored in -80C till RNA extraction that was performed using QIAGEN RNeasy Mini Kit, QuantiTect Reverse Transcription Kit and QuantiNova SYBR Green PCR Kit. Results We found that CXCR3B mRNA expression was significantly increased after phototherapy that is well known for immune modulatory properties. Moreover this was higher in excimer group therapy than NBUVB. Such findings highlight CXCR3B as an inherit defect in skin of patients with vitiligo and raise questions about its possible roles in maintaining vitiligo or causing relapses. Conclusion CXCR3B mRNA levels were significantly increased after treatment with either NBUVB or Excimer laser compared to mRNA levels before therapy. From our results we can conclude that elevated CXCR3B mRNA levels are obviously characteristic to patients with vitiligo and suggestive of persistent inherit defect of their melanocytes. It may also be responsible for the relapse and chronicity of vitiligo.