Potential Discrimination Research Articles

Markers of imminent myocardial infarction

Myocardial infarction is a leading cause of death globally but is notoriously difficult to predict. We aimed to identify biomarkers of an imminent first myocardial infarction and design relevant prediction models. Here, we constructed a new case–cohort consortium of 2,018 persons without prior cardiovascular disease from six European cohorts, among whom 420 developed a first myocardial infarction within 6 months after the baseline blood draw. We analyzed 817 proteins and 1,025 metabolites in biobanked blood and 16 clinical variables. Forty-eight proteins, 43 metabolites, age, sex and systolic blood pressure were associated with the risk of an imminent first myocardial infarction. Brain natriuretic peptide was most consistently associated with the risk of imminent myocardial infarction. Using clinically readily available variables, we devised a prediction model for an imminent first myocardial infarction for clinical use in the general population, with good discriminatory performance and potential for motivating primary prevention efforts.

Performance of plasma p-tau217 and NfL in an unselected memory clinic setting.

Plasma phosphorylated tau-217 (p-tau217) and neurofilament light (NfL) can differentiate between different dementias in selected cohorts. We aim to test the discrimination potential of these markers in a real-world cohort. We measured p-tau217 (ALZpath) and NfL (Quanterix) in 415 (unselected) consecutive memory clinic patients. Biomarker levels were dichotomized as low/high to create four biomarker profiles based on p-tau217 and NfL levels. p-Tau217 levels were highest in patients with Alzheimer's disease (AD) dementia, whereas NfL levels were highest in patients with frontotemporal dementia (FTD). Low p-tau217/low NfL was associated mostly with non-neurological diagnoses (79%), and high p-tau217/low NfL indicated AD pathology at any stage (84%). Low p-tau217/high NfL indicated FTD (38%) and high p-tau217/high NfL indicated AD dementia (87%). p-Tau217 can identify AD pathology at any disease stage. NfL can differentiate FTD from other diagnoses (e.g., AD dementia). Plasma p-tau217 and NfL can support clinical decision-making, and we suggest using them as complements to standard clinical assessment. Phosphorylated tau-2017 (p-tau217) can detect Alzheimer's disease (AD) across the clinical continuum.Neurofilament light (NfL) can differentiate frontotemporal dementia (FTD) from other diagnoses (AD dementia, dementia with Lewy bodies [DLB], and Psychiatry).p-Tau217 may detect AD co-pathology in other diseases or dementia types (e.g., DLB).p-Tau217 and NfL show potential for clinical implementation.

Data mining-based identification of epigenetic signatures with discrimination potential of lung adenocarcinoma and squamous cell carcinoma.

Mounting evidence suggests that lung adenocarcinoma (LAC) and lung squamous cell carcinoma (LSC) have different biological behaviors and therapeutic regimens in clinical practice. However, limited improvements in molecular differential diagnosis of the two entities have been achieved in recent decades. We aimed to find novel markers that could define non-small cell lung cancer (NSCLC) subtypes. We first explored publically available databases to search for DNA methylation signatures that enable a precise discrimination of LAC and LSC. Next-generation sequencing (NGS) was then used to analyze the methylation status and sites of candidate genes in LAC/LSC tissue samples, and a quantitative methylation-sensitive PCR (qMS-PCR) assay was conducted to test the performance of the selected maker in tissue samples and bronchoalveolar lavage fluid (BALF) specimens. We screened 19 top-ranked methylation loci that are differentially methylated between LAC and LSC. Among these hits, 6 methylation sites are enriched within the PREX1 gene promoter, thus becoming our focus. NGS analysis confirmed markedly higher PREX1 methylation levels in LAC than in LSC and revealed the right sites for detection of PREX1 methylation. Furthermore, PREX1 methylation analysis in lung cancer tissue samples defined 9 of 11 pathologically proven LACs, as well as 12 of 14 LSCs. In addition, ~ 80% LAC BALF samples showed methylated PREX1 compared to substantially lower test positivity (0-9%) of it in LSC and other lung conditions (P < 0.01). Our pilot study identified a unique epigenetic signature that could effectively distinguish LAC from LSC in various lung samples. It may enhance our in-depth understanding of the biology of lung cancer and pave the way for better accurate diagnosis and treatment stratification in the future.

Rapid diagnosis of systemic lupus erythematosus by Raman spectroscopy combined with spiking neural network

Multiple organs are affected by the autoimmune inflammatory connective tissue disease known as systemic lupus erythematosus (SLE). If not diagnosed and treated in a timely manner, it can lead to nephritis and damage to the blood system in severe cases, resulting in the patient's death. Therefore, correct and timely diagnosis and treatment are essential for patients. In this study, a framework based on neural network algorithm and Raman spectroscopy technique was established to diagnose SLE patients. Firstly, we pre-processed the obtained Raman data by three methods: baseline correction, smoothing processing and normalization methods, before using it as input for the model, and then ANN, ResNet and SNN classification models were established. The respective classification accuracies for SLE patients were 89.61%, 85.71%, and 95.65% for the three models, with corresponding AUC values of 0.8772, 0.8100, and 0.9555. The results of the experimental indicate that SNN possesses a good classification effect, and the number of model parameters is only 525,826, which is 414,221 less than that of ResNet model. Since the network only uses 0 and 1 to transmit information, and only has basic operations such as summation, compared with the second-generation artificial neural network, which simplifies the product operation of floating point numbers into multiple addition operations, the network has low energy consumption and is suitable for embedding portable Raman spectrometer for clinical diagnosis. This research highlights the significant potential for quick and precise SLE patient discrimination offered by Raman spectroscopy in conjunction with spiking neural networks.

Advancing canine mammary tumor diagnostics: Unraveling the diagnostic potential of Cytokeratin 19 through droplet digital PCR analysis

Cytokeratin 19 (CK19) is a complex intracytoplasmic cytoskeletal protein primarily localized in the ducts of the mammary gland and skin epithelial cells. In humans, the expression of CK19 gene within circulating tumor cells (CTCs) extracted from blood samples of breast cancer patients reflects tumor cell activity, offering valuable insights for predicting early metastatic relapse or monitoring treatment effectiveness. However, knowledge of serum tumor markers is limited in veterinary oncology. Recently, droplet digital PCR (ddPCR), has been employed to explore rare target genes due to its heightened sensitivity and accuracy as a novel molecular diagnostic tool. The objectives of this study were to investigate the expression of the CK19 mRNA in CTCs, non-neoplastic mammary tissues, and both benign and malignant canine mammary tumors (CMTs) through ddPCR analysis. In Study I, we optimized the discard volume for blood samples to reduce CK19 contamination from skin epithelial cells post-venipuncture. The results revealed that discarding the initial 3 mL of blood was adequate and effective in eliminating CK19 mRNA contamination. In Study II, after the removal of the initial 3 mL of blood, we investigated CK19 mRNA-positive CTCs in the peripheral blood of normal healthy dogs, including those with benign and malignant CMTs. Intriguingly, CK19 mRNA was undetectable in all blood samples. The expression of CK19 mRNA in mammary tissues was investigated in Study III. The copy number (CN) ratios of the CK19 gene in non-neoplastic mammary tissues (14.77 ± 14.65) were significantly higher (P < 0.05) than those in benign (4.23 ± 3.35) and malignant groups (6.56 ± 5.64). Notably, no difference was observed between the benign and malignant groups. In conclusion, CK19 mRNA appeared unlikely to be a suitable candidate as a biomarker in the peripheral blood of CMTs, while the CN ratio in mammary tissues could serve as a potential discriminator between non-neoplastic and CMT groups, complementing the gold standard of histopathological examination.

“Are we not going too far?“: Socio-ethical considerations of preimplantation genetic testing using polygenic risk scores according to healthcare professionals

The recent introduction of polygenic risk scores within preimplantation genetic testing (PGT-P) has been met with many concerns. To get more insights into the perspectives of relevant stakeholders on the socio-ethical aspects of PGT-P, an interview study with 31 healthcare professionals involved in reproductive medicine and genetics in Europe and North-America was performed. Healthcare professionals in our study were concerned that PGT-P was going too far in terms of selection, with regards to both medical conditions and non-medical traits. Healthcare professionals were worried about the ethical ‘slippery slope’ of PGT-P, the increasing medicalization of reproductive health, the commercial context of PGT-P, and potential stigmatization and discrimination. There were also concerns that the availability and the ‘technological imperative’ of PGT-P could lead to pressure and a sense of responsibility for parents to use PGT-P. Additionally, it could cause new anxieties about the child's health before the child has even been born. Since PGT-P provides polygenic risk scores before birth, the autonomy of the child has to be considered. These socio-ethical concerns heighten existing debates regarding reproductive genetic technologies and show that the specifics of PGT-P make this screening option especially ethically controversial.

High temperature requirement A1 and macrophage migration inhibitory factor in the cerebrospinal fluid; a potential marker of conversion from relapsing-remitting to secondary progressive multiple sclerosis

BackgroundPredictive and prognostic biomarkers for multiple sclerosis (MS) remain a significant gap in MS diagnosis and treatment monitoring. Currently, there are no timely markers to diagnose the transition to secondary progressive MS (SPMS). ObjectiveThis study aims to evaluate the discriminatory potential of the High temperature requirement serine protease (HTRA1)/Macrophage migration inhibitory factor (MIF) cerebrospinal fluid (CSF) ratio in distinguishing relapsing-remitting (RRMS) patients from SPMS patients. MethodsThe MIF and HTRA1 CSF levels were determined using ELISA in healthy controls (n = 23), RRMS patients before (n = 22) and after 1 year of dimethyl fumarate treatment (n = 11), as well as in SPMS patients before (n = 11) and after 2 years of mitoxantrone treatment (n = 7). The ability of the HTRA1/MIF ratio to discriminate the different groups was determined using receiver operating curve (ROC) analyses. ResultsThe ratio was significantly increased in treatment naïve RRMS patients while decreased again in SPMS patients at baseline. Systemic administrated disease modifying treatment (DMT) only significantly affected the ratio in RRMS patients. ROC analysis demonstrated that the ratio could discriminate treatment naïve RRMS patients from SPMS patients with 91% sensitivity and 100% specificity. ConclusionThe HTRA1/MIF ratio is a strong candidate as a MS biomarker for SPMS conversion.

Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot: Mixed Methods Study.

Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. The purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. A coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition-specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. AI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against certain age-based populations and individuals with disabilities. There were notable gaps in the comprehensiveness, accuracy, and readability of AI-generated exercise recommendations. Exercise and health care professionals should be aware of these limitations when using and endorsing AI-based technologies as a tool to support lifestyle change involving exercise.

Effects of juicing methods on the bioactive compounds and flavor quality of 'Black-seed' pomegranate from three producing areas.

Color, nutrients and flavor are the key characteristics of pomegranate juice, but they are susceptible to processing methods and raw materials. In this study, the effects of aril juicing and whole fruit juicing methods on the composition of 'Black-seed' pomegranate juice from three producing areas were studied, including physicochemical parameters, color attributes, organic acids, sugars, phenolic compounds, and volatile compounds. The whole fruit juicing method resulted in higher juice yields of pomegranate fruit with 69.01-72.59%, hue angle values were 5.95-6.45°, and the juice remained red. The highest level of citric acid (21.21 g L-1 ), total acids (24.78 g L-1 ), and total anthocyanin content (435.59 mg L-1 ) were found in whole fruit juice, and seven tannins were detected. The most abundant volatile compounds were (Z)-3-hexen-1-ol and 1-hexanol in all juice samples, with alcohol content increased and aldehydes content decreased by whole fruit juicing. Principal component analysis revealed that the 24 indexes (variable important in projection >1) clearly distinguished juice samples obtained by two juicing methods, with ellagic acid hexoside, (E)-2-heptenal, (+)-catechin, and octanoic acid having the best discriminatory potential. Overall, the effects of juicing method on 'Black-seed' pomegranate juice were greater than those of raw-material-producing areas. These results confirmed the potential for using the whole 'Black-seed' pomegranate for processing, and also provided a theoretical basis for the healthy product development and utilization of dark-color pomegranate varieties. © 2023 Society of Chemical Industry.

The addition of discrimination inhibitors stimulations discrimination potential and N2O emissions were linked to predation among microorganisms in long term nitrogen application and straw returning systems.

Ammonia oxidizing archaea (AOA) and ammonia oxidizing bacteria (AOB) have been proven to be key microorganisms driving the ammonia oxidation process. However, under different fertilization practices, there is a lack of research on the impact of interaction between predators and AOA or AOB on nitrogen cycling at the multi-trophic level. In this study, a network-oriented microscopic culture experiment was established based on four different long-term fertilization practices soils. We used the nitrification inhibitors 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxide-3-oxyl (PTIO) and 3, 4-Dimethylpyrazole phosphate (DMPP) inhibited AOA and AOB, respectively, to explore the impact of interaction between protists and AOA or AOB on nitrogen transformation. The results showed that long-term nitrogen application promoted the potential nitrification rate (PNR) and nitrous oxide (N2O) emission, and significantly increased the gene abundance of AOB, but had no obvious effect on AOA gene abundance. DMPP significantly reduced N2O emission and PNR, while PTIO had no obvious effect on them. Accordingly, in the multi-trophic microbial network, Cercozoa and Proteobacteria were identified as keystone taxa of protists and AOB, respectively, and were significantly positively correlated with N2O, PNR and nitrate nitrogen. However, Nitrososphaerota archaeon as the keystone species of AOA, had an obvious negative linkage to these indicators. The structural equation model (SEM) showed that AOA and AOB may be competitors to each other. Protists may promote AOB diversity through direct trophic interaction with AOA. The interaction pattern between protists and ammonia-oxidizing microorganisms significantly affects potential nitrification rate and N2O emission, which has important implications for soil nitrogen cycle.

Duomenų vertės „atrakinimas” – misija (ne)įmanoma?

The article provides insights into the growing popularity of new technologies and the amount of data that is being generated worldwide. Therefore, legislators are obligated to issue laws that are up to date. Hence, this article analyses the new proposed legislation in the European Union that ensures the possibility for individuals and businesses to gain access and exert control over data and share it with third parties. The authors of this paper conclude that the opportunity of freely sharing generated data is worthwhile, however, the drawbacks, such as concerns about privacy, potential discrimination and biases, as well as lack of infrastructure and personal data protection, should also be considered.

Engineering comments in doctoral student appointments: biased fabrications and revolving door governance practices in STEM subjects seen from gender equity and academic justice perspectives

ABSTRACT This article derives from ongoing higher education governance research in Sweden using a mix of ethnographic methodologies and data to explore and analyse patterns of gender and class inequality and injustice. The article has very specific data comprising two STEM doctoral appointment procedures together and uses a particular methodology called Qualitative Content Analysis (QCA). It raises questions relating to potential discrimination and injustice in the appointment procedure, including pure fabrication related to applicants’ competences and symbolic violence. Such violations are not uncommon in STEM, particularly toward women according to previous research, both within the ongoing project and by other researchers. Internal governance structures and procedures should anticipate and combat these tendencies. The article indicates that this did not happen in relation to the investigated appointment processes.

The Role of Telomere Length in Stress-related Aging and its Implications for Mental Health

Telomeres, the protective caps at chromosome ends, have emerged as crucial biomarkers of cellular aging and potential mediators of stress-induced physiological decline. This review synthesized current evidence on how chronic stress and various mental health conditions are associated with accelerated telomere shortening, potentially serving as a biological mechanism linking psychological distress to cellular aging and increased risk of age-related diseases. Research studies showed that major depressive disorder, post-traumatic stress disorder, and anxiety disorders have been consistently linked to shorter telomeres, while findings for bipolar disorder and schizophrenia remain mixed. The review explored the biological mechanisms underlying stress-induced telomere attrition, including oxidative stress, inflammation, and dysregulation of the hypothalamic-pituitary-adrenal axis. It critically evaluated telomere length as a potential biomarker for stress-related aging and mental health disorders, assessing its reliability and clinical relevance. The review also examined interventions targeting telomere biology, including lifestyle modifications, stress reduction techniques, and pharmacological approaches. These interventions showed promise in mitigating the effects of stress-related aging and improving mental health outcomes. However, methodological challenges and high inter-individual variability currently limit the clinical utility of telomere length assessment. Ethical implications of telomere-based interventions and diagnostics were also discussed, including issues of privacy, potential discrimination, and the blurring lines between treatment and enhancement.

Defecation Symptoms in Relation to Stool Consistency Significantly Reflect the Dyssynergic Pattern in High-resolution Anorectal Manometry in Constipated Patients.

To evaluate the usefulness of a 2-week patient-completed bowel habit and symptom diary as a screening tool for disordered rectoanal coordination (DRC). DRC is an important subgroup of chronic constipation that benefits from biofeedback treatment. Diagnosis of DRC requires a dyssynergic pattern (DP) of attempted defecation in high-resolution anorectal manometry (HRAM) and at least 1 other positive standardized examination, such as the balloon expulsion test or defecography. However, HRAM is generally limited to tertiary gastroenterology centres and finding tools for selecting patients for referral for further investigations would be of clinical value. Retrospective data from HRAM and a 2-week patient-completed bowel habit and symptom diary from 99 chronically constipated patients were analyzed. Fifty-seven percent of the patients had a DP pattern during HRAM. In the DP group, 76% of bowel movements with loose or normal stool resulted in a sense of incomplete evacuation compared with 55% of the non-DP group ( P =0.004). Straining and sensation of incomplete evacuation with the loose stool were significantly more common in the DP group ( P =0.032). Hard stool was a discriminator for non-DP ( P =0.044). Multiple logistic regression including incomplete evacuation and normal stool predicted DP with a sensitivity of 82% and a specificity of 50%. The sensation of incomplete evacuation with loose or normal stool could be a potential discriminator in favor of DP in chronically constipated patients. The bowel habit and symptom diary may be a useful tool for stratifying constipated patients for further investigation of suspected DRC.

Psychological responses and factors associated with depression and anxiety in entry personnel under quarantine during pandemic in China.

The global COVID-19 pandemic has highlighted critical concerns surrounding mental health. Social isolation measures, such as the quarantine of incoming travelers, are essential public health strategies for the prevention and control of infectious diseases. However, quarantine can lead to adverse psychological outcomes, including feelings of confinement, boredom, perceived scarcity of supplies and information, financial hardship, and social stigma. This study aims to assess the mental states of quarantined individuals, investigate the factors affecting their mental well-being, and examine their coping mechanisms, with the objective of providing recommendations to enhance mental health in anticipation of future outbreaks, such as Disease X. We surveyed 327 individuals in quarantine from September 22, 2020 to January 9, 2021, collecting general demographic data and information related to COVID-19. Depression and anxiety were assessed using the PHQ-9 and GAD-7 scales, respectively, while stress coping was evaluated with a simplified version of the Cope scale. We analyzed the relationships between independent variables and mental health outcomes. Among the individuals undergoing entry quarantine, 27.8% reported symptoms of depression, and 20.5% reported symptoms of anxiety. Students were more likely to experience depression compared to those with permanent jobs or no occupation. Significant risk factors for both depression and anxiety included pre-existing health conditions, lack of medical insurance, concerns about shortages of daily necessities during quarantine, and high scores for "guilt and self-blame." Additionally, participants who worried about the impact of the epidemic on their studies or work, and those with high scores for "denial," were more likely to exhibit depressive symptoms. On the other hand, participants who were concerned about potential rejection or discrimination from the outside world after quarantine were more prone to anxiety symptoms. Attention should be paid to the negative psychological reactions of the entry quarantined personnel, especially those with pre-existing health conditions, those without medical insurance, and students studying abroad. Accurate and effective epidemic dynamic information and preventive and control measures can be provided to the public to prevent fear and stigma against quarantined personnel.

Diagnostic value of late gadolinium enhancement at cardiovascular magnetic resonance to distinguish arrhythmogenic right ventricular cardiomyopathy from differentials

BackgroundWhile late gadolinium enhancement (LGE) is proposed as a diagnostic criterion for arrhythmogenic right ventricular cardiomyopathy (ARVC), the potential of LGE to distinguish ARVC from differentials remains unknown. We aimed to assess the diagnostic value of LGE for ARVC diagnosis. MethodsWe included 132 subjects (60% male, 47±11 years) who had undergone cardiac magnetic resonance imaging with LGE assessment present for ARVC or ARVC-differentials. ARVC was diagnosed as per 2010 Task Force Criteria (n=55). ARVC-differentials consisted of familial/genetic dilated cardiomyopathy (n=25), myocarditis (n=13), sarcoidosis (n=20), and amyloidosis (n=19). The diagnosis of all differentials was based upon the most current golden standard. Presence of LGE was evaluated using a 7-segment RV and 17-segment LV model. Subsequently, we assessed LGE patterns for every patient individually for fulfilling LV- and/or RV-LGE per Padua criteria, independent of their clinical diagnosis (i.e. phenotype). Diagnostic values were analysed using sensitivity and specificity for any RV-LGE, any LV-LGE, RV-LGE per Padua criteria, and prevalence graphs for LV-LGE per Padua criteria. Optimal integration of LGE for ARVC diagnosis was determined using classification-and-regression-tree analysis. Resultsone-third (38%) of ARVC patients had RV-LGE, while half (51%) had LV-LGE. RV-LGE was less frequently observed in ARVC vs. non-ARVC patients (38% vs. 58%, p=0.034) leading to a poor discriminatory potential (any RV-LGE: sensitivity 38%, specificity 42%; RV-LGE per Padua criteria: sensitivity 36%, specificity 44%). Compared to ARVC patients, non-ARVC patients more often had LV-LGE (91% vs. 51%, p<0.001) which was also more globally distributed (median 9 [IQR: 3-13] vs. 0 [IQR: 0-3] segments, p<0.001). Absence of anteroseptal and absence of extensive (≥5 segments) mid- mid-myocardial LV-LGE, and absence of moderate (≥2 segments) mid-myocardial LV-LGE predicted ARVC with good diagnostic performance (sensitivity 93%, specificity 78%). ConclusionsLGE is often present in ARVC differentials and may lead to false positive diagnoses when used without knowledge of LGE patterns. Moderate RV-LGE without anteroseptal and mid-myocardial LV-LGE is typically observed in ARVC.

Navigating Disclosure Obstacles Encountered by Individuals with HIV at Kakomo Healing Centre IV in Kabale District

HIV/AIDS remains a pressing global health concern, particularly impacting socio-economic development in various African nations, Uganda included. Revealing one's HIV-positive status to a family member or relative is crucial for adherence to effective antiretroviral therapy, which significantly enhances the survival and well-being of those living with HIV. To evaluate the hurdles faced by individuals with HIV at Kakomo HC IV in Kabale District regarding disclosure and to curtail new infections in this community, a descriptive crosssectional study was conducted. The study sampled individuals living with HIV at Kakomo HC IV randomly, utilizing a pretested questionnaire as the data collection instrument. The gathered data underwent coding, sorting, entry, and analysis through statistical software (SPSS), presented via tables and charts. Findings revealed that only 40 (50.6%) were adequately prepared before disclosing their status, while 30 (37.0%) neither prepared nor disclosed to anyone. 61 (63.5%) received education on the importance of disclosure during clinic visits, but 26 (46.4%) neither disclosed nor received such education. Barriers to disclosure primarily stemmed from anxiety about blame, stigma, fear of losing a partner, and violence among 18 (54.5%), 19 (52.8%), 30 (39.0%), and 2 (18.2%) individuals, respectively. Despite 62 (43.4%) intending to disclose to someone, 88 (98.9%) faced barriers to disclosing their status. Misconceptions in 51 (31.9%) communities and potential discrimination by families in the same proportion highlighted the challenges. Consequently, 123 (76.9%) still fear others spreading word of their HIV-positive status. Understanding disclosure motivations is crucial, requiring tailored strategies for decisionmaking based on the discloser's needs and their intended audience. The significance of support, proximity, and relational dynamics between the discloser and the recipient emphasizes the necessity for a secure environment during disclosure. Keywords: HIV/AIDS, Antiretroviral therapy, HIV-positive, HIV status, Stigma.

Enhancing Bone Infection Diagnosis with Raman Handheld Spectroscopy: Pathogen Discrimination and Diagnostic Potential.

Osteomyelitis is a bone disease caused by bacteria that can damage bone. Raman handheld spectroscopy has emerged as a promising diagnostic tool for detecting bone infection and can be used intraoperatively during surgical procedures. This study involved 120 bone samples from 40 patients, with 80 samples infected with either Staphylococcus aureus or Staphylococcus epidermidis. Raman handheld spectroscopy demonstrated successful differentiation between healthy and infected bone samples and between the two types of bacterial pathogens. Raman handheld spectroscopy appears to be a promising diagnostic tool in bone infection and holds the potential to overcome many of the shortcomings of traditional diagnostic procedures. Further research, however, is required to confirm its diagnostic capabilities and consider other factors, such as the limit of pathogen detection and optimal calibration standards.

Potential Overcriminalization in Religious Offenses: A Critical Analysis Of The Formulation Of The New National Criminal Code (Law 1 Number 2023)

Overcriminalization in the context of criminal law refers to the phenomenon where too many behaviors are defined as criminal offenses, which ultimately results in the expansion of law enforcement powers and an increase in the number of individuals caught up in the criminal justice system. This study examines overcriminalization in the formulation of religious offenses contained in Law Number 1, the Year 2023 on the Criminal Code (KUHP), focusing on Article 302 on incitement of a person to no religion or belief adopted in Indonesia and its impact on atheists or non-religious communities. The analysis highlights several important issues, such as the unclear definition of "inciting" in the article, its impact on freedom of speech, potential discrimination against minorities, and misuse of the law for political purposes. The research was conducted using a qualitative method, combining document studies, literature reviews, and analysis of relevant case law. The results show that Article 302 of the New National Criminal Code may lead to overcriminalization, as it regulates acts that can be considered part of freedom of expression and religion. This article can also be considered as limiting the right of individuals to choose their beliefs or religion, including the right not to have religious beliefs. In addition, this research highlights that this article is vulnerable to abuse by parties who have political interests or want to target specific groups. As a recommendation, this study suggests the need to reform the formulation of Article 302 of the National Criminal Code to reduce the impact of overcriminalization and protect human rights, such as freedom of speech.

Barriers and facilitators to the formation of professional identity among nursing students: A four-year longitudinal qualitative study

BackgroundNursing professional identity (NPI) is essential for nurses to develop their nursing profession. It reflects the competencies consistent with the professional practices of nurses and contributes to them providing better healthcare and public health. The formation process of NPI started with undergraduate nursing education and continued throughout the nursing career. ObjectiveTo explore nursing students' perceptions of facilitators and barriers to the formation of NPI during their study. MethodsA 4-year longitudinal, qualitative research design with yearly semi-structured interviews undertaken from 2019 to 2022. The reflexive thematic analysis methodology was applied for the data analysis. ResultsNinety-three nursing students were recruited, joining a group or individual interview. The four-year nursing baccalaureate program revealed a dynamic formation process of NPI: “Outsider of nursing”, “Entering the nursing courses”, “Building nursing competence”, and “Thinking and acting like a nurse”. A total of 12 themes were identified to present the barriers and facilitators to the NPI formation at different stages. Specifically, the six barriers include conflict between their ideals and reality, sociocultural stereotypes about nursing, the negative impact of COVID-19, the pre-internship concerns, struggling to meet expectations, and potential danger and discrimination in the healthcare settings. The enablers were: self-motivation and inner belief towards the nursing profession, the power of role models, the improvement of nursing capacity, well integration into the healthcare professional teams, understanding of the clinical environment, and recognition and encouragement from others. ConclusionsThe formation of nursing students' NPI is an ever-changing process, with various intrinsic and extrinsic influences during their four-year study. Nursing educators are suggested to prepare and develop students' professional comportment in their theoretical and clinical practice to develop their professional identity as a nurse.