Research Settings Research Articles

Health Literacy in Africa—A Scoping Review of Scientific Publications

Africa’s health landscape is rapidly changing, requiring new solutions such as a focus on health literacy. However, there is currently a limited overview of the development and application of health literacy in African countries and societies. This scoping review aims to analyze scientific publications on health literacy in Africa with regards to research approaches, historical developments, geographic origins, target populations and settings, and topical interests. The research followed Arksey and O’Malley six steps of scoping reviews and employed the Joanna Briggs Institute’s PCC method for search string formulation and the PRISMA-SCR checklist for reporting. On 11 July 2022, the following six databases were searched for scientific articles including included reports, policy briefs, book chapters, and research publications: PubMed, PsycINFO, Cochrane Library, ERIC, African Journals Online, and African Index Medicus. A total of 336 articles were identified. The research team co-developed a codebook and three researchers independently extracted data. The analysis provided the most comprehensive overview of the current scope and scale of health literacy in Africa to date. The publications represented 37 of the 54 African Union countries and dated back to 2001, although most were published in the last decade. The content analysis identified 13 broad themes, including mental health, communicable diseases, non-communicable diseases, maternal health, digital health, information and communication, health care, prevention and health promotion, conceptual perspectives, cultural perspectives, and outcomes and measurement. The analysis of target groups revealed a wide range of actors involved in different settings, mostly in health care or community settings. These comprehensive and novel findings can be used to prioritize future actions for public and professional capacity building, policy development, and improved practice to improve health literacy for all in Africa.

Ship Power System Network Reconfiguration Based on Swarm Exchange Particle Swarm Optimization Algorithm

As one of the important components of a ship, the ship’s integrated power system is an important safeguard for ships. In order to improve the service life of the ship’s power grid, the power system should be able to realize rapid reconstruction to ensure continuous power supply of important loads when the ship is attacked or fails suddenly. Therefore, it is of vital importance to study the reconfiguration technology of the ship’s integrated power system to ensure that it can quickly and stably cope with all kinds of emergencies in order to guarantee the safe and reliable navigation of the ship. This paper takes the ship’s ring power system as the research object and sets up the maximum recovery load and the minimum number of switching operations. The load is divided uniformly and the generator efficiency is balanced for the reconstruction of comprehensive function. It also sets up the system capacity, topology, and branch current limitations of the constraints to establish a mathematical model. The load branch correlation matrix method is used for branch capacity calculation and generator efficiency equalization calculation, and the load backup power supply path matrix is added on the basis of the matrix to judge the connectivity of some loads before reconfiguration. In this paper, for the network reconfiguration of the ship circular power system, which is a discrete nonlinear problem with multiple objectives, multiple time periods, and multiple constraints, we choose to use the particle swarm algorithm, which is suitable for global optimization, with a simple structure and fewer parameters; improve the particle swarm algorithm using the swarm exchange strategy by setting up two main and auxiliary swarms for global and local search; and exchange some of the particles with the golden ratio in order to keep the diversity of the populations. The simulation results of the network reconfiguration of the ship power system show that the improved algorithm can solve the power system network reconfiguration problem more effectively and provide a feasible reconfiguration scheme in a shorter time compared with the chaotic genetic algorithm under the same fault case test, and it also proves that the use of the swarm exchange particle swarm algorithm greatly improves the performance of reconfiguring the power grid of the ship.

Computational Tools for Hydrogen-Deuterium Exchange Mass Spectrometry Data Analysis.

Hydrogen-deuterium exchange (HDX) has become a pivotal method for investigating the structural and dynamic properties of proteins. The versatility and sensitivity of mass spectrometry (MS) made the technique the ideal companion for HDX, and today HDX-MS is addressing a growing number of applications in both academic research and industrial settings. The prolific generation of experimental data has spurred the concurrent development of numerous computational tools, designed to automate parts of the workflow while employing different strategies to achieve common objectives. Various computational methods are available to perform automated peptide searches and identification; different statistical tests have been implemented to quantify differences in the exchange pattern between two or more experimental conditions; alternative strategies have been developed to deconvolve and analyze peptides showing multimodal behavior; and different algorithms have been proposed to computationally increase the resolution of HDX-MS data, with the ultimate aim to provide information at the level of the single residue. This review delves into a comprehensive examination of the merits and drawbacks associated with the diverse strategies implemented by software tools for the analysis of HDX-MS data.

Interdisciplinary Labor

This reflection explores the anxiety and physical sensations felt by some scholars when navigating interdisciplinary research. The author describes personally experienced physical and emotional challenges faced during collaborative research, emphasizing the lack of common language and knowledge, and arguing for greater acknowledgment of these embodied experiences. The aim is to foster more honest and productive interdisciplinary dialogues, highlighting the importance of addressing emotional and physical responses to being able to succeed in collaborative research settings. Funding AcknowledgementThis work was supported by Riksbankens jubileumsfond (grant #MXM19-1161:1), to whom thanks are noted.

Validity, Reliability, and Cultural Adaptability of the Arabic Cognitive Flexibility Scale (Ar-CFS) Among Saudi Arabians: A Two-Cohort Investigation

Background/objectives: Cognitive flexibility is the mental skill that allows a person to shift between different ideas or concepts and think about several concepts simultaneously. A commonly used tool to assess cognitive flexibility is the Cognitive Flexibility Scale (CFS). This study focused on translating and validating the CFS into Arabic, given the lack of existing Arabic tools for assessing cognitive flexibility. Methods: Conducted at King Saud University, Riyadh, between April and June 2024, the study employed random sampling and involved 529 participants, including 419 students and 110 patients. Results: The average participant age was 25.8 years, with females making up 56.9% of the sample. Participants completed the Arabic CFS, along with the Emotion Regulation Questionnaire (ERQ) and the Perceived Stress Scale (PSS), at two time points 3–6 weeks apart. Reliability was evaluated through internal consistency (Cronbach’s alpha = 0.8) and test–retest reliability (intraclass correlation coefficient = 0.82). Item analysis indicated that removing any single item did not significantly impact overall reliability, and inter-item correlations were strongest between items 4 and 6 (0.55) and items 6 and 7 (0.51). Validity was assessed through face, content, and construct validity, with factor analysis revealing a dominant single component accounting for 34.4% of the variance, confirming the scale’s unidimensionality. Content validity indices for all items exceeded 0.9 in terms of relevance, importance, simplicity, and clarity. The Arabic CFS demonstrated good construct validity, showing significant correlations with the ERQ’s reappraisal and suppression dimensions and the PSS. Conclusion: In conclusion, the Arabic version of the CFS is a valid and reliable tool for assessing cognitive flexibility in Arabic-speaking populations. This tool will be valuable in both clinical and research settings within Saudi Arabia, offering a robust instrument for evaluating cognitive flexibility.

Chemical neurolysis of genicular nerves for chronic non-cancer knee pain: A scoping review.

Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse effects and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. Scoping review. All clinical and research settings. Adult participants with chronic non-cancer knee pain undergoing chemical neurolysis of genicular nerves. A literature search in MEDLINE, EMBASE and Cochrane Library was conducted up to 4 September 2023. Articles were searched via terms and keywords relating to "knee", "pain", "knee osteoarthritis", "ablation", "alcohol", "phenol" and "chemical neurolysis". Included articles were full text primary studies and in English. Data was extracted using an electronic database by 2 independent reviewers. There were 8 studies included in this review (including 1 randomized controlled trial), comprising 192 patients. There were 4 studies that used phenol, 3 studies that used alcohol, and 1 study that used either alcohol or phenol for chemical neurolysis. Both fluoroscopy and/or ultrasound guidance were utilized for nerve target identification. All studies demonstrated that chemical neurolysis resulted in improved pain and/or functional outcomes, with no serious adverse events reported. Chemical neurolysis of the genicular nerves is a promising treatment strategy for chronic knee pain. Interpretation of the available studies are limited by study heterogeneity and small sample sizes. High-quality randomized controlled trials are required to clarify the selection of appropriate nerve targets, choice of image guidance, and to compare with other ablative modalities.

A Real-Life Laboratory Setting for Clinical Practice, Education, and Research in Family Systems Care: Protocol for a Transformational Action Research Study.

Burdening health and illness issues such as physical or mental illnesses, accidents, disabilities, and life events such as birth or death influence the health and functioning of families and contribute to the complexity of care and health care costs. Considerable research has confirmed the benefits of a family systems-centered care approach for patients, family caregivers, families, and health care professionals. However, health care professionals face barriers in working with families, such as feeling unprepared. Family systems-centered therapeutic conversations support families' day-to-day coping, resilience, and health. A family systems care unit (FSCU) was recently established as a real-life laboratory at one of the Swiss Universities of Applied Sciences. In this unit, health care professionals offer therapeutic conversations to families and individual family members to support daily symptom management and functioning, soften suffering, and increase health and well-being. These conversations are observed in real time through a 1-way window by other health care professionals, students, and trainees and are recorded with video for research and education. Little is known about how therapeutic conversations contribute to meaningful changes in burdened families and the benefits of vicarious learning in a real-life laboratory setting for family systems care. In this research program, we aim to deepen our understanding of how therapeutic conversations support families and individuals experiencing burdening health and illness issues and how the FSCU laboratory setting supports the learning of students, clinical trainees, and health care professionals. Here we apply a transformational action research design, including parallel and subsequent substudies, to advance knowledge and practice in family systems care. Qualitative multiple-case study designs will be used to explore the benefits of therapeutic conversations by analyzing recordings of the therapeutic conversations. The learning processes of students, trainees, and professionals will be investigated with descriptive qualitative study designs based on single and focus group interviews. The data will be analyzed with established coding methods. Therapeutic conversations have been investigated in 3 single-case studies, each involving a sequence of 3 therapeutic conversation units. Data collection regarding the second research question is planned. Preliminary results confirm the therapeutic conversations to support families' coping. This renders the FSCU a setting for ethically sensitive research. This program will not only support the health and well-being of families, but also contribute to relieving the financial and workforce burdens in the health and social care system. DERR1-10.2196/53090.

Individual learning ambidexterity behavior and individual job performance in services: the role of organizational structure

AbstractThis study analyzed the impact of individual learning ambidexterity on individual job performance and tested the moderating effects of the organizational structure, represented in this research by formalization, decentralization, and structural differentiation. Despite the importance of individual learning ambidexterity, there is a limited understanding of how employees’ explorative and exploitative learning behaviors affect their individual job performance. The study expands the research by confirming the relevance of individual learning ambidexterity for individual performance for non-managerial employees; an understudied research setting for individual ambidexterity. We demonstrate that individual learning ambidexterity is positively correlated with individual job performance. We also provide evidence that formalization, decentralization, and structural differentiation moderate the effects of individual learning ambidexterity on individual job performance. The empirical context for the research was non-managerial employees from the Romanian IT services industry. Prior research has shown that ambidexterity is important in the IT industry, making it an adequate setting to analyze the effects of individual learning ambidexterity on individual job performance. By using polynomial regressions on a sample consisting of 342 employees, we were able to analyze four research hypotheses. This study demonstrates the moderating mechanism of organizational setting in the improvement of individual job performance in relation to individual learning ambidexterity. Taken as a whole, our findings provide new insights into how and under which organizational conditions the individual-level explorative and exploitative learning behaviors affect individual job performance.

Anthropometric Indices of Obstructive Sleep Apnea Patients in Mauritius.

Background Obstructive sleep apnea (OSA) is the most prevalent sleep-related breathing disorder, affecting a significant number of individuals globally.It is associated with poor quality of life and an increased risk of all-cause mortality. It is estimated that most of the patients suffering from OSA are obese. Anthropometric indices can help guide doctors towardthe diagnosis. Objectives This study aimed to establish specific anthropometric thresholds associated with OSA risk, allowing clinicians to identify individuals more likely to have OSA and who may need further evaluation, such as polysomnography. This targeted screening approach would enable better resource allocation to those at higher risk, potentially enhancing the efficiency of OSA diagnosis and management. Methods We conducted a descriptive study using data from the sole private sleep clinic in Mauritius. We analyzed case files of consecutive patients diagnosed with OSA over a 3.5-year period from January 2015 to June 2018. Results The study population comprised 170 patients (79.4% males) diagnosed with OSA by a polygraphy test.The mean age of OSA diagnosis in men and women was 51.7 ± 14.0 years and 53.8 ± 12.5 years, respectively.The mean neck circumference (NC) for males and females was 41.9 ± 3.9 cm and 38.2 ± 3.9 cm, while the mean waist circumference (WC) was 105.6 ± 12.2 cm for men and 103.4 ± 14.5 cm for women. The body mass index (BMI) was 29.1± 5.0 kg/m2 and 31.4± 6.8 kg/m2 for males and females, respectively. The apnea-hypopnea index (AHI) averaged to 42.1 ± 19.7 events/hour for men and 33.3 ± 16.4 events/hour for women.In male patients, we found a positive significant correlation (p<0.001) between AHI and the following parameters: BMI (r=0.443), WC(r=0.337), WC-to-height ratio (WHr) (r=0.378), NC(r =0.274), and neck-to-height ratio (NHr) (r =0.321).In women, we observed a positive significant correlation between apnea severity and the following: BMI (r=0.396, p=0.029), WC (r=0.462, p=0.005), and WHr (r=0.494, p=0.003).No significant relationships were observed between AHI and the following parameters in women: NC (r=0.317, p=0.064) and NHr (r=0.311, p=0.069). A total of 83.5% of patients had a Mallampati score of 3-4. Conclusion This study represents a pioneering effort on the island. While further research is necessary to establish exact anthropometric cutoff values, the findings offer crucial insights for physicians to identify high-risk individuals. With just a scale, measuring tape, and calculator, healthcare professionals can detect important health markers that extend beyond diagnosing OSA. These simple measurements not only help in predicting OSA but also provide a broader view of an individual's overall health, identifying risks that go beyond sleep issues. This research sets an important foundation for future OSA studies within the Mauritian population.

The Thoughtful program: a randomized controlled study of a mentalization-based mental health education intervention in a psychiatric outpatient population

Background P-factor and mentalizing theory and research set perspectives for transdiagnostic psychiatric treatments. Aims To test the effects of a low-cost mentalization-based health education program (the Thoughtful program) in an unselected waiting list population, from a psychiatric outpatient clinic in North Norway. Methods Waiting list patients were randomized (1:1 allocation): 79 patients in the control group were offered standard individual assessment and treatment. Seventy-nine patients in the intervention group were offered a one-day (six-hour) group-based Thoughtful course, plus individual assessment, and treatment. Results During a 6-month follow-up period, the number of patients in active assessment and treatment was 66% higher in the control group than in the intervention group. Self-reported patient questionnaire scores on mentalizing, well-being and suicidal ideation scores showed no significant changes in the control group. In the intervention group, significant changes were reported: Mentalizing scores improved by 72% and well-being scores improved by 55%. Suicidal ideation scores were not significantly changed. No adverse effects were registered. Limitations The results from this study should be interpreted with caution because of a small population size and low questionnaire response rate. The follow up period was limited to 6 months. Transfer of program information from intervention group patients to control group patients could not be guaranteed. It may be considered a limitation that diagnostic pattern analysis was not included in the study. Conclusions A low-cost transdiagnostic mentalization-based educational program in an outpatient psychiatry clinic may improve patient mentalizing and wellbeing without adverse effects and reduce the use of hospital services.

Artificial intelligence governance framework for healthcare.

Recent advancements in the field of Artificial Intelligence (AI) provide promising applications of this technology with the aim of solving complex healthcare challenges. These include optimizing operational efficiencies, supporting clinical administrative functions, and improving care outcomes. Numerous AI models are validated in research settings but few make their way into useful applications due to challenges associated with implementation and adoption. In this article, we describe some of these challenges, along with the need for a facilitating entity to safely translate AI systems into practical use. The authors propose a new AI governance framework to enable healthcare organizations with a mechanism to implement and adopt AI systems.

A short version of the Everyday Cognition scale can predict clinical progression and cognitive decline.

The Everyday Cognition scale (ECog-39) scores are associated with future cognitive decline. We investigated whether the 12-item ECog (ECog-12), which is being collected in Alzheimer's Disease Neuroimaging Initiative (ADNI)4, can predict progression. Baseline self (PT)- and study partner (SP)-ECog-12 data were extracted from the 39-item version collected in the ADNI. Weibull analysis examined the relationship between baseline ECog-12 and future clinical progression (change in Clinical Dementia Rating Sum of Boxes [CDR-SB] scores and diagnostic conversion). Higher PT- and SP-ECog-12 scores were associated with faster CDR-SB worsening, with hazard ratios in cognitively unimpaired (CU) 3.34 and 9.61, mild cognitive impairment (MCI) 1.44 and 2.82, and dementia 0.93 and 1.82. They were associated with conversion from CU to MCI 3.01 and 6.24 and MCI to dementia 1.61 and 3.07. SP-ECog-12 provided a higher prognostic value for predicting clinical progression, so this can help identify and monitor patients at risk in research and health-care settings. The 12-item Everyday Cognition scale (ECog-12) data obtained from both raters increased diagnostic conversion risk from cognitively unimpaired to mild cognitive impairment (MCI) and from MCI to dementia. ECog-12, rated by study partners, was associated with an increased risk of Clinical Dementia Rating Sum of Boxes worsening in all diagnostic groups. Our results provide novel information about the specific scoring outputs and rater types (participant vs. study partner) of ECog-12 that can facilitate screening, prioritization, and longitudinal monitoring of the clinical progression of participants in Alzheimer's Disease Neuroimaging Initiative 4 and other Alzheimer's disease clinical studies, clinical trials, and in health-care settings.

Society of Surgical Oncology Consensus Statement: Assessing the Evidence for and Utility of Gene Expression Profiling of Primary Cutaneous Melanoma.

Gene expression profiling (GEP) of primary cutaneous melanoma aims to offer prognostic and predictive information to guide clinical care. Despite limited evidence of clinical utility, these tests are increasingly incorporated into clinical care. A panel of melanoma experts from the Society of Surgical Oncology convened to develop recommendations regarding the use of GEP to guide management of patients with melanoma. The use of currently available GEP tests were evaluated in three clinical scenarios: (1) the utility in patient selection for sentinel lymph node biopsy; (2) the utility to guide surveillance; and (3) the utility to inform adjuvant therapy. As a basis for these recommendations, the panel performed a systematic review of the literature, including articles published from January 2012 until August 2023. After review of 137 articles,50met the inclusion criteria. These articles included evidence related to three available GEP tests: 31-GEP, CP-GEP, and 11-GEP. The consensus recommendations were finalized using a modified Delphi process. The panel found that current evidence often fails to account for known clinicopathologic risk factors and lacks high-level data. The panel recognizes that thestudy of GEP tests is still evolving. The integration of GEP into routine clinical practice for predicting sentinel lymph node status and patient prognosis in melanoma is therefore not currently recommended. At present, GEP should be considered primarily an investigational tool, ideally used in the context of clinical trials or specialized research settings.

Engaging for Sustainable Development and Transformation – Exploring the Concept of Transformative Academic Institutions

Abstract Universities are expected to play a proactive role in the sustainable development and transformation of their regions. However, they face external and internal barriers to play that role. One possible approach to overcome those barriers is through transformative academic institutions (TAIs). TAIs are defined as research centres created within universities to proactively engage in territorial development processes and can act as ‘living labs’ from which universities can draw lessons when developing a regionally engaged role. The article explores the TAI concept further by posing the following research question: How does the TAI approach look like in different contexts? What factors support and/or hinder TAI development? To that end, we analyse the case of five academic partners working in different organisational research settings within larger university structures. Our exploration of TAI practices followed an action research approach with participatory design methods to identify commonalities, challenges, and opportunities. Findings point to a more strategic partnering with external (non-academic) actors to contribute to (longer-term) change processes that address regional sustainability challenges. This can take universities towards new roles in curating collective knowledge and catalysing and facilitating change.

Culturally-relevant physical activity for public health promotion: global evidence synthesis

Abstract Background The WHO has noted the importance of cultural insights for health. Culturally-relevant physical activity has a growing evidence base in many regions and specific populations, but the scope and scale for global health promotion is underexplored. Methods A multinational expert team used a critical literature review method to: (1) define culturally-relevant physical activity; (2) delineate relevant characteristics supporting inclusion in population-level health promotion and surveillance; and (3) provide agenda setting in research, policy, and practice from a global public health promotion perspective. The critical review method, which evaluates rather than summarizes literature, was chosen as the research evidence is complex, broad, and has not been synthesized previously from this perspective. Results Culturally-relevant physical activity was defined as practices that include physical activity based on a population’s cultural customs. These can be Indigenous (e.g., hula, an Indigenous dance of Native Hawaiians) or regional (e.g., Shota (Shotë), an Albanian folk dance). Practices have shared characteristics that support multi-dimensional value for health, engagement, and healing. These include a collectivist, intergenerational component, passed from elders and shared forward with children as part of a community. Many have foundations in nature, a strength for health and wellbeing in green and blue spaces. Many include traditional art, clothing, accessories, and music with deep significance, including care for the tools and location of practice (e.g, drums, boats, land). Many practices would not be captured in harmonized public health surveillance systems despite their value. From this synthesis, research hypotheses were created and next steps proposed. Conclusions This evidence synthesis supports engagement, planning, uptake, policy, surveillance, and study of culturally-relevant physical activity for public health promotion locally and globally. Key messages • An important strength of culturally-relevant physical activity is that it is context and population specific. However, this may hide the scope and scale of the existing evidence supporting this work. • This evidence synthesis confirms how culturally-relevant physical activity is valuable globally across shared assets in research and practice, supporting next steps for public health promotion.

Research examining microcirculatory dynamics in diseases that cause oedema using skin blood flow and skin reperfusion pressure

Oedema is a build-up of fluid in the tissues in the body. It can develop due to diseases including heart failure and kidney disease. It usually occurs in the limbs, where it can cause discomfort, joint stiffness or pain. However, fluid can also accumulate in the brain, which is called cerebral oedema or in the blood vessels serving the lungs, called pulmonary oedema. A type of oedema called pitting oedema is more prevalent than the other type, non-pitting oedema. In order to treat the condition, the underlying cause must be resolved. Treatment can involve diuretics to help the release of fluids, positioning to encourage draining or compression to force fluids away. Researchers at the Faculty of Rehabilitation at Reiwa Health Sciences University led by Dr Haruki Kogo are examining the microcirculatory dynamics of diseases that cause oedema using skin blood flow and skin reperfusion pressure. They have developed a device that can diagnose oedema and confirmed the reproducibility and validity of the device. They have registered the trademark and plan to commercialise the device for use in clinical and research settings. The device is able to measure the depth of the surface imprint in pitting oedema patients, simplifying the evaluation of pitting oedema, which will be extremely useful in clinical settings. The researchers tested the device across two hospitals, comparing the results with results obtained from the popular circumference measurement method and ultrasound imaging measurement. The team found that there was a strong correlation between measurements from the device and the tissue thickness measurement derived from the ultrasound. This confirmed that the device is a reliable gauge for the measurement of oedema.

Assessment of coronary microvascular function with absolute coronary fl ow measurements

Abstract Background Reliable assessment of microvascular function is essential, both in research setting and clinical practice. New techniques, such as continuous coronary thermodilution, are very promising and could revolutionize the field. However, there is a need for proper validation before widespread use is possible. Purpose The goals of this study were: 1. to validate the potential of saline infusion to generate maximum hyperemia in vivo. 2. to validate absolute blood flow (ABF) measured with continuous coronary thermodilution at higher (40-50 ml/min) infusion speeds 3. To assess the safety of higher infusion speeds. Methods Fourteen closed-chest sheep underwent ABF measurements with increasing saline infusion speeds with and without adenosine. Another seven open-chest sheep underwent these measurements with epicardial doppler flow probes on both the left anterior descending artery and left circumflex coronary artery. Maximal hyperemia was defined as maximal flow after 45 seconds of proximal occlusion. The principles of laboratory animal care and all national regulations were followed. Results 20 ml/min of saline infusion induced lower hyperemic coronary flow (140 vs 191 ml/min, p=0.0165) and lower coronary flow reserve (CFR) (1.82 vs 3.21, p= &amp;lt;0.0001) than coronary occlusion. In contrast, 30 ml/min resulted in flow (196 vs 192 ml/min, p=0.8292) and CFR (2.77 vs 3.21, p=0.1107) that were not different from post-occlusion. There was a significant flow overestimation bias (Bland-Altman: Bias ± SD: -73.09 ± 30.52, 95% Limits of agreement: -132.9 to -13.27) with 40-50ml/min of saline. Occasionally, higher saline infusion rates resulted in ischemic ECG-changes and ventricular fibrillation (9.5% at 50 ml/min). Conclusions Continuous saline infusion of 30ml/min, but not 20 ml/min, induced maximal hyperemia. ABF measured with saline infusion speeds of 40-50 ml/min was not accurate nor safe, and should therefore be avoided.

Advancements in colorectal cancer detection: The role of immuno‐positron emission tomography, immuno‐single‐photon emission computed tomography, and machine learning applications

AbstractColorectal cancer (CRC) ranks as the world's second most prevalent cancer and third in mortality. Detection and diagnosis are crucial in research and clinical settings. While colonoscopy and computed tomographic colonography are widely used for identifying organic lesions, positron emission tomography (PET) and single‐photon emission computed tomography (SPECT) offer superior visualization of molecular changes. These immuno‐PET and immuno‐SPECT techniques surpass conventional [18F] Fluorodeoxyglucose PET/CT in specificity and sensitivity, improving CRC diagnostics and supporting therapeutic strategies. This review emphasizes the role of immuno‐PET/SPECT in CRC diagnosis and establishing a foundation for therapeutic strategies, facilitating hierarchical management through the identification of treatment‐responsive populations, prediction of therapeutic outcomes, and support for intraoperative imaging. This review introduces the preclinical and clinical utility of immunoconjugates for detecting colorectal adenomas, and primary, metastatic, or recurrent CRC, focusing on specific CRC cell targets like the epidermal growth factor receptor and carcinoembryonic antigen. The review also covers various mAb‐based immunoconjugates and engineered mAb fragments, including diabodies and minibodies. Finally, it looks into the great promise of machine learning in PET or SPECT and it addresses the challenges of translating preclinical successes into clinical practice for colorectal adenoma diagnosis, proposing potential solutions and directions for future research.

The power of the adult attachment interview in predicting subsequent psychopathology: a tribute to Mary Main

ABSTRACT Mary Main’s conceptualization and operationalization of attachment states of mind through the Adult Attachment Interview (AAI) represent seminal contributions to the attachment field. The AAI is a semi-structured clinical interview used to assess attachment states of mind that is widely used in research and clinical settings. Unresolved state of mind regarding loss or trauma has been linked to concurrent internalizing symptoms. The current study explored the associations between unresolved classification and later depression and anxiety, above and beyond trauma history and symptoms. Participants (n = 70) were parents (98.6% female, 67.1% Black/African-American) from a follow-up of a randomized clinical trial of a parenting program for families referred to child welfare services. Parents completed the AAI, Childhood Trauma Questionnaire, and the Psychiatric Diagnostic Screening Questionnaire at timepoint 1 (T1) and the Brief Symptom Inventory approximately 12 years later, at timepoint 2 (T2). Hierarchical regressions revealed that unresolved state of mind significantly predicted depression at T2, and marginally predicted anxiety at T2, above and beyond childhood trauma, post-traumatic stress symptoms, and early internalizing symptoms. These results suggest that unresolved states of mind are clinically significant and provide unique information about later internalizing symptoms in adults with a history of trauma or loss.

Participatory topological mapping: A novel approach for exploring and communicating situated knowledge of complex socio-ecological systems

Land use change impacts on Sámi reindeer husbandry are well-documented, but existing maps often fail to capture socio-ecological relationships between herders, reindeer and nature. Conventional Geographic Information Systems (GIS) simplify these relationships, lacking local context and excluding valuable knowledge due to their rigid structure. This paper introduces participatory topological mapping, a low-tech, knowledge co-production method that allows communities to share geospatial insights without advanced software. Combining hand-drawn maps with a standardised topological structure facilitates the visualisation of geographical relationships and dynamic land use systems from a local perspective. Developed and assessed through a Swedish case study in collaboration with Vittangi and Malå reindeer herding communities, the method aims to reduce barriers to knowledge exchange and enhance dialogue between Indigenous knowledge-holders, researchers and decision-makers. The paper discusses the authors’ experiences with participatory topological mapping, emphasising its potential and limitations for knowledge exchange. The method is advocated for broader use, recognising its value in articulating concerns about land use change beyond research settings and reindeer husbandry. Participatory topological mapping enables knowledge-holders to control the map and its narrative, deciding what is included or excluded. The maps and accompanying stories are valuable sources for documenting, sharing and analysing local perspectives on landscapes and the effects of land use change. The method treats mapping as a social process with the potential to affect how we understanding the world. When thoughtfully applied, it offers a valuable avenue for knowledge co-production, fostering deeper engagement, supporting informed decision-making and empowering communities.