Therapeutic Interaction Research Articles

Integrated oral microgel system ameliorates renal fibrosis by hitchhiking co-delivery and targeted gut flora modulation

BackgroundRenal fibrosis is a progressive process associated with chronic kidney disease (CKD), contributing to impaired kidney function. Active constituents in traditional Chinese herbs, such as emodin (EMO) and asiatic acid (AA), exhibit potent anti-fibrotic properties. However, the oral administration of EMO and AA results in low bioavailability and limited kidney accumulation. Additionally, while oral probiotics have been accepted for CKD treatment through gut microbiota modulation, a significant challenge lies in ensuring their viability upon administration. Therefore, our study aims to address both renal fibrosis and gut microbiota imbalance through innovative co-delivery strategies.ResultsIn this study, we developed yeast cell wall particles (YCWPs) encapsulating EMO and AA self-assembled nanoparticles (NPYs) and embedded them, along with Lactobacillus casei Zhang, in chitosan/sodium alginate (CS/SA) microgels. The developed microgels showed significant controlled release properties for the loaded NPYs and prolonged the retention time of Lactobacillus casei Zhang (L. casei Zhang) in the intestine. Furthermore, in vivo biodistribution showed that the microgel-carried NPYs significantly accumulated in the obstructed kidneys of rats, thereby substantially increasing the accumulation of EMO and AA in the impaired kidneys. More importantly, through hitchhiking delivery based on yeast cell wall and positive modulation of gut microbiota, our microgels with this synergistic strategy of therapeutic and modulatory interactions could regulate the TGF-β/Smad signaling pathway and thus effectively ameliorate renal fibrosis in unilateral ureteral obstruction (UUO) rats.ConclusionIn conclusion, our work provides a new strategy for the treatment of renal fibrosis based on hitchhiking co-delivery of nanodrugs and probiotics to achieve synergistic effects of disease treatment and targeted gut flora modulation.Graphical

In Silico Discovery and Predictive Modeling of Novel Acetylcholinesterase (AChE) Inhibitors for Alzheimer's Treatment.

Alzheimer's disease, akin to coronary artery disease of the heart, is a progressive brain disorder driven by nerve cell damage. This study utilized computational methods to explore 14 anti-acetylcholinesterase (AChE) derivatives (1 ̶ 14) as potential treatments. By scrutinizing their interactions with 11 essential target proteins (AChE, Aβ, BChE, GSK-3β, MAO B, PDE-9, Prion, PSEN-1, sEH, Tau, and TDP-43) and comparing them with established drugs such as donepezil, galantamine, memantine, and rivastigmine, ligand 14 emerged as notable. During molecular dynamics simulations, the protein boasting the strongest bond with the critical 1QTI protein and exceeding drug-likeness criteria also exhibited remarkable stability within the enzyme's pocket across diverse temperatures (300 ̶ 320 K). In addition, we utilized density functional theory (DFT) to compute dipole moments and molecular orbital properties, including assessing the thermodynamic stability of AChE derivatives. This finding suggests a welldefined, potentially therapeutic interaction further supported by theoretical and future in vitro and in vivo investigations. Ligand 14 thus emerges as a promising candidate in the fight against Alzheimer's disease.

Unraveling the Microbiome–Human Body Axis: A Comprehensive Examination of Therapeutic Strategies, Interactions and Implications

This review scrutinizes the intricate interplay between the microbiome and the human body, exploring its multifaceted dimensions and far-reaching implications. The human microbiome, comprising diverse microbial communities inhabiting various anatomical niches, is increasingly recognized as a critical determinant of human health and disease. Through an extensive examination of current research, this review elucidates the dynamic interactions between the microbiome and host physiology across multiple organ systems. Key topics include the establishment and maintenance of microbiota diversity, the influence of host factors on microbial composition, and the bidirectional communication pathways between microbiota and host cells. Furthermore, we delve into the functional implications of microbiome dysbiosis in disease states, emphasizing its role in shaping immune responses, metabolic processes, and neurological functions. Additionally, this review discusses emerging therapeutic strategies aimed at modulating the microbiome to restore host–microbe homeostasis and promote health. Microbiota fecal transplantation represents a groundbreaking therapeutic approach in the management of dysbiosis-related diseases, offering a promising avenue for restoring microbial balance within the gut ecosystem. This innovative therapy involves the transfer of fecal microbiota from a healthy donor to an individual suffering from dysbiosis, aiming to replenish beneficial microbial populations and mitigate pathological imbalances. By synthesizing findings from diverse fields, this review offers valuable insights into the complex relationship between the microbiome and the human body, highlighting avenues for future research and clinical interventions.

Structural Characterization of Monoclonal Antibodies and Epitope Mapping by FFAP Footprinting.

Covalent labeling in combination with mass spectrometry is a powerful approach used in structural biology to study protein structures, interactions, and dynamics. Recently, the toolbox of covalent labeling techniques has been expanded with fast fluoroalkylation of proteins (FFAP). FFAP is a novel radical labeling method that utilizes fluoroalkyl radicals generated from hypervalent Togni reagents for targeting aromatic residues. This report further demonstrates the benefits of FFAP as a new method for structural characterization of therapeutic antibodies and interaction interfaces of antigen-antibody complexes. The results obtained from human trastuzumab and its complex with human epidermal growth factor receptor 2 (HER2) correlate well with previously published structural data and demonstrate the potential of FFAP in structural biology.

MyoTRIM, an engineered tripartite motif (TRIM) protein, recapitulates canonical phosphatidylserine binding and enhances cell membrane resealing capacity

Duchenne Muscular Dystrophy (DMD) is the most prevalent hereditary neuromuscular disease and involves progressive muscle degeneration that contributes to early death. DMD is caused by mutations in the dystrophin gene, which eliminates its expression and leads to compromised structural integrity of the muscle cell plasma membrane. Although there is no cure for DMD, a recently approved gene therapy has shown desirable primary endpoints, including dystrophin expression, but limited secondary functional endpoints. Moreover, this genetic approach is limited to patients within a narrow age range. Therefore, novel therapies addressing the underlying structural cause of the disease remain necessary. The tripartite motif protein 72/mitsugumin 53 (TRIM72/MG53) is integral for an effective membrane repair response after injury. We have reported that overexpression of MG53 or exogenous delivery of recombinant human MG53 protein (rhMG53) can increase membrane repair capacity in many different cell types and improve pathology in multiple muscular dystrophy animal models. MG53 is thought to mediate this effect by binding phosphatidylserine (PS) at membrane injury sites. Yet, the structural basis of this therapeutic interaction is poorly understood. Here, we test the hypothesis that we can recapitulate the therapeutic effects of rhMG53 by engineering a novel TRIM protein, MyoTRIM, that retains PS binding capabilities while eliminating its canonical enzymatic activity. Using molecular, cellular, and physiological methodologies, we tested an engineered catalytic inactive MG53 variant, MyoTRIM. We found that enzymatic activity is dispensable for canonical subcellular localization and improved membrane resealing kinetics when endogenously overexpressed or made available exogenously as a recombinant protein. We report MG53’s propensity to aggregate in the presence or absence of specific canonical protein domains. Additionally, we demonstrate that MyoTRIM can bind PS and establish that carboxy-terminal domains are required for effcient PS binding. Lastly, we show preliminary data highlighting MyoTRIM’s therapeutic potential in dystrophic mouse models, suggesting improved functional outcomes, i.e. increased membrane repair and muscle force production. Taken together, these data suggest that the engineered protein MyoTRIM can recapitulate MG53’s therapeutic effect on membrane resealing while eliminating the canonical E3 ligase catalytic activity, thereby eliminating undesirable metabolic side effects during treatment. 5F31AR080555. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Understanding exercise referrals in primary care: a qualitative study of General Practitioners and Physiotherapists

BackgroundPhysical inactivity is estimated to cost the UK National Health Service over £7.4 billion per year. Healthcare practitioners have a key role in supporting increases in physical activity (PA) levels, including referring to exercise referral schemes. To date, there has been little research into practitioner perspectives on referrals to exercise schemes. ObjectivesTo explore the views and experiences of General Practitioners (GPs) and physiotherapists in relation to factors which influence referral and adherence to exercise referral schemes. Design setting and participantsQualitative study of primary care-based practitioners in Glasgow, UK. MethodsSemi-structured interviews were conducted with 14 practitioners (seven GPs and seven physiotherapists). Interviews were recorded and analysed thematically. ResultsFour themes are presented. Firstly, all people, including healthcare practitioners, bring inherent biases which are influenced by their background, experiences and worldviews to a consultation which impact their approach to PA promotion. Secondly, clinical time pressures are a major barrier to effective PA promotion. Thirdly, patient-led, compassionate care which seeks to fully understand a patient is the most vital component of behaviour change, with suggestions that promoting peer support and the use of personal anecdotes to normalise vulnerabilities might be helpful. Lastly, providing ongoing support for change was felt to be beneficial to PA promotion. This is often accessed through exercise referral schemes and improved by better collaboration between exercise providers and referring practitioners. ConclusionPractitioners believed exercise referrals could be improved with more targeted training in behaviour change facilitation, support for multidisciplinary working, and enhanced communication between the programmes and referrers. Additionally, supporting behaviour change requires time for compassionate care and fully understanding patients’ motivations and beliefs. Lack of time was felt to be the greatest current barrier to effective PA promotion. Contribution of the Paper•Previous physical activity promotion research has focussed on overcoming barriers to physical activity.•Few studies have considered the effect of the therapeutic interaction on successful exercise referrals.•In this qualitative study, primary care-based practitioners (GPs and physiotherapists) reported inherent biases which affected referrals, as well as time pressures.•Targeted training, support for multidisciplinary working, and enhanced communication between the programmes and referrers, would improve referrals.

Analyzing molecular signatures in preeclampsia and fetal growth restriction: Identifying key genes, pathways, and therapeutic targets for preterm birth.

Intrauterine growth restriction (IUGR) and preeclampsia (PE) are intricately linked with specific maternal health conditions, exhibit shared placental abnormalities, and play pivotal roles in precipitating preterm birth (PTB) incidences. However, the molecular mechanism underlying the association between PE and IUGR has not been determined. Therefore, we aimed to analyze the data of females with PE and those with PE + IUGR to identify the key gene(s), their molecular pathways, and potential therapeutic interactions. In this study, a comprehensive relationship analysis of both PE and PE + IUGR was conducted using RNA sequence datasets. Using two datasets (GSE148241 and GSE114691), differential gene expression analysis via DESeq2 through R-programming was performed. Gene set enrichment analysis was performed using ClusterProfiler, protein‒protein interaction (PPI) networks were constructed, and cluster analyses were conducted using String and MCODE in Cytoscape. Functional enrichment analyses of the resulting subnetworks were performed using ClueGO software. The hub genes were identified under both conditions using the CytoHubba method. Finally, the most common hub protein was docked against a library of bioactive flavonoids and PTB drugs using the PyRx AutoDock tool, followed by molecular dynamic (MD) simulation analysis. Pharmacokinetic analysis was performed to determine the ADMET properties of the compounds using pkCSM. We identified eight hub genes highly expressed in the case of PE, namely, PTGS2, ENG, KIT, MME, CGA, GAPDH, GPX3, and P4HA1, and the network of the PE + IUGR gene set demonstrated that nine hub genes were overexpressed, namely, PTGS2, FGF7, FGF10, IL10, SPP1, MPO, THBS1, CYBB, and PF4. PTGS2 was the most common hub gene found under both conditions (PE and PEIUGR). Moreover, the greater (-9.1kcal/mol) molecular binding of flavoxate to PTGS2 was found to have satisfactory pharmacokinetic properties compared with those of other compounds. The flavoxate-bound PTGS2 protein complex remained stable throughout the simulation; with a ligand fit to protein, i.e., a RMSD ranging from ∼2.0 to 4.0Å and a RMSF ranging from ∼0.5 to 2.9Å, was observed throughout the 100ns analysis. The findings of this study may be useful for treating PE and IUGR in the management of PTB.

Therapeutic Chatbots as Cognitive-Affective Artifacts

Conversational Artificial Intelligence (CAI) systems (also known as AI “chatbots”) are among the most promising examples of the use of technology in mental health care. With already millions of users worldwide, CAI is likely to change the landscape of psychological help. Most researchers agree that existing CAIs are not “digital therapists” and using them is not a substitute for psychotherapy delivered by a human. But if they are not therapists, what are they, and what role can they play in mental health care? To answer these questions, we appeal to two well-established and widely discussed concepts: cognitive and affective artifacts. Cognitive artifacts are artificial devices contributing functionally to the performance of a cognitive task. Affective artifacts are objects which have the capacity to alter subjects’ affective state. We argue that therapeutic CAIs are a kind of cognitive-affective artifacts which contribute to positive therapeutic change by (i) simulating a (quasi-)therapeutic interaction, (ii) supporting the performance of cognitive tasks, and (iii) altering the affective condition of their users. This sheds new light on why virtually all existing mental health CAIs implement principles and techniques of Cognitive Behavioral Therapy — a therapeutic orientation according to which affective change and, ultimately, positive therapeutic change is mediated by cognitive change. Simultaneously, it allows us to conceptualize better the potential and limitations of applying these technologies in therapy.

Systematic Evaluation of Aegle marmelos-Derived Compounds: Potential Therapeutic Agents Against Inflammation and Oxidative Stress.

Aim This study aimed to evaluate the potential antioxidant and anti-inflammatory properties of Aegle marmelos active compoundsthrough a multifaceted approach. The investigation encompasses molecular docking studies, computational pharmacokinetic predictions, and in vitro assessments, with a focus on understanding their physiochemical properties, pharmacokinetics, and molecular interactions. Materials and methods This study was conducted in the Research Departmentof Biochemistry, Saveetha Medical College & Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Tamilnadu, India. The study employed Soxhlet and methanol extraction techniques to obtain Aegle marmelos extracts, which were then subjected to antioxidant and anti-inflammatory assays. Antioxidant activity was assessed using the H2O2 assay, while anti-inflammatory potential was determined via the egg albumin denaturation assay. Molecular docking studies were conducted with human heme oxygenase 1 (HO-1) and human zanthine oxidoreductase (XO) proteins to elucidate potential therapeutic interactions. Furthermore, computational tools like SwissADME, pkCSM, and ADMETlab 2.0 were utilized to predict physiochemical and pharmacokinetic properties, providing insights into the compoundabsorption, distribution, metabolism, and excretion profiles. This integrated approach aimed to comprehensively evaluate the therapeutic potential of Aegle marmelos-derived compounds against inflammation and oxidative stress-related disorders, paving the way for future drug development endeavors. Results In the antioxidant assay, Aegle marmelos methanolic tuber extracts showed exceptional absorption of 87.4%, surpassing the reference standard. In the anti-inflammatory assay, the extracts displayed an absorption of approximately 79%, indicating significant anti-inflammatory potential. Auraptene, imperatorin, luvangetin, and psoralen exhibited favorable pharmacokinetic properties and adherence to the Lipinski rule of 5, suggesting promising drug development potential. In molecular docking, imperatorin demonstrated the highest binding affinity to HHO-1 and XO. Conclusion The study on Aegle marmelos highlights its potential as a therapeutic agent due to its potent antioxidant and anti-inflammatory properties. Phytochemical constituents, such as auraptene, imperatorin, luvangetin, and psoralen, show promising pharmacokinetic profiles, suggesting their suitability for drug development. Molecular docking analysis reveals imperatorin as the most effective binder to key enzymes, emphasizing its therapeutic potential against inflammation and oxidative stress-related disorders.

Internet-Delivered Affect-Focused Psychodynamic Therapy for Adolescent Depression: Treatment Principles and Clinical Application in the ERiCA Project

ABSTRACT Internet-delivered, therapist-guided, self-help programs are novel ways to deliver psychotherapeutic interventions adapted from established therapy models. Such programs can be easily accessed online and may offer an important treatment option for patients who struggle with barriers to seeking out and engaging in face-to-face psychotherapy, including depressed adolescents. While there are evidence-based Internet-delivered self-help programs based on cognitive-behavioral therapies (i.e. ICBT) for adolescent depression, a program based on psychodynamic principles (i.e. IPDT) has so far been lacking. In this article we describe the IPDT program developed within the ERiCA project, which has so far been evaluated in two randomized controlled trials (RCTs). We further provide a case example from one of the trials to illustrate the treatment process and therapeutic interaction in detail. Given the novelty of the approach, we will particularly highlight and discuss how a psychodynamic understanding of adolescent development and depressive dynamics as well as affect-focused treatment principles inform the treatment, including the therapist’s role, tasks, and choice of interventions. The potential implications and utility of IPDT for regular clinical practice are elaborated as well as potential research directions for the future.

Humanitarian Love in Values-Based Practice and Health Professionals’ Psychosocial Outcomes: Systematic Review

IntroductionThe literature on Values-Based Practice often neglects the significance of love in therapeutic interactions, sometimes treating it as taboo or crossing professional boundaries.ObjectivesThis systematic review investigates the role of humanitarian love in the lives of healthcare professionals and its psychosocial impact, aiming to establish it as a core value in values-based practice.MethodsWe conducted a PRISMA 2020-compliant systematic review, searching databases (CINAHL, PubMed, Scopus) from inception to April 3, 2023, using PEO elements: health professionals (P), love (E), psychosocial impact (O). Two independent reviewers conducted screening, data extraction, and bias assessment. A narrative synthesis of the data was applied. The selection process is presented in Figure 1.ResultsEight articles met the inclusion criteria, comprising 1,948 participants (median age: 28.55). Humanitarian love encompassed compassionate love, self-compassion, and affection. Humanitarian love showed a negative correlation with burnout, compassion fatigue, self-judgment, and secure attachment, while positively correlating with professional well-being, professional commitment, self-care, patience, diversity acceptance, spirituality, self-kindness, and ethical values. Humanitarian love significantly influenced healthcare professionals’ psychosocial well-being. The main outcomes are presented in Figure 2.Image:Image 2:ConclusionsThis review highlights humanitarian love’s potential to enhance the psychosocial well-being of healthcare professionals and emphasizes its significance as a core value in values-based practice. Cultivating humanitarian love among healthcare professionals through research and interventions could bolster their resilience, job satisfaction, and overall fulfillment in their roles.Disclosure of InterestNone Declared

Exploring Phytochemicals for Diabetes Management: Mechanisms, Efficacy, and Future Directions

In the realm of global health diplomacy, diabetes mellitus undoubtedly poses a significant challenge. Furthermore, there is a pressing need to explore alternative and complementary therapies. Phytochemicals, which are naturally occurring bioactive compounds found in plants, exhibit distinct biochemical properties, rendering them promising candidates for diabetes management. This review focuses on the potential of various classes of phytochemicals, including polyphenols, alkaloids, terpenoids, organosulfur compounds, and polysaccharides, in diabetes management. Each class demonstrates unique mechanisms of action, contributing to therapeutic effects such as enhancing insulin sensitivity, reducing carbohydrate digestion and glucose absorption, regulating antioxidant stress, inflammation, and glucose metabolism. While successful preclinical trials provide valuable insights, further rigorous clinical trials are imperative to ascertain the therapeutic efficacy, optimal dosage, bioavailability, and potential interactions with concomitant medications. Understanding the functional pathways of plant-derived substances is crucial, as it enables the formulation of precise strategies for incorporating them as dietary supplements for individuals with diabetes mellitus. Keywords: Phytochemicals, diabetes mellitus, insulin sensitivity, glucose metabolism, oxidative stress, and inflammation.

Push and Pull: Role of Therapist Mentalizing in Navigating Therapeutic Distance.

In the relational playground of psychotherapy, negotiating therapeutic distance is crucial for the process as well as the outcome of treatment. The challenge of navigating this closeness and distance may be accentuated during emotionally charged interactions in therapy. Therapist and client may get locked in complementary, rigid positions, leading to either submission or resistance to the others' demands. The therapist's ability to respond appropriately to these pushes and pulls is supported by their ability to mentalize, which is their ability to attend to and understand their own states of mind while being aware of others' states of mind. Therapists are expected to maintain a mentalizing stance throughout and despite the relevance and impact of therapist mentalization, there is relatively less research, training, or practice-related guidance on how to maintain this balance. We use case illustrations to demonstrate therapeutic interactions that can trigger non-mentalizing for the therapist and reflect on ways of recognizing and addressing these patterns related to closeness and distance. We also share recommendations for reflective practice and supervision, training as well as research on therapist mentalization.

Therapeutic Interaction in Dropout and Adhesion Cases in an Intervention with Mothers

O presente estudo teve como objetivo descrever as interações estabelecidas entre uma terapeuta, uma cliente que abandonou (participante A) e uma cliente que aderiu a uma intervenção (participante S) com mães em grupo. Por meio de um sistema de categorias foram categorizadas duas horas de filmagem da última sessão de que tanto A quanto S participaram (terceira sessão), sessão esta que contou com todas as etapas do programa. Resultados gerais: a) as categorias da terapeuta de Solicitação de Relato, Recomendação, Interpretação e Aprovação foram mais apresentadas para a cliente A; b) os resultados da cliente A indicaram a ausência de Concordância e presença de Oposição, o oposto do apresentado pela cliente S; e c) os resultados das análises indicaram que para S as Recomendações e Interpretações da terapeuta foram antecedidas ou sucedidas por Empatia e Aprovação, diferentemente do que ocorreu para a cliente A. De forma geral considera-se a importância da investigação de elementos contextuais, além das frequências de comportamentos. Conclui-se que são características da interação terapêutica relacionadas à adesão a uma intervenção com mães em grupo a alternância entre categorias diretivas e não diretivas do terapeuta, alta frequência de Concordância e baixa ocorrência de Oposição por parte do cliente.

HIV-TB Coinfection: Current Therapeutic Approaches and Drug Interactions.

The co-occurrence of human immunodeficiency virus (HIV) and tuberculosis (TB) infection poses a significant global health challenge. Treatment of HIV and TB co-infection often necessitates combination therapy involving antiretroviral therapy (ART) for HIV and anti-TB medications, which introduces the potential for drug-drug interactions (DDIs). These interactions can significantly impact treatment outcomes, the efficacy of treatment, safety, and overall patient well-being. This review aims to provide a comprehensive analysis of the DDIs between anti-HIV and anti-TB drugs as well as potential adverse effects resulting from the concomitant use of these medications. Furthermore, such findings may be used to develop personalized therapeutic strategies, dose adjustments, or alternative drug choices to minimize the risk of adverse outcomes and ensure the effective management of HIV and TB co-infection.

Quantitative Analysis of Therapeutic Antibody Interactions with Fcγ Receptors Using High-Speed Atomic Force Microscopy.

This study employed high-speed atomic force microscopy to quantitatively analyze the interactions between therapeutic antibodies and Fcγ receptors (FcγRs). Antibodies are essential components of the immune system and are integral to biopharmaceuticals. The focus of this study was on immunoglobulin G molecules, which are crucial for antigen binding via the Fab segments and cytotoxic functions through their Fc portions. We conducted real-time, label-free observations of the interactions of rituximab and mogamulizumab with the recombinant FcγRIIIa and FcγRIIa. The dwell times of FcγR binding were measured at the single-molecule level, which revealed an extended interaction duration of mogamulizumab with FcγRIIIa compared with that of rituximab. This is linked to enhanced antibody-dependent cellular cytotoxicity that is attributed to the absence of the core fucosylation of Fc-linked N-glycan. This study also emphasizes the crucial role of the Fab segments in the interaction with FcγRIIa as well as that with FcγRIIIa. This approach provided quantitative insight into therapeutic antibody interactions and exemplified kinetic proofreading, where cellular discrimination relies on ligand residence times. Observing the dwell times of antibodies on the effector molecules has emerged as a robust indicator of therapeutic antibody efficacy. Ultimately, these findings pave the way for the development of refined therapeutic antibodies with tailored interactions with specific FcγRs. This research contributes to the advancement of biopharmaceutical antibody design and optimizing antibody-based treatments for enhanced efficacy and precision.

How counselling psychologists address issues of race with clients from black Asian and minority ethnic backgrounds: A discourse analysis

The prejudiced experiences that Black, Asian and Minority Ethnic (BAME) clients report when discussing culture, racial discrimination and race has been documented. However, research seldom investigates the practitioners’ interpretations when engaging with clients from non-White ethnic backgrounds. This raises questions about how professionals address individuals' needs in clinical and supervisory practice. Therefore, the present study shed light on the discourses counselling psychologists use to address and discuss issues of race and discrimination when talking with clients in clinical practice. Semi-structured interviews were conducted with a purposive sample of six counselling psychologists (mean age 40 years) who had engaged with clients or supervisees from a BAME background. A Discourse Analysis (DA) was employed to analyze dialogue used by participants in discussing race and discrimination in counselling psychology practice. This analysis yielded three main discourses when counselling psychologists described their therapeutic interactions with BAME clients and supervises. These were Systemic Institutional Racism; Legitimizing Racism; and Challenging Systemic Racism. The first two discourses alluded to similar repertoires present in the discussions of white counselling psychologist participants, whereas the discourse challenging systemic racism was constructed by BAME counselling psychologists. Findings indicate that becoming attuned and open to discussing race-related difficulties supports favorable outcomes in practice when engaging with BAME individuals. This research offers valuable implications for service provision across counselling and therapeutic practice.

The Future of Psychotherapy Research and Neuroscience: Introducing the 4E/MoBI Approach to the Study of Patient–Therapist Interaction

The integration of neuroscience and psychotherapy research has long been a topic of interest in the field of mental health. A significant challenge in psychotherapy research is understanding the dyadic interaction between patient and therapist. This interaction is complex, emerging from a myriad of multi-level factors such as gestures, verbal communication, mentalization, and environmental influences. This article aims to present a roadmap for the future integration of neuroscience and psychotherapy research, addressing the complexities of human interaction. We introduce the 4E/MoBI approach, a framework that combines theoretical and methodological tools to study the dynamics of the brain, body, and environment in real-world settings. This approach emphasizes the use of physiological systems (e.g., heart and brain), behavioral interactions (e.g., conversations and eye-tracking), and environmental video recordings. Additionally, the scalable experimental design (SED) heuristic is discussed as a method to blend controlled experiments with real-world scenarios, allowing for the parametric testing of neurobehavioral markers. As a practical demonstration of the SED heuristic within the 4E/MoBI framework, a concrete experimental example using the N170 event-related potential (ERP) component is presented. While the N170 ERP component is not posited as the foundational marker in the field, it serves to illustrate the application of hypothesis-driven designs and analyses. The 4E/MoBI approach offers a promising avenue for the integration of neuroscience and psychotherapy research. By addressing existing gaps, such as the physiology and phenomenology of expertise in psychotherapy, this framework can foster a virtuous relationship between the two disciplines, paving the way for more comprehensive and nuanced understandings of therapeutic interactions.

Network Pharmacology Reveals Potential Targets and Mechanisms of Luteolin in Treating Small Vessel Vasculitis

Small vessel vasculitis encompasses various inflammations in blood vessels, with IgA vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis being prominent types. Luteolin, a natural flavonoid found in diverse flora, displays notable anti-inflammatory properties, suggesting its therapeutic potential for inflammatory conditions. The study aims to scrutinize the plausible mechanism by which luteolin functions as a remedial entity for small vessel vasculitis. The study employed network pharmacology methods to investigate the potential therapeutic mechanisms of luteolin for small vessel vasculitis. Luteolin target genes were obtained from online databases, and disease-related target genes were collected from multiple sources. Our exploration into these foundational mechanisms involved protein-protein interaction networks, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes pathway analyses. The study identified 24 shared target genes between luteolin and small vessel vasculitis. The protein-protein interaction analysis highlighted key targets such as Protein kinase B alpha and Matrix metallopeptidase 9. Kyoto Encyclopedia of Genes and Genomes pathway enrichment unveiled participation in signaling pathways, including Tumor necrosis factor signaling, Vascular endothelial growth factor signaling, and Interleukin 17 signaling. Molecular docking analysis demonstrated stable binding between luteolin and Protein kinase B alpha, Matrix metallopeptidase 9, indicating potential therapeutic interactions. Luteolin may exhibits potential therapeutic effects for Small vessel vasculitis by interacting with Protein kinase B alpha and Matrix metallopeptidase 9 and involvement in Tumor necrosis factor signaling pathway, Vascular endothelial growth factor signaling pathway, Platelet activation, Interleukin 17 signaling pathway.

On solidarity and generosity in supervision

In the supervisory process, dialectical tensions arise between the supervisee and the supervisor. Often, the source of these tensions is the significant difference in their perceptions of the meanings of the unfolding therapeutic reality, intensified by belonging to distinct professional generations and reconstructing therapeutic interactions in different ways. According to the Hegelian model, mutual recognition and validation as independent and autonomous professionals help the supervisory dyad overcome dialectical tensions, reach new understandings, and grow as clinicians. Supervisors who acknowledge their vulnerability and manifest generosity and solidarity with supervisees can readily recognize and validate the supervisees and minimize the dialectical tensions.