Updated Information Research Articles

Effects of early marriage among women married before reaching 18 years old (qualitative study approach)

BackgroundThe consequences of early marriage have become a global concern for young women. The detrimental effects of early marriage disproportionately affect girls. Regarding its effects in poor nations like Ethiopia, there is a dearth of data. As a result, this study offers baseline, first-hand, and updated information for both the nation and the study area.ObjectiveThe purpose of this study was to investigate the effects of early marriage on Guji women who were married before the age of 18.MethodsThis qualitative study used a phenomenological approach and was carried out from January to April 2024. An in-depth interview technique was employed to collect the data. The interviews were conducted in the Oromo language. A purposive sampling technique was applied to choose the study participants. A total of 25 women who met the eligibility criteria were selected. A thematic data analysis approach was employed to analyze the data in this study.ResultsThree themes, 10 subthemes, and more than hundreds of codes were extracted after the interview data were analyzed. The main themes and subthemes of this study were as follows: 1-Precipitators of early marriage (abduction and arranged marriage); 2-Consequences of early marriage (emotional damage, moral damage, early marriage is a risk factor for maternal and child health, early marriage is a major cause for girls to drop out of school, poverty, gender-based violence and divorce, lack of essential life skills); and 3-Attitudes toward early marriage (early marriage is a harmful cultural practice; girls should be protected).ConclusionThe study’s findings illustrated the multidimensional effect of early marriage, necessitating the involvement of numerous sectors and stakeholders. The community, religious leaders, the health, education, and legal sectors, as well as the parents of young girls, should all take an active role in delaying early marriage. This indicates the development of policies that permit cooperation amongst all relevant parties. Creating awareness among girls, families, and the community through community-based education is crucial. Early married women should participate in intervention programs to provide their experience to young girls. Women who are victims of early marriage must receive full support to mitigate its negative consequences.

Precision oncology platforms: practical strategies for genomic database utilization in cancer treatment.

In recent years, the expansion of molecularly targeted cancer therapies has significantly advanced precision oncology. Parallel developments in next-generation sequencing (NGS) technologies have also improved precision oncology applications, making genomic analysis of tumors more affordable and accessible. Targeted NGS panels now enable the rapid identification of diverse actionable mutations, requiring clinicians to efficiently assess the predictive value of cancer biomarkers for specific treatments. The urgency for timely and accurate decision-making in oncology emphasizes the importance of reliable precision oncology software. Online clinical decision-making tools and associated cancer databases have been designed by consolidating genomic data into standardized, accessible formats. These new platforms are highly integrated and crucial for identifying actionable somatic genomic biomarkers essential for tumor survival, determining corresponding drug targets, and selecting appropriate treatments based on the mutational profile of each patient's tumor. To help oncologists and translational cancer researchers unfamiliar with these tools, we review the utility, accuracy, and comprehensiveness of several commonly used precision medicine software options currently available. Our analysis categorized selected genomic databases based on their primary content, utility, and how well they provide practical guidance for interpreting somatic biomarker data. We identified several comprehensive, mostly open-access platforms that are easy to use for genetic biomarker searches, each with unique features and limitations. Among the precision oncology tools we evaluated, we found MyCancerGenome and OncoKB to be the first choice, offering comprehensive, accurate up-to-date information on the clinical significance of somatic mutations. To illustrate the application of these precision oncology tools in clinical settings, we evaluated three case studies to see how use of the platforms could have influenced treatment planning. Most of the precision oncology software evaluated could be easily streamlined into clinical workflows to provide updated information on approved drugs and clinical trials related the actionable mutations detected. Some platforms were very intuitive and easy to use, while others, often developed in smaller academic settings, were more difficult to navigate and may not be updated consistently. Future enhancements, incorporating artificial intelligence algorithms, are likely to improve integration of the platforms with diverse big data sources, enabling more accurate predictions of potential therapeutic responses.

Shopee E-Commerce Website Quality Analysis Based on User Perception Using the Webqual Method

This study aims to analyze the quality of Shopee's e-commerce site using the WebQual method approach. Three main dimensions, namely usability, information quality, and service interaction, are used to evaluate the quality of the Shopee website from the user's point of view. This method measures users' perception of the main aspects that determine their experience in using the Shopee website. The results of the study show that although Shopee has succeeded in providing a responsive and informative platform, several areas need improvement, especially related to aspects of service interaction and the security of users' personal information. In conclusion, Shopee needs to optimize several important aspects to improve the user experience and strengthen its position as a leading e-commerce platform in Southeast Asia. Improved design and navigation of a more modern and intuitive interface can make it easier for users to navigate the platform. In addition, real-time updates of product information regarding stock and prices will help prevent user dissatisfaction. Shopee also needs to improve customer service, both with the addition of staff and technology such as advanced chatbots, to answer customer needs faster. Finally, increased security and transparency regarding transactions and protection of personal data will strengthen user trust in this platform. Through these efforts, Shopee is expected to be able to provide a better shopping experience and maintain the loyalty of its users in the midst of fierce e-commerce competition.

Population density estimates and conservation status of Aegla jacutinga Marçal & Teixeira, 2020 (Decapoda: Anomura: Aeglidae) from the type locality in Brazil

Abstract Anomuran crabs of the genus AeglaLeach, 1821 are endemic to temperate and subtropical regions of South America and are commonly found in streams and rivers, where they are generally restricted to healthy environments because they are sensitive to environmental changes. The genus presents worrying data regarding its conservation, like the many Brazilian freshwater species classified as being at some level of threat of extinction. We inventoried unexplored watersheds, estimated the population density of Aegla jacutinga Marçal & Teixeira, 2020 in its type locality, updated information on the distribution of the species, and assessed its conservation status using IUCN criteria.

Construction of a digital twin model for incremental aggregation of multi type load information in hybrid microgrids under integrity constraints

In the multi type load information of hybrid microgrids, data loss or incompleteness may occur due to network congestion, signal interference, equipment failures, and other reasons. Especially with the continuous generation of new load data, gradually incorporating these new data into the existing aggregation process to achieve continuous updating and optimization of load information. Therefore, this article proposes a digital twin model construction method for incremental aggregation of multi type load information in hybrid microgrids under integrity constraints. The Leida criterion and cubic exponential smoothing method are used to preprocess various load data of hybrid microgrids, remove abnormal data, reduce data fluctuations, and make the data more interpretable. Establish integrity constraints for multiple load data of hybrid microgrids and extract load characteristics of hybrid microgrids. Based on these, establish a digital twin model for the incremental aggregation of multiple load information in a hybrid microgrid, and solve the model using an improved K-means algorithm to achieve continuous updating and optimization of load information. The experimental results show that the data sharing delay of this method is 0.12 s, the load is basically consistent with the actual value, and the relative error of the load data is 4%.

Exploring Pharmacological Mechanisms, Clinical Trials and Patent Landscapes of Berberine: A Review

Abstract: Traditional Chinese medicine has used berberine (BBR) for a long time. Berberine is a natural compound found in several plants, including Berberis lyceum Royle, Berberis thunbergii DC, Berberis koreana Palib., Berberis vulgaris L., Mahonia aquifolium, Mahonia bealei (Fort.) Carr., and Chelidonium majus L. Berberine is believed to help treat many diseases, such as ovarian and colorectal cancer, high blood pressure, Parkinson's and Alzheimer's disease, diabetes, heart disorders, depression, viral infections, and inflammatory diseases. However, when taken orally, berberine quickly breaks down in the body, leading to low levels in the bloodstream. This means that its absorption in the intestines is limited, which reduces its effectiveness despite its potential health benefits. The liver is the main organ that processes and uses berberine in both animals and humans, and about 84% of berberine and its byproducts are excreted in the feces. We thoroughly reviewed the available research on berberine from reliable sources like PubMed, ScienceDirect, ClinicalTrials. gov, and Scopus. Our study summarizes the latest findings on the therapeutic benefits of berberine and provides updated information on clinical research and patents. This review covers the various pharmacological effects of berberine, including its use in treating Alzheimer's disease, high blood pressure, neuroprotective effects, anti-arrhythmia, Parkinson's disease, diabetes, cancer, and depression.

Margaret: Streamlining Research Productivity Analysis in Colombia with an R Package for GrupLAC Integration

Margaret is an advanced R package designed to systematically extract and consolidate data pertaining to research outputs (such as publications, books, book chapters, and conference presentations) of scientific groups from the GrupLAC platform, an online application managed by Minciencias in Colombia for the registration and updating of researcher and research group information in the fields of science, technology, and innovation. The challenge of monitoring and evaluating scientific production across various web platforms presents a substantial barrier to universities in tracking their contributions effectively. To address this challenge, Margaret accepts a designated list of links corresponding to university-affiliated research groups within GrupLAC. Utilizing web-scraping techniques, the package retrieves and compiles this data into a comprehensive XLSX file. This file encompasses information across 51 distinct categories of research products, enabling research directors to meticulously assess, monitor, and enhance various strategies that aim to augment the production, quality, and impact of scientific outputs. The Shiny application is publicly accessible and can be accessed via the following link: https://ucatolicaluisamigo-investigaciones.shinyapps.io/margaret/

Summary of the National Advisory Committee on Immunization (NACI) Seasonal Influenza Vaccine Statement for 2024-2025.

The National Advisory Committee on Immunization (NACI) reviews the evolving evidence on influenza immunization and provides annual recommendations regarding the use of seasonal influenza vaccines. The NACI Statement on Seasonal Influenza Vaccine for 2024-2025 updates the NACI recommendations from the previous year. To summarize the 2024-2025 NACI seasonal influenza vaccine recommendations and to highlight new and updated information. For the development of the Statement on Seasonal Influenza Vaccine for 2024-2025, the NACI Influenza Working Group applied the NACI evidence-based process to assess available evidence and formulate recommendations. These recommendations underwent a thorough evaluation and were approved by NACI based on the available evidence. Key updates for the 2024-2025 influenza season include updated immunization recommendations reflecting changes in influenza epidemiology and revised guidance for vaccine administration during pregnancy and in older adults. The National Advisory Committee on Immunization recommends that any age-appropriate quadrivalent or trivalent influenza vaccine should be used for individuals six months of age and older who do not have contraindications or precautions. NACI reaffirms the importance of influenza vaccination with inactivated or recombinant influenza vaccines in pregnancy. Finally, NACI recommends that inactivated high-dose (IIV-HD), inactivated adjuvanted (IIV-Adj) or recombinant influenza vaccine (RIV) should be offered, when available, over other influenza vaccines for adults 65 years of age and older.

Advancements in Contemporary Pharmacological Innovation: Mechanistic Insights and Emerging Trends in Drug Discovery and Development

Developing a new drug and bringing it to the market is a complex and time-consuming process that involves multiple phases of drug discovery and development. However, recent advancements in various technologies, such as multi-omics, genome editing, Artificial Intelligence (AI), and Machine Learning (ML), have significantly improved this process. These technologies have made the process more accurate, less time-consuming, and cost-effective compared to the conventional methods of drug discovery and development. In the current age, discovering and developing drugs is a collaborative effort that involves scientific breakthroughs, technological advancements, and regulatory oversight. The pharmaceutical industry is constantly innovating new techniques, fostering interdisciplinary collaboration, and prioritizing patient-centered approaches. In this review, we explore the latest and most updated information about using advanced technologies in drug discovery. The review begins by briefly explaining the conventional drug discovery and development process, and then delves into the applications of multi-omics, genome editing technology, systems biology, artificial intelligence, and machine learning.

Epidemiological Studies on COVID-19 and Mental Health in Mexico: Better Methodology for Better results: a Literature Review

Background. Updated information is required on studies conducted in Mexico on the mental health consequences of COVID-19. Objective. In comparison with previous efforts, we increased the timeframe of the literature search to February 2023 and used a larger list of potential mental health outcomes. Method. We used common international literature databases and more local databases, such as SciELO, and the Biblioteca Virtual en Salud (BVS). We focussed on the methodological issues of these studies, their prevalence estimates and suspected risk factors. Results. We reported on ninety-five studies that included Mexican data on symptoms of alcohol use, anxiety, depression, gaming, sleep problems and suicidal thoughts and behaviours. In most cases, we found a cross-sectional survey with self-reported information on mental health symptoms usually although not always with validated screening instruments and scales. These studies were implemented on websites, and sometimes over the phone, on self-selected volunteers. We found a small subset of fourteen longitudinal datasets (for alcohol use, anxiety, depression, and suicidal thoughts and behaviours) that suggested a more cautious interpretation of the effects of the COVID-19 pandemic on the mental health of Mexicans. Discussion and conclusion. Although the initial rapid studies during the early phases of the pandemic yielded warning signs, they did not necessarily follow standard epidemiological principles. Methodological improvements are required for future studies on the mental health consequences of natural, man-made disasters and epidemic contingencies.

El Uso de la Gamificación para Mejorar el Idioma Inglés en un Proceso de Enseñanza – Aprendizaje en una Escuela de Chone

The objective of the research was: Analyze how to improve English language learning through gamification at a school in Chone. Updated investigative information was examined that allowed us to identify reasons that limit students learning and that teachers face, which is why the use of recreational activities is considered important to use for a better teaching process, the literary review indicates that songs help students learn faster, enjoy classes, the gamification strategy, which is a technique that uses the game as a mechanism for non-playful contexts, which aims to optimize the stimulation and collaboration of students, to make music learning fun and interactive. The affirmation of the positive of the use of music is because the student becomes emotionally involved and facilitates a notable and explanatory argument for learning. The approach and type of research was quantitative and qualitative, the methodological process was a bibliographic review of specialists on the subject, scientific journals on the Internet, among others, in addition, and the results achieved indicate that 100% of those surveyed consider the use of gamification to be transcendental for the teaching-learning process of English as a second language, which will give students the opportunity to insert themselves into the current interconnected global world, which will be of pedagogical benefit, formative, social and economic.

Features of electronic (virtual) internationalisation of higher education in Russia and Kazakhstan

Introduction. The use of information and communications technologies in the sphere of higher education has received its new embodiment in promoting universities into the global educational space. The aim of the study was to find out how electronic internationalisation is implemented in some universities in Russia and Kazakhstan and what the prospects for its development are. Materials and methods. The survey was implemented on the basis of the methodology for scrutinising Englishlanguage pages of university websites, developed by the Russian Council on International Affairs in 2015. Materials from 5 English-language versions of websites of state universities in Russia and 5 websites of state universities in Kazakhstan were used. The used methods involved induction of empirical material collection; comparative method of studying the results; analysis and generalisation. Results. The most stuffed website sections of all selected five Russian universities are “About the University” (100%), “Contacts” (96%), “University History” (90%), “Admission” (96%), “University Mission and Strategic Goals” (93%), “Science and Research” (90%), “Units and Departments” (80%), “Foreign Partners” (80%). In 80% of the universities, all or most (2/3 of the total number) curricula in the English language have no news blocks in English or additional materials about the programmes (presentations, videos, booklets, etc.). The section “Career” in English is the most problematic in almost all of the surveyed universities. It is singled out as a special section only in 60% of the explored Russian universities. The most stuffed website sections of all selected five Kazakhstani universities are “Contacts” (84%), “About the University” (60%), “Admission” (60%) and “Science and Research” (50%). The other sections are less than 50% complete. Moreover, the section “Career” (28%) is the most problematic in terms of data content. The study showed that the Russian state universities which are in the top 5 in terms of student numbers are striving to improve the English-language versions of their websites and translate website sections into other popular languages. The survey of the Kazakhstan universities showed the opportunities for the development of electronic internationalisation in the country. Conclusion. Electronic internationalisation is a new promising form of international communication for universities in Russia and Kazakhstan. Some recommendations were formulated to develop electronic (virtual) internationalisation for both countries: translation of websites into other foreign languages; regular updating of information along with the development of strategic and marketing plans; promoting international identification of universities; use of digital marketing; due account of the immersive nature of internationalisation.

Metformin (The Miracle Drug) Kinetics in Different Diseases such as Cancer

: Metformin, a miracle drug that was introduced a century ago, could be considered for various aspects of diseases such as diabetes (type 1 and 2), cancer prevention or chemotherapy, metabolic and neurodegenerative disease. It is well known that the frequency of cancer is higher in patients with type 2 diabetes mellitus. This review aims to provide updated information regarding clinical pharmacokinetics and the mechanism of action of Metformin in different diseases such as cancer. Diabetes type 1 is another chronic autoimmune disease detected usually in early childhood due to immune-mediated devastation of insulin-producing pancreatic beta-cells. Because of the lack of effective therapeutic approaches, its prevalence is increasing. Regarding cancer, an estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths were reported in 2020 worldwide. By 50-60% bioavailability, the main route of metformin excretion is through urine. Its mechanism of action is based on 1) initiation of adenosine monophosphate-activated kinase, 2) block proinflammatory paths in perivascular adipose tissue, 3) decrease in monocyte-to-macrophage differentiation in vascular tissues, and 4) improvement in endothelial function. Metformin induces adenosine monophosphate-activated protein kinase signaling and suppresses gluconeogenesis. Antitumor properties of Metformin include a decrease in reactive oxygen species generation and inducing autophagy. In addition to glucose-lowering effects, Metformin has moderate anti-inflammatory and antioxidative effects. It could improve lipid profile and reduce overweight individuals' body mass and arterial blood pressure. In type 1 diabetes, Metformin reduces the requirement for daily insulin and improves glycemia. Its long-term use decreases cardiovascular events. In addition to inhibiting the synthesis of lipids via a reduction in oxidative stress, Metformin inhibits inflammation and increases energy metabolism. Finally, by reducing micro- and macro-vascular consequences, mortality-related diabetes and cancer decline by metformin administration. Therefore, in addition to diabetes, Metformin could reduce the proliferation of cancer cells and the possibility of malignancies in different types of cancer.

Postoperative conditions of rehabilitative interest in lung transplantation: a systematic review.

Lung transplantation is an elective treatment option for end-stage respiratory diseases in which all medical therapy options have been exhausted. The current study aimed to identify updated information on the postoperative conditions that may impair rehabilitation after lung transplantation and to provide specific considerations of their clinical relevance during the recovery process. The present study is a systematic review conducted by searching three primary databases: the United States National Library of Medicine PubMed system, Scopus, and the Cochrane Library. The databases were searched for articles published from database inception until May 2024; at the end of the selection process, 27 documents were included in the final analysis. The retrieved material identified 19 conditions of rehabilitative interest that potentially affect the postoperative course: graft dysfunction, dysphagia, postsurgical pain, cognitive impairment, chronic lung allograft dysfunction-bronchiolitis obliterans syndrome, phrenic nerve injury, delayed extracorporeal membrane oxygenation weaning, airway clearance, refractory hypoxemia, mediastinitis, reduced oxidative capacity, sternal dehiscence, coronavirus disease 2019 (COVID-19), gastroparesis, ossification of the elbow, Takotsubo cardiomyopathy, airway dehiscence, recurrent pleural effusion, and scapular prolapse. Although some patients are not amenable to rehabilitation techniques, others can significantly improve with rehabilitation.

Design Principles for a Higher Education Course Focusing on Lifelong Learning

Lifelong learning for solving work assignments is essential for societal and personal development. Higher education is one natural part of lifelong learning and, therefore, needs to be re-focused from solely younger students to include professionals and their development goals. One problem related to giving a course for professionals is their struggle between work assignments and the course. Focusing on the added perspective of professionals for higher education, this study presents five design principles for courses for professionals. Design principles are guidelines based on experience and iterative development in higher education. The empirical data comes from a course in digitalisation and digital transformation, which was given thrice. The course participants were professionals from private and public organisations in Sweden. The empirical data originates from the professionals who made a check-in, mid-term evaluation, and evaluation after the course, resulting in 75 entries. Two researchers analysed the first two course entries inductively, forming the foundation for the first round of design principles. The course design for the third round was then revised according to its weaknesses. Based on the strengths and weaknesses found in empirical material from all three courses, the current design principles are professional pathways referring to new knowledge directly linked to real-world applications, knowledge evolution, meaning gradual integration of knowledge using seminars and examination assignments, preparedness protocol focusing on updated information and structured templates for the seminars. Further, the design principle of collaborative connection includes discussion where professionals exchange experiences, and the last principle, learning fusion, directs toward blended learning by combining face-to-face seminars and films. The revised course design, according to the design principles, implied that the number of professionals graduating and their grades increased. The findings of this study add theoretically to existing knowledge and practical implications by providing design principles that higher education teachers and other stakeholders can use to design or revise professional development courses. The design principles could be used stand-alone or combined to increase professionals' learning and satisfaction.

Drug-facilitated sexual assault: An observational retrospective study in Barcelona (2018-2022)

Abstract Background Barcelona handles 400 to 500 sexual assaults yearly. Substance use is expected in one-third of reported assaults, being alcohol and cocaine the most detected substances. Nevertheless, there is a lack of updated information with reliable, recent, and context-specific data. Methods Retrospective observational study in people attended at the reference hospital for sexual assault care in Barcelona (H.Clinic) within 24 hours of the drug facilitated sexual assault (DFSA) in the period 2018-2022. Univariate and bivariate analysis have been carried out to describe the characteristics of the victims and identify possible associations with the assault settings, relationship with the aggressor and substances involved. Results Among 682 cases of DFSA, women represent 85%. Most incidents (73%) occur in the 18 to 35 age group, primarily in homes (42%), public spaces (23%), and nightlife establishments (15%). Spanish nationality is most common in both sexes (50%), yet Latin American men are prominent in drug-involved cases compared to non-Spanish European men. While alcohol (55%) and cocaine (28%) remain common, emerging drugs like GHB (15%) and MDMA (23%) are rising. The aggressor varies depending on the age and sex of the victim, with the perpetrator often being known (46%) in cases involving minor victims, while it tends to be unknown (46%) in cases involving adult victims. Chemical submission-related cases increased steadily, reaching 17% in 2022. Among these victims, 75% were women, with MDMA and cocaine being prevalent, while methamphetamine and GHB were more common among men. All these findings are statistically significant. Conclusions The study highlights a significant number of drug-facilitated sexual assaults mostly among young women, often occurring domestically, alongside emerging substance use trends. Adaptable surveillance systems are crucial to address these dynamic patterns and support vulnerable populations for safer environments. Key messages • Drug facilitated sexual assaults are a global health issue that demands attention through a gender perspective. Substances, spaces and consumption patterns evolve over time and across generations. • Patterns in substance use vary by age, nationality, sex, and consumption type, highlighting vulnerable population groups needing focused protection and assault prevention.

Biology, morphometric and integrative taxonomy of litchi fruit borer, Conopomorpha sinensis Bradley, 1986: A major pest of litchi (Litchi chinensis Sonn.)

Abstract Conopomorpha sinensis (Lepidoptera: Gracillariidae), commonly known as the litchi fruit borer, is a devastating pest of litchi, leading to substantial economic losses in fruit production. The present study was incepted to supplement updated information on biology, morphometrics, integrative taxonomy, and phylogenetic analysis of C. sinensis. The duration of developmental stages such as egg, larval, pre-pupal, pupal, male and female adult lasts for 3.45 ± 1.13, 11.10 ± 2.52, 2.05 ± 0.51, 5.85 ± 0.88, 5.55 ± 1.00, and 9.00 ± 1.12 days, respectively. The average fecundity was 33.10 ± 6.84 eggs/female. The head capsule width for five larval instars was 0.11 ± 0.01, 0.18 ± 0.02, 0.34 ± 0.01, 0.58 ± 0.04, and 0.64 ± 0.06 mm, respectively. Phylogenetic analysis revealed distinct species-groups formed by C. sinensis with other fruit borer species considered (C. cramerella, C. litchiella Bradley, and Thaumatotibia batrachopa (Meyrick)). Understanding the life cycle of C. sinensis and its correct identification is crucial for targeted pest control strategies. Traditional and molecular taxonomy assist in rapid and accurate species identification and understanding of the evolutionary relationships among Conopomorpha species.

Check, Please! Supervisor-Learner Dyads Using "Checking" for Clinical Support During Indirect Supervision.

Indirect supervision is essential for granting autonomy to learners. Sometimes referred to as leaving the learner "unsupervised," there is growing recognition that learners and supervisors engage in clinical support through ongoing interactions, albeit at a distance. To understand how the complementary activities of asking for and providing clinical support at a distance come together as indirect supervision by identifying the natural language used between learners and supervisors. A collective case study of 15 attending physician-senior medical resident dyads from 2018 to 2023. Each case consisted of 2 full days of ethnographic observation of the resident on an internal medicine clinical teaching unit in one of three metropolitan hospitals; 2 end of day interviews with each dyad member; and a third interview with the attending after the 2-week rotation. Fifteen internal medicine residents (PGY-2 and PGY-3) who were scheduled to work for the first time with 15 attending physicians. Data collection was iterative with deductive and inductive analysis to identify patterns of communication. The language of "checking," such as checkpoints, checking on, and checking in, was central to communications within dyads. Indirect supervision included attendings using scheduled checkpoints and backstage oversight activities to check on the senior resident's patient care while expecting residents to access their support, as needed, by checking-in with them. Residents checked in with their attending to relay patient information updates, ask questions, and hint at needing their plans doublechecked; these communications had similar formats making them difficult to distinguish but functioned to preserve resident independence while accessing clinical support. Indirect supervision creates clinical support through ongoing communication between learners and supervisors at a distance. It is a collaborative process for mutual reassurance that safe patient care is being provided and that support is available when needed.

Conditional survival of younger patients with mantle cell lymphoma: Results from a randomized phase III trial of the European MCL Network.

During a fatal disease, patients often request updated information on their prognosis. After patients have already survived a certain time, conditional survival captures their future survival probability. We investigated conditional overall and failure-free survival in 473 younger mantle cell lymphoma (MCL) patients from a randomized phase III trial comparing immunochemotherapies R-CHOP and alternating R-CHOP/R-DHAP before autologous transplantation. Using conditional Kaplan-Meier method and Cox regression, we estimated subsequent survival of patients who had survived 1-8 years, considering MIPI, Ki-67, and treatment failure status. Starting at a lower level, R-CHOP patients only showed increasing subsequent survival as they survived longer (5-year conditional survival: 72% and 81% after surviving 1 and 7 years), while R-CHOP/R-DHAP patients had stable future survival over time (77% and 78%). The prognostic value of MIPI diminished after 3 years in R-CHOP patients but remained unchanged after R-CHOP/R-DHAP. Patients with treatment failure had markedly inferior survival compared with those in ongoing remission, regardless of the time survived. The longer patients remained in remission, the longer they would stay free of treatment failures. Our results enable personalized counselling for younger MCL patients by offering dynamic prognosis and underscore the importance of highly effective first-line treatment to improve survival.

Working memory gating in obesity is moderated by striatal dopaminergic gene variants.

Everyday life requires an adaptive balance between distraction-resistant maintenance of information and the flexibility to update this information when needed. These opposing mechanisms are proposed to be balanced through a working memory gating mechanism. Prior research indicates that obesity may elevate the risk of working memory deficits, yet the underlying mechanisms remain elusive. Dopaminergic alterations have emerged as a potential mediator. However, current models suggest these alterations should only shift the balance in working memory tasks, not produce overall deficits. The empirical support for this notion is currently lacking, however. To address this gap, we pooled data from three studies (N = 320) where participants performed a working memory gating task. Higher BMI was associated with overall poorer working memory, irrespective of whether there was a need to maintain or update information. However, when participants, in addition to BMI level, were categorized based on certain putative dopamine-signaling characteristics (single-nucleotide polymorphisms [SNPs]; specifically, Taq1A and DARPP-32), distinct working memory gating effects emerged. These SNPs, primarily associated with striatal dopamine transmission, appear to be linked with differences in updating, specifically, among high-BMI individuals. Moreover, blood amino acid ratio, which indicates central dopamine synthesis capacity, combined with BMI shifted the balance between distractor-resistant maintenance and updating. These findings suggest that both dopamine-dependent and dopamine-independent cognitive effects exist in obesity. Understanding these effects is crucial if we aim to modify maladaptive cognitive profiles in individuals with obesity.