Search Results (2,318)

Background/Objectives: Collaboration in mental health care is essential for implementing a model oriented towards the psychosocial rehabilitation of people based on multifaceted interventions involving different actors and sectors of society to respond to demands. Despite the benefits presented by the scientific evidence, there are still many barriers to collaborative care, and professionals continue to struggle in reorienting their conduct. The current situation demands organization and the framing of well-founded action plans to overcome challenges, which in turn requires a detailed understanding of collaborative practices in mental health care and their conceptual boundaries. A concept analysis was undertaken to propose a working definition of collaborative practices in mental health care (CPMHC). Methods: This paper used the Walker and Avant concept analysis method. This includes identifying the defining concept attributes, antecedents, consequences, and empirical referents. A literature search was carried out from November 2024 to February 2025 in three databases (Medline, CINAHL, and LILACS), considering studies published between 2010 and 2024. Results: The final sample of literature investigated consisted of 30 studies. The key attributes were effective communication, building bonds, co-responsibility for care, hierarchical flexibility, articulation between services, providers and community, monitoring and evaluating of care processes, and attention to the plurality of sociocultural contexts. Conclusions: This comprehensive analysis contributes to guiding future research and policy development of collaborative practices in mental health, considering the individual, relational, institutional, and social levels. Further research is possible to deepen the understanding of the production of collaborative practices in mental health in the face of the complexity of social relations and structural inequities. Full article

Background: The education process for newly diagnosed Type 1 diabetes mellitus (T1D) patients and their families, primarily led by diabetes specialist nurses, is essential for gaining knowledge about the disease and its management. However, few assessment tools have been employed to evaluate long-term knowledge retention among T1D patients years after diagnosis. Methods: We developed a 20-question test to assess the knowledge of patients and their families at the conclusion of the initial education process and again 6–12 months later. Demographic and clinical data were also collected. Statistical analyses included comparisons between the first and second test results, as well as evaluation of potential contributing factors. The internal consistency and construct validity of the questionnaire were evaluated. Results: Forty-four patients completed both assessments, with a median interval of 11.5 months between them. The average score on the first test was 88.6, which declined to 82.7 on the second assessment (p < 0.001). In univariate analysis, factors positively associated with higher scores included Jewish ethnicity, lower HbA1c levels, and shorter hospitalization duration. Multivariate analysis revealed that parents had lower odds of experiencing a significant score decline compared to patients. Cronbach’s alpha was 0.69, and Principal Component Analysis (PCA) identified eight components accounting for 67.1% of the total variance. Conclusions: Healthcare providers should consider offering re-education to patients and their families approximately one year after diagnosis, with particular attention to high-risk populations during the initial education phase. Further studies are needed to examine this tool’s performance in larger cohorts. Full article

Posterior capsule opacification (PCO), a frequent complication of cataract surgery, arises from dysregulated wound healing and fibrotic transformation of residual lens epithelial cells. While transcriptomic and machine learning (ML) approaches have elucidated fibrosis-related pathways in other tissues, the molecular divergence between regenerative and fibrotic outcomes in the lens remains unclear. Here, we used an ex vivo chick lens injury model to simulate post-surgical conditions, collecting RNA from lenses undergoing either regenerative wound healing or fibrosis between days 1–3 post-injury. Bulk RNA sequencing data were normalized, log-transformed, and subjected to univariate filtering prior to training LASSO, SVM, and RF ML models to identify discriminatory gene signatures. Each model was independently validated using a held-out test set. Distinct gene sets were identified, including fibrosis-associated genes (VGLL3, CEBPD, MXRA7, LMNA, gga-miR-143, RF00072) and wound-healing-associated genes (HS3ST2, ID1), with several achieving perfect classification. Gene Set Enrichment Analysis revealed divergent pathway activation, including extracellular matrix remodeling, DNA replication, and spliceosome associated with fibrosis. RT-PCR in independent explants confirmed key differential expression levels. These findings demonstrate the utility of supervised ML for discovering lens-specific fibrotic and regenerative gene features and nominate biomarkers for targeted intervention to mitigate PCO. Full article

We obtain different categories of singularities of fuzzy retracts, fuzzy deformation retracts, and fuzzy foldings on fuzzy fundamental groups of the fuzzy Friedmann–Lemaître–Robertson–Walker Space ${\tilde{W}}^4$. The fuzzy fundamental groups of fuzzy submanifolds in ${\tilde{W}}^4$ are characterized combinatorially using these fuzzy geometrical transformations. Also, the fuzzy fundamental groups of the fuzzy geodesics and the limit fuzzy foldings of ${\tilde{W}}^4$ are described. New types of fuzzy singularity of some fuzzy geometrical transformations of ${\tilde{W}}^4$ are obtained. Finally, the regularity of some other fuzzy retract singularities are discussed. Full article

This paper aims to discuss the transition of new graduate nurses into the workforce, the preparation provided to equip them through the novice–beginner stage, and the theory–practice conundrum. Background: In Australia, new graduate transition programs have been in existence since the 1990s. While there is widespread acknowledgment that this period is pivotal for new graduate nurses entering the profession, there is a lack of consensus on the definition of best practice to achieve optimal preparation for new graduate nurses transitioning into the workforce. Methods: This discussion paper integrates the nursing literature on this topic with the extensive professional experiences of the authors, who are currently working as clinicians in metropolitan hospitals and hold academic positions at universities. Their insights are informed by the literature sourced from peer-reviewed English language journals, including reviews, empirical studies, and national and international reports. Discussion: Recruiting and retaining nurses presents a multifaceted challenge that requires the development of effective tools and strategies to build a sustainable workforce. Both the literature and the authors’ experiences highlight several key factors influencing the preparedness of new graduates. These factors include workplace culture, the demands placed on new graduates, and the support, education, and training they receive. The perspectives shared in this article offer valuable discussion points that can deepen our understanding of the current issues and contribute to the development of more effective solutions. Full article

Background: Choroidal nevi are common, benign tumors. These tumors rarely cause adverse retinal sequalae, but when they do, they can lead to disruption of the outer retina and vision loss. In this paper, we used high-resolution retinal imaging modalities, optical coherence tomography (OCT) and adaptive optics scanning laser ophthalmoscopy (AOSLO), to longitudinally monitor retinal sequelae of a submacular choroidal nevus. Methods: A 31-year-old female with a high-risk choroidal nevus resulting in subretinal fluid (SRF) and a 30-year-old control subject were longitudinally imaged with AOSLO and OCT in this study over 18 and 22 months. Regions of interest (ROI) including the macular region (where SRF was present) and the site of laser photocoagulation were imaged repeatedly over time. The depth of SRF in a discrete ROI was quantified with OCT and AOSLO images were assessed for visualization of photoreceptors and retinal pigmented epithelium (RPE). Cell-like structures that infiltrated the site of laser photocoagulation were measured and their count was assessed over time. In the control subject, images were assessed for RPE visualization and the presence and stability of cell-like structures. Results: We demonstrate that AOSLO can be used to assess cellular-level changes at small ROIs in the retina over time. We show the response of the retina to SRF and laser photocoagulation. We demonstrate that the RPE can be visualized when SRF is present, which does not appear to depend on the height of retinal elevation. We also demonstrate that cell-like structures, presumably immune cells, are present within and adjacent to areas of SRF on both OCT and AOSLO, and that similar cell-like structures infiltrate areas of retinal laser photocoagulation. Conclusions: Our study demonstrates that dynamic, cellular-level retinal responses to SRF and laser photocoagulation can be monitored over time with AOSLO in living humans. Many retinal conditions exhibit similar retinal findings and laser photocoagulation is also indicated in numerous retinal conditions. AOSLO imaging may provide future opportunities to better understand the clinical implications of such responses in vivo. Full article

Alzheimer’s dementia (AD) is a disease of the ageing brain. It begins in the hippocampal region with the epicentre in the entorhinal cortex, then gradually extends into adjacent brain areas involved in memory and cognition. The events which initiate the damage are unknown and under intense investigation. Localization to the hippocampus can now be explained by anatomical features of the blood vessels supplying this region. Blood supply and hence oxygen delivery to the area are jeopardized by poor flow through narrowed arteries. In genomic and metabolomic studies, the respiratory chain and mitochondrial pathways which generate ATP were leading pathways associated with AD. This review explores the notion that ATP depletion resulting from hippocampal hypoperfusion has a prime role in initiating damage. Sections cover sensing of ATP depletion and protective responses, vulnerable processes with very heavy ATP consumption (the malate shuttle, the glutamate/glutamine/GABA (γ-aminobutyric acid) cycle, and axonal transport), phospholipid disturbances and peroxidation by reactive oxygen species, hippocampal perfusion and the effects of hypertension, chronic hypoxia, and arterial vasospasm, and an overview of recent relevant genomic studies. The findings demonstrate strong scientific arguments for the proposal with increasing supportive evidence. These lines of enquiry should be pursued. Full article

Background/Objectives: In late 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused a pandemic called the ‘coronavirus disease 2019’ (COVID-19). After the acute SARS-CoV-2 infection, many individuals (up to 33%) complained of unexplained symptoms involving multiple organ systems and were diagnosed as having Long COVID-19 (LC-19). Currently, LC-19 is inadequately defined, requiring the formation of consistent diagnostic parameters to provide a foundation for ongoing and future studies of epidemiology, risk factors, clinical characteristics, and therapy. LC-19 represents a significant burden on multiple levels. The reduced ability of workers to return to work or compromised work efficiency has led to consequences at national, economic, and societal levels by increasing dependence on community services. On a personal scale, the isolation and helplessness caused by the disease and its subsequent impact on the patient’s mental health and quality of life are incalculable. Methods: In this paper, we used Walker and Avants’ eight-step approach to perform a concept analysis of the term “Long COVID-19” and define its impact across these parameters. Results: Using this methodology, we provide an improved definition of LC-19 by connecting the clinical symptomology with previously under-addressed factors, such as mental, psychological, economic, and social effects. This definition of LC-19 features can help improve diagnostic procedures and help plan relevant healthcare services. Conclusions: LC-19 represents a complex and pressing public health challenge with diverse symptomology, an unpredictable timeline, and complex pathophysiology. This concept analysis serves as a tool for improving LC-19 definition, but it remains a dynamic disease with evolving diagnostic and therapeutic approaches, requiring deeper investigation and understanding of its long-term effects. Full article

This paper contains three newly recorded genera (Wittonola László, Ronkay & Ronkay, 2015; Aeneanola László, Ronkay & Ronkay, 2013; and Evonima Walker, 1865) and each new species (W. bicyanasp. nov., A. crassasp. nov., and E. palawanensissp. nov.) from Palawan, the Philippines. We provide illustrations of three new species and their genitalia, photographs of collecting sites, and checklists of the three genera. Full article

Topographic slope is a key parameter for characterizing landscape geomorphology. The Ice, Cloud, and Land Elevation Satellite-2 (ICESat-2) offers high-resolution along-track slopes based on the ground profiles generated by dense signal photons. However, the across-track slopes are typically derived using the ground photon geolocations from the weak-beam and strong-beam pair, limiting the retrieval accuracy and losing valid results over rugged terrains. The goal of this study is to propose a new method to derive the across-track slope merely using single-track photon data of a strong beam based on the theoretical formula of the received signal pulse width. Based on the ICESat-2 photon data over the Walker Lake area, the specific purposes are to (1) extract the along-track slope and surface roughness from the signal photon data on the ground; (2) generate an elevation frequency histogram (EFH) and calculate its root mean square (RMS) width; and (3) derive the across-track slope from the RMS width of the EFH and evaluate the retrieval accuracy against the across-track slope from the ICESat-2 product and plane fitting method. The results show that the mean absolute error (MAE) obtained by our method is 11.45°, which is comparable to the ICESat-2 method (11.61°) and the plane fitting method (12.51°). Our method produces the least invalid data proportion of ~2.5%, significantly outperforming both the plane fitting method (10.29%) and the ICESat-2 method (32.32%). Specifically, when the reference across-track slope exceeds 30°, our method can consistently yield the optimal across-track slopes, where the absolute median, inter quartile range, and whisker range of the across-track slope residuals have reductions greater than 4.44°, 1.31°, and 0.10°, respectively. Overall, our method is well-suited for the across-track slope estimation over rugged terrains and can provide higher-precision, higher-resolution, and more valid across-track slopes. Full article

Nucleocytoplasmic trafficking is a highly regulated process that allows the cell to control the partitioning of proteins and nucleic acids between the cytosolic and nuclear compartments. The Ebola virus minor matrix protein VP24 (eVP24) hijacks this process by binding to a region on the NPI-1 subfamily of karyopherin alpha (KPNA) nuclear importers. This region overlaps with the activated transcription factor STAT1 binding site on KPNAs, preventing STAT1 nuclear localization and activation of antiviral gene transcription. However, the molecular interactions of eVP24-KPNA5 binding that lead to the nuclear localization of eVP24 remain poorly characterized. Here, we show that trafficking of eVP24 into the nucleus by KPNA5 requires simultaneous binding of cargo. We also describe the conformational dynamics of KPNA5 and interactions with eVP24 and cargo nuclear localization sequences (NLS) using biophysical approaches. Our results reveal that eVP24 binding to KPNA5 does not impact cargo NLS binding to KPNA5, indicating that simultaneous binding of both cellular cargo and eVP24 to KPNA5 is likely required for nuclear trafficking. Together, these results provide a biophysical basis for how Ebola virus VP24 protein gains access to the nucleus during Ebola virus infection. Full article

Background/Objectives: Spacer dislocation is among the most frequent mechanical complications after revision total hip arthroplasty for periprosthetic hip infection. Spacer dislocations may be managed conservatively, but there are no guidelines on the rehabilitation of these patients, and the restriction of weight bearing is still under debate. Methods: We first report the case of a patient with hip spacer cranial dislocation, judged unfit to be surgically treated once more for a medium period, who started a rehabilitation program with partial weight bearing. Results: After two weeks of inpatient rehabilitation, the patient started to maintain the standing position with partial weight bearing on the affected side. Following hospital discharge we continued rehabilitation in the outpatient clinic. Despite the finding of the denervation of the ipsilateral quadriceps, three months after admission, she was able to walk for short distances using a walker, initially with the help of a therapist and then with supervision. About one year later, she was able to undergo the reimplantation of the definitive prosthesis. Conclusions: Despite the spacer dislocation, walking short distances is a feasible goal, even with assistance, wearing a brace and using a walker. Future research is needed to confirm and expand upon this observation and to understand the mechanisms underlying the development of neurological complications to implement effective prevention strategies. Full article

This study aims to investigate the release of potentially toxic elements from disposable paper and plastic cups when exposed to hot water, simulating the scenario of their use in hot beverage consumption, and to assess the associated health risks. By using ICP-MS, twelve potentially toxic elements, namely As, Ba, Cd, Co, Cr, Cu, Mn, Mo, Pb, Sb, V, and Zn, were determined in leachates, revealing significant variability in mass fractions between paper and plastic cups, with plastic cups demonstrating greater leaching potential. Health risk assessments, including hazard quotient (HQ) and excess lifetime cancer risk (ELCR), indicated minimal non-carcinogenic and carcinogenic risks for most elements, except Pb, which posed elevated non-carcinogenic risk, especially in plastic cups. Children showed higher relative exposure levels compared to adults due to their lower body weights (the HQ in children is two times greater than in adults). Overall, the findings of the current study underscore the need for stricter monitoring and regulation of materials used in disposable cups, especially plastic ones, to mitigate potential health risks. Future investigations should assess the leaching behavior of potentially toxic elements under conditions that accurately mimic real-world usage. Such investigations ought to incorporate a systematic evaluation of diverse temperature regimes, varying exposure durations, and different beverage types. Full article

The resistance distance is a squared Euclidean metric on the vertices of a graph derived from the consideration of a graph as an electrical circuit. Its connection with the commute time of a random walker on the graph has made it particularly appealing for the analysis of networks. Here, we prove that the resistance distance is given by a difference of “mass concentrations” obtained at the vertices of a graph by a diffusive process. The nature of this diffusive process is characterized here by means of an operator corresponding to the matrix logarithm of a Perron-like matrix based on the pseudoinverse of the graph Laplacian. We prove also that this operator is indeed the Laplacian matrix of a signed version of the original graph, in which nonnearest neighbors’ “interactions” are also considered. In this way, the resistance distance is part of a family of squared Euclidean distances emerging from diffusive dynamics on graphs. Full article

Virtual fencing (VF) offers a promising alternative to conventional or electrified fences for managing livestock grazing distribution. This study evaluated the behavioral responses of 25 Rarámuri Criollo cows fitted with Nofence^® collars in Pine Valley, CA, USA. The VF system was deployed in chaparral rangeland pastures. The study included a 14-day training phase followed by an 18-day testing phase. The collar-recorded variables, including audio warnings and electric pulses, animal movement, and daily typical behavior patterns of cows classified into a High or Low virtual fence response group, were compared using repeated-measure analyses with mixed models. During training, High-response cows (i.e., resistant responders) received more audio warnings and electric pulses, while Low-response cows (i.e., active responders) had fewer audio warnings and electric pulses, explored smaller areas, and exhibited lower mobility. Despite these differences, both groups showed a time-dependent decrease in the pulse-to-warning ratio, indicating increased reliance on audio cues and reduced need for electrical stimulation to achieve similar containment rates. In the testing phase, both groups maintained high containment with minimal reinforcement. The study found that Rarámuri Criollo cows can effectively adapt to virtual fencing technology, achieving over 99% containment rate while displaying typical diurnal patterns for grazing, resting, or traveling behavior. These findings support the technical feasibility of using virtual fencing in chaparral rangelands and underscore the importance of accounting for individual behavioral variability in behavior-based containment systems. Full article