Thinking Globally in the Pursuit of Individual Identity: Diversity, Equity, and Inclusion in the International Journal of Medical Students (IJMS)

Diversity, equity, and inclusion (DEI) are core values that are unequivocally essential to healthcare research and practice. However, global health inequities remain pervasive and disruptive to the delivery of healthcare. This unacceptable lack of inclusivity and equity infiltrates all aspects of medicine, including research and publication. Accordingly, there is a dissemination of unbalanced and homogenous perspectives which are not representative of the global population. The International Journal of Medical Students (IJMS) has strived to counter such biases through the development of content and the process of its publication. Further, the selection of its editorial team and ambassadors is conducted with the intention of diversity. We respect individual differences and celebrate them as strengths adding to the quality of our journal. Therefore, the IJMS has taken a positive step toward an equitable environment by publishing a policy statement on DEI. We hope to lead by example by fostering a culture of inclusivity for all researchers, regardless of background. Though, we recognize the complexity of implementing comprehensive DEI practices and consider it our duty to the community that we continuously develop through a dedicated effort and iterative process

Effect of a Weight Loss and Lifestyle Intervention on Dietary Behavior in Men with Obstructive Sleep Apnea: The INTERAPNEA Trial

This study investigated the effects of an eight-week interdisciplinary weight loss and lifestyle intervention on dietary behavior in men who were overweight/had obesity and moderateto- severe obstructive sleep apnea (OSA). It was based on data from INTERAPNEA (ClinicalTrials.gov ID: NCT03851653); a randomized clinical trial conducted from April 2019 to April 2020. Men aged 18–65 years with moderate-to-severe OSA and a body mass index 25 kg/m2 were randomly assigned to a usual-care group or an eight-week interdisciplinary weight loss and lifestyle intervention combined with usual-care. Dietary behavior was assessed through the Food Behavior Checklist (FBC) and the Mediterranean Diet Adherence Screener (MEDAS). Of the 89 participants who underwent randomization, 75 completed the intervention endpoint assessment, 89 participants being therefore included in the intention-to-treat analyses, and 75 in the per-protocol approach. As compared with usual-care, the intervention group had greater improvements at intervention endpoint in dietary behavior, as measured by the FBC total score (20% increase in FBC total score, mean between-group difference, 8.7; 95% confidence interval, 5.7 to 11.7), and MEDAS total score (33% increase in MEDAS total score, mean between-group difference, 2.1; 95% CI 1.3 to 2.9). At 6 months after intervention, the intervention group also had greater improvements in both the FBC total score (15% increase) and MEDAS total score (25% increase), with mean between-group differences of 7.7 (CI 95%, 4.4 to 10.9) and 1.7 (CI 95%, 0.9 to 2.6), respectively. An eight-week interdisciplinary weight loss and lifestyle intervention resulted in meaningful and sustainable improvements in dietary behavior, including adherence to the Mediterranean diet in men who were overweight/ had obesity and CPAP-treated moderate-to-severe OSA.Spanish Government FPU16/01093 FPU14/04172 FPU19/01609University of Granada-LoMonaco S.L. Sleep Research Cathedra University of Granada Plan Propio de Investigacion 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES)Regional Ministry of Economy, Knowledge, Enterprise, and Universities (CECEU) of Andalusia (European Regional Development Funds) SOMM17/6107/UG

Overview of progress in European medium sized tokamaks towards an integrated plasma-edge/wall solution

Integrating the plasma core performance with an edge and scrape-off layer (SOL) that leads to tolerable heat and particle loads on the wall is a major challenge. The new European medium size tokamak task force (EU-MST) coordinates research on ASDEX Upgrade (AUG), MAST and TCV. This multi-machine approach within EU-MST, covering a wide parameter range, is instrumental to progress in the field, as ITER and DEMO core/pedestal and SOL parameters are not achievable simultaneously in present day devices. A two prong approach is adopted. On the one hand, scenarios with tolerable transient heat and particle loads, including active edge localised mode (ELM) control are developed. On the other hand, divertor solutions including advanced magnetic configurations are studied. Considerable progress has been made on both approaches, in particular in the fields of: ELM control with resonant magnetic perturbations (RMP), small ELM regimes, detachment onset and control, as well as filamentary scrape-off-layer transport. For example full ELM suppression has now been achieved on AUG at low collisionality with n = 2 RMP maintaining good confinement HH(98,y2) 0.95. Advances have been made with respect to detachment onset and control. Studies in advanced divertor configurations (Snowflake, Super-X and X-point target divertor) shed new light on SOL physics. Cross field filamentary transport has been characterised in a wide parameter regime on AUG, MAST and TCV progressing the theoretical and experimental understanding crucial for predicting first wall loads in ITER and DEMO. Conditions in the SOL also play a crucial role for ELM stability and access to small ELM regimes.European Commission (EUROfusion 633053

Simultaneous measurement of humidity and temperature based on a partially coated optical fiber long period grating

A humidity and temperature optical fiber sensor based on a long-period grating (LPG), which can provide simultaneous response to both magnitudes, is proposed and demonstrated via experiments. Previously, the LPG was fully coated with humidity sensitive nanostructured polymeric thin films by the Layer-by-Layer (LbL) nano assembly technique. Hence the surrounding refractive index was changed, so provoking wavelength shifts of the attenuation bands of the transmission spectrum. This fully coated LPG was exposed to relative humidity (RH) and temperature tests, varying from 20% to 80% RH and from 25 to 85ºC, respectively. Then, half of the LPG coating was chemically removed and this results in the splitting of the main attenuation band into two different contributions. When this semi-coated LPG was also exposed to RH and temperature tests, the new two attenuation bands presented different behaviors for humidity and temperature. This novel dual-wavelength based sensing method enables the simultaneous measurement of RH and temperature using only one LPG.This work was supported in part by the Spanish Ministry of Economy and Competitiveness - through the projects CICYT-FEDER TEC2013-43679-R and TEC2014-60378-C2-1-R. It was also supported by a UPNA pre-doctoral research grant, by the Program of International Excellence Campus VLC/Campus, by the grant of program SANTIAGO GRISOLIA, and by the Research Excellency Award Program GVA PROMETEO 2013/012.Urrutia, A.; Goicoechea, J.; Ricchiuti, AL.; Barrera Vilar, D.; Sales Maicas, S.; Arregui, FJ. (2016). Simultaneous measurement of humidity and temperature based on a partially coated optical fiber long period grating. Sensors and Actuators B: Chemical. 227(5):135-141. https://doi.org/10.1016/j.snb.2015.12.031S135141227

Representation of Racial and Ethnic Minorities and Their Preferences for Mood Stabilizing Treatment Selection for Bipolar Disorder: A Systematic Review

Background: The use of second-generation antipsychotics for bipolar disorder (BD) has increased in the past years1Concerns on potential serious medical side effects and need for blood level monitoring of some traditional mood stabilizers along with other factors have influenced this change. Shared decision-making (SDM) strategies have been implemented in clinical settings due to their ability to engage patients in the process of treatment selection.2 Within minority groups with mental illnesses, socioeconomic factors, individual concerns, and cultural variations in clinical presentations, are often overlooked or misrepresented when assessing the patient’s treatment preferences. Although several studies evaluating the effectiveness of SDM interventions in BD, the representation of patients that belong to minority groups and how their preferences and outcomes differ from those belonging to non-minority groups is unknown. The primary aim of this is to assess the inclusion of minority patients in studies assessing SDM strategies in patients with BD. Methods: After the systematic search, screening and data extraction will be conducted in a duplicate and independent manner. We will include interventional studies implementing strategies for SDM in patients diagnosed with bipolar disorder. Data on the proportion of minorities included in the studies, as well as on quality indicators for the clinical encounter regarding SDM, treatment adherence, and clinical outcomes will be extracted. Results and Conclusion: We have no results yet, but the relevance of the expected results is discussed. Compared to non-Hispanic white patients, patients from minority racial/ethnic groups have lower odds of receiving classic mood stabilizers and higher rates of antipsychotic prescription.3 Patients that belong to minority groups are also at higher risk of misdiagnosis -with subsequent delay in the diagnosis-, and of mistreatment.4 These disparities have been associated with potential cognitive biases that lead to symptom misattribution, inadequate treatment regimens and omission of patient’s sociocultural background.5 Patient-centered care could also benefit the assessment of risk factors that are common to specific groups (e.g., metabolic risk in Hispanic patients).6,7 Moreover, SDM can help understand better the values, preferences for treatment choices and help evaluate if patient engagement can be translated into clinical benefits and an improved quality of life

Influence of Dynamic Balance on Jumping-Based Asymmetries in Team Sport: A between-Sports Comparison in Basketball and Handball Athletes

The aims of the present study were to analyze mobility, dynamic balance and lower-limb strength and the prevalence of asymmetry according to the type of sport and assess the association between inter-limb asymmetry and sports performance. A total of 23 basketball and 25 handball players performed a test battery consisting of functional movements and a jump test. Inter-limb asymmetry was calculated using a standard percentage difference equation. A between-groups comparison analysis was carried out, and Pearson’s correlation coefficients (r) were calculated to establish a relationship between asymmetries and physical performance. The results found athletes in different sports to exhibit different performance in functional movements and the jump test, but no bilateral asymmetries. The reactive strength index (RSI) and stiffness asymmetries were significantly associated with the anterior reach Y-balance test (YBT) (r = -0.412; p < 0.01 and r = -0.359; p < 0.05, respectively), and the unilateral triple hop test (THTU) was negatively correlated to anterior reach, posterior lateral reach YBT and YBT composite YBT (r = -0.341 to -0.377; p < 0.05). These findings suggest that the asymmetries exhibited important dispersion not dependent upon the type of sport but on each individual and the applied test. In addition, asymmetry in anterior direction YBT showed the strongest association to the rest of the sports performance variables

Adhesion mechanisms of Actinobacillus pleuropneumoniae to the porcine respiratory system and biofilm formation

Actinobacillus pleuropneumoniae is a Gram-negative bacterium and the causative agent of porcine pleuropneumonia, a highly contagious disease of pigs characterised by fibrinohaemorrhagic necrotising pneumonia. Although it has been well controlled in some developed countries, outbreaks can occur in pigs of all ages in contact with asymptomatic carriers, leading to significant economic losses to the swine industry due to the high morbidity and mortality rates. Adhesion is a critical step in the colonisation of the swine respiratory tract and the pathogenesis of the porcine pleuropneumonia; however, a literature review of this process is not available to date. Therefore, this review aims to provide information regarding the molecules that have been described in the adhesion of A. pleuropneumoniae to cells and tissues of the porcine respiratory tract. Since adhesion is the first step in biofilm formation, we included a section to describe the genes involved in this process; some of these genes could participate directly or indirectly in the adhesion of A. pleuropneumoniae to the porcine respiratory system. Although the role of biofilms in porcine pleuropneumonia is still not clear, these molecules could be considered in the future as candidates for vaccine development

Celecoxib accelerates functional recovery after sciatic nerve crush in the rat

The inflammatory response appears to be essential in the modulation of the degeneration and regeneration process after peripheral nerve injury. In injured nerves, cyclooxygenase-2 (COX-2) is strongly upregulated around the injury site, possibly playing a role in the regulation of the inflammatory response. In this study we investigated the effect of celecoxib, a COX-2 inhibitor, on functional recovery after sciatic nerve crush in rats. Unilateral sciatic nerve crush injury was performed on 10 male Wistar rats. Animals on the experimental group (n = 5) received celecoxib (10 mg/kg ip) immediately before the crush injury and daily for 7 days after the injury. Control group (n = 5) received normal saline at equal regimen. A sham group (n = 5), where sciatic nerve was exposed but not crushed, was also evaluated. Functional recovery was then assessed by calculating the sciatic functional index (SFI) on days 0,1,7,14 and 21 in all groups, and registering the day of motor and walking onset. In comparison with control group, celecoxib treatment (experimental group) had significant beneficial effects on SFI, with a significantly better score on day 7. Anti-inflammatory drug celecoxib should be considered in the treatment of peripheral nerve injuries, but further studies are needed to explain the mechanism of its neuroprotective effects

Litter decomposition and net foliar nutrient release of Austrocedrus chilensis (D. Don) Pic. Serm. et Bizzarri forests in El Bolsón, Río Negro

Se determinó la descomposición de hojas, ramas y troncos en tres rodales maduros de Austrocedrus chilensis. La tasa de descomposición (k) foliar no mostró diferencias significativas entre rodales, siendo el promedio de 0.27 año-1. La tasa de descomposición de ramas finas, gruesas y troncos fue de 0.095, 0.06 y 0.013 año-1, respectivamente. La vida media fue 2.6, 7.4, 12 y 53 años, respectivamente. La concentración mineral foliar aumentó (N, Ca, Al, Fe, cenizas totales), no cambió (S, Mn) o descendió (P, K, Mg) durante el tiempo del estudio. El N no mostró liberación neta. La tasa de liberación de los otros elementos y el orden fueron: K (0.60) ³ P (0.59) > Mg (0.40) > S (0.21) > Ca (0.10). La liberación de Ca se realizó a menor tasa que la descomposición; el Mg, el P y el K lo hicieron más rápidamente. El Fe, el Al y el Mn, inicialmente liberados, mostraron una consistente pero no significativa inmovilización. Concluimos que (1) las tasas de descomposición de detritos decrecen con su tamaño, (2) las diferencias entre rodales no influyen significativamente en la k foliar, (3) la liberación foliar neta difiere para cada elemento químico y algunos se apartan de modelos previos, (4) el contenido de N foliar se mantiene constante durante la descomposición, (5) la liberación es más rápida para los nutrientes más móviles, (6) el aumento de la concentración de Ca y su menor tasa de liberación respecto de la descomposición llevaría a un aumento relativo del mismo en la capa F, (7) el leve aumento de Fe y Al en el mantillo sugiere que su disponibilidad no causa una elevada traslocación e inmovilización microbiana, ni alcanza niveles tóxicos, (8) las tasas de descomposición foliar están dentro del rango de las coníferas del hemisferio norte y son similares o menores a las de Nothofagus spp. perennes y deciduos, respectivamente, (9) las tasas de descomposición de detritos gruesos son similares o levemente mayores a las de coníferas del hemisferio norte e inferiores a las de Nothofagus spp. de Tierra del Fuego.Decomposition constant of fallen leaves, thin (&lt; 1 cm diameter) and coarse (1-5 cm) branches and stems (&gt; 5 cm) were determined in mature stands of Austrocedrus chilensis. Leaves and branches were fieldincubated (522 days) using litter bags while a chronosequence of stems was employed. Foliar decay rate k did not show significant differences among stands and the mean for the pool was 0.27 year-1. The k constant was 0.095, 0.06 and 0.013 year-1 for thin, coarse branches and stems, respectively. Half-life was 2.6, 7.4, 12 and 53 years for leaves, thin and coarse branches and stems, respectively. Elemental concentration (N, Ca, Al, Fe) and total ash in decaying leaves increased, did not change (S, Mn) or decreased (P, K, Mg) during leaves decomposition assay. There was no net N-release from leaves decomposition. For other nutrients, release rate and ranking was K (0.60) ³ P (0.59) &gt; Mg (0.40) &gt; S (0.21) &gt; Ca (0.10). Calcium release rate was slower than decay, while Mg, P and K released more quickly. After initial release, Fe, Al and Mn showed a non-significant but consistent slight immobilization. We conclude that (1) detritus decay rates decrease with size increase, (2) differences among stands do not influence significantly foliar decay rates, (3) foliar nutrient release is different for each chemical element and some of them do not fit described models, (4) N-content seems to be constant during decomposition period, (5) release is faster for the more mobile nutrients, especially during phase I, (6) the increase in Ca and its lower release rate with respect to dry mass decay rate may cause a relative Caincrement in the F-layer, and a somewhat similar but more marked sink could occur with microelements, (7) the slight increase of Fe and Al in leaf-litter suggests that their availability do not allow high microbial traslocation and immobilization, and do not attain toxic levels, (8) foliar decay rates were in the range of Northern Hemisphere conifers, and similar or lower than those of broad-leaved evergreen and deciduous Nothofagus spp., respectively, from South America, (9) coarse woody debris decay rates were similar or slightly higher than for Northern Hemisphere conifers and lower than for Nothofagus spp. from Tierra del Fuego.Laboratorio de Investigación de Sistemas Ecológicos y Ambientale