Has Motivational Interviewing fallen into its own Premature Focus Trap?

Since the initial conception of the behaviour change method Motivational Interviewing, there has been a shift evident in epistemological, methodological and practical applications, from an inductive, process and practitioner-focussed approach to that which is more deductive, research-outcome, and confirmatory-focussed. This paper highlights the conceptual and practical problems of adopting this approach, including the consequences of assessing the what (deductive outcome-focussed) at the expense of the how (inductively process-focussed). We encourage a return to an inductive, practitioner and client-focussed MI approach and propose the use of Computer Assisted Qualitative Data Analysis Systems such as NVivo in research initiatives to support this aim

Recapitulation of Human Retinal Development from Human Pluripotent Stem Cells Generates Transplantable Populations of Cone Photoreceptors

Transplantation of rod photoreceptors, derived either from neonatal retinae or pluripotent stem cells (PSCs), can restore rod-mediated visual function in murine models of inherited blindness. However, humans depend more upon cone photoreceptors that are required for daylight, color, and high-acuity vision. Indeed, macular retinopathies involving loss of cones are leading causes of blindness. An essential step for developing stem cell-based therapies for maculopathies is the ability to generate transplantable human cones from renewable sources. Here, we report a modified 2D/3D protocol for generating hPSC-derived neural retinal vesicles with well-formed ONL-like structures containing cones and rods bearing inner segments and connecting cilia, nascent outer segments, and presynaptic structures. This differentiation system recapitulates human photoreceptor development, allowing the isolation and transplantation of a pure population of stage-matched cones. Purified human long/medium cones survive and become incorporated within the adult mouse retina, supporting the potential of photoreceptor transplantation for treating retinal degeneration

Recapitulation of Human Retinal Development from Human Pluripotent Stem Cells Generates Transplantable Populations of Cone Photoreceptors

Transplantation of rod photoreceptors, derived either from neonatal retinae or pluripotent stem cells (PSCs), can restore rod-mediated visual function in murine models of inherited blindness. However, humans depend more upon cone photoreceptors that are required for daylight, color, and high-acuity vision. Indeed, macular retinopathies involving loss of cones are leading causes of blindness. An essential step for developing stem cell-based therapies for maculopathies is the ability to generate transplantable human cones from renewable sources. Here, we report a modified 2D/3D protocol for generating hPSC-derived neural retinal vesicles with well-formed ONL-like structures containing cones and rods bearing inner segments and connecting cilia, nascent outer segments, and presynaptic structures. This differentiation system recapitulates human photoreceptor development, allowing the isolation and transplantation of a pure population of stage-matched cones. Purified human long/medium cones survive and become incorporated within the adult mouse retina, supporting the potential of photoreceptor transplantation for treating retinal degeneration.</p

Observation of γγ → ττ in proton-proton collisions and limits on the anomalous electromagnetic moments of the τ lepton

The production of a pair of τ leptons via photon–photon fusion, γγ → ττ, is observed for the f irst time in proton–proton collisions, with a significance of 5.3 standard deviations. This observation is based on a data set recorded with the CMS detector at the LHC at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 138 fb−1. Events with a pair of τ leptons produced via photon–photon fusion are selected by requiring them to be back-to-back in the azimuthal direction and to have a minimum number of charged hadrons associated with their production vertex. The τ leptons are reconstructed in their leptonic and hadronic decay modes. The measured fiducial cross section of γγ → ττ is σfid obs = 12.4+3.8 −3.1 fb. Constraints are set on the contributions to the anomalous magnetic moment (aτ) and electric dipole moments (dτ) of the τ lepton originating from potential effects of new physics on the γττ vertex: aτ = 0.0009+0.0032 −0.0031 and |dτ| &lt; 2.9×10−17ecm (95% confidence level), consistent with the standard model

Mycobacterium Avium Complex Infection as a Rare Cause of Cerebral Mass Lesion and IRIS in a Patient with AIDS: Case Report and Review of the Literature

A patient with advanced HIV/AIDS presented with a brain abscess. While brain biopsy culture and pathology were unrevealing, universal broad-range polymerase chain reaction (uPCR) demonstrated Mycobacterium avium complex (MAC). We review the clinicopathologic characteristics of MAC brain abscesses and highlight the effectiveness of uPCR as a diagnostic tool in partially treated infections

Mycobacterium Avium Complex Infection as a Rare Cause of Cerebral Mass Lesion and IRIS in a Patient with AIDS: Case Report and Review of the Literature

Abstract A patient with advanced HIV/AIDS presented with a brain abscess. While brain biopsy culture and pathology were unrevealing, universal broad-range PCR (uPCR) demonstrated Mycobacterium avium complex (MAC). We review the clinicopathologic characteristics of MAC brain abscesses and highlight the effectiveness of uPCR as a diagnostic tool in partially-treated infections.</jats:p

163. High Prevalence of Urogenital and Rectal <i>Mycoplasma genitalium</i> in U.S. MSM with a History of STIs in the Last Year

Abstract Background M. genitalium (M. gen) is an under-recognized sexually transmitted bacterial pathogen that causes 15-25% of nongonococcal urethritis (NGU) in men. Asymptomatic M. gen may serve as a reservoir, lead to transmission to sexual contacts, and drive the development of drug resistance. M. gen may be associated with an increased risk of HIV acquisition, as seen in some studies. Data are limited on M. gen prevalence among U.S. men who have sex with men (MSM) living with HIV or HIV-uninfected and on pre-exposure prophylaxis (PrEP). Methods We analyzed baseline prevalence of urogenital and rectal M. gen using the Aptima Mycoplasma genitalium nucleic acid amplification test in participants enrolled in DoxyPEP, an ongoing randomized, open label trial of the effectiveness of doxycycline post-exposure prophylaxis (PEP) on incidence of gonorrhea, chlamydia, and early syphilis among MSM and transgender women living with HIV or on PrEP in San Francisco and Seattle (NCT03980223). Participants completing at least one follow up visit were also assessed for M. gen persistence, clearance, and incidence. Testing was at regular intervals and not symptom driven. Results This analysis included 122 men; 34% with HIV and 66% on PrEP. In the prior 12 months, 18.9% had a diagnosis of syphilis, 58.2% chlamydia, and 63.9% gonorrhea. At baseline, M. gen was present in at least one site in 24%; 9% in the urine and 16% in the rectum, with 1 testing positive at both sites. M. gen presence was not associated with age, ethnicity, race, HIV status, number of partners in the past 3 months, or bacterial STI in the past 3 months. 65 participants had follow up tests a median of 9.1 months after baseline (IQR 7.8-9.8); among 7 participants with urogenital M. gen at baseline, M. gen cleared in 6 and persisted in 1. Among 11 participants with rectal M. gen at baseline, M. gen cleared in 4 cleared and persisted in 7. At follow up, M. gen was detected in 2 urine and 9 rectal specimens in those previously negative at these sites. Figure 1. Baseline prevalence of urogenital and rectal M. genitalium in MSM at high risk for STIs enrolled in DoxyPEP Figure 2. Detection of urogenital and rectal M. genitalium among participants with baseline and follow up testing Conclusion In this cohort of MSM with a recent diagnosis of a bacterial STI, routine testing identified urogenital or rectal M. gen in 24% of participants at baseline and 31% at either baseline or follow-up. The association of persistent M. gen with the risk for subsequent symptomatic infection and drug resistance merits further investigation. Disclosures Emma D. Bainbridge, MD, MPH, Hologic (Grant/Research Support) Olusegun O. Soge, PhD, Hologic Inc. (Grant/Research Support)SpeeDx Inc. (Grant/Research Support) Annie Luetkemeyer, MD, Cepheid (Grant/Research Support)Hologic (Grant/Research Support)Mayne Pharma (Grant/Research Support) </jats:sec

Opinions of key stakeholders concerning involuntary admission of patients under the Mental Health Act 2001

Objectives. To evaluate and compare the opinions of key stakeholders involved in the involuntary admission and treatment of patients under the Mental Health Act (MHA) 2001 regarding their views towards the operation of the legislation. Methods. We employed a descriptive survey design. A questionnaire was distributed to stakeholders involved in the operation of the MHA2001 (except service users, whose views were explored in a separate qualitative study) via paper or online versions evaluating their opinions regarding the operation of the MHA 2001 in relation to assessment, care, rights, transfer and information available. Results. Stakeholders agreed that in their opinion that patients generally benefit from the care they receive (79%) and that the MHA 2001 ensures an independent and fair review of the person’s detention (65%). However, only 23% of stakeholders were satisfied with the process of transferring patients to hospital and with the clinical assessment procedures therein (37%), with the greatest levels of dissatisfaction amongst Gardai (Police), general practitioners (GPs) and family members. Conclusions. While the introduction of the MHA 2001 has assisted delivery of care to patients with improved adherence to international human rights frameworks applicable at the time of its enactment, substantial dissatisfaction with the implementation of theMHA2001 in practice is experienced by stakeholders particularly at the distressing phase of clinical assessment and transfer to hospital

Characteristics of High-Titer Convalescent Plasma and Antibody Dynamics After Administration in Patients With Severe Coronavirus Disease 2019

Abstract We characterized the antibody composition of coronavirus disease 2019 (COVID-19) convalescent plasma (CCP) and the immunologic responses of hospitalized COVID-19 patients after receiving CCP or nonimmune fresh frozen plasma. Despite selection of CCP with significantly higher total immunoglobulin G than recipients, neutralizing antibody levels did not differ between donor plasma and CCP recipients.</jats:p