Professionalism: Informal Consultations about Skin Diseases

Introduction: “Informal consultation” refers to informal self-referral to clinicians for medical advice. This questionnaire-based study explores non-dermatology doctors’ experiences with informal consultations on skin diseases. Method: A 13-item questionnaire-based study was conducted in 2020, involving a convenience sample of doctors from a district general hospital. Doctors working in the dermatology department were excluded from the questionnaire. The numerical data derived from the questionnaire were analysed using descriptive statistics, and free text data were analysed using content analysis. Results: The questionnaire response rate was 29/33 (88%), consisting of 27 doctors-in-training and two medical consultants. Twenty-four of 29 (83%) respondents reported that they were asked to provide dermatological advice outside of healthcare settings. The main source of self-referrals was first-degree relatives, as reported by 23/29 (79%) respondents. Twenty-five of 29 (86%) did not document the advice provided. Conclusions: Non-dermatology doctors encounter informal consultations on skin diseases. These requests put a burden on the work–life balance of clinicians involved, and there are risks associated with mismanaging such requests. Doctors in training would benefit from support and guidance from their supervisors on how to navigate this professionalism issue safely

Facilitators and barriers in HIV linkage to care interventions: a qualitative evidence review

To synthesize qualitative evidence on linkage to care interventions for people living with HIV

Barriers and facilitators of interventions for improving antiretroviral therapy adherence: a systematic review of global qualitative evidence.

INTRODUCTION: Qualitative research on antiretroviral therapy (ART) adherence interventions can provide a deeper understanding of intervention facilitators and barriers. This systematic review aims to synthesize qualitative evidence of interventions for improving ART adherence and to inform patient-centred policymaking. METHODS: We searched 19 databases to identify studies presenting primary qualitative data on the experiences, attitudes and acceptability of interventions to improve ART adherence among PLHIV and treatment providers. We used thematic synthesis to synthesize qualitative evidence and the CERQual (Confidence in the Evidence from Reviews of Qualitative Research) approach to assess the confidence of review findings. RESULTS: Of 2982 references identified, a total of 31 studies from 17 countries were included. Twelve studies were conducted in high-income countries, 13 in middle-income countries and six in low-income countries. Study populations focused on adults living with HIV (21 studies, n=1025), children living with HIV (two studies, n=46), adolescents living with HIV (four studies, n=70) and pregnant women living with HIV (one study, n=79). Twenty-three studies examined PLHIV perspectives and 13 studies examined healthcare provider perspectives. We identified six themes related to types of interventions, including task shifting, education, mobile phone text messaging, directly observed therapy, medical professional outreach and complex interventions. We also identified five cross-cutting themes, including strengthening social relationships, ensuring confidentiality, empowerment of PLHIV, compensation and integrating religious beliefs into interventions. Our qualitative evidence suggests that strengthening PLHIV social relationships, PLHIV empowerment and developing culturally appropriate interventions may facilitate adherence interventions. Our study indicates that potential barriers are inadequate training and compensation for lay health workers and inadvertent disclosure of serostatus by participating in the intervention. CONCLUSIONS: Our study evaluated adherence interventions based on qualitative data from PLHIV and health providers. The study underlines the importance of incorporating social and cultural factors into the design and implementation of interventions. Further qualitative research is needed to evaluate ART adherence interventions

Search for gravitational-lensing signatures in the full third observing run of the LIGO-Virgo network

Gravitational lensing by massive objects along the line of sight to the source causes distortions of gravitational wave-signals; such distortions may reveal information about fundamental physics, cosmology and astrophysics. In this work, we have extended the search for lensing signatures to all binary black hole events from the third observing run of the LIGO--Virgo network. We search for repeated signals from strong lensing by 1) performing targeted searches for subthreshold signals, 2) calculating the degree of overlap amongst the intrinsic parameters and sky location of pairs of signals, 3) comparing the similarities of the spectrograms amongst pairs of signals, and 4) performing dual-signal Bayesian analysis that takes into account selection effects and astrophysical knowledge. We also search for distortions to the gravitational waveform caused by 1) frequency-independent phase shifts in strongly lensed images, and 2) frequency-dependent modulation of the amplitude and phase due to point masses. None of these searches yields significant evidence for lensing. Finally, we use the non-detection of gravitational-wave lensing to constrain the lensing rate based on the latest merger-rate estimates and the fraction of dark matter composed of compact objects

Search for eccentric black hole coalescences during the third observing run of LIGO and Virgo

Despite the growing number of confident binary black hole coalescences observed through gravitational waves so far, the astrophysical origin of these binaries remains uncertain. Orbital eccentricity is one of the clearest tracers of binary formation channels. Identifying binary eccentricity, however, remains challenging due to the limited availability of gravitational waveforms that include effects of eccentricity. Here, we present observational results for a waveform-independent search sensitive to eccentric black hole coalescences, covering the third observing run (O3) of the LIGO and Virgo detectors. We identified no new high-significance candidates beyond those that were already identified with searches focusing on quasi-circular binaries. We determine the sensitivity of our search to high-mass (total mass M>70 M⊙) binaries covering eccentricities up to 0.3 at 15 Hz orbital frequency, and use this to compare model predictions to search results. Assuming all detections are indeed quasi-circular, for our fiducial population model, we place an upper limit for the merger rate density of high-mass binaries with eccentricities 0<e≤0.3 at 0.33 Gpc−3 yr−1 at 90\% confidence level

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Knockdown effects of CHIP and UCH-L1 on chaperone-mediated autophagy.

Chaperone-mediated autophagy (CMA) is a selective form of autophagy which degrades cytosolic proteins bearing a CMA-targeting motif. CMA is carried out by chaperone proteins and aberrant CMA function has been implicated in disease. Its physiological regulation is not well understood, which is important for manipulating CMA in disease conditions. In this study, we explored plausible roles of ubiquitin-modifying enzymes in CMA. Previously, our lab detected polyubiquitinated proteins and ubiquitin-modifying enzymes in lysosomes that perform CMA. Such enzymes included CHIP (carboxyl terminus of Hsp70-interacting protein) and UCH-L1 (ubiquitin carboxy-terminal hydrolase L1). To investigate their functions, we examined their effects on CMA components. CMA-related chaperones bind and direct substrates to lysosomal membrane receptor LAMP-2A which subsequently multimerizes, creating a channel for substrates to enter lysosomes for degradation. Lysosomal membrane LAMP-2A levels directly correlate with CMA activity. We found that in SH-SY5Y cells depleted of CHIP or UCH-L1, some of the chaperones involved in CMA are affected. In particular, we observed a significant increase in LAMP-2A levels with a concomitant increase in LAMP-2A stability in both knockdown cells. Our results suggest that CHIP and UCH-L1 may influence CMA activity by modulating the levels of CMA chaperones and LAMP-2A in lysosomes.Bachelor of Science in Biological Science

Unintended consequences: Nutritional impact and potential pitfalls of switching from animal‐ to plant‐based foods

10.3390/nu13082527Nutrients138252

A critical appraisal of the evidence supporting consumer motivations for alternative proteins

10.3390/foods10010024Foods1012