There has been a proliferation of initiatives targeted towards improving psychological wellbeing among medical learners. Yet many learners do not seek assistance due to stigma against help seeking. Understanding the prevailing discourses on the effects of mental health stigma in the context of medical education will improve insight on how to address stigma and improve wellbeing. In this study, the authors sought to explore discourses on stigma in medical education through a Foucauldian Critical Discourse Analysis.

The authors assembled several sets of texts related to stigma in medical education. The initial archive consisted of social media discourse and was expanded to include digital news media. Next, the authors conducted semi-structured qualitative interviews with medical students, residents and faculty. Using principles of Critical Discourse Analysis informed by the writings of Michel Foucault, the authors analysed the archive to identify truth statements, representative statements and discursive efplications for the teaching, learning and overall wellbeing of medical learners. The tensions between discourses on disclosure and performance have the potential to perpetuate further distress for learners and worsen asymmetries in power. Interventions to address stigma would benefit from understanding and addressing the role of power and hierarchy in maintaining and dismantling stigma.

Blood supply to the nasoseptal flap may be compromised in patients who had previous irradiation to the head and neck region, hence, affecting its viability. Here, we evaluate the role of an endonasal acoustic Doppler sonography in predicting the survival of the nasoseptal flap in this group of patients.

Retrospective cohort.

Retrospective review of patients with previous irradiation to the head and neck region who had undergone endoscopic endonasal surgeries requiring nasoseptal flap as reconstruction. Survival rates of nasoseptal flap were compared between groups where endonasal Doppler was used.

A total of 28 patients were identified with previous irradiation to the head and neck region who had undergone endoscopic endonasal surgeries requiring nasoseptal flap as reconstruction. The overall survival rate of nasoseptal flap is 67.8% (19 out of 28). Endonasal acoustic Doppler was used in 17 of these patients, of which 13 patients had a positive signal. The flap survival rate in the Doppler-positive group compared to the non-Doppler group was significantly better at 100% vs 45.4% (P= .003). Among those where the endonasal Doppler was used, the flap survival rate with a negative doppler signal was significantly worse at 25%, compared with 100% flap survival in those with positive doppler signal (P= .006). The positive predictive value of a positive endonasal Doppler signal with flap survival is 100%.

The use of endonasal acoustic Doppler may be useful in predicting the viability of nasoseptal flap in postirradiated patients who need a local mucosal flap coverage.

Level 3 Laryngoscope, 2022.

Level 3 Laryngoscope, 2022.Simulation of crystal structures of series 1(2)-R-1(2)H-[1,2,3]triazolo[4,5-e][1,2,3,4]tetrazine 5,7-dioxides, 1,5,7-trioxides, 4,6-dioxides and 3,4,6-trioxides was carried out using an original technique based on the method of atom-atom potentials and quantum chemistry. The effect of the position of the substituent in the triazole ring on the change in the crystal structures of these compounds and their thermochemical characteristics was studied for the first time. For some of synthesized compounds, thermochemical characteristics were investigated and differential scanning calorimetry curves were obtained. Detonation parameters were calculated, on the basis of which the prospects for the use of the considered compounds were assessed.

Lung transplant recipients undergo bronchoalveolar lavage (BAL) to detect antecedents of chronic lung allograft dysfunction (CLAD), but routine assessment of BAL cytology is controversial. We hypothesized that inflammation on BAL cytology would predict CLAD-free survival.

In a single-center retrospective cohort, associations between cytology results and clinical characteristics were compared using generalized-estimating equation-adjusted regression. The association between BAL inflammation and CLAD or death risk was assessed using time-dependent Cox models.

In 3365 cytology reports from 451 subjects, inflammation was the most common finding (6.2%, 210 cases), followed by fungal forms (5.3%, 178 cases, including 24 cases of suspectedAspergillus). Inflammation on BAL cytology was more common in procedures for symptoms (8.5%) versus surveillance (3.2%, p<.001). Inflammation on cytology was associated with automated neutrophil and lymphocyte counts, acute cellular rejection, infection, and portended a 2.2-fold hazard ratio (CI1.2-4.0, p=.007) for CLAD or death.However, inflammation by cytology did not inform CLAD-free survival risk beyond automated BAL cell counts (p=.57).

Inflammation on BAL cytology is clinically significant, suggesting acute rejection or infection and increased risk of CLAD or death. However, other indicators of allograft inflammation can substitute for much of the information provided by BAL cytology.

Inflammation on BAL cytology is clinically significant, suggesting acute rejection or infection and increased risk of CLAD or death. However, other indicators of allograft inflammation can substitute for much of the information provided by BAL cytology.

School-based health centers (SBHCs) provide health care to vulnerable youth. The purpose of the study was to identify characteristics of youth who use SBHCs with the highest frequency to understand their health needs and receipt of health services.

This study examined cross-sectional survey data from adolescents in 3 urban school districts (n=2641) to identify the characteristics of youth who use SBHCs with high frequency (10+ visits). Analyses included calculations of simple frequencies and percentages, chi-square tests of significance and multivariate regression.

High-frequency SBHC users were more likely to have seriously considered attempting suicide (adjusted odds ratio [AOR] 3.2), be sexually active (AOR 6.8), and have been victimized at school (AOR 2.2) compared to their peers who did not use the SBHC. High-frequency SBHC users were also significantly more likely than their peers to report „always” getting mental health (AOR 7.0) and sexual health (AOR 6.6) care when needed, and having talked with a health care provider about their moods/feelings (AOR 3.1) and how school is going (AOR 3.2) in the past year.

These findings hold important relevance to demonstrating the value of SBHCs in increasing vulnerable youth’s access to health care, particularly in urban settings.

These findings hold important relevance to demonstrating the value of SBHCs in increasing vulnerable youth’s access to health care, particularly in urban settings.

Deep convolutional neural network (CNN) and its derivatives have recently shown great promise in the prediction of brain disorders using brain connectome data. Existing deep CNN methods using single global row and column convolutional filters have limited ability to extract discriminative information from brain connectome for prediction tasks.

This paper presents a novel deep Connectome-Inception CNN (ConCeptCNN) model, which is developed based on multiple convolutional filters. The proposed model is used to extract topological features from brain connectome data for neurological disorders classification and analysis.

The ConCeptCNN uses multiple vector-shaped filters extract topological information from the brain connectome at different levels for complementary feature embeddings of brain connectome. The proposed model is validated using two datasets the Neuro Bureau ADHD-200 dataset and the Cincinnati Early Prediction Study (CINEPS) dataset.

In a cross-validation experiment, the ConCeptCNN achieved a prediction accuracy of 78.7% for the detection of attention deficit hyperactivity disorder (ADHD) in adolescents and an accuracy of 81.6% for the prediction of cognitive deficits at 2 years corrected age in very preterm infants. In addition to the classification tasks, the ConCeptCNN identified several brain regions that are discriminative to neurodevelopmental disorders.

We compared the ConCeptCNN with several peer CNN methods. The results demonstrated that proposed model improves overall classification performance of neurodevelopmental disorders prediction tasks.

We compared the ConCeptCNN with several peer CNN methods. The results demonstrated that proposed model improves overall classification performance of neurodevelopmental disorders prediction tasks.Although the N6 -methyladenosine (m6 A) modification is the most prevalent RNA modification in eukaryotes, the global m6 A modification landscape and its molecular regulatory mechanism in response to drought stress remain unclear. Transcriptome-wide m6 A methylome profiling revealed that m6 A is mainly enriched in the coding sequence and 3′ untranslated region in response to drought stress in apple, by recognizing the plant-specific sequence motif UGUAH (H=A, U or C). We identified a catalytically active component of the m6 A methyltransferase complex, MdMTA. An in vitro methyl transfer assay, dot blot, LC-MS/MS and m6 A-sequencing (m6 A-seq) suggested that MdMTA is an m6 A writer and essential for m6 A mRNA modification. Further studies revealed that MdMTA is required for apple drought tolerance. m6 A-seq and RNA-seq analyses under drought conditions showed that MdMTA mediates m6 A modification and transcripts of mRNAs involved in oxidative stress and lignin deposition. Moreover, m6 A modification promotes mRNA stability and the translation efficiency of these genes in response to drought stress. Consistently, MdMTA enhances lignin deposition and scavenging of reactive oxygen species under drought conditions. Our results reveal the global involvement of m6 A modification in the drought response of perennial apple trees and illustrate its molecular mechanisms, thereby providing candidate genes for the breeding of stress-tolerant apple cultivars.

Due to cognitive and emotional differences between individuals who have and have not stopped self-injuring, we explored these in the context of desire to stop.

Australian university students (n = 374) completed cognitive and emotional measures. Comparisons were made between those who had self-injured in the past 12 months and those who had not, and between individuals who reported wanting to stop self-injuring and those who did not.

Approximately 20% of participants did not want to stop self-injuring. Cognitive emotional factors (psychological distress, self-efficacy to resist, difficulties regulating emotion, interpersonal functions, and outcome expectancies) differentiated individuals who had and had not stopped, but could not explain differences in desire to stop.

Factors associated with desire to stop are not the same as factors underlying behavioural cessation. Motivational approaches to changes in self-injurious behaviour would be beneficial for clinicians and their clients.

Factors associated with desire to stop are not the same as factors underlying behavioural cessation.