Aims: Psychoeducation for patients with anxiety disorders has been associated with reduced symptoms, improved quality of life, and increased response to treatment. However, there is much heterogeneity in such interventions. Patients with anxiety disorders can have maladaptive cognitive patterns such as catastrophic thinking, attentional biases toward threat, and cognitive avoidance. These patterns can interfere with the processing and assimilation of psychoeducational content, potentially reducing its effectiveness. Our hypothesis is that psychological safety plays a key role in increasing the effectiveness of psychoeducational interventions for patients with anxiety disorders. We aim to critically review the role of psychological safety in such interventions and to explore its impact on medical education in psychiatry.

Methods: Sources were identified through searches via databases including PubMed, PsycINFO, Scopus, Cochrane Library, and Google Scholar. Results were then critically analysed with key themes extracted to evaluate the role of psychological safety in psychoeducation. A narrative synthesis was then performed, exploring the influence of this on medical education in psychiatry.

Results: Several key themes were identified. Psychological safety has a mediating role between the quality of doctor-patient communication and patients’ self-disclosure, which can be limited by various fears, including a fear of negative judgment in this population. Patient engagement, which has a multidimensional construct, is also impacted by the presence of psychological safety which increases patient openness and comfort. Psychological safety also aids collaborative efforts within the healthcare ecosystem, positively impacting the outcomes of psychoeducational processes. The influence of psychological safety on the concept of the therapeutic interpersonal relationship in psychoeducation was also explored, with implications for open communication and the perception of threats. Proposed enhancements to assessments and curriculum for educational efforts in anxiety disorders and corresponding psychoeducational interventions through the active provision of psychological safety concepts were discussed.

Conclusion: This critical review highlights the pivotal role of psychological safety in enhancing the effectiveness of psychoeducational interventions for patients with anxiety disorders. By equipping clinicians to create safe environments, these efforts can optimize psychoeducational interventions and ultimately improve care for patients with anxiety disorders. Targeted studies on specific subgroups of patients with anxiety disorders should be performed to better qualify and quantify the impact of psychological safety in psychoeducational interventions in these subgroups.

Although dietary factors have been examined as potential risk factors for liver cancer, the evidence is still inconclusive. Using a diet-wide association analysis, our research evaluated the associations of 126 foods and nutrients on the risk of liver cancer in a Chinese population. We obtained the diet consumption of 72,680 women in the Shanghai Women’s Health Study using baseline dietary questionnaires. The association between each food and nutrient and liver cancer risk was quantified by Cox regression model. A false discovery rate of 0.05 was used to determine the foods and nutrients which need to be verified. Totally 256 incident liver cancer cases were identified in 1,267,391 person-years during the follow-up duration. At the statistical significance level (P ≤ 0.05), higher intakes of cooked wheaten foods, pear, grape and copper were inversely associated with liver cancer risk, while spinach, leafy vegetables, eggplant and carrots showed the positive associations. After considering multiple comparisons, no dietary variable was associated with liver cancer risk. Similar findings were seen in the stratification, secondary and sensitivity analyses. Our findings observed no significant association between dietary factors and liver cancer risk after considering multiple comparisons in Chinese women. More evidence is needed to explore the associations between diet and female liver cancer occurrence.

The global challenge of methane emissions from enteric fermentation is critical, as it contributes significantly to atmospheric greenhouse gases and represents a loss of energy that could otherwise be utilized by ruminants. With the increasing demand for dairy and meat products, finding effective methods to reduce methane production is essential. This review explores the use of advanced meta-omics techniques – including metagenomics, metatranscriptomics, metaproteomics, and metabolomics – to deepen our understanding of ruminal methane production and identify potential strategies for its mitigation. These high-throughput technologies provide comprehensive insights into the rumen microbial communities and their metabolic functions by analyzing DNA, RNA, proteins, and metabolites directly from environmental samples. Metagenomics and metatranscriptomics offer a detailed view of microbial diversity and gene expression, while metaproteomics can identify specific enzymes and proteins directly involved in methane production pathways, revealing potential targets for mitigation strategies. Integrating these meta-omics approaches allows for a holistic understanding of the microbial processes that drive methane emissions, enabling the development of more precise interventions, such as tailored dietary modifications and the use of specific inhibitors. This review underscores the importance of a multi-omics strategy in characterizing microbial roles and interactions within the rumen, which is crucial for devising effective and sustainable methods to reduce methane emissions without compromising livestock productivity.

Recent years have witnessed significant developments in medical negligence jurisprudence. In 2015, the Supreme Court in Montgomery v Lanarkshire Health Board famously departed from the House of Lords decision in Sidaway v Board of Governors of the Bethlem Royal Hospital and the Maudsley Hospital by ruling that the professional practice test set out in Bolam v Friern Hospital Management Committee no longer applied to the doctor's duty to give advice to the patient. In particular, the Supreme Court in Montgomery held as follows:

During the existence of Proto-Tethys Ocean (550–430 Ma), microcontinents in northern East Gondwana merged with the northern margin of India-Australia, completing the assembly of Gondwana. Ongoing controversy surrounds the disappearance of the Proto-Tethys Ocean, the dynamic mechanisms of suturing and the palaeogeographic relationships among microcontinents in northern East Gondwana, contributing to the uncertainty about the tectonic evolution of the region. This paper concerns the lower Silurian Zusailing Formation in the Hainan Island and focuses on the affinity between Hainan Island and various microcontinents in northern East Gondwana during the early Silurian. We use detrital zircon geochronology to reconstruct the closure process of the Proto-Tethys Ocean and show that the detrital zircon U–Pb age groups of the lower Silurian Zusailing Formation are 2800–2200, 2100–1350, 1250–950, 600–480 and 480–430 Ma, with a significant age peak of ca. 449 Ma. Furthermore, the analysis of detrital zircon geochemistry and europium anomalies shows that the Hainan Island crust continued to thicken during 600–434 Ma. Comparing the age spectrum of early Palaeozoic detrital zircons from Hainan Island and various microcontinents in northern East Gondwana, as well as the affinity among them during the Silurian, we conclude that the closure of the eastern Proto-Tethys Ocean evolved from unidirectional subduction (600–480 Ma) to bidirectional subduction (480–430 Ma).

OBJECTIVES/GOALS: Decoding the origins of cell-free DNA (cfDNA) released from dying cells in a liquid biopsy sample (e.g. blood) offers the potential to provide insight into the dynamic, organism-wide changes reflective of health and disease. Thus, making cfDNA an ideal target for serial, minimally invasive monitoring of disease-related changes. METHODS/STUDY POPULATION: We develop a probabilistic method that leverages the co-regulation of neighboring CpG sites on individual methylome-wide sequencing (WGBS) reads to more flexibly model cell-specific methylation compared to prior methods that focus on the methylation rate of a single CpG site. We then extend our cross-sectional model to account for sequential sampling within the same subject. The increased sampling frequency is critical to identifying the evolutionary dynamics of disease progression influencing treatment response and resistance, and disease recurrence. We utilize Bayesian inference techniques to model patient-specific longitudinal profiles of cell-type turnover in simulated serial samples. RESULTS/ANTICIPATED RESULTS: We found our model more effective at capturing a range of methylation patterns on cfDNA fragments with lower Root Mean Square Error across simulations compared to a single CpG model. We apply our model to detect significant (p < 0.05, Friedman’s test) increases in cellular contributions from lung and cardiac tissue in breast cancer patients (n=15) undergoing radiation therapy compared to baseline. We also identify signals of radiation induced toxicity to the liver in right-sided breast cancer patients (n=8) receiving radiation treatment compared to left-sided breast cancer patients (n=7). Finally, we show our extended model results in more efficient estimates of simulated cell-type turnover profiles compared to analyzing serial samples cross-sectionally, ignoring the longitudinal nature of the data. DISCUSSION/SIGNIFICANCE: Here we address an unmet need in developing novel statistical methodologies to decode the origins of methylated cfDNA obtained from liquid biopsy samples. We demonstrate the far-ranging clinical utility of serial liquid biopsy sampling to complement and advance the standards of clinical care in oncology and other pathologies.

The role of Mn oxide in the abiotic formation of humic substances has been well demonstrated. However, information on the effect of crystal structure and surface-chemical characteristics of Mn oxide on this process is limited. In the present study, hexagonal and triclinic birnessites, synthesized in acidic and alkali media, were used to study the influence of the crystal-structure properties of birnessites on the oxidative polymerization of hydroquinone and to elucidate the catalytic mechanism of birnessites in the abiotic formation of humic-like polymers in hydroquinone-birnessite systems. The intermediate and final products formed in solution and solid-residue phases were identified by UV/Visible spectroscopy, atomic absorption spectrometry, Fourier-transform infrared spectroscopy, X-ray diffraction, solid-phase microextraction-gaschromatography-mas ss pectrometry, ion chromatography, and ultrafiltration. The degree of oxidative polymerization of hydroquinone wasenhanced with increase in the interlayer hydrated H+, the average oxidation state (AOS), and the specific surface area of birnessites. The nature of the functional groups of the humic-like polymers formed was, however, almost identical when hydroquinone was catalyzed by hexagonal and triclinic birnessites with similar AOS of Mn. The results indicated that crystal structure and surface-chemistry characteristics have significant influence on the oxidative activity of birnessites and the degree of polymerization of hydroquinone, but have little effect on the abiotic formation mechanism of humic-like polymers. The proposed oxidative polymerization pathway for hydroquinone isthat, asit approachesthe birnessite, it formsp recursor surface complexes. Asa strong oxidant, birnessite accepts an electron from hydroquinone, which is oxidized to 1,4-benzoquinone. The coupling, cleavage, polymerization, and decarboxylation reactionsaccompany the generation of 1,4-benzoquinone, lead to the release of CO2 and carboxylic acid fragments, the generation of rhodochrosite, and the ultimate formation of humic-like polymers. These findings are of fundamental significance in understanding the catalytic role of birnessite and the mechanism for the abiotic formation of humic substances in nature.

In order to establish a compact all-optical Thomson scattering source, experimental studies were conducted on the 45 TW Ti: sapphire laser facility. By including a steel wafer, mixed gas, and plasma mirror into a double-exit jet, several mechanisms, such as shock-assisted ionization injection, ionization injection, and driving laser reflection, were integrated into one source. So, the source of complexity was remarkably reduced. Electron bunches with central energy fluctuating from 90 to 160 MeV can be produced. Plasma mirrors were used to reflect the driving laser. The scattering of the reflected laser on the electron bunches led to the generation of X-ray photons. Through comparing the X-ray spots under different experimental conditions, it is confirmed that the X-ray photons are generated by Thomson scattering. For further application, the energy spectra and source size of the Thomson scattering source were measured. The unfolded spectrum contains a large amount of low-energy photons besides a peak near 67 keV. Through importing the electron energy spectrum into the Monte Carlo simulation code, the different contributions of the photons with small and large emitting angles can be used to explain the origin of the unfolded spectrum. The maximum photon energy extended to about 500 keV. The total photon production was 107/pulse. The FWHM source size was about 12 μm.

In this study, a novel, cost-effective miniaturized tag antenna was developed for applications on the human body. To achieve impedance matching with the complex conjugate impedance of the Monza-4 tag chip (7.17–j74.22 Ω at 915 MHz), the proposed structure was configured by coarsely tuning the positions of vias and fine-tuning the small gaps of its coupled patches. For further reducing the profile and dimensions of the antenna, a design technique based on the three-dimensional dipole antenna current distribution was used. The proposed antenna configuration was not only miniaturized but also achieved a long stable reading distance (>5.0 m) and a wide impedance bandwidth of 71 MHz or 7.65% (covering the ultrahigh frequency radio frequency identification ranges in most regions), regardless of the location of the tag on the human body. Experiments were conducted to validate the simulated results, and adequate agreement was found between the simulated results and the measured results.

Although ethanol treatment is widely used to activate oocytes, the underlying mechanisms are largely unclear. Roles of intracellular calcium stores and extracellular calcium in ethanol-induced activation (EIA) of oocytes remain to be verified, and whether calcium-sensing receptor (CaSR) is involved in EIA is unknown. This study showed that calcium-free ageing (CFA) in vitro significantly decreased intracellular stored calcium (sCa) and CaSR expression, and impaired EIA, spindle/chromosome morphology and developmental potential of mouse oocytes. Although EIA in oocytes with full sCa after ageing with calcium does not require calcium influx, calcium influx is essential for EIA of oocytes with reduced sCa after CFA. Furthermore, the extremely low EIA rate in oocytes with CFA-downregulated CaSR expression and the fact that inhibiting CaSR significantly decreased the EIA of oocytes with a full complement of CaSR suggest that CaSR played a significant role in the EIA of ageing oocytes. In conclusion, CFA impaired EIA and the developmental potential of mouse oocytes by decreasing sCa and downregulating CaSR expression. Because mouse oocytes routinely treated for activation (18 h post hCG) are equipped with a full sCa complement and CaSR, the present results suggest that, while calcium influx is not essential, CaSR is required for the EIA of oocytes.

Objectives: COVID-19 booster uptake has remained poor among healthcare workers (HCWs) despite evidence of improved immunity against the SARS-COV-2 δ (delta) and ο (omicron) variants. Although most studies have used a questionnaire to assess hesitancy, we aimed to identify factors affecting booster hesitancy by examining actual vaccine uptake across time. Methods: COVID-19 vaccination database records were extracted for HCWs working at 7 Singaporean public primary-care clinics between January and December 2021. Data included sex, profession, place of practice, vaccination type, and dates. Time to booster was calculated from the date of vaccination minus the date of eligibility. The χ2 test was used to compare the relationship between first dose and booster hesitancy. The Kaplan-Meier method and the log-rank test were used to evaluate differences in cumulative booster uptake. Multivariate Cox regression was used to investigate predictors of timely booster vaccination. The vaccination rate was charted across time and was corroborated with media releases pertaining to legislative changes. Results: Of 891 primary-care HCWs, 877 (98.9%) were fully vaccinated and 73.8% of eligible HCWs had taken the booster. HCWs were less booster hesitant (median, 16 days; range, 5–31.3) compared to the first dose (median, 39 days; range, 13–119.3). First-dose–hesitant HCWs were more likely to be booster hesitant (OR, 3.66; 95% CI, 2.61–5.14). Adjusting for sex, workplace, and time to first dose, ancillary HCWs (HR, 1.53; 95% CI, 1.03–2.28), medical HCWs (HR, 1.8; 95% CI, 1.18–2.74), and nursing HCWs (HR, 1.8; 95% CI, 1.18–2.37) received boosters earlier than administrative staff. No temporal relationship was observed for booster uptake, legislative changes, or COVID-19 case numbers. Conclusions: Vaccine hesitancy among HCWs had improved from first dose to booster, with timely booster vaccination among medical and nursing staff. Tailored education, risk messaging, and strategic legislation might help reduce delayed booster vaccination. This study was approved by the National Healthcare Group (NHG) Domain Specific Review Board (DSRB), Singapore on December 28, 2021 (Reg No. 2021/01120).

Neurocognitive development is a dynamic process over the life course and is influenced by intrauterine factors as well as later life environment. Using data from the Pune Maternal Nutrition Study from 1994 to 2008, we investigate the association of in utero, birth, and childhood conditions with offspring neurocognitive development in 686 participants of the cohort, at age 12 years. The life course exposure variables in the analysis include maternal pre-pregnancy size and nutrition during pregnancy, offspring birth measurements, nutrition and physical growth at age 12 years along with parental education and socio-economic status. We used the novel Bayesian Model Averaging (BMA) approach; which has been shown to have better predictive performance over traditional tests of associations. Our study employs eight standard neurocognitive tests that measure intelligence, working memory, visuo-conceptual and verbal learning, and decision-making/attention at 12 years of age. We control for nutritional-metabolic information based on blood measurements from the pregnant mothers and the children at 12 years of age. Our findings highlight the critical role of parental education and socio-economic background in determining child neurocognitive performance. Maternal characteristics (pre-pregnancy BMI, fasting insulin during pregnancy) and child height at 12 years were also robust predictors on the BMA. A range of early factors – such as maternal folate and ferritin concentrations during pregnancy, and child’s head circumference at birth – remained important determinants of some dimensions of child’s neurocognitive development, but their associations were not robust once we account for model uncertainty. Our results suggest that intrauterine influences on long- term neurocognitive outcomes may be potentially reversible by post-birth remediation. In addition to the current nutritional interventions, public health policy should also consider social interventions in children born into families with low socio-economic status to improve human capital.

Following Bridgeman, we demonstrate several families of infinite dilogarithm identities associated with Fibonacci numbers, Lucas numbers, convergents of continued fractions of even periods, and terms arising from various recurrence relations.

By combining multiple input multiple output (MIMO) technology and multiple matched filters with frequency diverse array (FDA), FDA-MIMO radar can be used to achieve two-dimensional target localization with range and angle. In this paper, we propose two FDA-MIMO multi-pulse target localization methods based on tensor decomposition. Based on the canonical polyadic decomposition theory, the signal models of CPD-DP-FDA with double-pulse and CPD-SP-FDA with stepped frequency pulses are established. By analyzing the signal processing procedures of the two schemes, the indicator beampattern used for target localization is obtained. The parameter estimation accuracy of the proposed method is investigated in single target and multiple targets scenarios, and the proposed method is compared with the traditional double-pulse method. The results show that the target localization method based on tensor decomposition can effectively solve the problem of multi-target indication ambiguity. The target positioning effect can be further improved by combining stepped frequency pulses. The derivation of Cramer–Rao Lower Bound (CRLB) demonstrates the superiority of the method.