Wipe it off: A meta-analytic review of the psychological consequences and antecedents of physical cleansing.

Physical cleansing is a human universal. It serves health and survival functions. It also carries rich psychological meanings that interest scholars across disciplines. What psychological effects result from cleansing? What psychological states trigger cleansing? The present meta-analysis takes stock of all experimental studies examining the psychological consequences and antecedents of cleansing-related thoughts, feelings, and behaviors (e.g., feeling less guilty after cleansing; spontaneously cleansing oneself after thinking of unwelcomed sexual encounter). It includes 129 records, 230 experiments, and 551 effects from 42,793 participants. Effect sizes were synthesized in random-effects models using robust variance estimates with small-sample corrections, supplemented by other techniques. Outliers were excluded using leave-one-out diagnostics and sensitivity analysis. Publication bias was assessed and corrected for using eight methods. Theoretical, methodological, sample, and report moderators were coded. After excluding outliers, without bias correction, the synthesized effect size estimate was g = 0.315, 95% CI [0.277, 0.354]. Using various bias correction methods, the estimate ranged from g = 0.103 to 0.331 and always exhibited considerable heterogeneity. Effect sizes were especially large for behavioral measures and varied significantly between sample types, sample regions, and report types. Meanwhile, effects were domain-general (observed in the moral domain and beyond), bidirectional (physical cleansing ↔ psychological variables), and robust across theoretical types, manipulation operationalizations, and study designs. Limitations included mixed replicability, suboptimal methodological rigor, and restricted sample diversity. We recommend future studies to (a) incorporate power analysis, preregistration, and replication; (b) investigate generalizability across samples; (c) strengthen discriminant validity; and (d) test competing theoretical accounts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Acceptability of self-administered antigen test for COVID-19 in the Philippines.

OBJECTIVES: In response to the Omicron surge in early 2022, the HTA Philippines evaluated the acceptability of Filipinos in using self-administered antigen tests (SAAgTs) as part of COVID-19 HTAs in the Philippines. METHODS: Scoping review from literature databases was initially conducted to identify preset codes in the use of SAAgT. Preset codes were used to establish the questions for focus group discussions (FGDs). Semi-structured questionnaires were created through Delphi technique. FGDs with four stakeholder groups (i.e., nine healthcare workers [HCWs], seven representatives of at-risk groups, six economic frontliners, and seven representatives of micro-small-medium-sized enterprises) were conducted. RESULTS: Discomfort in being a target of stigma and being prescribed an "illness identity" when suspected or confirmed COVID-19-positive, along with lack of confidence to perform self-test, caused hesitancy in self-testing among participants. The need for subsidies for test kits from the government or employers was emphasized to increase its accessibility. Having a designated access point and reporting system for SAAgT was highlighted to avoid nepotism (padrino system attributed to debt of gratitude), inequitable distribution, and lapses in reporting. A participatory approach to education was perceived as crucial to reduce any misconceptions associated with the use of SAAgT. CONCLUSIONS: All FGD groups expressed favorable reviews on the implementation of SAAgT because it can potentially reduce the burden of health facility-administered tests. These findings were considered by the HTA Council in the recommendation of SAAgT as part of the overarching national strategies for the diagnosis and screening of COVID-19.

Epidemiology and antimicrobial resistance profile of invasive non-typhoidal Salmonella from the Philippines Antimicrobial Resistance Surveillance Program, 2014-2018.

Objective: The epidemiology of invasive non-typhoidal Salmonella (iNTS) in the Philippines is not well elaborated. The present study describes the serotype distribution and antimicrobial susceptibility patterns of iNTS in the Philippines from 2014 to 2018. Methods: Invasive NTS isolates were collected through the Department of Health's Antimicrobial Resistance Surveillance Program (ARSP). The identification of the isolates was confirmed using automated (Vitek®, bioMérieux, Marcy l'Étoile, France) and conventional methods. The isolates were serotyped using the slide agglutination method, and susceptibility testing was performed using Clinical and Laboratory Standards Institute guidelines. Demographic data were collected from the ARSP database. Results: There were 138 isolates collected from human invasive specimens with 97.8% from blood samples. The most common serotypes were Salmonella Enteritidis (n = 84, 60.9%) and Salmonella Typhimurium (n = 18, 13.0%). Most of the isolates were from males (n = 88, 63.8%) and from the 0-5-year age group (n = 61, 44.2%). The proportions of iNTS isolates resistant to first-line antibiotics were as follows: ampicillin (23.2%), chloramphenicol (9.6%), ciprofloxacin (8.7%), ceftriaxone (2.2%) and trimethoprim-sulfamethoxazole (8.8%). The proportion of isolates with multidrug resistance was 13.0% (18/138) with the most common resistance profile being resistance to ampicillin-chloramphenicol-ciprofloxacin from Salmonella Enteritidis isolates (n = 5). Discussion: Resistance to first-line antibiotics limits the therapeutic choices for Salmonella infection. Relevant local antimicrobial resistance data on iNTS may support appropriate empiric therapy among vulnerable populations.

Pain sensitivity predicts support for moral and political views across the aisle.

We live in a time of exacerbating political polarization. Bridging the ideological divide is hard. Although some strategies have been found effective for interpersonal persuasion and interaction across the aisle, little is known about what intrapersonal attributes predict which individuals are more inclined to support their ideological opponent's views. The present work identifies a low-level attribute-sensitivity to physical pain-that robustly predicts individual variations in support for moral and political views typically favored by one's ideological opponent. We first summarize a psychophysical validation of an established pain sensitivity measure (n = 263), then report a series of exploratory and preregistered confirmatory studies and replications (N = 7,360) finding that more (vs. less) pain-sensitive liberal Americans show greater endorsement of moral foundations typically endorsed by conservatives (Studies 1a-1c), higher likelihood of voting for Trump over Biden in the 2020 presidential election, stronger support for Republican politicians, and more conservative attitudes toward contentious political issues (Studies 2a and 2b). Conservatives show the mirroring pattern. These "cross-aisle" effects of pain sensitivity are driven by heightened harm perception (Study 3). They defy lay intuitions (Study 4). They are not attributable to multicollinearity or response set. The consistent findings across studies highlight the value of deriving integrative predictions from multiple previously unconnected perspectives (social properties of pain, moral foundations theory, dyadic morality theory, principle of multiple determinants in higher mental processes). They open up novel directions for theorizing and research on why pain sensitivity predicts support for moral and political views across the aisle. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Gut microbiota short-chain fatty acids and their impact on the host thyroid function and diseases.

Thyroid disorders are clinically characterized by alterations of L-3,5,3',5'-tetraiodothyronine (T4), L-3,5,3'-triiodothyronine (T3), and/or thyroid-stimulating hormone (TSH) levels in the blood. The most frequent thyroid disorders are hypothyroidism, hyperthyroidism, and hypothyroxinemia. These conditions affect cell differentiation, function, and metabolism. It has been reported that 40% of the world's population suffers from some type of thyroid disorder and that several factors increase susceptibility to these diseases. Among them are iodine intake, environmental contamination, smoking, certain drugs, and genetic factors. Recently, the intestinal microbiota, composed of more than trillions of microbes, has emerged as a critical player in human health, and dysbiosis has been linked to thyroid diseases. The intestinal microbiota can affect host physiology by producing metabolites derived from dietary fiber, such as short-chain fatty acids (SCFAs). SCFAs have local actions in the intestine and can affect the central nervous system and immune system. Modulation of SCFAs-producing bacteria has also been connected to metabolic diseases, such as obesity and diabetes. In this review, we discuss how alterations in the production of SCFAs due to dysbiosis in patients could be related to thyroid disorders. The studies reviewed here may be of significant interest to endocrinology researchers and medical practitioners.

Machine learning applied in maternal and fetal health: a narrative review focused on pregnancy diseases and complications.

Introduction: Machine learning (ML) corresponds to a wide variety of methods that use mathematics, statistics and computational science to learn from multiple variables simultaneously. By means of pattern recognition, ML methods are able to find hidden correlations and accomplish accurate predictions regarding different conditions. ML has been successfully used to solve varied problems in different areas of science, such as psychology, economics, biology and chemistry. Therefore, we wondered how far it has penetrated into the field of obstetrics and gynecology. Aim: To describe the state of art regarding the use of ML in the context of pregnancy diseases and complications. Methodology: Publications were searched in PubMed, Web of Science and Google Scholar. Seven subjects of interest were considered: gestational diabetes mellitus, preeclampsia, perinatal death, spontaneous abortion, preterm birth, cesarean section, and fetal malformations. Current state: ML has been widely applied in all the included subjects. Its uses are varied, the most common being the prediction of perinatal disorders. Other ML applications include (but are not restricted to) biomarker discovery, risk estimation, correlation assessment, pharmacological treatment prediction, drug screening, data acquisition and data extraction. Most of the reviewed articles were published in the last five years. The most employed ML methods in the field are non-linear. Except for logistic regression, linear methods are rarely used. Future challenges: To improve data recording, storage and update in medical and research settings from different realities. To develop more accurate and understandable ML models using data from cutting-edge instruments. To carry out validation and impact analysis studies of currently existing high-accuracy ML models. Conclusion: The use of ML in pregnancy diseases and complications is quite recent, and has increased over the last few years. The applications are varied and point not only to the diagnosis, but also to the management, treatment, and pathophysiological understanding of perinatal alterations. Facing the challenges that come with working with different types of data, the handling of increasingly large amounts of information, the development of emerging technologies, and the need of translational studies, it is expected that the use of ML continue growing in the field of obstetrics and gynecology.

Insights into Early Steps of Decanoic Acid Self-Assemblies under Prebiotic Temperatures Using Molecular Dynamics Simulations.

The origin of life possibly required processes in confined systems that facilitated simple chemical reactions and other more complex reactions impossible to achieve under the condition of infinite dilution. In this context, the self-assembly of micelles or vesicles derived from prebiotic amphiphilic molecules is a cornerstone in the chemical evolution pathway. A prime example of these building blocks is decanoic acid, a short-chain fatty acid capable of self-assembling under ambient conditions. This study explored a simplified system made of decanoic acids under temperatures ranging from 0 °C to 110 °C to replicate prebiotic conditions. The study revealed the first point of aggregation of decanoic acid into vesicles and examined the insertion of a prebiotic-like peptide in a primitive bilayer. The information gathered from this research provides critical insights into molecule interactions with primitive membranes, allowing us to understand the first nanometric compartments needed to trigger further reactions that were essential for the origin of life.

Transient gestational hypothyroxinemia accelerates and enhances ulcerative colitis-like disorder in the male offspring.

Introduction: Gestational hypothyroxinemia (HTX) is a condition that occurs frequently at the beginning of pregnancy, and it correlates with cognitive impairment, autism, and attentional deficit in the offspring. Evidence in animal models suggests that gestational HTX can increase the susceptibility of the offspring to develop strong inflammation in immune-mediated inflammatory diseases. Ulcerative colitis (UC) is a frequent inflammatory bowel disease with unknown causes. Therefore, the intensity of ulcerative colitis-like disorder (UCLD) and the cellular and molecular factors involved in proinflammatory or anti-inflammatory responses were analyzed in the offspring gestated in HTX (HTX-offspring) and compared with the offspring gestated in euthyroidism (Control-offspring). Methods: Gestational HTX was induced by the administration of 2-mercapto-1-methylimidazole in drinking water to pregnant mice during E10-E14. The HTX-offspring were induced with UCLD by the acute administration of dextran sodium sulfate (DSS). The score of UCLD symptomatology was registered every day, and colon histopathology, immune cells, and molecular factors involved in the inflammatory or anti-inflammatory response were analyzed on day 6 of DSS treatment. Results: The HTX-offspring displayed earlier UCLD pathological symptoms compared with the Control-offspring. After 6 days of DSS treatment, the HTX-offspring almost doubled the score of the Control-offspring. The histopathological analyses of the colon samples showed signs of inflammation at the distal and medial colon for both the HTX-offspring and Control-offspring. However, significantly more inflammatory features were detected in the proximal colon of the HTX-offspring induced with UCLD compared with the Control-offspring induced with UCLD. Significantly reduced mRNA contents encoding for protective molecules like glutamate-cysteine ligase catalytic subunit (GCLC) and mucin-2 (MUC-2) were found in the colon of the HTX-offspring as compared with the Control-offspring. Higher percentages of Th17 lymphocytes were detected in the colon tissues of the HTX-offspring induced or not with UCLD as compared with the Control-offspring. Discussion: Gestational HTX accelerates the onset and increases the intensity of UCLD in the offspring. The low expression of MUC-2 and GCLC together with high levels of Th17 Lymphocytes in the colon tissue suggests that the HTX-offspring has molecular and cellular features that favor inflammation and tissue damage. These results are important evidence to be aware of the impact of gestational HTX as a risk factor for UCLD development in offspring.

Hora Dorada de neutropenia febril en cáncer pediátrico Hospital de Niños "J. M. de los Ríos"

Tratamientos intensificados se asocian con neutropenia severa, identificada como factor de riesgo de complicaciones infecciosas en pacientes con enfermedades neoplásicas. Objetivo: Evaluar la importancia del momento de inicio del tratamiento antibiótico en la evolución y pronóstico de pacientes con neutropenia febril (NF) por Cáncer ingresados al Hospital de Niños "J.M. de los Ríos" entre febrero 2020 ­ febrero 2022. Métodos: Estudio descriptivo, prospectivo, transversal, analítico, se registró formulario de recolección de datos y base de datos Google Drive para análisis estadístico por distribución de frecuencias y porcentajes. Se entregó Consentimiento y Asentimiento Informado a padres y pacientes, ambos aprobados por Comisión de Bioética, capacitándose en manejo de fiebre neutropénica. Incluyó pacientes con fiebre durante la primera hora después de recibir quimioterapia, indicándoseles antibióticos. Resultados: Sexo masculino 63,2 % (36/57) de los casos de NF y preescolares 43,9 % (25/57) fueron los más afectados. Leucemia Linfocítica Aguda fue el cáncer más frecuente 68,4 % (39/57) y Bacteriemia 40,4 % (23/57) la patología infecciosa predominante. Evolucionaron satisfactoriamente en la mayoría de los casos; la Media de la estancia hospitalaria fue 14,56 días, más prolongada en pacientes con Leucemia Linfocítica Aguda en fase de inducción. Gramnegativos los aislamientos predominantes 35,1 % (20/57), representados por Pseudomonas aeruginosa. El tiempo de cumplimiento de antibióticos fue 4 - 12 horas desde el inicio de fiebre. Mortalidad ocurrió por enfermedad de base mal controlada. Conclusiones: Cumplimiento de antibióticos durante la primera hora de fiebre neutropénica en pacientes pediátricos con cáncer disminuye complicaciones infecciosas, estancia hospitalaria y mortalidad.

Intensified treatments are associated with severe neutropenia, identified as a risk factor for infectious complications in patients with neoplastic diseases. Objective: To evaluate the importance of the moment of initiation of antibiotic treatment in the evolution and prognosis of patients with febrile neutropenia (NF) due to Cancer admitted to the Hospital de Niños J.M. de los Ríos between February 2020 - February 2022. Methods: Descriptive, prospective, cross-sectional, analytical study, a data collection form and Google Drive database were registered for statistical analysis by distribution of frequencies and percentages. Consent and Informed Assent were given to parents and patients, both approved by the Bioethics Commission, training in the management of neutropenic fever. It included patients with fever during the first hour after receiving chemotherapy, indicating antibiotics. Results: Male sex 63.2 % (36/57) of the cases of NF and preschoolers 43.9 % (25/57) were the most affected. Acute Lymphocytic Leukemia was the most frequent cancer 68.4 % (39/57) and Bacteremia 40.4 % (23/57) the predominant infectious pathology. They evolved satisfactorily in most cases; Mean hospital stay was 14.56 days, longer in patients with Acute Lymphocytic Leukemia in the induction phase. Gram-negative the predominant isolates 35.1 % (20/57), represented by Pseudomonas aeruginosa. Antibiotic compliance time was 4 - 12 hours from the onset of fever. Mortality occurred due to poorly controlled underlying disease. Conclusions: Antibiotic compliance during the first hour of neutropenic fever in pediatric patients with cancer reduces infectious complications, hospital stay and mortality.

Relationships between Social Networking Sites Use and Self-Esteem: The Moderating Role of Gender.

With the prevalence of the internet, there is growing attention on the impacts of social networking sites use among adolescents. The purpose of this study was to explore the relationships between different types of online activities (i.e., information searching, social interaction and entertainment) and self-esteem. It examined whether the relationships vary across gender. One hundred and ninety-three students (57.5% males; Mage = 13.33, SDage = 1.58) participated in the present study. Unexpectedly, the associations between online activities and self-esteem were not significant (p > 0.05). Path analysis showed gender moderated the relationships between social interaction activities and self-esteem. Females reported higher levels of engagement in social interaction activities and self-esteem than their male counterparts. The present study shows the importance of assessing different types of online activities as a predictor for understanding the impact of social media use among adolescents.

Risk Factors from Pregnancy to Adulthood in Multiple Sclerosis Outcome.

Multiple sclerosis (MS) is an autoimmune disease characterized by a robust inflammatory response against myelin sheath antigens, which causes astrocyte and microglial activation and demyelination of the central nervous system (CNS). Multiple genetic predispositions and environmental factors are known to influence the immune response in autoimmune diseases, such as MS, and in the experimental autoimmune encephalomyelitis (EAE) model. Although the predisposition to suffer from MS seems to be a multifactorial process, a highly sensitive period is pregnancy due to factors that alter the development and differentiation of the CNS and the immune system, which increases the offspring's susceptibility to develop MS. In this regard, there is evidence that thyroid hormone deficiency during gestation, such as hypothyroidism or hypothyroxinemia, may increase susceptibility to autoimmune diseases such as MS. In this review, we discuss the relevance of the gestational period for the development of MS in adulthood.

Molecular characterization of drug-resistant Mycobacterium tuberculosis among Filipino patients derived from the national tuberculosis prevalence survey Philippines 2016.

Tuberculosis, caused by Mycobacterium tuberculosis, remains a high burden disease and leading cause of mortality in the Philippines. Understanding the genetic diversity of M. tuberculosis strains in the population, including those that are multi-drug resistant (MDR), will aid in formulating strategies for effective TB control and prevention. By whole genome sequencing of M. tuberculosis isolates (n = 100) from patients of the Philippine 2016 National Tuberculosis Prevalence Survey, we sought to provide a baseline assessment of the genotypic and phylogenetic characteristics of the isolates. The majority (96/100) of the isolates were EAI2-Manila strain-type (lineage 1), with one Lineage 2 (Beijing), one Lineage 3 (CAS1), and two Lineage 4 (LAM9) strains. The EAI2-Manila clade was not significantly associated with patient's phenotypic and in silico drug resistance profile. Five (5/6) MDR-TB isolates predicted by in silico profiling were concordant with phenotypic drug resistance profile. Twenty-one mutations were identified in nine drug resistance-related genes, all of which have been reported in previous studies. Overall, the results from this study contribute to the growing data on the molecular characteristics of Philippine M. tuberculosis isolates, which can help in developing tools for rapid diagnosis of TB in the country, and thereby reducing the high burden of disease.

Beliefs on the causes of birth defects as perceived by mothers of children with birth defects in a tertiary care hospital in the Philippines.

There are several ethnolinguistic groups or ethnicities in the Philippines, and genetic counselors may encounter clients with diverse beliefs, inscribed by their culture, about health conditions. Thus, clients may attribute the cause of a birth defect to a socio-culturally based health belief. The present study aimed to explore the beliefs on the causes of birth defects held by mothers of children diagnosed to have birth defects. The study was conducted as a qualitative descriptive pilot study in Baguio General Hospital and Medical Health Center (BGHMC), a birth defect surveillance site tertiary care hospital in the Philippines. Participants were mothers of children diagnosed to have birth defects at the BGHMC. In-depth interviews were used to collect data from 18 participants aged 18-46 years. Birth defect conditions of the participants' children included congenital heart defect, cleft lip and palate, hydrocephalus, imperforate anus, hypospadias, and microcephaly. When the participants were asked about their views on the causes of birth defects in their children, they perceived that genetics or heredity, stress, a fall during pregnancy, maternal sickness, teenage pregnancy, thin uterine lining, twin-twin transfusion syndrome, and God's will have caused it. Findings also showed that mothers of children with the birth defect have both biomedically and socio-culturally based health beliefs. Awareness of these health belief systems will help the genetic counselor provide appropriate genetics education and psychosocial support to their clients.

The impact of the micronutrient iodine in health and diseases.

Adequate iodine nutrition is crucial for all mammals by playing his starring role as a component of thyroid hormones, which are key regulators of cellular processes for life such as differentiation, growth, function, and metabolism. Deficiency or excess of iodine in the diet are worldwide highly frequent conditions that are responsible of health problems like hypothyroidism, hypothyroxinemia, goiter, thyroiditis, hyperthyroidism, and autoimmune thyroid diseases among others. The incorporation of iodine in salt or other nutrients resolved the consequences of severe iodine deficiency like goiter, cretinism. However, this strategy in several countries led to other ailments like Hashimoto autoimmune thyroiditis, hyperthyroidism, and hypothyroidism. The goal of this review is to analyze and discuss the different aspects of iodine nutrition for human health comprising its biological role through thyroid hormones, pathogen control, and the regulation of the intestinal microbiota.

Respiratory viral infections during pregnancy: effects of SARS-CoV-2 and other related viruses over the offspring.

Little is known about the consequences of viral infection for pregnant woman or for the fetus. This issue became important with the appearance of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The infection with SARS-CoV-2 causes a respiratory syndrome known as COVID-19. The fast spreading around the world and the fact that without a treatment or vaccine humans are completely exposed, converts emerging viral diseases in a significant risk for pregnant women and their infants. At this time, during SARS-CoV-2 pandemics pregnant women are not considered as a risk population and little is known about the effects of viral infections over the offspring although the amount of emerging evidence showing detrimental effects for the mother and the fetus. This issue highlights the importance to understand the effects of viral infections during pregnancy. In this work, we analyze the effects of viral infections, like SARS-CoV-2 and other related viruses during pregnancy over the mother and the consequences for the offspring.

Operational challenges of the Philippine Antimicrobial Resistance Surveillance Program during the COVID-19 pandemic.

Problem: Operation of the Philippine Antimicrobial Resistance Surveillance Program (ARSP) has been affected by the coronavirus disease 2019 (COVID-19) pandemic, during which time difficulties in maintaining laboratory functions, staffing levels and participation were reported. Context: The COVID-19 pandemic has increased pressure on most health systems and programmes in the Philippines, including ARSP. As ARSP is the source of national data on antimicrobial resistance (AMR) trends, there are concerns that the negative effects of the pandemic may have impacted the quality of data produced. Action: We describe disruptions to laboratory operations, personnel availability and participation in ARSP surveillance, and their impact on reported data for 2020. Outcome: Surveillance operations were challenged by reallocation of human, infrastructure and financial resources for pandemic response among both the sentinel sites and the coordinating laboratory, the Antimicrobial Resistance Surveillance Reference Laboratory. There was a decrease in the amount of data submitted to the surveillance system, as well as in the number of isolates sent to the reference laboratory for confirmation of bacterial identification and antimicrobial susceptibility testing. Nevertheless, overall performance scores of the sentinel sites for most parameters were comparable to 2019, the year before the pandemic. Discussion: The impact of operational changes to ARSP due to the pandemic needs to be considered when analysing AMR surveillance data from 2020. Automation of data submission, good working relationships between the coordinating laboratory and sentinel sites, and supply chain system strengthening were identified as key to maintaining AMR surveillance during the COVID-19 pandemic.

Asymptomatic Herpes Simplex Virus Type 1 Infection Causes an Earlier Onset and More Severe Experimental Autoimmune Encephalomyelitis.

Multiple sclerosis (MS) is an increasingly prevalent progressive autoimmune and debilitating chronic disease that involves the detrimental recognition of central nervous system (CNS) antigens by the immune system. Although significant progress has been made in the last decades on the biology of MS and the identification of novel therapies to treat its symptoms, the etiology of this disease remains unknown. However, recent studies have suggested that viral infections may contribute to disease onset. Interestingly, a potential association between herpes simplex virus type 1 (HSV-1) infection and MS has been reported, yet a direct relationship among both has not been conclusively demonstrated. Experimental autoimmune encephalomyelitis (EAE) recapitulates several aspects of MS in humans and is widely used to study this disease. Here, we evaluated the effect of asymptomatic brain infection by HSV-1 on the onset and severity of EAE in C57BL/6 mice. We also evaluated the effect of infection with an HSV-1-mutant that is attenuated in neurovirulence and does not cause encephalitis. Importantly, we observed more severe EAE in mice previously infected either, with the wild-type (WT) or the mutant HSV-1, as compared to uninfected control mice. Also, earlier EAE onset was seen after WT virus inoculation. These findings support the notion that a previous exposure to HSV-1 can accelerate and enhance EAE, which suggests a potential contribution of asymptomatic HSV-1 to the onset and severity of MS.

Factors associated with attrition among residents in pediatrics: A mixed-method study in a single center in the Philippines

@#<p style="text-align: justify;"><strong>Background.</strong> Attrition in residency training can lead to lower workplace morale and increased costs. Finding associated factors can help revise admissions criteria or identify at-risk residents.</p><p style="text-align: justify;"><strong>Objective.</strong> We aimed to determine factors associated with attrition among residents in pediatrics.</p><p style="text-align: justify;"><strong>Methods.</strong> We applied a mixed cross-sectional (survey) and retrospective cohort (records review) study design. Residents who began training in the Philippine General Hospital in 2012-2018 were included. Our primary outcomes were non-completion of training within three years (attrition), completion beyond three years or ongoing training at a delayed year level (off-cycle), and the composite of attrition or off-cycle. Fisher's exact probability test and t-test were used to compare the non-attrition group versus the attrition group, and the non-attrition group versus the attrition or off-cycle group.</p><p style="text-align: justify;"><strong>Results.</strong> The overall attrition rate and off-cycle rate among 162 residents were 7.41% and 4.32%, respectively. The survey response rate was 73.00%. Four factors were significantly associated with attrition: higher age at entry into the program (p = 0.030), advanced degree (p = 0.009), longer interval from internship completion to start of residency training (p = 0.017), and a lower case presentation score (p = 0.048). The proportion of respondents older than 29 years was significantly higher in the attrition group than the non-attrition group (40.00% vs 0.94%, p = 0.031). Higher age at entry was also significantly associated with the composite outcome (attrition or off-cycle).</p><p style="text-align: justify;"><strong>Conclusion.</strong> Older age at entry, advanced degree, a longer interval from internship, and lower-case presentation scores were associated with attrition among residents in pediatrics from a single center.</p>