Ethical Implications of Mentor Influence on Career Choices in Dermatology.

Mentorship is a critical aspect of personal and professional development throughout anyone's life. Unlike many other fields, a medical career is a long multistep process that can begin in high school and continue throughout a physician's career. When considering competitive specialties such as dermatology, mentors are increasingly crucial in helping students successfully match to programs of their choice, but the variability and extent of mentorship can raise ethical concerns. We discuss the evolution of mentorship in dermatology and the potential ethical issues involved. We propose possible solutions to the ethical conflict between mentor and mentee.

Deep margin elevation with one-year follow-up: A case report.

Deep margin elevation (DME) is a conservative treatment of a tooth with extensive subgingival caries. It is an alternative approach to more invasive restorative procedures. The DME enables successful tooth isolation to do root canal treatments and enables performing indirect restorations, improving dental function and patient comfort without complications.

Air mycobiome in the National Library of Greece following relocation to novel premises.

The aim of this work was to study the diversity and spatiotemporal fluctuations of airborne fungi in the National Library of Greece after its relocation from the Vallianeio historic building in the center of Athens to entirely new premises at the Stavros Niarchos Foundation Cultural Center, and also to compare the fungal aerosol in between the two sites. The air mycobiota were studied by a volumetric culture-based method, during the year 2019 in order to assess their diversity and abundance and to compare with those previously reported in the historic building. Twenty-eight genera of filamentous fungi were recovered indoors and 17 outdoors, in addition to yeasts registered as a group. The number of fungal genera recovered was almost similar in both premises, whereas seventeen genera indoors were identical, dominated by Penicillium, Cladosporium and Aspergillus. The mean daily fungal concentration was found to be 66 CFU m-3 indoors and 927 CFU m-3 outdoors in the new location vs 293 and 428 CFU m- 3 indoors and 707 and 648 CFU m- 3 outdoors in the previous one. The mean daily concentration indoors was consistently and significantly lower (P < 0.05) in the new building than in the historic one, although it was higher outdoors. The indoor/outdoor ratio for the total fungi was 0.07 in the new vs 0.41 and 0.66 in the previous one and reveals a superior indoor air quality in the new site. Air temperature and occupancy had a statistically significant impact on the concentration of indoor fungi. The remarkably reduced concentration of the mycobiota in the new premises indicated a considerable decline in fungal burden, mainly due to technological excellency of the facility and continuous preventive measures to ensure an enhanced indoor air quality in the National Library of Greece. This case study provides a paradigm about upgrading of indoor air after re-establishment of a facility in another setting.

Sources of PM2.5 exposure misclassification in three Finnish register-based study populations and the impact on attenuation of health effect estimates.

Air pollution is a leading environmental health risk factor. The risk estimates, primarily based on air pollution epidemiology, are sensitive to exposure misclassification, which can result in underestimation. To address some of these challenges, our aim is to investigate how the length of the period over which the exposure is averaged, trends in long-term PM2.5 concentrations, and the seasonal variability are associated with each other. Furthermore, we assess the impact of residential relocation on exposure levels and quantify random exposure misclassification due to modelling and its impact on the attenuation of effects with respect to averaging time. We used nested air quality modelling across Finland, gridded population, and address histories from three study populations: the MATEX pregnancy and preschool children cohorts, as well as the FINPARK study's individuals diagnosed with Parkinson's disease and their controls, to estimate PM2.5 exposures. The prediction error was estimated by comparing modelled concentrations to observations and by using previous estimates for random monitoring instrument error. Due to the decreasing trend in PM2.5 concentrations, exposure levels rose progressively with longer averaging times, increasing by up to 28 % over a 16-year period. The shorter the exposure period, the more pronounced the seasonal effects: pregnant mothers' trimester-specific exposures were 13-22 % higher for trimesters ending in spring and 10-16 % lower for those ending in autumn compared to the average for the entire pregnancy. Residential relocation had a relatively minor impact on the exposure levels of the preschool children and adult FINPARK study population, but this effect was possibly partly masked by the decreasing trend. The results indicated that using predicted concentrations led to random exposure misclassification and potentially attenuated health effects. This effect became more notable when increasing the length of the exposure period from 3 months to 5 years, doubling the underestimation ratio from 1.5 to 3.1.

An estimation of future county-level cement production and associated air pollutant emissions in China through artificial neural networks.

Cement production and its air pollutant and carbon dioxides (CO2) emissions in China will be relocated greatly as a joint effect of diverse development of industrial economy and implementation of environmental policies for different regions. The future pathway and spatial pattern of emissions are important for policy making of air quality improvement and CO2 emission abatement, as well as coordinating regional development. In this study, we developed an artificial neural network (ANN) model to predict cement production at the county level and to calculate the associated emissions of air pollutants and CO2 at the county level till 2060. Results show that the cement production will decline from 2327 million metric tons (Mt) in 2015 to 704 Mt. in 2060 under the Shared Socioeconomic Pathways 1 (SSP1). Counties closer to provincial capital will experience greater retirement of cement industry. Likewise, the emissions of air pollutants and CO2 will experience a steady downward trend driven by the declining cement production and the improvement of pollution control technologies. There will be a more significant regional heterogeneity in the reduction of production and emissions at city level compared to the province level. With the clearance for nearly two-thirds of counties, future cement production and emissions will be more intensively distributed in a few cities. The shares of emissions in southwestern regions will grow from 2015 to 2060 while those of eastern regions will continue decreasing. The comparison between the changing spatial distributions of emissions and gross domestic product (GDP) indicates a positive effect of existing policies in reconciling regional economic development and air pollution controls. The outcome could support the analyses on the impact of industrial development on air quality and public health, and the method can be applied widely for other industrial sectors for a more comprehensive understanding of future emission relocation.

Expecting Relocation to a Nursing Home: Longitudinal Links with Functional Limitations, Self-Rated Health, and Life Satisfaction.

INTRODUCTION: Developing realistic expectations of future old age constitutes an adaptational process which facilitates the anticipation of and adjustment to challenges, such as relocation to a nursing home. Developing such expectations might minimize the negative impacts of relocation. This pre-registered study examined (1) to which extent lower levels and declines in health (i.e., functional limitations and self-rated health) and life satisfaction before relocation were associated with higher levels and increases in expectations to relocate and (2) to which extent higher expectations to relocate were associated with more positive changes in health and life satisfaction after relocation. METHODS: Using data from the Health and Retirement Study (HRS; 2006-2018), we selected older adults (aged 65 years and older) who relocated to a nursing home. We used latent growth curve models to assess the longitudinal links between self-reported measures of health, life satisfaction, and expectations to relocate to a nursing home from up to 7 years before (n = 1,048) until up to 5 years after relocation (n = 307). RESULTS: As hypothesized, more functional limitations and lower self-rated health were related to higher expectations of relocation. Surprisingly, changes in expectations to relocate were not related to changes in health and life satisfaction before relocation. Moreover, expectations to relocate were not associated with changes in health and life satisfaction after relocation. CONCLUSION: The absence of a link between expectations to relocate to a nursing home with changes in health and well-being suggests that these expectations did not constitute adaptational processes before or after this transition.

Sex-based factors influencing perceived relocation stress and glycemic control among older adults with diabetes.

This study investigated sex differences perceived relocation stress and glycemic control among older adults with type 2 diabetes in long-term care facilities. A cross-sectional correlation design was used to recruit 120 residents during their first year after moving into the facilities in southern Taiwan. The results showed that almost two-thirds of the participants (64.2%) were women. The mean age was 79.62 (SD = 1.71). Older women with diabetes were reported to have significantly lower levels of education and poor glycemic control but higher levels of perceived relocation stress than men; however, functional independence was significantly higher in men. Although perceived relocation stress significantly predicted HbA1c levels in both women and men, length of stay was also significant in predicting HbA1c levels in women. These findings indicate the need for effective physical and psychological measures to improve glycemic control during the first year of stay in long-term care facilities.

Long-term evacuation and obesity: a 12-year follow-up comparative study of residents inside and outside Katsurao Village after the Fukushima nuclear disaster.

Objective: Evacuation, owing to a disaster, impacts various aspects of an individual's life, including health status. This study aimed to determine the prevalence of obesity among residents of Katsurao Village, Fukushima Prefecture, after the evacuation order due to the Fukushima nuclear disaster in 2011 was lifted in 2016 and to compare the prevalence of obesity by place of residence (inside or outside the village). Methods: The number of examinees, sex, age, place of residence, body mass index (BMI), exercise habits, smoking habits, drinking habits, and dietary status were extracted from the results of health checkups since 2016. We compared the BMI of the indigenes of Katsurao Village by place of residence (inside or outside the village) over time. Results: Although 7 years have passed since 2016, ~70% of the registered residents of Katsurao Village still live outside the village. The obesity rates have consistently been higher among people living outside the village compared to those inside, and the place of residence was the only factor significantly associated with obesity. Conclusion: The findings of this study suggest early intervention is necessary to prevent health risks associated with disaster evacuation if the evacuation period is prolonged.

Training Outcomes and Satisfaction in Canadian MD/PhD and MD/MSc Programs: Findings from a National Survey.

PURPOSE: Despite the impact of physician-scientists on scientific discovery and translational medicine, several reports have signalled their declining workforce, reduced funding, and insufficient protected research time. Given the paucity of outcome data on Canadian MD/PhD programs, this study presents a national portrait of the sociodemographic characteristics, training trajectories, productivity, and satisfaction in trainees and alumni from Canadian MD/PhD and MD/MSc programs. METHODS: Quantitative data were collected in a national survey launched in 2021. Respondents included 74 MD/PhD alumni and 121 trainees across 12 Canadian MD/PhD and MD/MSc programs. RESULTS: Among MD/PhD alumni, 51% were independent practitioners/researchers while others underwent residency training. Most trainees (88%) were in MD/PhD programs. Significantly more alumni identified as men than did trainees. Significantly more alumni conducted clinical and health services research, while more trainees conducted basic science research. Average time to MD/PhD completion was 8 years, with no correlation to subsequent research outcomes. Self-reported research productivity was highest during MD/PhD training. Concerning training trajectories, most alumni completed residency, pursued additional training, and practised in Canada. Finally, regression models showed that trainees and alumni were satisfied with programs, with significant moderators in trainee models. CONCLUSION: Survey findings showed Canadian MD/PhD and MD/MSc programs recruit more diverse cohorts of trainees than before, provide productive research years, and graduate alumni who pursue training and academic employment in Canada. Both alumni and trainees are largely satisfied with these training programs. The need to collect in-depth longitudinal data on Canadian MD/PhD graduates to monitor diversity and success metrics is discussed.

Nurses on shacking ground-A qualitative study of Danish dermatology and allergology nurses' experiences of relocation during the COVID-19 pandemic.

AIM: To investigate dermatology and allergology nurses' experiences of relocation from an outpatient clinic to a newly established COVID-19 infectious disease ward. DESIGN: A phenomenological-hermeneutical approach was applied. METHODS: Three focus groups with nurses were conducted from June to August 2020. Data were analysed in accordance with Ricoeur's theory of interpretation. RESULTS: The relocation represented a challenging period that involved uncertainty and evoked feelings of excitement and dedication towards the nursing profession. Nurses felt obligated to help; however, they also experienced that they did not have a say in the relocation. The placement on the infectious disease ward was characterized by adaptations in three areas: unfamiliar working environment, unfamiliar team competencies and inadequate nursing training. E-learning training was experienced as insufficient, as it did not enhance the nurses' specific competencies or confidence in caring for patients with COVID-19. CONCLUSION: The relocation of nurses from an outpatient clinic to a new COVID-19 infectious disease ward created a dilemma between nurses' sense of duty and their right to self-determination. A prompt relocation into a newly established unfamiliar field caused frustrations because there were no unspoken rules to rely on. Managers should take nurses' experiences and perceptions under careful consideration and strive for more involvement in future scenarios. PATIENT OR PUBLIC CONTRIBUTIONS: No patient or public contribution.

[Effects of food waste biogas residue composting on soil aggregates and its organic matter content in relocation site]. / åŽ¨ä½™åžƒåœ¾æ²¼æ¸£å †è‚¥å¯¹æ¬è¿åœ°åœŸå£¤å›¢èšä½“åŠå ¶æœ‰æœºè´¨å«é‡çš„å½±å“.

Understanding the effects of food waste biogas residue composting and chemical amendments on soil aggregates composition of different particle sizes, stability, and organic matter distribution in relocation sites could provide primary data for improving soil quality and land utilization of food waste biogas residue composting. We analyzed the characteristics of soil aggregates distribution, stability of aggregates, and organic matter content in different particle sizes under treatments with different application amounts of food waste biogas residue composting, chemical amendments (ß-cyclodextrin, calcium sulfate and ferric oxide were mixed at a mass ratio of 1:1:1), and control (100% soil). The results showed that 20% (soil: biogas residue composting=8:2) and 30% (soil: biogas residue composting =7:3) biogas residue composting significantly decreased the micro-aggregates content with the particle size of <0.106 mm and increased the large aggregates content with the particle size of 0.5-1.0 mm. All treatments significantly increased large aggregates content with the particle size of ≥2.0 mm, soil aggregate structure content, and mean weight diameter, but reduced the percentage of aggregate destruction. Among all the treatments, the effect of mixes application of 20% biogas residue composting and chemical amendments was the best. Biogas residue composting treatments significantly affected the distribution of organic matter in soil aggregates, with the strongest effect under 30% biogas residue composting treatment. Biogas residue composting treatments significantly increased soil organic matter content in all aggregates, with the maximal increase of organic matter content in soil micro-aggregates with the particle size of 0.106-0.25 mm. In conclusion, biogas residue composting could increase organic matter content of soil aggregates in different particle sizes, promote the formation of large soil aggregates, and improve the stability of aggregation. Specifically, the mixed application of biogas residue composting and chemical amendments performed better on soil improvement in relocation site.

Restricted antennal movement impacts the tandem running dynamics in a ponerine ant.

BACKGROUND: Tandem running is a recruitment method found in some species of ants where one ant follows another ant to reach a destination having maintained a physical contact with its antennae, throughout the journey. It is considered that the exchange of information regarding the destination among the nestmates happened during the process of tandem running. We examined the impact of restricting antennal movement on tandem running by using Diacamma indicum, a tandem-running ponerine ant by following 480 tandem runs across 9 treatment colonies and comparing it with 10 control relocating colonies. RESULT: Though all the 19 colonies relocated successfully, treatment colonies took significantly longer time to do so. Restricted antennal movement did not influence the ability to become tandem leaders, initiate tandem runs or the work organization significantly. However, antennae-restricted ants performed fewer tandem runs and took significantly longer time. Followers with single or both antennae-restriction performed significantly higher number of interruptions and the alignment between the leader and follower was impacted as antenna-restricted followers subtended a greater angle and walked more to the side of the leader as compared to the control followers. CONCLUSION: This study showed unhindered movement of the followers' antennae is important for tandem-running ants. In the next step, to gain a comprehensive understanding of this recruitment method, it is essential to individually delineate different sensory modalities.

Exploring residential relocation- differences between newcomers and settled residents in health, travel behaviour and neighbourhood perceptions.

This study explores whether people who have recently moved to an area differ from longer-term residents in their health, travel behaviour, and perceptions of the environment. Using a large, representative sample from the UKHLS, Newcomers demonstrate significantly lower mental and physical health, reduced car commuting, and a higher likelihood of liking their neighbourhood. Area deprivation, urbanicity, household income, and age emerge as influential moderators with i.e. Newcomers in affluent areas experiencing lower physical health than Settled Residents, and rural Newcomers expressing less neighbourhood satisfaction. Our findings highlight that Newcomers' perceptions of their environment diverge and environmental influences vary among population segments, potentially impacting related health behaviours such as active travel. Furthermore, residential relocation introduces Newcomers with distinct characteristics into areas, affecting the context in which potential population health interventions aiming to influence health behaviours operate. This necessitates a deeper understanding of what influences reactions to the environment as well as ongoing adaptation of environmental interventions to respond to changing contexts within the same location over time.

How far are we off? Analyzing the accuracy of surgical margin relocation in the head and neck.

BACKGROUND: Positive surgical margin rates remain high in head and neck cancer surgery. Relocation is challenging given the complex, three-dimensional (3D) anatomy. METHODS: Prospective, multi-institutional study to determine accuracy of head and neck surgeons and pathologists relocating margins on virtual 3D specimen models using written descriptions from pathology reports. Using 3D models of 10 head and neck surgical specimens, each participant relocated 20 mucosal margins (10 perpendicular, 10 shave). RESULTS: A total of 32 participants, 23 surgeons and 9 pathologists, marked 640 margins. Of the 320 marked perpendicular margins, 49.7% were greater than 1 centimeter from the true margin with a mean relocation error of 10.2 mm. Marked shave margins overlapped with the true margin a mean 54% of the time, with no overlap in 44 of 320 (13.8%) shave margins. CONCLUSIONS: Surgical margin relocation is imprecise and challenging even for experienced surgeons and pathologists. New communication technologies are needed.

Levels of photoactivated phototropin modulate signal transmission during the chloroplast accumulation response.

Chloroplasts accumulate in regions of plant cells exposed to irradiation to maximize light reception for efficient photosynthesis. This response is mediated by the blue-light receptor phototropin. Upon the perception of blue light, phototropin is photoactivated, an unknown signal is transmitted from the photoactivated phototropin to distant chloroplasts, and the chloroplasts begin their directional movement. How activated phototropin initiates this signal transmission is unknown. Here, using the liverwort Marchantia polymorpha, we analysed whether increased photoactive phototropin levels mediate signal transmission and chloroplast behaviour during the accumulation response. The signal transmission rate was higher in transgenic cells overexpressing phototropin than in wild-type cells. However, the chloroplast directional movement was similar between wild-type and transgenic cells. Consistent with the observation, increasing the amount of photoactivated phototropin through higher blue-light intensity also accelerated signal transmission but did not affect chloroplast behaviour in wild-type cells. Photoactivation of phototropin under weak blue-light led to the greater protein level of phosphorylated phototropin in cells overexpressing phototropin than in wild-type cells, whereas the autophosphorylation level within each phototropin molecule was similar. These results indicate that the abundance of photoactivated phototropin modulates the signal transmission rate to distant chloroplasts but does not affect chloroplast behaviour during the accumulation response.

Further Insights on Honey and Propolis from Gerês (Portugal) and Their Bioactivities: Unraveling the Impact of Beehive Relocation.

Propolis, a bee product, is known for its variability of chemical and bioactive profiles. However, Portuguese propolis from Gerês, normally obtained by mixing propolis from three places-Bugalho, Felgueiras and Toutelo-has shown similar chemical and biological profiles over the years. Recently, a new propolis place-Roca-was added to the apiary to replace Bugalho, lost to the 2017 wildfires, hence questioning the previously claimed constancy of Gerês propolis. To unravel to what extent the beehive relocation affected this constancy, we studied different Gerês propolis samples collected in three consecutive years (2017-2019) composed of different combinations of source places. Two honey samples, collected before (2017) and after (2018) the occurrence of the wildfire, were also investigated. Total phenolics, flavonoids and ortho-diphenols contents were determined and the antioxidant and antimicrobial activities were evaluated, using the DPPH assay and the agar dilution method, respectively. Although both antimicrobial and antioxidant activities were generally in the ranges usually obtained from Gerês propolis, some variations were detected for the samples, with different compositions when compared to previous years. This work reinforces the importance of the consistency of a combination of several factors for the protection and preservation of the flora near the hives, providing bee products with more constant chemical and biological profiles over the years.

Deep Margin Elevation - A Retrospective Clinical Study.

PURPOSE: The aim of this retrospective study was to assess the short- to mid-term restorative and periodontal outcome of deep margin elevation (DME) performed using resin composite. MATERIALS AND METHODS: Twenty-eight teeth treated with DME and indirect adhesive restorations were followed-up for a mean of 25.4 months (minimum: 12 months). Clinical and radiographic examination assessed the adaptation of the DME material and indirect restorations, presence of recurrent caries or discoloration, periodontal health at DME and non-DME sites, and periapical health. RESULTS: The overall success rate was 96.6%. One tooth showed signs and symptoms of apical pathology after 34 months following DME. No caries, discoloration, or periodontal pockets were detected in any of the treated teeth. DME had no detrimental effect on the gingival/periodontal health or plaque accumulation. There was no correlation between the distance from the DME material to the marginal bone level and pocket depth, gingival inflammation, and plaque accumulation (p > 0.05). CONCLUSION: Deep margin elevation might be considered a safe procedure for teeth with deep subgingival proximal caries in the short- and mid-term.

Psychological interventions designed to reduce relocation stress for older people transitioning into permanent residential aged care: a systematic scoping review.

OBJECTIVES: This study aimed to identify and evaluate psychological interventions or strategies designed to reduce relocation stress in older people making the permanent transition into residential aged care. METHOD: A scoping review following the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted. An electronic search of nine databases and the search engine google scholar was completed in December 2022. Article screening and quality appraisal was undertaken independently by at least two reviewers. RESULTS: Eight full-text articles were included for review, from which four psychological interventions were identified: 1) Resident peer support; 2) Life review; 3) Mental Health Service for Older Adults; 4) The Program to Enhance Adjustment to Residential Living. No interventions were implemented before transitioning into care; all were implemented within three months of resident relocation into an aged care facility. CONCLUSION: The transition to residential aged care is an inherently distressing experience. The absence of interventions implemented during the pre- and mid-transition phases presents a gap in the literature and suggests an opportunity for early intervention. As population ageing continues to increase, there is a pressing need for the development and implementation of interventions aimed at reducing symptoms of depression and anxiety for older people undertaking this major life transition.