UNASSIGNED: Clinical data are usually analyzed with the assumption that knowledge gathered from group averages applies to the individual. Doing so potentially obscures patients with meaningfully different trajectories of therapeutic change. Needed are \"idionomic\" methods that first examine idiographic patterns before nomothetic generalizations are made. The objective of this paper is to test whether such an idionomic method leads to different clinical conclusions.
UNASSIGNED: 51 patients completed weekly process measures and symptom severity over a period of eight weeks. Change trajectories were analyzed using a nomothetic approach and an idiographic approach with bottom-up clustering of similar individuals. The outcome was patients\' well-being at post-treatment.
UNASSIGNED: Individuals differed in the extent that underlying processes were linked to symptoms. Average trend lines did not represent the intraindividual changes well. The idionomic approach readily identified subgroups of patients that differentially predicted distal outcomes (well-being).
UNASSIGNED: Relying exclusively on average results may lead to an oversight of intraindividual pathways. Characterizing data first using idiographic approaches led to more refined conclusions, which is clinically useful, scientifically rigorous, and may help advance individualized psychotherapy approaches.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s10608-023-10453-x.

UNASSIGNED: The science and practice of psychopathology and psychological intervention of today is more like an island archipelago than it is a single land mass, and connections between different traditions are both limited and fraught with misunderstanding.
UNASSIGNED: Our analysis and solution to the problem is process-based therapy (PBT). PBT defines psychopathology as failed adaptation processes to a given context. Therapy involves adaptation through context-dependent or context-altering applications of biopsychosocial strategies that allows a goal to be met.
UNASSIGNED: This coherent approach to more transtheoretical and integrative concepts of clinical training and practice provides a firm foundation by targeting biopsychosocial processes of change, analyzing these processes using an idiographic complex network analytic approach, and organizing findings on the intellectual agora of multi-dimensional and multi-level evolutionary science.
UNASSIGNED: PBT is a new empirical form of functional analysis, resulting in interventions and trainings that are built on elements or kernels of direct relevance to client\'s specific needs. In PBT, case formulation continues as long as treatment persists.

BACKGROUND: Contraceptive use is known to have a positive impact on maternal and child health outcomes; however, its use is still low in low-income countries, especially among people in humanitarian situations. This study explored decision-making processes towards the use of contraceptives by people in humanitarian situations to inform program design and uptake.
METHODS: A qualitative exploratory study was conducted among women of reproductive age (15-49 years) and men (15-60 years) living in three refugee settlements of Pagirinya, Nyumanzi, and Mirieyi and the surrounding host communities in Adjumani district, Uganda. Data were collected using 49 in-depth interviews (IDIs), 11 Key Informant Interviews (KIIs,) and 20 Focus Group Discussions (FGDs). Inductive thematic analysis was done with the aid of Atlas ti. Version 14.
RESULTS: We found that the decision-making processes entailed linear and nonlinear internalized cognitive and contextual processes involving four dynamic pathways. In the linear pathway, participants reported starting with 1) idea inception, 2) followed by cognitive processing, 3) consultation, and 4) decision-making for contraceptive use. The complex linear pathway happened when participants did not go through consultation but went straight to decision-making. However, participants who followed the non-linear pathway repeatedly went back to cognitive processing. Some women after consultation, or those already using and those not using contraceptives, decided to go back to cognitive processing to reconsider their current positions. This study found that some women who were not using contraceptives ended up using, while some who were using contraception ended up dropping out.
CONCLUSIONS: This study showed dynamic decision-making processes involving both internal and external environments as triggers to decision-making for contraceptive use. Interventions to increase contraceptive use should target both users and significant others who influence the decision to use particularly among refugees.
BACKGROUND: This study was registered by Makerere University School of Public Health Higher Degrees Research and Ethic Committee (HDREC) #188 and approved by Uganda National Council of Science and Technology on 15th/7/2021, Registration number-SS809ES.

UNASSIGNED: Global challenges arise from infectious diseases which represent significant challenges to the provision of healthcare, requiring efficient management procedures to limit transmission. Evaluating current outbreak management processes within UK healthcare services is essential for identifying strengths, weaknesses, and potential improvements.
UNASSIGNED: This study aimed to assess infection prevention and control (IPC) practitioners\' access to outbreak management (OM) data. Secondary objectives involved determining IPC practitioners\' perceptions of outbreak management processes and the state of digitalisation of OM in the UK.
UNASSIGNED: National cross-sectional survey data were collected to evaluate current outbreak management approaches. To supplement this, information requests were sent to the 10 largest teaching and research NHS hospital trusts in England.
UNASSIGNED: The survey received 55 responses with 53 considered for analysis. Out of 10 NHS trusts, nine provided completed FOI responses, while one was unable to provide data.
UNASSIGNED: The study offers unique insights into prevailing outbreak management practices within UK health services. Although positive perceptions surround key outbreak management stages, concerns arise, including varying confidence levels in surveillance processes\' robustness, efficacy of management interventions, and communication effectiveness.
UNASSIGNED: The study highlights challenges with OM processes in the UK, including issues like poor surveillance and delayed outbreak detection. Positive practitioner perceptions contrast with concerns over data collection, follow-up, and limited digitalisation, relying on basic tools like Excel and Word, hindering retrospective learning.

Restoring biodiversity-based resilience and ecosystem multi-functionality needs to be informed by more accurate predictions of animal biodiversity responses to environmental change. Ecological models make a substantial contribution to this understanding, especially when they encode the biological mechanisms and processes that give rise to emergent patterns (population, community, ecosystem properties and dynamics). Here, a distinction between \'mechanistic\' and \'process-based\' ecological models is established to review existing approaches. Mechanistic and process-based ecological models have made key advances to understanding the structure, function and dynamics of animal biodiversity, but are typically designed to account for specific levels of biological organisation and spatiotemporal scales. Cross-scale ecological models, which predict emergent co-occurring biodiversity patterns at interacting scales of space, time and biological organisation, is a critical next step in predictive ecology. A way forward is to first capitalise on existing models to systematically evaluate the ability of scale-explicit mechanisms and processes to predict emergent patterns at alternative scales. Such model intercomparisons will reveal mechanism to process transitions across fine to broad scales, overcome approach-specific barriers to model realism or tractability and identify gaps which necessitate the development of new fundamental principles. Key challenges surrounding model complexity and uncertainty would need to be addressed, and while opportunities from big data can streamline the integration of multiple scale-explicit biodiversity patterns, ambitious cross-scale field studies are also needed. Crucially, overcoming cross-scale ecological modelling challenges would unite disparate fields of ecology with the common goal of improving the evidence-base to safeguard biodiversity and ecosystems under novel environmental change.

In their anthology Everything Flows: Towards a Processual Philosophy of Biology, Daniel J. Nicholson and John Dupré argue that modern theories of biology imply that the fundamental structure of reality is processual at its core. In the present work, I first examine the implicit and explicit metaphysical presuppositions the editors make in order to allow for such an inference from scientific theory to ontology. After showing the difficulties of a naïve transfer of theoretical entities to fundamental ontology, I argue that the editors can nevertheless extend their claims beyond the mere articulation of different domain ontologies. This leads to the idea of a scientifically informed induction base for an ontology of processes.

OBJECTIVE: The study investigated the association between FLG-AS1 and cervical cancer prognosis and the interaction mechanism between FLG-AS1 and miR-147b in order to identify potential therapeutic targets for cervical cancer.
METHODS: In this study, tissue samples and clinicopathological characteristics were obtained from 125 cervical cancer patients. FLG-AS1 expression levels in the samples were detected by polymerase chain reaction assay. CCK-8 and Transwell assays were used to evaluate FLG-AS1\'s impact on cervical cancer cell proliferation and metastasis. The mechanism of action of FLG-AS1 and miR-147b was probed by a dual luciferase reporter gene assay. The prognostic nature of FLG-AS1 in cervical cancer was explored by a series of statistical approaches.
RESULTS: In cervical cancer cells and tissues, FLG-AS1 expression is markedly downregulated. FLG-AS1 inhibits the activities of cervical cancer cells by negatively regulating miR-147b expression. Patients with cervical cancer have a poor prognosis when FLG-AS1 expression is low.
CONCLUSIONS: FLG-AS1 may be considered as a novel cervical cancer prognostic biomarker candidate, which affects cancer cell progression by negatively regulating miR-147b.

The IFIH1 gene, encoding melanoma differentiation-associated protein 5 (MDA5), is an indispensable innate immune regulator involved in the early detection of viral infections. Previous studies described MDA5 dysregulation in weakened immunological responses, and increased susceptibility to microbial infections and autoimmune disorders. Monoallelic gain-of-function of the IFIH1 gene has been associated with multisystem disorders, namely Aicardi-Goutieres and Singleton-Merten syndromes, while biallelic loss causes immunodeficiency. In this study, nine patients suffering from recurrent infections, inflammatory diseases, severe COVID-19 or multisystem inflammatory syndrome in children (MIS-C) were identified with putative loss-of-function IFIH1 variants by whole-exome sequencing. All patients revealed signs of lymphopaenia and an increase in inflammatory markers, including CRP, amyloid A, ferritin and IL-6. One patient with a pathogenic homozygous variant c.2807+1G>A was the most severe case showing immunodeficiency and glomerulonephritis. The c.1641+1G>C variant was identified in the heterozygous state in patients suffering from periodic fever, COVID-19 or MIS-C, while the c.2016delA variant was identified in two patients with inflammatory bowel disease or MIS-C. There was a significant association between IFIH1 monoallelic loss of function and susceptibility to infections in males. Expression analysis showed that PBMCs of one patient with a c.2016delA variant had a significant decrease in ISG15, IFNA and IFNG transcript levels, compared to normal PBMCs, upon stimulation with Poly(I:C), suggesting that MDA5 receptor truncation disrupts the immune response. Our findings accentuate the implication of rare monogenic IFIH1 loss-of-function variants in altering the immune response, and severely predisposing patients to inflammatory and infectious diseases, including SARS-CoV-2-related disorders.

BACKGROUND: Cow\'s milk protein allergy (CMPA) remains relatively understudied in Latin America.
METHODS: In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE-mediated reactions with IgE sensitization or non-IgE-mediated reactions or symptoms following exposure to cow\'s milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil-derived neurotoxin (EDN), in addition to double-blinded placebo-controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year.
RESULTS: Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE-mediated CMPA was observed in only six patients. In those with non-IgE-mediated CMPA, FC had a median of 284 mg/dL (IQR: 138.5-415.5), while EDN had a median of 508.5 mg/dL (IQR: 160.25-868). One year after diagnosis, median FC significantly decreased (p < 0.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein-based formulas achieved tolerance (p = 0.08).
CONCLUSIONS: Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region.

BACKGROUND: The COVID-19 pandemic represents one of the greatest ever challenges for healthcare. In the UK and beyond, acute medical units (AMUs) are the first point of assessment and care for the majority of medical inpatients. By their design and systems, they inevitably played an important role in the COVID-19 response but to date little has been published on how the COVID-19 pandemic has affected how AMUs have reorganised their resources, processes and structure.
METHODS: This retrospective study in August 2020 of 10 AMUs across Europe and Australasia used a standardised questionnaire to investigate existing practice and structure of AMUs, the national context of local hospital experience, changes to practice during the COVID-19 pandemic and views regarding future practice.
RESULTS: Changes to AMU structure, process and organisation are described in two contexts: preventing and controlling the spread of COVID-19 and adding value to the patient\'s acute care journey in the local context. We describe novel practices that have arisen and highlight areas of concern.
CONCLUSIONS: The AMUs were able to adapt to meet the demands of acute care delivery during the first wave of the COVID-19 pandemic. Operational planning and prioritisation of resources must be optimised to ensure sustainability of these services for future waves.