Antimicrobial risk assessment-Aggregating aquatic chemical and resistome emissions.

Urban water systems receive and emit antimicrobial chemicals, resistant bacterial strains, and resistance genes (ARGs), thus representing "antimicrobial hotspots". Currently, regional environmental risk assessment (ERA) is carried out using drug consumption data and threshold concentrations derived based on chemical-specific minimum inhibitory concentration values. A legislative proposal by the European Commission released in 2022 addresses the need to include selected ARGs besides the chemical concentration-based ERAs.

Artificial Intelligence-Generated Writing in the ERAS Personal Statement: An Emerging Quandary for Post-graduate Medical Education.

Objective: This study was designed to investigate if artificial intelligence (AI) detection software can determine the use of AI in personal statements for residency applications.

Method: Previously written personal statements were collected from physicians who had already matched to residency through the Electronic Residency Application System. Physicians were recruited for the study through collegial relationships and were given study information via email.

A critical meta-analysis of predicted no effect concentrations for antimicrobial resistance selection in the environment.

Antimicrobial resistance (AMR) is one of the greatest threats to human health with a growing body of evidence demonstrating that selection for AMR can occur at environmental antimicrobial concentrations. Understanding the concentrations at which selection for resistance may occur is critical to help inform environmental risk assessments and highlight where mitigation strategies are required. A variety of experimental and data approaches have been used to determine these concentrations.

Lisdexamfetamine-Induced Psychosis in a Patient With a Neurodevelopmental Disorder.

Individuals diagnosed with autism spectrum disorder (ASD) often experience a higher occurrence of comorbid attention deficit hyperactivity disorder (ADHD). Stimulant medications are frequently prescribed to manage ADHD. In rare instances, the use of stimulant medications has been linked to the development of psychotic symptoms.

The Effects of Remote Cognitive Training Combined With a Mobile App Intervention on Psychosis: Double-Blind Randomized Controlled Trial.

Background: Impairments in cognition and motivation are core features of psychosis and strong predictors of social and occupational functioning. Accumulating evidence indicates that cognitive deficits in psychosis can be improved by computer-based cognitive training programs; however, barriers include access and adherence to cognitive training exercises. Limited evidence-based methods have been established to enhance motivated behavior.

Selection for antimicrobial resistance in the plastisphere.

Microplastics and antimicrobials are widespread contaminants that threaten global systems and frequently co-exist in the presence of human or animal pathogens. Whilst the impact of each of these contaminants has been studied in isolation, the influence of this co-occurrence in driving antimicrobial resistance (AMR) in microplastic-adhered microbial communities, known as 'the Plastisphere', is not well understood. This review proposes the mechanisms by which interactions between antimicrobials and microplastics may drive selection for AMR in the Plastisphere.

Culturing the Plastisphere: comparing methods to isolate culturable bacteria colonising microplastics.

Microplastics quickly become colonised by diverse microbial communities, known as the Plastisphere. There is growing concern that microplastics may support the enrichment and spread of pathogenic or antimicrobial resistant microorganisms, although research to support the unique role of microplastics in comparison to control particles remains inconclusive. Limitations to this research include the microbiological methods available for isolating adhered microbes.

The Virtual Couch: a Curriculum on the Question of the Fundamentals of Remote Psychotherapy-Pilot Study.

Objective: With a rise in remote clinical practice related to the COVID-19 pandemic, a novel remote psychotherapy curriculum was presented to psychiatry residents and fellows to address the urgent need to teach trainees how to adapt traditional psychotherapy skills to telepsychiatry settings.

Methods: Trainees completed a survey before and after receiving the curriculum to assess remote psychotherapy skills and areas for growth.

Results: Eighteen trainees (24% fellows, 77% residents) completed the pre-curriculum survey, and 28 trainees (26% fellows, 74% residents) completed the post-curriculum survey.

Systemic Racism's Impact on Minority Children and Youth With Psychosis: Enacting Antiracist Strategies in Psychosis Care.

Psychotic disorders represent a treatable but debilitating subset of mental illnesses. Children and adolescents who are given a diagnosis of psychosis are at risk for serious sequelae that may affect cognitive and social function. Alarmingly, evidence has shown that racial differences exist in the diagnosis and progression of pathology.

Functional metagenomic libraries generated from anthropogenically impacted environments reveal importance of metabolic genes in biocide and antibiotic resistance.

Anthropogenic activities result in the release of antimicrobial resistant bacteria and a cocktail of antimicrobial compounds into the environment that may directly select or indirectly co-select for antimicrobial resistance (AMR). Many studies use metagenome sequencing or qPCR-based approaches to study the environmental resistome but these methods are limited by knowledge. In this study, a functional metagenomic approach was used to explore biocide resistance mechanisms in two contaminated environments and a pristine site, and to identify whether potentially novel genes conferring biocide resistance also conferred resistance or reduced susceptibility to antibiotics.

When the Supervisor Needs a Supervisor: A Case-based Guide for Developing Psychotherapy Supervisors.

Supervision of psychotherapy is recognized as fundamental for attaining competency in psychotherapy. However, there is a lack of training in "best practices" of supervisory skills, and some supervisors may lack contemporary knowledge to support supervisees adequately. Training program leadership challenged by limited time and resources to provide supervisors with the necessary education and support can benefit from additional resources for developing psychotherapy supervisors.

The Complex Interplay Between Antibiotic Resistance and Pharmaceutical and Personal Care Products in the Environment.

Antibiotic-resistant bacteria (ARB) and antibiotic resistance genes (ARGs) are important environmental contaminants. Nonetheless, what drives the evolution, spread, and transmission of antibiotic resistance dissemination is still poorly understood. The abundance of ARB and ARGs is often elevated in human-impacted areas, especially in environments receiving fecal wastes, or in the presence of complex mixtures of chemical contaminants, such as pharmaceuticals and personal care products.

Does Environmental Exposure to Pharmaceutical and Personal Care Product Residues Result in the Selection of Antimicrobial-Resistant Microorganisms, and is this Important in Terms of Human Health Outcomes?

The environment plays a critical role in the development, dissemination, and transmission of antimicrobial resistance (AMR). Pharmaceuticals and personal care products (PPCPs) enter the environment through direct application to the environment and through anthropogenic pollution. Although there is a growing body of evidence defining minimal selective concentrations (MSCs) of antibiotics and the role antibiotics play in horizontal gene transfer (HGT), there is limited evidence on the role of non-antibiotic PPCPs.

Non-antibiotic pharmaceuticals promote conjugative plasmid transfer at a community-wide level.

Background: Horizontal gene transfer (HGT) plays a critical role in the spread of antibiotic resistance and the evolutionary shaping of bacterial communities. Conjugation is the most well characterized pathway for the spread of antibiotic resistance, compared to transformation and transduction. While antibiotics have been found to induce HGT, it remains unknown whether non-antibiotic pharmaceuticals can facilitate conjugation at a microbial community-wide level.

Antifungal Exposure and Resistance Development: Defining Minimal Selective Antifungal Concentrations and Testing Methodologies.

This scoping review aims to summarise the current understanding of selection for antifungal resistance (AFR) and to compare and contrast this with selection for antibacterial resistance, which has received more research attention. AFR is an emerging global threat to human health, associated with high mortality rates, absence of effective surveillance systems and with few alternative treatment options available. Clinical AFR is well documented, with additional settings increasingly being recognised to play a role in the evolution and spread of AFR.

Heightened risk factors in the midst of the pandemic: Supporting individuals with psychosis during COVID-19.

Purpose: This article aims to describe distinct vulnerabilities to the psychosocial stress from coronavirus disease 2019 (COVID-19) on individuals with psychosis and provide practical ways to reduce the vulnerabilities.

Conclusion: Societal changes and stress have come in the wake of the COVID-19. Individuals with psychosis are more susceptible to stress, cognitive biases, and lack social support.

Dawning of a new ERA: Environmental Risk Assessment of antibiotics and their potential to select for antimicrobial resistance.

Antibiotics and antimicrobials are used, misused and overused in human and veterinary medicine, animal husbandry and aquaculture. These compounds can persist in both human and animal waste and then enter the environment through a variety of mechanisms. Though generally measured environmental concentrations (MECs) of antibiotics in aquatic systems are significantly lower than point of therapeutic use concentrations, there is increasing evidence that suggests these concentrations may still enrich antimicrobial resistant bacteria.

The 'SELection End points in Communities of bacTeria' (SELECT) Method: A Novel Experimental Assay to Facilitate Risk Assessment of Selection for Antimicrobial Resistance in the Environment.

Background: Antimicrobial resistance (AMR) is one of the most significant health threats to society. A growing body of research demonstrates selection for AMR likely occurs at environmental concentrations of antibiotics. However, no standardized experimental approaches for determining selective concentrations of antimicrobials currently exist, preventing appropriate environmental and human health risk assessment of AMR.

Evolution of antibiotic resistance at low antibiotic concentrations including selection below the minimal selective concentration.

Determining the selective potential of antibiotics at environmental concentrations is critical for designing effective strategies to limit selection for antibiotic resistance. This study determined the minimal selective concentrations (MSCs) for macrolide and fluoroquinolone antibiotics included on the European Commission's Water Framework Directive's priority hazardous substances Watch List. The macrolides demonstrated positive selection for ermF at concentrations 1-2 orders of magnitude greater (>500 and <750 µg/L) than measured environmental concentrations (MECs).

Mortality and morbidity of locally acquired hepatitis E in the national Scottish cohort: a multicentre retrospective study.

Background: Hepatitis E virus (HEV) is the most common acute viral hepatitis in Scotland. Little is known about the burden of morbidity and mortality, which can be high in chronic liver disease or immunocompromised states.

Aims: To record the morbidity and mortality of HEV in Scotland.