A broad spectrum protein glycosylation system influences type II protein secretion and associated phenotypes in Vibrio cholerae

Protein secretion plays a crucial role for bacterial pathogens, exemplified by facultative human-pathoge

Discrete Accidental Symmetry for a Particle in a Constant Magnetic Field on a Torus

A classical particle in a constant magnetic field undergoes cyclotron motion on a circular orbit. At the quantum level, the fact that all classical orbits are closed gives rise to degeneracies in the spectrum. It is well-known that the spectrum of a charged particle in a constant magnetic field consists of infinitely degenerate Landau levels. Just as for the $1/r$ and $r^2$ potentials, one thus expects some hidden accidental symmetry, in this case with infinite-dimensional representations. Indeed, the position of the center of the cyclotron circle plays the role of a Runge-Lenz vector. After identifying the corresponding accidental symmetry algebra, we re-analyze the system in a finite periodic volume. Interestingly, similar to the quantum mechanical breaking of CP invariance due to the $\theta$-vacuum angle in non-Abelian gauge theories, quantum effects due to two self-adjoint extension parameters $\theta_x$ and $\theta_y$ explicitly break the continuous translation invariance of the classical theory. This reduces the symmetry to a discrete magnetic translation group and leads to finite degeneracy. Similar to a particle moving on a cone, a particle in a constant magnetic field shows a very peculiar realization of accidental symmetry in quantum mechanics.Comment: 25 pages, 2 figure

t(6;14)(p25.3;q11.2) TRA/IRF4

Review on t(6;14)(p25.3;q11.2) TRA/IRF4, with data on clinics, and the genes involved

Safety and immunogenicity of live viral vaccines in a multicenter cohort of pediatric transplant recipients

IMPORTANCE: Live vaccines (measles-mumps-rubella [MMR] and varicella-zoster virus [VZV]) have not been recommended after solid organ transplant due to concern for inciting vaccine strain infection in an immunocompromised host. However, the rates of measles, mumps, and varicella are rising nationally and internationally, leaving susceptible immunocompromised children at risk for life-threating conditions. OBJECTIVE: To determine the safety and immunogenicity of live vaccines in pediatric liver and kidney transplant recipients. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included select pediatric liver and kidney transplant recipients who had not completed their primary MMR and VZV vaccine series and/or who displayed nonprotective serum antibody levels at enrollment between January 1, 2002, and February 28, 2023. Eligibility for live vaccine was determined by individual US pediatric solid organ transplant center protocols. EXPOSURES: Exposure was defined as receipt of a posttransplant live vaccine. Transplant recipients received 1 to 3 doses of MMR vaccine and/or 1 to 3 doses of VZV vaccine. MAIN OUTCOME AND MEASURE: Safety data were collected following each vaccination, and antibody levels were obtained at 0 to 3 months and 1 year following vaccination. Comparisons were performed using Mann-Whitney U test, and factors associated with development of postvaccination protective antibodies were explored using univariate analysis. RESULTS: The cohort included 281 children (270 [96%] liver, 9 [3%] kidney, 2 [1%] liver-kidney recipients) from 18 centers. The median time from transplant to enrollment was 6.3 years (IQR, 3.4-11.1 years). The median age at first posttransplant vaccine was 8.9 years (IQR, 4.7-13.8 years). A total of 202 of 275 (73%) children were receiving low-level monotherapy immunosuppression at the time of vaccination. The majority of children developed protective antibodies following vaccination (107 of 149 [72%] varicella, 130 of 152 [86%] measles, 100 of 120 [83%] mumps, and 124 of 125 [99%] rubella). One year post vaccination, the majority of children who initially mounted protective antibodies maintained this protection (34 of 44 [77%] varicella, 45 of 49 [92%] measles, 35 of 42 [83%] mumps, 51 of 54 [94%] rubella). Five children developed clinical varicella, all of which resolved within 1 week. There were no cases of measles or rubella and no episodes of graft rejection within 1 month of vaccination. There was no association between antibody response and immunosuppression level at the time of vaccination. CONCLUSIONS AND RELEVANCE: The findings suggest that live vaccinations may be safe and immunogenic after solid organ transplant in select pediatric recipients and can offer protection against circulating measles, mumps, and varicella

Lymphomatoid papulosis (LyP) with 6p25.3 rearrangement

Review on lymphomatoid papulosis (LyP) with 6p25.3 rearrangement, with data on clinics, and the genes implicated

Information Systems for Disability Determination: A Multi-Stakeholder Assessment of Electronic Medical Evidence Needs and Processes

This study focuses on Health Information Technology (Health IT) in improving the decision-making process concerning disability benefits. Using a multimethod, multilevel approach that includes case analysis and semi-structured interviews, this study examines the practices, challenges, and potential solutions or methods involved in adequate and timely collection of medical evidence through information technology (IT) to support disability determination. Researchers collected qualitative data through fifty-six semi-structured thirty-minute interviews with Disability Determination Services (DDS) personnel in three states. Based on site observations, interviews, and document analysis, they developed two provider case studies. To demonstrate the adequacy and timeliness of medical evidence collection, the study also examined and reviewed twelve disability claimant cases. Findings suggest that, at the payer and provider levels, electronic solutions provide more adequate and timely responses to medical evidence requests. Based on the case studies, implemented Health IT reduces incomplete medical evidence and decreases provider turnaround time in processing a payer’s requests. Among the claims examined, 50 percent received low scores for adequacy of medical evidence and 33 percent received high or medium scores for delay of return of medical evidence of record. This examination of disability determination demonstrated that Health IT holds promise for clinical data use in this context

Qualitatively understanding patients' and health professionals' experiences of the BRECONDA breast reconstruction decision aid

Copyright © 2016 John Wiley & Sons, Ltd. Objective: Women diagnosed with breast cancer or ductal carcinoma in situ and those with a genetic susceptibility to developing this disease face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women's experiences of using the Breast RECONstruction Decision Aid (BRECONDA) and health professionals' feedback regarding the impact of this resource on patients' knowledge and decision making about breast reconstruction. Method: Semistructured interviews were conducted with women who accessed the BRECONDA intervention (N=36) and with their healthcare providers (N=6). All interviews were transcribed verbatim and subjected to thematic analysis by 3 independent coders. Results: Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed 4 themes: overall impressions and aesthetics; personal relevance and utility; introducing BRECONDA; and advantages and suggested improvements. Analysis of health professionals' interviews also revealed 4 themes: need for BRECONDA, impact of BRECONDA, potential difficulties that may arise in using the decision aid, and recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. Conclusion: These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources

A systematic review of internet-based worksite wellness approaches for cardiovascular disease risk management: outcomes, challenges & opportunities.

ContextThe internet is gaining popularity as a means of delivering employee-based cardiovascular (CV) wellness interventions though little is known about the cardiovascular health outcomes of these programs. In this review, we examined the effectiveness of internet-based employee cardiovascular wellness and prevention programs.Evidence acquisitionWe conducted a systematic review by searching PubMed, Web of Science and Cochrane library for all published studies on internet-based programs aimed at improving CV health among employees up to November 2012. We grouped the outcomes according to the American Heart Association (AHA) indicators of cardiovascular wellbeing--weight, BP, lipids, smoking, physical activity, diet, and blood glucose.Evidence synthesisA total of 18 randomized trials and 11 follow-up studies met our inclusion/exclusion criteria. Follow-up duration ranged from 6-24 months. There were significant differences in intervention types and number of components in each intervention. Modest improvements were observed in more than half of the studies with weight related outcomes while no improvement was seen in virtually all the studies with physical activity outcome. In general, internet-based programs were more successful if the interventions also included some physical contact and environmental modification, and if they were targeted at specific disease entities such as hypertension. Only a few of the studies were conducted in persons at-risk for CVD, none in blue-collar workers or low-income earners.ConclusionInternet based programs hold promise for improving the cardiovascular wellness among employees however much work is required to fully understand its utility and long term impact especially in special/at-risk populations

Impact of weight maintenance and loss on diabetes risk and burden: a population-based study in 33,184 participants

$\textbf{Background}$ Weight loss in individuals at high risk of diabetes is an effective prevention method and a major component of the currently prevailing diabetes prevention strategies. The aim of the present study was to investigate the public health potential for diabetes prevention of weight maintenance or moderate weight loss on a population level in an observational cohort with repeated measurements of weight and diabetes status. $\textbf{Methods}$ Height, weight and diabetes status were objectively measured at baseline and 10 year follow-up in a population-based cohort of 33,184 participants aged 30–60 years between 1990 and 2013 in Västerbotten County, Sweden. The association between risk of incident diabetes and change in BMI or relative weight was modelled using multivariate logistic regression. Population attributable fractions (PAF) were used to assess population impact of shift in weight. $\textbf{Results}$ Mean (SD) BMI at baseline was 25.0 (3.6) kg/m$^2$. Increase in relative weight between baseline and follow-up was linearly associated with incident diabetes risk, odds ratio (OR) 1.05 (95% confidence interval (CI) 1.04–1.06) per 1% change in weight. Compared to weight maintenance (±1.0 kg/m$^2$), weight gain of >+1.0 kg/m$^2$ was associated with an increased risk of incident diabetes, OR 1.52 (95% CI 1.32, 1.74), representing a PAF of 21.9% (95% CI 15.8, 27.6%). For moderate weight loss (−1.0 to −2.0 kg/m$^2$) the OR was 0.72 (95% CI 0.52, 0.99). $\textbf{Conclusions}$ Weight maintenance in adulthood is strongly associated with reduced incident diabetes risk and there is considerable potential for diabetes prevention in promoting this as a whole population strategy.This work was supported by the Medical Research Council [MC_UU_12015/ 4], the Swedish Council for Working Life and Social Research [FAS 2006_1512] and the Swedish Research Council [2006-21576-36119-666]. The Västerbotten Intervention Programme is financed by Västerbotten County Council. Dr Feldman is supported by the Raymond and Beverly Sackler Foundation through Churchill College, Cambridge