Changes of empathy in medical college and medical school students: 1-year follow up study

BACKGROUND: This study aims to determine the correlation between medical education systems, medical college (MC) and medical school (MS), and empathy by investigating the changes in empathy among students with each additional year of medical education. METHODS: The subjects were MC and MS students who had participated in the same study the previous year. All participants completed the same self-report instruments: a questionnaire on sociodemographic characteristics, and the Korean edition of the Student Version of the Jefferson Scale of Empathy (JSE-S-K), Among 334 students, the final analysis was conducted on the data provided by 113 MC and 120 MS students, excluding 101 with incomplete data. RESULTS: The age and sex did not affect the changes in empathy. Though the JSE-S-K score of MS was significantly higher than that of MC in initial investigation, this study found no difference of empathy between MC and MS. CONCLUSION: Empathy increased significantly after one year of medical education. The difference between two education systems, MC and MS, did not affect the changes in empathy

A High Step-up Modular Isolated DC-DC Converter for Large Capacity Photovoltaic Generation System integrated into MVDC Grids

Nowadays, the research and design of the DC-DC conversion system has become more and more popular in the application of photovoltaic generation into the medium voltage DC (MVDC) grids. A novel high power modular isolated DC-DC converter with high step-up ratio is proposed as a module of the DC-DC conversion system in this paper. Based on the input parallel and output series (IPOS) connections of the proposed modular converters, the system is easy to achieve high capacity and high voltage. A two-stage structure is employed in the proposed converter. The interleaved boost topology is applied to the front-stage, which realizes MPPT for PV arrays with low input current ripples. The full-bridge LLC topology is employed as the back-stage, which lowers power losses by the implementation of soft-switching. The voltage gain of the proposed converter is derived in detail. The theoretical analysis and control strategy are studied in depth. Simulation and experiment verify the feasibility and effectiveness of the proposed converter.N

Consecutive Junction-Induced Efficient Charge Separation Mechanisms for High-Performance MoS2/Quantum Dot Phototransistors.

Phototransistors that are based on a hybrid vertical heterojunction structure of two-dimensional (2D)/quantum dots (QDs) have recently attracted attention as a promising device architecture for enhancing the quantum efficiency of photodetectors. However, to optimize the device structure to allow for more efficient charge separation and transfer to the electrodes, a better understanding of the photophysical mechanisms that take place in these architectures is required. Here, we employ a novel concept involving the modulation of the built-in potential within the QD layers for creating a new hybrid MoS2/PbS QDs phototransistor with consecutive type II junctions. The effects of the built-in potential across the depletion region near the type II junction interface in the QD layers are found to improve the photoresponse as well as decrease the response times to 950 μs, which is the faster response time (by orders of magnitude) than that recorded for previously reported 2D/QD phototransistors. Also, by implementing an electric-field modulation of the MoS2 channel, our experimental results reveal that the detectivity can be as large as 1 × 1011 jones. This work demonstrates an important pathway toward designing hybrid phototransistors and mixed-dimensional van der Waals heterostructures.The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP/2007−2013)/ERC Grant Agreement no. 340538. This work was also supported by the National Research Foundation of Korea (NRF) (2015M2A2A6A02045252) and Samsung Global Research Outreach (Samsung GRO) program. In addition, S.M.M. would like to thank The Royal Society for financial support

Therapeutic genome editing for Charcot-marie-tooth disease type 1a

Charcot-Marie-Tooth 1A (CMT1A) is the most common inherited neuropathy without a known therapy, which is caused by a 1.4 Mb duplication on human chromosome 17, which includes the gene encoding the peripheral myelin protein of 22 kDa (PMP22). Overexpressed PMP22 protein from its gene duplication is thought to cause demyelination and subsequently axonal degeneration in the peripheral nervous system (PNS). Here, we targeted regulatory region of human PMP22 to normalize overexpressed PMP22 level in C22 mice, a mouse model of CMT1A harboring multi copies of human PMP22. Direct local intraneural delivery of CRISPR/Cas9 designed to target TATA-box of PMP22 before the onset of disease, downregulates gene expression of PMP22 and preserves both myelin and axons. Notably, the same approach was effective in partial rescue of demyelination even after the onset of disease. Collectively, our data present a potential therapeutic efficacy of CRISPR/Cas9-mediated targeting of regulatory region of PMP22 to treat CMT1A. Please click Additional Files below to see the full abstract

Analysis of Hemodialysis-Associated Hypoglycemia in Patients with Type 2 Diabetes Using a Continuous Glucose Monitoring System

Background: Adequate glycemic control is important for patients with end-stage renal disease on maintenance hemodialysis (HD). Continuous glucose monitoring (CGM) systems are reported as a useful method for glucose monitoring in patients under maintenance HD. The object of this study was to describe glucose profiles and hypoglycemia associated with HD in diabetes patients using a CGM system. Methods: We recruited nine medically stable patients with type 2 diabetes under maintenance HD. CGMS (R) System Gold (R) (Medtronic MiniMed, Northridge, CA) was applied to the subjects for 144 h. During the period, HD using glucose-containing dialysate was performed every other day. Various glucose profiles were calculated from the CGM readings and compared between the day on and the day off dialysis. Results: Mean +/- SD for age, duration of diabetes, and hemoglobin A1c were 67 +/- 9 years, 24 +/- 9 years, and 8.6 +/- 1.2%, respectively. Hemoglobin A1c was correlated with mean glucose (rho = 0.780, P < 0.05) and with area under the curve for glucose above 180 mg/ dL (rho = 0.797, P < 0.05). Although there was no difference for mean amplitude of glycemic excursion between the day on and off HD, hypoglycemia occurred predominantly with day on HD. In the subjects who maintained antidiabetes agents with day on HD, glucose levels decreased with initiation of HD, causing significantly lower glucose levels compared to those during the equivalent time of the following day without HD. Conclusions: According to the CGM system, glucose variability was not affected by HD. However, in spite of glucose-containing dialysate, HD seemed to increase the risk of hypoglycemia.This study was supported by a grant from the Korea Science and Engineering Foundation (KOSEF) (0521-20080010) by the Ministry of Education, Science and Technology (MEST), by a grant from the Innovative Research Institute for Cell Therapy (A062260) by the Ministry of Health and Welfare, Republic of Korea, and by WCU project (R31-2008-000- 10103-0) of the MEST and the KOSEF.*INT DIAB FED, 2010, DIAB ATL*AM DIAB ASS, 2010, DIABETES CARE S1, V33, pS4Drechsler C, 2009, CIRCULATION, V120, P2421, DOI 10.1161/CIRCULATIONAHA.109.857268Riveline JP, 2009, NEPHROL DIAL TRANSPL, V24, P2866, DOI 10.1093/ndt/gfp181Kazempour-Ardebili S, 2009, DIABETES CARE, V32, P1137, DOI 10.2337/dc08-1688Kohnert KD, 2009, DIABETES CARE, V32, P1058, DOI 10.2337/dc08-1956SHIM Y, 2009, KOREAN J NUTR, V42, P577Tamborlane WV, 2008, NEW ENGL J MED, V359, P1464Wentholt IME, 2008, DIABETOLOGIA, V51, P183, DOI 10.1007/s00125-007-0842-6*US REN DAT SYST, 2008, USRSD 2008 ANN DAT RKohnert KD, 2007, DIABETES RES CLIN PR, V77, P420, DOI 10.1016/j.diabres.2007.01.021Burmeister JE, 2007, NEPHROL DIAL TRANSPL, V22, P1184, DOI 10.1093/ndt/gfl710Williams ME, 2006, KIDNEY INT, V70, P1503, DOI 10.1038/sj.ki.5001789Monnier L, 2006, JAMA-J AM MED ASSOC, V295, P1681Sangill M, 2006, AM J KIDNEY DIS, V47, P636, DOI 10.1053/j.ajkd.2006.01.007Rigalleau V, 2005, CURR OPIN CLIN NUTR, V8, P463Childs BP, 2005, DIABETES CARE, V28, P1245TANSEY MJ, 2005, DIABETES TECHNOL THE, V7, P109Loipl J, 2005, RENAL FAILURE, V27, P305, DOI 10.1081/JDI-200056608Cryer PE, 2003, DIABETES CARE, V26, P1902Djakoure-Platonoff C, 2003, DIABETES METAB, V29, P159Guerci B, 2003, DIABETES CARE, V26, P582*DIRECNET STUD GRO, 2003, DIABETES TECHNOL THE, V5, P781Boland E, 2001, DIABETES CARE, V24, P1858Morioka T, 2001, DIABETES CARE, V24, P909Kovatchev BP, 2000, J CLIN ENDOCR METAB, V85, P4287Jackson MA, 2000, CLIN NEPHROL, V54, P30Haviv YS, 2000, RENAL FAILURE, V22, P219Mastrototaro J, 1999, J PEDIATR ENDOCR MET, V12, P751Nakao T, 1998, INTERNAL MED, V37, P8261998, LANCET, V352, P837Davis SN, 1997, DIABETES, V46, P1328Morgan L, 1996, DIABETIC MED, V13, P5141993, N ENGL J MED, V329, P977MITRAKOU A, 1991, AM J PHYSIOL, V260, pE67DEFEO P, 1988, J CLIN INVEST, V82, P436SCHWARTZ NS, 1987, J CLIN INVEST, V79, P777SERVICE FJ, 1970, DIABETES, V19, P644

Genomic profile analysis of diffuse-type gastric cancers

Background: Stomach cancer is the third deadliest among all cancers worldwide. Although incidence of the intestinal-type gastric cancer has decreased, the incidence of diffuse-type is still increasing and its progression is notoriously aggressive. There is insufficient information on genome variations of diffuse-type gastric cancer because its cells are usually mixed with normal cells, and this low cellularity has made it difficult to analyze the genome. Results: We analyze whole genomes and corresponding exomes of diffuse-type gastric cancer, using matched tumor and normal samples from 14 diffuse-type and five intestinal-type gastric cancer patients. Somatic variations found in the diffuse-type gastric cancer are compared to those of the intestinal-type and to previously reported variants. We determine the average exonic somatic mutation rate of the two types. We find associated candidate driver genes, and identify seven novel somatic mutations in CDH1, which is a well-known gastric cancer-associated gene. Three-dimensional structure analysis of the mutated E-cadherin protein suggests that these new somatic mutations could cause significant functional perturbations of critical calcium-binding sites in the EC1-2 junction. Chromosomal instability analysis shows that the MDM2 gene is amplified. After thorough structural analysis, a novel fusion gene TSC2-RNF216 is identified, which may simultaneously disrupt tumor-suppressive pathways and activate tumorigenesis. Conclusions: We report the genomic profile of diffuse-type gastric cancers including new somatic variations, a novel fusion gene, and amplification and deletion of certain chromosomal regions that contain oncogenes and tumor suppressors.open121

Truly form-factor–free industrially scalable system integration for electronic textile architectures with multifunctional fiber devices

Funding Information: This work was supported by the European Commission (H2020, 1D-NEON, grant agreement ID: 685758). J.M.K. and L.G.O. acknowledge the support from the U.K. Research and Innovation (EPSRC, EP/P027628/1). We thank Y. Bernstein and J. Faulkner for helping with grammar check. Funding Information: Acknowledgments Funding:ThisworkwassupportedbytheEuropeanCommission(H2020,1D-NEON,grant agreementID:685758).J.M.K.andL.G.O.acknowledgethesupportfromtheU.K.Researchand Innovation(EPSRC,EP/P027628/1).W ethankY .BernsteinandJ.Faulknerforhelpingwith grammarcheck.Authorcontributions:S.L.andJ.M.K.conceivedtheproject.S.L.,L.G.O.,P .B., R.Martins,andJ.M.K.supervisedtheproject.S.L.andH.L.developedF-PD.S.L.,Y .-W .L., G.-H.A., D.-W .S., J.I.S.,andS.C.developedF-SC.C.L.F ., A.S.,R.I.,P .B., andR.Martinsdevelopedfiber transistor.S.L.,H.L.,andS.C.developedF-LED.ThefiberdeviceswereevaluatedbyS.L.,H.W .C., D.-W .S., H.L.,S.J.,S.D.H.,S.Y .B., S.Z.,W .H.-C., Y .-H.S., X.-B.F ., T .H.L., J.-W .J., andY .K. The developmentofweavingprocesswasconductedbyS.L.,H.W .C., F .M.M., P .J., andV .G.C. Thelaser interconnectionwasdevelopedbyS.L.,H.W .C., K.U.,M.E.,andM.S.Thetextiledemonstrations werecharacterizedbyS.L.,H.W .C., D.-W .S., J.Y ., S.S.,U.E.,S.N.,A.C.,A.M.,R.Momentè,J.G.,N.D., S.M.,C.-H.K.,M.L.,A.N.,D.J.,M.C.,andY .C. ThismanuscriptwaswrittenbyS.L.andJ.M.K.and reviewed by H.W .C., D.-W .S., M.C.,L.G.O., P .B., E.F ., and G.A.J.A. All authors discussed the results andcommentedonthemanuscript.Competinginterests:Theauthorsdeclarethattheyhave nocompetinginterests.Dataandmaterialsavailability:Alldataneededtoevaluatethe conclusionsinthepaperarepresentinthepaperand/ortheSupplementaryMaterials. Publisher Copyright: Copyright © 2023 The Authors, some rights reserved.An integrated textile electronic system is reported here, enabling a truly free form factor system via textile manufacturing integration of fiber-based electronic components. Intelligent and smart systems require freedom of form factor, unrestricted design, and unlimited scale. Initial attempts to develop conductive fibers and textile electronics failed to achieve reliable integration and performance required for industrial-scale manufacturing of technical textiles by standard weaving technologies. Here, we present a textile electronic system with functional one-dimensional devices, including fiber photodetectors (as an input device), fiber supercapacitors (as an energy storage device), fiber field-effect transistors (as an electronic driving device), and fiber quantum dot light-emitting diodes (as an output device). As a proof of concept applicable to smart homes, a textile electronic system composed of multiple functional fiber components is demonstrated, enabling luminance modulation and letter indication depending on sunlight intensity.publishersversionpublishe

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Hypergravity Load Modulates Acetaminophen Nephrotoxicity via Endoplasmic Reticulum Stress in Association with Hepatic microRNA-122 Expression

Hypergravity conditions may subject the kidney to intrinsic stress and lead to hemodynamic kidney dysfunction. However, the mechanisms underlying this phenomenon remain unclear. Accumulation of unfolded proteins in the endoplasmic reticulum (i.e., ER stress) is often observed in kidney diseases. Therefore, this study investigated whether hypergravity stress alters acetaminophen-induced renal toxicity in vivo, as well as the molecular mechanisms involved in this process. C57BL/6 mice were submitted to one or three loads of +9 Gx hypergravity for 1 h with or without acetaminophen (APAP) treatment. The protein levels of cell survival markers, including pAKT and pCREB, were decreased in the kidney after acetaminophen treatment with a single hypergravity load. Additionally, the combined treatment increased kidney injury markers, serum creatinine, and Bax, Bcl2, and Kim-1 transcript levels and enhanced ER stress-related markers were further. Moreover, multiple hypergravity loads enabled mice to overcome kidney injury, as indicated by decreases in serum creatinine content and ER stress marker levels, along with increased cell viability indices. Similarly, multiple hypergravity loads plus APAP elevated miR-122 levels in the kidney, which likely originated from the liver, as the levels of primary miR-122 increased only in the liver and not the kidney. Importantly, this phenomenon may contribute to overcoming hypergravity-induced kidney injury. Taken together, our results demonstrate that APAP-exposed mice submitted to a single load of hypergravity exhibited more pronounced kidney dysfunction due to increased ER stress, which may be overcome by repetitive hypergravity loads presumably due to increased production of miR-122 in the liver. Thus, our study provides novel insights into the mechanisms by which hypergravity stress plus APAP medication induce kidney injury, which may be overcome by repeated hypergravity exposure