Highly Differentiated, Resting Gn-Specific Memory CD8+ T Cells Persist Years after Infection by Andes Hantavirus

In man, infection with South American Andes virus (ANDV) causes hantavirus cardiopulmonary syndrome (HCPS). HCPS due to ANDV is endemic in Southern Chile and much of Argentina and increasing numbers of cases are reported all over South America. A case-fatality rate of about 36% together with the absence of successful antiviral therapies urge the development of a vaccine. Although T-cell responses were shown to be critically involved in immunity to hantaviruses in mouse models, no data are available on the magnitude, specificity and longevity of ANDV-specific memory T-cell responses in patients. Using sets of overlapping peptides in IFN-γ ELISPOT assays, we herein show in 78 Chilean convalescent patients that Gn-derived epitopes were immunodominant as compared to those from the N- and Gc-proteins. Furthermore, while the relative contribution of the N-specific response significantly declined over time, Gn-specific responses remained readily detectable ex vivo up to 13 years after the acute infection. Tetramer analysis further showed that up to 16.8% of all circulating CD3+CD8+ T cells were specific for the single HLA-B*3501-restricted epitope Gn465–473 years after the acute infection. Remarkably, Gn465–473–specific cells readily secreted IFN-γ, granzyme B and TNF-α but not IL-2 upon stimulation and showed a ‘revertant’ CD45RA+CD27−CD28−CCR7−CD127− effector memory phenotype, thereby resembling a phenotype seen in other latent virus infections. Most intriguingly, titers of neutralizing antibodies increased over time in 10/17 individuals months to years after the acute infection and independently of whether they were residents of endemic areas or not. Thus, our data suggest intrinsic, latent antigenic stimulation of Gn-specific T-cells. However, it remains a major task for future studies to proof this hypothesis by determination of viral antigen in convalescent patients. Furthermore, it remains to be seen whether Gn-specific T cells are critical for viral control and protective immunity. If so, Gn-derived immunodominant epitopes could be of high value for future ANDV vaccines

Riskfaktorer för att utveckla posttraumatiskt stressyndrom hos ungdomar : En deskriptiv litteraturstudie

Bakgrund Posttraumatiskt stressyndrom bör betraktas som en folkhälsosjukdom där diagnostisering och behandling behöver uppmärksammas. Ungdomar som överlevt livshotande händelser tenderar att återuppleva dessa traumatiska händelser och undviker att handskas med känslorna som uppkommer, vilket kan leda till psykiska besvär. Syfte Att undersöka riskfaktorer som finns för att utveckla posttraumatiskt stressyndrom bland ungdomar samt undersöka vilka datainsamlingsmetoder de inkluderade artiklarna valt. Metod Deskriptiv design användes i litteraturstudien som inkluderar 13 stycken vetenskapliga artiklar från databaserna PsycInfo och PubMed. Likheter och skillnader i artiklarnas resultat identifierades och använda datainsamlingsmetoder sammanställdes. Huvudresultat Att vara utsatt för våld och traumatiska händelser såsom fysisk skada eller se någon lida/dö, vara tjej, äldre ungdom, utsatt för daglig stress, splittrad familj och sämre socialt stöd var riskfaktorer för att utveckla posttraumatiskt stressyndrom. Tio av tretton artiklar hade kvantitativ ansats och använde frågeformulär för att få svar på vilka riskfaktorer det fanns. En artikel hade kvantitativ ansats men använde inte frågeformulär och två hade endast kvalitativ ansats i form av intervju som datainsamlingsmetod. Slutsats Denna litteraturstudie identifierade olika riskfaktorer som ligger till grund för utveckling av PTSD bland ungdomar. De vanligaste som återkom i nästan alla studier var att utsättas för våld, vara med om traumatiska händelser, vara tjej, sämre socialt stöd inom familj och skola, förlora en anhörig och vardagliga stressorer. Att som sjuksköterska och övrig vårdpersonal inneha denna kunskap kan bidra till att tidigare kunna identifiera ungdomar med PTSD samt anpassa omvårdnaden till denna grupp på bästa sätt.Background Posttraumatic stress disorder should be considered as a public health disease where diagnosing and treatment require attention. Adolescents who have survived life-threatening events tend to relive these traumatic events and avoid to deal with the emotions that occur, which can lead to mental disorders. Aim Identify which risk factors there is to develop posttraumatic stress disorder among adolescents and examine which data collection methods the included articles have chosen. Method Descriptive design has been used in this literature study including 13 articles collected from the databases PsycInfo and PubMed and has been categorized by similarities and differences. The articles data collection methods has been presented from the methodological aspect. Main results To be exposed to violence and traumatic events as physical injury or see someone suffer/die, be a girl, older adolescent, exposed to daily stress, broken family and have less social support were some risk factors for developing posttraumatic stress disorder. Ten of thirteen articles had a quantitative approach and used questionnaire to get responses for which risk factors there was. One article had a quantitative approach but did not use a questionnaire and two articles had qualitative approach and used interview as data collection method. Conclusion In this literature study different risk factors were identified underlying to develop PTSD among adolescents. The most common risk factors in almost all of the studies were to be exposed to violence, experience traumatic events, be a girl, have less social support from family and school, lose a family member and daily stress. As a nurse it is important to keep this in mind so the care for the adolescents are as good as possible and that coping is used in the right way

Prevalence of back pain, its effect on functional ability and health-related quality of life in lower limb amputees secondary to trauma or tumour: a comparison across three levels of amputation.

Background and Objectives: The prevalence of back pain and its effect on function and health-related quality of life across three levels of lower limb amputation secondary to trauma or tumour was studied. Study design: Cross-sectional survey. Methods: Forty-six lower limb amputees, aged 19-78 years, participated. The Roland Morris disability questionnaire (RMDQ) and the short form 36 health survey (SF-36) were used. Results: Participants reported more back pain after amputation than before (p < 0.001). There was a significant association between back pain daily or several times/week and severe or moderate disability reporting on the RMDQ (p = 0.003). On the SF-36, the group as a whole scored significantly lower in health-related quality of life with regard to physical functioning, role physical, bodily pain, general health, social functioning and the physical component summary (PCS), and significantly higher in the mental component summary (MCS) compared to normative Swedish data. When all three levels of amputation were compared, no statistically significant differences were found in the RMDQ or SF-36 results. Conclusions: There was a high prevalence of back pain after amputation. Almost all participants having back pain daily or several times per week reported severe or moderate disability on the RMDQ. The group as a whole scored significantly lower for health-related quality of life in the PCS and significantly higher in the MCS compared to normative Swedish data. Clinical relevance The high prevalence of back pain, and the significant association between back pain daily or several times per week and severe or moderate disability on the RMDQ, and the negative correlation between RMDQ and SF-36, may have clinical relevance with regard to rehabilitation and follow-up of lower limb amputation

The association between perceived stigma and substance use disorder treatment outcomes: a review.

Substance use disorders (SUDs) take a heavy toll on those who have them and on society more broadly. These disorders are often difficult to treat, and relapse is common. Perhaps, because of these factors, these disorders are highly stigmatized worldwide. The purpose of this study is to examine empirical work intended to determine the impact of perceived social stigma and self-stigma on the process of recovering from SUDs with the assistance of formal treatment services. Qualitative studies confirmed that stigma experiences are common among those with these disorders and that these experiences can negatively impact feelings and beliefs about treatment. One quantitative study provided good statistical support for a direct effect of stigma on outcomes, but this was contradicted by other longitudinal data. In general, quantitative articles suggested an indirect effect of stigma on treatment outcomes, via negative emotions and cognitive mechanisms such as feelings of self-efficacy. However, it was notable that there was little consistency in the literature as to definitions and measurement of the constructs of recovery, perceived social stigma, and self-stigma. Future work should focus on bringing clarity, and validated measures, to this problem in order to better determine the nature of these relationships

Health Care Disparities Knowledge, Attitudes, and Behaviors in Resident Physicians

Purpose: Health care disparities are an important but sometimes underrepresented topic in graduate medical education. In this study we measured the impact of educational and behavioral interventions on resident knowledge about and attitudes toward health care disparities. Methods: Faculty from 6 residency programs designed and presented an hour-long educational intervention to emphasize the importance of and increase resident knowledge about health care disparities. Selected residents then helped design a month-long behavioral intervention to engage their peers in conversations about disparities with patients. Surveys were administered pre- and post-educational intervention as well as post-behavioral intervention in order to measure the impact each intervention had on resident knowledge and attitudes. Results: Paired-samples t-tests showed that residents were more knowledgeable about health care disparities issues following didactic teaching (P \u3c 0.001) and felt such issues were more important (P \u3c 0.001). Furthermore, presence of these feelings significantly predicted the frequency of engaging in the behavioral intervention (r = 0.44, P \u3c 0.01). Conclusions: Two brief, simple interventions produced significant changes in resident knowledge, attitudes and behaviors regarding health care disparities. The educational intervention was most effective at increasing knowledge of disparities in general and encouraging participation in the behavioral intervention, while the behavioral intervention was useful in increasing knowledge of specific patients’ barriers to care

A reference genome for pea provides insight into legume genome evolution

International audienceWe report the first annotated chromosome-level reference genome assembly for pea, Gregor Mendel’s original genetic model. Phylogenetics and paleogenomics show genomic rearrangements across legumes and suggest a major role for repetitive elements in pea genome evolution. Compared to other sequenced Leguminosae genomes, the pea genome shows intense gene dynamics, most likely associated with genome size expansion when the Fabeae diverged from its sister tribes. During Pisum evolution, translocation and transposition differentially occurred across lineages. This reference sequence will accelerate our understanding of the molecular basis of agronomically important traits and support crop improvement