Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Der almanach des blauen reiters als gesamtkunstwerk: eine interdisziplinäre untersuchung

Perhaps more than any other, the Modernist period (c. 1890-1939) is defined by its culture. This book analyses arguably the most valuable surviving primary source of the period, the Blue Rider almanac (Der Blaue Reiter, 1912), whilst investigating the fundamental nature of the relationship between the Arts with particular reference to the Modernist period. The almanac is conceptualised as a 'total work of art', and established as the twentieth century's most significant attempt at both theorising and exemplifying the concept of a Gesamtkunstwerk. The insight gained necessitates not just a reappraisal of the Blue Rider movement, but the entire Modernist period. Edited by Franz Marc and Wassily Kandinsky, the almanac includes essays on art and music, numerous illustrations of diverse artworks, three scores, a poem, a prose extract, an essay by Kandinsky on his theory of so-called stage composition and one such work, The Yellow Sound (Der gelbe Klang). Despite the abundance of secondary literature on the Blue Rider, the almanac has never before been considered in its entirety. Indeed, much of its contents has been passed over completely. This publication re-evaluates the almanac as a collective, international and quintessentially interdisciplinary undertaking. Chapter I examines the major ideas underpinning the almanac, such as the perception of art as a spiritual phenomenon and the belief that the question of form was secondary. An extensive central chapter is divided into sections on Art, Music, Literature and Stage, and includes individual analyses of the contributions to the almanac, whilst drawing out links between them and relating them to the framework of ideas. The final chapter assesses the almanac as a Gesamtkunstwerk in the light of such factors as its contents, structure and layout, the emphasis on the participation of artists as authors, and the use of language within the publication

Can grip strength be used as a surrogate marker to monitor recovery from shoulder fatigue?

Muscular fatigue impacts on normal shoulder function, which is particularly pertinent to throwing athletes. This study aimed to investigate the relationship between grip strength and shoulder muscle fatigue to evaluate the role of grip strength as a surrogate measure for upper limb performance. Twenty healthy participants were recruited. EMG was recorded from 15 shoulder muscles during different fatiguing contractions: an initial baseline recording (Fat-Baseline); after a shoulder exhausting exercise regime (Fat-Exhaustion); and after a 10 minute rest period (Fat-Recovery). Grip strength was similarly measured in the same conditions. Grip strength differed significantly across the testing scenarios (p= 0.012 - <0.001). Greater fatigue was seen in anterior deltoid, middle deltoid, posterior deltoid and supraspinatus in the Fat-Exhaustion contraction as compared to the Fat-Baseline contraction (p=<0.001-0.043). Greater fatigue was seen during the Fat-Recovery contraction for the trapezius, serratus anterior and biceps brachii as compared to the Fat-Exhaustion contraction (p=0.008-0.038). Grip strength decreased following an exhausting exercise protocol but recovered to baseline following a rest period. Conversely, EMG indices of fatigue did not recover. Additional fatigue was seen reflecting a reorganisation of movement strategy. Therefore, susceptibility to injury still exists if grip strength alone is used as a barometer of upper limb performance

Virtual Reality in Nursing Education and Clinical Practice: A Scoping Review

Virtual reality, including modalities such as: immersive/augmented reality, gaming, and screenbased simulations as an educational strategy has become a reality in nursing education and practice. • These experiences provide an opportunity to apply clinical learning in a virtual setting (Hansen & Dunn, 2020; Verkuyl & Hughes, 2019). • The aim of this scoping review was to identify gaps, review the body of nursing literature on virtual reality, and further clarify concepts/related concepts of virtual reality

Vibration as an adjunct to exercise: its impact on shoulder muscle activation

Purpose There is an interest within elite sport in understanding the impact of a vibrating platform as an adjunct to exercise in the training and rehabilitation of throwing athletes. However, there has been no comprehensive evaluation of its impact on the rotator cuf muscles or its efect on the timing of shoulder muscle recruitment more globally. Methods Twenty healthy participants were recruited with EMG recorded from 15 shoulder girdle muscles. Isometric shoulder fexion at 25% maximal voluntary contraction was performed in three testing scenarios [no vibration; whole body vibration (WBV); and arm vibration (AV)]. A press up and triceps dips with and without vibration were also performed. Muscular recruitment was assessed pre- and post-vibration exposure as participants initiated forward fexion. Results Activation of the anterior deltoid (p=0.002), serratus anterior (p=0.004), and rotator cuf muscles (p=0.004–0.022) occurred signifcantly earlier following exposure to vibration. Signifcantly greater activation was seen in the anterior, middle and posterior deltoid, upper, middle and lower trapezius, serratus anterior, teres major, latissimus dorsi, supraspinatus, and infraspinatus when the isometric contraction was performed with either WBV and/or AV (p= <0.001–0.040). Similarly, increased activation was also demonstrated during the press up and triceps dips when performed with vibration. Conclusion The use of vibration as an adjunct to exercise provokes a near global increase in shoulder muscle activation level. Furthermore, exposure to vibration alters muscular recruitment improving readiness for movement. This has potential implications within elite sport for both training and game preparation; however, further longitudinal work is required

Integrative Review of Interprofessional Simulation in Nursing Practice

AIM: The aim of this integrative review was to examine what is known about interprofessional (IP) simulation involving practicing nurses. BACKGROUND: The use of simulation within health care education and practice has rapidly expanded; however, there is a gap in what is known about the benefits of nurses engaging in IP simulation. METHOD: Five reviewers conducted a systematic literature search on studies of IP simulation among practicing nurses, published between January 1, 2010, and July 1, 2016. An initial sample of 1,400 articles was found and was further narrowed to 18 studies. RESULTS: There is a role for IP simulation in enhancing nurses\u27 roles and understanding of the roles of other practitioners. However, the diversity of studies and lack of rigor prevents the formation of conclusive evidence to support IP simulation in enhancing patient care quality and safety. CONCLUSION: Structured simulation research designs using published guidelines for best practice implementation are needed