Diagnostic test interpretation and referral delay in patients with interstitial lung disease.

BACKGROUND:Diagnostic delays are common in patients with interstitial lung disease (ILD). A substantial percentage of patients experience a diagnostic delay in the primary care setting, but the factors underpinning this observation remain unclear. In this multi-center investigation, we assessed ILD reporting on diagnostic test interpretation and its association with subsequent pulmonology referral by a primary care physician (PCP). METHODS:A retrospective cohort analysis of patients referred to the ILD programs at UC-Davis and University of Chicago by a PCP within each institution was performed. Computed tomography (CT) of the chest and abdomen and pulmonary function test (PFT) were reviewed to identify the date ILD features were first present and determine the time from diagnostic test to pulmonology referral. The association between ILD reporting on diagnostic test interpretation and pulmonology referral was assessed, as was the association between years of diagnostic delay and changes in fibrotic features on longitudinal chest CT. RESULTS:One hundred and forty-six patients were included in the final analysis. Prior to pulmonology referral, 66% (n = 97) of patients underwent chest CT, 15% (n = 21) underwent PFT and 15% (n = 21) underwent abdominal CT. ILD features were reported on 84, 62 and 33% of chest CT, PFT and abdominal CT interpretations, respectively. ILD reporting was associated with shorter time to pulmonology referral when undergoing chest CT (1.3 vs 15.1 months, respectively; p = 0.02), but not PFT or abdominal CT. ILD reporting was associated with increased likelihood of pulmonology referral within 6 months of diagnostic test when undergoing chest CT (rate ratio 2.17, 95% CI 1.03-4.56; p = 0.04), but not PFT or abdominal CT. Each year of diagnostic delay was associated with a 1.8% increase in percent fibrosis on chest CT. Patients with documented dyspnea had shorter time to chest CT acquisition and pulmonology referral than patients with documented cough and lung crackles. CONCLUSIONS:Determinants of ILD diagnostic delays in the primary care setting include underreporting of ILD features on diagnostic testing and prolonged time to pulmonology referral even when ILD is reported. Interventions to modulate these factors may reduce ILD diagnostic delays in the primary care setting

Utilização de perfil em rede social para divulgação de informação em saúde da criança: Relato de experiência

Este é um relato de experiência que tem como objetivo apresentar a utilização de um perfil da rede social Instagram® que divulga informações em saúde da criança. Tal perfil foi criado no início da pandemia da COVID-19 como forma de continuidade do projeto de extensão Enfermagem na Promoção da Saúde e Prevenção de Agravos na Infância, que era desenvolvido de forma presencial e passou a ser virtual. Nesse contexto, este relato apresenta as adaptações das atividades presenciais e as mudanças que precisaram ser adotadas após a pandemia. Entre 1º de junho de 2020 e 31 de dezembro de 2021 foram feitas 128 postagens, sendo 35 vídeos e 93 imagens relacionadas à saúde da criança. Em relação aos vídeos, o total foi de 6694 visualizações, enquanto no que se refere às imagens o total de curtidas foi de 3196. O perfil possui 828 seguidores, incluindo discentes e docentes de vários cursos e instituições, responsáveis por crianças e outros membros da comunidade. As adaptações das atividades, que passaram a ser virtuais, possibilitaram uma convivência harmônica entre as integrantes do projeto, com respeito, compromisso e potencial contribuição para o aprendizado. Em suma, a rede social se mostra de extrema importância, visto que a internet é um meio de comunicação em massa de fácil acesso à população, que a utiliza para realizar buscas sobre diversos temas. Palavras-chave: Cuidado da Criança; Família; Mídias Sociais; Relações Comunidade-Instituição; Enfermagem Pediátrica Use of a social network profile for the dissemination of information on children's health: experience report Abstract: This article is an experience report that aims to present the use of a social network profile in the Instagram® to disseminate information on child health. This profile was created at the beginning of the COVID-19 pandemic to continue the extension project "Nursing in Health Promotion and Prevention of Childhood Illnesses," which was developed in-person and became virtual. In this context, this report presents the adaptations of the in-person activities and the changes that needed to be adopted after the pandemic. Between June 1rst, 2020, and December 31rst, 2021, there were 128 posts on the profile, from which 35 were videos and 93 were images related to the child's health. Regarding the videos, there were 6694 views, while concerning the images, the total of likes was 3196. The profile has 828 followers, including students and professors from various courses and institutions, responsible for children and other community members. The adaptations of the activities, which became virtual, enabled a harmonious coexistence between the project members, with respect, commitment, and potential contribution to learning. In short, the social network is critical since the internet is a form of mass communication with easy access to the population, who uses it to conduct research on various topics. Keywords: Child Care; Family; Social Media; Community-Institution Relations; Pediatric Nursing

Current understanding and future research priorities in malignancy associated with inborn errors of immunity and DNA repair disorders : the perspective of an interdisciplinary working group

Patients with inborn errors of immunity or DNA repair defects are at significant risk of developing malignancy and this complication of their underlying condition represents a substantial cause of morbidity and mortality. Whilst this risk is increasingly well-recognized, our understanding of the causative mechanisms remains incomplete. Diagnosing cancer is challenging in the presence of underlying co-morbidities and frequently other inflammatory and lymphoproliferative processes. We lack a structured approach to management despite recognizing the competing challenges of poor response to therapy and increased risk of toxicity. Finally, clinicians need guidance on how to screen for malignancy in many of these predisposing immunodeficiencies. In order to begin to address these challenges, we brought together representatives of European Immunology and Pediatric Haemato-Oncology to define the current state of our knowledge and identify priorities for clinical and research development. We propose key developmental priorities which our two communities will need to work together to address, collaborating with colleagues around the world

MIGHTEE-HI: The first MeerKAT HI mass function from an untargeted interferometric survey

We present the first measurement of the HI mass function (HIMF) using data from MeerKAT, based on 276 direct detections from the MIGHTEE Survey Early Science data covering a period of approximately a billion years ($0 \leq z \leq 0.084$). This is the first HIMF measured using interferometric data over non-group or cluster field, i.e. a deep blank field. We constrain the parameters of the Schechter function which describes the HIMF with two different methods: $1/\rm V_{\rm max}$ and Modified Maximum Likelihood (MML). We find a low-mass slope $\alpha=-1.29^{+0.37}_{-0.26}$, `knee' mass $\log_{10}(M_{*}/{\rm M_{\odot}}) = 10.07^{+0.24}_{-0.24}$ and normalisation $\log_{10}(\phi_{*}/\rm Mpc^{-3})=-2.34^{+0.32}_{-0.36}$ ($H_0 = 67.4$ kms$^{-1}$ Mpc$^{-1}$) for $1/\rm V_{\rm max}$ and $\alpha=-1.44^{+0.13}_{-0.10}$, `knee' mass $\log_{10}(M_{*}/{\rm M_{\odot}}) = 10.22^{+0.10}_{-0.13}$ and normalisation $\log_{10}(\phi_{*}/\rm Mpc^{-3})=-2.52^{+0.19}_{-0.14}$ for MML. When using $1/\rm V_{\rm max}$ we find both the low-mass slope and `knee' mass to be consistent within $1\sigma$ with previous studies based on single-dish surveys. The cosmological mass density of HI is found to be slightly larger than previously reported: $\Omega_{\rm HI}=5.46^{+0.94}_{-0.99} \times 10^{-4}h^{-1}_{67.4}$ from $1/\rm V_{\rm max}$ and $\Omega_{\rm HI}=6.31^{+0.31}_{-0.31} \times 10^{-4}h^{-1}_{67.4}$ from MML but consistent within the uncertainties. We find no evidence for evolution of the HIMF over the last billion years.Comment: 13 pages, 9 figures, accepted for publication in MNRA

Oxidative Coupling as a Biomimetic Approach to the Synthesis of Scytonemin

The first total synthesis of the dimeric alkaloid pigment scytonemin is described. The key transformations In Its synthesis from 3-indole acetic acid are a Heck carbocyclization and a Suzuki-Miyaura cross-coupling, orchestrated In a stereospecific tandem fashion, followed by a biosynthetically inspired oxidative dimerization. The tandem sequence generates a tetracyclic (E)-3-(arylidene)-3,4-dihydrocyclopenta[b]indol-2(1H)-one that is subsequently dimerized into the unique homodimeric core structure of scytonemin

JINGLE, a JCMT legacy survey of dust and gas for galaxy evolution studies - I. Survey overview and first results

JINGLE is a new JCMT legacy survey designed to systematically study the cold interstellar medium of galaxies in the local Universe. As part of the survey we perform 850 μm continuum measurements with SCUBA-2 for a representative sample of 193 Herschel-selected galaxies with M* \u3e 109 M⊙, as well as integrated CO(2-1) line fluxes with RxA3m for a subset of 90 of these galaxies. The sample is selected from fields covered by the Herschel-ATLAS survey that are also targeted by the MaNGA optical integral-field spectroscopic survey. The new JCMT observations combined with the multiwavelength ancillary data will allow for the robust characterization of the properties of dust in the nearby Universe, and the benchmarking of scaling relations between dust, gas, and global galaxy properties. In this paper we give an overview of the survey objectives and details about the sample selection and JCMT observations, present a consistent 30-band UV-to-FIR photometric catalogue with derived properties, and introduce the JINGLE Main Data Release. Science highlights include the non-linearity of the relation between 850 μm luminosity and CO line luminosity (log LCO(2-1) = 1.372 logL850-1.376), and the serendipitous discovery of candidate z \u3e 6 galaxies

Confirmation of a charged charmoniumlike state Zc(3885)∓Z_c(3885)^{\mp} in e+e−→π±(DDˉ∗)∓e^+e^-\to\pi^{\pm}(D\bar{D}^*)^\mp with double DD tag

We present a study of the process $e^+e^-\to\pi^{\pm}(D\bar{D}^*)^{\mp}$ using data samples of 1092~pb$^{-1}$ at $\sqrt{s}=4.23$~GeV and 826~pb$^{-1}$ at $\sqrt{s}=4.26$~GeV collected with the BESIII detector at the BEPCII storage ring. With full reconstruction of the $D$ meson pair and the bachelor $\pi^{\pm}$ in the final state, we confirm the existence of the charged structure $Z_c(3885)^{\mp}$ in the $(D\bar{D}^*)^{\mp}$ system in the two isospin processes $e^+e^-\to\pi^+D^0D^{*-}$ and $e^+e^-\to\pi^+D^-D^{*0}$. By performing a simultaneous fit, the statistical significance of $Zc(3885)^{\mp}$ signal is determined to be greater than 10$\sigma$, and its pole mass and width are measured to be $M_{\rm{pole}}$=(3881.7$\pm$1.6(stat.)$\pm$1.6(syst.))~MeV/$c^2$ and $\Gamma_{\rm{pole}}$=(26.6$\pm$2.0(stat.)$\pm$2.1(syst.))~MeV, respectively. The Born cross section times the $(D\bar{D}^*)^{\mp}$ branching fraction ($\sigma(e^+e^-\to\pi^{\pm}Z_{c}(3885)^{\mp}) \times Br(Z_{c}(3885)^{\mp}\to(D\bar{D}^*)^{\mp})$) is measured to be $(141.6\pm7.9(\text{stat.})\pm12.3(\text{syst.}))~\text{pb}$ at $\sqrt{s}=4.23$~GeV and $(108.4\pm6.9(\text{stat.})\pm8.8(\text{syst.}))~\text{pb}$ at $\sqrt{s}=4.26$~GeV. The polar angular distribution of the $\pi^{\pm}$-$Z_c(3885)^{\mp}$ system is consistent with the expectation of a quantum number assignment of $J^P=1^+$ for $Z_c(3885)^{\mp}$

JINGLE, a JCMT legacy survey of dust and gas for galaxy evolution studies: II. SCUBA-2 850 μm data reduction and dust flux density catalogues

We present the SCUBA-2 850μm component of JINGLE, the new JCMT large survey for dust and gas in nearby galaxies, which with 193 galaxies is the largest targeted survey of nearby galaxies at 850 μm. We provide details of our SCUBA-2 data reduction pipeline, optimized for slightly extended sources, and including a calibration model adjusted to match conventions used in other far-infrared (FIR) data. We measure total integrated fluxes for the entire JINGLE sample in 10 infrared/submillimetre bands, including all WISE, Herschel-PACS, Herschel-SPIRE, and SCUBA-2 850 μm maps, statistically accounting for the contamination by CO(J = 3-2) in the 850 μm band. Of our initial sample of 193 galaxies, 191 are detected at 250 μm with a ≥5σ significance. In the SCUBA-2 850 μm band we detect 126 galaxies with ≥3σ significance. The distribution of the JINGLE galaxies in FIR/sub-millimetre colour-colour plots reveals that the sample is not well fit by single modified-blackbody models that assume a single dust-emissivity index (β). Instead, our new 850 μm data suggest either that a large fraction of our objects require β < 1.5, or that a model allowing for an excess of sub-mm emission (e.g. a broken dust emissivity law, or a very cold dust component ≲10 K) is required. We provide relations to convert FIR colours to dust temperature and β for JINGLE-like galaxies. For JINGLE the FIR colours correlate more strongly with star-formation rate surface-density rather than the stellar surface-density, suggesting heating of dust is greater due to younger rather than older stellar-populations, consistent with the low proportion of early-type galaxies in the sample

The FANC pathway is activated by adenovirus infection and promotes viral replication-dependent recombination

Deciphering the crosstalk between a host cell and a virus during infection is important not only to better define viral biology but also to improve our understanding of cellular processes. We identified the FANC pathway as a helper of viral replication and recombination by searching for cellular targets that are modified by adenovirus (Ad) infection and are involved in its outcome. This pathway, which is involved in the DNA damage response and checkpoint control, is altered in Fanconi anaemia, a rare cancer predisposition syndrome. We show here that Ad5 infection activates the FANC pathway independent of the classical DNA damage response. Infection with a non-replicating Ad shows that the presence of viral DNA is not sufficient to induce the monoubiquitination of FANCD2 but still activates the DNA damage response coordinated by phospho-NBS1 and phospho-CHK1. E1A expression alone fails to induce FANCD2 monoubiquitination, indicating that a productive viral infection and/or replication is required for FANC pathway activation. Our data indicate that Ad5 infection induces FANCD2 activation to promote its own replication. Specifically, we show that FANCD2 is involved in the recombination process that accompanies viral DNA replication. This study provides evidence of a DNA damage-independent function of the FANC pathway and identifies a cellular system involved in Ad5 recombination

In vivo migration of labeled autologous natural killer cells to liver metastases in patients with colon carcinoma

BACKGROUND: Besides being the effectors of native anti-tumor cytotoxicity, NK cells participate in T-lymphocyte responses by promoting the maturation of dendritic cells (DC). Adherent NK (A-NK) cells constitute a subset of IL-2-stimulated NK cells which show increased expression of integrins and the ability to adhere to solid surface and to migrate, infiltrate, and destroy cancer. A critical issue in therapy of metastatic disease is the optimization of NK cell migration to tumor tissues and their persistence therein. This study compares localization to liver metastases of autologous A-NK cells administered via the systemic (intravenous, i.v.) versus locoregional (intraarterial, i.a.) routes. PATIENTS AND METHODS: A-NK cells expanded ex-vivo with IL-2 and labeled with (111)In-oxine were injected i.a. in the liver of three colon carcinoma patients. After 30 days, each patient had a new preparation of (111)In-A-NK cells injected i.v. Migration of these cells to various organs was evaluated by SPET and their differential localization to normal and neoplastic liver was demonstrated after i.v. injection of (99m)Tc-phytate. RESULTS: A-NK cells expressed a donor-dependent CD56(+)CD16(+)CD3(- )(NK) or CD56(+)CD16(+)CD3(+ )(NKT) phenotype. When injected i.v., these cells localized to the lung before being visible in the spleen and liver. By contrast, localization of i.a. injected A-NK cells was virtually confined to the spleen and liver. Binding of A-NK cells to liver neoplastic tissues was observed only after i.a. injections. CONCLUSION: This unique study design demonstrates that A-NK cells adoptively transferred to the liver via the intraarterial route have preferential access and substantial accumulation to the tumor site