Long-term human hematopoiesis in the SCID-hu mouse.

Coimplantation of small fragments of human fetal thymus and fetal liver into immunodeficient SCID mice resulted in the formation of a unique structure (Thy/Liv). Thereafter, the SCID-hu mice showed reproducible and long-term reconstitution of human hematopoietic activity. For periods lasting 5-11 mo after transplantation, active T lymphopoiesis was observed inside the grafts and cells that were negative for T cell markers were found to have colony-forming units for granulocyte/macrophage (CFU-GM) and erythroid burst-forming unit (BFU-E) activity in the methylcellulose colony assay. In addition, structures similar to normal human bone marrow were observed inside the Thy/Liv grafts, consisting of blast cells, mature and immature forms of myelomonocytic cells, and megakaryocytes. These data indicate long-term maintenance, in vivo, of human progenitor cells for the T lymphoid, myelomonocytic, erythroid, and megakaryocytic lineages. The role of the implanted fetal liver fragments was analyzed using HLA-mismatched Thy/Liv implants. The HLA type of the liver donor was found on T cells and macrophages in the graft. In addition, cells grown in the methylcellulose colony assay and cells in a bone marrow-like structure, the thymic isle, expressed the HLA type of the liver donor. Thus, the Thy/Liv implants provided a microenvironment in which to follow human hematopoietic progenitor cells for multiple lineages. The formation of the Thy/Liv structures also results in a continuous source of human T cells in the peripheral circulation of the SCID-hu mouse. Though present for 5-11 mo, these cells did not engage in a xenograft (graft-versus-host) reaction. This animal model, the first in which multilineage human hematopoietic activity is maintained for long periods of time, should be useful for the analysis of human hematopoiesis in vivo

The Veterinary Nurse Workshops 2015: feline patients and stress

It is important that feline stress is considered in cats in the veterinary hospital, as stress can negatively impact on the welfare of the individual in several ways, for example, stressed cat can often be difficult to examine and may require restraint during handling. Such handling can often further impact negatively on the animal's emotional state — such signs of stress related to the veterinary environment and difficulty in examining can make it hard to make a diagnosis. Furthermore, for animals experiencing a stay in the veterinary hospital, stress can increase the recovery time of the patient. It is therefore important to assess each feline patient and take measures appropriate to that individual to help them cope in an inherently stressful environment. As animals descended from a solitary ancestor, cats are often very subtle in their body language and behaviour (e.g. posture, facial expressions, type and frequency of specific behaviours), and as a result signs of stress can be difficult to detect. However, veterinary nurses are well placed to monitor behavioural signs of stress displayed by patients in the hospital. As well as learning such signs, being able to communicate them both verbally and through the use of written records will not only ensure each patient has the best care from nurse to nurse, it will also help any student nurses in the practice learn these skills. Stress in the feline patient was the subject of discussion at The Veterinary Nurse workshops 201

Sexual preventative health in US sexual minority women: a review

Despite growing interest and research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) health topics over the last 20 years, relatively little is known about sexual minority women. This review seeks to explore sexual practices, use of preventative measures including barrier methods during sexual activity, sexually transmitted infection rates, and use of screening healthcare services by sexual minority women. Additionally, the role healthcare providers can take in filling this knowledge gap and providing appropriate services is reviewed

Sexual preventative health in US sexual minority women: a review

Despite growing interest and research in lesbian, gay, bisexual, transgender, and queer (LGBTQ) health topics over the last 20 years, relatively little is known about sexual minority women. This review seeks to explore sexual practices, use of preventative measures including barrier methods during sexual activity, sexually transmitted infection rates, and use of screening healthcare services by sexual minority women. Additionally, the role healthcare providers can take in filling this knowledge gap and providing appropriate services is reviewed

A method for finding new sets of axioms for classes of semigroups

We introduce a general technique for finding sets of axioms for a given class of semigroups. To illustrate the technique, we provide new sets of defining axioms for groups of exponent n, bands, and semilattices

Scavenger 0.1: A Theorem Prover Based on Conflict Resolution

This paper introduces Scavenger, the first theorem prover for pure first-order logic without equality based on the new conflict resolution calculus. Conflict resolution has a restricted resolution inference rule that resembles (a first-order generalization of) unit propagation as well as a rule for assuming decision literals and a rule for deriving new clauses by (a first-order generalization of) conflict-driven clause learning.Comment: Published at CADE 201

Related Enteric Viruses Have Different Requirements for Host Microbiota in Mice

Accumulating evidence suggests that intestinal bacteria promote enteric virus infection in mice. For example, previous work demonstrated that antibiotic treatment of mice prior to oral infection with poliovirus reduced viral replication and pathogenesis. Here, we examined the effect of antibiotic treatment on infection with coxsackievirus B3 (CVB3), a picornavirus closely related to poliovirus. We treated mice with a mixture of five antibiotics to deplete host microbiota and examined CVB3 replication and pathogenesis following oral inoculation. We found that, as seen with poliovirus, CVB3 shedding and pathogenesis were reduced in antibiotic-treated mice. While treatment with just two antibiotics, vancomycin and ampicillin, was sufficient to reduce CVB3 replication and pathogenesis, this treatment had no effect on poliovirus. The quantity and composition of bacterial communities were altered by treatment with the five-antibiotic cocktail and by treatment with vancomycin and ampicillin. To determine whether more-subtle changes in bacterial populations impact viral replication, we examined viral infection in mice treated with milder antibiotic regimens. Mice treated with one-tenth the standard concentration of the normal antibiotic cocktail supported replication of poliovirus but not CVB3. Importantly, a single dose of one antibiotic, streptomycin, was sufficient to reduce CVB3 shedding and pathogenesis while having no effect on poliovirus shedding and pathogenesis. Overall, replication and pathogenesis of CVB3 are more sensitive to antibiotic treatment than poliovirus, indicating that closely related viruses may differ with respect to their reliance on microbiota. IMPORTANCE Recent data indicate that intestinal bacteria promote intestinal infection of several enteric viruses. Here, we show that coxsackievirus, an enteric virus in the picornavirus family, also relies on microbiota for intestinal replication and pathogenesis. Relatively minor depletion of the microbiota was sufficient to decrease coxsackievirus infection, while poliovirus infection was unaffected. Surprisingly, a single dose of one antibiotic was sufficient to reduce coxsackievirus infection. Therefore, these data indicate that closely related viruses may differ with respect to their reliance on microbiota

Mapping change in medical student attitudes regarding lesbian, gay and bisexual healthcare

Despite significant social advances among lesbian, gay, bisexual, and transgender (LGBT) individuals, healthcare disparities remain prevalent. Medical education represents a prime opportunity for addressing this need. Thus, we undertook this study to explore second year medical students’ attitudes regarding equal access to healthcare services including erectile dysfunction medication, family planning medications and technology, and partner health insurance coverage. Nearly 1500 allopathic medical students were surveyed from 2006 to 2014 during their second pre-clinical training year. While attitudes regarding care between LGB patients and heterosexual patients were often similar, there was a significant change in favor of providing insurance coverage for in-vitro and assisted reproduction services for lesbian women (increasing from 70% of students in favor in 2008 to 87% of students in 2013). Similarly, the proportion of students in favor of providing health insurance coverage for prescription drugs to same sex partners significantly increased from 2009 to 2013. Additionally, students noted healthcare providers should be required to provide equal access to care for all patients regardless of marital status or sexual practices (96% agreement in 2006 and 98.6% agreement in 2014). Even with this significant increase in medical student approval of certain healthcare services for LGB patients, continuing to integrate LGBT healthcare topics into medical education curriculum remains critically important

Improving communication in intensive care unit to ward transitions: Protocol for multisite national implementation of the ICU-PAUSE handoff tool

BACKGROUND: The intensive care unit (ICU)-ward transfer poses a particularly high-risk period for patients. The period after transfer has been associated with adverse events and additional work for care teams related to miscommunication or omission of information. Standardized handoff processes have been found to reduce communication errors and adverse patient events in other clinical environments but are understudied at the ICU-ward interface. We previously developed an electronic ICU-ward transfer tool, ICU-PAUSE, which embeds the key elements and diagnostic reasoning to facilitate a safe transfer of care at ICU discharge. OBJECTIVE: The aim of this study is to evaluate the implementation process of the ICU-PAUSE handoff tool across 10 academic medical centers, including the rate of adoption and acceptability, as perceived by clinical care teams. METHODS: ICU-PAUSE will be implemented in the medical ICU across 10 academic hospitals, with each site customizing the tool to their institution\u27s needs. Our mixed methods study will include a combination of a chart review, quantitative surveys, and qualitative interviews. After a 90-day implementation period, we will conduct a retrospective chart review to evaluate the rate of uptake of ICU-PAUSE. We will also conduct postimplementation surveys of providers to assess perceptions of the tool and its impact on the frequency of communication errors and adverse events during ICU-ward transfers. Lastly, we will conduct semistructured interviews of faculty stakeholders with subsequent thematic analysis with the goal of identifying benefits and barriers in implementing and using ICU-PAUSE. RESULTS: ICU-PAUSE was piloted in the medical ICU at Barnes-Jewish Hospital, the teaching hospital of Washington University School of Medicine in St. Louis, in 2019. As of July 2022, implementation of ICU-PAUSE is ongoing at 6 of 10 participating sites. Our results will be published in 2023. CONCLUSIONS: Our process of ICU-PAUSE implementation embeds each step of template design, uptake, and customization in the needs of users and key stakeholders. Here, we introduce our approach to evaluate its acceptability, usability, and impact on communication errors according to the tenets of sociotechnical theory. We anticipate that ICU-PAUSE will offer an effective handoff tool for the ICU-ward transition that can be generalized to other institutions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40918