Molecular characterization of a human matrix attachment region epigenetic regulator.

Matrix attachment regions (MAR) generally act as epigenetic regulatory sequences that increase gene expression, and they were proposed to partition chromosomes into loop-forming domains. However, their molecular mode of action remains poorly understood. Here, we assessed the possible contribution of the AT-rich core and adjacent transcription factor binding motifs to the transcription augmenting and anti-silencing effects of human MAR 1-68. Either flanking sequences together with the AT-rich core were required to obtain the full MAR effects. Shortened MAR derivatives retaining full MAR activity were constructed from combinations of the AT-rich sequence and multimerized transcription factor binding motifs, implying that both transcription factors and the AT-rich microsatellite sequence are required to mediate the MAR effect. Genomic analysis indicated that MAR AT-rich cores may be depleted of histones and enriched in RNA polymerase II, providing a molecular interpretation of their chromatin domain insulator and transcriptional augmentation activities

Telemedicine consultation to the general ICU

Early implementations of intensive care unit (ICU) telemedicine, or tele-ICU, focused on using remote intensivists to alleviate intensivist staffing shortages and to meet national ICU staffing standards. With decreasing technology acquisition and implementation costs and improved technological capabilities, the use cases for ICU telemedicine consultations have expanded. Traditional tele-ICU consultation includes ICU patient triage for improved hospital system resource allocation and continuous monitoring of critically ill patients to promote early interventions that prevent patient deterioration. With the widespread adoption of electronic medical records, integration of medical devices, and sensorization of the environment, the boundaries of ICU tele-consulting will rapidly expand. This expansion should allow a wide array of specialist consultation for patients within an ICU while also extending the ability of intensivists to tele-consult on patients not located in the ICU. Such activities have the potential to expand the reach of ICU care beyond the walls of the ICU, leading to improved care of patients who are trending toward critical illness and thus preventing the need for ICU admission. The barriers to more universal use of telemedicine for critical care consultations include staffing needs, existing work processes, and the attitudes and perceptions of ICU staff. Models for telemedicine implementations are highly variable and depend on the resources and use cases of individual healthcare systems. At this time there is no single optimal model of ICU telemedicine. As models continue to mature and evolve, the value that telemedicine brings to critically ill patients, providers, and healthcare systems will be better established

Echinococcus multilocularis infection in the field vole (Microtus agrestis): an ecological model for studies on transmission dynamics

We propose a model involving the oral inoculation of Echinococcus multilocularis eggs in a vole species and examine the infection dynamics in a dose-response experiment. Defined doses, 100 (n = 8), 500 (n = 5) and 1000 (n = 5) of E. multilocularis eggs were used to inoculate Microtus agrestis. Four female C57BL/6j mice were inoculated with 1000 eggs as positive controls. The groups inoculated with 100 and 500 eggs exhibited significantly higher lesion numbers, and relatively smaller lesion size was observed in the 1000 dose group. Undetectable abortive lesions may be responsible for some form of resource limitation early in the infection, resulting in lower lesion counts and size in the 1000 dose group. The C57BL/6j mice exhibited significantly fewer lesions than M. agrestis. The feasibility of measuring corticosterone (which has been shown to downregulate Th1 cytokines) in rodent hair and tumour necrosis factor (TNF) production in spleen cells was demonstrated by a positive correlation between corticosterone levels and higher lesion counts and TNF production in C57BL/6j, respectively. These results suggest that M. agrestis is more prone to a Th2 immune response than C57BL/6j, which is associated with E. multilocularis susceptibility and may explain why the parasite develops more slowly in murine models. This is the first data to suggest that M. agrestis is capable of supporting E. multilocularis transmission and thus may be suited as a model to describe the infection dynamics in an intermediate host that affects transmission under natural conditions