Nitrate metabolism in tobacco leaves overexpressing Arabidopsis nitrite reductase

AbstractPrimary nitrogen assimilation in plants includes the reduction of nitrite to ammonium in the chloroplasts by the enzyme nitrite reductase (NiR EC:1.7.7.1) or in the plastids of non-photosynthetic organs. Here we report on a study overexpressing the Arabidopsis thaliana NiR (AtNiR) gene in tobacco plants under the control of a constitutive promoter (CERV – Carnation Etched Ring Virus). The aim was to overexpress AtNiR in an attempt to alter the level of residual nitrite in the leaf which can act as precursor to the formation of nitrosamines. The impact of increasing the activity of AtNiR produced an increase in leaf protein and a stay-green phenotype in the primary transformed AtNiR population. Investigation of the T1 homozygous population demonstrated elevated nitrate reductase (NR) activity, reductions in leaf nitrite and nitrate and the amino acids proline, glutamine and glutamate. Chlorophyl content of the transgenic lines was increased, as evidenced by the stay-green phenotype. This reveals the importance of NiR in primary nitrogen assimilation and how modification of this key enzyme affects both the nitrogen and carbon metabolism of tobacco plants

Improving the Quality and Delivery of Substance Use Disorder Resource List

Introduction The state of New Mexico has numerous organizations that help individuals with substance use disorders (SUDs). University of New Mexico Hospital (UNMH) social workers had previously started a list of these resources; however, it was neither updated nor used often. We aim to improve the quality, awareness, and delivery of this list on UNMH internal medicine (IM) inpatient units. Methods To improve the quality of the list we developed a concise SUD resource document using the pre-existing list as a template. We modified the list after feedback from patients, providers and literacy specialists. The final list was organized alphabetically and categorized according to the services offered, with brief descriptions about each facility added. For baseline data on awareness of the list, we administered surveys to available inpatient IM providers. 31st increase the awareness of the list, we educated IM residents on clinical inpatient services at UNMH biweekly about its purpose and availability. We administered surveys before each education session for two months. To improve the accessibility of the list, we regularly supplied each resident workroom with the resource list. After receiving hospital approval, we uploaded the list onto the UNMH electronic medical record system. Results At baseline, we surveyed 37 IM providers. 89% viewed the delivery of resources to patients with SUD as important. Of this group, 55% were aware that the list was available to give patients and only 20% of them knew how to access it. After two months of education, 100% of surveyed providers viewed the delivery of resources to patients with SUD as important. We increased the awareness and knowledge of its accessibility by 18% and 60%, respectively, from baseline. Conclusion Our quality improvement project increased awareness and ease of access of the SUD resource list. These successes demonstrate that a simple delivery method for resource lists can be implemented in a short time. Our next steps include spreading awareness of how to access the list electronically through biweekly education sessions and ongoing surveying, as well as educating other hospital departments. We are currently assessing whether retrospective chart reviews may help determine the frequency of its use

Durvalumab Plus Carboplatin/Paclitaxel Followed by Maintenance Durvalumab With or Without Olaparib as First-Line Treatment for Advanced Endometrial Cancer: The Phase III DUO-E Trial

PURPOSE Immunotherapy and chemotherapy combinations have shown activity in endometrial cancer, with greater benefit in mismatch repair (MMR)-deficient (dMMR) than MMR-proficient (pMMR) disease. Adding a poly(ADP-ribose) polymerase inhibitor may improve outcomes, especially in pMMR disease. METHODS This phase III, global, double-blind, placebo-controlled trial randomly assigned eligible patients with newly diagnosed advanced or recurrent endometrial cancer 1:1:1 to: carboplatin/paclitaxel plus durvalumab placebo followed by placebo maintenance (control arm); carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib placebo (durvalumab arm); or carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab plus olaparib (durvalumab + olaparib arm). The primary end points were progression-free survival (PFS) in the durvalumab arm versus control and the durvalumab + olaparib arm versus control. RESULTS Seven hundred eighteen patients were randomly assigned. In the intention-to-treat population, statistically significant PFS benefit was observed in the durvalumab (hazard ratio [HR], 0.71 [95% CI, 0.57 to 0.89]; P = .003) and durvalumab + olaparib arms (HR, 0.55 [95% CI, 0.43 to 0.69]; P < .0001) versus control. Prespecified, exploratory subgroup analyses showed PFS benefit in dMMR (HR [durvalumab v control], 0.42 [95% CI, 0.22 to 0.80]; HR [durvalumab + olaparib v control], 0.41 [95% CI, 0.21 to 0.75]) and pMMR subgroups (HR [durvalumab v control], 0.77 [95% CI, 0.60 to 0.97]; HR [durvalumab + olaparib v control] 0.57; [95% CI, 0.44 to 0.73]); and in PD-L1-positive subgroups (HR [durvalumab v control], 0.63 [95% CI, 0.48 to 0.83]; HR [durvalumab + olaparib v control], 0.42 [95% CI, 0.31 to 0.57]). Interim overall survival results (maturity approximately 28%) were supportive of the primary outcomes (durvalumab v control: HR, 0.77 [95% CI, 0.56 to 1.07]; P = .120; durvalumab + olaparib v control: HR, 0.59 [95% CI, 0.42 to 0.83]; P = .003). The safety profiles of the experimental arms were generally consistent with individual agents. CONCLUSION Carboplatin/paclitaxel plus durvalumab followed by maintenance durvalumab with or without olaparib demonstrated a statistically significant and clinically meaningful PFS benefit in patients with advanced or recurrent endometrial cancer

Will Mary Jane Leave You Heartbroken? Marijuana Use and Risk of Takotsubo Cardiomyopathy

Takotsubo cardiomyopathy (TTC) is prevalent in 2% of patients who present with symptoms suggestive of acute myocardial infarction. It may be triggered by stressful events, resulting in catecholamine surges, myocardial stunning, and disturbances in contractility. TTC in males has been associated with marijuana use and leads to a fivefold increased risk of cardiac events. Marijuana is thought to generate a similar surge in catecholamines leading to tachycardia and elevation of both systolic and diastolic blood pressure. The question remains whether this catecholamine surge is sufficient enough to cause TTC. It is apparent a correlation between marijuana use and TTC may exist. Exogenous cannabinoid stimulation may lead to myocardial stunning via stimulation seen with hypercatecholaminergic states. Understanding the risk factors involved and increasing awareness of cardiovascular complications related to cannabinoid substances becomes more relevant as its use is increasing both recreationally and medically.  We present a case of a 50 year-old African-American male with hypertension and regular marijuana use who presented with chest pain radiating to the back. Due to abnormal electrocardiogram and positive cardiac biomarkers concerning for acute coronary syndrome, the patient underwent subsequent coronary angiography that showed no significant coronary obstruction; however, left ventriculogram showed the characteristic apical ballooning of TTC. Our case highlights the pathophysiological mechanism suspected to trigger TTC

sj-docx-1-inq-10.1177_00469580231159742 – Supplemental material for Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study

Supplemental material, sj-docx-1-inq-10.1177_00469580231159742 for Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study by Andrea Nickerson, Luis Gutierrez-Mock, Laura Buback, Susie Welty, Lynhea M. Anicete, Sabrina Sanchez, Wayne T.A. Enanoria and Mike Reid in INQUIRY: The Journal of Health Care Organization, Provision, and Financing</p

sj-docx-2-inq-10.1177_00469580231159742 – Supplemental material for Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study

Supplemental material, sj-docx-2-inq-10.1177_00469580231159742 for Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study by Andrea Nickerson, Luis Gutierrez-Mock, Laura Buback, Susie Welty, Lynhea M. Anicete, Sabrina Sanchez, Wayne T.A. Enanoria and Mike Reid in INQUIRY: The Journal of Health Care Organization, Provision, and Financing</p

Factors Influencing Parent and Guardian Decisions on Vaccinating Their Children Against SARS-CoV-2: A Qualitative Study

This qualitative analysis sought to explore factors that influenced parent/guardian intentions to vaccinate their children against SARS-CoV-2 in San Francisco, California, USA in order to inform San Francisco Department of Public Health’s (SFDPH) youth vaccine rollout program. 30-minute, semi-structured telephone interviews were conducted with parents and guardians in either Spanish or English. Respondents shared their perspectives on vaccinating their children against SARS-CoV-2. Interviews were conducted over the telephone and recorded on Zoom. Participants (n = 40) were parents/guardians responding on behalf of their adolescent children (age 13+) and parents/guardians identified from the SFDPH COVID-19 testing database who tested for SARS-CoV-2 within the last 2 weeks. Interviews were conducted, audio recorded, transcribed, translated into English as appropriate, and rapidly analyzed in REDCap according to matrix analysis methodology to develop parent study themes. Perspectives on child vaccination were then explored through thematic analysis. Three themes were identified from the thematic analysis: (1) parental desires for children to return to school safely, (2) unclear messaging and information on COVID-19 prevention and vaccination, and (3) consideration of child’s desires or opinions on receiving the vaccine. This study highlights specific factors influencing parent/guardian decisions on whether to vaccinate their children against SARS-CoV-2. The analysis also illustrates a potential role for children to play in influencing household vaccine decision-making