Les simulations préparatoires aux consultations prénatales

Background: Rehearsal simulations are patient-specific case-matched tasks performed immediately prior to the actual task, with the objective of improving performance. Objective: How does rehearsal simulation for antenatal consults impact how residents learn to engage in difficult conversations with families? Study Design: Residents in the NICU performed case-matched video recorded rehearsal simulations, followed by actual antenatal consults. The purpose of antenatal consults is to prepare parents expecting a complication with their baby before birth. Questionnaires assessed changes in resident confidence and self-assessment of communication skills. Residents were interviewed for qualitative data to explore the overall impact of rehearsal simulation on their learning and performance. Results: Thirteen residents participated. Rehearsal simulation improved confidence with a more organized approach of medical content and better communication techniques, allowing for a shift of focus from a checklist approach to building rapport and displaying empathy. Conclusions: While rehearsal simulation did not prepare residents for unexpected parent responses, trainees’ increased confidence with medical content organization and communication techniques created space for reflection-in-action and compassionate approaches.Contexte : Les simulations préparatoires correspondent à des cas spécifiques de patients et elles sont effectuées immédiatement avant l’intervention réelle, dans le but d’améliorer la performance. Objectif : Comment la simulation préparatoire pratiquée avant une consultation prénatale influence-t-elle la manière dont les résidents apprennent à engager une conversation difficile avec les familles? Méthodes : Les résidents de l’unité de soins intensifs néonatals ont effectué des simulations préparatoires adaptées à la situation clinique à venir, qui ont été filmées. Ils ont par la suite effectué les consultations prénatales réelles. L’objet des consultations prénatales est de préparer les parents lorsque des complications sont anticipées, et ce  avant la naissance de leur bébé. Nous avons évalué les changements au niveau de la confiance des résidents et l’autoévaluation par ces derniers de leurs compétences en communication par le biais de questionnaires. Les résidents ont participé à une entrevue, qui a fourni les données qualitatives afin d’explorer l’impact global de la simulation sur leur apprentissage et leur performance. Résultats : Treize résidents ont participé à l’étude. La simulation préparatoire a rehaussé leur confiance en eux, car elle les a aidés à adopter une approche plus organisée du contenu médical et de meilleures techniques de communication, permettant de passer d’une approche par  « cases à cocher » à une approche basée sur l’établissement d’un lien avec les parents et à la manifestation d’empathie. Conclusions : Bien que la simulation préparatoire n’ait pas préparé les résidents aux réactions inattendues des parents, la confiance accrue des stagiaires en leur capacité à organiser le contenu médical et en leurs techniques de communication a laissé place à la réflexion dans l’action et aux approches compatissantes

Therapeutic Antibodies Targeting CSF1 Impede Macrophage Recruitment in a Xenograft Model of Tenosynovial Giant Cell Tumor

Tenosynovial giant cell tumor is a neoplastic disease of joints that can cause severe morbidity. Recurrences are common following local therapy, and no effective medical therapy currently exists. Recent work has demonstrated that all cases overexpress macrophage colony-stimulating factor (CSF1), usually as a consequence of an activating gene translocation, resulting in an influx of macrophages that form the bulk of the tumor. New anti-CSF1 drugs have been developed; however there are no preclinical models suitable for evaluation of drug benefits in this disease. In this paper, we describe a novel renal subcapsular xenograft model of tenosynovial giant cell tumor. Using this model, we demonstrate that an anti-CSF1 monoclonal antibody significantly inhibits host macrophage infiltration into this tumor. The results from this model support clinical trials of equivalent humanized agents and anti-CSF1R small molecule drugs in cases of tenosynovial giant cell tumor refractory to conventional local therapy

A Network for Scene Processing in the Macaque Temporal Lobe

Spatial navigation is a complex process, but one that is essential for any mobile organism. We localized a region in the macaque occipitotemporal sulcus that responds preferentially to images of scenes. Single- unit recording revealed that this region, which we term the lateral place patch (LPP), contained a large concentration of scene-selective single units. These units were not modulated by spatial layout alone but were instead modulated by a combination of spatial and nonspatial factors, with individual units coding specific scene parts. We further demonstrate by microstimulation that LPP is connected with extrastriate visual areas V4V and DP and a sceneselective medial place patch in the parahippocampal gyrus, revealing a ventral network for visual scene processing in the macaque

Las concepciones acerca del juego de niños de cinco países: hacia un mejor conocimiento de la actividad lúdica

Drawing on a mixed-methods cross-cultural study undertaken in five locations in Argentina, Denmark, Hong Kong, England and the United States in 2018, this paper explores how children (aged five and seven) conceive of playfulness. Following a card-sorting task, 387 children selected familiar activities that they felt were most representative of play and not-play and explained their reasons. The children’s justifications were fully transcribed, and five corpora were created (one per site). Lexicometry was applied, generating sets of the characteristic responses per age in each site. In-depth qualitative interpretation of these modal responses revealed nine dimensions across play and not-play: pleasure, social context, materials, movement, agency, risk, goal, time and focus. Commonalities revealed that children’s ideas around play are not aligned with specific activities but with the sense of agency in a secure physical and social context when carrying out an activity experienced as an end in itself. Implications for playful pedagogies highlight the need to open up play with opportunities for children’s choice and initiative, confident exploration and immersion in the activities in which they participate.Fil: Mukherjee, Sarah Jane. The Open University; Reino UnidoFil: Bugallo, Lucía. Universidad Nacional del Comahue. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales; ArgentinaFil: Scheuer, Nora. Universidad Nacional del Comahue. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales; ArgentinaFil: Cremin, Teresa. The Open University; Reino UnidoFil: Montoro, Maria Virginia. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; Argentina. Universidad Nacional del Comahue. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Patagonia Norte. Instituto Patagónico de Estudios de Humanidades y Ciencias Sociales; ArgentinaFil: Ferrero, Martha. Universidad Nacional del Comahue. Centro Regional Universitario Bariloche; ArgentinaFil: Preston, Marcia. ;Fil: Cheng, Doris.. The Tung Wah College; Hong KongFil: Golinkoff, Roberta. ;Fil: Popp, Jill. The Lego Foundation; Dinamarc

Function of bidirectional sensitivity in the otolith organs established by transcription factor Emx2

Otolith organs of the inner ear are innervated by two parallel afferent projections to the brainstem and cerebellum. These innervations were proposed to segregate across the line of polarity reversal (LPR) within each otolith organ, which divides the organ into two regions of hair cells (HC) with opposite stereociliary orientation. The relationship and functional significance of these anatomical features are not known.Here, we show regional expression of Emx2 in otolith organs, which establishes LPR, mediates the neuronal segregation across LPR and constitutes the bidirectional sensitivity function. Conditional knockout (cKO) of Emx2 in HCs lacks LPR. Tmie cKO, in which mechanotransduction was abolished selectively in HCs within the Emx2 expression domain also lacks bidirectional sensitivity. Analyses of both mutants indicate that LPR is specifically required formice to swimcomfortably and to traverse a balance beam efficiently, but LPR is not required formice to stay on a rotating rod

Expression and membrane-targeting of an active plant cytochrome P450 in the chloroplast of the green alga Chlamydomonas reinhardtii

The unicellular green alga Chlamydomonas reinhardtii has potential as a cell factory for the production of recombinant proteins and other compounds, but mainstream adoption has been hindered by a scarcity of genetic tools and a need to identify products that can be generated in a cost-effective manner. A promising strategy is to use algal chloroplasts as a site for synthesis of high value bioactive compounds such as diterpenoids since these are derived from metabolic building blocks that occur naturally within the organelle. However, synthesis of these complex plant metabolites requires the introduction of membrane-associated enzymes including cytochrome P450 enzymes (P450s). Here, we show that a gene (CYP79A1) encoding a model P450 can be introduced into the C. reinhardtii chloroplast genome using a simple transformation system. The gene is stably expressed and the P450 is efficiently targeted into chloroplast membranes by means of its endogenous N-terminal anchor domain, where it is active and accounts for 0.4% of total cell protein. These results provide proof of concept for the introduction of diterpenoid synthesis pathways into the chloroplast of C. reinhardtii

Conceptions of play by children in five countries: towards an understanding of playfulness <i>(Las concepciones acerca del juego de niños de cinco países: hacia un mejor conocimiento de la actividad lúdica)</i>

Drawing on a mixed-methods cross-cultural study undertaken in five locations in Argentina, Denmark, Hong Kong, England and the United States in 2018, this paper explores how children (aged five and seven) conceive of playfulness. Following a card-sorting task, 387 children selected familiar activities that they felt were most representative of play and not-play and explained their reasons. The children’s justifications were fully transcribed, and five corpora were created (one per site). Lexicometry was applied, generating sets of the characteristic responses per age in each site. In-depth qualitative interpretation of these modal responses revealed nine dimensions across play and not-play: pleasure, social context, materials, movement, agency, risk, goal, time and focus. Commonalities revealed that children’s ideas around play are not aligned with specific activities but with the sense of agency in a secure physical and social context when carrying out an activity experienced as an end in itself. Implications for playful pedagogies highlight the need to open up play with opportunities for children’s choice and initiative, confident exploration and immersion in the activities in which they participate.RESUMENA partir de un estudio multicultural de métodos mixtos realizado en 2018 en cinco localidades de Argentina, Dinamarca, Hong Kong, Reino Unido y Estados Unidos, en este artículo se exploran las concepciones acerca de la actividad lúdica de niños de cinco y siete años. Tras una tarea de clasificación de tarjetas, 387 niñas y niños seleccionaron aquellas actividades familiares que consideraban más representativas de juego y aquellas más ajenas al juego y explicaron sus razones. Se realizó una transcripción completa de sus justificaciones y se crearon cinco corpus (uno por localidad). Mediante la lexicometría, se generaron conjuntos de respuestas características por edad en cada localidad. Una interpretación cualitativa detallada de las respuestas reveló nueve dimensiones lúdicas y no lúdicas: disfrute, contexto social, materiales, movimiento, agencia, riesgo, meta, tiempo y focalización. Las coincidencias revelaron que las ideas que los niños albergan en torno al juego no están vinculadas a actividades específicas sino a un sentido de agencia en un contexto físico y social seguro a la hora de realizar una actividad como fin en sí misma. Las implicaciones para las pedagogías lúdicas subrayan la necesidad de incorporar al juego oportunidades de elección e iniciativa para los niños, así como una exploración e inmersión segura en las actividades en las que participan

Integrative single-cell meta-analysis reveals disease-relevant vascular cell states and markers in human atherosclerosis

Coronary artery disease (CAD) is characterized by atherosclerotic plaque formation in the arterial wall. CAD progression involves complex interactions and phenotypic plasticity among vascular and immune cell lineages. Single-cell RNA-seq (scRNA-seq) studies have highlighted lineage-specific transcriptomic signatures, but human cell phenotypes remain controversial. Here, we perform an integrated meta-analysis of 22 scRNA-seq libraries to generate a comprehensive map of human atherosclerosis with 118,578 cells. Besides characterizing granular cell-type diversity and communication, we leverage this atlas to provide insights into smooth muscle cell (SMC) modulation. We integrate genome-wide association study data and uncover a critical role for modulated SMC phenotypes in CAD, myocardial infarction, and coronary calcification. Finally, we identify fibromyocyte/fibrochondrogenic SMC markers (LTBP1 and CRTAC1) as proxies of atherosclerosis progression and validate these through omics and spatial imaging analyses. Altogether, we create a unified atlas of human atherosclerosis informing cell state-specific mechanistic and translational studies of cardiovascular diseases.</p

Prevalence of internet addiction and gaming disorders in Southeast Asia: A meta-analysis.

This meta-analytic review aimed to examine the pooled prevalence rates of Internet addiction and gaming disorders in Southeast Asia. Several databases including PubMed, MEDLINE, PsycINFO, Web of Science, Embase, and Cochrane Central were searched and a total of 24 studies were included in this study. The selection of studies was conducted in accordance to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two meta-analyses were conducted to examine data on Internet addiction and gaming disorders separately. A random-effects model was employed to derive the pooled prevalence rate. Mixed-effects meta-regression and subgroup analyses were performed to examine the moderators of the between-study heterogeneity. Publication bias was tested using the Egger's regression test and funnel plot. Only seven out of the 11 Southeast Asian countries were represented in the literature. All except for two of the included studies were cross-sectional in nature. The findings revealed a pooled prevalence rate of 20.0% (95% confidence interval: 14.5%-27.0%) and 10.1% (95% confidence interval: 7.3%-13.8%) for Internet addiction and gaming disorders respectively. Mean age and study population were significant moderators of the between-study heterogeneity in the prevalence rates of gaming disorders such that samples involving older participants showed higher prevalence rate than those involving younger individuals. Country of study was found to be significant moderator of the between-heterogeneity for both Internet addiction and gaming disorders, however the findings should be interpreted with caution due to the small and unbalanced sample sizes. There was no significant publication bias. Such epidemiology research should be extended to the Southeast Asian countries that have not been studied or are under-studied. Given that the prevalence rates appear to be higher in Southeast Asia than in other world regions, future research should also explore the factors behind these inter-regional differences. Further longitudinal studies should also be conducted to examine the trajectories of such disorders

Genomic, Pathway Network, and Immunologic Features Distinguishing Squamous Carcinomas

This integrated, multiplatform PanCancer Atlas study co-mapped and identified distinguishing molecular features of squamous cell carcinomas (SCCs) from five sites associated with smokin