SH2D1A Regulates T-dependent Humoral Autoimmunity

The signaling lymphocytic activation molecule (SLAM)/CD150 family includes a family of chromosome 1–encoded cell surface molecules with costimulatory functions mediated in part by the adaptor protein SH2D1A (SLAM-associated protein, SAP). Deficiency in SH2D1A protects mice from an experimental model of lupus, including the development of hypergammaglobulinemia, autoantibodies including anti–double stranded DNA, and renal disease. This protection did not reflect grossly defective T or B cell function per se because SH2D1A-deficient mice were susceptible to experimental autoimmune encephalomyelitis, a T cell–dependent disease, and they were capable of mounting normal T-independent antigen-specific immunoglobulin responses. Instead, T-dependent antibody responses were impaired in SH2D1A-deficient mice, reflecting defective germinal center formation. These findings demonstrate a specific role for the SLAM–SH2D1A system in the regulation of T-dependent humoral immune responses, implicating members of the CD150–SH2D1A family as targets in the pathogenesis and therapy of antibody-mediated autoimmune and allergic diseases

Characteristics of the National Applicant Pool for Clinical Informatics Fellowships (2016-2017)

We conducted a national study to assess the numbers and diversity of applicants for 2016 and 2017 clinical informatics fellowship positions. In each year, we collected data on the number of applications that programs received from candidates who were ultimately successful vs. unsuccessful. In 2017, we also conducted an anonymous applicant survey. Successful candidates applied to an average of 4.2 and 5.5 programs for 2016 and 2017, respectively. In the survey, unsuccessful candidates reported applying to fewer programs. Assuming unsuccessful candidates submitted between 2-5 applications each, the total applicant pool numbered 42-69 for 2016 (competing for 24 positions) and 52-85 for 2017 (competing for 30 positions). Among survey respondents (n=33), 24% were female, 1 was black and none were Hispanic. We conclude that greater efforts are needed to enhance interest in clinical informatics among medical students and residents, particularly among women and members of underrepresented minority groups

Inpatient Telehealth Experience of Patients With Limited English Proficiency: Cross-sectional Survey and Semistructured Interview Study

BackgroundPatients with limited English proficiency (LEP) are at a higher risk of poor health outcomes and are less likely to use telehealth than English-speaking patients. To date, there is no formal evaluation of inpatient (IP) telehealth user experience of patients and their families by language preference during visits with their clinicians. ObjectiveThis study aims to compare the experiences of English- and Spanish-speaking patients and their families using IP telehealth, as well as to evaluate the experience of Spanish interpreters providing services through IP telehealth. MethodsWe prospectively administered a survey to English- and Spanish-speaking patients and their families who used IP telehealth from October 1, 2020, to March 31, 2021. We performed semistructured phone interviews of hospital-based Spanish interpreters who provided services through IP telehealth. ResultsA total of 661 surveys were administered, with completion rates of 18% (112/621) in English and 62% (25/40) in Spanish. On a 10-point scale, the overall satisfaction of Spanish speakers (median 10, IQR 10-10) was higher than that of English speakers (median 9, IQR 8-10; P=.001). Both English- and Spanish-speaking patients used IP telehealth for visits with their primary IP care team, subspecialty consultants, and other clinicians. Hospital tablets were used more often than personal devices, and only English-speaking patients used personal laptops. Patients and their families encountered challenges with log-in, team coordination with multiple users, and equipment availability. Interpreters encountered challenges with audio and video quality, communication, safety, and Wi-Fi access. ConclusionsBoth English- and Spanish-speaking patients reported high satisfaction using IP telehealth across multiple disciplines despite the workflow challenges identified by interpreters. Significant investment is needed to provide robust infrastructure to support use by all patients, especially the integration of multiple users to provide interpreter services for patients with LEP

Development of the diagnostic tools for the COMPASS-U tokamak and plans for the first plasma

The COMPASS-U tokamak (R = 0.894 m, a = 0.27 m, Bt = 5 T, Ip = 2 MA) is a new medium-size device with fully metallic plasma facing components, currently under construction at the Institute of Plasma Physics of the Czech Academy of Sciences in Prague. It features a unique combination of parameters, such as a high temperature of the tokamak walls up to 500 ◦C allowing a high recycling regime, a high magnetic field connected with a high plasma density above 1020 m -3 and with a high heat flux (perpendicular to divertor targets) density at the outer strikepoint up to 90 MW/m2 in attached conditions. These parameters of the device pose strict constraints and requirements on the design of individual diagnostic systems. Strategy and present status of the development of the diagnostic systems for COMPASS-U are provided. Plans for a diagnostic set for the first plasma are reviewed. The review of the diagnostics systems involves the high-temperature compatible slow (up to 20 kHz) and fast (up to several MHz) inductive and non-inductive magnetic sensors (including Thick Printed Copper coils and Hall sensors), the sub-millimetre interferometer with an unambiguous channel, Electron Cyclotron Emission, the interlock and overview cameras, high resolution Thomson scattering, radiation diagnostics (neutron diagnostics, soft and hard X-ray diagnostics, bolometers, impurity monitors, effective ion charge), probe diagnostics (including rail probes) and manipulators

Overview of the COMPASS results

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Preliminary design of the COMPASS upgrade tokamak

COMPASS Upgrade is a new medium size, high magnetic field tokamak (R = 0.9 m, Bt = 5 T, Ip = 2 MA) currently under design in the Czech Republic. It will provide unique capabilities for addressing some of the key challenges in plasma exhaust physics, advanced confinement modes and advanced plasma configurations as well as testing new plasma facing materials and liquid metal divertor concepts. This paper contains an overview of the preliminary engineering design of the main systems of the COMPASS Upgrade tokamak (vacuum vessel, central solenoid and poloidal field coils, toroidal field coils, support structure, cryostat, cryogenic system, power supply system and machine monitoring and protection system). The description of foreseen auxiliary plasma heating systems and plasma diagnostics is also provided as well as a summary of expected plasma performance and available plasma configurations