1,141 research outputs found

    High EMSY expression defines a BRCA‐like subgroup of high‐grade serous ovarian carcinoma with prolonged survival and hypersensitivity to platinum

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    Background Approximately half of high‐grade serous ovarian carcinomas (HGSOCs) demonstrate homologous recombination repair (HR) pathway defects, resulting in a distinct clinical phenotype comprising hypersensitivity to platinum, superior clinical outcome, and greater sensitivity to poly(adenosine diphosphate‐ribose) polymerase (PARP) inhibitors. EMSY, which is known to be amplified in breast and ovarian cancers, encodes a protein reported to bind and inactivate BRCA2. Thus, EMSY overexpression may mimic BRCA2 mutation, resulting in HR deficiency. However, to our knowledge, the phenotypic consequences of EMSY overexpression in HGSOC patients has not been explored. Methods Here we investigate the impact of EMSY expression on clinical outcome and sensitivity to platinum‐based chemotherapy using available data from transcriptomically characterized HGSOC cohorts. Results High EMSY expression was associated with better clinical outcome in a cohort of 265 patients with HGSOC from Edinburgh (overall survival multivariable hazard ratio, 0.58 [95% CI, 0.38‐0.88; P = .011] and progression‐free survival multivariable hazard ratio, 0.62 [95% CI, 0.40‐0.96; P = .030]). Superior outcome also was demonstrated in the Medical Research Council ICON7 clinical trial and multiple publicly available data sets. Patients within the Edinburgh cohort who had high EMSY expression were found to demonstrate greater rates of complete response to multiple platinum‐containing chemotherapy regimens (radiological complete response rate of 44.4% vs 12.5% at second exposure; P = .035) and corresponding prolonged time to disease progression (median, 151.5 days vs 60.5 days after third platinum exposure; P = .004). Conclusions Patients with HGSOCs demonstrating high EMSY expression appear to experience prolonged survival and greater platinum sensitivity, reminiscent of BRCA‐mutant cases. These data are consistent with the notion that EMSY overexpression may render HGSOCs HR deficient

    <i>Trypanosoma brucei rhodesiense</i> transmitted by a single tsetse fly bite in vervet monkeys as a model of human African trypanosomiasis

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    Sleeping sickness is caused by a species of trypanosome blood parasite that is transmitted by tsetse flies. To understand better how infection with this parasite leads to disease, we provide here the most detailed description yet of the course of infection and disease onset in vervet monkeys. One infected tsetse fly was allowed to feed on each host individual, and in all cases infections were successful. The characteristics of infection and disease were similar in all hosts, but the rate of progression varied considerably. Parasites were first detected in the blood 4-10 days after infection, showing that migration of parasites from the site of fly bite was very rapid. Anaemia was a key feature of disease, with a reduction in the numbers and average size of red blood cells and associated decline in numbers of platelets and white blood cells. One to six weeks after infection, parasites were observed in the cerebrospinal fluid (CSF), indicating that they had moved from the blood into the brain; this was associated with a white cell infiltration. This study shows that fly-transmitted infection in vervets accurately mimics human disease and provides a robust model to understand better how sleeping sickness develops

    The 2021 western North America heat wave among the most extreme events ever recorded globally

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    This is the final version. Available on open access from the American Association for the Advancement of Science via the DOI in this recordData and materials availability: ERA5 dataset is available from the Copernicus Climate Change Service (C3S) Climate Data Store. JRA55 dataset is available from the JRA project webpage. CanESM5 data are available from CMIP6 search interface, https://esgf-node.llnl.gov/search/cmip6/. GHCNd station data are available from NOAA Climate Data Online. The code used to generate the figures in this paper and the Supplementary Materials is available from https://zenodo.org/record/6325508 or https://github.com/BrisClim, and this can be used to rapidly assess the extremeness of heat waves relative to other events globally. All data needed to evaluate the conclusions in the paper are present in the paper and/or the Supplementary Materials.In June 2021, western North America experienced a record-breaking heat wave outside the distribution of previously observed temperatures. While it is clear that the event was extreme, it is not obvious whether other areas in the world have also experienced events so far outside their natural variability. Using a novel assessment of heat extremes, we investigate how extreme this event was in the global context. Characterizing the relative intensity of an event as the number of standard deviations from the mean, the western North America heat wave is remarkable, coming in at over four standard deviations. Throughout the globe, where we have reliable data, only five other heat waves were found to be more extreme since 1960. We find that in both reanalyses and climate projections, the statistical distribution of extremes increases through time, in line with the distribution mean shift due to climate change. Regions that, by chance, have not had a recent extreme heat wave may be less prepared for potentially imminent events.Natural Environment Research Council (NERC

    Job satisfaction and its modeling among township health center employees: a quantitative study in poor rural China

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    <p>Abstract</p> <p>Background</p> <p>Job satisfaction is important to staff management of township health centers (THCs), as it is associated with organizational performance, quality of care and employee retention. The purpose of this study was to measure job satisfaction level of THC employees in poor rural China and to identify relevant features in order to provide policy advice on human resource development of health service institutions in poor regions.</p> <p>Methods</p> <p>A self-completion questionnaire was used to assess the job satisfaction and relevant features (response rate: 90.5%) among 172 employees (i.e., clinic doctors, medico-technical workers and public health workers) of 17 THCs in Anhui and Xinjiang provinces of China. The study covered a time period of two months in 2007.</p> <p>Results</p> <p>The mean staff job satisfaction scored 83.3, which was in the category of "somewhat satisfied" on a scale ranging from 0 (extremely dissatisfied) to 100 (extremely satisfied) by employing Likert's transformation formula. Exploratory factor analysis (EFA) revealed eight domains involved in modeling of job satisfaction, among which, the caregivers were more satisfied with job significance (88.2), job competency (87.9) and teamwork (87.7), as compared with work reward (72.9) and working conditions (79.7). Mean job satisfaction in Xinjiang (89.7) was higher than that in Anhui (75.5).</p> <p>Conclusions</p> <p>Employees of THCs have moderate job satisfactions in poor areas, which need to be raised further by improving their working conditions and reward.</p

    Outcomes of Operatively Treated Acute Knee Dislocations

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    Knee dislocation is a complex and rare injury often presenting in the context of high velocity trauma. The aim of this study is to establish the subjective outcomes of surgically treated knee dislocations. A total of 20 knees dislocations treated by open repair were reviewed. Their progress and outcomes were assessed by using a modified Lysholm score questionnaire. Data was obtained on patient demographics, details of injury, investigation, treatment, rehabilitation, 24 months objective outcome and subjective outcomes. Six patients had a vascular deficit and six had neurological deficits. The median range of motion was 0°-100°. Patients with an initially lower pre-injury level of function were able to return an activity level comparable to their pre-injury status. 22% of competitive athletes retuned to competitive sports. 38% of patients undertaking heavy activity returned to comparable pre-injury level of activity and 67% of patients undertaking moderate level of activity before injury returned to a comparable level after repair. 68% regularly had problems running, 70% problem squatting, 40% swelling and 42% problem with stairs. Most patients however did not have locking of the knee or problems with knees giving way. Patients pain scores decreased over time to an acceptable level. Despite the severity of the injury, majority of patients achieved a satisfactory outcome, although none of the patients reached the same level of function as before the injury. 80% of the patients were satisfied with their outcome. All dissatisfied patients suffered postoperative complications

    Learner control in animated multimedia instructions

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    The interactivity principle in multimedia learning states that giving learners control over pace and order of instructions decreases cognitive load and increases transfer performance. We tested this guideline by comparing a learner-paced instruction with a system-paced instruction. Time-on-task and interactive behavior were logged, and were also related to interest, prior knowledge, and cognitive involvement. We successfully replicated the interactivity principle in terms of better transfer. However, this coincided with a large increase in time-on-task. Also, large individual differences existed in the use of learner control options, which were mostly unrelated to the other variables. Thus, the benefits of introducing learner control in multimedia learning are at the expense of learning efficiency, and it remains unclear for whom the interactivity principle works best

    Coastal Upwelling Supplies Oxygen-Depleted Water to the Columbia River Estuary

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    Low dissolved oxygen (DO) is a common feature of many estuarine and shallow-water environments, and is often attributed to anthropogenic nutrient enrichment from terrestrial-fluvial pathways. However, recent events in the U.S. Pacific Northwest have highlighted that wind-forced upwelling can cause naturally occurring low DO water to move onto the continental shelf, leading to mortalities of benthic fish and invertebrates. Coastal estuaries in the Pacific Northwest are strongly linked to ocean forcings, and here we report observations on the spatial and temporal patterns of oxygen concentration in the Columbia River estuary. Hydrographic measurements were made from transect (spatial survey) or anchor station (temporal survey) deployments over a variety of wind stresses and tidal states during the upwelling seasons of 2006 through 2008. During this period, biologically stressful levels of dissolved oxygen were observed to enter the Columbia River estuary from oceanic sources, with minimum values close to the hypoxic threshold of 2.0 mg L−1. Riverine water was consistently normoxic. Upwelling wind stress controlled the timing and magnitude of low DO events, while tidal-modulated estuarine circulation patterns influenced the spatial extent and duration of exposure to low DO water. Strong upwelling during neap tides produced the largest impact on the estuary. The observed oxygen concentrations likely had deleterious behavioral and physiological consequences for migrating juvenile salmon and benthic crabs. Based on a wind-forced supply mechanism, low DO events are probably common to the Columbia River and other regional estuaries and if conditions on the shelf deteriorate further, as observations and models predict, Pacific Northwest estuarine habitats could experience a decrease in environmental quality
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