1,393 research outputs found

    Multi-targeted loss of the antigen presentation molecule MR1 during HSV-1 and HSV-2 infection

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    Summary: The major histocompatibility complex (MHC), Class-I-related (MR1) molecule presents microbiome-synthesized metabolites to Mucosal-associated invariant T (MAIT) cells, present at sites of herpes simplex virus (HSV) infection. During HSV type 1 (HSV-1) infection there is a profound and rapid loss of MR1, in part due to expression of unique short 3 protein. Here we show that virion host shutoff RNase protein downregulates MR1 protein, through loss of MR1 transcripts. Furthermore, a third viral protein, infected cell protein 22, also downregulates MR1, but not classical MHC-I molecules. This occurs early in the MR1 trafficking pathway through proteasomal degradation. Finally, HSV-2 infection results in the loss of MR1 transcripts, and intracellular and surface MR1 protein, comparable to that seen during HSV-1 infection. Thus HSV coordinates a multifaceted attack on the MR1 antigen presentation pathway, potentially protecting infected cells from MAIT cell T cell receptor-mediated detection at sites of primary infection and reactivation

    The Impact of Parentification on Adult Health Behaviors and Outcomes

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    Parentification is a multi-dimensional phenomenon that is often examined as it is occurring to affected members of this population: children. More specifically, adolescents tend to be the primary focus of such research endeavors devoted to areas like mental health and substance use. The literature is ripe with best practices for many disciplines (e.g., social work, psychology, etc.) in service to those impacted by parentification as well as those that are responsible for imparting the parentification experience (i.e., parents). What is less understood is how parentification informs health behavior and outcomes in adulthood, which is the focus of the current research that seeks to further these conversations with a comprehensive extension into specific health behaviors and outcomes as they relate to the experience of parentified adults. An evidence review will occur to 1) identify the gaps in understanding between parentification in adults and specific health behaviors and outcomes and 2) discern to the extent possible which demographic variables (e.g., gender, age, etc.) are of significance to the parentification experience. The review will begin the development of an instrument in which parentification and underrepresented health behaviors and outcomes will be assessed. Results will reveal the gaps in understanding and provide the path forward for future research activities by way of evidence-based instrument development and assessment., which will deepen the existing conversation around the impact of parentification on adult health behavior and outcomes. Parentification is not a new concept, nor is the conversation around it. However, the health impact on adulthood has not been fully explored as it relates to 1) health behaviors like help seeking and self-care and 2) multi-dimensional health outcomes: physical, emotional, social, etc. This endeavor will yield insight that several disciplines and affected populations can use to either strengthen or sustain health behaviors and outcomes

    [In Press] The language-specificity of phonetic adaptation to talkers

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    Listeners adapt efficiently to new talkers by using lexical knowledge to resolve perceptual uncertainty. This adaptation has been widely observed, both in first (L1) and in second languages (L2). Here, adaptation was tested in both the L1 and L2 of speakers of Mandarin and English, two very dissimilar languages. A sound midway between /f/ and /s/ replacing either /f/ or /s/ in Mandarin words presented for lexical decision (e.g., bu4fa3 ‚Äúillegal‚ÄĚ; kuan1song1 ‚Äúloose‚ÄĚ) prompted the expected adaptation; it induced an expanded /f/ category in phoneme categorization when it had replaced /f/, but an expanded /s/ category when it had replaced /s/. Both L1 listeners and English-native listeners with L2 Mandarin showed this effect. In English, however (with e.g., traffic; insane), we observed adaptation in L1 but not in L2; Mandarin-native listeners, despite scoring highly in the English lexical decision training, did not adapt their category boundaries for /f/ and /s/. Whether the ambiguous sound appeared syllable-initially (as in Mandarin phonology) versus word-finally (providing more word identity information) made no difference. Perceptual learning for talker adaptation is language-specific in that successful lexically guided adaptation in one language does not guarantee adaptation in other known languages; the enabling conditions for adaptation may be multiple and diverse

    COVID-19 severity and cardiovascular outcomes in SARS-CoV-2-infected patients with cancer and cardiovascular disease

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    Background: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. Objectives: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. Methods: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ‚Č• 55 or female ‚Č• 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. Results: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54‚Äď74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11‚Äď1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p<0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31‚Äď1.74] vs. OR 1.04 [95% CI 0.90‚Äď1.20], pinteraction <0.001). Conclusions: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)

    Diabetes Management in Preoperative Hospitalized Patients: Improving Quality Measures on an Orthopedic Trauma and Surgical Unit

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    Objective: Implement nursing education for the staff nurses on an orthopedic trauma and medical surgical unit to improve diabetes management in preoperative patients. Design: Evidence -based practice/quality improvement. Setting/Local Problem: 33-bed orthopedic trauma and surgical unit. Participants: Staff nurses employed on an orthopedic trauma and surgical unit Interventions/Measurements. A pre- and post- was design with an embedded education module to assess for understanding. The aim of this was to improve preoperative diabetes education to have better glycemic control postoperatively and reduce the number of adverse events. Results: Nurses preintervention mean scores were 14.00 and 16.00 after the e-learning module. The educational module provided was statistically significant (pConclusion: The use of an e-learning module to educate staff nurses resulted in a significant increase in perioperative diabetes management knowledge. Nurses play a vital role in perioperative diabetes management and preventing adverse events. The use of e-learning modules has the potential to increase nurses’ knowledge base leading to better patient outcomes

    COVID-19 severity and cardiovascular outcomes in SARS-CoV-2-infected patients with cancer and cardiovascular disease

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    BACKGROUND: Data regarding outcomes among patients with cancer and co-morbid cardiovascular disease (CVD)/cardiovascular risk factors (CVRF) after SARS-CoV-2 infection are limited. OBJECTIVES: To compare Coronavirus disease 2019 (COVID-19) related complications among cancer patients with and without co-morbid CVD/CVRF. METHODS: Retrospective cohort study of patients with cancer and laboratory-confirmed SARS-CoV-2, reported to the COVID-19 and Cancer Consortium (CCC19) registry from 03/17/2020 to 12/31/2021. CVD/CVRF was defined as established CVD or no established CVD, male ‚Č• 55 or female ‚Č• 60 years, and one additional CVRF. The primary endpoint was an ordinal COVID-19 severity outcome including need for hospitalization, supplemental oxygen, intensive care unit (ICU), mechanical ventilation, ICU or mechanical ventilation plus vasopressors, and death. Secondary endpoints included incident adverse CV events. Ordinal logistic regression models estimated associations of CVD/CVRF with COVID-19 severity. Effect modification by recent cancer therapy was evaluated. RESULTS: Among 10,876 SARS-CoV-2 infected patients with cancer (median age 65 [IQR 54-74] years, 53% female, 52% White), 6253 patients (57%) had co-morbid CVD/CVRF. Co-morbid CVD/CVRF was associated with higher COVID-19 severity (adjusted OR: 1.25 [95% CI 1.11-1.40]). Adverse CV events were significantly higher in patients with CVD/CVRF (all p\u3c0.001). CVD/CVRF was associated with worse COVID-19 severity in patients who had not received recent cancer therapy, but not in those undergoing active cancer therapy (OR 1.51 [95% CI 1.31-1.74] vs. OR 1.04 [95% CI 0.90-1.20], p(interaction) \u3c0.001). CONCLUSIONS: Co-morbid CVD/CVRF is associated with higher COVID-19 severity among patients with cancer, particularly those not receiving active cancer therapy. While infrequent, COVID-19 related CV complications were higher in patients with comorbid CVD/CVRF. (COVID-19 and Cancer Consortium Registry [CCC19]; NCT04354701)

    Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study.

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    BACKGROUND Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours. METHODS In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186. FINDINGS Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78·6%] female patients and 4922 [21·4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1·4 [IQR 0·6-3·4]) compared with the prepandemic phase (2·0 [0·9-3·7]; p<0·0001) and pandemic decrease phase (2·3 [1·0-5·0]; p<0·0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69·0%] of 3704 vs 1515 [71·5%] of 2119; OR 1·1 [95% CI 1·0-1·3]; p=0·042), lymph node metastases (343 [9·3%] vs 264 [12·5%]; OR 1·4 [1·2-1·7]; p=0·0001), and tumours at high risk of structural disease recurrence (203 [5·7%] of 3584 vs 155 [7·7%] of 2006; OR 1·4 [1·1-1·7]; p=0·0039). INTERPRETATION Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation. FUNDING None

    Average Household Income in Relation to Individual Dietary Consumption of Fruits and Vegetables

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    The purpose of this analysis is to review data from the USDA Economic Research Survey in a data collection regarding FoodAPS National Household Food Acquisition and Purchase Survey. Our data include a sample size of 4,826 participating households with 279 variables describing each household. Several variables were utilized which include average collective income for households, perceptions of fruit and vegetable prices and quality, self-reporting items about perceived fruit and vegetable consumption, and financial survey responses. With these chosen variables we made initial inferences that there would be a relationship between income and fruit consumption. We predict that throughout the duration of the study, we will find a relationship to explain how collective income affects recommended fruit and vegetable consumptions in households. We began our study by cleaning our data and variables as they pose relevance to our research. Then we began making graphs and charts of each variable to visually inspect univariate variables. When we begin running analysis, we will perform statistical testing to identify if there is a relationship between our independent variable (fruit and vegetable consumption) and our dependent variable (household income). Through the results of these, we can start making conclusions as to whether our hypothesis can be supported. Our analysis models will include frequency tables that will show various correlation coefficients between both our categorical and continuous variables and present any statistical relationship between our chosen variables. Finally, conclusions are drawn from T-tests to show our hypothesis and prediction is supported and that there is some relationship between our variables to show that average household income may influence fruit and vegetable consumption. If these results show predicted conclusions, we will have evidence that allow for policy change and public health advancements as it relates to ensuring individuals have readily access to healthy diets regardless of income
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