TcR-α recombinations in renal cell carcinoma exome files correlate with an intermediate level of T-cell exhaustion biomarkers.

Renal cell carcinoma exome-derived, V(D)J recombination reads had an elevated presence and variability, for both TcR-α and -ß, when compared to marginal tissue, reflecting an opportunity to assess tumor immunogenicity by comparison with marginal tissue T cells. PD-1, PD-L2, CTLA4 and FOXP3, all of which are implicated in the evasion of an anti-tumor immune response, had a significantly higher expression for samples representing co-detection of productive TcR-α and -ß recombination reads. Samples representing tumors with productive TcR-α recombination reads but no detectable, productive TcR-ß recombination reads, reflected a 20% survival advantage, and RNASeq data indicated an intermediate level of immune checkpoint gene expression for those samples. These results raise the question of whether relatively high levels of detection of productive TcR-α recombination reads, in comparison with detection of reads representing the TcR-ß gene, identify a microenvironment that has not yet entered a T-cell exhaustion phase and may thereby represent conditions for immune enhancements that do not require anti-immune checkpoint therapies.

Pharmacists' empathy after a postgraduate course in narrative medicine: an observational study.

BACKGROUND: Narrative medicine is a recent cross-disciplinary approach which through aesthetic activities such as reading fiction and creative writing aims to encourage empathy, reflection, professionalism, and trustworthiness in the encounter between patients and health care professionals. AIM: The aim of this study was to evaluate changes in level of empathy after a postgraduate course in narrative medicine among pharmacists conducting medication counselling. METHOD: During 2020-2021, three courses in narrative medicine among pharmacists with the aim to enhance empathy were held in Odense, Denmark. The primary outcome was the pharmacists' self-reported level of empathy before and after the course measured with Jefferson Scale of Empathy (JSE), which is a validated 20 item scale with higher scores indicating higher levels of cognitive empathy. RESULTS: A total of 33 community and hospital pharmacists participated in the three courses. The pharmacists' median age was 41 years, 91% were female, 76% were working in community pharmacy, and 47% were, according to themselves, rare readers. The pharmacists completed the JSE scale before and after the course. A statistically significant increase was found in mean total JSE score from 109.9 ± 17.1 before the course to 115.7 ± 14.6 after the course (p = 0.0362). CONCLUSION: Following the course in narrative medicine the level of empathy for the pharmacists according to JSE was enhanced. We recommend that future studies also use patient-reported outcomes to explore if the self-experienced enhanced empathy among pharmacists affects the patients' experience of their encounters.

Märta Tikkanen's gender and alcohol saga.

Märta Tikkanen's poetry collection Århundradets kärlekssaga (The love story of the century, 1978) is a confessional book on life in a family where the husband and father is an alcohol abuser. It is also a love story about a married couple who love one another despite the terrible challenges posed to the relationship by alcoholism. The poetry collection became one of the most influential books in contemporary Nordic fiction, its themes on gender roles and alcohol abuse setting the trend in the Nordic discussion of women's liberation. Märta Tikkanen's courage to tell her own private story inspired other women to confess their gender equality problems to the public. The alcohol abuse of Märta Tikkanen's husband Henrik Tikkanen was seen as an allegory for the more general problems in the relation between men and women. My essay introduces Märta Tikkanen's poetry collection and discusses how the poems develop the theme of gender and alcohol. I will also compare her description of their marriage with Henrik Tikkanen's self-portrait in his autobiographical novella Mariegatan 26, Kronohagen (1977). The analysis refers to contemporary research on gender and alcohol abuse and discusses how the poems contribute to a public recognition of the relationship between gender and alcohol abuse. The essay discusses the reception of Märta Tikkanen's influential poems and explores her treatment of alcohol and gender in relation to other Nordic confessional or fictional books on alcohol abuse.