SPICER: Self-supervised learning for MRI with automatic coil sensitivity estimation and reconstruction.

PURPOSE: To introduce a novel deep model-based architecture (DMBA), SPICER, that uses pairs of noisy and undersampled k-space measurements of the same object to jointly train a model for MRI reconstruction and automatic coil sensitivity estimation. METHODS: SPICER consists of two modules to simultaneously reconstructs accurate MR images and estimates high-quality coil sensitivity maps (CSMs). The first module, CSM estimation module, uses a convolutional neural network (CNN) to estimate CSMs from the raw measurements. The second module, DMBA-based MRI reconstruction module, forms reconstructed images from the input measurements and the estimated CSMs using both the physical measurement model and learned CNN prior. With the benefit of our self-supervised learning strategy, SPICER can be efficiently trained without any fully sampled reference data. RESULTS: We validate SPICER on both open-access datasets and experimentally collected data, showing that it can achieve state-of-the-art performance in highly accelerated data acquisition settings (up to 10 × $$ 10\times $$ ). Our results also highlight the importance of different modules of SPICER-including the DMBA, the CSM estimation, and the SPICER training loss-on the final performance of the method. Moreover, SPICER can estimate better CSMs than pre-estimation methods especially when the ACS data is limited. CONCLUSION: Despite being trained on noisy undersampled data, SPICER can reconstruct high-quality images and CSMs in highly undersampled settings, which outperforms other self-supervised learning methods and matches the performance of the well-known E2E-VarNet trained on fully sampled ground-truth data.

Spatial risk of Haemaphysalis longicornis borne Dabieshan tick virus (DBTV) in China.

The uncertainty and unknowability of emerging infectious diseases have caused many major public health and security incidents in recent years. As a new tick-borne disease, Dabieshan tick virus (DBTV) necessitate systematic epidemiological and spatial distribution analysis. In this study, tick samples from Liaoning Province were collected and used to evaluate distribution of DBTV in ticks. Outbreak points of DBTV and the records of the vector Haemaphysalis longicornis in China were collected and used to establish a prediction model using niche model combined with environmental factors. We found that H. longicornis and DBTV were widely distributed in Liaoning Province. The risk analysis results showed that the DBTV in the eastern provinces of China has a high risk, and the risk is greatly influenced by elevation, land cover, and meteorological factors. The risk geographical area predicted by the model is significantly larger than the detected positive areas, indicating that the etiological survey is seriously insufficient. This study provided molecular and important epidemiological evidence for etiological ecology of DBTV. The predicted high-risk areas indicated the insufficient monitoring and risk evaluation and the necessity of future monitoring and control work.

Tracheostomy care of non-ventilated patients and COVID considerations: A scoping review of clinical practice guidelines and consensus statements.

BACKGROUND: The purpose of this study is to examine and evaluate the existing clinical practice guidelines and consensus statements regarding tracheostomy care for non-mechanically ventilated patients. METHODS: A systematic search of databases, and professional organisations was conducted from inception to 19 March 2023. Two appraisers evaluated each guideline using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Text and Opinion Papers. RESULTS: No specific clinical guidelines exist on airway management in non-mechanically ventilated patients. Of 6318 articles identified, we included 12 clinical practice guidelines, and 9 consensus statements, which were from China, the US, the UK, South Korea, Australia, France and Belgium. The AGREE II scores in six domains are (1) the scope and purpose, 70.30%; (2) stakeholder involvement, 37.61%; (3) rigor of development, 33.97%; (4) clarity of presentation, 68.16%; (5) applicability, 44.23% and (6) editorial independence, 40.06%. The overall quality of evidence was level B. The summarised recommendations for clinical practice encompass the following six areas: airway humidification, management of the trach cuff, management of inner cannula, tracheostoma care, tracheostomy suctioning and management and prevention of common post-operative complications. CONCLUSIONS: The overall quality of the clinical guidelines on non-ventilated tracheostomy care was moderate, and further improvements are needed in domains of stakeholder involvement, applicability, clarity of presentation and editorial independence. Recommendations on non-ventilated tracheostomy care are often embedded in the guidelines on ventilated tracheostomy. Specific clinical guidelines are needed to provide a standardised approach to tracheostomy care for non-ventilated patients. RELEVANCE TO CLINICAL PRACTICE: Patients with non-ventilated tracheostomy need specialised airway management. Improving patient outcomes requires standardised protocols, patient involvement, quality evaluation, and interdisciplinary approaches. NO PATIENT OR PUBLIC CONTRIBUTION: The study reviewed clinical practice guidelines and consensus statements, therefore patient or public input was not needed.

Menstrual and psychosocial characteristics associated with high-risk of premenstrual dysphoric disorder among university students: a cross-sectional study.

Up to 92 percent of Chinese women of reproductive age have pre-menstrual syndrome (PMS). The severe form of PMS (i.e. pre-menstrual dysphoric disorder [PMDD]) negatively affects women's everyday functioning and reproductive health. This study examined the relationships between menstrual, psychosocial characteristics and the risk of PMDD among young Chinese women. A cross-sectional online survey was conducted among Chinese university students in Hong Kong. Logistic regression was used to compute adjusted odds ratio (aOR) for the association of high-risk PMDD with menstrual and psychosocial characteristics. A total of 541 Chinese university students were recruited. Approximately 53 percent of female students were at high risk of developing PMDD. The high-risk PMDD group was significantly associated with a heavy volume of menstrual flow (aOR = 2.17, 95 percent CI 1.06-4.45), irregular menstrual cycle (1.72, 1.17-2.52), high dysmenorrhea (2.80, 1.95-4.04) and older ages of menarche (0.67, 0.45-0.98) in the menstrual characteristics. In the psychosocial characteristics, high-risk PMDD was significantly associated with symptoms of anxiety (2.19, 1.48-3.32) and depression (2.22, 1.48-3.32), high loneliness (1.94, 1.34-2.79) and low resilience (2.21, 1.52-3.23) levels. Additionally, resilience had a potential moderating effect on the associations between the high risk of PMDD and anxiety, depression and loneliness. The development and delivery of interventions that can enhance resilience and manage psychological distress would be beneficial for young Chinese women's reproductive health.

A Systematic Review of Self-Management Interventions Conducted Across Global Settings for Depressive Symptoms in Persons with HIV.

Depressive symptoms can affect health outcomes in people living with HIV (PLWH) including adherence to treatment and disease prognosis. Self-management interventions targeting depressive symptoms have been effective in preventing these negative sequelae of depressive symptoms. The processes of self-management include learning skills related to living with the illness needs, accessing resources to manage the illness, and coping with the illness. A systematic literature review was conducted to appraise and synthesize the current evidence of self-management interventions targeting depressive symptoms in PLWH. Following the PRISMA guidelines, an electronic search of 4 databases was conducted. Original studies written in English that used a randomized controlled trial design to test the effect of self-management intervention on depressive symptoms were included. Studies were selected that were published on/before April 19, 2022, thus yielding 13 relevant articles. Risk of bias was assessed using the NIH Quality Assessment Tool for Controlled Intervention Studies and narrative synthesis was used to synthesize the results. 40 to 755 participants were included in the studies, with each using various measures to assess depressive symptoms pre-and post-intervention, and timepoints for assessing depressive symptoms post-intervention varied. While 12 studies showed a significant reduction in depressive symptoms post-intervention, only 4 studies that used individual coaching or technology showed lower depressive symptoms in intervention groups in comparison to the control groups. This review can be used to inform scale-up and dissemination of these interventions to improve depressive symptoms in PLWH.

RESUMEN: Los síntomas depresivos pueden afectar el estado de salud en personas que viven con el VIH (PLWH, por sus siglas en inglés), incluyendo la adherencia al tratamiento y el pronóstico de la enfermedad. Las intervenciones de autocuidado enfocadas a los síntomas depresivos han sido eficaces para prevenir estas secuelas negativas de los síntomas depresivos. Los procesos de autogestión incluyen habilidades de aprendizaje relacionadas con enfocarse a vivir con la enfermedad necesidades, acceder a recursos para manejar la enfermedad y afrontar a la enfermedad. Se realizó una revisión sistemática de la literatura para evaluar y sintetizar la evidencia actual de las intervenciones de autocuidado dirigidas a los síntomas depresivos en personas que viven con el VIH. Siguiendo las directrices PRISMA, se realizó una búsqueda electrónica en 4 bases de datos. Se incluyeron estudios originales escritos en inglés que utilizaron un diseño de ensayo controlado aleatorio para evaluar el efecto de la intervención de autocuidado sobre los síntomas depresivos. Se seleccionaron estudios que se publicaron el 19 de abril de 2022 o antes, obteniendo 13 artículos relevantes. El riesgo de sesgo se evaluó mediante la herramienta de evaluación de la calidad de los NIH para estudios de intervención controlados y se utilizó la síntesis narrativa para sintetizar los resultados. Se incluyeron de 40 a 755 participantes en los estudios. Los estudios utilizaron diversas medidas para evaluar los síntomas depresivos antes y después de la intervención, y los puntos temporales para evaluar los síntomas depresivos después de la intervención variaron. Mientras que 12 estudios mostraron una reducción significativa en los síntomas depresivos después de la intervención, solo 4 estudios que usaron entrenamiento individual o tecnología mostraron síntomas depresivos más bajos en los grupos de intervención en comparación con los grupos de control. Esta revisión se puede utilizar para informar la ampliación y difusión de estas intervenciones para mejorar los síntomas depresivos en las personas que viven con el VIH.

Single LED visible light positioning system based on image sensor and calculated azimuth angle.

A single-lamp visible light positioning (VLP) system based on an optical camera is proposed and demonstrated. The system uses a circular light-emitting diode (LED) to transmit ID data, and a common smartphone camera for positioning. First, we propose a scheme to calculate the azimuth angle using a marked lamp bead, avoiding the use of a magnetometer, which can improve the accuracy of the azimuth angle. Second, we propose a new positioning method using a chord in the image plane, which passes through the midpoints of two chords parallel to the LED plane. The experimental results show that when the experimental area is 1.8m×3.6m, the three-dimensional (3D) average positioning errors are 8.0, 7.5, and 7.2 cm for the heights of 1.75, 1.45, and 1.2 m.

Working status and seasonal meteorological conditions predict physical activity levels in people living with HIV.

Little is known about how demographic, employment and meteorological factors impact physical activity. We conducted an analysis to explore these associations from participants (N = 447) from six cities in the United States and matched their activity data with abstracted local meteorological data from National Oceanic and Atmospheric Administration (NOAA) weather reports. Participants were purposively recruited in 3-month blocks, from December 2015 to October 2017, to reflect physical activity engagement across the seasons. We calculated total physical activity (minutes/week) based on 7-day physical activity recall. Mild correlations were observed between meteorological factors and correlated with lower physical activity. Participants were least active in autumn (Median = 220 min/week) and most active in spring (Median = 375 min/week). In addition to level of education and total hours of work, maximum temperature, relative humidity, heating degree day, precipitation and sunset time together explained 17.6% of variance in total physical activity. Programs assisting in employment for PLHIV and those that promote indoor physical activity during more strenuous seasons are needed. Additional research to better understand the selection, preferences, and impact of indoor environments on physical activity is warranted.

Effectiveness of pictographs in improving patient education outcomes: a systematic review.

The objective of this review was to investigate process of pictograph development and the effectiveness of pictographs in patient education. We conducted searches in Medline/PubMed, CINAHL with full text, PsycInfo, ERIC and Cochrane Library with keywords: (pictograph or pictorial) AND (patient education) NOT (children or adolescent or youth or child or teenagers). After excluding manuscripts that did not meet inclusion criteria, 56 articles were included between the time of the last review on this topic (January 2008) and May 2019. There are 17 descriptive studies, 27 randomized control trial studies, 9 quasi-experimental studies and 2 unique literatures in the systematic review. Major goals of the studies are pictograph development or validation. The majority of manuscripts (n = 48) supported the approach. However, six studies did not find significant differences in the outcome. Differences in patient population, pictograph designs and author-developed outcome measurements made it difficult to compare the findings. There is a lack of evidence on validating information outcome measurements. This review demonstrated that implementing pictographs into patient education is a promising approach for better information understanding and health management. Pictographic interventions need to be carefully developed and validated with both the targeted patient population and the clinical experts.

UDiTaS™, a genome editing detection method for indels and genome rearrangements.

BACKGROUND: Understanding the diversity of repair outcomes after introducing a genomic cut is essential for realizing the therapeutic potential of genomic editing technologies. Targeted PCR amplification combined with Next Generation Sequencing (NGS) or enzymatic digestion, while broadly used in the genome editing field, has critical limitations for detecting and quantifying structural variants such as large deletions (greater than approximately 100 base pairs), inversions, and translocations. RESULTS: To overcome these limitations, we have developed a Uni-Directional Targeted Sequencing methodology, UDiTaS, that is quantitative, removes biases associated with variable-length PCR amplification, and can measure structural changes in addition to small insertion and deletion events (indels), all in a single reaction. We have applied UDiTaS to a variety of samples, including those treated with a clinically relevant pair of S. aureus Cas9 single guide RNAs (sgRNAs) targeting CEP290, and a pair of S. pyogenes Cas9 sgRNAs at T-cell relevant loci. In both cases, we have simultaneously measured small and large edits, including inversions and translocations, exemplifying UDiTaS as a valuable tool for the analysis of genome editing outcomes. CONCLUSIONS: UDiTaS is a robust and streamlined sequencing method useful for measuring small indels as well as structural rearrangements, like translocations, in a single reaction. UDiTaS is especially useful for pre-clinical and clinical application of gene editing to measure on- and off-target editing, large and small.

Comparing ChatGPT and clinical nurses' performances on tracheostomy care: A cross-sectional study.

Background: The release of ChatGPT for general use in 2023 by OpenAI has significantly expanded the possible applications of generative artificial intelligence in the healthcare sector, particularly in terms of information retrieval by patients, medical and nursing students, and healthcare personnel. Objective: To compare the performance of ChatGPT-3.5 and ChatGPT-4.0 to clinical nurses on answering questions about tracheostomy care, as well as to determine whether using different prompts to pre-define the scope of the ChatGPT affects the accuracy of their responses. Design: Cross-sectional study. Setting: The data collected from the ChatGPT was collected using the ChatGPT-3.5 and 4.0 using access provided by the University of Hong Kong. The data from the clinical nurses working in mainland China was collected using the Qualtrics survey program. Participants: No participants were needed for collecting the ChatGPT responses. A total of 272 clinical nurses, with 98.5 % of them working in tertiary care hospitals in mainland China, were recruited using a snowball sampling approach. Method: We used 43 tracheostomy care-related questions in a multiple-choice format to evaluate the performance of ChatGPT-3.5, ChatGPT-4.0, and clinical nurses. ChatGPT-3.5 and GPT-4.0 were both queried three times with the same questions by different prompts: no prompt, patient-friendly prompt, and act-as-nurse prompt. All responses were independently graded by two qualified otorhinolaryngology nurses on a 3-point accuracy scale (correct, partially correct, and incorrect). The Chi-squared test and Fisher exact test with post-hoc Bonferroni adjustment were used to assess the differences in performance between the three groups, as well as the differences in accuracy between different prompts. Results: ChatGPT-4.0 showed significantly higher accuracy, with 64.3 % of responses rated as 'correct', compared to 60.5 % in ChatGPT-3.5 and 36.7 % in clinical nurses (X 2 = 74.192, p < .001). Except for the 'care for the tracheostomy stoma and surrounding skin' domain (X2 = 6.227, p = .156), scores from ChatGPT-3.5 and -4.0 were significantly better than nurses' on domains related to airway humidification, cuff management, tracheostomy tube care, suction techniques, and management of complications. Overall, ChatGPT-4.0 consistently performed well in all domains, achieving over 50 % accuracy in each domain. Alterations to the prompt had no impact on the performance of ChatGPT-3.5 or -4.0. Conclusion: ChatGPT may serve as a complementary medical information tool for patients and physicians to improve knowledge in tracheostomy care. Tweetable abstract: ChatGPT-4.0 can answer tracheostomy care questions better than most clinical nurses. There is no reason nurses should not be using it.

Effectiveness of Dyadic Advance Care Planning: A Systematic Review and Meta-Analysis.

CONTEXT: Making decisions regarding end-of-life care is particularly challenging for patients and their family caregivers. Studies have advocated that family involvement in advance care planning is important to provide goal-concordant care and to increase family caregivers' preparation for surrogate decision-making. However, there is a lack of evidence to examine the effectiveness of advance care planning using the patient-caregiver dyadic approach. OBJECTIVES: To evaluate the effectiveness of dyadic advance care planning. METHODS: A literature search was systematically carried out in 7 databases from inception to March 2023. All randomized controlled trials with advance care planning interventions for mentally competent adults and their family caregivers were included. Meta-analysis was conducted for available quantitative data related to end-of-life care; Otherwise, narrative syntheses were performed. RESULTS: In total, 14 randomized controlled trials were included. The main contents of all interventions were summarized into five categories, namely sharing illness experience and perception, introducing knowledge about advance care planning and end-of-life care, discussing individual's/dyads' values, goals, and care preferences, addressing dyads' discordance, and providing supports to complete advance care planning behaviors. The meta-analysis showed that dyadic advance care planning had significant effects on advance directive documentation (OR = 7.58, 95% CI [1.41, 40.63], P = 0.02) and proactive communication with doctors (OR = 2.42, 95% CI [1.42, 4.12], P = 0.001). In addition, interventions may improve dyad's congruence on end-of-life care, family caregivers' confidence in surrogate decision-making, and quality of end-of-life communication. CONCLUSIONS: This review supports that dyadic advance care planning is a promising approach to preparing patients and their family caregivers for end-of-life communication and decision-making. Given that this multifaceted process is influenced by multiple factors within the socio-cultural context, future studies are warranted to identify the barriers and facilitators to implement dyadic advance care planning in real-world settings.

Hidden features of NAD-RNA epitranscriptome in Drosophila life cycle.

Nicotinamide adenine dinucleotide (NAD), a nucleotide-containing metabolite, can be incorporated into the RNA 5'-terminus to result in NAD-capped RNA (NAD-RNA). Since NAD has been heightened as one of the most essential metabolites in cells, its linkage to RNA represents a critical but poorly studied modification at the epitranscriptomic level. Here, we design a highly sensitive method, DO-seq, to capture NAD-RNAs. Using Drosophila, we identify thousands of previously unexplored NAD-RNAs and their dynamics in the fly life cycle, from embryo to adult. We show the evidence that chromosomal clustering might be the structural basis by which co-expression can couple with NAD capping on physically and functionally linked genes. Furthermore, we note that NAD capping of cuticle genes inversely correlates with their gene expression. Combined, we propose NAD-RNA epitranscriptome as a hidden layer of regulation that underlies biological processes. DO-seq empowers the identification of NAD-capped RNAs, facilitating functional investigation into this modification.

Icariin Ameliorates D-galactose-induced Cell Injury in Neuron-like PC12 Cells by Inhibiting MPTP Opening.

OBJECTIVE: Icariin (ICA) has a good neuroprotective effect and can upregulate neuronal basal autophagy in naturally aging rats. Mitochondrial dysfunction is associated with brain aging-related neurodegenerative diseases. Abnormal opening of the mitochondrial permeability transition pore (mPTP) is a crucial factor in mitochondrial dysfunction and is associated with excessive autophagy. This study aimed to explore that ICA protects against neuronal injury by blocking the mPTP opening and down-regulating autophagy levels in a D-galactose (D-gal)-induced cell injury model. METHODS: A cell model of neuronal injury was established in rat pheochromocytoma cells (PC12 cells) treated with 200 mmol/L D-gal for 48 h. In this cell model, PC12 cells were pre-treated with different concentrations of ICA for 24 h. MTT was used to detect cell viability. Senescence associated ß-galactosidase (SA-ß-Gal) staining was used to observe cell senescence. Western blot analysis was performed to detect the expression levels of a senescence-related protein (p21), autophagy markers (LC3B, p62, Atg7, Atg5 and Beclin 1), mitochondrial fission and fusion-related proteins (Drp1, Mfn2 and Opa1), and mitophagy markers (Pink1 and Parkin). The changes of autophagic flow were detected by using mRFP-GFP-LC3 adenovirus. The intracellular ultrastructure was observed by transmission electron microscopy. Immunofluorescence was used to detect mPTP, mitochondrial membrane potential (MMP), mitochondrial reactive oxygen species (mtROS) and ROS levels. ROS and apoptosis levels were detected by flow cytometry. RESULTS: D-gal treatment significantly decreased the viability of PC12 cells, and markedly increased the SA-ß-Gal positive cells as compared to the control group. With the D-gal stimulation, the expression of p21 was significantly up-regulated. Furthermore, D-gal stimulation resulted in an elevated LC3B II/I ratio and decreased p62 expression. Meanwhile, autophagosomes and autolysosomes were significantly increased, indicating abnormal activation of autophagy levels. In addition, in this D-gal-induced model of cell injury, the mPTP was abnormally open, the ROS generation was continuously increased, the MMP was gradually decreased, and the apoptosis was increased. ICA effectively improved mitochondrial dysfunction to protect against D-gal-induced cell injury and apoptosis. It strongly inhibited excessive autophagy by blocking the opening of the mPTP. Cotreatment with ICA and an mPTP inhibitor (cyclosporin A) did not ameliorate mitochondrial dysfunction. However, the protective effects were attenuated by cotreatment with ICA and an mPTP activator (lonidamine). CONCLUSION: ICA inhibits the activation of excessive autophagy and thus improves mitochondrial dysfunction by blocking the mPTP opening.

MR Cranial Bone Imaging: Evaluation of Both Motion-Corrected and Automated Deep Learning Pseudo-CT Estimated MR Images.

BACKGROUND AND PURPOSE: CT imaging exposes patients to ionizing radiation. MR imaging is radiation free but previously has not been able to produce diagnostic-quality images of bone on a timeline suitable for clinical use. We developed automated motion correction and use deep learning to generate pseudo-CT images from MR images. We aim to evaluate whether motion-corrected pseudo-CT produces cranial images that have potential to be acceptable for clinical use. MATERIALS AND METHODS: Patients younger than age 18 who underwent CT imaging of the head for either trauma or evaluation of cranial suture patency were recruited. Subjects underwent a 5-minute golden-angle stack-of-stars radial volumetric interpolated breath-hold MR image. Motion correction was applied to the MR imaging followed by a deep learning-based method to generate pseudo-CT images. CT and pseudo-CT images were evaluated and, based on indication for imaging, either presence of skull fracture or cranial suture patency was first recorded while viewing the MR imaging-based pseudo-CT and then recorded while viewing the clinical CT. RESULTS: A total of 12 patients underwent CT and MR imaging to evaluate suture patency, and 60 patients underwent CT and MR imaging for evaluation of head trauma. For cranial suture patency, pseudo-CT had 100% specificity and 100% sensitivity for the identification of suture closure. For identification of skull fractures, pseudo-CT had 100% specificity and 90% sensitivity. CONCLUSIONS: Our early results show that automated motion-corrected and deep learning-generated pseudo-CT images of the pediatric skull have potential for clinical use and offer a high level of diagnostic accuracy when compared with standard CT scans.

Negotiating and Struggling for a New Life: Stigma, Spirituality, and Coping Strategies of People Living with HIV in Myanmar.

Although enacted and internalized stigma is a continuing problem for people living with HIV (PLWH) in Southeast Asia, there is little understanding of how PLWH cope with discrimination, exclusion, and other negative outcomes caused by HIV-related stigmatization. This article aims to bridge this gap by analyzing the lived experiences of HIV-related stigmatization and coping strategies among 30 people with HIV in Myanmar, a country heavily influenced by religion, especially Buddhism. Among the 30 study participants, 20 were female and 10 were male, with ages ranging from 18 to 50 years. Through the lens of Bourdieu's concepts of habitus, field, and capital, this article first elucidates the various forms of stigmatization in family, work, social, and other settings as symbolic violence on people with HIV. The present article shows that spirituality serves as a perceptual and action framework for people with HIV to generate reflexivity toward their HIV infection and related stigmatization and to further engage in agentic responses. More importantly, this article demonstrates how people with HIV draw on spirituality to support peers in reclaiming control over their lives and how they are perceived by society. The findings indicate that the local context, especially cultural and religious resources, should be considered when developing interventions to mitigate HIV-related stigmatization in Southeast Asia.

TEA domain transcription factor 1(TEAD1) induces cardiac fibroblasts cells remodeling through BRD4/Wnt4 pathway.

Cardiac fibroblasts (CFs) are the primary cells tasked with depositing and remodeling collagen and significantly associated with heart failure (HF). TEAD1 has been shown to be essential for heart development and homeostasis. However, fibroblast endogenous TEAD1 in cardiac remodeling remains incompletely understood. Transcriptomic analyses revealed consistently upregulated cardiac TEAD1 expression in mice 4 weeks after transverse aortic constriction (TAC) and Ang-II infusion. Further investigation revealed that CFs were the primary cell type expressing elevated TEAD1 levels in response to pressure overload. Conditional TEAD1 knockout was achieved by crossing TEAD1-floxed mice with CFs- and myofibroblasts-specific Cre mice. Echocardiographic and histological analyses demonstrated that CFs- and myofibroblasts-specific TEAD1 deficiency and treatment with TEAD1 inhibitor, VT103, ameliorated TAC-induced cardiac remodeling. Mechanistically, RNA-seq and ChIP-seq analysis identified Wnt4 as a novel TEAD1 target. TEAD1 has been shown to promote the fibroblast-to-myofibroblast transition through the Wnt signalling pathway, and genetic Wnt4 knockdown inhibited the pro-transformation phenotype in CFs with TEAD1 overexpression. Furthermore, co-immunoprecipitation combined with mass spectrometry, chromatin immunoprecipitation, and luciferase assays demonstrated interaction between TEAD1 and BET protein BRD4, leading to the binding and activation of the Wnt4 promoter. In conclusion, TEAD1 is an essential regulator of the pro-fibrotic CFs phenotype associated with pathological cardiac remodeling via the BRD4/Wnt4 signalling pathway.

The Social, Mental, and Physical Health Impacts of the COVID-19 Pandemic on People With HIV: Protocol of an Observational International Multisite Study.

ABSTRACT: As the COVID-19 pandemic spread across the world, immunocompromised individuals such as people with HIV (PWH) may have faced a disproportionate impact on their health and HIV outcomes, both from COVID-19 and from the strategies enacted to contain it. Based on the SPIRIT guidelines, we describe the protocol for an international multisite observational study being conducted by The International Nursing Network for HIV Research, with the Coordinating Center based at the University of California, San Francisco (UCSF) School of Nursing. Site Principal Investigators implement a standardized protocol to recruit PWH to complete the study online or in-person. Questions address demographics; HIV continuum of care indicators; mental and social health; COVID-19 and vaccination knowledge, attitudes, behaviors, and fears; and overall outcomes. Results of this study will contribute to knowledge that can inform responses to future public health crises to minimize their impacts on vulnerable populations such as PWH.

Relationship of weight loss to quality of life and symptom distress among postsurgical survivors of oesophageal cancer who received chemotherapy.

PURPOSE: Weight loss is highly prevalent in oesophageal cancer survivors, who often experience disease-related or treatment-related symptoms and quality of life (QoL) impairment. This study aimed to explore the relationships among weight loss, symptom distress, and QoL postoperatively in patients with oesophageal cancer undergoing chemotherapy and to identify the factors influencing the QoL. METHODS: We conducted a retrospective observational study with 101 patients and collected data on weight loss (percentage of total body mass loss), QoL (EORTC-QLQ-C30 and EORTC-QLQ-OES-18), and symptom distress (MDASI-GI-C). The associations among weight loss, QoL, and symptom distress were assessed using Pearson's correlation. Multiple linear regression analysis was used to identify independent factors influencing patients' QoL scores. RESULTS: The distribution of weight loss of each stage in survivors of oesophageal cancer was 1.00% (SD: 2.48%), 4.69% (SD: 4.73%), 1.66% (SD: 5.37%), 2.83% (SD: 4.89%) respectively. The mean QoL score was 66.24 (SD 18.65). The participants' mean symptom severity and symptom interference scores were 3.30 (SD 1.74) and 2.76 (SD 1.90), respectively. Weight loss and symptom distress were negatively related to patients' QoL (p < 0.05, p < 0.01, respectively). Weight loss between 6 months before diagnosis and the time of diagnosis (p < 0.05) and symptom interference (p < 0.01) were independent predictors for the QoL. CONCLUSIONS: This study suggests that oesophageal cancer survivors with larger weight reduction between 6 months before diagnosis and the time of diagnosis and more symptom distress have a worse QoL. Clinicians should focus more on patients' weight and symptom management to improve their QoL.

How does the COVID-19 pandemic impact medication adherence of patients with chronic disease?: A systematic review.

OBJECTIVE: To determine how the COVID-19 pandemic impacts patients with chronic disease medication adherence. METHODS: Four electronic databases, PubMed, MEDLINE, Web of Science, and CINAHL Plus Full Text, were searched for literature between 2019 and 2021. Abstracts and later full texts were independently screened by the authors of this review using inclusion and exclusion criteria to determine relevance to our study. Joanna Briggs Institute (JBI) critical appraisal tools were used to assess the quality of included texts. Relevant information and data from the included texts were extracted into tables for data synthesis and analysis. RESULTS: Ten studies met the study criteria, the most popular study design was cross-sectional design (n = 9, 90.0%), others were case series (n = 1, 10.0%). Barriers to medication adherence and facilitators of medication adherence were the major two themes that participants reported regarding the impact of COVID-19 on medication adherence. Moreover, these two main themes have been organized in sub-themes that are dealt with in-depth. DISCUSSION: Our results could heighten healthcare providers, stakeholders, and policy leaders' awareness of providing appropriate support for chronic disease patients, especially regarding medication adherence. Future research incorporating programs that support patients' needs is recommended.

Lactobacillus salivarius WZ1 Inhibits the Inflammatory Injury of Mouse Jejunum Caused by Enterotoxigenic Escherichia coli K88 by Regulating the TLR4/NF-κB/MyD88 Inflammatory Pathway and Gut Microbiota.

Replacing antibiotics with probiotics has become an important way to safely and effectively prevent and treat some gastrointestinal diseases. This study was conducted to investigate whether Lactobacillus salivarius WZ1 (L.S) could reduce the inflammatory injury to the mouse jejunum induced by Escherichia coli (ETEC) K88. Forty Kunming mice were randomly divided into four groups with 10 mice in each group. From day 1 to day 14, the control group and the E. coli group were administered with normal saline each day, while the L.S group and the L.S + E. coli group were gavaged with Lactobacillus salivarius WZ1 1 × 108 CFU/mL each day. On the 15th day, the E. coli group and the L.S + E. coli group were intragastrically administered ETEC K88 1 × 109 CFU/mL and sacrificed 24 h later. Our results show that pretreatment with Lactobacillus salivarius WZ1 can dramatically protect the jejunum morphological structure from the changes caused by ETEC K88 and relieve the morphological lesions of the jejunum, inhibiting changes in the mRNA expressions of TNF-α, IL-1ß and IL-6 and the protein expressions of TLR4, NF-κB and MyD88 in the intestinal tissue of mice caused by ETEC K88. Moreover, pretreatment with Lactobacillus salivarius WZ1 also increased the relative abundance of beneficial genera such as Lactobacillus and Bifidobacterium and decreased the abundance of harmful genera such as Ralstonia and Helicobacter in the gut. These results demonstrate that Lactobacillus salivarius WZ1 can inhibit the inflammatory damage caused by ETEC K88 in mouse jejunum by regulating the TLR4/NF-κB/MyD88 inflammatory pathway and gut microbiota.