Classical BSE dismissed as the cause of CWD in Norwegian red deer despite strain similarities between both prion agents.

The first case of CWD in a Norwegian red deer was detected by a routine ELISA test and confirmed by western blotting and immunohistochemistry in the brain stem of the animal. Two different western blotting tests were conducted independently in two different laboratories, showing that the red deer glycoprofile was different from the Norwegian CWD reindeer and CWD moose and from North American CWD. The isolate showed nevertheless features similar to the classical BSE (BSE-C) strain. Furthermore, BSE-C could not be excluded based on the PrPSc immunohistochemistry staining in the brainstem and the absence of detectable PrPSc in the lymphoid tissues. Because of the known ability of BSE-C to cross species barriers as well as its zoonotic potential, the CWD red deer isolate was submitted to the EURL Strain Typing Expert Group (STEG) as a BSE-C suspect for further investigation. In addition, different strain typing in vivo and in vitro strategies aiming at identifying the BSE-C strain in the red deer isolate were performed independently in three research groups and BSE-C was not found in it. These results suggest that the Norwegian CWD red deer case was infected with a previously unknown CWD type and further investigation is needed to determine the characteristics of this potential new CWD strain.

Motivators, barriers and communication channels for blood donation in relation to students at a university in Spain.

BACKGROUND: Targeting young people to donate blood is a particularly promising option. The aim of this work was to know the motivators, barriers and preferred communication channels for blood donation among university students, and to determine the factors that explain why donors give blood. MATERIALS AND METHODS: A questionnaire was distributed to 420 students (response rate: 88.3 %) attending the University of Huelva (Spain). Data were gathered on sociodemographic variables, blood donation history, motivators and barriers to donation, and communication channels. Non-parametric contrasts were used to determine possible differences in the sociodemographic characteristics or donation history, and logistic regression to determine the factors associated to donation. RESULTS: 67.38 % of the students surveyed were non-donors, 12.94 % were first-time donors, 11.05 % were infrequent donors and 8.63 % were frequent donors. "Solidarity" was the main motivator for donating blood (40 %). "Lack of information on where and how to give blood" was the main barrier for non-donors (26.4 %), with "medical reasons" cited by first-time donors (22.2 %). 93.8 % of donors wished to be notified about their next donation appointment. The majority of those surveyed preferred e-mail to receive alerts and information on donation campaigns. The factors that explained blood donation were over 26 years of age and place of residence. CONCLUSION: The study identified differences in the motivators, barriers and choice of communication channel among the university students in terms of blood donation, and the factors that explain blood donation. This knowledge is a useful source of information when designing blood donation campaigns that target young people.

Topological defects in cholesteric liquid crystals induced by monolayer domains with orientational chirality.

Unless stabilized by colloids or confinement with well-defined boundary conditions, defects in liquid crystals remain elusive short-lived objects that tend to disappear with time to minimize the medium's free energy. In this work we use multimodal three-dimensional imaging to visualize cholesteric director structures to show that self-assembled chiral molecular monolayer domains can stabilize topologically constrained defect configurations when in contact with a cholesteric liquid crystal. The cholesteric liquid crystal, having features of both coarse-grained lamellar and nematic liquid crystal with chiral symmetry breaking, allows us to explore the interplay of chirality and implications of layering on the formed defects and director configurations.

Effectiveness of an Interactive mHealth App (EVITE) in Improving Lifestyle After a Coronary Event: Randomized Controlled Trial.

BACKGROUND: Coronary heart disease is one of the leading causes of mortality worldwide. Secondary prevention is essential, as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve lifestyles. OBJECTIVE: This study aimed to evaluate the effect of an mHealth intervention on people with coronary heart disease who received percutaneous coronary intervention. Improvements in lifestyle regarding diet, physical activity, and smoking; level of knowledge of a healthy lifestyle and the control of cardiovascular risk factors (CVRFs); and therapeutic adherence and quality of life were analyzed. METHODS: This was a randomized controlled trial with a parallel group design assigned 1:1 to either an intervention involving a smartphone app (mHealth group) or to standard health care (control group). The app was used for setting aims, the self-monitoring of lifestyle and CVRFs using measurements and records, educating people with access to information on their screens about healthy lifestyles and adhering to treatment, and giving motivation through feedback about achievements and aspects to improve. Both groups were assessed after 9 months. The primary outcome variables were adherence to the Mediterranean diet, frequency of food consumed, patient-reported physical activity, smoking, knowledge of healthy lifestyles and the control of CVRFs, adherence to treatment, quality of life, well-being, and satisfaction. RESULTS: The study analyzed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (92/128, 71.9%), with a mean age of 59.49 (SD 8.97) years. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (mean 11.83, SD 1.74 points vs mean 10.14, SD 2.02 points; P<.001), frequency of food consumption, patient-reported physical activity (mean 619.14, SD 318.21 min/week vs mean 471.70, SD 261.43 min/week; P=.007), giving up smoking (25/67, 75% vs 11/61, 42%; P=.01), level of knowledge of healthy lifestyles and the control of CVRFs (mean 118.70, SD 2.65 points vs mean 111.25, SD 9.05 points; P<.001), and the physical component of the quality of life 12-item Short Form survey (SF-12; mean 45.80, SD 10.79 points vs mean 41.40, SD 10.78 points; P=.02). Overall satisfaction was higher in the mHealth group (mean 48.22, SD 3.89 vs mean 46.00, SD 4.82 points; P=.002) and app satisfaction and usability were high (mean 44.38, SD 6.18 out of 50 points and mean 95.22, SD 7.37 out of 100). CONCLUSIONS: The EVITE app was effective in improving the lifestyle of patients in terms of adherence to the Mediterranean diet, frequency of healthy food consumption, physical activity, giving up smoking, knowledge of healthy lifestyles and controlling CVRFs, quality of life, and overall satisfaction. The app satisfaction and usability were excellent. TRIAL REGISTRATION: Clinicaltrials.gov NCT04118504; https://clinicaltrials.gov/study/NCT04118504.

Impact of creative workshops in an institutionalized patient with moderate/severe cognitive impairment with behavioral disorders: A case report.

The Hospital Care Unit for individuals with intellectual disabilities and behavioral disorders provides comprehensive care in a controlled and video-surveyed facility that minimizes access to potentially manipulative materials during aggression or pica episodes. The patient was admitted to the unit due to issues including ingestion of non-edible fluids, aggression toward staff and other patients, and self-injury. All patients participated in occupational activities led by an occupational therapist from Monday to Friday from 10 a.m. to 11:30 a.m. In addition, creative workshops such as cinema forums and cooking workshops were held on some afternoons. During the analyzed period from January to June 2022, the patient experienced three episodes of pica, 14 assaults toward staff, and eight toward peers. All of these incidents occurred after dinner and were triggered either by the inability to eat dessert or by refusal to brush teeth afterward. In our case study, the implementation of creative workshops such as cooking had a positive effect on decreasing instances of pica and aggression. These workshops slightly improved participation in other occupational therapy activities and stabilized the patient's behavior, increasing the likelihood of her being able to return to her habitual residence.

Chiral-symmetry selection in soft monolayers under vortical flow.

Herein, we report and interpret a new chiral-selection phenomenon in the orientational ordering of soft-assembled domains that arise spontaneously in Langmuir monolayers of an azobenzene derivative at the air/water interface. The orientational chirality of isolated sub-millimeter domains was unambiguously assessed by optical microscopy. The selection process, quantified by using an enantiomeric excess parameter, was controlled by stirring the aqueous subphase. We have studied the dependence of this process on stirring rate and handedness, stirring time, temperature, and on the initial state of the monolayer. The influence of the concomitant cis/trans isomerization on the reported chiral-selection process is also discussed.

Motivation and Limiting Factors for Adherence to Weight Loss Interventions among Patients with Obesity in Primary Care.

The cornerstones of obesity management are diet, physical activity and behavioral change. However, there is considerable scientific evidence that lifestyle interventions to treat obesity are rarely implemented in primary care. The aim of this study is to analyze motivation to lose weight among patients with obesity, the resources implemented by primary care centers to promote behavioral change and the limiting factors reported by the patients themselves when attempting to lose weight. A total of 209 patients diagnosed with obesity were interviewed. The variables were obtained from both electronic clinical records (sex, age, BMI, diagnosis of metabolic syndrome and records of activities prescribed to promote behavioral change) and a self-administered personal questionnaire. A total of 67.5% of the respondents reported not having sufficient motivation to adhere to a weight loss program. Records of behavioral change activities were identified in only 3% of the clinical records reviewed. The barriers to adherence to diet and exercise plans most frequently mentioned by patients were not having a prescribed diet (27.8%), joint pain (17.7%), getting tired or bored of dieting (14.8%) and laziness (11.5%). Both the high percentage of patients reporting insufficient motivation to lose weight and the barriers to weight loss identified suggest that patients feel the need to improve their motivation, which should be promoted through primary care.

Design and Validation of a Scale of Knowledge of Cardiovascular Risk Factors and Lifestyle after Coronary Event.

BACKGROUND: It is important for health professionals to have tools available to assess patients' knowledge of lifestyle and cardiovascular risk factors after they have suffered a coronary event and determine whether educational interventions are effective. This study aims to design and validate a scale to evaluate this knowledge. METHODS: Four-phase instrument design: (A) Conceptual review. (B) Review by experts. (C) Pilot test-retest. (D) Psychometric validation of the final version of the questionnaire with 24 items. A panel of experts performed the content validity. The reliability of the scale was measured using Cronbach's alpha score and criterion validity was evaluated by comparing the total scores for knowledge obtained by the participants among the three education level groups. The construct and dimensional structure validity were assessed using exploratory factor analysis. RESULTS: A total of 143 people participated, 30 in the pilot study and 113 (68% male, 60.2 ± 9 years) in the psychometric validation of version 3 of the scale. A Cronbach's alpha score of 0.887 was reached for this version. The factor analysis showed that the items were distributed into five factors that explained 57% of the variance. Significant differences were observed in the level of knowledge among the patients of the three levels of education (low, moderate and high) (99.20 ± 11.93, 105.92 ± 7.85, 109.78 ± 8.76 points, p = 0.003), as there was a negative correlation between age and knowledge level (r = -0.213, p = 0.024). CONCLUSIONS: The scale presents psychometric properties that are evidence of its reliability and validity. The relationship demonstrated between the level of knowledge and age, sex and level of education shows the importance of emphasizing educational interventions for elderly people and those with a lower level of education.

Healing of defects at the interface of nematic liquid crystals and structured Langmuir-Blodgett monolayers.

We use Langmuir-Blodgett molecular monolayers and nematic liquid crystals as model two- and three-dimensional orientationally ordered systems to study the stability and healing of topological defects at their contact interfaces. Integer-strength defects at the monolayer induce disclinations of similar strength in the nematic that, however, do not propagate deep into the bulk, but rather form single- or double-split arch-shaped loops pinned to the interface. This behavior is qualitatively independent of the far-field director orientation and involves either half-integer singular or twist-escaped unity-strength nonsingular nematic disclinations. These two defect configurations can be selected by varying sample preparation given their comparable free energy, consistently with direct probing by use of laser tweezers.

Evaluation of Obesity Management Recorded in Electronic Clinical History: A Cohort Study.

BACKGROUND: The prevalence of obesity is increasing worldwide. Because of their close proximity to the population, primary care physicians and nurses are in a unique position to motivate and advise patients with obesity on a healthy diet and increased physical activity. Drawing from information recorded in electronic clinical records, we evaluated how the general recommendations included in obesity guidelines are being implemented in routine clinical practice. METHODS: This study drew from the following data from a cohort of 209 patients with obesity that attended primary care consultations: electronic clinical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether their health professional documented compliance with the recommendations of the evidence-based obesity guidelines in their electronic history. RESULTS: Only 25.4% of the clinical records met all the criteria established in the therapeutic guidelines regarding diet prescription, 1.4% for physical activity and 1.5% for behavioral change activities. The patients whose records mentioned diet prescription and physical activity and who received follow-up consultations for both factors had lower average BMI and WC, although this relationship was not significant after adjusting for baseline. CONCLUSIONS: We found that only a small number of records in the electronic clinical histories followed the evidence-based obesity guidelines. Recording dietetic prescription and physical exercise in the patient's clinical record is associated with better control of obesity.

Chiral selection by interfacial shearing of self-assembled achiral molecules.

We report a novel phenomenon of chiral selection in self-assembled condensates of achiral amphiphiles. The handedness of chiral textures, reproducing the collective rotational component of the molecular orientation inside submillimeter circular domains, is correlated with the sign of a vortical stirring in the aqueous subphase. We propose an explanation based on the distinctive kinetics of topological defect annihilation during domain coalescence at the initial coarsening stage of a phase-separating monolayer.

Cisplatin-mediated impairment of mitochondrial DNA metabolism inversely correlates with glutathione levels.

Cisplatin accumulates in mitochondria, which are a major target for this drug in cancer cells. Thus alterations in mitochondrial function have been implicated in cancer cell resistance to chemotherapeutic agents. Moreover, cisplatin toxic side effects seem to be associated with mitochondrial injury in vivo and in vitro. In order to clarify the potential effect of cisplatin in mtDNA (mitochondrial DNA) maintenance and expression, we have analysed rat liver mtDNA and mtRNA (mitochondrial RNA) synthesis as well as their stability under the influence of in vivo treatment or in vitro exposure to cisplatin. We show that cisplatin causes a direct and significant impairment of mtDNA and mtRNA synthesis and decreases steady-state levels of mtRNAs in isolated mitochondria. Furthermore, in vivo treatment of the animals with cisplatin exerts a protective effect from the impairment of mtRNA metabolism caused by in vitro exposure to the drug, by means of increased mitochondrial GSH levels after in vivo cisplatin treatment.

[Physicians' awareness and assessment of shared decision making in oncology practice.] / onocimiento y evaluación de la toma de decisiones compartidas en la práctica oncológica desde el punto de vista médico.

OBJECTIVE: Implementation of Shared Decision Making (SDM) in oncology is limited. The objective of the study was to determine the extent of physicians' awareness of Shared Decision Making (SDM) in their treatment of cancer patients, the usefulness that they assign to SDM, the role they play, their assessment of SDM, and perceptions of the main barriers and facilitators to its use. METHODS: A questionnaire was completed by medical oncologists, radiation oncologists and general surgeons working in Andalusia (Spain). Sociodemographic, clinical-care and aspects of SDM variables were collected. SDM was evaluated using the SDM-Q-Doc questionnaire. Non-parametric contrasts were used to determine the possible differences between medical specialties. RESULTS: The questionnaire was sent to 351 physicians. The response rate was 37.04%, 63 women and 67 men, with an average age of 45.6 years and 18.04 years' experience. Of these, 33.08% were medical oncologists, 34.61% radiation oncologists and 29.23% general surgeons. A total of 82.3% stated they had received no training in SDM, whereas 33.8% said they knew a lot about SDM and applied it in practice; 80% considered it to be very useful. In addition, 60% of respondents said they were mainly the ones who made the decisions on treatment. An evaluation of SDM on the SDM-Q-Doc scale showed that all the specialities scored more than 80/100. The main barriers to applying SDM were the difficulty patients experienced in understanding what they needed to know, the lack of decision aids and time. CONCLUSIONS: Some 82% of physicians have no training in SDM and 66% don´t use it in practice, with decisions on treatment taken mainly by the physicians themselves. Strategies to increase training in SDM and to implement it into clinical practice are important.

OBJETIVO: La implementación de la Toma de Decisiones Compartidas (TDC) en oncología es escasa. El objetivo del estudio fue determinar el conocimiento de la TDC que tienen los médicos que tratan a pacientes con cáncer, la utilidad que le conceden, el rol que desempeñan, la evaluación que hacen, y las barreras y facilitadores que encuentran para su uso. METODOS: Se realizó una encuesta a oncólogos médicos, oncólogos radioterápicos y cirujanos generales que ejercían en Andalucía (España). Se recogieron variables sociodemográficas, clínico-asistenciales y de aspectos de la TDC. La TDC se evaluó mediante el cuestionario SDM-Q-Doc. Se emplearon contrastes no paramétricos para determinar las posibles diferencias entre especialidades médicas. RESULTADOS: El cuestionario se envió a 351 médicos y la tasa de respuesta fue del 37,04%. Respondieron 63 mujeres y 67 hombres, con un promedio de 45,6 años de edad y 18,04 años de experiencia. El 33,08% eran oncólogos médicos, el 34,61% oncólogos radioterápicos y el 29,23% cirujanos generales. El 82,3% no tenía formación en TDC y el 33,8% reconocía saber bastante y utilizarla en su práctica habitual. El 80% consideró que era muy útil. El 60% respondió que la decisión sobre el tratamiento la tomaban mayormente ellos. Al evaluar la TDC con la escala SDM-Q-Doc, todas las especialidades obtuvieron más de 80 puntos sobre 100. Las principales barreras para aplicar la TDC fueron la dificultad del paciente para entender lo que necesitaba saber, la falta de instrumentos de apoyo, así como la falta de tiempo. CONCLUSIONES: Un 82% de los médicos no tiene formación en TDC y un 66% no la utiliza en su práctica habitual, tomando la decisión sobre el tratamiento mayoritariamente ellos. Es importante adoptar estrategias para aumentar la formación en TDC e implementarla en la práctica clínica diaria.

Composition and dynamics of human mitochondrial nucleoids.

The organization of multiple mitochondrial DNA (mtDNA) molecules in discrete protein-DNA complexes called nucleoids is well studied in Saccharomyces cerevisiae. Similar structures have recently been observed in human cells by the colocalization of a Twinkle-GFP fusion protein with mtDNA. However, nucleoids in mammalian cells are poorly characterized and are often thought of as relatively simple structures, despite the yeast paradigm. In this article we have used immunocytochemistry and biochemical isolation procedures to characterize the composition of human mitochondrial nucleoids. The results show that both the mitochondrial transcription factor TFAM and mitochondrial single-stranded DNA-binding protein colocalize with Twinkle in intramitochondrial foci defined as nucleoids by the specific incorporation of bromodeoxyuridine. Furthermore, mtDNA polymerase POLG and various other as yet unidentified proteins copurify with mtDNA nucleoids using a biochemical isolation procedure, as does TFAM. The results demonstrated that mtDNA in mammalian cells is organized in discrete protein-rich structures within the mitochondrial network. In vivo time-lapse imaging of nucleoids show they are dynamic structures able to divide and redistribute in the mitochondrial network and suggest that nucleoids are the mitochondrial units of inheritance. Nucleoids did not colocalize with dynamin-related protein 1, Drp1, a protein of the mitochondrial fission machinery.

OXPHOS, pyrimidine nucleotides, and Alzheimer's disease: a pharmacogenomics approach.

We present a new hypothesis on the contribution of a dysfunction of the oxidative phosphorylation system, through a decrease in the de novo synthesis of pyrimidine nucleotides, to the pathogenesis of late onset Alzheimer's disease (AD). In the light of this proposition, different treatments for AD patients, such as enhancing the electron flow downstream the coenzyme Q10 of the mitochondrial respiratory chain or increasing mitochondrial biogenesis or directly providing pyrimidines, would be possible. AD is a multifactorial disorder and not all patients would benefit from these treatments. Those healthy individuals harboring mtDNA haplotypes related to a coupled OXPHOS function would probably be the better candidates for these preventive therapies.

Conocimiento y evaluación de la toma de decisiones compartidas en la práctica oncológica desde el punto de vista médico / Physicians' awareness and assessment of shared decision making in oncology practice

OBJETIVO: La implementación de la Toma de Decisiones Compartidas (TDC) en oncología es escasa. El objetivo del estudio fue determinar el conocimiento de la TDC que tienen los médicos que tratan a pacientes con cáncer, la utilidad que le conceden, el rol que desempeñan, la evaluación que hacen, y las barreras y facilitadores que encuentran para su uso. MÉTODOS: Se realizó una encuesta a oncólogos médicos, oncólogos radioterápicos y cirujanos generales que ejercían en Andalucía (España). Se recogieron variables sociodemográficas, clínico-asistenciales y de aspectos de la TDC. La TDC se evaluó mediante el cuestionario SDM-Q-Doc. Se emplearon contrastes no paramétricos para determinar las posibles diferencias entre especialidades médicas. RESULTADOS: El cuestionario se envió a 351 médicos y la tasa de respuesta fue del 37,04%. Respondieron 63 mujeres y 67 hombres, con un promedio de 45,6 años de edad y 18,04 años de experiencia. El 33,08% eran oncólogos médicos, el 34,61% oncólogos radioterápicos y el 29,23% cirujanos generales. El 82,3% no tenía formación en TDC y el 33,8% reconocía saber bastante y utilizarla en su práctica habitual. El 80% consideró que era muy útil. El 60% respondió que la decisión sobre el tratamiento la tomaban mayormente ellos. Al evaluar la TDC con la escala SDM-Q-Doc, todas las especialidades obtuvieron más de 80 puntos sobre 100. Las principales barreras para aplicar la TDC fueron la dificultad del paciente para entender lo que necesitaba saber, la falta de instrumentos de apoyo, así como la falta de tiempo. CONCLUSIONES: Un 82% de los médicos no tiene formación en TDC y un 66% no la utiliza en su práctica habitual, tomando la decisión sobre el tratamiento mayoritariamente ellos. Es importante adoptar estrategias para aumentar la formación en TDC e implementarla en la práctica clínica diaria

OBJECTIVE: Implementation of Shared Decision Making (SDM) in oncology is limited. The objective of the study was to determine the extent of physicians' awareness of Shared Decision Making (SDM) in their treatment of cancer patients, the usefulness that they assign to SDM, the role they play, their assessment of SDM, and perceptions of the main barriers and facilitators to its use. METHODS: A questionnaire was completed by medical oncologists, radiation oncologists and general surgeons working in Andalusia (Spain). Sociodemographic, clinical-care and aspects of SDM variables were collected. SDM was evaluated using the SDM-Q-Doc questionnaire. Non-parametric contrasts were used to determine the possible differences between medical specialties. RESULTS: The questionnaire was sent to 351 physicians. The response rate was 37.04%, 63 women and 67 men, with an average age of 45.6 years and 18.04 years' experience. Of these, 33.08% were medical oncologists, 34.61% radiation oncologists and 29.23% general surgeons. A total of 82.3% stated they had received no training in SDM, whereas 33.8% said they knew a lot about SDM and applied it in practice; 80% considered it to be very useful. In addition, 60% of respondents said they were mainly the ones who made the decisions on treatment. An evaluation of SDM on the SDM-Q-Doc scale showed that all the specialities scored more than 80/100. The main barriers to applying SDM were the difficulty patients experienced in understanding what they needed to know, the lack of decision aids and time. CONCLUSIONS: Some 82% of physicians have no training in SDM and 66% don't use it in practice, with decisions on treatment taken mainly by the physicians themselves. Strategies to increase training in SDM and to implement it into clinical practice are important

Stirring competes with chemical induction in chiral selection of soft matter aggregates.

Chirality, the absence of mirror symmetry, can be equally invoked in relation to physical forces and chemical induction processes, yet a competition between these two types of influence is rarely reported. Here we present a self-assembled soft matter system in which chiral selection is controlled by the combined independent action of a chiral dopant and vortical stirring, which are arbitrarily coupled, either constructively or destructively. In the latter case, perfect compensation, that is, absence of a net chiral effect, is realized. The induced enantiomorphic excess is measured in terms of the statistical imbalance of an ensemble of submillimetre domains, where achiral molecules self-assemble with a well-defined orientational chirality that is unambiguously resolved using optical microscopy. The possibility of combining top-down and bottom-up strategies to induce a chiral predominance in a supramolecular system of achiral components should be recognized as a new twist in the process of chiral recognition, selection and control.

[Unplanned extubations in patients in the ventilator weaning phase in the intensive care unit: Incidence and risk factors]. / Extubaciones no programadas en pacientes sometidos a fase de destete en cuidados intensivos: incidencia y factores de riesgo.

OBJECTIVES: To identify the incidence of unplanned extubations (UE) in a general intensive care unit (ICU) and associated risk factors. METHODS: An analytical, observational and prospective study was performed in an eight-bed general ICU over a 6-month period. The participants consisted of 79 consecutive patients who underwent mechanical ventilation for 12 h or more and who were under the ventilator weaning phase. The variables studied were age, days of endotracheal intubation, length of stay in the ICU, weaning phase and the APACHE II prognostic score; the degree of sedation and/or agitation was evaluated using Riker's Sedation-Agitation Scale. The incidence density of UEs was calculated and the variables measured in the extubated and non-extubated groups were compared using the Mann Whitney U-test. RESULTS: Among the 79 patients studied, UE occurred in 15 (18.9%). Of these events, 76.9% occurred during the ventilator weaning phase. There were 11 cases (73.3%) of self-extubations, three cases (20%) of accidental removal and one case (6.6%) of endotracheal tube obstruction. Age equal to or less than 60 years was a risk factor. No relationship was found with the remaining factors studied: days of hospital stay, days of endotracheal intubation or APACHE score. CONCLUSIONS: Patients at risk for UE were younger and showed agitation on the Riker scale. UEs usually occurred during the ventilator weaning phase.

Tid1 isoforms are mitochondrial DnaJ-like chaperones with unique carboxyl termini that determine cytosolic fate.

Tid1 is a human homolog of bacterial DnaJ and the Drosophila tumor suppressor Tid56 that has two alternatively spliced isoforms, Tid1-long and -short (Tid1-L and -S), which differ only at their carboxyl termini. Although Tid1 proteins localize overwhelmingly to mitochondria, published data demonstrate principally nonmitochondrial protein interactions and activities. This study was undertaken to determine whether Tid1 proteins function as mitochondrial DnaJ-like chaperones and to resolve the paradox of how proteins targeted primarily to mitochondria function in nonmitochondrial pathways. Here we demonstrate that Tid1 isoforms exhibit a conserved mitochondrial DnaJ-like function substituting for the yeast mitochondrial DnaJ-like protein Mdj1p. Like Mdj1p, Tid1 localizes to human mitochondrial nucleoids, which are large protein complexes bound to mitochondrial DNA. Unlike other DnaJs, Tid1-L and -S form heterocomplexes; both unassembled and complexed Tid1 are observed in human cells. Results demonstrate that Tid1-L has a longer residency time in the cytosol prior to mitochondrial import as compared with Tid1-S; Tid1-L is also significantly more stable in the cytosol than Tid1-S, which is rapidly degraded. The longer cytosolic residency time and the half-life of Tid1-L are explained by its interaction with cytosolic Hsc70 and potential protein substrates such as the STAT1 and STAT3 transcription factors. We show that the unique carboxyl terminus of Tid1-L is required for interaction with Hsc70 and STAT1 and -3. We propose that the association of Tid1 with chaperones and/or protein substrates in the cytosol provides a mechanism for the alternate fates and functions of Tid1 in mitochondrial and nonmitochondrial pathways.