Structural basis of direct and inverted DNA sequence repeat recognition by helix-turn-helix transcription factors.

Some transcription factors bind DNA motifs containing direct or inverted sequence repeats. Preference for each of these DNA topologies is dictated by structural constraints. Most prokaryotic regulators form symmetric oligomers, which require operators with a dyad structure. Binding to direct repeats requires breaking the internal symmetry, a property restricted to a few regulators, most of them from the AraC family. The KorA family of transcriptional repressors, involved in plasmid propagation and stability, includes members that form symmetric dimers and recognize inverted repeats. Our structural analyses show that ArdK, a member of this family, can form a symmetric dimer similar to that observed for KorA, yet it binds direct sequence repeats as a non-symmetric dimer. This is possible by the 180° rotation of one of the helix-turn-helix domains. We then probed and confirmed that ArdK shows affinity for an inverted repeat, which, surprisingly, is also recognized by a non-symmetrical dimer. Our results indicate that structural flexibility at different positions in the dimerization interface constrains transcription factors to bind DNA sequences with one of these two alternative DNA topologies.

ArdC, a ssDNA-binding protein with a metalloprotease domain, overpasses the recipient hsdRMS restriction system broadening conjugation host range.

Plasmids, when transferred by conjugation in natural environments, must overpass restriction-modification systems of the recipient cell. We demonstrate that protein ArdC, encoded by broad host range plasmid R388, was required for conjugation from Escherichia coli to Pseudomonas putida. Expression of ardC was required in the recipient cells, but not in the donor cells. Besides, ardC was not required for conjugation if the hsdRMS system was deleted in P. putida recipient cells. ardC was also required if the hsdRMS system was present in E. coli recipient cells. Thus, ArdC has antirestriction activity against the HsdRMS system and consequently broadens R388 plasmid host range. The crystal structure of ArdC was solved both in the absence and presence of Mn2+. ArdC is composed of a non-specific ssDNA binding N-terminal domain and a C-terminal metalloprotease domain, although the metalloprotease activity was not needed for the antirestriction function. We also observed by RNA-seq that ArdC-dependent conjugation triggered an SOS response in the P. putida recipient cells. Our findings give new insights, and open new questions, into the antirestriction strategies developed by plasmids to counteract bacterial restriction strategies and settle into new hosts.

Identification of a peripheral blood gene signature predicting aortic valve calcification.

Calcific aortic valve disease (CAVD) is a significant cause of illness and death worldwide. Identification of early predictive markers could help optimize patient management. RNA-sequencing was carried out on human fetal aortic valves at gestational weeks 9, 13, and 22 and on a case-control study with adult noncalcified and calcified bicuspid and tricuspid aortic valves. In dimension reduction and clustering analyses, diseased valves tended to cluster with fetal valves at week 9 rather than normal adult valves, suggesting that part of the disease program might be due to reiterated developmental processes. The analysis of groups of coregulated genes revealed predominant immune-metabolic signatures, including innate and adaptive immune responses involving lymphocyte T-cell metabolic adaptation. Cytokine and chemokine signaling, cell migration, and proliferation were all increased in CAVD, whereas oxidative phosphorylation and protein translation were decreased. Discrete immune-metabolic gene signatures were present at fetal stages and increased in adult controls, suggesting that these processes intensify throughout life and heighten in disease. Cellular stress response and neurodegeneration gene signatures were aberrantly expressed in CAVD, pointing to a mechanistic link between chronic inflammation and biological aging. Comparison of the valve RNA-sequencing data set with a case-control study of whole blood transcriptomes from asymptomatic individuals with early aortic valve calcification identified a highly predictive gene signature of CAVD and of moderate aortic valve calcification in overtly healthy individuals. These data deepen and broaden our understanding of the molecular basis of CAVD and identify a peripheral blood gene signature for the early detection of aortic valve calcification.

'Where do we come from and where are we going?' A study about the transformation of knowledge related to long-term care.

The care crisis manifests the tensions and profound changes which are taking place in contemporary long-term care systems, leading to new care views and modalities in society. Through 26 interviews conducted with caregivers, family members and elderly people with care needs, this study aims to make visible the transformation in the conceptions of care in the Basque Country. First, the results show the displacement of familiarist ideas and values. Second, we describe the daily management of the social and moral tensions associated with outsourcing and the meaning of care work. Third, the findings indicate the emergence of new perspectives on the modalities of care. The contribution of cognitive polyphasia towards analysing the management and integration of new knowledge associated with care in a specific socio-cultural context is discussed. Finally, we consider the applicability of our findings in terms of relevant solutions for care management and innovation in this field.

Language use and stereotyping: the role of approach and avoidance motivation goals.

The use of more abstract language to describe expected behaviors as opposed to unexpected behaviors has traditionally been considered a way of stereotype maintenance. This tendency is known as linguistic expectancy bias. Two experiments examined the influence of approach and avoidance motivational orientations on the production of this linguistic expectancy bias. It was predicted that approach strategic orientation is likely to describe expectancy consistent behaviors at a higher level of linguistic abstraction than expectancy inconsistent behaviors. In contrast, avoidance strategic orientation is likely to describe both expectancy consistent behaviors and expectancy inconsistent behaviors at a lower level of linguistic abstraction, thus facilitating the disappearance of linguistic expectancy bias. Two experiments confirmed these expectations, using strategic orientation manipulations based either on communication goals or on motor action, and measuring linguistic abstraction either on forced-choice answer format or on free descriptions. Implications for the generalisation of linguistic expectancy bias are discussed.

Understanding the relationship between perceived development of the competition plan and sport performance: mediating effects of self-efficacy and state depression.

The effectiveness of competition plans on athletes' performance outcomes was assessed while accounting for the mediating influence of state depression and self-efficacy. Competition plans reflect an integrated and personalized plan that consists of a set of decision-making rules based on the principles of self-control and self-efficacy development that are tailored to the specific demands of an upcoming competition in a given sport and highly individualized to take into account the specific qualities of the athlete. The relationship between the development of a competition plan and athletes' evaluations of their competitive outcomes was of interest. 11 elite athletes participating in 104 competitions involving 7 different sports participated. Results support the beneficial effect of a well-developed competition plan in affecting athletes' perceived performance; the relationship was mediated by state depression and self-efficacy. Coaches and sport psychologists should devote increased attention to the development and refinement of athletes' precompetition performance plans while also considering participants' self-efficacy and mood characteristics.

Assessment of feedback for the teaching of nursing practice.

OBJECTIVE: to analyze the self-reported knowledge of professors in the use of feedback in the teaching of nursing practice; train professors to use this process; and evaluate the results of this training. METHOD: a qualitative study of research-action type. The focus group technique was used with seven collaborators of a nursing technical school. For content analysis, the Bardin framework was used and, for intervention, the Problematization Methodology supported by Pendleton's Rules. RESULTS: most present in their curricula training to teach. It is pointed out that feedback is a simple and essential assessment tool, although universal discourse does not express the exact dimension of feedback potentialities. The intervention was effective to solidify feedback. FINAL CONSIDERATION: this study shows that feedback should be disseminated and consolidated among the teaching staff of nursing technical education [corrected].

Searching for Glycosylated Natural Products in Actinomycetes and Identification of Novel Macrolactams and Angucyclines.

Many bioactive natural products are glycosylated compounds in which the sugar components usually participate in interaction and molecular recognition of the cellular target. Therefore, the presence of sugar moieties is important, in some cases essential, for bioactivity. Searching for novel glycosylated bioactive compounds is an important aim in the field of the research for natural products from actinomycetes. A great majority of these sugar moieties belong to the 6-deoxyhexoses and share two common biosynthetic steps catalyzed by a NDP-D-glucose synthase (GS) and a NDP-D-glucose 4,6-dehydratase (DH). Based on this fact, seventy one Streptomyces strains isolated from the integument of ants of the Tribe Attini were screened for the presence of biosynthetic gene clusters (BGCs) for glycosylated compounds. Total DNAs were analyzed by PCR amplification using oligo primers for GSs and DHs and also for a NDP-D-glucose-2,3-dehydratases. Amplicons were used in gene disruption experiments to generate non-producing mutants in the corresponding clusters. Eleven mutants were obtained and comparative dereplication analyses between the wild type strains and the corresponding mutants allowed in some cases the identification of the compound coded by the corresponding cluster (lobophorins, vicenistatin, chromomycins and benzanthrins) and that of two novel macrolactams (sipanmycin A and B). Several strains did not show UPLC differential peaks between the wild type strain and mutant profiles. However, after genome sequencing of these strains, the activation of the expression of two clusters was achieved by using nutritional and genetic approaches leading to the identification of compounds of the cervimycins family and two novel members of the warkmycins family. Our work defines a useful strategy for the identification new glycosylated compounds by a combination of genome mining, gene inactivation experiments and the activation of silent biosynthetic clusters in Streptomyces strains.

Aortic valve repair: An exciting journey / Reparación valvular aórtica: una experiencia emocionante

Abstract Aortic valve repair has become an attractive alternative to aortic valve replacement in most of the patients with aortic insufficiency. To improve reproducibility and durability "geometric anatomy" of the valve has been developed to guide the repair. Expert centers were able to publish remarkable short- and long-term results for aortic valve sparing procedures. Therefore, data comparing composite valve grafting and aortic valve sparing procedures revealed similar early mortality. Also, late mortality, thromboembolism, stroke and bleeding risks were significantly lower in patients undergoing aortic valve repair and late durability was equivalent1. However, the complexity of the procedures makes aortic valve repair difficult to be adopted into daily surgical practice. Accordingly, starting your own aortic valve repair program requires conviction, training, facilities, quality control and a well structured heart valve team to let your program succeed.

Resumen La reparación valvular aórtica se ha convertido en una alternativa atractiva al reemplazo, en la mayoría de pacientes con insuficiencia aórtica. Para mejorar la reproducibilidad y la durabilidad, se ha desarrollado una "anatomía geométrica" de la válvula para guiar la reparación. Los centros expertos han publicado resultados notables a corto y largo plazo en preservación valvular aórtica. Además, los estudios que compararon el cambio valvular por tubo valvulado con los procedimientos de preservación valvular, mostraron una mortalidad temprana similar, con riesgos de mortalidad tardía, como tromboembolia pulmonar, accidente cerebrovascular y hemorragia, significativamente menores en los pacientes sometidos a reparación valvular aórtica, con una durabilidad tardía equivalente1. Sin embargo, la complejidad de los procedimientos dificulta la adopción de la reparación valvular aórtica en la práctica diaria. En consecuencia, comenzar un programa de reparación valvular aórtica requiere convicción, capacitación, instalaciones, control de calidad y un equipo bien estructurado para que sea exitoso.

Understanding an Ebola outbreak: Social representations of emerging infectious diseases.

This study examined the collective image of the 2014-2015 Ebola outbreak, to understand how people incorporate this epidemic in their everyday thinking. A free association exercise elicited by Ebola was answered by 294 people from Spain and the content was analysed using Alceste software. First, results showed that Ebola was represented as inherently African. Second, it was also depicted as a global threat creating fear. People also felt anger, and they blamed political authorities and the mass media for the failure to manage this crisis. Finally, this research underlines the importance of the social representations to understand how current outbreaks are cognitively represented and emotionally faced as a key factor to appropriately manage future epidemics.

Linguistic signatures of regulatory focus: how abstraction fits promotion more than prevention.

In 3 experiments, the authors investigated how strategic inclinations associated with promotion versus prevention orientations--that is, eager approach versus vigilant avoidance, respectively--affect the use of language. It is hypothesized that eager promotion strategies used to attain desired end states entail using more abstract language than used with vigilant prevention strategies. This is shown to hold for experimentally induced relationship goals (Experiment 1) and communication goals (Experiment 2). In the 3rd experiment, the authors examined the impact of abstractly and concretely worded messages upon the behavioral intentions of chronically prevention- and promotion-oriented individuals and found support for the hypothesis that behavioral intentions to engage in specific activities are stronger when there is a fit between message wording and chronic orientation than when there is no fit. The broader implications of these findings are discussed.

Assessment of feedback for the teaching of nursing practice / Evaluación del proceso de feedback para la enseñanza de la práctica de enfermería / Avaliação do processo de feedback para o ensino da prática de enfermagem

ABSTRACT Objective: Construct and validate instrument content for nursing consultation in an adult chemotherapy outpatient clinic. Method: Methodological study composed of two stages: elaboration of the instrument and validation of content. A literary review of the dimensions of customer care was carried out in the light of Theory of Basic Human Needs Theory, culminating in two instruments: one for admission consultation and other for follow-up. The content was validated by the evaluation of listed experts based on the adapted Fehring's Validation Model. Results: In the first round, two items of the admission instrument and three items of follow-up required reformulation. In the second round, there was an increase in agreement rate: 11% in the instrument of admission and 10% in follow-up. Final Consideration: The instrument represents a guideline for the Nursing Process and future research, but it cannot be seen as a substitute for nurses' knowledge and clinical reasoning.

RESUMEN Objetivo: Construir y validar contenido de instrumento para consulta de enfermería en ambulatorio de quimioterapia de adultos. Método: Estudio metodológico compuesto por dos etapas: elaboración del instrumento y validación de contenido. Se realizó una revisión literaria de las dimensiones del cuidado de la clientela, a la luz de la Teoría de las Necesidades Humanas Básicas, culminando en dos instrumentos: uno para consulta de admisión y otro de seguimiento. El contenido fue validado por la evaluación de expertos listados con base en el Modelo de Validación de Fehring adaptado. Resultados: En la primera ronda, dos ítems del instrumento de admisión y tres de seguimiento necesitaban reformulación. En la segunda ronda, hubo aumento de la tasa de concordancia: 11% en el instrumento de admisión y 10% de seguimiento. Consideraciones Finales: El instrumento representa un orientador del proceso de enfermería y de futuras investigaciones, pero no puede ser visto como un sustituto del conocimiento y del raciocinio clínico del enfermero.

RESUMO Objetivo: Construir e validar conteúdo de instrumento para consulta de enfermagem em ambulatório de quimioterapia de adultos. Método: Estudo metodológico composto por duas etapas: Elaboração do instrumento e validação de conteúdo. Foi realizada revisão literária das dimensões do cuidado da clientela, à luz da Teoria das Necessidades Humanas Básicas, culminando em dois instrumentos: Um para consulta de admissão e outro de seguimento. O conteúdo foi validado pela avaliação de experts listados com base no Modelo de Validação de Fehring adaptado. Resultados: Na primeira rodada, dois itens do instrumento de admissão e três de seguimento necessitaram de reformulação. Na segunda rodada, houve aumento da taxa de concordância: 11% no instrumento de admissão e 10% de seguimento. Considerações Finais: O instrumento representa um norteador do Processo de Enfermagem e de futuras pesquisas, mas não pode ser visto como um substituto do conhecimento e do raciocínio clínico do enfermeiro.

Extracción incidental de un stent: complicación rara de la intervención coronaria percutánea / Incidental retrieval of a stent: a rare complication of percutaneous coronary intervention

La extracción incidental de un stent coronario es una complicación poco frecuente en las intervenciones coronarias percutáneas. En este evento adverso, pese a ser infrecuente, se han reducido las tasas de incidencia en los últimos años, sin embargo debe tenerse en cuenta por los cardiólogos intervencionistas como una complicación que representa en el paciente alta probabilidad de morbimortalidad. Se presenta el caso de un paciente quien presenta extracción no intencional de un stent previamente implantado en una reintervención coronaria.

Coronary stent incidental retrieval is a rare complication of percutaneous coronary intervention. Although the incidence of this unusual adverse event has decreased in recent years, interventionist cardiologists should be aware this complication represents increased risk of morbidity and mortality for patients. A case is presented of incidental retrieval of a stent which was previously placed during a coronary reintervention.

HIV- and AIDS-related stigma: psychosocial aspects in a representative Spanish sample.

This study evaluates the prevalence of HIV stigma in Spain and analyzes some variables that may affect its existence. In 2008, we conducted a computer-assisted telephone survey of 1607 people, representative of the Spanish population. Two-wave random stratified sampling was performed, first selecting the home and then the person, depending on the rates of age and sex. About 50% of the population feels discomfort about potential contact with people with HIV and tries to avoid it and 20% advocate discriminatory policies involving physical or social segregation of people with HIV. The belief that HIV is easily transmitted through social contact (15%) and blaming people with HIV for their disease (19.3%) are associated with stigmatization. Degree of proximity to people with HIV, political ideology, educational level, and age are also associated with the degree of stigmatization. According to these results, we suggest that, in order to reduce stigma, we need to modify the erroneous beliefs about the transmission pathways, decrease attributions of blame to people with HIV, and increase contact with them. These interventions should particularly target older people, people with a low educational level, and people with a more conservative political ideology.

Implante de válvula aórtica ranscateter en estenosis aórtica severa / Aortic valve implant ranscateter in severe aortic stenosis

Objetivo: describir el primer caso de implante de válvula aortica transcatéter (Transcatheter aortic valve implantation: TAVI) en el Hospital de San José en una paciente con estenosis aortica severa degenerativa sintomática con disfunción sistólica severa. Diseño del estudio: reporte de caso. Metodología: mujer de 76 años referida al servicio bajo la sospecha de síndrome coronario agudo y estenosis aórtica severa sintomática, considerando candidata a manejo intervenconista mediante TAVI. Se trata del primer caso en el cual se implementa dicho procedimiento en el servivio de Hemodinamia del Hospital de San José ­ Sociedad de Cirugía de Bogotá. Conclusión: la TAVI es una alternativa valida para intervenir paciente con riesgo quirúrgico. El servicio de Hemodinamia del Hospital de San José ­ Sociedad de Cirugía de Bogotá dispone del recurso asistencial necesario para llevar este tipo de procedimientos.

Objective: to describe the first case of transcatheter aortic valve implantation (TAVI) performed at Hospital Infantil Universitario de San José of Bogotá, in a patient with symptomatic severe degenerative aortic valve stenosis with severe systolic dysfunction. Study Design: a case report. Methodology: a 76-year-old woman referred to the hemodynamics service with clinical suspicion for acute coronary syndrome and symptomatic severe aortic stenosis, considered a suitable candidate for interventional management with TAVI. This is the first case of this procedure performed at the hemodynamics service of said hospital. Conclusion: TAVI is a valid option for patients who are deemed at intermediate, high or extremely high risk of complications from surgical aortic valve replacement. The hemodynamics service of Hospital Infantil Universitario de San José of Bogotá, has the necessary healthcare resources to deliver this type of procedures.