Variables Associated with Attitudes toward Biodebridement Using Lucilia sericata Larvae in a Group of Nurses.

Despite numerous studies and recommendations, the acceptance of treatments involving medicinal maggots in many clinics has been slow. Several factors may account for this, including the gender of nurses administering the treatment, their level of work experience, and their perceived level of personal stress. The aim of the study was to assess the impact of selected variables (gender, work experience, stress level) on the readiness of nurses to administer maggot debridement therapy (MDT), which is a form of biodebridement. The study population was a cohort of 290 wound care nurses providing specialist care for patients with chronic wounds. It was assumed that the identified variables may determine the implementation of larval therapy in everyday professional practice. A subsample of 35 men and 35 women was further analyzed to determine if gender, work experience, and/or personal stress levels were correlated with attitudes towards the utilization of maggots in biodebridement. Assessment tools included the Perceived Stress Scale (PSS-10) and the MDT 10 Perception Assessment Questionnaire, a protocol by which the subject ranked six wound photographs in order of repulsiveness and responded to questions regarding demographic variables, which include education and work experience. The visual perception of pictures of a wound with larvae is indirectly an indicator of the attitude towards larval therapy. Selection of the photograph with maggots on the wound as the most repulsive image was associated with a personal appraisal of not being ready to implement maggot therapy (chi-square = 8.430, p = 0.015). Low work experience (chi-square = 14.039, df = 4, p = 0.007), and low readiness for MDT (chi-square = 8.430, df = 2, p = 0.015) were also associated with unpreparedness to administer maggot therapy. Neither gender nor perceived stress level were exclusively associated with disgust for maggots or lack of readiness to implement MDT. Low professional experience and a deficit of knowledge in maggot therapy may negatively affect the readiness of nurses to administer biodebridement. Gender and personal stress levels do not affect nurses' readiness to utilize larval therapy.

Orthorexia Nervosa and its association with obsessive-compulsive disorder symptoms: initial cross-cultural comparison between Polish and Italian university students.

There is limited evidence of a link between Orthorexia Nervosa (ON) and Obsessive-Compulsive Disorder (OCD), and no definitive conclusions can be drawn. The interplay between socio-cultural context and ON has been poorly investigated as well. Therefore, the objectives of the present study were: (1) to investigate the differences in ON and OCD symptoms and (2) to assess the relationship between ON and OCD symptoms among university students. Six hundred and sixty-six university students participated in the present study: 286 from Poland and 320 from Italy. No age, gender and marital status differences were identified between two samples of university students. However, on average, Polish university students had a higher Body Mass Index than Italian ones. Our findings showed that Polish students present more problems related to obsessive symptomatology, core beliefs of OCD, perfectionism traits, and a major ON symptomatology than Italian ones. Also, Polish students with a higher level of ON exhibited higher levels of OCD symptoms and parental expectations/parental criticism. While Italian students with a higher level of ON showed higher levels of perfectionism features (organization and concern over mistakes). In general, correlations were low as confirmation of partial independence ON from OCD symptoms and core beliefs of OCD in both Polish and Italian university students. The present results highlight a need for further investigation of the correlates of ON across different cultural groups. Future research may screen individuals with ON to determine the comorbidity between ON and OCD symptomology to facilitate appropriate treatment choices. LEVEL OF EVIDENCE: Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Application of Lucilia sericata Larvae in Debridement of Pressure Wounds in Outpatient Settings.

Biological therapy using Lucilia sericata larvae has numerous advocates worldwide, yet it is still fairly unknown and not commonly applied in daily practice because of the limited awareness and insufficient experience of medical and nursing personnel. There are case reports suggesting that maggot therapy can be applied and supported by lay caregivers, provided they are supervised and informed by physicians/nurses. The foregoing observation suggests that the method should be considered for implementation by a wider group of caregivers if accepted and meticulously supervised by trained and experienced medical staff. The concerns related to the therapeutic use of maggots in certain regions seem understandable, but are not supported by scientific facts. It should be noted that many therapeutic agents (including brood) used in medicine are of natural origin, and are associated with low production costs and high possibilities of implementation in the course of therapy. By analyzing the literature and using our own clinical and research experience, we have come to conclusions related to using larvae therapy, as a quick and safe method providing cleaning and revitalization in the process of treating wounds of various etiologies, especially pressure ulcers. In the current study, medical-grade Lucilia sericata maggots were applied to remove necrotic tissue from deep pressure sores. The treatment is mostly accepted by both caregivers and patients. In most cases, it is conducted by trained and experienced medical personnel in home and outpatient settings. Over the course of the conducted analyzes involving the collected specimens, there were no statistically significant relationships (p> 0.05) confirmed between the wound surface successfully cleared by brood and variables, such as time from wound formation, location, surface size, and the depth of damage to the tissue structure. The lack of statistical dependence may result from the small size of the studied group. Based on the current findings, we have formulated the following conclusions: Maggot Debridement Therapy (MDT) is a fast and effective method enabling the preparation of the wound bed. The use of MDT in outpatient settings is safe and acceptable for patients and their caregivers.

Psychosocial Late Effects in Adolescent and Young Adult Survivors of Childhood Cancer Diagnosed with Leukemia, Lymphoma, and Central Nervous System Tumor.

Purpose: The prevalence of psychosocial late effects and quality of life in adolescent and young adult (AYA)-aged survivors of pediatric cancer have been studied. Methods: The study was conducted in AYA survivors who had been diagnosed with leukemia, lymphoma, or brain tumor, had completed treatment at least 1 year before the study, and were 15-39 years old at study enrollment. The control group consisted of healthy volunteers. A questionnaire comprised a demographic form, eight questions concerning mental health and the disease, and survey The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Controls received a questionnaire without questions concerning an illness. Results: Most of survivors believed that cancer treatment might have a serious influence on their health. Survivors significantly more frequently declared using drugs: neuroleptics, tranquilizers, and antidepressants than controls. Survivors of leukemia demonstrated significantly more problems in cognitive functioning than lymphoma survivors. Females were significantly more disabled in emotional functioning than males. Young adults more often reported dysfunction in emotional functioning compared to adolescents. Survivors who were assessed ≥10 years since therapy reported significantly more disadvantage in social functioning than those assessed <10 years since treatment completion. Survivors reported significantly more disadvantages in social functioning than controls. Allogeneic hematopoietic stem cell transplantation survivors more often suffered cognitive limitations. Irradiated survivors more often attended psychological therapy. Conclusions: Survivors of pediatric cancer are vulnerable to consequences of oncological treatment, making their quality life significantly worse in comparison with healthy controls. They need to be monitored, supported, and educated.

Effective reaction rates for diffusion-limited reaction cycles.

Biological signals in cells are transmitted with the use of reaction cycles, such as the phosphorylation-dephosphorylation cycle, in which substrate is modified by antagonistic enzymes. An appreciable share of such reactions takes place in crowded environments of two-dimensional structures, such as plasma membrane or intracellular membranes, and is expected to be diffusion-controlled. In this work, starting from the microscopic bimolecular reaction rate constants and using estimates of the mean first-passage time for an enzyme-substrate encounter, we derive diffusion-dependent effective macroscopic reaction rate coefficients (EMRRC) for a generic reaction cycle. Each EMRRC was found to be half of the harmonic average of the microscopic rate constant (phosphorylation c or dephosphorylation d), and the effective (crowding-dependent) motility divided by a slowly decreasing logarithmic function of the sum of the enzyme concentrations. This implies that when c and d differ, the two EMRRCs scale differently with the motility, rendering the steady-state fraction of phosphorylated substrate molecules diffusion-dependent. Analytical predictions are verified using kinetic Monte Carlo simulations on the two-dimensional triangular lattice at the single-molecule resolution. It is demonstrated that the proposed formulas estimate the steady-state concentrations and effective reaction rates for different sets of microscopic reaction rates and concentrations of reactants, including a non-trivial example where with increasing diffusivity the fraction of phosphorylated substrate molecules changes from 10% to 90%.

Using noise to control heterogeneity of isogenic populations in homogenous environments.

We explore the extent to which the phenotypes of individual, genetically identical cells can be controlled independently from each other using only a single homogeneous environmental input. We show that such control is theoretically impossible if restricted to a deterministic setting, but it can be achieved readily if one exploits heterogeneities introduced at the single-cell level due to stochastic fluctuations in gene regulation. Using stochastic analyses of a bistable genetic toggle switch, we develop a control strategy that maximizes the chances that a chosen cell will express one phenotype, while the rest express another. The control mechanism uses UV radiation to enhance identically protein degradation in all cells. Control of individual cells is made possible only by monitoring stochastic protein fluctuations and applying UV control at favorable times and levels. For two identical cells, our stochastic control law can drive protein expression of a chosen cell above its neighbor with a better than 99% success rate. In a population of 30 identical cells, we can drive a given cell to remain consistently within the top 20%. Although cellular noise typically impairs predictability for biological responses, our results show that it can also simultaneously improve controllability for those same responses.

Effective reaction rates in diffusion-limited phosphorylation-dephosphorylation cycles.

We investigate the kinetics of the ubiquitous phosphorylation-dephosphorylation cycle on biological membranes by means of kinetic Monte Carlo simulations on the triangular lattice. We establish the dependence of effective macroscopic reaction rate coefficients as well as the steady-state phosphorylated substrate fraction on the diffusion coefficient and concentrations of opposing enzymes: kinases and phosphatases. In the limits of zero and infinite diffusion, the numerical results agree with analytical predictions; these two limits give the lower and the upper bound for the macroscopic rate coefficients, respectively. In the zero-diffusion limit, which is important in the analysis of dense systems, phosphorylation and dephosphorylation reactions can convert only these substrates which remain in contact with opposing enzymes. In the most studied regime of nonzero but small diffusion, a contribution linearly proportional to the diffusion coefficient appears in the reaction rate. In this regime, the presence of opposing enzymes creates inhomogeneities in the (de)phosphorylated substrate distributions: The spatial correlation function shows that enzymes are surrounded by clouds of converted substrates. This effect becomes important at low enzyme concentrations, substantially lowering effective reaction rates. Effective reaction rates decrease with decreasing diffusion and this dependence is more pronounced for the less-abundant enzyme. Consequently, the steady-state fraction of phosphorylated substrates can increase or decrease with diffusion, depending on relative concentrations of both enzymes. Additionally, steady states are controlled by molecular crowders which, mostly by lowering the effective diffusion of reactants, favor the more abundant enzyme.

Computational analysis of an autophagy/translation switch based on mutual inhibition of MTORC1 and ULK1.

We constructed a mechanistic, computational model for regulation of (macro)autophagy and protein synthesis (at the level of translation). The model was formulated to study the system-level consequences of interactions among the following proteins: two key components of MTOR complex 1 (MTORC1), namely the protein kinase MTOR (mechanistic target of rapamycin) and the scaffold protein RPTOR; the autophagy-initiating protein kinase ULK1; and the multimeric energy-sensing AMP-activated protein kinase (AMPK). Inputs of the model include intrinsic AMPK kinase activity, which is taken as an adjustable surrogate parameter for cellular energy level or AMP:ATP ratio, and rapamycin dose, which controls MTORC1 activity. Outputs of the model include the phosphorylation level of the translational repressor EIF4EBP1, a substrate of MTORC1, and the phosphorylation level of AMBRA1 (activating molecule in BECN1-regulated autophagy), a substrate of ULK1 critical for autophagosome formation. The model incorporates reciprocal regulation of mTORC1 and ULK1 by AMPK, mutual inhibition of MTORC1 and ULK1, and ULK1-mediated negative feedback regulation of AMPK. Through analysis of the model, we find that these processes may be responsible, depending on conditions, for graded responses to stress inputs, for bistable switching between autophagy and protein synthesis, or relaxation oscillations, comprising alternating periods of autophagy and protein synthesis. A sensitivity analysis indicates that the prediction of oscillatory behavior is robust to changes of the parameter values of the model. The model provides testable predictions about the behavior of the AMPK-MTORC1-ULK1 network, which plays a central role in maintaining cellular energy and nutrient homeostasis.

[The quality of the work-home and home-work relationship in the context of personal resources]. / Jakosec relacji praca-dom oraz dom-praca w kontekccie posiadanych zasobów osobistych.

BACKGROUND: The aim of the study was to examine whether gain or loss of personal resources is associated with conflict or facilitation between work and family. MATERIAL AND METHODS: The study involved 90 employees (mean age: 34.5 years). The Polish version of COR-Evaluation (Conservation of Resources-Evaluation) questionnaire, developed by Hobfoll and adapted by Dudek et al, was used to assess personal resources. The questionnaire enables to estimate gain and loss of 40 resources and calculate the overall level of gained or lost resources. SWING Questionnaire (Survey Work-Home Interaction, Nijmegen), developed by Geurts et al. and adapted by Mosicka-Teske and Merecz), was used to examine the quality of work-home and home-work relationship. RESULTS: The gain of personal resources positively correlates with both home-work facilitation (HWF) and work-home facilitation (WHF). Improvement of the family relations proved to be the most significant predictor of HWF and WHF. The loss of personal resources coincides with high level of conflict between the investigated areas of life. The main predictor of home-work conflict (HWC) was the variable relating to restrictions of access to medical services. In case of work-home conflict (WHC) the reduction of material security in case of dramatic life events was the major predictor. CONCLUSIONS: The results confirmed that the gain of resources is crucial for HWF/WHF, while their loss is an important factor, when the HWC/WHC is considered. The resources, which proved to be the main predictors of work-home and home-work relatiohship were alsoindicated. The obtained information may be beneficial to human resources managers, especially in designing the activities aimed at increasing the satisfaction and effectiveness of employees.

Gene expression in self-repressing system with multiple gene copies.

We analyze a simple model of a self-repressing system with multiple gene copies. Protein molecules may bound to DNA promoters and block their own transcription. We derive analytical expressions for the variance of the number of protein molecules in the stationary state in the self-consistent mean-field approximation. We show that the Fano factor (the variance divided by the mean value) is bigger for the one-gene case than for two gene copies and the difference decreases to zero as frequencies of binding and unbinding increase to infinity.

Inactivation of the wall-associated de-N-acetylase (PgdA) of Listeria monocytogenes results in greater susceptibility of the cells to induced autolysis.

Several species of Gram-positive bacteria have cell wall peptidoglycan (syn. murein) in which not all of the sugar moieties are N-acetylated. This has recently been shown to be a secondary effect, caused by the action of a peptidoglycan N-acetylglucosamine deacetylase. We have found that the opportunistic pathogen Listeria monocytogenes is unusual in having three enzymes with such activity, two of which remain in the cytoplasm. Here, we examine the enzyme (PgdA) that crosses the cytoplasmic membrane and is localized in the cell wall. We purified a hexa-His-tagged form of PgdA to study its activity and constructed a mutant devoid of functional Lmo0415 (PgdA) protein. L. monocytogenes PgdA protein exhibited peptidoglycan N-acetylglucosamine deacetylase activity with natural substrates (peptidoglycan) from both L. monocytogenes and Escherichia coli as well as the peptidoglycan sugar chain component N-acetylglucosamine, but not with N-acetylmuramic acid. As was reported recently [6], inactivation of the structural gene was not lethal for L. monocytogenes nor did it affect growth rate or morphology of the cells. However, the pgdA mutant was more prone to autolysis induced by such agents as Triton X-100 and EDTA, and is more susceptible to the cationic antimicrobial peptides (CAMP) lysozyme and mutanolysin, using either peptidoglycan muramidases or autolysis-inducing agents. The pgdA mutant was also slightly more susceptible than the wild-type strain to the action of certain beta-lactam antibiotics. Our results indicate that protein PgdA plays a protective physiological role for listerial cells.