Alone but flowing: The effects of autotelic personality and extraversion on solitary flow.

OBJECTIVE/BACKGROUND: Flow, a psychological state of intense engagement in and enjoyment of an activity, can arise during both solitary and socially interactive experiences. In the literature, whereas people high in extraversion have difficulty achieving flow in solitude, those with an autotelic personality-a combination of traits that make people prone to flow-readily experience flow in both solitary and interactive conditions. In this pre-registered experiment, we investigated whether autotelic personality mitigates the negative association between solitary flow and extraversion. METHOD: Participants and their romantic partners (final N = 368) played the game Perfection™ in three conditions (order was counterbalanced): alone (solitary condition), in the presence of their partner without interaction (mere-presence condition), and collaboratively (interactive condition). RESULTS: There were independent, positive main effects of extraversion and autotelic personality on flow experience in mere-presence and interactive conditions. However, the positive effect of extraversion on solitary flow was only significant among participants with high (vs. low) autotelic personality. In all conditions, flow experience was associated with greater low-arousal positive affect and lesser high-arousal negative affect. CONCLUSIONS: The findings shed light on the role of personality in promoting solitary flow experiences, and particularly how traits might interact to determine optimal and non-optimal conditions for achieving flow.

Learning with AI Language Models: Guidelines for the Development and Scoring of Medical Questions for Higher Education.

In medical and biomedical education, traditional teaching methods often struggle to engage students and promote critical thinking. The use of AI language models has the potential to transform teaching and learning practices by offering an innovative, active learning approach that promotes intellectual curiosity and deeper understanding. To effectively integrate AI language models into biomedical education, it is essential for educators to understand the benefits and limitations of these tools and how they can be employed to achieve high-level learning outcomes.This article explores the use of AI language models in biomedical education, focusing on their application in both classroom teaching and learning assignments. Using the SOLO taxonomy as a framework, I discuss strategies for designing questions that challenge students to exercise critical thinking and problem-solving skills, even when assisted by AI models. Additionally, I propose a scoring rubric for evaluating student performance when collaborating with AI language models, ensuring a comprehensive assessment of their learning outcomes.AI language models offer a promising opportunity for enhancing student engagement and promoting active learning in the biomedical field. Understanding the potential use of these technologies allows educators to create learning experiences that are fit for their students' needs, encouraging intellectual curiosity and a deeper understanding of complex subjects. The application of these tools will be fundamental to provide more effective and engaging learning experiences for students in the future.

Preparing solo mothers for childbirth and parenthood - The importance of being with like-minded women.

OBJECTIVES: Denmark and many high-income countries have seen an increase in the number of single women getting pregnant through medical assisted reproduction (MAR). These women are also named solo mothers. According to the Danish Health Authorities, they should, as all other pregnant women, be offered antenatal education. The aim of this study was to explore solo mothers' needs in order to prepare them for childbirth and parenthood. METHODS: This qualitative study was set to investigate solo mothers' experiences and requirements during pregnancy toprepare them for childbirth and parenting. Semi-structured interviews were conducted by telephone or face-to-face. A systematic text condensation and interpretation was used to analyse data. RESULTS: 38 interviews were conducted before and after pregnancy. Twenty solo mothers participated in the study. Three themes emerged from the analysis: 'Confrontation with the normative pregnancy', 'Mirroring and network' and 'Using formal and informal sources to gain information'. CONCLUSION: The conventional antenatal packages offered by the healthcare system did not meet the solo mothers' needs. The women called for content and information tailored to single parents. Solo mothers may benefit from structured antenatal classes in small groups. Being with like-minded women was essential for preparing for childbirth and parenting.

Using deep learning-based artificial intelligence electronic images in improving middle school teachers' literacy.

With the rapid development of societal information, electronic educational resources have become an indispensable component of modern education. In response to the increasingly formidable challenges faced by secondary school teachers, this study endeavors to analyze and explore the application of artificial intelligence (AI) methods to enhance their cognitive literacy. Initially, this discourse delves into the application of AI-generated electronic images in the training and instruction of middle school educators, subjecting it to thorough analysis. Emphasis is placed on elucidating the pivotal role played by AI electronic images in elevating the proficiency of middle school teachers. Subsequently, an integrated intelligent device serves as the foundation for establishing a model that applies intelligent classification and algorithms based on the Structure of the Observed Learning Outcome (SOLO). This model is designed to assess the cognitive literacy and teaching efficacy of middle school educators, and its performance is juxtaposed with classification algorithms such as support vector machine (SVM) and decision trees. The findings reveal that, following 600 iterations of the model, the SVM algorithm achieves a 77% accuracy rate in recognizing teacher literacy, whereas the SOLO algorithm attains 80%. Concurrently, the spatial complexities of the SVM-based and SOLO-based intelligent literacy improvement models are determined to be 45 and 22, respectively. Notably, it is discerned that, with escalating iterations, the SOLO algorithm exhibits higher accuracy and reduced spatial complexity in evaluating teachers' pedagogical literacy. Consequently, the utilization of AI methodologies proves highly efficacious in advancing electronic imaging technology and enhancing the efficacy of image recognition in educational instruction.

Examining the health and wellness of solo self-employed workers through narratives of precarity: a qualitative study.

BACKGROUND: In recent decades, there has been a significant transformation in the world of work that is characterized by a shift from traditional manufacturing and managerial capitalism, which offered stable full-time employment, to new forms of entrepreneurial capitalism. This new paradigm involves various forms of insecure, contingent, and non-standard work arrangements. Within this context, there has been a noticeable rise in Self-Employed individuals, exhibiting a wide range of -working arrangements. Despite numerous investigations into the factors driving individuals towards Self-Employment and the associated uncertainties and insecurities impacting their lives and job prospects, studies have specifically delved into the connection between the precarious identity of Self-Employed workers and their overall health and well-being. This exploratory study drew on a 'precarity' lens to make contributions to knowledge about Self-Employed workers, aiming to explore how their vulnerable social position might have detrimental effects on their health and well-being. METHODS: Drawing on in-depth interviews with 24 solo Self-Employed people in Ontario (January - July 2021), narrative thematic analysis was conducted based on participants' narratives of their work experiences. The dataset was analyzed with the support of NVIVO qualitative data analysis software to elicit narratives and themes. FINDINGS: The findings showed that people opt into Self-Employment because they prefer flexibility and autonomy in their working life. However, moving forward, in the guise of flexibility, they encounter a life of precarity, in terms of job unsustainability, uncertainties, insecurities, unstable working hours and income, and exclusion from social benefits. As a result, the health and well-being of Self-Employed workers are adversely affected by anger, anomie, and anxiety, bringing forward potential risks for a growing population. CONCLUSION AND IMPLICATIONS: Neoliberalism fabricates a 'precariat' Self-Employed class. This is a social position that is vague, volatile, and contingent, that foreshadows potential threats of the health and wellbeing of a growing population in the changing workforce. The findings in this research facilitate some policy implications and practices at the federal or provincial government level to better support the health and wellbeing of SE'd workers.

Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022.

BACKGROUND: The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy. METHODS: Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded. RESULTS: Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs. CONCLUSION: These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.

Do Growers Using Solo Fungicides Affect the Durability of Disease Control of Growers Using Mixtures and Alternations? The Case of Spot-Form Net Blotch in Western Australia.

Growers often use alternations or mixtures of fungicides to slow down the development of resistance to fungicides. However, within a landscape, some growers will implement such resistance management methods, whereas others do not, and may even apply solo components of the resistance management program. We investigated whether growers using solo components of resistant management programs affect the durability of disease control in fields of those who implement fungicide resistance management. We developed a spatially implicit semidiscrete epidemiological model for the development of fungicide resistance. The model simulates the development of epidemics of spot-form net blotch disease, caused by the pathogen Pyrenophora teres f. maculata. The landscape comprises three types of fields, grouped according to their treatment program, with spore dispersal between fields early in the cropping season. In one field type, a fungicide resistance management method is implemented, whereas in the two others, it is not, with one of these field types using a component of the fungicide resistance management program. The output of the model suggests that the use of component fungicides does affect the durability of disease control for growers using resistance management programs. The magnitude of the effect depends on the characteristics of the pathosystem, the degree of inoculum mixing between fields, and the resistance management program being used. Additionally, although increasing the amount of the solo component in the landscape generally decreases the lifespan within which the resistance management program provides effective control, situations exist where the lifespan may be minimized at intermediate levels of the solo component fungicide. [Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Responses of tomato hybrid cultivars to soil application of humic acid under greenhouse conditions

Abstract Responses of three tomato (Lycopersicon esculentum Mill.) hybrids viz. 'Luanova', 'Savarona' and 'Tessera' to various doses (0, 0.5, 1.0, 1.5 and 2.0 g L-1) of soil application of humic acid (HA) were evaluated in terms of plant growth, productivity and quality of fruits, under greenhouse conditions, during 2011-12 and 2012-13. In addition to improved quality characteristics, higher values for yield and yield components were recorded for tomato fruits harvested from plants of 'Tessera' cultivar compared to those harvested from other hybrids tested, regardless of growing seasons. Plants from 'Luanova' cultivar were, however, earlier in fruiting with higher number of fruits per plant. Soil application of HA presented positive effects on yield and physicochemical quality of tomato fruits irrespective of the dose of HA and the cultivar investigated, in both seasons. Soil application of HA at higher dose 1.5 g L-1 exhibited better results in all the three tomato cultivars tested, in terms of their vegetative and reproductive growth, and significantly improved the physicochemical quality of their fruits. Conclusively, the tomato hybrid 'Tessera' was found suitable for cultivation under greenhouse conditions while soil application of aqueous solution of HA @ 1.5 g L-1 substantially resulted in higher production of quality tomato fruits.

Resumo Respostas de três híbridos de tomate (Lycopersicon esculentum Mill.) viz. 'Luanova', 'Savarona' e 'Tessera' para várias doses (0, 0,5, 1,0, 1,5 e 2,0 g L-1) de aplicação de ácido húmico (AH) no solo foram avaliadas em termos de crescimento da planta, produtividade e qualidade de frutas, em casa de vegetação, durante 2011-12 e 2012-13. Além das características de qualidade melhoradas, valores mais elevados para o rendimento e os componentes do rendimento foram registrados para frutos de tomate colhidos de plantas do cultivar 'Tessera' em comparação com aqueles colhidos de outros híbridos testados, independentemente das estações de cultivo. As plantas do cultivar 'Luanova', no entanto, frutificaram mais cedo com maior número de frutos por planta. A aplicação de AH no solo apresentou efeitos positivos sobre a produtividade e a qualidade físico-química dos frutos de tomate, independentemente da dose de AH e do cultivar investigado, nas duas safras. A aplicação de HA no solo na dose maior de 1,5 g L-1 apresentou melhores resultados nos três cultivares de tomate testados, quanto ao crescimento vegetativo e reprodutivo, e melhorou significativamente a qualidade físico-química dos frutos. Conclusivamente, o híbrido de tomate 'Tessera' foi considerado adequado para cultivo em casa de vegetação, enquanto a aplicação no solo de solução aquosa de HA @ 1,5 g L-1 resultou substancialmente em maior produção de frutos de tomate de qualidade.

Variations in soil physico-chemical properties, soil stocks, and soil stoichiometry under different soil layers, the major forest region Liupan Mountains of Northwest China

Abstract Liupan Mountains are an important region in China in the context of forest cover and vegetation due to huge afforestation and plantation practices, which brought changes in soil physio-chemical properties, soil stocks, and soil stoichiometries are rarely been understood. The study aims to explore the distribution of soil nutrients at 1-m soil depth in the plantation forest region. The soil samples at five depth increments (0-20, 20-40, 40-60, 60-80, and 80-100 cm) were collected and analyzed for different soil physio-chemical characteristics. The results showed a significant variation in soil bulk density (BD), soil porosity, pH, cation exchange capacity (CEC), and electric conductivity (EC) values. More soil BD (1.41 g cm-3) and pH (6.97) were noticed in the deep soil layer (80-100 cm), while the highest values of porosity (60.6%), EC (0.09 mS cm-1), and CEC (32.9 c mol kg-1) were reflected in the uppermost soil layer (0-20 cm). Similarly, the highest contents of soil organic carbon (SOC), total phosphorus (TP), available phosphorus (AP), total nitrogen (TN), and available potassium (AK) were calculated in the surface soil layer (0-20 cm). With increasing soil depth increment a decreasing trend in the SOC and other nutrient concentration were found, whereas the soil total potassium (TK) produced a negative correlation with soil layer depth. The entire results produced the distribution of SOCs and TNs (stocks) at various soil depths in forestland patterns were 020cm > 2040cm > 4060cm 6080cm 80100 cm. Furthermore, the stoichiometric ratios of C, N, and P, the C/P, and N/P ratios showed maximum values (66.49 and 5.46) in 0-20 cm and lowest values (23.78 and 1.91) in 80-100 cm soil layer depth. Though the C/N ratio was statistically similar across the whole soil profile (0-100 cm). These results highlighted that the soil depth increments might largely be attributed to fluctuations in soil physio-chemical properties, soil stocks, and soil stoichiometries. Further study is needed to draw more conclusions on nutrient dynamics, soil stocks, and soil stoichiometry in these forests.

Resumo As montanhas de Liupan são uma região importante na China no contexto de cobertura florestal e vegetação devido às enormes práticas de florestamento e plantação, que trouxeram mudanças nas propriedades físico-químicas do solo, e estoques e estequiometrias do solo raramente são compreendidos. O estudo visa explorar a distribuição de nutrientes do solo a 1 m de profundidade do solo na região da floresta plantada. As amostras de solo em cinco incrementos de profundidade (0-20, 20-40, 40-60, 60-80 e 80-100 cm) foram coletadas e analisadas para diferentes características físico-químicas do solo. Os resultados mostraram uma variação significativa nos valores de densidade do solo (BD), porosidade do solo, pH, capacidade de troca catiônica (CEC) e condutividade elétrica (CE). Mais DB do solo (1,41 g cm-3) e pH (6,97) do solo foram observados na camada profunda do solo (80-100 cm), enquanto os maiores valores de porosidade (60,6%), CE (0,09 mS cm-1) e CEC (32,9 c mol kg-1) foram refletidos na camada superior do solo (0-20 cm). Da mesma forma, os maiores teores de carbono orgânico do solo (SOC), fósforo total (TP), fósforo disponível (AP), nitrogênio total (TN) e potássio disponível (AK) foram calculados na camada superficial do solo (0-20 cm). Com o aumento do incremento da profundidade do solo, uma tendência decrescente no SOC e na concentração de outros nutrientes foi encontrada, enquanto o potássio total do solo (TK) produziu uma correlação negativa com a profundidade da camada do solo. Todos os resultados produziram a distribuição de SOCs e TNs (estoques) em várias profundidades de solo em padrões de floresta 0 20cm> 20 40cm> 40 60cm 60 80cm 80 100 cm. Além disso, as relações estequiométricas de C, N e P, as relações C / P e N / P, apresentaram valores máximos (66,49 e 5,46) em 0-20 cm, e valores mais baixos (23,78 e 1,91) em solo de 80-100 cm profundidade da camada. Embora a relação C / N fosse estatisticamente semelhante em todo o perfil do solo (0-100 cm). Esses resultados destacaram que os incrementos de profundidade do solo podem ser amplamente atribuídos a flutuações nas propriedades físico-químicas do solo, estoques e estequiometrias do solo. Mais estudos são necessários para tirar conclusões adicionais sobre a dinâmica dos nutrientes, estoques de solo e estequiometria do solo nessas florestas.

Variations in soil physico-chemical properties, soil stocks, and soil stoichiometry under different soil layers, the major forest region Liupan Mountains of Northwest China / Variações nas propriedades físico-químicas do solo, estoques e estequiometria do solo sob diferentes camadas de solo, a principal região florestal das montanhas Liupan do noroeste da China

Liupan Mountains are an important region in China in the context of forest cover and vegetation due to huge afforestation and plantation practices, which brought changes in soil physio-chemical properties, soil stocks, and soil stoichiometries are rarely been understood. The study aims to explore the distribution of soil nutrients at 1-m soil depth in the plantation forest region. The soil samples at five depth increments (0-20, 20-40, 40-60, 60-80, and 80-100 cm) were collected and analyzed for different soil physio-chemical characteristics. The results showed a significant variation in soil bulk density (BD), soil porosity, pH, cation exchange capacity (CEC), and electric conductivity (EC) values. More soil BD (1.41 g cm-3) and pH (6.97) were noticed in the deep soil layer (80-100 cm), while the highest values of porosity (60.6%), EC (0.09 mS cm-1), and CEC (32.9 c mol kg-1) were reflected in the uppermost soil layer (0-20 cm). Similarly, the highest contents of soil organic carbon (SOC), total phosphorus (TP), available phosphorus (AP), total nitrogen (TN), and available potassium (AK) were calculated in the surface soil layer (0-20 cm). With increasing soil depth increment a decreasing trend in the SOC and other nutrient concentration were found, whereas the soil total potassium (TK) produced a negative correlation with soil layer depth. The entire results produced the distribution of SOCs and TNs (stocks) at various soil depths in forestland patterns were 0→20cm > 20→40cm > 40→60cm ≥ 60→80cm ≥ 80→100 cm. Furthermore, the stoichiometric ratios of C, N, and P, the C/P, and N/P ratios showed maximum values (66.49 and 5.46) in 0-20 cm and lowest values (23.78 and 1.91) in 80-100 cm soil layer depth. Though the C/N ratio was statistically similar across the whole soil profile (0-100 cm). These results highlighted that the soil depth increments might largely be attributed to fluctuations in soil physio-chemical properties, soil stocks, and soil stoichiometries. Further study is needed to draw more conclusions on nutrient dynamics, soil stocks, and soil stoichiometry in these forests.

As montanhas de Liupan são uma região importante na China no contexto de cobertura florestal e vegetação devido às enormes práticas de florestamento e plantação, que trouxeram mudanças nas propriedades físico-químicas do solo, e estoques e estequiometrias do solo raramente são compreendidos. O estudo visa explorar a distribuição de nutrientes do solo a 1 m de profundidade do solo na região da floresta plantada. As amostras de solo em cinco incrementos de profundidade (0-20, 20-40, 40-60, 60-80 e 80-100 cm) foram coletadas e analisadas para diferentes características físico-químicas do solo. Os resultados mostraram uma variação significativa nos valores de densidade do solo (BD), porosidade do solo, pH, capacidade de troca catiônica (CEC) e condutividade elétrica (CE). Mais DB do solo (1,41 g cm-3) e pH (6,97) do solo foram observados na camada profunda do solo (80-100 cm), enquanto os maiores valores de porosidade (60,6%), CE (0,09 mS cm-1) e CEC (32,9 c mol kg-1) foram refletidos na camada superior do solo (0-20 cm). Da mesma forma, os maiores teores de carbono orgânico do solo (SOC), fósforo total (TP), fósforo disponível (AP), nitrogênio total (TN) e potássio disponível (AK) foram calculados na camada superficial do solo (0-20 cm). Com o aumento do incremento da profundidade do solo, uma tendência decrescente no SOC e na concentração de outros nutrientes foi encontrada, enquanto o potássio total do solo (TK) produziu uma correlação negativa com a profundidade da camada do solo. Todos os resultados produziram a distribuição de SOCs e TNs (estoques) em várias profundidades de solo em padrões de floresta 0 → 20cm> 20 → 40cm> 40 → 60cm ≥ 60 → 80cm ≥ 80 → 100 cm. Além disso, as relações estequiométricas de C, N e P, as relações C / P e N / P, apresentaram valores máximos (66,49 e 5,46) em 0-20 cm, e valores mais baixos (23,78 e 1,91) em solo de 80-100 cm profundidade da camada. Embora a relação C / N fosse estatisticamente semelhante em todo o perfil do solo (0-100 cm). Esses resultados destacaram que os incrementos de profundidade do solo podem ser amplamente atribuídos a flutuações nas propriedades físico-químicas do solo, estoques e estequiometrias do solo. Mais estudos são necessários para tirar conclusões adicionais sobre a dinâmica dos nutrientes, estoques de solo e estequiometria do solo nessas florestas.

Supercritical transesterification of vegetable oil and ethanol: temperature and residence time effects on phase formation and water content

Supercritical transesterification has emerged as a readily available alternative for biodiesel production since no catalyst is required, thereby generating fewer waste products. In this research, the supercritical transesterification of refined vegetable oil and aqueous ethanol was carried out at temperatures 400 to 480 °C and a 12:1 ethanol to oil molar ratio, to assess the effect of temperature and residence time in the formation of a homogeneous phase, effluent appearance and increased water content derived from glycerol etherification. The results showed that water was produced at temperatures higher than 400 °C, as expected from the occurrence of glycerol etherification, and that prolonged times resulted in gas and soot formation, indicating esters decomposition. Through water mass balances, it was possible to identify the set of operation conditions in which the water formed from glycerol etherification matched with the maximum expected according to the proposed reaction scheme.

La transesterificación supercrítica se ha propuesto como una alternativa para la producción de biodiesel ya que no requiere catalizador de esta manera se generan menos residuos. En esta investigación, la transesterificación supercrítica de aceite vegetal refinado y etanol acuoso se llevó a cabo a temperaturas en el rango 400 a 480 °C y relación molar etanol a aceite de 12:1, para evaluar el efecto de la temperatura y el tiempo de residencia en la formación de una fase homogénea, apariencia del efluente e incremento del contenido de agua resultado de las reacciones de eterificación del glicerol. Los resultados mostraron que se produjo agua a temperaturas mayores a 400°C, atribuida a la eterificación del glicerol, y que tiempos de residencia prolongados resultaron en formación de gas y hollín, indicativo de reacciones de descomposición de esteres. A través de balances de masa, fue posible identificar el conjunto de condiciones de operación a las cuales el agua formada por la eterificación del glicerol coincide con el valor máximo esperado de acuerdo con el esquema de reacción propuesto.

A transesterificação supercrítica foi proposta como uma alternativa para a produção de biodiesel porque não requer catalisador e, dessa forma, gera menos resíduos. Nesta pesquisa, a transesterificação supercrítica de aceite vegetal refinado e etanol acuoso foi conduzida a temperaturas entre 400 e 480 °C e uma relação molar de etanol e aceite de 12: 1, para avaliar o efeito da temperatura e do tempo de residência na formação de uma fase homogênea, apariência do efluente e aumento do conteúdo de água resultante das reações de eterificação do glicerol. Os resultados mostraram que se produziu água a temperaturas maiores que 400°C, atribuída à eterificação do glicerol, e que os tempos de residência prolongados resultaram na formação de gás e hollín, indicativo de reações de decomposição de ésteres. Por meio de balanças de massa, foi possível identificar o conjunto de condições de operação em que a água formada pela eterificação do glicerol coincide com o valor máximo esperado de acordo com o esquema de reação proposto.

Association of the rs5186 polymorphism of the AGTR1 gene with decreased eGFR in patients with type 2 diabetes from Mexico City.

BACKGROUND: Early biomarkers search for Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM), as genetic markers to identify vulnerable carriers of the disease even before Glomerular Filtration Rate (GFR) decline or microalbuminuria development, has been relevant during the last few years. The rs5186 (A116C) polymorphism of the Angiotensin II Receptor Type I gene (AGTR1), has been associated to multiple effects of renal injury risk, commonly detected in patients with Diabetes Mellitus (DM). It has been described that rs5186 could have an effect in stability proteins that assemble Angiotensin II Receptor Type I (AT1), modifying its action, which is why it should be considered as a risk factor for Chronic Kidney Disease (CKD), characterized by a GFR progressive reduction. Even though, the association between rs5186 AGTR1 gene polymorphism and DKD in patients with T2DM has been controversial, inconclusive, and even absent. This disputable issue might be as a result of association studies in which many and varied clinical phenotypes included are contemplated as CKD inductors and enhancers. Although, the sample sizes studied in patients with T2DM are undersized and did not have a strict inclusion criteria, lacking of biochemical markers or KDOQI classification, which have hindered its examination. OBJECTIVE: The aim of our study was to establish an association between rs5186 AGTR1 gene polymorphism and GFR depletion, assessed as a risk factor to DKD development in patients with T2DM. METHODS: We analyzed 297 not related patients with T2DM, divided into 221 controls (KDOQI 1) and 76 cases (KDOQI 2). Arterial pressure, anthropometric and biochemical parameters were measured. rs5186 of AGTR1 genotyping was performed by TaqMan assay real-time PCR method. Allele and genotype frequencies, and Hardy-Weinberg equilibrium were measured. Normality test for data distribution was analyzed by Shapiro-Wilk test, variable comparison by Student's t-test for continuous variables, and Chi-squared test for categorical variables; ANOVA test was used for mean comparison of more than two groups. Effect of rs5186 to DKD was estimated by multiple heritability adjustment models for risk variables of DKD. Statistical significance was indicated by p<0.05. Data was analyzed using Statistical Package STATA v11 software. RESULTS: Dominant and Over-dominant models showed a likelihood ratio to GFR depletion of 1.89 (1.05-3.39, p=0.031) and 2.01 (1.08-3.73, p=0.023) in patients with T2DM. Risk factor increased to 2.54 (1.10-5.89) in women in Over-dominant model. CONCLUSION: In clinical practice, most of nephropathies progress at a slow pace into a total breakdown of renal function, even asymptomatic. This is the first study, reporting that rs5186 polymorphism of AGTR1 gene contribution to GFR depletion, and this could be evaluated as a predisposing factor for DKD in patients with T2DM.

A case of a transcatheter valve-in-valve implantation using balloon expandable valve for failed SOLO SMART stentless bioprosthetic valve.

A 74-year-old man who had undergone surgical aortic valve replacement with the SOLO SMART stentless bioprosthetic valve 25 mm (LivaNova PLC, London, UK) and mitral valve replacement with MOSAIC 29 mm (Medtronic, Minneapolis, USA) 4 years previously was diagnosed with congestive heart failure, and transferred to our hospital. Echocardiography revealed severe aortic regurgitation caused by degraded bioprosthetic valve. He required continuous dobutamine administration to maintain hemodynamics. As a result of heart team discussion, we decided to perform transcatheter valve-in-valve implantation (ViV-TAVI) using balloon expandable valve (Sapien 3, Edwards Lifesciences, Irvine, USA). Since SOLO SMART stentless valve was placed to Valsalva sinus at the supra-annular level with continuous sutures, we planned to anchor TAVI valve 4 mm to the left ventricular side from the bottom of the failed stentless valve. Two pigtail catheters were placed at the bottom of the failed stentless valve leaflet to mark the nadir of stentless valve. After ViV-TAVI, the patient no longer required catecholamine administration and was discharged home one month later. This is the first case of ViV-TAVI using balloon expandable valve for failed SOLO SMART stentless bioprosthetic valve in a Japanese patient. Learning objective: Transcatheter valve-in-valve implantation (ViV-TAVI) for stentless valves is known to be technically challenging due to poor fluoroscopic visibility. Because the SOLO SMART stentless bioprosthetic valve is sutured to the wall of the sinus of Valsalva above the annulus, the landing point of transcatheter heart valve is at a native annulus which is lower than the bottom of the SOLO SMART leaflet. We describe the first Japanese case of ViV-TAVI with balloon expandable valve for the SOLO SMART stentless bioprosthetic valve.

Asociación del polimorfismo rs5186 del gen AGTR1 con disminución de la TFGe en pacientes con diabetes tipo 2 de la Ciudad de México / Association of the rs5186 polymorphism of the AGTR1 gene with decreased eGFR in patients with type 2 diabetes from Mexico City

Antecedentes: La búsqueda de biomarcadores tempranos de enfermedad renal diabética (ERD) en pacientes con diabetes mellitus tipo 2 (DMT2), como los marcadores genéticos para identificar pacientes vulnerables de la enfermedad, incluso antes de la presencia de una disminución de la estimación de tasa de filtrado glomerular (TFGe) o presencia de microalbuminuria ha cobrado importancia en los últimos años. El polimorfismo rs5186 (A1166C) presente en el gen receptor tipo 1 de la angiotensina II (AGTR1) ha sido asociado a distintos efectos del riesgo de daño renal que suelen estar presentes en pacientes con diabetes mellitus (DM). Se ha descrito que el rs5186 podría influir en la estabilidad de las proteínas que conforman al receptor de la angiotensina II tipo 1 (AT1) alterando su actividad, por lo que podría ser considerado como un factor de riesgo a enfermedad renal crónica (ERC) caracterizada por una disminución progresiva de la TFG. Sin embargo, la asociación del polimorfismo rs5186 del gen AGTR1 con ERD en pacientes con DMT2 ha sido controversial, no concluyente, incluso nula. Las controversias podrían ser por los estudios de asociación y estimación del riesgo del rs5186 previamente reportados incluyen distintos fenotipos clínicos considerados como inductores y potenciadores de ERC, además, los tamaños de las muestras analizadas en pacientes con DMT2 eran pequeñas y no tenían un control estricto en su inclusión, careciendo incluso de marcadores bioquímicos o estadificación KDOQI que han dificultado su análisis. Objetivo: Determinar la asociación del rs5186 del gen AGTR1 con la disminución de TFGe considerada como riesgo al desarrollo de ERD en pacientes con DMT2.(AU)

Background: Early biomarkers search for Diabetic Kidney Disease (DKD) in patients with Type 2 Diabetes Mellitus (T2DM), as genetic markers to identify vulnerable carriers of the disease even before Glomerular Filtration Rate (GFR) decline or microalbuminuria development, has been relevant during the last few years. The rs5186 (A116C) polymorphism of the Angiotensin II Receptor Type I gene (AGTR1), has been associated to multiple effects of renal injury risk, commonly detected in patients with Diabetes Mellitus (DM). It has been described that rs5186 could have an effect in stability proteins that assemble Angiotensin II Receptor Type I (AT1), modifying its action, which is why it should be considered as a risk factor for Chronic Kidney Disease (CKD), characterized by a GFR progressive reduction. Even though, the association between rs5186 AGTR1 gene polymorphism and DKD in patients with T2DM has been controversial, inconclusive, and even absent. This disputable issue might be as a result of association studies in which many and varied clinical phenotypes included are contemplated as CKD inductors and enhancers. Although, the sample sizes studied in patients with T2DM are undersized and did not have a strict inclusion criteria, lacking of biochemical markers or KDOQI classification, which have hindered its examination.Objective: The aim of our study was to establish an association between rs5186 AGTR1 gene polymorphism and GFR depletion, assessed as a risk factor to DKD development in patients with T2DM. (AU)

Starting a Solo Practice.

Opening a small private dermatology practice can be a rewarding experience. It may seem like a lot of trouble, but in no other setting will you have so much freedom, control, and directly be able to see the consequences of your efforts. Economically, you must realize that in other settings, all these "chores" you must do in a solo practice are paid for by you out of overhead, which can greatly exceed what it costs if you do it yourself in a small practice. That is, a small private practice can be economically more rewarding and flexible than working for a dermatology group, particularly a multispecialty group. It requires months of preparation, planning, hard work, persistence, and a strong desire to establish a practice that operates on your own terms.

SARS-CoV-2 infection induces epigenetic changes in the LTR69 subfamily of endogenous retroviruses.

Accumulating evidence suggests that endogenous retroviruses (ERVs) play an important role in the host response to infection and the development of disease. By analyzing ChIP-sequencing data sets, we show that SARS-CoV-2 infection induces H3K27 acetylation of several loci within the LTR69 subfamily of ERVs. Using functional assays, we identified one SARS-CoV-2-activated LTR69 locus, termed Dup69, which exhibits regulatory activity and is responsive to the transcription factors IRF3 and p65/RELA. LTR69_Dup69 is located about 500 bp upstream of a long non-coding RNA gene (ENSG00000289418) and within the PTPRN2 gene encoding a diabetes-associated autoantigen. Both ENSG00000289418 and PTPRN2 showed a significant increase in expression upon SARS-CoV-2 infection. Thus, our study sheds light on the interplay of exogenous with endogenous viruses and helps to understand how ERVs regulate gene expression during infection.

Single-operator left atrial appendage occlusion utilizing conscious sedation, transoesophageal echocardiography, lack of outpatient pre-imaging, and same-day expedited discharge: a feasibility case series.

Background: Contemporary procedural guidelines for percutaneous left atrial appendage occlusions (LAAO) with the WATCHMAN device often require the utilization of pre-screening imaging, general anaesthesia, intubation, a dedicated intra-procedural echocardiographer, and overnight observation. For these reasons, LAAO with the WATCHMAN is not economically feasible for many hospital systems. Thus, we sought to evaluate a newstrategy for implantation that may provide a more minimalistic and less cumbersome approach to LAAO. Case summary: We describe five cases utilizing single-operator left atrial appendage occlusion utilizing conscious sedation, transoesophageal echocardiography, lack of outpatient pre-imaging, and same-day expedited discharge (SOLO-CLOSE)-a novel single-operator procedural strategy for LAAO that safely foregoes the aforementioned procedural requirements and allows for same-day early discharge. All five patients were observed according to our newly devised SOLO-CLOSE protocol and were safely discharged home the same day. Follow-up transoesophageal echocardiography (TEE) at 45 days and 1 year revealed well-seated and well-anchored devices with no leaks (<5 mm) or device-related thrombi. Discussion: The SOLO-CLOSE series is the first ever documented WATCHMAN strategy that utilizes a single-operator, TEE-guided, nurse-driven conscious sedation protocol that defers pre-screening imaging and allows for same-day discharge. The versatility of this technique allows proceduralists to comfortably achieve successful LAAO despite a wide range of risk profiles. This single-operator technique has potential to become a widely accepted universal approach for non-pharmacological cardioembolic stroke prophylaxis due to its efficacy, safety, simplicity, and presumable cost-effectiveness.

The largest HIV-1-infected T cell clones in children on long-term combination antiretroviral therapy contain solo LTRs.

Combination antiretroviral therapy (cART) suppresses viral replication but does not cure HIV infection because a reservoir of infectious (intact) HIV proviruses persists in long-lived CD4+T cells. However, a large majority (>95%) of HIV-infected cells that persist on effective cART carry defective (non-infectious) proviruses. Defective proviruses consisting of only a single LTR (solo long terminal repeat) are commonly found as endogenous retroviruses in many animal species, but the frequency of solo-LTR HIV proviruses has not been well defined. Here we show that, in five pediatric donors whose viremia was suppressed on cART for at least 5 years, the proviruses in the nine largest clones of HIV-infected cells were solo LTRs. The sizes of five of these clones were assayed longitudinally by integration site-specific quantitative PCR. Minor waxing and waning of the clones was observed, suggesting that these clones are generally stable over time. Our findings show that solo LTRs comprise a large fraction of the proviruses in infected cell clones that persist in children on long-term cART. IMPORTANCE This work highlights that severely deleted HIV-1 proviruses comprise a significant proportion of the proviral landscape and are often overlooked.

Solo surgery in robot-assisted gastrectomy versus laparoscopic gastrectomy for gastric cancer: a propensity score-matched analysis.

BACKGROUND: Robot-assisted gastrectomy (RG) for gastric cancer is still not well standardized. This study aimed to explore the feasibility and effectiveness of solo surgery in robot-assisted gastrectomy (SRG) for gastric cancer compared to laparoscopic gastrectomy (LG). METHODS: This was a single-center retrospective comparative study between SRG and conventional LG. Between April 2015 and December 2022, 510 patients underwent gastrectomy, and data from a prospectively collected database were analyzed. We identified 372 patients who underwent LG (n = 267) and SRG (n = 105) and the remaining 138 patients were excluded because of remnant gastric cancer, esophagogastric junction cancer, open gastrectomy, concurrent surgery for concomitant malignancies, RG before starting SRG, or cases in which the author was unable to perform or supervise gastrectomy. Propensity score matching was performed at a ratio of 1:1 to reduce bias from confounding patient-related variables, and short-term outcomes were compared between the groups. RESULTS: After propensity score matching, 90 pairs of patients who underwent LG and SRG were selected. In the propensity-matched cohort, the operation time was significantly shorter in the SRG group than that in the LG group (SRG = 305.7 ± 74.0 min vs. LG = 340.3 ± 91.65 min, p < 0.0058), less estimated blood loss was observed in the SRG group than that in the LG group (SRG = 25.6 ± 50.6 mL vs. LG = 76.1 ± 104.2 mL, p < 0.0001) and postoperative hospital stay was shorter in the SRG group than that in the LG group (SRG = 7.1 ± 0.8 days vs. LG = 9.1 ± 7.7 days, p = 0.015). CONCLUSION: We found that SRG for gastric cancer was technically feasible and effective with favorable short-term outcomes, including shorter operative time, less estimated blood loss, shorter hospital stays, and lower postoperative morbidity than those in LG.

A method for assessing students' interpretations of contextualized data.

Learning to interpret data in context is an important educational outcome. To assess students' attainment of this outcome, it is necessary to examine the interplay between their contextual and statistical reasoning. We describe a research method designed to do so. The method draws upon Toulmin's (1958, 2003) model of argumentation for the first stage of qualitative data analysis and the Structure of the Observed Learning Outcome (SOLO) (Biggs & Collis, 1991) model for the second stage. Toulmin analyses help identify the justifications and expressions of uncertainty students provide in their interpretive arguments. Subsequent analyses based on the multi-modal conceptualization of SOLO help characterize the quality of student arguments relative to one another. Existing literature and an empirical example are drawn upon to explain how the Toulmin and SOLO models can be used in tandem to analyze students' interpretations of contextualized data. We also explain how pairing Toulmin and SOLO can address theoretical and practical limitations that arise when using just one of the two models on its own.