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Cardiac fibroblasts are a major source of cardiac fibrosis during heart repair processes in various heart diseases. Although it has been shown that cardiac fibroblasts become senescent in response to heart injury, it is unknown how the senescence of cardiac fibroblasts is regulated in vivo. Gata4, a cardiogenic transcription factor essential for heart development, is also expressed in cardiac fibroblasts. However, it remains elusive about the role of Gata4 in cardiac fibroblasts. To define the role of Gata4 in cardiac fibroblasts, we generated cardiac fibroblast-specific Gata4 knockout mice by cross-breeding Tcf21-MerCreMer mice with Gata4fl/fl mice. Using this mouse model, we could genetically ablate Gata4 in Tcf21 positive cardiac fibroblasts in an inducible manner upon tamoxifen administration. We found that cardiac fibroblast-specific deletion of Gata4 spontaneously induces senescence in cardiac fibroblasts in vivo and in vitro. We also found that Gata4 expression in both cardiomyocytes and non-myocytes significantly decreases in the aged heart. Interestingly, when αMHC-MerCreMer mice were bred with Gata4fl/fl mice to generate cardiomyocyte-specific Gata4 knockout mice, no senescent cells were detected in the hearts. Taken together, our results demonstrate that Gata4 deficiency in cardiac fibroblasts activates a program of cellular senescence, suggesting a novel molecular mechanism of cardiac fibroblast senescence.

The human gut microbiome is a dynamic ecosystem of microorganisms, influenced by numerous disparate factors including diet, age, and lifestyle. Investigating how changes in these variables affect the microbial gut community is limited due to the high variability found between individuals’ microbiota and limits inherent in sampling methodologies. Here we developed a microbial community with a defined species content - Lactocaseibacillus rhamnosus, Streptococcus salivarius, Enterococcus faecalis, and Bifidobacterium bifidum – mimicking the microbiota present in the small intestine. The biofilm community reached a steady state within 5–6 days of culture in a semi-batch system and once harvested and re-inoculated into a new reactor, the steady state was re-established within 24 hours. Biofilm development, microcolony structure, viability, and biomass were determined. Overall, this new “mock” community system can accurately mimic the small intestine microbiota and provide a platform to study community changes that occur due to environmental and chemical factors and lead to dysbiosis.

Government and media authorities play essential roles in distributing lifesaving resources and information to the public during an epidemic. Throughout US history and in past epidemics, the relationship between the public, government, and media has developed from a minimal communication to a vast, interconnected system in which information may flow in different ways. Since the 1960s, economic, sociocultural, and political factors have shown a decline in public trust over the years. Then, ever since the advent of social media, traditional media sources have been struggling to maintain trust with news consumers. Today, as the COVID-19 pandemic raged across the world, the role of social media has grown among the public. Providing the latest updates on world news and connecting people from all over the world, social media has been a popular alternative source for news media. However, social media also presents a danger due to the lack of editorial oversight for posts; anyone can share disinformation and may further contribute to the distrust in government and traditional media. My paper contends that social media has had a key role in discounting the credibility of traditional news while fueling public distrust of the government during the COVID-19 pandemic. Analysis of foreign governments that were successful in gaining public trust shows that government authorities used both traditional media and social media effectively to successfully contain disinformation on the virus. US government and media authorities must establish long term plans to create a stronger line of communication

Invasive plant species can have significant, adverse effects on forest ecosystems. By outcompeting native species for resources, invasive species suppress the richness and diversity of many forest communities. This study focuses on the associations of Amur honeysuckle (Lonicera maackii Rupr.) with spring flora in Raven Run Nature Sanctuary in Lexington, Kentucky, where abundant L. maackii threatens native biodiversity. Plots were surveyed for percent herbaceous groundcover and abundance of flowering spring flora at three levels of L. maackii density (high, low, and no L. maackii). Results indicate that L. maackii abundance is associated with lower species richness, abundance, and early-season diversity of flowering native spring flora. Importantly, this study extends the existing robust literature evaluating the widespread effects of L. maackii to the Kentucky River Palisades, a sensitive and botanically important corridor in central Kentucky.

BackgroundMulti-cancer early detection tests have been developed to enable earlier detection of multiple cancer types through screening. As reflected by patient-reported outcomes (PROs), the psychosocial impact of cancer screening is not yet clear. Our aim is to evaluate the impact of cancer screening through PRO assessment.MethodsA systematic review was conducted using MEDLINE, EMBASE, and reference lists of articles from January 2000 to August 2020 for relevant publications assessing the psychosocial impact of cancer screening before and within 1 year after screening in the general asymptomatic population, including following receipt of results. Studies focused on diagnostic evaluation or involving patients previously diagnosed with cancer were excluded.ResultsIn total, 31 studies (12 randomized controlled trials; 19 observational studies) were included, reflecting PRO assessments associated with lung, breast, colorectal, anal, ovarian, cervical, and prostate cancer screening procedures. The most commonly assessed construct was symptoms of anxiety, using the State-Trait Anxiety Inventory. Cancer-specific distress and worry were also assessed using a broad range of measures. Overall, individuals tolerated screening procedures well with no major psychosocial effects. Of note, increases in symptoms of anxiety and levels of distress and worry were generally found prior to communication of screening results and following communication of indeterminate or positive results that required further testing. These negative psychosocial effects were, however, not long-lasting and returned to baseline relatively soon after screening. Furthermore, individuals with higher cancer risk, such as current smokers and those with a family history of cancer, tended to have higher levels of anxiety and distress throughout the screening process, including following negative or indeterminate results.ConclusionsThe psychosocial impact of cancer screening is relatively low overall and short-lived, even following false-positive test results. Individuals with a higher risk of cancer tend to experience more symptoms of anxiety and distress during the screening process; thus, more attention to this group is recommended.

Background Musculoskeletal specialists have the expertise to distinguish between (1) symptoms that correspond well with observed pathophysiology and (2) disproportionate or incongruent symptoms that may suggest mental and social health opportunities. There is evidence that patient verbal and nonverbal communication can help with this discernment. This study carried this line of research one step further by addressing whether patient linguistic tones, as assessed with use of Linguistic Inquiry and Word Count (LIWC), are associated with symptoms of depression and health anxiety. We also sought associations between both patient and clinician linguistic tones and patient-perceived clinician empathy. Methods A secondary analysis of transcripts of video and audio recordings of 109 adult patients seeking musculoskeletal specialty care was performed. Patients also completed questionnaires quantifying symptoms of depression (PROMIS [Patient-Reported Outcomes Measurement Information System] Depression computerized adaptive test), self-efficacy when in pain (Pain Self-Efficacy Questionnaire, 2-question version), symptoms of health anxiety (5-item Short Health Anxiety Inventory [SHAI-5]), and perceived clinician empathy (Jefferson Scale of Patient Perceptions of Physician Empathy [JSPPPE]). LIWC was used to detect the relative strength of various emotional tones, cognitive processes, and core drives and needs. Bivariate and multivariable regression analyses sought factors associated with symptoms of depression, symptoms of health anxiety, and patient perception of clinician empathy. Results With greater levels of depression, patients express less emotion overall as detected with use of computational linguistic analysis. After accounting for demographic variables, there were no specific linguistic tones associated with health anxiety and symptoms of depression. Stronger negative linguistic tones were associated with lower pain self-efficacy. Greater perceived clinician empathy was associated with more words spoken by the clinician and the patient, greater patient use of adjectives, lower prevalence of patient tones of "analytic," lower clinician tones of "social," and greater tones of "cause." Conclusions Musculoskeletal specialists cannot depend on people experiencing symptoms of psychological distress to verbally express their feelings. Clinical relevance Specialists may be more likely to identify important symptoms of psychological distress if they anticipate lower emotional expressiveness and are attentive to specific words, concepts, and mannerisms known to be associated with distress.

Evaluating the aerosolization of droplets from surgical instruments to assess the implications of surgery in SARS-CoV-2 transmission for both patients and providers. Cadaver study. Outpatient surgery center. Aerosolized particles between 0.3 and 25 microns were measured. Instruments tested included monopolar cautery with and without suction, bipolar cautery, a bipolar vessel sealing device, and tissue scissors. Each trial was compared to a background reading. Monopolar cautery without suction, Ligasure used continuously and Bipolar cautery produced the most aerosols. Monopolar cautery with simultaneous suction produced no detectable aerosols. Ligasure used for a single cycle produced notably fewer aerosols than during continuous use. Most aerosols produced were

RATIONALE Studies identified kininogen as a potential biomarker of preeclampsia, a major cause of adverse maternal outcomes. High-molecular-weight kininogen (HK) and its activated form participate in numerous pathways associated with establishing and maintaining pregnancy. However, dynamic changes in HK and naturally occurring HK-derived peptides during the natural course of pregnancy are largely unknown. METHODS Longitudinal serum samples during the course of normal pregnancy (trimesters T1, T2, T3) from 60 pregnant women were analyzed by western blot with an anti-HK antibody. Circulating peptides in longitudinal serum specimens derived from 50 participants were enriched using nanoporous silica thin films. Peptides were identified by liquid chromatography/tandem mass spectrometry (LC/MS/MS) and database searching. Relative quantification was performed using MaxQuant and in-house scripts. Normality was evaluated by either ANOVA or Friedman tests with p

This article aims to highlight and pose commentary on the issues arising from the body embodied knowledge which, I, as a woman possess around the impact of media on body image satisfaction. With fo...

Background: The differential for soft tissue tumors of the hand and upper limb is broad. Hematologic malignancy remains quite low on the differential for soft tissue tumors involving the hand, and there is little in the literature describing surgical management of such cutaneous manifestations. When the tumor is large or involves the thumb, careful consideration of reconstructive options is required. Methods: We present a rare case of an aggressively enlarging mycosis fungoides, a cutaneous T-cell lymphoma tumor, involving the thumb. This tumor had a history of multiple failed treatment attempts, including radiation and chemotherapy. Results: Our surgical plan was a reverse radial forearm osteocutaneous flap. Conclusion: A reverse radial osteocutaneous forearm flap was successfully used to avoid thumb amputation and preserve thumb function.

Entire issue of the Journal of China and International Relations: Volume 6, Number 2., Journal of China and International Relations, Vol 6 No 2 (2018): JCIR

2018 Special Issue for the Journal of China and International Relations

Background Sickle cell disease (SCD) affects multiple organ systems. Complications of SCD such as pulmonary hypertension (PHT) and sickle cell nephropathy (SCN) are associated with an increased mortality. Both PHT and SCN have some common risk factors. In adults, PHT has been found to be associated with albuminuria, a manifestation of SCN. There is no data on this association in children. We conducted a study to determine if elevated pulmonary artery systolic pressures estimated on echocardiogram was associated with proteinuria in children with SCD. Methods A detailed retrospective chart review was conducted on a cohort of sickle cell patients screened with echocardiograms from June 2005 to July 2010. Patients who had an initial screening echocardiogram and urine analysis within 1 year were included. Longitudinal data from all subsequent echocardiograms and urine analyses were collected. Results Eighty-five patients were included. On initial echocardiograms 32.9% had an elevated tricuspid regurgitant jet velocity (TRV) ≥2.5 m/second. On follow up, in the 28 patients with elevated TRV, 49.27% of all repeat echocardiograms showed persistent elevation. In the 57 patients with normal baseline TRV, 73.6% of all repeat echocardiograms continued to have normal TRV. On initial screening 7.14% of patients with elevated TRV had proteinuria compared to 1.75% without elevated TRV. On follow up, 19.08% of repeat urinalysis had proteinuria in patients with elevated baseline TRV compared to 12.35% in patients with normal baseline TRV (P = 0.04). Conclusions Elevated TRV ≥ 2.5 m/second is significantly associated with proteinuria on longitudinal follow up in children with SCD. Pediatr Blood Cancer 2012; 58: 937–940. © 2011 Wiley Periodicals, Inc.

Adverse event (AE)-related costs represent an important component of economic models for cancer care. However, since previous studies mostly focused on specific AEs, treatments, or cancer types, limited information is currently available. Therefore, this study assessed the incremental healthcare costs associated with a large number of AEs among patients diagnosed with some of the most prevalent types of cancer. Data were obtained from a large US claims database. Adult patients were included if diagnosed with and treated for one of the following cancer types: breast, digestive organs and peritoneum, genitourinary organs (including bladder and ovary and other uterine adnexa), lung, lymphatic and hematopoietic tissue, and skin. Treatment episodes were defined as the period from initiation of the first antineoplastic pharmacologic therapy to discontinuation (i.e., gap of ≥ 45 days), or change in treatment regimen, or end of data availability. A total of 36 AEs were selected from the product inserts of 104 treatments recommended by practice guidelines. A retrospective matched cohort design was used, matching a treatment episode with a certain AE with a treatment episode without that AE. A total of 412,005 patients were selected, for a total of 794,243 treatment episodes, resulting in 1,617,368 matched treatment episodes across all 36 AEs. Incremental healthcare costs associated with AEs of any severity ranged from $546 for cough/upper respiratory infections to $24,633 for gastrointestinal perforation. The three most costly AEs when considering any severity were gastrointestinal perforation ($24,633), central nervous system hemorrhage ($24,322), and sepsis/septicemia ($23,510). Incremental healthcare costs associated with severe AEs ranged from $15,709 for dermatitis and rash to $48,538 for gastrointestinal fistula. The three most costly severe AEs were gastrointestinal fistula ($48,538), gastrointestinal perforation ($41,281), and central nervous system hemorrhage ($38,428). In conclusion, AEs during treatment episodes for cancer were frequent and associated with a substantial economic burden.

Journal of China and International Relations, Vol 1 No 1 (2013)