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Feeding experiments with stable isotopes established that the potent 20S-proteasome inhibitors salinosporamide A and B are biosynthesized in the marine bacterium Salinispora tropicafrom three biosynthetic building blocks, namely, acetate, -hydroxy-2‘-cyclohexenylalanine, and either butyrate or a tetrose-derived chlorinated molecule. The unexpected observation that the chlorinated four-carbon residue in salinosporamide A is derived from a different metabolic origin than the non-chlorinated four-carbon unit in salinosporamide B is suggestive of a convergent biosynthesis to these two anticancer natural products. [ABSTRACT FROM AUTHOR]

Transition to long-term care can be a challenging period for older adults, with high risk for negative outcomes, including depression, anxiety, and fear. However, music therapy has the potential to enhance related protective factors because it emphasizes individual strengths by leveraging culture-specific resources, facilitates relationships and a sense of belonging through joint music-making, and provides opportunities to process and make sense of one's experiences in the "new normal" through sharing of music-related emotions. The purpose of this study was to explore the perspectives of older adult long-term care residents, their care team staff, and their music therapists to develop a conceptual framework for the role of music therapy in older adults' transition and adjustment to long-term care. A grounded theory approach was used to conceptualize this process. Interviews with 17 participants were transcribed and analyzed using open, axial, and selective coding. The resulting theoretical model describes a progression of qualities and benefits of music therapy that leads to residents "feeling their best self." Related categories include: Music therapy is accessible and engaging; Music therapy is personal and meaningful; Music therapy acts as a bridge to other resources; Music therapy facilitates transformation; and Music therapy facilitates community integration. This initial theoretical model provides a foundation for clinical assessment and interventions. Future research is needed for continued testing and refining this theory., (© The Author(s) 2023. Published by Oxford University Press on behalf of American Music Therapy Association. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: The number of general practitioners (GPs) per inhabitant, used commonly as an indicator of primary care (PC) access, reports only imprecisely on the true availability of GPs. The aim of this study is to develop a new PC access indicator that better reflects the availability of GPs to take care of patients at the population level, the average GP time availability per inhabitant per year., Methods: We extracted the data from the Commonwealth Fund International Health Policy Survey of Primary Care Physicians conducted in 2015, including 11 Western countries and 12,049 randomly drawn GPs. We built the indicator by combining two questions about weekly workload in hours and percentage of time spent on face-to-face contact with patients. The indicator was then adjusted regarding the number of GPs, the weeks worked per year and the country's population size., Results: On average, GPs worked 43 h a week. The average time spent on face-to-face contact with patients was 30.5 h/week (35 h including emails and telephone contact), ranging from 22 h in Sweden and 38 h in France. The mean time available of GPs for face-to-face contact was 69 min/inhabitant/year, ranging from 38 min in Sweden to 118 min in Australia. Including email and telephone contact, the mean contact time rose to 79 min/inhabitant/year, ranging from 48 min in Sweden to 127 min in Australia., Conclusion: The new indicator provides an accurate and sensitive estimate of a GP's true time availability at the population level. Results should be interpreted in the context of PC workforce organization, which may help guide GP workforce development., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Beer, Cohidon and Senn.)

Background: Macrosomatognosiais the illusory sensation of a substantially enlarged body part. This disorder of the body schema, also called "Alice in wonderland syndrome" is still poorly understood and requires careful documentation and analysis of cases. The patient presented here is unique owing to his unusual macrosomatognosia phenomenology, but also given the unreported localization of his most significant lesion in the right thalamus that allowed consistent anatomo-clinical analysis., Case Presentation: This 45-years old man presented mainly with long-lasting and quasi-delusional macrosomatognosia associated to sensory deficits, both involving the left upper-body, in the context of a right thalamic ischemic lesion most presumably located in the ventral posterolateral nucleus. Fine-grained probabilistic and deterministic tractography revealed the most eloquent targets of the lesion projections to be the ipsilateral precuneus, superior parietal lobule,but also the right primary somatosensory cortex and, to a lesser extent, the right primary motor cortex. Under stationary neurorehabilitation, the patient slowly improved his symptoms and could be discharged back home and, later on, partially return to work., Conclusion: We discuss deficient neural processing and integration of sensory inputs within the right ventral posterolateral nucleus lesion as possible mechanisms underlying macrosomatognosia in light of observed anatomo-clinical correlations. On the other hand, difficulty to classify this unique constellation of Alice in wonderland syndrome calls for an alternative taxonomy of cognitive and psychic aspects of illusory body-size perceptions.

The family of vertebrate Mef2 transcription factors is comprised of four members named Mef2a, Mef2b, Mef2c, and Mef2d. These transcription factors are regulators of the myogenic programs with crucial roles in development of skeletal, cardiac and smooth muscle cells. Mef2a and Mef2c are essential for cardiac development in mice. In Xenopus, mef2c and mef2d but not mef2a were recently shown to be expressed during cardiogenesis. We here investigated the function of Mef2c and Mef2d during Xenopus laevis cardiogenesis. Knocking down either gene by corresponding antisense morpholino oligonucleotides led to profound heart defects including morphological abnormalities, pericardial edema, and brachycardia. Marker gene expression analyses and rescue experiments revealed that (i) both genes are required for proper cardiac gene expression, (ii) Mef2d can compensate for the loss of Mef2c but not vice versa, and (iii) the γ domain of Mef2c is required for early cardiac development. Taken together, our data provide novel insights into the function of Mef2 during cardiogenesis, highlight evolutionary differences between species and might have an impact on attempts of direct reprogramming.

A 1-month-old infant presented with a swelling on the head present from birth. Physical examination showed a healthy infant with a solid swelling on the back of the head with a diameter of approximately 6 cm. Radiography showed a calcified cephalohaematoma.

Historically, it has been difficult to obtain population based data on the uptake of influenza immunisation in people aged under 65 years who are at risk of serious illness or death from influenza and its complications. Data obtained electronically from 96% of all practices in Wales demonstrated that uptake in this group is low, with only a quarter of eligible patients immunised. Uptake varies considerably between patient groups and between geographical areas. This suggests an opportunity for significant health gain from targeted interventions to improve uptake.