The aim of using the game-based tool Kahoot! was to evaluate and reinforce the contents taught in the subject of Management and Administration of Nursing, Ethics and Health Legislation Services ...included in the Degree in Nursing, during the 2016-2017 academic year.
A prospective quasi-experimental study was carried out on a sample of 116 students. 10 multiple-choice questions were designed, with only one possible correct answer and a 20-second-limited response time for each of the questions. Four of these questions previously answered in the classroom using this game were chosen (20% of the exam). Each one of them corresponded to one unit of the topics taught in the subject. In order to participate in the educational game, students needed their smartphones or electronic devices. After completing the game, the students' satisfaction level derived from its use was assessed.
The correct answer rate in the educational game was greater than 50% for all questions except for one, in which the rate was 28.8% (P<0.05). Response time as related to score presented statistically significant differences, and higher scores for those questions with lower response time (P<0.001). The questions included in the final test which had been previously answered using Kahoot! showed a significantly higher difficulty index than the rest of the final exam questions (P<0.05). Question 3 was the easiest, while being the one in which the highest-scoring students obtained more wrong answers. For the students this tool was easy to use (89.6%) and they positively valued the content acquisition and comprehension, as well as the teacher-student interaction (P<0.05).
The implementation of educational games which consider response time and correct answers favors competitiveness and motivates students to actively participate in their learning process.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A low-activity variant of endoplasmic reticulum aminopeptidase 1 (ERAP1), Hap10, is associated with the autoinflammatory disorder Behçet's disease (BD) in epistasis with HLA-B*51, which is the main ...risk factor for this disorder. The role of Hap10 in BD pathogenesis is unknown. We sought to define the effects of Hap10 on the HLA-B*51 peptidome and to distinguish these effects from those due to HLA-B*51 polymorphisms unrelated to disease. The peptidome of the BD-associated HLA-B*51:08 subtype expressed in a Hap10-positive cell line was isolated, characterized by mass spectrometry, and compared with the HLA-B*51:01 peptidome from cells expressing more active ERAP1 allotypes. We additionally performed synthetic peptide digestions with recombinant ERAP1 variants and estimated peptide-binding affinity with standard algorithms. In the BD-associated ERAP1 context of B*51:08, longer peptides were generated; of the two major HLA-B*51 subpeptidomes with Pro-2 and Ala-2, the former one was significantly reduced, and the latter was increased and showed more ERAP1-susceptible N-terminal residues. These effects were readily explained by the low activity of Hap10 and the differential susceptibility of X–Pro and X–Ala bonds to ERAP1 trimming and together resulted in a significantly altered peptidome with lower affinity. The differences due to ERAP1 were clearly distinguished from those due to HLA-B*51 subtype polymorphism, which affected residue frequencies at internal positions of the peptide ligands. The alterations in the nature and affinity of HLA-B*51·peptide complexes probably affect T-cell and natural killer cell recognition, providing a sound basis for the joint association of ERAP1 and HLA-B*51 with BD.
Objective
To determine the influence of endoplasmic reticulum aminopeptidase 2 (ERAP‐2) expression on the HLA–B*27 peptidome in live cells.
Methods
Using immunoaffinity chromatography and acid ...extraction, HLA–B*27:05–bound peptides were isolated from 2 ERAP‐2–negative lymphoblastoid cell lines and 1 ERAP‐2–positive lymphoblastoid cell line expressing functionally indistinguishable ERAP‐1 variants. More than 2,000–4,000 B*27:05 ligands were identified from each cell line, and their relative abundance was established by quantitative tandem mass spectrometry and MaxQuant‐based peptide analyses. Pairwise comparisons were used to determine the structural features of peptides whose relative abundance was dependent on the presence of ERAP‐2. Synthetic peptide digestions were performed with recombinant ERAP‐1 and ERAP‐2. Peptide affinity was estimated with standard algorithms.
Results
The B*27:05 peptidome from ERAP‐2–positive cells showed 3–4% fewer peptides with N‐terminal basic residues than did the peptidome from ERAP‐2–negative cells. Among the shared peptides, those most abundant in the presence of ERAP‐2 included more nonamers, fewer decamers, and fewer N‐terminal basic residues than the peptides predominant in ERAP‐2–negative cells. These ERAP‐2–dependent changes did not alter the global affinity of the B*27:05 peptidome.
Conclusion
ERAP‐2 significantly influences the B*27:05‐bound peptidome by destroying some ligands and decreasing the abundance of many more ligands with N‐terminal basic residues, while increasing the abundance of nonamers. The former effects are best explained by direct ERAP‐2 trimming. The effects on peptide length might be attributed to ERAP‐2–induced activation of ERAP‐1 trimming. These data support the notion of a peptide‐mediated mechanism as the basis for the association of ERAP‐2 with ankylosing spondylitis. Analogous effects on other major histocompatibility complex class I peptidomes might explain the involvement of ERAP‐2 in HLA–B27–negative spondyloarthritis.
Objective
To characterize the alterations, as well as their mechanisms, induced in the HLA–B27–bound peptidome expressed in live cells by the natural ERAP1 polymorphisms predisposing to ankylosing ...spondylitis (AS): R528K and N575D/Q725R.
Methods
HLA–B*27:05–bound peptides were isolated from 3 human lymphoid cell lines expressing distinct ERAP1 variants differing at residues 528 and/or 575/725. The high‐performance liquid chromatography–fractionated peptide pools were compared by mass spectrometry based on identity of molecular mass and chromatographic retention time. The relative amount of each shared peptide in any given cell line pair was estimated from the respective ion peak intensities. Peptide sequencing was also carried out by mass spectrometry.
Results
HLA–B27–bound ligands predominant in the context of the ERAP1 variant with K528 collectively showed higher molecular mass, higher frequency of N‐terminal residues resistant to ERAP1, and bulkier residues downstream of the N‐terminus, relative to peptides predominant in the R528 context. None of these differences were observed with ERAP1 variants differing at positions 575/725, but not at residue 528. Neither R528K nor N575D/Q725R altered the mean length of B*27:05‐bound ligands.
Conclusion
The R528K, but not the N575D/Q725R, polymorphism alters the expression levels of many HLA–B*27:05–bound peptides, depending on the susceptibility of their N‐terminal residues to trimming and depending on the size of the amino acid side chains at multiple positions downstream of the N‐terminus. The significant alterations in the B*27:05 peptidome and the structural features of the peptides that determine their differential expression in distinct ERAP1 contexts account for the association of the R528K polymorphism with AS.
•ERAP1 is a multifunctional aminopeptidase involved in antigen processing.•It is associated with ankylosing spondylitis and other MHC-I-related diseases.•ERAP1 polymorphism has a significant ...influence on the HLA-B27 peptidome.•This influence is based on altering the epitope generation/destruction balance.•The pathogenetic role of ERAP1 might go beyond its influence on antigen processing.
The endoplasmic reticulum aminopeptidase 1 (ERAP1) is a multifunctional enzyme involved in the final processing of Major Histocompatibility Complex class I (MHC-I) ligands and with a significant influence in the stability and immunological properties of MHC-I proteins. ERAP1 polymorphism is associated with ankylosing spondylitis among HLA-B27-positive individuals and the altered enzymatic activity of natural variants has significant effects on the HLA-B27 peptidome, suggesting a critical pathogenetic role of peptides in this disease. Likewise, the association of ERAP1 with other MHC-I associated disorders and its epistasis with their susceptibility MHC alleles point out to a general role of the MHC-I peptidome in these diseases. The functional interaction between ERAP1 and HLA-B27 or other MHC-I molecules may be related to the processing of specific epitopes, or to a more general peptide-dependent influence on other biological features of the MHC-I proteins. In addition, from a consideration of the reported functions of ERAP1, including its involvement in angiogenesis and macrophage activation, a more complex and multi-level influence in the inflammatory and immune pathways operating in these diseases cannot be ruled out.
Objective
To characterize the peptidome of the Behçet's disease–associated HLA–B*51:01 allotype as well as the differential features of major peptide subsets and their distinct endoplasmic reticulum ...aminopeptidase 1 (ERAP‐1)–mediated processing.
Methods
The endogenous B*51:01‐bound peptidome was characterized from 721.221 transfectant cells, after affinity chromatography and acid extraction, by tandem mass spectrometry. Recombinant ERAP‐1 variants were used to digest synthetic B*51:01 ligands. HLA and transporter associated with antigen processing (TAP) binding affinities of peptide ligands were calculated with well‐established algorithms. ERAP‐1 and ERAP‐2 from 721.221 cells were characterized by genomic sequencing and Western blotting.
Results
The B*51:01 peptidome consisted of 29.5% octamers, 61.7% nonamers, 4.8% decamers, and 4.0% longer peptides. The major peptide motif consisted of Pro and Ala at position 2, aliphatic/aromatic position 3 residues, and Val and Ile at the C‐terminal position. The ligands with Pro or Ala at position 2 constituted 2 distinct subpeptidomes. Peptides with Pro at position 2 showed higher affinity for B*51:01 and lower affinity for TAP than those with Ala at position 2. Most important, both peptide subsets differed drastically in the susceptibility of their position 1 residues to ERAP‐1, revealing a distinct influence of this enzyme on both subpeptidomes, which may alter their balance, affecting the global affinity of B*51:01–peptide complexes.
Conclusion
ERAP‐1 has a significant influence on the B*51:01 peptidome and its affinity. This influence is based on very distinct effects on the 2 subpeptidomes, whereby only peptides in the subpeptidome with Ala at position 2 are extensively destroyed, except when their position 1 residues are ERAP‐1 resistant. This pattern provides a mechanism for the epistatic association of ERAP‐1 and B*51:01 in Behçet's disease.
The Spanish Civil War (1936-1939) is an example of a historic event involving nurses, with the participation of professional and volunteer nurses from Spain and other countries. In this context, ...nurses were trained over short periods of time and recruited to work at hospitals serving the two warring camps.
To identify the characteristics of the training received by volunteer nurses on both sides in the Spanish Civil War and compare it with previous experiences in the history.
Historical research.
Heuristic and hermeneutical analysis of nurse training manuals and news articles from 1936 to 1939. Spanish primary sources were consulted at the Red Cross Documentation Centre Archive in Madrid, the General Military Archive in Ávila, the Municipal Newspaper Archive in Madrid, and the archives of Spanish daily newspapers ABC and La Vanguardia. The following variables were analysed: duration, entry requirements, and theoretical content of the training courses. Consolidated Criteria for Reporting Qualitative Research (COREQ) has been used.
Both sides in the conflict offered a varied training programme, which was supported by official institutions and private initiatives. The courses lasted between one week and two months. Entry requirements were influenced by education level, age, moral conduct, health status, and social and political background. Training content focused on the techniques needed in conflict settings and covered specific moral values.
Despite the different social and political characteristics of the two warring factions, the variety of training programmes on offer, the entry requirements, and the theoretical content of volunteer nurse training were similar on both sides. At the end of the Spanish Civil War, volunteer nurses on the Republican side suffered reprisals or had to go into exile. We now know that some countries involved in World War II provided training courses for volunteer nurses. It would therefore be interesting to ascertain whether Spanish volunteer nurses contributed their experience to these courses.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: The COVID-19 pandemic has contributed to the occurrence of work-related stress on nursing staff. Being resilience an essential element to countering adversity. The aim of the study was to ...assess burnout syndrome as well as resilience in hospital-care nurses during the first outbreak of the COVID-19 pandemic. Methods: A cross-sectional descriptive study of burnout syndrome and resilience of 101 nurses during the first COVID-19 outbreak. The Maslach Burnout Inventory and the Scale of Resilience of Connor-Davidson were used. Results: The burnout average score was 74.35 ± 12.78 points, and resilience was 27.94 ± 5.84. Temporary nurses reached a lower average score for the emotional fatigue dimension (23.80 ± 10.39 points) p < 0.05. The emotional fatigue dimension correlated adversely with the average score of resilience (r = −0.271; p < 0.001). Conclusions: The level of burnout in nurses was high, being higher on those who took care of COVID-19 patients. Resilient nurses were able to better cope with stressful situations.
•The interaction between ERAP1/ERAP2 and MHC-I in inflammatory diseases is reviewed.•ERAP1/ERAP2 have analogous effects on disparate peptidomes.•Similar mechanisms may underlie the contribution of ...ERAP1/ERAP2 and MHC-I to disease.
The inflammatory diseases that are most strongly associated with major histocompatibility Complex class I (MHC-I) alleles are also influenced by endoplasmic reticulum aminopeptidase (ERAP) 1 and/or 2, often in epistasis with the susceptibility MHC-I allele. This review will focus on the four major MHC-I-associated inflammatory disorders: ankylosing spondylitis, birdshot chorioretinopathy, Behçet’s disease and psoriasis. The genetics of ERAP1/ERAP2 association and the alterations induced by polymorphism of these enzymes on the risk MHC-I allotypes will be examined. A pattern emerges of analogous effects on peptide length, sequence and affinity of disparate peptidomes, suggesting that similar peptide-mediated mechanisms underlie the pathogenesis and the joint contribution of ERAP1/ERAP2 and MHC-I to distinct inflammatory diseases. Processing of specific antigens, peptide-dependent changes in global properties of the MHC-I molecules, such as folding and stability, or both may be pathogenic.
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