Medical literature seems not to have a consistent definition of interpersonal skills, but there is a consensus on the value of emotional intelligence, empathy and effective communication. This ...editorial reflects on both empirical data and personal experience to consider the relative value of interpersonal versus technical skills in the patient experience of partnership in healthcare. It explores the question of whether technical or interpersonal skills are more valuable in medical care. On highlighting the different attitudes towards technical and interpersonal skills among patients in different medical specialities, this editorial suggests that the contemporary focus on interpersonal skills is driven by a recognition that patient experience encompasses more than just successful outcomes. The quality of a patient's remaining life and their sense of respect, care and dignity are also important. It concludes with the emphasis that both technical and interpersonal skills are crucial in patient care and that a holistic understanding of patient experience can enhance medical education and practice.
Evidence of life on Earth is manifestly preserved in the rock record. However, the microfossil record only extends to ∼3.5 billion years (Ga), the chemofossil record arguably to ∼3.8 Ga, and the rock ...record to 4.0 Ga. Detrital zircons from Jack Hills, Western Australia range in age up to nearly 4.4 Ga. From a population of over 10,000 Jack Hills zircons, we identified one >3.8-Ga zircon that contains primary graphite inclusions. Here, we report carbon isotopic measurements on these inclusions in a concordant, 4.10 ± 0.01-Ga zircon. We interpret these inclusions as primary due to their enclosure in a crack-free host as shown by transmission X-ray microscopy and their crystal habit. Their δ13CPDB of −24 ± 5‰ is consistent with a biogenic origin and may be evidence that a terrestrial biosphere had emerged by 4.1 Ga, or ∼300 My earlier than has been previously proposed.
Equal access to public services is a foundational element of democratic societies. Yet, stark inequalities in access to public services persist, partially due to bureaucratic discrimination, or ...differential treatment by bureaucrats. This study investigates the causal mechanism of bureaucratic discrimination, arguing that racial discrimination can serve as a means of cream skimming, when there are economic incentives to prioritize easier-to-serve clientele. We predict that in the absence of information regarding prospective clients' performance, group-level performance information will be imposed on racially minoritized individuals. We implemented a nationwide email correspondence audit experiment including all charter school principals in the U.S. (n = 5850). The findings show that Black email aliases faced significantly higher administrative burdens in trying to get access to charter schools than White email aliases when no performance signal was provided. However, when a direct signal of clients' performance was introduced, the racial disparities diminished. Overall, these results provide evidence on the causal mechanism of bureaucratic discrimination as a means of cream-skimming.
Gut mucosal barrier breakdown and inflammation have been associated with high levels of flagellin, the principal bacterial flagellar protein. Although several gut commensals can produce flagella, ...flagellin levels are low in the healthy gut, suggesting the existence of control mechanisms. We find that mice lacking the flagellin receptor Toll-like receptor 5 (TLR5) exhibit a profound loss of flagellin-specific immunoglobulins (Igs) despite higher total Ig levels in the gut. Ribotyping of IgA-coated cecal microbiota showed Proteobacteria evading antibody coating in the TLR5−/− gut. A diversity of microbiome members overexpressed flagellar genes in the TLR5−/− host. Proteobacteria and Firmicutes penetrated small intestinal villi, and flagellated bacteria breached the colonic mucosal barrier. In vitro, flagellin-specific Ig inhibited bacterial motility and downregulated flagellar gene expression. Thus, innate-immunity-directed development of flagellin-specific adaptive immune responses can modulate the microbiome’s production of flagella in a three-way interaction that helps to maintain mucosal barrier integrity and homeostasis.
•TLR5−/− mice have reduced levels of anti-flagellin antibodies in the gut•Flagella-related genes of commensal microbes are upregulated in TLR5−/− mouse guts•Antibodies against flagellin induce downregulation of flagella genes•Flagellated bacteria penetrate TLR5−/− small intestinal villi and mucosal barrier
The development and implementation of sustainable catalytic technologies is key to delivering our net‐zero targets. Here we review how engineered enzymes, with a focus on those developed using ...directed evolution, can be deployed to improve the sustainability of numerous processes and help to conserve our environment. Efficient and robust biocatalysts have been engineered to capture carbon dioxide (CO2) and have been embedded into new efficient metabolic CO2 fixation pathways. Enzymes have been refined for bioremediation, enhancing their ability to degrade toxic and harmful pollutants. Biocatalytic recycling is gaining momentum, with engineered cutinases and PETases developed for the depolymerization of the abundant plastic, polyethylene terephthalate (PET). Finally, biocatalytic approaches for accessing petroleum‐based feedstocks and chemicals are expanding, using optimized enzymes to convert plant biomass into biofuels or other high value products. Through these examples, we hope to illustrate how enzyme engineering and biocatalysis can contribute to the development of cleaner and more efficient chemical industry.
This review highlights how engineered enzymes have been developed and implemented to help address environmental challenges. Topics include the use of engineered enzymes for improving carbon capture and utilisation, bioremediation, plastic deconstruction, and renewable feedstock generation. Successes, challenges, and opportunities for future enzyme engineering campaigns to improve environmental sustainability are discussed.
A wide variety of minerals occur as inclusions in igneous zircon and can provide valuable evidence of source magma composition from originally magmatic zircons in metamorphic and clastic sedimentary ...rocks. However, it is not clear the extent to which zircons preserve the primary composition of their inclusions through a variety of geologic processes. This paper documents a case study of inclusion-rich, originally igneous zircon from an orthogneiss in the Blue Ridge of southwest Virginia. Zircon inclusions isolated from cracks contain 4 % clearly metamorphic phases (mainly in hosts with disturbed U–Pb systems) and otherwise retain distinct plagioclase chemistry, K-feldspar/plagioclase pairs, and biotite with much wider-ranging Mg/(Mg + Fe) than biotite in the rock matrix. A clearly secondary mineralization suite filling cracks in the zircons consists of quartz, biotite, albite, and epidote. Overall, these zircons preserve mineral inclusions distinct from their current host rock (except when exposed to external environments via cracks), demonstrating that non-metamict zircons may preserve their primary inclusion assemblages through later amphibolite to lower granulite facies metamorphism.
Postmitotic cell growth defines cell shape and size during development. However, the mechanisms regulating postmitotic cell growth in plants remain unknown. Here we report the discovery of a basic ...helix-loop-helix (bHLH) transcription factor called RSL4 (ROOT HAIR DEFECTIVE 6-LIKE 4) that is sufficient to promote postmitotic cell growth in Arabidopsis thaliana root-hair cells. Loss of RSL4 function resulted in the development of very short root hairs. In contrast, constitutive RSL4 expression programmed constitutive growth, resulting in the formation of very long root hairs. Hair-cell growth signals, such as auxin and low phosphate availability, modulate hair cell extension by regulating RSL4 transcript and protein levels. RSL4 is thus a regulator of growth that integrates endogenous developmental and exogenous environmental signals that together control postmitotic growth in root hairs. The control of postmitotic growth by transcription factors may represent a general mechanism for regulating cell size across diverse organisms.
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