Hospice care involves focusing on our patients’ goals of care and good symptom management. This coincides with a focus on their comfort, dignity, and respect. Working with lesbian, gay, bisexual, ...transgender, queer and/or questioning (LGBTQ+) patients on a hospice service can be challenging for medical staff. Many of these potential challenges relate to lack of training of medical professionals. These patients often receive discriminatory care compared to those who do not identify as LGBTQ+. This case study describes an assigned-male-at-birth Veteran admitted to a Veterans Affairs Community Living Center (CLC) hospice service who, after admission, informed staff of the strong desire to go forward with gender reassignment. Despite a prognosis of 6 months, working with the Veteran to help achieve these goals, supporting the medical plans for providing gender-transition information, and focusing on addressing the Veteran with appropriate pronouns were critical to our medical team’s support for our Veteran at this difficult time.
The purpose of this descriptive study was to identify whether meaning reconstruction was associated with indicators of bereavement adaptation in 66 spouses and adult child caregivers of person’s with ...Alzheimer’s disease. A cross-sectional mixed-methods design was used. Hierarchical regression models were used to examine whether meaning making predicted grief, depression, and positive and states of mind in the sample. Qualitative interviews were conducted to gain further knowledge about ways in which Alzheimer’s disease caregivers construct meaning during bereavement. The majority of participants reported experiencing positive aspects of meaning reconstruction. Benefit-finding and identity change contributed to reductions in grief, and benefit-finding contributed to positive states of mind. Being a spouse and female gender contributed to increased grief and depression. Bereaved caregivers who are at risk for high levels of grief should be targeted for grief therapy interventions that foster meaning making.
There is extensive evidence that activation of the immune system is both necessary and required for the development of angiotensin II (Ang II)-induced hypertension in males. The purpose of this study ...was to determine whether sex differences exist in the ability of the adaptive immune system to induce Ang II-dependent hypertension and whether central and renal T-cell infiltration during Ang II-induced hypertension is sex dependent. Recombinant activating gene-1 (Rag-1)(-/-) mice, lacking both T and B cells, were used. Male and female Rag-1(-/-) mice received adoptive transfer of male CD3(+) T cells 3 weeks before 14-day Ang II infusion (490 ng/kg per minute). Blood pressure was monitored via tail cuff. In the absence of T cells, systolic blood pressure responses to Ang II were similar between sexes (Δ22.1 mm Hg males versus Δ18 mm : Hg females). After adoptive transfer of male T cells, Ang II significantly increased systolic blood pressure in males (Δ37.7 mm : Hg; P<0.05) when compared with females (Δ13.7 mm : Hg). Flow cytometric analysis of total T cells and CD4(+), CD8(+), and regulatory Foxp3(+)-CD4(+) T-cell subsets identified that renal lymphocyte infiltration was significantly increased in males versus females in both control and Ang II-infused animals (P<0.05). Immunohistochemical staining for CD3(+)-positive T cells in the subfornical organ region of the brain was increased in males when compared with that in females. These results suggest that female Rag-1(-/-) mice are protected from male T-cell-mediated increases in Ang II-induced hypertension when compared with their male counterparts, and this protection may involve sex differences in the magnitude of T-cell infiltration of the kidney and brain.
Summary
Aging of the world population and a concomitant increase in age‐related diseases and disabilities mandates the search for strategies to increase healthspan, the length of time an individual ...lives healthy and productively. Due to the age‐related decline of the immune system, infectious diseases remain among the top 5–10 causes of mortality and morbidity in the elderly, and improving immune function during aging remains an important aspect of healthspan extension. Calorie restriction (CR) and more recently rapamycin (rapa) feeding have both been used to extend lifespan in mice. Preciously few studies have actually investigated the impact of each of these interventions upon in vivo immune defense against relevant microbial challenge in old organisms. We tested how rapa and CR each impacted the immune system in adult and old mice. We report that each intervention differentially altered T‐cell development in the thymus, peripheral T‐cell maintenance, T‐cell function and host survival after West Nile virus infection, inducing distinct but deleterious consequences to the aging immune system. We conclude that neither rapa feeding nor CR, in the current form/administration regimen, may be optimal strategies for extending healthy immune function and, with it, lifespan.
Background Menopause is associated with an increase in the prevalence and severity of hypertension in women. Although premenopausal females are protected against T cell-dependent immune activation ...and development of angiotensin II (Ang II) hypertension, this protection is lost in postmenopausal females. Therefore, the current study hypothesized that specific CD4
T cell pathways are regulated by sex hormones and Ang II to mediate progression from premenopausal protection to postmenopausal hypertension. Methods and Results Menopause was induced in C57BL/6 mice via repeated 4-vinylcyclohexene diepoxide injections, while premenopausal females received sesame oil vehicle. A subset of premenopausal mice and all menopausal mice were infused with Ang II for 14 days (Control, Ang II, Meno/Ang II). Proteomic and phosphoproteomic profiles of CD4
T cells isolated from spleens were examined. Ang II markedly increased CD4
T cell protein abundance and phosphorylation associated with DNA and histone methylation in both premenopausal and postmenopausal females. Compared with premenopausal T cells, Ang II infusion in menopausal mice increased T cell phosphorylation of MP2K2, an upstream regulator of ERK, and was associated with upregulated phosphorylation at ERK targeted sites. Additionally, Ang II infusion in menopausal mice decreased T cell phosphorylation of TLN1, a key regulator of IL-2Rα and FOXP3 expression. Conclusions These findings identify novel, distinct T cell pathways that influence T cell-mediated inflammation during postmenopausal hypertension.
The phosphate-solubilizing microorganism is essential for soil quality and plant development and can serve as an alternative to reduce such Brazilian needs for importing phosphate overseas. Here, we ...isolated and selected bacteria from Brazilian Cerrado soils capable of solubilize phosphate. We obtained 53 bacteria isolates, of which 23 could solubilize phosphate at a pH of 7.0, 17 could solubilize phosphate at a pH of 6.0, and 8 could solubilize at a pH of 5.5. Using 16S rRNA gene sequences, we identified nine bacteria species clustered in four groups:
Bacillus
sp.,
Pseudomonas
sp.,
Priestia
sp., and
Klebsiella
sp. Our results revealed that the UFT01 (
P. aeruginosa
) and UFT42 (
B. cereus
) isolates exhibited the best phosphate solubilization performance at all tested pH values. We further recorded higher levels of solubilization and phosphate availability six days after the soil inoculation with
P. aeruginosa
, and enzymatic analysis of the soil samples revealed that the
P. aeruginosa
-inoculated samples resulted in four-fold higher enzymatic activities when compared to non-inoculated soils. The
B. cereus
soil inoculation increased β-glucosidase activities and resulted in reduced the activities of arylsulfatase. Altogether, our findings demonstrated that
P. aeruginosa
and
B. cereus
isolated from Cerrado soils showed high phosphate solubilization potential.
Abstract Background Food protein‐induced enterocolitis syndrome (FPIES) is a non–IgE‐mediated food allergy. In the last few years, after the publication of the consensus guidelines, with refined ...diagnostic criteria and improved awareness, FPIES is diagnosed with increased frequency. However, despite having a background of immune dysregulation, this complication has just been described once in the posttransplant setting, in an adult patient. To the best of our knowledge, there are no reports of pediatric patients developing FPIES after a hematopoietic stem cell transplant (HCT). Methods Retrospective review of a pediatric patient who developed severe FPIEs after a HCT. Results In this case report, the clinical presentation and diagnosis challenges of a pediatric patient who developed severe FPIES after HCT are described. The patient developed severe vomiting, diarrhea, lethargy, and shock and required admission to the pediatric intensive care unit in three occasions before the diagnosis was made. Conclusions To the best of our knowledge, this is the first report of severe FPIES post‐HCT in a pediatric patient. Physicians who are looking after pediatric patients in the post‐HCT setting need to be aware of this possibility and include this entity in the differential diagnosis in order to reduce its associated morbidity.
The purpose of this prospective study was to identify factors in 66 spouses and adult child caregivers of person's with Alzheimer's disease prior to the death that predicted higher levels of grief in ...bereavement. A hierarchical regression model was tested. Predeath grief, dysfunctional coping, depression, social support, and decreased positive states of mind explained 54.7% of the variance in postdeath grief. Factors that contributed significantly to postdeath grief included predeath grief and depression. Results from this study indicate that risk factors for postdeath grief can be predicted prior to the death.
Citrullus lanatus (Thunb.) is an important crop in Brazil and affected by relevant insect vectors, including thrips (Thysanoptera: Thripidae). The present work was focused on evaluating the presence ...of Groundnut ringspot virus (GRSV) associated with Frankliniella sp. (Thysanoptera: Thripidae) in watermelon, C. lanatus , cultivated in the Brazilian Cerrado biome. Several species of thrips were collected from four commercial crops located in Gurupi, Lagoa da Confusao, Formoso do Araguaia and Porto Nacional counties, all of them belonging to the Brazilian state of Tocantins). The total viral RNA obtained from the thrips was enriched and used to perform ugh RT-PCR. Using specific primers, a 644 bp fragment of the GRSV nucleocapsid was identified in all insect samples, which allowed us to perform a phylogenetic analysis with GRSV sequences described for other geographical regions. The findings demonstrate the wide distribution of the GRSV virus in commercial watermelon crops in the Brazilian Cerrado Biome. The association with Frankliniella sp. is highlighted as one of the most relevant vector pathways in this region of high intensity and advanced agriculture. In addition, phylogenetic analysis demonstrated a close relationship between GRSV sequences from South Africa and Brazil. These findings may contribute to the understanding of GRSV distribution in watermelon crops in different localities of Brazilian Cerrado Biome.
Dimorphisms occur when alternative developmental pathways produce discrete phenotypes within a species, and may promote evolutionary novelty in morphology, life history, and behavior. Among marine ...invertebrates, intra-specific dimorphism in larval type (poecilogony) is notably rare, but should provide insight into the selective forces acting on larval strategies. Most established cases of poecilogony appear to be allelic polymorphisms, with local expression regulated by population-genetic processes. Here, we present evidence that dimorphic larval development in the sea slug Alderia willowi is a seasonal polyphenism; the type of larvae produced by an adult slug depends on the rearing environment in which that slug matured. In field surveys of 1996–1999 and 2007–2009, the population in Mission Bay, San Diego (California, USA) produced only short-lived lecithotrophic larvae in summer and early fall, but a varying proportion of slugs expressed planktotrophy in winter and spring. In laboratory experiments, slugs reared under summer conditions (high temperature, high salinity) produced the highest proportion of lecithotrophic offspring, whereas winter conditions (low temperature, low salinity) induced the lowest proportion of lecithotrophy. The shift to a nondispersive morph under summer conditions may be an adaptive response to historical closure of coastal wetlands during the dry season in southern California, which would inhibit dispersal by larvae of back-bay taxa. In most animal polyphenisms, a single larval type is produced and the rearing environment determines which adult phenotype develops. In contrast, alternative larval morphs are produced by A. willowi in response to seasonal cues experienced by the adult stage, varying the phenotype and dispersal potential of offspring. As the only known case of polyphenism in mode of larval development, A. willowi should become a model organism for mechanistic studies of dimorphism and the evolution of alternative life histories.
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