Background
Patients are increasingly taking an active role in the design and delivery of surgical research. Public communication of results should also be encouraged, but this is often limited to ...non‐expert commentary. This study assessed the role of plain English s disseminated via social media in engaging patients and clinicians in the communication of surgical research.
Methods
A three‐arm randomized controlled trial with crossover of two intervention arms was performed. Manuscripts accepted for publication in BJS were allocated to one of three arms and disseminated via Twitter: plain English s, visual s and standard tweets. The primary outcome was online engagement (a composite of tweets, replies and likes) by members of the public within 14 days. The secondary outcome was online engagement by healthcare professionals.
Results
Forty‐one manuscripts were randomized to plain English s (14), visual s (14) and standard tweets (13). The number of public engagements was low, with a mean of 1·8 (range 0–8), 2·5 (0–11), and 1·2 (0–4) for plain English s, visual s and standard tweets respectively. The mean number of engagements by healthcare professionals was 29·4 (6–66), 45·3 (6–161) and 28·8 (10–52) respectively. Overall, visual s attracted a significantly greater number of engagements than plain English ones (P < 0·001).
Conclusion
Online, public engagement with surgical research was low. Overall engagement (predominantly from healthcare professionals) was enhanced by the use of visual s.
Antecedentes
Los pacientes están tomando cada vez más un papel activo en el diseño y en la difusión de la investigación quirúrgica. También se debe fomentar la comunicación pública de los resultados, pero a menudo ésta se limita a comentarios de personas no expertas. Este estudio evaluó el papel de los resúmenes redactados en un inglés sencillo difundidos a través de las redes sociales para involucrar a pacientes y médicos en la comunicación de la investigación quirúrgica.
Métodos
Se realizó un ensayo aleatorizado y controlado de tres brazos con un diseño cruzado de los dos brazos de intervención. Los manuscritos aceptados para publicación en BJS se asignaron a tres brazos y se difundieron vía twitter: resúmenes redactados en un inglés sencillo, resúmenes visuales, y tweets estándar. El criterio de valoración principal fue la interacción online (variable compuesta de tweets, respuestas y me gusta) por parte del público durante los primeros 14 días. El criterio de valoración secundario fue la interacción online de los profesionales de la salud.
Resultados
Un total de 41 manuscritos se asignaron al azar a resúmenes redactados en un inglés sencillo (n = 14), resúmenes visuales (n = 14) y tweets estándar (n = 13). El número de interacciones por parte del público fue bajo, con una media de 1,8 (rango 0‐8), 2,5 (rango 0‐11) y 1,2 (rango 0‐4) para resúmenes en inglés sencillo, resúmenes visuales y tweets estándar, respectivamente. El número medio de interacciones por profesionales de la salud fue de 29,4 (rango 6‐66), 45,3 (6‐161) y 28,8 (10‐52). En general, los resúmenes visuales atrajeron un número significativamente mayor de interacciones que los de inglés sencillo (P = 0,001).
Conclusión
La interacción online del público con la investigación quirúrgica fue baja. La participación general (predominantemente de profesionales de la salud) mejoró mediante el uso de resúmenes visuales. Los próximos trabajos podrían considerar si el público desea interaccionar y de qué modo con resúmenes redactados en un inglés sencillo.
A randomized assessment of plain English and visual s for public dissemination of surgical research was performed via Twitter. Overall engagement (predominantly from healthcare professionals) was enhanced by the use of visual s. Public engagement was low. HCP, healthcare professional.
Public not ready
The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and ...severe exacerbations. Here we report that the microbiota's dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium + Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium + Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium's relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002).
Biofluorescence occurs when a living organism absorbs high energy light and reemits it at longer wavelengths. Many species within clades of vertebrates are known to fluoresce including mammals, ...reptiles, birds, and fish. Most, if not all, amphibians exhibit biofluorescence when exposed to either blue (440-460 nm) or ultra-violet (360-380 nm) wavelengths of light. Salamanders (Lissamphibia: Caudata) appear to consistently fluoresce in green wavelengths (520-560 nm) when excited by blue light. Biofluorescence is theorized to have many ecological functions including mate signaling, camouflage, and mimicry. Despite the discovery of their biofluorescence, its role in salamander ecology and behavior remains unresolved. In this study we present the first case of biofluorescent sexual dimorphism within Amphibia and the first documentation of the biofluorescent pattern of a salamander within the Plethodon jordani species complex. This sexually dimorphic trait was discovered in the southern Appalachian endemic species, Southern Gray-Cheeked Salamander (Plethodon metcalfi, Brimley in Proc Biol Soc Wash 25:135-140, 1912), and may extend into other species within the Plethodon jordani and Plethodon glutinosus species complexes. We propose that this sexually dimorphic trait could be related to fluorescence of ventral modified granular glands used in plethodontid chemosensory communication.
The prehistoric colonization of islands in Remote Oceania that began ∼3400 B.P. represents what was arguably the most expansive and ambitious maritime dispersal of humans across any of the world’s ...seas or oceans. Though archaeological evidence has provided a relatively clear picture of when many of the major island groups were colonized, there is still considerable debate as to where these settlers originated from and their strategies/trajectories used to reach habitable land that other datasets (genetic, linguistic) are also still trying to resolve. To address these issues, we have harnessed the power of high-resolution climatic and oceanographic datasets in multiple seafaring simulation platforms to examine major pulses of colonization in the region. Our analysis, which takes into consideration currents, land distribution, wind periodicity, the influence of El Niño Southern Oscillation (ENSO) events, and “shortest-hop” trajectories, demonstrate that (i) seasonal and semiannual climatic changes were highly influential in structuring ancient Pacific voyaging; (ii) western Micronesia was likely settled from somewhere around the Maluku (Molucca) Islands; (iii) Samoa was the most probable staging area for the colonization of East Polynesia; and (iv) although there are major differences in success rates depending on time of year and the occurrence of ENSO events, settlement of Hawai’i and New Zealand is possible from the Marquesas or Society Islands, the same being the case for settlement of Easter Island from Mangareva or the Marquesas.
Severe asthma in children is a complicated and heterogeneous disorder that is extremely challenging to treat. Although most children with asthma derive clinical benefit from daily administration of ...low-to-medium-dose inhaled corticosteroid (ICS) therapy, a small subset of children with "severe" or "refractory" asthma require high doses of ICS and even systemic corticosteroids to maintain symptom control. These children with severe asthma are at increased risk for adverse outcomes including medication-related side effects and recurrent and life-threatening exacerbations that significantly impair quality of life. This review highlights findings on severe asthma in school-age children (age 6-17 years) from the National Heart, Lung and Blood Institute's Severe Asthma Research Program (SARP) over a 10-year period, between 2001 and 2011. Although SARP has advanced knowledge of the unique clinical, biological, and molecular attributes of severe asthma in children, considerable gaps remain for which additional studies are needed.
Leptin inhibits synthesis of hypothalamic NPY and downregulation of NPY is associated with appetite suppression, increased sympathetic nervous system outflow, and increased energy expenditure. 12 ...Increasing leptin levels activate the thyroid hormone, gonadal, and growth hormone axes and suppress the pituitary-adrenal axis. 13 It must be emphasised that human obesity is a complex disorder, probably resulting from both multigenetic and environmental predispositions, and that leptin deficiency is a very rare cause of human obesity. 14 Indeed, circulating leptin levels are typically higher than normal in human obesity, indicating that it is a leptin resistant state. 15 Even within the hypothalamus the NPY axis is clearly not a final common pathway for appetite control as the appetite stimulating orexins can induce feeding despite blockade of the NPY axis. 16 REGULATION OF LEPTIN PRODUCTION Leptin production is regulated by several factors. 17, 18 Insulin and glucocorticoids act directly on adipocytes to increase leptin production, and chronic hyperinsulinaemia and increased cortisol turnover may underlie the increase in leptin expression observed in obesity.
The fractional exhaled nitric oxide (FE
) test is a point-of-care test that is used in the assessment of asthma.
To provide evidence-based clinical guidance on whether FE
testing is indicated to ...optimize asthma treatment in patients with asthma in whom treatment is being considered.
An international, multidisciplinary panel of experts was convened to form a consensus document regarding a single question relevant to the use of FE
. The question was selected from three potential questions based on the greatest perceived impact on clinical practice and the unmet need for evidence-based answers related to this question. The panel performed systematic reviews of published randomized controlled trials between 2004 and 2019 and followed the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) evidence-to-decision framework to develop recommendations. All panel members evaluated and approved the recommendations.
After considering the overall low quality of the evidence, the panel made a conditional recommendation for FE
-based care. In patients with asthma in whom treatment is being considered, we suggest that FE
is beneficial and should be used in addition to usual care. This judgment is based on a balance of effects that probably favors the intervention; the moderate costs and availability of resources, which probably favors the intervention; and the perceived acceptability and feasibility of the intervention in daily practice.
Clinicians should consider this recommendation to measure FE
in patients with asthma in whom treatment is being considered based on current best available evidence.
The potential of induced pluripotent stem cells (iPSCs) in disease modeling and regenerative medicine is vast, but current methodologies remain inefficient. Understanding the cellular mechanisms ...underlying iPSC reprogramming, such as the metabolic shift from oxidative to glycolytic energy production, is key to improving its efficiency. We have developed a lentiviral reporter system to assay longitudinal changes in cell signaling and transcription factor activity in living cells throughout iPSC reprogramming of human dermal fibroblasts. We reveal early NF-κB, AP-1, and NRF2 transcription factor activation prior to a temporal peak in hypoxia inducible factor α (HIFα) activity. Mechanistically, we show that an early burst in oxidative phosphorylation and elevated reactive oxygen species generation mediates increased NRF2 activity, which in turn initiates the HIFα-mediated glycolytic shift and may modulate glucose redistribution to the pentose phosphate pathway. Critically, inhibition of NRF2 by KEAP1 overexpression compromises metabolic reprogramming and results in reduced efficiency of iPSC colony formation.
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•Cells increase proliferation, OXPHOS, and ROS production early in reprogramming•The antioxidant response is therefore active at this stage, prior to HIFα activation•NRF2 promotes HIFα activation, the metabolic switch, and colony formation•NRF2 activation is concomitant with glucose redistribution to the PPP
Hawkins et al. examine the metabolic shift during iPSC reprogramming. They propose that increased proliferation of cells driven by transgene expression can lead to increased oxidative phosphorylation resulting in ROS production. Elevated ROS activates NRF2, promoting HIFα activation and the switch to glycolysis.
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