Inhibition of C5AR1 impairs osteoclast mobilization and prevents bone loss.

Age-related and chemotherapy-induced bone loss depends on cellular senescence and the cell secretory phenotype. However, the factors secreted in the senescent microenvironment that contribute to bone loss remain elusive. Here, we report a central role for the inflammatory alternative complement system in skeletal bone loss. Through transcriptomic analysis of bone samples, we identified complement factor D, a rate-limiting factor of the alternative pathway of complement, which is among the most responsive factors to chemotherapy or estrogen deficiency. We show that osteoblasts and osteocytes are major inducers of complement activation, while monocytes and osteoclasts are their primary targets. Genetic deletion of C5ar1, the receptor of the anaphylatoxin C5a, or treatment with a C5AR1 inhibitor reduced monocyte chemotaxis and osteoclast differentiation. Moreover, genetic deficiency or inhibition of C5AR1 partially prevented bone loss and osteoclastogenesis upon chemotherapy or ovariectomy. Altogether, these lines of evidence support the idea that inhibition of alternative complement pathways may have some therapeutic benefit in osteopenic disorders.

Back to Clinical Training during the COVID-19 Pandemic: Perspective of Nursing Students.

INTRODUCTION: The COVID-19 pandemic has affected many areas of life, including the formation of nursing students. After the COVID-19 crisis, learning during clinical training created different challenges. Nursing schools are responsible for ensuring that structures are in place to facilitate coping in the changed clinical setting. This study aimed to analyze nursing students' perceptions during clinical training while caring for COVID-19 patients. MATERIAL AND METHODS: A qualitative phenomenological study that explored nursing students' perceptions of learning in clinical settings with COVID-19 patients was performed. A total of 15 semi-structured face-to-face interviews were conducted with nursing students who carried out their clinical practices in COVID-19 units during February and April 2022. RESULTS: Through content analysis, categorization, and the method of comparison constant, four categories emerged: feelings, challenges, coping methods, and clinical practices. The students had to learn to "work" with fear and uncertainty and self-manage the emotional burden using different coping techniques to deal with learning during their practices. Interacting with professors and clinical tutors during the clinical practice were positive experiences. CONCLUSIONS: This study constituted an opportunity to build new and adapted educational approaches for teachers to train nursing students to deal with their emotions and thoughts in future pandemic situations.

Challenge, fear and pride: nursing students working as nurses in COVID-19 care units.

CONTEXT AND PURPOSE: During the crisis caused by the COVID-19 pandemic in Spain, students in the year of undergraduate degree were hired to provide care assistance support in hospitals. The purpose of the study is to explore their experiences of their premature professional incorporation into patient care in a pandemic situation. METHODS: A descriptive phenomenology research study was conducted. Data were collected in two phases: 1) Two focus groups and 2) Ten in-depth individual semi-structured interviews between July and August 2021. RESULTS: Twenty-two Nursing students from a Madrid University School of Nursing participated. All worked in COVID hospitalization units, 6 in intensive care units. Four main categories were identified. Student-professional nurse transition, Learning, Hospital integration and Emotions. CONCLUSION: Despite all the fears and negative emotions, the nursing students do not regret the decision to accept a contract to work as a healthcare professional in the COVID-19 pandemic. They feel that the pandemic has allowed them to see life from another perspective and with other priorities, strengthening their vocation to nursing.