Early predictors of intestinal complications in pediatric-onset Crohn's disease: A long-term cohort study in Taiwan.

PURPOSE: Identifying reliable prognostic factors for pediatric-onset Crohn's disease (CD) is important for guiding early treatment. This study aimed to evaluate the validity of various clinical parameters for predicting long-term intestinal complications in pediatric-onset CD patients with CD in Taiwan. METHODS: This was a single-center, retrospective study. Patients diagnosed with CD under 18 years of age at our hospital between January 1999 and December 2021 were enrolled. The baseline clinical variables and the Pediatric Crohn's Disease Activity Index (PCDAI) were obtained. Patients were categorized into low-, medium-, or high-risk groups based on the 2020 European Crohn's and Colitis Organization and European Society for Pediatric Gastroenterology Hepatology and Nutrition (ECCO-ESPGHAN) guidelines. The primary endpoint was the occurrence of new intestinal complications. RESULTS: Among 53 enrolled patients (33 males and 20 females), 8 patients (33.96%) developed intestinal complications during the follow-up period (median 6.42 years, 3.17-9.75 years). Patients in the initial ECCO-ESPGHAN medium- or high-risk group had a 4.71-fold higher risk of intestinal complications than those in the low-risk group [hazard ratio = 4.71, p = 0.023] after adjusting for PCDAI in the multivariate Cox proportional hazard analysis. The other clinical variables did not reach statistical significance in predicting intestinal complications. The positive and negative predictive values of the ECCO-ESPGHAN stratification method for intestinal complications were 48.15% and 80.77%, respectively. CONCLUSIONS: ECCO-ESPGHAN risk stratification is an effective early predictor of long-term intestinal complications in the Taiwanese population and may be used in clinical practice to guide early advanced therapy.

Inactivity May Identify Older Intensive Care Unit Survivors at Risk for Post-Intensive Care Syndrome.

BACKGROUND: Older adults (≥age 65) admitted to an intensive care unit (ICU) are profoundly inactive during hospitalization. Older ICU survivors often experience life-changing symptoms, including cognitive dysfunction, physical impairment, and/or psychological distress, which are components of post-intensive care syndrome (PICS). OBJECTIVES: To explore trends between inactivity and symptoms of PICS in older ICU survivors. METHODS: This study was a secondary analysis of pooled data obtained from 2 primary, prospective, cross-sectional studies of older ICU survivors. After ICU discharge, 49 English- and Spanish-speaking participants who were functionally independent before admission and who had received mechanical ventilation while in the ICU were enrolled. Actigraphy was used to measure post-ICU hourly activity counts (12:00 AM to 11:59 PM). Selected instruments from the National Institutes of Health Toolbox and Patient-Reported Outcomes Measurement Information System were used to assess symptoms of PICS: cognitive dysfunction, physical impairment, and psychological distress. RESULTS: Graphs illustrated trends between inactivity and greater symptom severity of PICS: participants who were less active tended to score worse than one standard deviation of the mean on each outcome. Greater daytime activity was concurrently observed with higher performances on cognitive and physical assessments and better scores on psychological measures. CONCLUSIONS: Post-ICU inactivity may identify older ICU survivors who may be at risk for PICS and may guide future research interventions to mitigate symptom burden.

Efficacy of Amplification for Tinnitus Relief in People With Mild Hearing Loss.

PURPOSE: The study aimed to evaluate the efficacy of amplification with hearing aids for people with chronic subjective tinnitus and mild hearing loss. METHOD: In this randomized, controlled, three-arm trial, 38 subjects with a primary complaint of tinnitus were randomly assigned to one of the three treatment groups. Twelve subjects received informational counselling (IC) only, 13 received IC with hearing aid fitting, and 13 subjects received IC with individualized music stimulation for 12 months. The primary efficacy analysis in tinnitus severity was based on the change from baseline to 12 months after the 1st day of the intervention. Secondary outcome measures included tinnitus impact, psychological and mental health effects, subjective ratings, and psychoacoustically measured tinnitus loudness. RESULTS: A statistically significant treatment difference among the three groups in the Chinese Tinnitus Functional Index (TFI-CH) total score at the predefined end point in Month 12 was observed (F = 3.34, p = .04, partial η2 = .16). Reductions in the TFI-CH scores in both the hearing aid and the customized music group were more prominent than in the IC-only group. Only the hearing aid group showed a significantly greater treatment effect than the IC-only group. CONCLUSION: Results from this study support that a combination of hearing aid use and IC can help improve tinnitus in people with mild hearing loss. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25015979.

Fatigue, Toll-Like Receptor 4, and Pro-Inflammatory Cytokines in Adults With Subarachnoid Hemorrhage: A 6-Month Longitudinal Study.

BACKGROUND: Fatigue is prevalent in subarachnoid hemorrhage (SAH) survivors. Biological mechanisms underlying fatigue post-SAH are not clear. Inflammation may contribute to the development of fatigue. This study aimed to examine the associations between inflammatory markers and fatigue during the first 6 months post-SAH. Specific biomarkers examined included both early and concurrent expression of Toll-Like Receptor 4 (TLR4) messenger RNA (mRNA) and plasma concentrations of pro-inflammatory cytokines, Tumor Necrosis Factor-alpha (TNF-α), Interleukin (IL)1ß, and IL6. METHODS: We conducted a 6-month longitudinal study with a convenience sample of 43 SAH survivors. We collected blood samples on days 2, 3, and 7 and 2, 3, and 6 months post-SAH to assess biomarkers. Fatigue was assessed by the PROMIS Fatigue Scale at 2, 3, and 6 months. Linear mixed models were used to test the associations between early (days 2, 3, and 7) and concurrent (2, 3, and 6 months) TLR4 mRNA expression (TagMan gene expression assays) and TNF-α, IL1ß, and IL6 plasma concentrations (multiplex assays) and concurrent fatigue. RESULTS: 28% of SAH survivors experienced fatigue during the first 6 months post-SAH. Fatigue levels in SAH survivors were higher than those of the U.S. population and consistent during the 6 months. Experience of fatigue during the 6 months post-SAH was associated with higher IL1ß plasma concentrations on day 7 and IL1ß, IL6, and TNF-α plasma concentrations during the 6 months post-SAH. CONCLUSION: Inflammation appears to underlie the development of fatigue in SAH survivors.

A sustainable layered nanofiber/sheet aerogels enabling repeated life cycles for effective oil/water separation.

Discarded oil-containing absorbents, which has been used in handling oil spills, are tricky to deal with and have rose global environmental concerns regarding release of microplastics. Herein, we developed a facile strategy to fabricate sustainable absorbents by a gas-inflating method, through which 2D electrospinning polycaprolactone nanofiber membranes were directly inflated into highly porous 3D nanofiber/sheet aerogels with layered long fiber structure. The membranes were inflated rapidly from a baseline porosity of 81.98% into 97.36-99.42% in 10-60 min. The obtained aerogels were further wrapped with -CH3 ended siloxane structures using CH3SiCl3. This hydrophobic absorbent (CA ≈ 145°) could rapidly trap oils from water with sorption range of 25.60-42.13 g/g and be recycled by simple squeeze due to its mechanical robustness. As-prepared aerogels also showed high separation efficiency to separate oils from both oil/water mixtures and oil-in-water emulsions (>96.4%). Interestingly, the oil-loaded absorbent after cleaning with absolute ethanol could be re-dissolved in selected solvents and promptly reconstituted by re-electrospinning and gas-inflation. The reconstituted aerogels were used as fire-new oil absorbents for repeated life cycles. The novel design, low cost and sustainability of the absorbent provides an efficient and environmentally-friendly solution for handling oil spills.

Biomass Chitosan-Based Tubular/Sheet Superhydrophobic Aerogels Enable Efficient Oil/Water Separation.

Water pollution, which is caused by leakage of oily substances, has been recognized as one of the most serious global environmental pollutions endangering the ecosystem. High-quality porous materials with superwettability, which are typically constructed in the form of aerogels, hold huge potential in the field of adsorption and removal of oily substances form water. Herein, we developed a facile strategy to fabricate a novel biomass absorbent with a layered tubular/sheet structure for efficient oil/water separation. The aerogels were fabricated by assembling hollow poplar catkin fiber into chitosan sheets using a directional freeze-drying method. The obtained aerogels were further wrapped with -CH3-ended siloxane structures using CH3SiCl3. This superhydrophobic aerogel (CA ≈ 154 ± 0.4°) could rapidly trap and remove oils from water with a large sorption range of 33.06-73.22 g/g. The aerogel facilitated stable oil recovery (90.07-92.34%) by squeezing after 10 sorption-desorption cycles because of its mechanical robustness (91.76% strain remaining after 50 compress-release cycles). The novel design, low cost, and sustainability of the aerogel provide an efficient and environmentally friendly solution for handling oil spills.

Circulating Tumor Cell Enumeration for Serial Monitoring of Treatment Outcomes for Locally Advanced Esophageal Squamous Cell Carcinoma.

We aim to reveal the clinical significance and potential usefulness of dynamic monitoring of CTCs to track therapeutic responses and improve survival for advanced ESCC patients. Peripheral blood (PB) (n = 389) and azygos vein blood (AVB) (n = 13) samplings were recruited prospectively from 88 ESCC patients undergoing curative surgery from 2017 to 2022. Longitudinal CTC enumeration was performed with epithelial (EpCAM/pan-cytokeratins/MUC1) and mesenchymal (vimentin) markers at 12 serial timepoints at any of the pre-treatment, all of the post-treatments/pre-surgery, post-surgery follow-ups for 3-year, and relapse. Longitudinal real-time CTC analysis in PB and AVB suggests more CTCs are released early at pre-surgery and 3-month post-surgery into the circulation from the CTRT group compared to the up-front surgery group. High CTC levels at pre-treatments, 1-/3-month post-surgery, unfavorable changes of CTC levels between all post-treatment/pre-surgery and 1-month or 3-month post-surgery (Hazard Ratio (HR) = 6.662, p < 0.001), were independent prognosticators for curative treatment. The unfavorable pre-surgery CTC status was independent prognostic and predictive for neoadjuvant treatment efficacy (HR = 3.652, p = 0.035). The aggressive CTC clusters were more frequently observed in AVB compared to PB. Its role as an independent prognosticator with relapse was first reported in ESCC (HR = 2.539, p = 0.068). CTC clusters and longitudinal CTC monitoring provide useful prognostic information and potential predictive biomarkers to help guide clinicians in improving disease management.

Systematic review: Individual-level factors and social determinants of health impacting sleep health in individuals with inflammatory bowel disease.

AIM: To examine the individual-level factors and social determinants of health (SDOH) linked to sleep health among individuals with inflammatory bowel disease (IBD). DESIGN: Systematic review without meta-analysis. DATA SOURCES: Four databases (PubMed, Web of Science, CINAHL and PsycINFO) were searched in February 2022. REVIEW METHODS: Databases were searched with keywords related to IBD and sleep. The review was conducted per the PRISMA protocol. The checklist for analytical cross-sectional studies published by the Joanna Briggs Institute was used for quality appraisal. Factors were organized by individual, social and societal levels according to the social-ecological model of sleep health. RESULTS: In the review, 45 studies were identified and synthesized. All studies examined individual-level factors with sleep, with age being the most common factor studied. Only nine studies considered a social determinant of health which included marital status, number of children, education level, annual income, employment status, work tenure, type of employment, area of residence, minority status/ethnicity and COVID-19. However, the source of information for the social determinant of health was not clearly defined for more than half of these studies. CONCLUSION: Although IBD sleep research has explored individual-level factors (i.e. age) that impact sleep health, there is a lack of information on the SDOH that can contribute to sleep health. IMPACT: This review provides insight into the different factors that have been examined in IBD sleep research. By determining the SDOH that impact sleep, nursing research can inform sustainable and tailored interventions that focus on changing behaviour and improving sleep of individuals of varying backgrounds and life experiences. There is a continued need for nurses in practice and research to explore the SDOH that influence health outcomes and the daily lives of those with IBD.

Cytosolic galectin-4 enchains bacteria, restricts their motility, and promotes inflammasome activation in intestinal epithelial cells.

Galectin-4, a member of the galectin family of animal glycan-binding proteins (GBPs), is specifically expressed in gastrointestinal epithelial cells and is known to be able to bind microbes. However, its function in host-gut microbe interactions remains unknown. Here, we show that intracellular galectin-4 in intestinal epithelial cells (IECs) coats cytosolic Salmonella enterica serovar Worthington and induces the formation of bacterial chains and aggregates. Galectin-4 enchains bacteria during their growth by binding to the O-antigen of lipopolysaccharides. Furthermore, the binding of galectin-4 to bacterial surfaces restricts intracellular bacterial motility. Galectin-4 enhances caspase-1 activation and mature IL-18 production in infected IECs especially when autophagy is inhibited. Finally, orally administered S. enterica serovar Worthington, which is recognized by human galectin-4 but not mouse galectin-4, translocated from the intestines to mesenteric lymph nodes less effectively in human galectin-4-transgenic mice than in littermate controls. Our results suggest that galectin-4 plays an important role in host-gut microbe interactions and prevents the dissemination of pathogens. The results of the study revealed a novel mechanism of host-microbe interactions that involves the direct binding of cytosolic lectins to glycans on intracellular microbes.

Photothermal and Concus Finn capillary assisted superhydrophobic fibrous network enabling instant viscous oil transport for crude oil cleanup.

Rapid and effective removal of highly viscous oil spills from the sea remains a great challenge globally. Superhydrophobic materials are attractive candidates for handling oil spills, but they are restrained to recover oils with low viscosity exclusively. Herein, we report a novel polypyrrole wrapped superhydrophobic fibrous network using cross-shaped polyester fibers as starting blocks. The polypyrrole coating enables the absorbent to convert light to heat, ensuring that the viscosity of heavy oils in the proximity can be easily controlled. In the meanwhile, the special structure of the starting fibers initiates Concus Finn (CFin) capillary allowing instant oil transport in the network. When the absorbent is exposed to light oils (0-500 mPa.s), the oils can be transported instantly via CFin capillary. Interestingly, under synergistic effect of light-to-heat conversion and CFin capillary, a drawing-sticking crude oil strip (105 mPa.s) is sucked instantly against gravity by the absorbent. The absorbent is successfully applied to efficiently separate both oil/water mixtures and oil/water emulsions (efficiency > 99%). Such absorbent can absorb 62.99-74.23 g/g light oils on average and up to 123.3 g/g crude oil under 0-2 sun illumination, holding a huge potential in managing oil spills.

Amis Pacilo and Yami Cipoho are not the same as the Pacific breadfruit starch crop-Target enrichment phylogenomics of a long-misidentified Artocarpus species sheds light on the northward Austronesian migration from the Philippines to Taiwan.

'Breadfruit' is a common tree species in Taiwan. In the indigenous Austronesian Amis culture of eastern Taiwan, 'breadfruit' is known as Pacilo, and its fruits are consumed as food. On Lanyu (Botel Tobago) where the indigenous Yami people live, 'breadfruit' is called Cipoho and used for constructing houses and plank-boats. Elsewhere in Taiwan, 'breadfruit' is also a common ornamental tree. As an essential component of traditional Yami culture, Cipoho has long been assumed to have been transported from the Batanes Island of the Philippines to Lanyu. As such, it represents a commensal species that potentially can be used to test the hypothesis of the northward Austronesian migration 'into' Taiwan. However, recent phylogenomic studies using target enrichment show that Taiwanese 'breadfruit' might not be the same as the Pacific breadfruit (Artocarpus altilis), which was domesticated in Oceania and widely cultivated throughout the tropics. To resolve persistent misidentification of this culturally and economically important tree species of Taiwan, we sampled 36 trees of Taiwanese Artocarpus and used the Moraceae probe set to enrich 529 nuclear genes. Along with 28 archived Artocarpus sequence datasets (representing a dozen taxa from all subgenera), phylogenomic analyses showed that all Taiwanese 'breadfruit' samples, together with a cultivated ornamental tree from Hawaii, form a fully supported clade within the A. treculianus complex, which is composed only of endemic Philippine species. Morphologically, the Taiwanese 'breadfruit' matches the characters of A. treculianus. Within the Taiwanese samples of A. treculianus, Amis samples form a fully supported clade derived from within the paraphyletic grade composed of Yami samples, suggesting a Lanyu origin. Results of our target enrichment phylogenomics are consistent with the scenario that Cipoho was transported northward from the Philippines to Lanyu by Yami ancestors, though the possibility that A. treculianus is native to Lanyu cannot be ruled out completely.

Biomimetic Fibrous Leaf-Vein Membrane Enabling Unidirectional Water Penetration and Effective Antibacterial PM Filtration.

Air pollution induced by pathogenic particulate matter (PM) has posed a serious threat to public health worldwide. Advanced air filters are thus required, not only exhibiting high PM capture efficiency, low breathing resistance, and high internal moisture transferring performance but also isolating and inactivating external pathogenic aerosols. In this study, we demonstrated a facile approach to construct a biomimetic fibrous leaf-vein membrane with unidirectional water penetration and effective antibacterial PM filtration by one-step electrospinning of poly(vinylidene fluoride) (PVDF)-based multilayer nanofibers. With ultrathin fibers penetrating the skeletal framework of bimodal thick fibers, the membranes showed gradient interconnected porous structures and achieved a highly efficient and stable (in an acid and alkali environment) PM0.3 interception (>99.98%) with low air drag (51-71 Pa). In addition, the gradient narrow pores of the membranes contributed to a gradient higher hydrophilicity. The subsequent unidirectional water motion effectively isolates pathogenic aerosols typically generated by external individuals or ultrafast water penetration from the inverse face. Moreover, the membranes demonstrated an antibacterial efficacy (>99.99%) in a 5 min contact, inactivating the intercepted airborne pathogens efficiently. The test results proved that the proposed membranes were promising advanced air filters for respirator applications.

Analytical sensitivity of the Rapid Antigen Test kits for detection of SARS-CoV-2 Omicron variant BA.2 sublineage.

The severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) Omicron was classified as a variant of concern in November 2021. The sublineage BA.2 spreads rapidly worldwide. Currently, there is a lack of data for the parallel comparison of Rapid Antigen Test (RAT) Kits to detect SARS-CoV-2 Omicron BA.2. We evaluated the analytical sensitivity of 12 RAT kits to detect Omicron BA.2 in the present study. Analytical sensitivity was determined by means of the limit of detection (LOD). We prepared a dilution set using a respiratory specimen collected from a COVID-19 patient infected by Omicron BA.2. The reverse transcription-polymerase chain reaction was used as a reference method. The LOD results showed that all 12 RAT kits had comparable analytical sensitivity to detect Omicron BA.2. The RAT kits selected in the current study may be used for the first-line screening of the rapid spreading Omicron BA.2.

Evaluation of rapid antigen detection kits for detection of SARS-CoV-2 B.1.617.2 virus.

Aim: Currently, there is lack of data regarding rapid antigen detection (RAD) kits to detect SARS-CoV-2 B.1.617.2 virus. Objective: The purpose of this evaluation is to assess analytical sensitivity of 12 RAD kits against SARS-CoV-2 B.1.617.2. Study design: Analytical sensitivity was determined by limit of detection (LOD). A serial tenfold dilution set from a respiratory specimen collected from a COVID-19 patient infected by SARS-CoV-2 B.1.617.2 was used. RT-PCR was used as a reference method. Results: The LOD results showed that 11 and one RAD kits were 100- and 1000-fold less sensitive than RT-PCR respectively. Conclusion: The results showed that the RAD kits evaluated in this study may be used for first-line screening of the SARS-CoV-2 B.1.617.2 variant.

Biomass poplar catkin fiber-based superhydrophobic aerogel with tubular-lamellar interweaved neurons-like structure.

Superhydrophobic aerogels are attractive candidates in controlling oil spills. The major challenges for existing aerogels are the construction of mechanical endurance as well as accessible of building materials. Herein, a newfangled biomass superhydrophobic aerogel (M-PCF/CS) with both superior compressibility and oil caption speed is fabricated by assembling poplar catkin fiber (PCF) hollowed-out shell of 330 nm and chitosan (CS) into tubular-lamellar interweaved neurons-like structure. The resultant aerogels (porosity ~ 96.12%), with flexuous PCF as the elastic buffer and second-pore capillaries, exhibit large longitudinal and transverse compressibility, endurable fatigue tolerance, fast oil sorption rate with a capacity of 28.8-78.1 g/g at 5-25 s. In parallel, the aerogels are tolerant of NaCl, UV radiation, and organic solvents without superhydrophobic variation and a case of oil spill remediation via pump-supported experiment shows that the aerogels facilely achieve continuous oil recycling from seawater by 23052-43956 L·m-2·h-1. Furthermore, the resultant M-PCF/CS, with assistance of an oscillator, can be applied to separate oil/water emulsions with efficiency of 98.07-99.11%. The successful fabrication of this material provides a new design strategy for the construction of mechanically robust aerogels for speedy and economical cleanup of oil pollutants from water.

Hope in the context of chronic musculoskeletal pain: relationships of hope to pain and psychological distress.

INTRODUCTION: The cognitive model of hope suggests that people with high levels of hope are able to think about the ways to goals (pathways) and motivated to pursue those pathways to reach their goals (agency). We hypothesized that higher levels of hope would be related to lower levels of pain and less psychological distress (ie, anxiety and depression) and better adjustment. OBJECTIVES: This study aims to examine the relationship, if any, between cognition of hope and chronic musculoskeletal pain. METHODS: One hundred and six patients with chronic musculoskeletal pain were recruited by convenient sampling from 2 public hospitals in Hong Kong. We assessed the hope level, psychological distress, and health outcomes by psychometric inventories. RESULTS: Zero-order correlation results showed that hope was inversely associated with psychological distress (ie, anxiety and depression) and positively related to subjective self-efficacy. There was no significant relationship with severity of pain. Patients presented with longer duration of chronic musculoskeletal pain have higher hope level while pain developed after injury on duty have lower hope level. CONCLUSION: The findings of this cross-sectional study highlight the potential importance of hope in understanding adjustment to chronic musculoskeletal pain. Future longitudinal research could help reveal how hope and adjustment interact over the treatment of chronic pain cases.

Galectin-3 promotes noncanonical inflammasome activation through intracellular binding to lipopolysaccharide glycans.

Cytosolic lipopolysaccharides (LPSs) bind directly to caspase-4/5/11 through their lipid A moiety, inducing inflammatory caspase oligomerization and activation, which is identified as the noncanonical inflammasome pathway. Galectins, ß-galactoside-binding proteins, bind to various gram-negative bacterial LPS, which display ß-galactoside-containing polysaccharide chains. Galectins are mainly present intracellularly, but their interactions with cytosolic microbial glycans have not been investigated. We report that in cell-free systems, galectin-3 augments the LPS-induced assembly of caspase-4/11 oligomers, leading to increased caspase-4/11 activation. Its carboxyl-terminal carbohydrate-recognition domain is essential for this effect, and its N-terminal domain, which contributes to the self-association property of the protein, is also critical, suggesting that this promoting effect is dependent on the functional multivalency of galectin-3. Moreover, galectin-3 enhances intracellular LPS-induced caspase-4/11 oligomerization and activation, as well as gasdermin D cleavage in human embryonic kidney (HEK) 293T cells, and it additionally promotes interleukin-1ß production and pyroptotic death in macrophages. Galectin-3 also promotes caspase-11 activation and gasdermin D cleavage in macrophages treated with outer membrane vesicles, which are known to be taken up by cells and release LPSs into the cytosol. Coimmunoprecipitation confirmed that galectin-3 associates with caspase-11 after intracellular delivery of LPSs. Immunofluorescence staining revealed colocalization of LPSs, galectin-3, and caspase-11 independent of host N-glycans. Thus, we conclude that galectin-3 amplifies caspase-4/11 oligomerization and activation through LPS glycan binding, resulting in more intense pyroptosis-a critical mechanism of host resistance against bacterial infection that may provide opportunities for new therapeutic interventions.

Healthcare Professional Experiences of Clinical Incident in Hong Kong: A Qualitative Study.

BACKGROUND: Studies showed that adverse events within health care settings can lead to two victims. The first victim is the patient and family and the second victim is the involved healthcare professionals. However, there is a lack of research studying the experiences of healthcare professionals encountering clinical incidents in Hong Kong. This paper reports a qualitative study in exploring the healthcare professional experiences of clinical incident, their impacts and needs. METHODS: This study is the second part of the mixed research method with two studies conducted in a cluster of hospitals in Hong Kong. Study 1 was a quantitative questionnaire survey and Study 2 was a qualitative In-Depth Interview. In study 2, a semi-interview guide was used. RESULTS: Results showed that symptoms experienced after the clinical incident were mostly from psychological, physical, then social and lastly spiritual aspects which were consistent with those found in study 1 and other studies. Using content analysis for analyzing the impacts, four themes were identified. Concerning the impacts immediately from the clinical incident, two themes emerged were 1) facing emotion distress and 2) maintaining rationality. Regarding the impacts after the clinical incident, another two themes were 3) managing further emotional distress 4) restoring personal wellness. With regard to the needs after clinical incidents, three themes emerged were 1) self-recovery; 2) senior good mentoring and 3) positive organization climate with emphasis on enhancement of training and development of a positive practice culture. CONCLUSION: Great impacts are found with healthcare professionals encountering clinical incidents from a holistic perspective. They need time for self-recovery with support from good supervisors, peers and a caring environment. Some recommendations based on the findings of the study are made.

Galectin-8 Is Upregulated in Keratinocytes by IL-17A and Promotes Proliferation by Regulating Mitosis in Psoriasis.

Psoriasis is a chronic inflammatory skin disease that develops under the influence of the IL-23/T helper 17 cell axis and is characterized by intense inflammation and prominent epidermal hyperplasia. In this study, we demonstrate that galectin-8, a ß-galactoside‒binding lectin, is upregulated in the epidermis of human psoriatic skin lesions as well as in a mouse model of psoriasis induced by intradermal IL-23 injections and in IL-17A‒treated keratinocytes. We show that keratinocyte proliferation is less prominent in galectin-8‒knockout mice after intradermal IL-23 treatment than in wild-type mice. In addition, we show that galectin-8 levels in keratinocytes are positively correlated with the ability of the cells to proliferate and that transitioning from mitosis into G1 phase is delayed in galectin-8‒knockout HaCaT cells after cell-cycle synchronization and release. We demonstrate by immunofluorescence staining and immunoblotting the presence of galectin-8 within the mitotic apparatus. We reveal by coimmunoprecipitation and mass spectrometry analysis that α-tubulin interacts with galectin-8 during mitosis. Finally, we show that in the absence of galectin-8, pericentrin compactness is lessened and mitotic microtubule length is shortened, as demonstrated by immunofluorescence staining. We conclude that galectin-8 is upregulated in psoriasis and contributes to the hyperproliferation of keratinocytes by maintaining centrosome integrity during mitosis through interacting with α-tubulin.

The complete plastid genome and phylogenetic analysis of Gracilaria chilensis.

Gracilaria chilensis is an economically important species of macroalgae. The plastid genome sequence of G. chilensis is 185,640 bp with a GC content of 29.34%. A total of 236 genes were determined, containing 203 protein-encoding genes, three rRNA genes, 30 tRNA genes, and one intron (with intronic ORF) inserted into the trnM gene. The gene content and structure of Gracilariaceae species were relatively well conserved. The phylogenetic analysis, based on the red algal plastid genomes, suggested that G. chilensis had a closer relationship with Gracilaria tenuistipitata var. liui in Gracilaria.