[The association of job satisfaction with self-reported burnout among urologists with migration background working at German hospitals : Results of the EUTAKD study]. / Die Assoziation von beruflicher Zufriedenheit mit selbstberichtetem Burnout bei Urologen und Urologinnen mit Migrationshintergrund tätig an deutschen Kliniken : Ergebnisse der EUTAKD-Studie.

INTRODUCTION: Urologists with a migration background currently provide patient care in German hospitals. Study results on job satisfaction and burnout of this important professional group have not been available so far. MATERIALS AND METHODS: Between August and October 2020, a questionnaire (SurveyMonkey® with 101 items) was conducted among urologists with migration background working in German hospitals regarding professional satisfaction and a validated survey of burnout (Maslach Burnout Inventory), among others. The subject of this work was the association of job satisfaction with the critical thresholds of burnout in the domains of emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). RESULTS: For this work, 68 questionnaires could be completely analyzed. Study participants were dominantly male (90%), between 30 and 39 years of age (69%), married (72%), and working full-time (94%). Above critical thresholds of high burnout in the EE, DP, and PA domains were 27.9% (n = 19), 35.3% (n = 24), and 73.5% (n = 50) of study participants. A sum score was formed from five of a total of 39 satisfaction items, which independently predicted the EE and DP endpoints and a combined EE and DP endpoint in well-adjusted regression models. For each individual score of the sum score (range 5-25 points), the probability of a critical burnout is reduced by a relative 57% (EE), 25% (DP), and 34% (combined endpoint). In contrast, permanent employment contract, the clinic position as senior physician or chief physician, working full-time, and a married marital status significantly reduced the critical PA domain. CONCLUSION: Several dimensions of professional satisfaction were identified, the improvement of which could contribute to a decrease in burnout among urologists with a migrant background. Future intervention studies aimed at improving job satisfaction must follow.

Depressive symptoms in relation to periodontal health in a Jordanian sample.

OBJECTIVES: This cross-sectional study examines the relationship of depression symptoms to periodontal diseases and decayed (D), missing (M) and filled teeth (FT) in a sample of the Jordanian population. METHODS: Subjects escorting dental patients attending two dental hospitals in North Jordan were included. Each subject received full periodontal examination, including probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI) and plaque index (PI). The numbers of M, D and F teeth were also recorded. The Zung Self-rating Depression Scale was used to determine susceptibility to depression. RESULTS: The frequency of high susceptibility to depression among periodontitis-free subjects and those with periodontitis was found to be 48% and 50% respectively. There was no statistically significant association between susceptibility to depression symptoms and periodontal parameters, including PPD, CAL, PI and GI (P > 0.05). HOWEVER, SUBJECTS WITH LOW SUSCEPTIBILITY TO DEPRESSION HAD SIGNIFICANTLY MORE FT THAN SUBJECTS HIGHLY SUSCEPTIBLE TO DEPRESSION. CONCLUSIONS: High susceptibility to depression does not play a significant role in the aetiology and severity of periodontitis in the population studied.

Control of the nuclear localization of Extradenticle by competing nuclear import and export signals.

The Drosophila PBC protein Extradenticle (Exd) is regulated at the level of its subcellular distribution: It is cytoplasmic in the absence of Homothorax (Hth), a Meis family member, and nuclear in the presence of Hth. Here we present evidence that, in the absence of Hth, Exd is exported from nuclei due to the activity of a nuclear export signal (NES). The activity of this NES is inhibited by the antibiotic Leptomycin B, suggesting that Exd is exported by a CRM1/exportin1-related export pathway. By analyzing the subcellular localization of Exd deletion mutants in imaginal discs and cultured cells, we identified three elements in Exd, a putative NES, a nuclear localization sequence (NLS), and a region required for Hth-mediated nuclear localization. This latter region coincides with a domain in Exd that binds Hth protein in vitro. When Exd is uncomplexed with Hth, the NES dominates over the NLS. When Exd is expressed together with Hth, or when the NES is deleted, Exd is nuclear. Thus, Hth is required to overcome the influence of the NES, possibly by inducing a conformational change in Exd. Finally, we provide evidence that Hth and Exd normally interact in the cytoplasm, and that Hth also has an NLS. We propose that in Exd there exists a balance between the activities of an NES and an NLS, and that Hth alters this balance in favor of the NLS.

Generation of multiple antagonistic domains along the proximodistal axis during Drosophila leg development.

homothorax (hth) is a Drosophila member of the Meis family of homeobox genes. hth function is required for the nuclear localization of the Hox cofactor Extradenticle (EXD). We show here that there is also a post-transcriptional control of HTH by exd: exd activity is required for the apparent stability of the HTH protein. In leg imaginal discs, hth expression is limited to the domain of exd function and this domain is complementary to the domain in which the Wingless (WG) and Decapentaplegic (DPP) signals are active. We demonstrate that WG and DPP act together through their targets Distal-less (Dll) and dachshund (dac) to restrict hth expression, and therefore EXD's nuclear localization, to the most proximal regions of the leg disc. Furthermore, there is a reciprocal repression exerted by HTH on these and other DPP and WG downstream targets that restricts their expression to non-hth-expressing cells. Thus, there exists in the leg disc a set of mutually antagonistic interactions between proximal cells, which we define as those that express hth, and distal cells, or those that do not express hth. In addition, we show that dac negatively regulates Dll. We suggest that these antagonistic relationships help to convert the WG and DPP activity gradients into discreet domains of gene expression along the proximodistal axis.

Antagonism between extradenticle function and Hedgehog signalling in the developing limb.

The Drosophila homeobox gene extradenticle (exd) encodes a highly conserved cofactor of Hox proteins. exd activity is regulated post-translationally by a mechanism involving nuclear translocation; only nuclear Exd protein is functional. The exd gene is required for patterning of the proximal region of the leg, whereas patterning of the distal region requires signalling by the Wingless (Wg) and Decapentaplegic (Dpp) proteins, which are in turn activated by Hedgehog (Hh). Here we show that exd function and Dpp/Wg signalling are antagonistic and divide the leg into two mutually exclusive domains. In the proximal domain, exd activity prevents cells from responding to Dpp and Wg. Conversely, in the distal domain, exd function is suppressed by the Dpp/Wg response gene Distal-less (Dll), which prevents the nuclear transport of Exd. We also found that the product of a murine homologue of exd (Pbx1) is regulated at the subcellular level, and that its pattern of nuclear localization in the mouse limb resembles that of Exd in the Drosophila leg. These findings suggest that the division of the limb into two antagonistic domains, as defined by exd (Pbx1) function and Hh signalling, may be a general feature of limb development.

Nuclear translocation of extradenticle requires homothorax, which encodes an extradenticle-related homeodomain protein.

We show that homothorax (hth) is required for the Hox genes to pattern the body of the fruit fly, Drosophila melanogaster. hth is necessary for the nuclear localization of an essential HOX cofactor, Extradenticle (EXD), and encodes a homeodomain protein that shares extensive identity with the product of Meis1, a murine proto-oncogene. MEIS1 is able to rescue hth mutant phenotypes and can induce the cytoplasmic-to-nuclear translocation of EXD in cell culture and Drosophila embryos. Thus, Meis1 is a murine homolog of hth. MEIS1/HTH also specifically binds to EXD with high affinity in vitro. These data suggest a novel and evolutionarily conserved mechanism for regulating HOX activity in which a direct protein-protein interaction between EXD and HTH results in EXD's nuclear translocation.

Nuclear import of the homeodomain protein extradenticle in response to Wg and Dpp signalling.

In Drosophila, Decapentaplegic (Dpp) and Wingless (Wg) are two secreted signalling proteins of the transforming growth factor (TGF)-beta and Wnt families, respectively. Although both are often required during development, only a few downstream components of these signalling pathways have been described. Here we present evidence that in the embryonic midgut both signalling pathways control the subcellular localization of the homeodomain protein encoded by the extradenticle (exd) gene. Exd protein is predominantly nuclear in endoderm cells close to Dpp-and Wg-secreting cells of the visceral mesoderm, but is in the cytoplasm in more distant endoderm cells. Both dpp and wg are required for the nuclear localization of Exd in the endoderm, whereas ectopic expression of dpp and wg expands the domain of nuclear Exd. Furthermore, the nuclear import of Exd correlates with the transcription of an exd-dependent reporter gene in the endoderm. Thus one mechanism by which extracellular signals might control pattern is by directing the graded nuclear localization of homeodomain proteins such as Exd that directly control the expression of target genes.

Molecular characterization of a peripheral receptor for cannabinoids.

The major active ingredient of marijuana, delta 9-tetrahydrocannabinol (delta 9-THC), has been used as a psychoactive agent for thousands of years. Marijuana, and delta 9-THC, also exert a wide range of other effects including analgesia, anti-inflammation, immunosuppression, anticonvulsion, alleviation of intraocular pressure in glaucoma, and attenuation of vomiting. The clinical application of cannabinoids has, however, been limited by their psychoactive effects, and this has led to interest in the biochemical bases of their action. Progress stemmed initially from the synthesis of potent derivatives of delta 9-THC, and more recently from the cloning of a gene encoding a G-protein-coupled receptor for cannabinoids. This receptor is expressed in the brain but not in the periphery, except for a low level in testes. It has been proposed that the nonpsychoactive effects of cannabinoids are either mediated centrally or through direct interaction with other, non-receptor proteins. Here we report the cloning of a receptor for cannabinoids that is not expressed in the brain but rather in macrophages in the marginal zone of spleen.

The nutritional status of children of displaced families in Beirut.

The nutritional status of children of displaced families in Greater Beirut was investigated in 1986 (a sample of 146 households) and in 1991 (137 households). Data on demographic variables, nutrient intake (calories, protein, and iron), and anthropometric measurements were collected. Iron intake was only 50-57% of the RDA for the 1-3 age group, and 35.6% and 32.0% of all children consumed < 60% of the RDA for iron in 1986 and 1991, respectively. Main sources of protein were dairy products, milk and eggs. The lower nutrient intake in 1991 compared to 1986 was negatively related to social class. Anthropometric measurements showed an increased past and recent undernutrition of the children in 1991 as compared to both the 1986 child sample and the NCHS standard child population. Severe inflation and marked increase in food prices were reflected in dietary intake and growth of the children. Food aid programmes, government subsidy of bread, and partial wage correction were possible stabilizing factors for the most destitute groups but not for the total population of displaced children.

PIP: 2 professors from the American University of Beirut analyzed 1986 and 1991 data on children of 283 displaced families in Greater Beirut, Lebanon, to examine their nutritional status and contributing socioeconomic factors. Between 1986 and 1991, while the civil war raged, inflation rates increased 2200% (food prices rose 900-6300%). The government subsidized bread, operated a food aid program for destitute families, and instituted partial wage correction. Mean caloric intake was within acceptable levels, but about 10% of the children received less than 60% of the recommended dietary allowance (RDA) for calories in both years. Mean caloric intake was less than the RDA for the 7-10 year old age group (88%) in 1986 and 94% in 1991). The mean iron intake for both years was very low for 1-3 year old children (50-57% of RDA). Further, 35.6% of children in 1986 and 32% in 1991 consumed less than 60% of the RDA for iron. Dairy products, eggs, and legumes accounted for most of the protein intake which tended to be adequate. Children of semiskilled and unskilled fathers consumed more nutrients than did those of other occupational groups, because poor families received more food aid (p .05). Children in 1991 exhibited more signs of undernutrition (e.g., poor growth) than did those in 1986. For example, 22.2% of 1-3 year old children weighed less than the 10th NCHS percentile in 1991 compared to 12% in 1986. Further, 16% of the same age children were in the 10th percentile for weight-by-height in 1991, while just 12% were in 1986. These results show that very high inflation rates and subsequent increases in food prices adversely affected dietary intake and growth patterns of the children of displaced families, even though the government subsidized bread and enacted wage correction. Furthermore, the food aid programs just helped the very poorest children.