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Epigenetic repression of antiviral genes by SARS-CoV-2 NSP1

by Dimitrios G. Anastasakis, Daniel Benhalevy, Nicolas Çuburu, Nihal Altan-Bonnet, Markus Hafner

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) evades the innate immune machinery through multiple viral proteins, including nonstructural protein 1 (NSP1). While NSP1 is known to suppress translation of host mRNAs, the mechanisms underlying its immune evasion properties remain elusive. By integrating RNA-seq, ribosome footprinting, and ChIP-seq in A549 cells we found that NSP1 predominantly represses transcription of immune-related genes by favoring Histone 3 Lysine 9 dimethylation (H3K9me2). G9a/GLP H3K9 methyltransferase inhibitor UNC0638 restored expression of antiviral genes and restricted SARS-CoV-2 replication. Our multi-omics study unravels an epigenetic mechanism underlying host immune evasion by SARS-CoV-2 NSP1. Elucidating the factors involved in this phenomenon, may have implications for understanding and treating viral infections and other immunomodulatory diseases.

Prevalence and clustering of NANDA‐I nursing diagnoses in the pre‐hospital emergency care setting: A retrospective records review study

Abstract

Aim

To determine the prevalence and clustering of NANDA-International nursing diagnoses in patients assisted by pre-hospital emergency teams.

Design

Retrospective descriptive study of electronic record review.

Methods

Episodes recorded during 2019, including at least a nursing diagnosis, were recovered from the electronic health records of a Spanish public emergency agency (N = 28,847). Descriptive statistics were used to characterize the sample and determine prevalence. A two-step cluster analysis was used to group nursing diagnoses. A comparison between clusters in sociodemographic and medical problems was performed. Data were accessed in November 2020.

Results

Risk for falls (00155) (27.3%), Anxiety (00146) (23.2%), Acute pain (00132), Fear (00148) and Ineffective breathing pattern (00032) represented 96.1% of all recorded diagnoses. A six-cluster solution (n = 26.788) was found. Five clusters had a single high-prevalence diagnosis predominance: Risk for falls (00155) in cluster 1, Anxiety (00146) in cluster 2, Fear (00148) in cluster 3, Acute pain (00132) in cluster 4 and Ineffective breathing pattern (00032) in cluster 6. Cluster 5 had several high prevalence diagnoses which co-occurred: Risk for unstable blood glucose level (00179), Ineffective coping (00069), Ineffective health management (00078), Impaired comfort (00214) and Impaired verbal communication (00051).

Conclusion

Five nursing diagnoses accounted for almost the entire prevalence. The identified clusters showed that pre-hospital patients present six patterns of nursing diagnoses. Five clusters were predominated by a predominant nursing diagnosis related to patient safety, coping, comfort, and activity/rest, respectively. The sixth cluster grouped several nursing diagnoses applicable to exacerbations of chronic diseases.

Implications for the profession and/or patient care

Knowing the prevalence and clustering of nursing diagnoses allows a better understanding of the human responses of patients attended by pre-hospital emergency teams and increases the evidence of individualized/standardized care plans in the pre-hospital clinical setting.

Impact

What problem did the study address? There are different models of pre-hospital emergency care services. The use of standardized nursing languages in the pre-hospital setting is not homogeneous. Studies on NANDA-I nursing diagnoses in the pre-hospital context are scarce, and those available are conducted on small samples.

What were the main findings? This paper reports the study with the largest sample among the few published on NANDA-I nursing diagnoses in the pre-hospital care setting. Five nursing diagnoses represented 96.1% of all recorded. These diagnoses were related to patients' safety/protection and coping/stress tolerance. Patients attended by pre-hospital care teams are grouped into six clusters based on the nursing diagnoses, and this classification is independent of the medical conditions the patient suffers.

Where and on whom will the research have an impact?

Knowing the prevalence of nursing diagnoses allows a better understanding of the human responses of patients treated in the pre-hospital setting, increasing the evidence of individualized and standardized care plans for pre-hospital care.

Reporting method

STROBE checklist has been used as a reporting method.

No Patient or Public Contribution

Only patients' records were reviewed without further involvement.

Exploring home births in Catalonia (Spain): A cross‐sectional study of women's experiences and influencing factors

Abstract

Aim

The study explores the experiences of women with low-risk pregnancies and no complications who planned a home birth.

Design

A cross-sectional study was conducted using an online questionnaire.

Methods

The questionnaire included socio-demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home-birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS.

Results

A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife.

Conclusions

Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births.

Implications for the Profession and Patient Care

Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home.

Impact

Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home-birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home-birthing women.

Reporting Method

The study followed the STROBE checklist guidelines for cross-sectional studies.

Public Contribution

Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means.

What are the perceptions and concerns of people living with diabetes and National Health Service staff around the potential implementation of AI-assisted screening for diabetic eye disease? Development and validation of a survey for use in a secondary car

Por: Willis · K. · Chaudhry · U. A. R. · Chandrasekaran · L. · Wahlich · C. · Olvera-Barrios · A. · Chambers · R. · Bolter · L. · Anderson · J. · Barman · S. A. · Fajtl · J. · Welikala · R. · Egan · C. · Tufail · A. · Owen · C. G. · Rudnicka · A. · On behalf of the ARIAS Research Group · S
Introduction

The English National Health Service (NHS) Diabetic Eye Screening Programme (DESP) performs around 2.3 million eye screening appointments annually, generating approximately 13 million retinal images that are graded by humans for the presence or severity of diabetic retinopathy. Previous research has shown that automated retinal image analysis systems, including artificial intelligence (AI), can identify images with no disease from those with diabetic retinopathy as safely and effectively as human graders, and could significantly reduce the workload for human graders. Some algorithms can also determine the level of severity of the retinopathy with similar performance to humans. There is a need to examine perceptions and concerns surrounding AI-assisted eye-screening among people living with diabetes and NHS staff, if AI was to be introduced into the DESP, to identify factors that may influence acceptance of this technology.

Methods and analysis

People living with diabetes and staff from the North East London (NEL) NHS DESP were invited to participate in two respective focus groups to codesign two online surveys exploring their perceptions and concerns around the potential introduction of AI-assisted screening.

Focus group participants were representative of the local population in terms of ages and ethnicity. Participants’ feedback was taken into consideration to update surveys which were circulated for further feedback. Surveys will be piloted at the NEL DESP and followed by semistructured interviews to assess accessibility, usability and to validate the surveys.

Validated surveys will be distributed by other NHS DESP sites, and also via patient groups on social media, relevant charities and the British Association of Retinal Screeners. Post-survey evaluative interviews will be undertaken among those who consent to participate in further research.

Ethics and dissemination

Ethical approval has been obtained by the NHS Research Ethics Committee (IRAS ID: 316631). Survey results will be shared and discussed with focus groups to facilitate preparation of findings for publication and to inform codesign of outreach activities to address concerns and perceptions identified.

Nivel de depresión en adolescentes de bachillerato de la Unidad Educativa Chilla

Introducción: La depresión es una alteración del estado de ánimo que puede ocasionar desaliento y poca esperanza sobre su futuro; además, puede presentarse en todas las etapas de la vida y con mayor frecuencia en la adolescencia, debido a la serie de cambios físicos y psicológicos que se presentan lo cual los hace vulnerables a padecerla. Objetivo: Caracterizar el nivel de depresión en los adolescentes de bachillerato de la Unidad Educativa Chilla. Metodología: Estudio cuantitativo, descriptivo de corte transversal, en el cual se contó con la participación de 60 adolescentes; se utilizó como instrumento el test de Beck (BDI-2), que evalúa las dimensiones, somática motivacional y dimensión cognitiva afectiva. Resultados: el análisis de resultados demostró que el 38.3% están en edad de 17 años, el 51.7% son hombres, el 70% pertenecen a la zona urbana, un 100% tienen un estado civil soltero/a, mientras que el 40% cursan el tercero de bachillerato. Además, se logró evidenciar el nivel de depresión en base a la dimensión somática-motivacional donde el 40% tiene un nivel mínimo y el 11,7% un nivel grave; en la dimensión cognitivo-afectiva, el 43,3% presenta un nivel de depresión leve y el 1.7% un nivel grave, en cuanto al nivel general de depresión se muestra que, el 33,3% presentó un nivel mínimo y 16.7% un nivel grave. Conclusión: la depresión es uno de los grandes problemas de salud mental que afecta a la adolescencia, sobre todo genera alteraciones en las dimensiones somática y cognitiva del ser humano.

Prevalencia de los cambios dermatológicos en personas diabéticas con ulceración del pie

Objetivo principal: Estimar la prevalencia de alteraciones dermatológicas en personas diabéticas con ulceración del pie atendidas en un centro de referencia en diabetes en Bahía. Metodología: Estudio transversal y retrospectivo. La población del estudio consistió en 133 pacientes tratados en 2017 y la recopilación de datos tuvo lugar entre agosto y octubre de 2018. Para el análisis de datos se utilizaron estadísticas descriptivas realizadas utilizando el software estadístico Statistical Package for the Social Sciences (SPSS 16.0). Resultados principales: El cambio más frecuente fue la callosidad (48,1%) seguido de xeroderma (47,4%), micosis interdigital (18%), onicomicosis (13,5%), fisuras (6,8%). Entre el momento del diagnóstico de diabetes y fisuras se encontraron asociaciones entre el momento del diagnóstico de diabetes y fisuras (p= 0,019), úlcera neuropática y xeroderma (p=0,015), úlcera infectada y callos o callos (p=0,010). La onicomicosis y el xeroderma eran más frecuentes en los hombres, mientras que los callos en las mujeres. Conclusión principal: En esta investigación se encontraron nuevas asociaciones. Se observó que la salud de los pies es una brecha en la literatura y este estudio tiene como objetivo ampliar el conocimiento sobre este tema, sirviendo para guiar los comportamientos de atención al paciente en los servicios y calificar la atención médica de las personas diabéticas.

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