Prevalent Hallucinations during Medical Internships: Phantom Vibration and Ringing Syndromes

Background: Phantom vibration syndrome is a type of hallucination reported among mobile phone users in the general population. Another similar perception, phantom ringing syndrome, has not been previously described in the medical literature. Methods: A prospective longitudinal study of 74 medical interns (46 males, 28 females; mean age, 24.8±1.2 years) was conducted using repeated investigations of the prevalence and associated factors of phantom vibration and ringing. The accompanying symptoms of anxiety and depression were evaluated with the Beck Anxiety and Depression Inventories before the internship began, and again at the third, sixth, and twelfth internship months, and two weeks after the internship ended. Results: The baseline prevalence of phantom vibration was 78.1%, which increased to 95.9% and 93.2% in the third and sixth internship months. The prevalence returned to 80.8% at the twelfth month and decreased to 50.0% 2 weeks after the internship ended. The baseline prevalence of phantom ringing was 27.4%, which increased to 84.9%, 87.7%, and 86.3% in the third, sixth, and twelfth internship months, respectively. This returned to 54.2% two weeks after the internship ended. The anxiety and depression scores also increased during the internship, and returned to baseline two weeks after the internship. There was no significant correlation between phantom vibration/ringing and symptoms of anxiety or depression. The incidence of both phantom vibration and ringing syndromes significantly increased during the internship, and subsequent recovery. Conclusion: This study suggests that phantom vibration and ringing might be entities that are independent of anxiety or depression during evaluation of stress-associated experiences during medical internships

Motor neuron-derived Thsd7a is essential for zebrafish vascular development via the Notch-dll4 signaling pathway.

BackgroundDevelopment of neural and vascular systems displays astonishing similarities among vertebrates. This parallelism is under a precise control of complex guidance signals and neurovascular interactions. Previously, our group identified a highly conserved neural protein called thrombospondin type I domain containing 7A (THSD7A). Soluble THSD7A promoted and guided endothelial cell migration, tube formation and sprouting. In addition, we showed that thsd7a could be detected in the nervous system and was required for intersegmental vessels (ISV) patterning during zebrafish development. However, the exact origin of THSD7A and its effect on neurovascular interaction remains unclear.ResultsIn this study, we discovered that zebrafish thsd7a was expressed in the primary motor neurons. Knockdown of Thsd7a disrupted normal primary motor neuron formation and ISV sprouting in the Tg(kdr:EGFP/mnx1:TagRFP) double transgenic zebrafish. Interestingly, we found that Thsd7a morphants displayed distinct phenotypes that are very similar to the loss of Notch-delta like 4 (dll4) signaling. Transcript profiling further revealed that expression levels of notch1b and its downstream targets, vegfr2/3 and nrarpb, were down-regulated in the Thsd7a morphants. These data supported that zebrafish Thsd7a could regulate angiogenic sprouting via Notch-dll4 signaling during development.ConclusionsOur results suggested that motor neuron-derived Thsd7a plays a significant role in neurovascular interactions. Thsd7a could regulate ISV angiogenesis via Notch-dll4 signaling. Thus, Thsd7a is a potent angioneurin involved in the development of both neural and vascular systems

Maintaining the structural integrity of thebamboo mosaic virus 3′ untranslated region isnecessary for retaining the catalytic constant forminus-strand RNA synthesis

Background: Bamboo mosaic virus (BaMV) and the Potato virus X (PVX) are members of the genus Potexvirus andhave a single-stranded positive-sense RNA genome. The 3′-untranslated region (UTR) of the BaMV RNA genomewas mapped structurally into ABC (a cloverleaf-like), D (a stem-loop), and E (pseudoknot) domains. The BaMVreplicase complex that was isolated from the infected plants was able to recognize the 3′ UTR of PVX RNA toinitiate minus-strand RNA synthesis in vitro.Results: To investigate whether the 3′ UTR of PVX RNA is also compatible with BaMV replicase in vivo, weconstructed chimera mutants using a BaMV backbone containing the PVX 3′ UTR, which was inserted in or used toreplace the various domains in the 3′ UTR of BaMV. None of the mutants, except for the mutant with the PVX3′ UTR inserted upstream of the BaMV 3′ UTR, exhibited a detectable accumulation of viral RNA in Nicotianabenthamiana plants. The in vitro BaMV RdRp replication assay demonstrated that the RNA products were generatedby the short RNA transcripts, which were derived from the chimera mutants to various extents. Furthermore, theVmax/KM of the BaMV 3′ UTR (rABCDE) was approximately three fold higher than rABCP, rP, and rDE in minus-strandRNA synthesis. These mutants failed to accumulate viral products in protoplasts and plants, but were adequatelyreplicated in vitro.Conclusions: Among the various studied BaMV/PVX chimera mutants, the BaMV-S/PABCDE that containednon-interrupted BaMV 3′ UTR was the only mutant that exhibited a wild-type level of viral product accumulation inprotoplasts and plants. These results indicate that the continuity of the domains in the 3′ UTR of BaMV RNA wasnot interrupted and the domains were not replaced with the 3′ UTR of PVX RNA in vivo

The development of the job satisfaction scale for hospital staff in Taiwan

The current study attempts to construct a valid and applicable job satisfaction scale for measuring the contentment level of hospital staff in Taiwan. The job description inventory (JDI) and Job Satisfaction Index (JSI) were adopted as the foundation of the job satisfaction measure for hospital staff in a selected hospital. To verify and validate the scale, data collected in 2012 and 2013, were analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), respectively. Subsequently, Pearson correlations analysis was used to examine the strength and direction of the relationships between job satisfaction dimensions. Overall, the job satisfaction scale developed in this research illustrated valid and accurate measure for assessing hospital staffs' satisfaction. Both EFA and CFA results demonstrated that items consistently emerged six dimensions i.e. work environment, work achievement, compensation and benefits, education and training, promotion and evaluation, and management system. The findings also highlight that management support, work achievement, and promotion and evaluation are three critical factors that significantly contribute to high levels of job satisfaction for hospital staff

The Calder\'{o}n problem for nonlocal parabolic operators

We investigate inverse problems in the determination of leading coefficients for nonlocal parabolic operators, by knowing the corresponding Cauchy data in the exterior space-time domain. The key contribution is that we reduce nonlocal parabolic inverse problems to the corresponding local inverse problems with the lateral boundary Cauchy data. In addition, we derive a new equation and offer a novel proof of the unique continuation property for this new equation. We also build both uniqueness and non-uniqueness results for both nonlocal isotropic and anisotropic parabolic Calder\'on problems, respectively.Comment: 34 pages. All comments are welcom

The relationship between caregiving stress and child well-being among informal and formal kinship care families

The purpose of this study is to examine the relationship between caregiving stress and child well-being (i.e., child health and emotional/behavioral problems) among informal and formal kinship care families. This study also examines the role of kinship caregivers’ social engagement (i.e., weekly participation in volunteer activities and/or religious services) in the relationship with child well-being. A secondary aim of this study is to examine the variations across the two kinship care families: informal vs. formal kinship families. Kinship families are presumed to be a less disruptive and the least restrictive family-like environment for children whose parent(s) are not able to provide caregiving. However, kinship families have been found to present a profile with difficulties and limited support which raises significant concerns regarding the well-being of children in the care of kinship caregivers. Children in kinship families can be particularly vulnerable and may require additional supports, especially under a policy context that limited financial aids are available for poor families and caregivers who are experiencing greater stress without reliable support from social relationships. To examine the research questions, this study is based on a secondary data analysis using data from a national cross-sectional survey, the 1999 and 2002 National Survey of America’s Families (NSAF). The data include information on the health, economic, and social dimensions of well-being of U.S. children and families from a nationally representative probability sample of the civilian, noninstitutionalized population. The current study sample includes 1,623 children who were cared for by relatives without a parent present in the household. Informal kinship families (n=1,293) were defined as non-foster kinship care, while formal kinship families (n=330) were defined as foster kinship care. Weighted stepwise multivariate linear regressions are conducted to examine the relationships among caregiving stress (measured by the Parenting Aggravation Scale), child well-being (measured by the child general health perception and the Child Behavior and Emotional Problems Scale), and social engagement (measured by weekly volunteer activity and/or religious service participation). Findings from the study indicate that (1) Informal and formal kinship families present similarities in most demographic and well-being characteristics. Despite this, younger children (aged 6-11) in formal kinship families fared worse in behavioral outcomes than those in informal kinship families. Informal kinship families were more likely to live in poverty but less likely to receive public benefits (e.g., public assistance, food stamps), compared to formal kinship families. (2) Kinship caregiver caregiving stress was not significantly related to child health, but was found to be negatively associated with behavioral outcomes of both younger (aged 6-11) and older children (aged 12-17). (3) Kinship caregiver social engagement, specifically weekly participation in volunteer activities was only positively related to younger children’s behavior (aged 6-11). Weekly participation in volunteer activities also buffered the negative relationship between caregiving stress and children’s behavior. (4) Kinship family type was found to be a moderator of the relationship between caregiving stress and older children’s behavior (aged 12-17). That is, the negative association between caregiving stress and children’s behavioral outcome was stronger for formal kinship families and lessened for informal kinship families. Findings from this study have implications for practice, policy, and research. Based on the findings, practical suggestions are made to increase opportunities for kinship caregivers and children to engage in social activities/relationships within the community. Policy implications regard revisiting the eligibility of public assistance and supportive services for kinship caregivers and families. Future research should also assess and target different factors that are associated with child well-being, stress, and social engagement among a diverse group of kinship families

Immunogenic cell death: The cornerstone of oncolytic viro-immunotherapy

According to the World Health Organization, cancer is one of the leading global health concerns, causing nearly 10 million deaths in 2020. While classical chemotherapeutics produce strong cytotoxicity on cancer cells, they carry limitations of drug resistance and off-target effects and sometimes fail to elicit adequate antitumor protection against tumor relapse. Additionally, most cancer cells have developed various ways to escape immune surveillance. Nevertheless, novel anticancer strategies such as oncolytic viro-immunotherapy can trigger immunogenic cell death (ICD), which can quickly grasp the attention of the host defense machinery, resulting in an ensuing antitumor immune response. Specifically, oncolytic viruses (OVs) can infect and destroy targeted cancer cells and stimulate the immune system by exposing pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs) to promote inflammatory reactions, and concomitantly prime and induce antitumor immunity by the release of neoantigens from the damaged cancer cells. Thus, OVs can serve as a novel system to sensitize tumor cells for promising immunotherapies. This review discusses the concept of ICD in cancer, centralizing ICD-associated danger signals and their consequence in antitumor responses and ICD induced by OVs. We also shed light on the potential strategies to enhance the immunogenicity of OVs, including the use of genetically modified OVs and their combination with ICD-enhancing agents, which are helpful as forthcoming anticancer regimens

Strategies to Preclude Hepatitis C Virus Entry

Without a preventive vaccine, hepatitis C virus (HCV) remains an important pathogen worldwide with millions of carriers at risk of end-stage liver diseases. Despite the introduction of novel direct-acting antivirals (DAAs), resistance problems, challenges with the difficult-to-treat populations and high costs limit the widespread application of these drugs. Antivirals with alternative mechanism(s) of action, such as by restricting viral entry or cell-to-cell spread, could help expand the scope of antiviral strategies for the management of hepatitis C. Transfusion-associated HCV infection remains another issue in endemic and resource-limited areas around the world. This chapter describes some of the latest developments in antiviral strategies to preclude HCV entry, such as through monoclonal antibodies and small molecules, as well as measures to enhance the safety of therapeutic plasma products in blood transfusion