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Both pseudo-octahedral and pseudo-square pyramidal bis-iminoxolene complexes trans-(Diso)2RuCl2 and trans-(Diso)2Ru(PPh3) are structurally distorted, with the ruthenium atom slipping off the twofold axis of the idealized coordination polyhedra. These distortions take place because they allow or enhance π interactions between ruthenium and the iminoxolene π orbitals. [ABSTRACT FROM AUTHOR]

Objective Health care providers and health systems confronted new challenges to deliver timely, high-quality prenatal care during the coronavirus disease 2019 (COVID-19) pandemic as the pandemic raised concerns that care would be delayed or substantively changed. This study describes trends in prenatal care delivery in 2020 compared with 2018 to 2019 in a large, commercially insured population and investigates changes in obstetric care processes and outcomes. Study Design This retrospective cohort study uses de-identified administrative claims for commercially insured patients. Patients whose entire pregnancy took place from March 1 to December 31 in years 2018, 2019, and 2020 were included. Trends in prenatal care, including in-person, virtual, and emergency department visits, were evaluated, as were prenatal ultrasounds. The primary outcome was severe maternal morbidity (SMM). Secondary outcomes included preterm birth and stillbirth. To determine whether COVID-19 pandemic-related changes in prenatal care had an impact on maternal outcomes, we compared the outcome rates during the pandemic period in 2020 to equivalent periods in 2018 and 2019. Results In total, 35,112 patients were included in the study. There was a significant increase in the prevalence of telehealth visits, from 1.1 to 1.2% prior to the pandemic to 17.2% in 2020, as well as a significant decrease in patients who had at least one emergency department visit during 2020. Overall prenatal care and ultrasound utilization were unchanged. The rate of SMM across this period was stable (2.3–2.8%) with a statistically significant decrease in the preterm birth rate in 2020 (7.4%) compared with previous years (8.2–8.6%; p < 0.05) and an unchanged stillbirth rate was observed. Conclusion At a time when many fields of health care were reshaped during the pandemic, these observations reveal considerable resiliency in both the processes and outcomes of obstetric care. Key Points Overall prenatal care and ultrasound were unchanged from 2018 to 2019 to 2020. There was a large increase in the prevalence of telehealth visits in 2020. There was no change in the rate of severe maternal morbidity or stillbirth in 2020 compared with 2018 to 2019. [ABSTRACT FROM AUTHOR]

Introduction Clinicians caring for adults with borderline personality disorder (BPD) in acute settings such as the emergency department (ED) have little evidence/guidance to base decisions on. Specific/detailed guidance for managing BPD in the ED is needed given the morbidity and mortality risks, high service utilisation, unique challenges and risk of iatrogenic interventions. The primary objective of this study is to use a consensus method to develop a guideline for managing adults with BPD in the ED. This protocol and the key questions for the guideline were developed with the advice of people with BPD and their family members/support persons.Methods and analysis We will perform a four-phase Delphi study of an expert panel of clinicians, researchers, adults with BPD and their family members/support persons. Various disciplines (psychiatry, psychology, emergency medicine, nursing, social work) and treatment approaches will be included in the expert panel. An online questionnaire will be developed from systematic reviews, qualitative assessments of pivotal literature, and opinions suggested by the panel (phase 1). The panel will rate their agreement on opinions for each key question covering areas of emergency care of adults with BPD using two rounds of this questionnaire (phases 2 and 3). Opinions meeting predefined thresholds for consensus will be brought to consensus meetings moderated by an independent chair (phase 4). The purpose of these meetings is to finalise the set and phrasing of the opinions for each area of emergency care. These final opinions will be the recommendations in the guideline. If there are significant differences of opinion, the guideline will present both recommendations alongside one another.Ethics and dissemination This study has received ethics approval by the Hamilton Integrated Research Ethics Board in Hamilton, Ontario, Canada. The results of this study will be disseminated through peer-reviewed publications, conferences and national professional and patient/family/support associations.

ABSTRACT Several intracellular pathogens, such as Mycobacterium tuberculosis, damage endomembranes to access the cytosol and subvert innate immune responses. The host counteracts endomembrane damage by recruiting repair machineries that retain the pathogen inside the vacuole. Here, we show that the endoplasmic reticulum (ER)-Golgi protein oxysterol-binding protein (OSBP) and its Dictyostelium discoideum homolog OSBP8 are recruited to the Mycobacterium-containing vacuole (MCV) dependent on the presence of the ESX-1 secretion system, suggesting that their mobilization is associated with membrane damage. Lack of OSBP8 causes a hyperaccumulation of phosphatidylinositol-4-phosphate (PI4P) on the MCV and decreased cell viability. OSBP8-depleted cells had reduced lysosomal and degradative capabilities of their vacuoles that favored mycobacterial growth. In agreement with a potential role of OSBP8 in membrane repair, human macrophages infected with M. tuberculosis recruited OSBP in an ESX-1-dependent manner. These findings identified an ER-dependent repair mechanism for restoring MCVs in which OSBP8 functions to equilibrate PI4P levels on damaged membranes. IMPORTANCE Tuberculosis still remains a global burden and is one of the top infectious diseases from a single pathogen. Mycobacterium tuberculosis, the causative agent, has perfected many ways to replicate and persist within its host. While mycobacteria induce vacuole damage to evade the toxic environment and eventually escape into the cytosol, the host recruits repair machineries to restore the MCV membrane. However, how lipids are delivered for membrane repair is poorly understood. Using advanced fluorescence imaging and volumetric correlative approaches, we demonstrate that this involves the recruitment of the endoplasmic reticulum (ER)-Golgi lipid transfer protein OSBP8 in the Dictyostelium discoideum/Mycobacterium marinum system. Strikingly, depletion of OSBP8 affects lysosomal function accelerating mycobacterial growth. This indicates that an ER-dependent repair pathway constitutes a host defense mechanism against intracellular pathogens such as M. tuberculosis.

Background: One of the challenges of the 21st century is the high turnover rate in the nursing profession due to burnout and mental illness. From a biopsychosocial perspective, an individual's personality is an important vulnerability-resilience factor that comprises four temperament traits (i.e., a person's emotional reactions) and three character traits (i.e., self-regulation systems). Indeed, different personality profiles are associated to different coping strategies and health outcomes. Objective: We investigated and mapped the temperament and character of Swedish newly graduated and employed nurses’ in relation to the Swedish general population and an age-matched sub-sample. Design: In this cross-sectional study, nurses self-reported their personality (Temperament and Character Inventory) at the beginning of their employment. Setting: The data collection was conducted at a hospital in the South of Sweden. Participants: A total of 118 newly graduated and employed nurses (Mage = 25.95±5.58) and 1,564 individuals from the Swedish general population participated in the study. Methods: We calculated T-scores and percentiles for all seven personality dimensions using the Swedish norms (N = 1,564). The profiles were calculated by combining high/low percentiles scores in three temperament dimensions (Novelty Seeking: N/n, Harm Avoidance: H/h, and Reward Dependence: R/r) and in the three character dimensions (Self-Directedness: S/s, Cooperativeness: C/c and Self-Transcendence: T/t). Results: Regarding T-scores, the nurses reported moderately lower Novelty Seeking (> 0.5 SD), slightly higher Harm-Avoidance (about 0.5 SD), moderately higher Persistence (> 0.5 SD) and Reward Dependence (> 0.5 SD), and extremely lower Self-Directedness (> 1 SD). The prevalence of the most common temperament profiles among the nurses (Swedish general population in brackets) were: 39.80% [10.90%] Cautious (nHR), 21.20% [10.90] Reliable (nhR), and 15.30% [16.50%] Methodical (nHr). The prevalence of the most common character profiles among the nurses were: 31.40% [4.90%] Dependent (sCt), 25.40% [14.40%] Apathetic (sct), and 19.50% [8.80%] Moody (sCT). Conclusions: The analyses of the personality profiles showed that High Novelty Seeking (79%), high Harm Avoidance (65%) high Reward Dependence (80%), low Self-Directedness (95%), and low Self-Transcendence (60%) were more prevalent among the newly graduated and employed nurses. This may partially explain newly graduated nurses’ difficulties at work and high turnover rate. After all, a well-developed character is of special importance when working with patients with serious and terminal illness or under large global crises, such as the current pandemic. Hence, both education at universities and development at work need to be person-centered to reduce stress levels and promote positive self-regulation strategies.

For centuries, indigenous sheep have been bred in extensive low-input systems in Midwestern Brazil. The hypothesis of this study was the assumption that phenotypic evaluation of indigenous livestock may drive the establishment of breed standards and official breed recognition, and, therefore, promote more local business opportunities. On the basis of more integrative and participatory theoretical background to applying any decision based on phenotype, we designed this research to determine the most typical and unusual phenotypes of Pantaneiro sheep. Pantaneiro ewes (281 ewes from five conservation units in five counties) were evaluated, bearing in mind both conservation and development. Descriptive statistics were used to classify ewes into typical, intermediate, and unusual phenotypes. Chi-squared tests for association were performed to test if morphological variation in the different sampling sites occurred randomly (p > 0.05) or not (p < 0.05). Some results suggest some sort of diversifying selection pressure, i.e., distinct preferences among keepers. We observed considerable morphologic variation among ewes, but it was straightforward to determine the predominant phenotypes. The study evokes integrative agrobiodiversity by putting phenotypical characterization of indigenous livestock into perspective. Discussions coming from this study may support innovative governance and participative decision-making, allied with strategies that value the socioeconomic, biocultural, and adaptive aspects of indigenous livestock in tropical regions and developing countries. This is a challenge for government, rare-breed keepers, value-chain actors, and civil society.