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Bronchoalveolar lavage (BAL) is becoming a common procedure for research into infectious disease immunology. Little is known about the clinical factors which influence the main outcomes of the procedure. In research participants who underwent BAL according to guidelines, the BAL volume yield, and cell yield, concentration, viability, pellet colour and differential count were analysed for association with important participant characteristics such as active tuberculosis (TB) disease, TB exposure, HIV infection and recent SARS-CoV-2 infection. In 337 participants, BAL volume and BAL cell count were correlated in those with active TB disease, and current smokers. The right middle lobe yielded the highest volume. BAL cell and volume yields were lower in older participants, who also had more neutrophils. Current smokers yielded lower volumes and higher numbers of all cell types, and usually had a black pellet. Active TB disease was associated with higher cell yields, but this declined at the end of treatment. HIV infection was associated with more bloody pellets, and recent SARS-CoV-2 infection with a higher proportion of lymphocytes. These results allow researchers to optimise their participant and end assay selection for projects involving lung immune cells. [ABSTRACT FROM AUTHOR]

A pleural exudate that remains undiagnosed after a combined clinical assessment, thoracentesis, and imaging requires a pleural biopsy for a definitive diagnosis. Thoracoscopy is often the first method of choice to obtain tissue as it offers greater sensitivity and there is a perception of less risk. However, with imaging guidance, closed pleural biopsy is a safe, affordable, and effective alternative to diagnose all forms of pleural disease. Ultrasound (US) has several benefits when compared with computed tomography for image-guided biopsy, as it is widely available, can be performed bedside, and does not expose the patient to radiation. If performed in optimal conditions, a transthoracic USguided closed pleural biopsy can yield results comparable to those of thoracoscopy and a marked reduction in the complication rate versus blind biopsy. Abrams and Tru-Cut needles are the most widely used for a closed pleural biopsy. Either may be used with real-time image guidance or with a free-hand image-assisted technique to harvest up to 6 separate tissue samples. The needle choice will depend on the morphology of the lesion observed on imaging. The Tru-Cut is generally preferred for mass lesions of the pleura or pleura that is >20 mm in thickness, and the Abrams for pleural thickening of <20 mm or radiologically normal pleura. A transthoracic US may be used to detect, rule out, and prevent complications, such as bleeding, solid organ injury, or pneumothorax. The ability to perform thoracic US is a necessary skill in current respiratory practice, and US-guided closed pleural biopsy has a critical role in diagnosis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe and compare veterinary professionals' use of shared decision-making during companion animal appointments. DESIGN: Multi-practice cross-sectional study. SAMPLE: A purposive sample of 4 companion animal veterinary clinics in a group practice in Texas. PROCEDURES: A convenience sample of veterinary appointments were recorded January to March 2018 and audio-recordings were analyzed using the Observer OPTIONS instrument to assess shared decision-making. Each decision was categorized by veterinary professional involvement. RESULTS: A total of 76/85 (89%) appointments included at least 1 decision between the client and veterinary professional(s), with a total of 129 shared decisions. Decisions that involved both a veterinary technician and veterinarian scored significantly higher for elements of shared decision-making (OPTIONS = 29.5 + 8.4; n = 46), than veterinarian-only decisions (OPTIONS = 25.4 + 11.50; P = .040; n = 63), and veterinary technician-only decisions (OPTION5 = 22.5 + 7.15; P = .001; n = 20). Specific elements of shared decision-making that differed significantly based on veterinary professional involvement included educating the client about options (OPTION5 Item 3; P = .0041) and integrating the client's preference (OPTION5 Item 5; P = .0010). CLINICAL RELEVANCE: Findings suggest that clients are more involved in decision making related to their pet's health care when both the veterinary technician and veterinarian communicate with the client. Veterinary technicians' communication significantly enhanced client engagement in decision-making when working collaboratively with the veterinarian. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction. SAMPLE 4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys. PROCEDURES The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression. RESULTS Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008). CLINICAL RELEVANCE Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits. [ABSTRACT FROM AUTHOR]

Patients with secondary spontaneous pneumothorax (SSP) complicated by persistent air leak (PAL) and who are poor surgical candidates have limited treatment options. This case series explored autologous blood patch pleurodesis as a possible cost-effective management option. A total of 46 episodes of SSP with PAL were included. The procedure was successful in 33 (71.7%). Of these, 17 (51.5%) resolved within 1 day. The mean duration of intercostal drainage prior to the blood patch was 22 days in the successful group. Pneumothoraces with incomplete lung re-expansion at the time of procedure were successful in 20 of 30 (66.7%). Only human immunodeficiency virus infection was associated with failure (p = 0.03). Adverse events included transient fever (n = 3) that resolved spontaneously, and empyema (n = 3) which were successfully managed with antibiotics and pigtail drainage. We conclude that a large proportion of patients with SSP complicated by PAL who are unfit for surgery may be liberated from intercostal drainage by an autologous blood patch pleurodesis, with minimal adverse effects. [ABSTRACT FROM AUTHOR]

Percy Dearmer's time as a visiting lecturer at Berkeley Divinity School in Connecticut, USA, at the invitation of Dean William Palmer Ladd, from July 1918 to February 1919, marked a turning point in his life and career. As author of The Parson's Handbook (1899) and Vicar of St Mary's Primrose Hill (1901–1915), he was immersed in the Church of England. From 1919, when he left Berkeley Divinity School, with no offer of a clergy post until 1931, he worked on the margins of the church as a university lecturer, writer, and co-director of an experimental worshipping community. The experiences he had between 1915 and 1919 shaped this 'second' Dearmer: loss in the war; a second wife and new family; work with the YMCA in France and India; travels in the Anglican Communion and, not least, time at Berkeley where he consolidated these experiences, becoming attuned to those who wanted a spiritual life but were disillusioned by institutional religion, as expressed in The Art of Worship (1919). [ABSTRACT FROM AUTHOR]

Background: Inequality is rife throughout South Africa. The first wave of COVID-19 may have affected people in lower socioeconomic groups worse than the affluent. The SARS-CoV-2 seroprevalence and the specificity of anti-SARS-CoV-2 antibody tests in South Africa is not known. Methods: We tested 405 volunteers representing all socioeconomic strata from the workforce of a popular shopping and tourist complex in central Cape Town with the Abbott SARS-CoV-2 IgG assay. We assessed the association between antibody positivity and COVID-19 symptom status, medical history, and sociodemographic variables. We tested 137 serum samples from healthy controls collected in Cape Town prior to the COVID-19 pandemic, to confirm the specificity of the assay in the local population. Results: Of the 405 volunteers tested one month after the first peak of the epidemic in Cape Town, 96(23.7%) were SARS-CoV-2 IgG positive. Of those who tested positive, 46(47.9%) reported no symptoms of COVID-19 in the previous 6 months. Seropositivity was significantly associated with living in informal housing, residing in a subdistrict with low income-per household, and having a low-earning occupation. The specificity of the assay was 98.54%(95%CI 94.82%-99.82%) in the pre-COVID controls. Conclusions: There is a high background seroprevalence in Cape Town, particularly in people of lower socioeconomic status. Almost half of cases are asymptomatic, and therefore undiagnosed by local testing strategies. These results cannot be explained by low assay specificity. [ABSTRACT FROM AUTHOR]

In high-burden settings, the diagnosis of pleural tuberculosis (TB) is frequently inferred in patients who present with lymphocyte predominant exudative effusions and high adenosine deaminase (ADA) levels. Two recent small retrospective studies suggested that the lactate dehydrogenase (LDH)/ADA ratio is significantly lower in TB than in non-TB pleural effusions and that the LDH/ADA ratio may be useful in differentiating pleural TB from other pleural exudates. We compared the pleural LDH/ADA ratios, ADA levels, and lymphocyte predominance of a prospectively collected cohort of patients with proven pleural TB (n = 160) to those with a definitive alternative diagnosis (n = 68). The mean pleural fluid LDH/ADA ratio was lower in patients with pleural TB than alternative diagnoses (6.2 vs. 34.3, p < 0.001). The area under the receiver operating characteristic curve was 0.92 (p < 0.001) for LDH/ADA ratio and 0.88 (p < 0.001) for an ADA ≥40 U/L alone. A ratio of ≤12.5 had the best overall diagnostic efficiency, while a ratio of ≤10 had a specificity of 90% and a positive predictive value of 95%, with a sensitivity of 78%, making it a clinically useful "rule in" value for pleural TB in high incidence settings. When comparing the LDH/ADA ratio to an ADA level ≥40 U/L in the presence of a lymphocyte predominant effusion, the latter performed better. When lymphocyte values are unavailable, our data suggest that the LDH/ADA ratio is valuable in distinguishing TB effusions from other pleural exudates. [ABSTRACT FROM AUTHOR]

Summary: In addition to well‐known roles in RNA metabolism, the nucleolus and Cajal bodies (CBs), both located within the nucleus, are involved in plant responses to biotic and abiotic stress. Previously we showed that plants in which expression of the CB protein coilin is downregulated are more susceptible to certain viruses including tobacco rattle virus (TRV), suggesting a role of coilin in antiviral defence.Experiments with coilin‐deficient plants and the deletion mutant of the TRV 16K protein showed that both 16K and coilin are required for restriction of systemic TRV infection. The potential mechanisms of coilin‐mediated antiviral defence were elucidated via experiments involving co‐immunoprecipitation, use of NahG transgenic plants deficient in salicylic acid (SA) accumulation, measurement of endogenous SA concentrations and assessment of SA‐responsive gene expression.Here we show that TRV 16K interacts with and relocalizes coilin to the nucleolus. In wild‐type plants these events are accompanied by activation of SA‐responsive gene expression and restriction of TRV systemic infection. By contrast, viral systemic spread was enhanced in NahG plants, implicating SA in these processes.Our findings suggest that coilin is involved in plant defence, responding to TRV infection by recognition of the TRV‐encoded 16K protein and activating SA‐dependent defence pathways. [ABSTRACT FROM AUTHOR]

Tuberculous effusion is a common disease entity with a spectrum of presentations from a largely benign effusion, which resolves completely, to a complicated effusion with loculations, pleural thickening and even frank empyema, all of which may have a lasting effect on lung function. The pathogenesis is a combination of true pleural infection and an effusive hypersensitivity reaction, compartmentalized within the pleural space. Diagnostic thoracentesis with thorough pleural fluid analysis including biomarkers such as adenosine deaminase and gamma interferon achieves high accuracy in the correct clinical context. Definitive diagnosis may require invasive procedures to demonstrate histological evidence of caseating granulomas or microbiological evidence of the organism on smear or culture. Drug resistance is an emerging problem that requires vigilance and extra effort to acquire a complete drug sensitivity profile for each tuberculous effusion treated. Nucleic acid amplification tests such as Xpert MTB/RIF can be invaluable in this instance; however, the yield is low in pleural fluid. Treatment consists of standard anti‐tuberculous therapy or a guideline‐based individualized regimen in the case of drug resistance. There is low‐quality evidence that suggests possible benefit from corticosteroids; however, they are not currently recommended due to concomitant increased risk of adverse effects. Small studies report some short‐ and long‐term benefit from interventions such as therapeutic thoracentesis, intrapleural fibrinolytics and surgery but many questions remain to be answered. [ABSTRACT FROM AUTHOR]

OBJECTIVE To describe how North American veterinary medical teaching institutions VMTIs) provide communication skills training to students. SAMPLE Faculty coordinators of communication skills training programs (CSTPs) at 30 North American VMTIs. PROCEDURES An online survey instrument was designed and administered to each respondent followed by a telephone (n = 28) or in-person (2) interview. The survey and interview process were designed to evaluate all aspects of CSTPs, such as communication framework used, program format, number of student-contact hours, staffing models, outcome assessment, faculty background, program priorities, and challenges. Descriptive results were generated, and guidelines for future development of CSTPs were recommended. RESULTS 27 US and 3 Canadian VMTIs were represented, and communication skills training was required at all. Twenty-five CSTPs used the Calgary-Cambridge Guide framework. Respondents provided a mean of 33 student-contact hours of training, primarily in the first 3 years of the veterinary curriculum in lecture (mean, 12 hours), communication laboratory (13 hours), and self-study (8 hours) formats with formative feedback. Communication skills training was integrated with other disciplines at 27 VMTIs. Most CSTPs were coordinated and taught by I faculty member with a < 0.50 full-time equivalent commitment and no administrative support. Stated priorities included acquisition of resources for CSTP faculty, administrative support, and video-equipped facilities; increasing integration of CSTPs into curricula; and assessment of educational outcomes. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that support for CSTPs and recognition of their value continue to grow, but a lack of resources, faculty expertise, validated methods for outcomes assessment, and leadership remain challenges. [ABSTRACT FROM AUTHOR]

The article focuses on remarkable aspect of the COVID-19 pandemic is the intensity of the search for novel diagnostic and therapeutic tools. Topics include the recognition that COVID-19 is a novel disease with a multitude of clinical manifestations and unexpected respiratory phenotypes, overwhelming number of severely ill patients with COVID-19 pneumonia has generated a lot of information, and the data has poured out of country after country has passed many problems of COVID-19.

The authors convey their thoughts about indwelling pleural catheters (IPCs) for malignant pleural effusions. Topics mentioned include the practice of offering pleural interventions to patients who are truly asymptomatic, the impact of IPCs on the need for further pleural interventions and the number of days spent in hospital, and the use of a low-cost alternative to the current commercially available IPCs.

Kenneth E. Kirk is regarded as the person who revived moral theology in the Anglican tradition in the early to mid-twentieth century. This article argues that a renewal of interest in mysticism, led especially by W.R. Inge and Evelyn Underhill in the first two decades of the twentieth century, was influential upon Kirk’s outlook, especially his association of moral theology with ascetic theology (or mystical theology), and linking of personal holiness with ethics. Kirk made prayer – especially contemplative prayer – and worship primary in the education of the soul, the forging of Christian character and therefore the creation of a moral agent. [ABSTRACT FROM AUTHOR]

Tuberculosis (TB) is the leading infectious cause of death worldwide, and the commonest cause of death in people living with HIV. Globally, pleural TB remains one of the most frequent causes of pleural exudates, particularly in TB-endemic areas and in the HIV positive population. Most TB pleural effusions are exudates with high adenosine deaminase (ADA), lymphocyte-rich, straw-coloured and free flowing, with a low yield on mycobacterial culture. TB pleurisy can also present as loculated neutrophilpredominant effusions which mimic parapneumonic effusions. Rarely, they can present as frank TB empyema, containing an abundance of mycobacteria. Up to 80% of patients have parenchymal involvement on chest imaging. The diagnosis is simple if M. tuberculosis is detected in sputum, pleural fluid or biopsy specimens, and the recent advent of liquid medium culture techniques has increased the microbiological yield dramatically. Where the prevalence of TB is high the presence of a lymphocytepredominant exudate with a high ADA has a positive predictive value of 98%. In low prevalence areas, the absence of an elevated ADA and lymphocyte predominance makes TB very unlikely, and pleural biopsy should be performed to confirm the diagnosis. Pleural biopsy for liquid culture and susceptibility testing must also be considered where the prevalence of drug resistant TB is high. Treatment regimens are identical to those administered for pulmonary TB. Initial pleural drainage may have a role in symptom relief and in hastening the resolution of the effusion. Surgical intervention may be required in loculated effusions and empyemas. [ABSTRACT FROM AUTHOR]

Revascularization of an amputated limb within 4–6 h is essential to avoid extensive ischemia/reperfusion (I/R) injury leading to vascular leakage, edema and tissue necrosis. I/R injury is a pathological inflammatory condition that occurs during reperfusion of an organ or tissue after prolonged ischemia. It is characterized by a complex crosstalk between endothelial cell activation and the activation of plasma cascades. Vasculoprotective pharmacological intervention to prevent I/R injury might be an option to prolong the time window between limb amputation and successful replantation. We used C1-easterase inhibitor (C1-INH) in this study because of its known inhibitory effects on the activation of the complement, coagulation and kinin cascades. Forelimbs of 8 large white pigs were amputated, subjected to ischemia, and then reperfused with autologous whole blood. All limbs were exposed to 9 h of cold ischemia at 4 °C. After 2 h of cold ischemia the limbs were either perfused with of C1-INH (1U/ml in hydroxyethyl starch, n = 8) or hydroxyethyl starch alone (n = 7). After completion of the 9-h ischemia period, all limbs were ex vivo perfused with heparinized autologous whole blood for 12 h using a pediatric heart lung machine to simulate in vivo revascularization. Our results show that I/R injury in the control group led to a significant elevation of tissue deposition of IgG and IgM, complement C3b/c, C5b-9 and MBL. Also, activation of the kinin system was significantly increased, namely bradykinin in plasma, and expression of bradykinin receptors 1 and 2 in tissue. In addition, markers for endothelial integrity like expression of CD31, VE-cadherin and heparan sulfate proteoglycans were decreased in reperfused tissue. Limb I/R injury also led to activation of the coagulation cascade with a significant elevation of fibrin and thrombin deposition and increased fibrinogen-like protein-2 expression. C1-INH treated limbs showed much less activation of plasma cascades and better protection of endothelial integrity compared to the reperfused control limbs. In conclusion, the use of the cytoprotective drug C1-INH significantly reduced I/R injury by protecting the vascular endothelium as well as the muscle tissue from deposition of immunoglobulins, complement and fibrin. [ABSTRACT FROM AUTHOR]

Whereas research in the craniosacral field tends to focus on the benefits for the individual, in this paper I go a step further to argue that because of its psychoid nature, biodynamic craniosacral therapy (BCST) acts as an embodied practice to raise earth consciousness at both the collective and individual levels. The therapy is a light-touch practice grounded in empathetic presence in which practitioners work to attune the subtle rhythms of their own body, the client's body, and the "body" of the environment and natural world in which they meet. Referencing my clinical experience, the essay proposes that craniosacral biodynamics, bringing consciousness to the human organism, may offer a felt experience of the interconnectedness of all being, even bringing to consciousness our relationship with the earth itself. This essay highlights where Jungian theory and BCST not only overlap but also where they might support each other to revision our relationship to the planet. [ABSTRACT FROM AUTHOR]

In 1902, William James gave his Gifford Lectures in Edinburgh, entitled The Varieties of Religious Experience, in which he claimed that such experience was a part of human nature, and was necessarily the foundation of all institutional religion. His work has often been singled out as leading to an increasingly private and individualistic understanding of religion, but this paper places his work in a broader movement of the early twentieth century that heralded a revival of interest in religious experience and, especially, mysticism. It explores the work of two English writers, W.R. Inge and Evelyn Underhill, in relation to James, and argues that the revival of interest in mysticism was a significant response to the intellectual challenges to faith in modernity. [ABSTRACT FROM AUTHOR]

The article reflects on the study "Exploring the Impact of Toxic Attitudes and a Toxic Environment on the Veterinary Healthcare Team" which offers suggestions for optimizing team performance. It mentions that a satisfied team can be created through several measures which include maintaining effective communication, setting achievable goals, and dividing work load.

OBJECTIVE To evaluate veterinarian-client communication and veterinarian and client satisfaction with veterinary visits before and after veterinarians underwent a 6-month communication skills training program in a practice setting. DESIGN Case-based pretest-posttest intervention study. SAMPLE I purposely selected companion-animal practice. PROCEDURES The practice team (3 veterinarians. 5 veterinary technicians. I receptionist. and I office manager) participated m a 6-month educational program (intervention) that included interactive communication modules, individual coaching, and a communication laboratory. For each of the veterinarians. 6 appontments were video recorded and 30 additional clients completed a visit satisfaction survey both before and after the intervention. The Roier interaction analysis system was used to analyze the video-recorded appointments. RESULTS After the intervention, appointments were S.4 minutes longer and veterinarians asked 60% fewer elosed-ended lifestyle-social questions, provided M times as much biomedically related client education, and used I S and 1.25 times as much faciliutive and emotional rapport communication, respectively. compared with before the intervention. Clients provided veterinarians with 1.3 times as much biomedically related information and engaged in twice as much social conversation. After the intervention, veterinarians perceived their clients as complaining less and being more personable and trusting, and clients felt more involved in the appointment and reported that the veterinarian expressed greater interest in their opinion. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the intervention resulted in veterinarians who spent more time educating and building rapport with their clients and facilitating client input in an unhurried environment, which enhanced overall veterinarian visit satisfaction and various aspects of client visit satisfaction. [ABSTRACT FROM AUTHOR]

The article offers information no a study related to the effects of transthoracic ultrasound (TUS) of ultrasonography on daily clinical practitioners. Topics discussed include use of TUS for the assessment of pleural effusions (PE), pneumothoraces, pneumonia, and lung cancer; the role of aetiology and chronicity of an effusion in variations in the TUS appearance of a PE; and the results showing that the echogenicity of a PE have low specificity for identifying an underlying exudate.

The article focuses on significance of role playing in management of communication skills among veterinary team members. Topics discussed include exploration of different qualities associated with team members such as confidentiality, establishment of rapport among team members for stimulation of spontaneity in members, reenactments of different scenarios for enhancement of communication and development of professionalism by role-playing in non-judgmental environment.

The article looks at the treatment of diseases related to ornamental fish. Topics discussed include instruction on transporting fish, evaluation of fish patients and testing of basic water quality, and use of disposable gloves to minimize possible zoonotic disease transmission and to avoid damage to the fish's skin.

Background: End-stage renal disease is the irreversible final stage of chronic kidney disease and is fatal when not managed by either transplantation or dialysis. Transplantation is generally preferred over dialysis. However, to prevent graft rejection or loss, lifelong immunosuppression is required. Tacrolimus is currently the cornerstone of post-transplantation immunosuppression. The study aim was to carry out an economic evaluation of immunosuppression, including more recent agents such as a once-daily prolonged-release formulation of tacrolimus (Advagraf™) and belatacept, relative to a twice-daily immediate-release formulation of tacrolimus (Prograf™). Methods: A model was constructed comprising six states: onset of biopsy-confirmed acute rejection, functioning graft with or without a biopsy-confirmed acute rejection, non-functioning graft (dialysis), re-transplantation, and death. Data on clinical effectiveness were derived from a systematic literature review and the model captured the effects of patient adherence to immunosuppressant therapy on graft survival using relative risk of graft survival and published data on adherence in patients using Advagraf and Prograf. In the base case, the time horizon was 25 years and one-way and probabilistic sensitivity analyses were conducted. Results: The analysis demonstrated that Prograf was cost-effective when compared with cyclosporin and belatacept and was more effective than sirolimus, but would not be considered cost-effective against sirolimus. The modeled improvement in the adherence profile of patients using Advagraf relative to Prograf resulted in both improved clinical outcomes and reduced costs. Conclusion: Prograf was more clinically effective than cyclosporin, belatacept, and sirolimus, supporting its current positioning as the mainstay of immunosuppressive therapy in renal transplant recipients. Based on improved patient adherence with Advagraf, the model projected that Advagraf would be both more effective and less costly than Prograf. Replacing Prograf with Advagraf as the standard of care for post-transplant immunosuppression could likely result in both cost savings and improved clinical outcomes. [ABSTRACT FROM AUTHOR]

The article offers information on the concept of men who cry in the workplace. Topics discussed include the difference between men and women in expressing emotion, the expectation in men as strong, breadwinners, and leaders, and the research which found out that expression of emotions is associated with power and status in workplace relationships. Also mentioned the battle against societal constraints and cultural norms of showing emotions by men.

Endothelial dysfunction is an early event of vascular injury defined by a proinflammatory and procoagulant endothelial cell (EC) phenotype. Although endothelial glycocalyx disruption is associated with vascular damage, how various inflammatory stimuli affect the glycocalyx and whether arterial and venous cells respond differently is unknown. Using a 3D round-channel microfluidic system we investigated the endothelial glycocalyx, particularly heparan sulfate (HS), on porcine arterial and venous ECs. Heparan sulfate (HS)/glycocalyx expression was observed already under static conditions on venous ECs while it was flow-dependent on arterial cells. Furthermore, analysis of HS/glycocalyx response after stimulation with inflammatory cues revealed that venous, but not arterial ECs, are resistant to HS shedding. This finding was observed also on isolated porcine vessels. Persistence of HS on venous ECs prevented complement deposition and clot formation after stimulation with tumor necrosis factor α or lipopolysaccharide, whereas after xenogeneic activation no glycocalyx-mediated protection was observed. Contrarily, HS shedding on arterial cells, even without an inflammatory insult, was sufficient to induce a proinflammatory and procoagulant phenotype. Our data indicate that the dimorphic response of arterial and venous ECs is partially due to distinct HS/glycocalyx dynamics suggesting that arterial and venous thrombo-inflammatory disorders require targeted therapies. [ABSTRACT FROM AUTHOR]

Cajal bodies (CBs) are distinct nuclear bodies physically and functionally associated with the nucleolus. In addition to their traditional function in coordinating maturation of certain nuclear RNAs, CBs participate in cell cycle regulation, development, and regulation of stress responses. A key “signature” component of CBs is coilin, the scaffolding protein essential for CB formation and function. Using an RNA silencing (loss-of-function) approach, we describe here new phenomena whereby coilin also affects, directly or indirectly, a variety of interactions between host plants and viruses that have RNA or DNA genomes. Moreover, the effects of coilin on these interactions are manifested differently: coilin contributes to plant defense against tobacco rattle virus (tobravirus), tomato black ring virus (nepovirus), barley stripe mosaic virus (hordeivirus), and tomato golden mosaic virus (begomovirus). In contrast with potato virus Y (potyvirus) and turnip vein clearing virus (tobamovirus), coilin serves to increase virus pathogenicity. These findings show that interactions with coilin (or CBs) may involve diverse mechanisms with different viruses and that these mechanisms act at different phases of virus infection. Thus, coilin (CBs) has novel, unexpected natural functions that may be recruited or subverted by plant viruses for their own needs or, in contrast, are involved in plant defense mechanisms that suppress host susceptibility to the viruses. [ABSTRACT FROM AUTHOR]

The article focuses on the growing popularity of cathedrals in terms of worshippers and general visitors. It informs that the number of people attending services at Anglican cathedrals in England increased by 30 percent in the last 10 years. It also informs that growth in the number of worshippers at cathedrals is found in other parts of the Anglican Communion.

Objective--To describe the relationship between veterinarian and client genders and veterinarian-client-patient communication. Design--Cross-sectional descriptive study. Sample--Random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedures--For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed with the Roter interaction analysis system (RIAS). Linear regression was conducted to study the relationship between demographic factors, measures of veterinarian-client-patient communication, and gender of the veterinarian and client. Results--Female veterinarians conducted more relationship-centered appointments, provided more positive and rapport-building statements, talked more to the patient, and were perceived as less hurried or rushed, compared with male veterinarians. Clients were more likely to provide lifestyle-social information to female veterinarians. Same-gender veterinarian-client interactions were relationship centered and included client provision of more lifestyle-social information. Conclusions and Clinical Relevance--Gender influenced veterinarian-client-patient communication, and previously described physician gender differences in medical communication were largely replicated in the veterinary context. (J Am Vet Med Assoc 2012;241:81-88) [ABSTRACT FROM AUTHOR]

Aims. To evaluate the effect of a structured preoperative preparation on child and parent state anxiety, child behavioural change and parent satisfaction. Background. It is estimated that around 50-70% of hospitalised children experience severe anxiety and distress prior to surgery. Children who are highly anxious and distressed preoperatively are likely to be distressed on awakening and have negative postoperative behaviour. Although education before surgery has been found to be useful mostly in North America, the effectiveness of preoperative preparation programme adapted to the Australian context remains to be tested. Design. This single-blind randomised controlled study was conducted at a tertiary referral hospital for children in Western Australia. Methods. Following ethics approval and parental consent, 73 children and one of their carers (usually a parent) were randomly assigned into two groups. The control group had standard practice with no specific preoperative education and the experimental group received a preoperative preparation, including a photo file, demonstration of equipment using a role-modelling approach and a tour. Results. The preoperative preparation reduced parent state anxiety significantly (−2·32, CI −4·06 to −0·56, p = 0·009), but not child anxiety (−0·59, CI −1·23 to 0·06, p = 0·07). There was no significant difference in child postoperative behaviour or parent satisfaction between the groups. There was a significant two-point pain score reduction in the preoperative preparation group, when compared with the control group median 2 (IQR 5) and 4 (IQR 4), respectively ( p = 0·001). Conclusions. Preoperative preparation was more efficient on parent than child. Although the preoperative preparation had limited effect on child anxiety, it permitted to decrease pain experience in the postoperative period. Relevance to clinical practice. Parents should be actively involved in their child preoperative preparation. [ABSTRACT FROM AUTHOR]

Objective--To measure veterinarian satisfaction with companion animal visits through an adaptation of a previously validated physician visit satisfaction scale and to identify demographic, personality, appointment, and communication factors that contribute to veterinarian visit satisfaction. Design--Cross-sectional descriptive study. Sample--Random sample of 50 companion animal practitioners in southern Ontario, Canada, and convenience sample of 300 clients and their pets. Procedures--For each practitioner, 6 clinical appointments were videotaped, and the resulting 300 videotapes were analyzed by use of the Roter interaction analysis system. The physician satisfaction scale, Rosenberg self-esteem scale, and interpersonal reactivity index were used to measure veterinarian visit satisfaction, self-esteem, and empathy, respectively. Linear regression analysis was conducted to study the relationship between factors and veterinarian visit satisfaction. Results--Veterinarian visit satisfaction ranged from 1 to 5 (mean ± SD, 3.97 ± 0.99) and differed significantly between wellness appointments (mean scale score, 4.13) and problem appointments (mean scale score, 3.81). Various elements of client and veterinarian communication as well as personality measures of veterinarian self-esteem and empathy were associated with veterinarian satisfaction. The specific factors differed depending on the nature of the appointment. Conclusions and Clinical Relevance--Results suggested that veterinarian visit-specific satisfaction is enhanced through the use of communication that builds relationships with clients and is associated with degrees of veterinarian empathetic concern and veterinarian self-esteem. The implications extend to overall job satisfaction and its potential link to the health and well-being of individual veterinarians. [ABSTRACT FROM AUTHOR]

In this article the author discusses aspects of government supported public education in the United States. She claims that because public education is supported by tax payers indirectly, rather than by those who directly benefit from education, the education market will be under supplied, will be of poor quality, and suffer from neglect. A number of topics are addressed including the provisions of secondary education, aspects of the public funding of higher education, and the author's contention that education should be a private not a public good.

Abstract: Objective: To provide communication skills education to veterinary professionals in the practice setting and evaluate the training by measuring veterinarian communication pre- and post-intervention. Methods: This is a case-based pre-test/post-test intervention study of a veterinary practice in Denver, CO. Four veterinarians from a single practice and 48 clients (selected to represent wellness and problem visits) were recruited to the study. The veterinarians took part in a training intervention consisting of a year-long curriculum, including interactive communication modules, individual coaching and communication laboratories. Six visit interactions were measured for each of the 4 veterinarians pre- and post-skill training. The Roter interaction analysis system (RIAS) was used to analyze the study''s 48 videotapes. Results: Compared to the pre-training visits, veterinarians gathered twice as much lifestyle-social data (p <0.02), and used 1.5 times more partnership building (p <0.03) and positive rapport-building (p <0.01) communication. Clients provided 1.4 times more lifestyle/social information (p <0.02) and expressed 1.7 times more emotional statements (p <0.01) in post-training visits. Conclusion: The training intervention promoted a more client-centered approach to veterinarian–client communication. Practice implications: Practice-based communication training is novel to veterinary practice. As a case study, generalization of the findings are limited, however the findings support the efficacy of the communication intervention and enhanced utilization of veterinarian–client communication skills by these veterinarians. [Copyright &y& Elsevier]

Caspases are cysteine-dependent proteases and are important components of animal apoptosis. They introduce specific breaks after aspartate residues in a number of cellular proteins mediating programmed cell death (PCD). Plants encode only distant homologues of caspases, the metacaspases that are involved in PCD, but do not possess caspase-specific proteolytic activity. Nevertheless, plants do display caspase-like activities indicating that enzymes structurally distinct from classical caspases may operate as caspase-like proteases. Here, we report the identification and characterisation of a novel PCD-related subtilisin-like protease from tobacco and rice named phytaspase (plant aspartate-specific protease) that possesses caspase specificity distinct from that of other known caspase-like proteases. We provide evidence that phytaspase is synthesised as a proenzyme, which is autocatalytically processed to generate the mature enzyme. Overexpression and silencing of the phytaspase gene showed that phytaspase is essential for PCD-related responses to tobacco mosaic virus and abiotic stresses. Phytaspase is constitutively secreted into the apoplast before PCD, but unexpectedly is re-imported into the cell during PCD providing insights into how phytaspase operates. [ABSTRACT FROM AUTHOR]

Diversity is defined as differences between people, including age, gender, ethnicity, culture, religion, political affiliation, socio-economic status, education level, gender identity, sexual orientation, and physical, emotional, and mental abilities.1 Differentiating within such categories is natural but limits the ability to work with and learn through diversity. [ABSTRACT FROM AUTHOR]

The article discusses the effects of oversharing one's business enterprise with anyone. It mentions that oversharing about one's business enterprise with anyone can be done through social media and its bad effect is that it tends to damage professional relationships with clients and team members alike.

Objective—To compare the clinical interview process, content of the medical dialog, and emotional tone of the veterinarian-client-patient interaction during wellness appointments and appointments related to a health problem in companion animal practice. Design—Cross-sectional descriptive study. Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 problem appointments) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes. Results—Wellness appointments were characterized by a broad discussion of topics, with 50% of data-gathering statements and 27% of client education statements related to the pet's lifestyle activities and social interactions. Wellness appointments included twice as much verbal interaction with the pet as did problem appointments, and the emotional atmosphere of wellness appointments was generally relaxed. There were more social talk, laughter, statements of reassurance, and compliments directed toward the client and pet. In contrast, during problem appointments, 90% of the data gathering and client education focused on biomedical topics. Coders rated veterinarians as hurried during 30 of the 150 (20%) problem appointments; they rated clients as anxious during 39 (26%) problem appointments and as emotionally distressed during 21(14%). Conclusions and Clinical Relevance—Results suggested that veterinarian-client-patient communication differed between wellness and problem appointments. Owing to the emphasis on biomedical content during problem appointments, veterinarians may neglect lifestyle and social concerns that could impact patient management and outcomes, such as client satisfaction and adherence to veterinarian recommendations. [ABSTRACT FROM AUTHOR]

Objective—To identify communication patterns used by veterinarians during clinical appointments in companion animal practice. Design—Cross-sectional descriptive study. Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns. Results—175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twenty-three (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40). Conclusions and Clinical Relevance—Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these communication patterns has implications for veterinary training and client and patient outcomes. [ABSTRACT FROM AUTHOR]

Due to their capability of eliciting a form of posttranscriptional gene silencing (termed virus-induced gene silencing or VIGS), plant viruses are increasingly used as reverse-genetics tools for functional characterization of plant genes. RNA viruses have been shown to trigger silencing in a variety of host plants, including members of Solanacae and Arabidopsis (Arabidopsis thaliana). Several factors affect the silencing response, including host range and viral tropism within the plant. The work presented here demonstrates that a modified tobacco rattle virus (TRV) vector retaining the helper protein 2b, required for transmission by a specific vector nematode, not only invades and replicates extensively in whole plants, including meristems, but also triggers a pervasive systemic VIGS response in the roots of Nicotiana benthamiana, Arabidopsis, and tomato (Lycopersicon esculentum). This sustained .VIGS response was exemplified by the silencing of genes involved in root development (IRT1, TTG1 [transparent testa glabra], RHL1 [root hairless 1], and β-tubulin), lateral root-meristem function (RML1 [root meristemless1]), and nematode resistance (Mi). Roots of silenced plants exhibit reduced levels of target mRNA and phenocopy previously described mutant alleles. The TRV-2b vector displays increased infectivity and meristem invasion, both key requirements for efficient VIGS-based functional characterization of genes in root tissues. Our data suggest that the TRY helper protein 2b may have an essential role in the host regulatory mechanisms that control TRY invasion. [ABSTRACT FROM AUTHOR]

Objective-To identify specific components of veterinarian-client-patient communication during clinical appointments in companion animal practice. Design-Cross-sectional descriptive study. Sample Population-A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets. Procedure-For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped, and the Roter interaction analysis system (RIAS) was used to analyze the resulting 300 videotapes. Statements made during each appointment were classified by means of a communication framework reflecting the 4 essential tasks of the appointment (ie, data gathering, education and counseling, relationship building, and activation and partnership). Results-57% of the veterinarians contacted (50/87) and 99% of the clients contacted agreed to participate in the study. Mean duration of the appointments was 13 minutes. Typically, veterinarians contributed 62% of the total conversation and clients contributed 38%. Fifty-four percent of the veterinarian interaction was with the client, and 8% was with the pet. Data gathering constituted 9% of the veterinarian-to-client communication and was primarily accomplished through closed-ended questioning; 48% of veterinarian-to-client communication involved client education and counseling, 30% involved relationship building, and 7% involved activation and partnership (the remaining 6% constituted orientation). Conclusions and Clinical Relevance-Results suggest that the RIAS was a reliable method of assessing the structure, process, and content of veterinarian client-patient communication and that some veterinarians do not use all the tools needed for effective communication. [ABSTRACT FROM AUTHOR]