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Background We proposed that the behaviors that demonstrate compassionate care in the intensive care unit (ICU) can be self-assessed and improved among ICU clinicians. Literature showing views of intensivists about their own compassionate care attitudes is missing. Methods This was an observational, prospective, cross-sectional study. We surveyed clinicians who are members of professional societies of intensive care using the modified Schwartz Center Compassionate Care Scale® (SCCCS) about their self-reported compassionate care. A modified SCCCS instrument was disseminated via an email sent to the members of the Society of Critical Care Medicine and the European Society of Intensive Care Medicine between March and June 2021. Results Three hundred twenty-three clinicians completed the survey from a cohort of 1000 members who responded (32.3% response rate). The majority (54%) of respondents were male physicians of 49 (+ − 10 SD) years of age and 19 (12 + − SD) years in practice. The mean SCCCS was 88.5 (out of 100) with an average score of 8 for each question (out of 10), showing a high self-assessed physician rating of their compassionate care in the ICU. There was a positive association with age and years in practice with a higher score, especially for women ages 30–50 years ( P  = 0.03). Years in practice was also independently associated with greater compassion scores ( p  < 0.001). Lower scores were given to behaviors that reflect understanding perspectives of families and patients and showing caring and sensitivity. In contrast, the top scores were given to behaviors that included conducting family discussions and showing respect. Conclusion Physicians in the ICU self-score high in compassionate care, especially if they are more experienced, female, and older. Self-identified areas that need improvement are the humanistic qualities requiring sensitivity, such as cognitive empathy, which involves perspective-taking, reflective listening, asking open-ended questions, and understanding the patient’s context and worldview. These can be addressed in further clinical and ICU quality improvement initiatives.

Jorge Ferrer and colleagues have mapped regulatory SNP variants associated in GWAS with type 2 diabetes risk and glycemic traits to large clusters of enhancer elements regulating the transcriptional identity of pancreatic β cells via a highly connected transcription factor network. Type 2 diabetes affects over 300 million people, causing severe complications and premature death, yet the underlying molecular mechanisms are largely unknown. Pancreatic islet dysfunction is central in type 2 diabetes pathogenesis, and understanding islet genome regulation could therefore provide valuable mechanistic insights. We have now mapped and examined the function of human islet cis -regulatory networks. We identify genomic sequences that are targeted by islet transcription factors to drive islet-specific gene activity and show that most such sequences reside in clusters of enhancers that form physical three-dimensional chromatin domains. We find that sequence variants associated with type 2 diabetes and fasting glycemia are enriched in these clustered islet enhancers and identify trait-associated variants that disrupt DNA binding and islet enhancer activity. Our studies illustrate how islet transcription factors interact functionally with the epigenome and provide systematic evidence that the dysregulation of islet enhancers is relevant to the mechanisms underlying type 2 diabetes.

The genomic regulatory programmes that underlie human organogenesis are poorly understood. Pancreas development, in particular, has pivotal implications for pancreatic regeneration, cancer and diabetes. We have now characterized the regulatory landscape of embryonic multipotent progenitor cells that give rise to all pancreatic epithelial lineages. Using human embryonic pancreas and embryonic-stem-cell-derived progenitors we identify stage-specific transcripts and associated enhancers, many of which are co-occupied by transcription factors that are essential for pancreas development. We further show that TEAD1, a Hippo signalling effector, is an integral component of the transcription factor combinatorial code of pancreatic progenitor enhancers. TEAD and its coactivator YAP activate key pancreatic signalling mediators and transcription factors, and regulate the expansion of pancreatic progenitors. This work therefore uncovers a central role for TEAD and YAP as signal-responsive regulators of multipotent pancreatic progenitors, and provides a resource for the study of embryonic development of the human pancreas. By deciphering the transcriptional network of human embryonic pancreatic progenitors, Ferrer and colleagues identify the Hippo-responsive transcription factor TEAD1 as a regulator of the pancreatic progenitor enhancer programme.

Introduction/BackgroundAfter the studies that demonstrate the usefulness and benefit of one-step nucleic acid amplification technique (OSNA) in sentinel lymph node biopsy (SLNB) in endometrial and cervical cancer (1–4), we wanted to evaluate the expression of cytokeratin 19 (CK19) in vulvar carcinomas in order to perform intraoperative SLNB using OSNA.MethodologyThe expression of CK19 was studied in 23 paraffin tissues from vulvar biopsies diagnosed with squamous cell carcinoma from Donostia Hospital from January 2021 to December 2022. And 25 cases from Navarra Hospital from January 2021 to November 2022.ResultsThe total number of biopsies studied were 48. Of the 23 biopsies of Donostia Hospital, 6 were CK 19 positive (26%). However, in 25 biopsies of Navarra Hospital, CK19 positivity was observed in 10 (40%). Among positive cases, a different rate of staining was observed ( 8–95%). None of the positive cases was associated with HPV.A relatively different rate of CK19 expression was observed between centers. One of them approaching the percentage found in another published study (5). On the other hand, the highly diverse rate found in the two hospitals also presents similarities to the difference in CK19 expression described in cervical carcinomas (5–7).ConclusionDespite showing various positivities and in some cases of low rate, the fact of its existence makes considering the study of CK19 with immunohistochemistry in a protocol manner in biopsies of vulvar squamous cell carcinoma; patients who show such positivity could benefit from the intraoperative SLNB study with OSNA, increasing the detection of micrometastases, and avoiding the complications derived from a second intervention.DisclosuresNONE