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Empathy is a fundamental tool in clinical practice, but despite its importance and benefits, it is often underrepresented in medical curricula. This study explored the evolution of medical students' empathy longitudinally across six years of undergraduate training following the introduction of a curriculum with 4-hour workshops during each of the six clinical rotations from Years 4 to 6, complemented by self-reflections after each rotation. Students of the 2016 class (graduated 2022) completed the Jefferson Scale of Empathy-Students (JSE-S) and the Interpersonal Reactivity Index (IRI) at the beginning of Year 1 (T0) of studies, beginning Year 3 (T1), end Year 3 (T2) and end Year 6 (T3). The NEO Five-Factor Personality Inventory was completed at T0. Empathy scores across timepoints were analyzed using repeated measured analyses of variance (ANOVA). 36.1% and 32.5% of 169 eligible students completed the JSE-S and IRI scores respectively at all four timepoints. The JSE-S total mean score increased significantly across the six years of medical course (p < 0.001), as did the IRI total mean score (p < 0.001). In addition, the mean JSE-S total score increased significantly between T3 vs T0 (p < 0.001), T3 vs T2 (p < 0.001 and T2 vs T1 (p = 0.028); and the mean IRI total increased significantly between T3 vs T0 (p < 0.001) and T3 vs T2 (p < 0.001). Medical students who experienced a new professionalism program increased their empathy as measured by the JSE-S and IRI instruments across the six years of curriculum.

Torque teno virus (TTV) viral load (VL), a component of the human virome, increases during immune suppression or dysregulation. This study aimed to explore TTV VL in youths living with vertically acquired HIV (YWVH) and its potential as an immunovirological marker. We performed an observational, retrospective study involving YWVH under antiretroviral treatment (ART) from the Spanish Cohort of HIV-infected children, adolescents, and vertically HIV-infected patients transferred to Adult Units (CoRISpe-FARO), compared to HIV-negative healthy donors (HD). Plasma TTV VL was assessed by qPCR. T-cell phenotype was analysed on cryopreserved peripheral blood mononuclear cells by flow cytometry. Correlations with baseline CD4 and CD8 and long-term virological evolution were examined. A total of 57 YWVH were compared with 23 HD. YWVH had a median CD4 T-cells of 736 cells/mm 3 [IQR: 574–906], a median of 17 years [IQR: 14–20.5] since ART initiation, and 65 months [IQR: 39–116] under HIV-RNA virological control. TTV VL was higher among YWVH and in males compared with females ( p  < 0.05). Among YWVH, TTV VL correlated with CD4 and CD8 counts and the CD4/CD8 ratio ( p  = 0.002; r  = − 0.39, p  = 0.037; r  = 0.277, p  = 0.005; r  = − 0.37 respectively). TTV VL correlated with activation expression markers (HLA-DR+/CD38+) on CD4 ( p  = 0.007, r  = 0.39) and the soluble proinflammatory cytokine IL-6 ( p  = 0.006, r  = 0.38).

The COVID-19 pandemic remained worldwide for almost three years, but little is known about the dynamics of humoral immune response to the third dose over time and its protection from infection. Our aim was to assess the humoral immune response after the third dose of the different vaccines administered to SARS-CoV-2 naive and previously infected individuals, and its correlation with protection in an academic community. For each person studied (185), three blood samples were taken between December 2021 and July 2022, one month apart. Anti-S antibodies were quantified by ELISA, while anti-N antibody levels were determined by ECLIA. Most of the participants had received two doses of viral vector-based, mRNA-based and virus-inactivated vaccines. Although anti-N antibody levels revealed that 80% of the individuals had been exposed to the virus before or during the study, only 42% reported having been diagnosed. When anti-S IgG levels were measured 3–5 months after the second dose of any vaccine, they were higher in those previously infected individuals. The same results were observed for anti-N IgG levels in those who received 2 doses of the virus-inactivated vaccine. When analyzing the dynamics of anti-S antibodies we observed that, although positive IgG antibody levels were detected 5–6 months after the second dose administration, those observed 30–60 days after the third dose were significantly higher and remained so for at least 8 months. Higher levels of anti-S IgG antibodies at the first sampling were associated with a lower incidence of subsequent infection. The same association was seen in people who received the booster compared with those who received two doses. This study provides further evidence that anti-S IgG antibodies remained at high levels over time, and both anti-S levels and the third dose of anti-SARS-CoV-2 vaccine correlate with protection against the infection. It also shows that infection acts as a booster of immunization, increasing levels of both anti-N and anti-S IgG.

Various immune checkpoint proteins have been linked to cirrhosis. This study aimed to explore the association between plasma levels of these proteins measured one year after successful HCV treatment and persistently liver stiffness (defined as liver stiffness measurement (LSM) ≥ 12.5 kPa) five years after HCV treatment in people with HIV (PWH). We conducted a retrospective study involving 39 patients with HIV/HCV-coinfection who had advanced fibrosis or cirrhosis and achieved sustained virologic response (SVR). Plasma samples were obtained one year after treatment, and levels of immune checkpoints along with inflammatory biomarkers were evaluated using a Luminex 200 TM analyzer. Statistical analyses were performed using Generalized Linear Models (GLMs) with a gamma distribution. Spearman correlation tests were used to analyze the correlation between significant immune checkpoints and inflammatory biomarkers. Although LSM values showed a decreasing trend over the years following successful HCV treatment, this trend was not statistically significant due to substantial variability among PWH. Persistently high liver stiffness was observed in 61.5% of patients five years after HCV treatment. Elevated plasma levels of soluble BTLA, PD-1, and TIM-3 one year after HCV treatment were associated with persistently liver stiffness five years later. These significant immune checkpoints were found to correlate with inflammatory biomarkers in PWH with persistently high liver stiffness. In conclusion, increased plasma concentrations of immune checkpoints one year after successful HCV therapy were linked to persistently high liver stiffness five years later, particularly BTLA, PD-1, and TIM-3. This suggests a potential immunopathological mechanism in ongoing liver stiffness post-HCV eradication.

Our research explores the fascinating relationship between sponges and their resident microbes, focusing specifically on how these microbes might influence sponge reproduction. Sponges are marine animals known for their complex and beneficial partnerships with various microbes. While previous studies have mainly looked at how these microbes are passed from parent sponges to their offspring, our study is among the first to examine how microbial communities change during the different stages of sponge reproduction. By analyzing the microbial composition in five sponge species, we discovered that significant changes occur in species with premature oocytes, suggesting that microbes may play a crucial role in providing the necessary nutrients during early egg development. This work not only enhances our understanding of sponge biology but also opens up new avenues for studying how microbes support the reproductive success of their hosts in marine environments.

Hepatitis C virus (HCV) cure after all-oral direct-acting antiviral (DAA) therapy greatly improves the liver and immune system. We aimed to assess the impact of this HCV clearance on immune system-related markers in plasma and the gene expression profile in human immunodeficiency virus (HIV)/HCV-coinfected patients with advanced cirrhosis. We performed a prospective study on 33 HIV/HCV-coinfected patients at baseline and 36 weeks after the sustained virological response. Gene expression was evaluated by RNA-seq analysis on peripheral blood mononuclear cells (PBMCs) and plasma biomarkers by multiplex immunoassays. We found a decrease in plasma biomarkers (PD1, PDL1, CXCL10, CXCL8, IL12p70, IL10, and TGFβ) and liver disease markers (stiffness measurement (LSM), hepatic venous pressure gradient (HVPG), and transaminases, among others). Furthermore, decreased plasma levels of CXCL8, CXCL10, IL10, and PD1 were associated with reduced LSM values. We also found two upregulated ( HAS1 and IRG1 ) and 15 downregulated ( CXCL11, CCL8, CCL7, CCL2, ADARB2, RRAD, MX1, SIGLEC1, IFI44L, IFI44, IFI27, IFI6, IFIT3, IFIT1B , and IFIT1 ) genes at the end of follow-up, all interferon-stimulated genes (ISGs) grouped into four pathways (“cytokine-cytokine receptor interaction”, “viral protein interaction with cytokine and cytokine receptor”, “chemokine signaling pathway”, and “hepatitis C”). Additionally, the decrease in most of these ISGs was significantly related to reduced LSM and HVPG values. In conclusion, HIV/HCV-coinfected patients with advanced-HCV-related cirrhosis who eradicated HCV following DAA therapy exhibited an improvement in liver disease markers and a significant decrease in plasma biomarkers and gene expression related to antiviral/inflammatory response, particularly in levels of several chemokines and ISGs.

Background: This study evaluated titers and amplitudes of anti-E2 antibodies (anti-E2-Abs) and neutralizing antibodies against hepatitis C virus (HCV; anti-HCV-nAbs) in HIV/HCV-coinfected individuals over five years after successful HCV treatment completion. Methods: We retrospectively analyzed 76 HIV/HCV-coinfected patients achieving sustained virologic response post-HCV treatment. Plasma levels of anti-E2-Abs and anti-HCV-nAbs against five HCV genotypes (Gt1a, Gt1b, Gt2a, Gt3a, and Gt4a) were determined using ELISA and microneutralization assays, respectively. Statistical analyses comparing the three follow-up time points (baseline, one year, and five years post-HCV treatment) were performed using generalized linear mixed models, adjusting p-values with the false discovery rate (q-value). Results: Compared to baseline, anti-E2-Abs titers decreased at one year (1.9- to 2.3-fold, q-value < 0.001) and five years (3.4- to 9.1-fold, q-value < 0.001) post-HCV treatment. Anti-HCV-nAbs decreased 2.9- to 8.4-fold (q-value < 0.002) at one year and 17.8- to 90.4-fold (q-value < 0.001) at five years post-HCV treatment. Anti-HCV-nAbs titers against Gt3a were consistently the lowest. Nonresponse rates for anti-E2-Abs remained low throughout the follow-up, while anti-HCV-nAbs nonresponse rates increased 1.8- to 13.5-fold (q-value < 0.05) at five years post-HCV treatment, with Gt3a showing the highest nonresponse rate. Conclusions: Humoral immune responses against HCV decreased consistently one and five years post-HCV treatment, regardless of HCV genotype and previous HCV therapy or type of treatment (IFN- or DAA-based therapy). This decline was more pronounced for anti-HCV-nAbs, particularly against Gt3.

HCV eradication with antiviral treatment reduces hepatic disease, but some patients remain at risk of progression to cirrhosis despite HCV clearance. We aimed to examine the association between peripheral blood mononuclear cells (PBMCs) gene expression before HCV therapy and a pronounced decrease in the liver stiffness measurement (LSM) value in HIV/HCV-coinfected patients after HCV treatment and achievement of sustained virological response (SVR). We performed a retrospective study in 48 HIV/HCV-coinfected patients who started anti-HCV treatment with at least advanced fibrosis (LSM ≥9.5). Total RNA was extracted from PBMCs at baseline, and poly(A) RNA sequencing was performed. The outcome was an LSM reduction greater than 50% (LSMred>50%) about 48 weeks after HCV treatment. Seven patients (14.5%) reduced LSM by over 50%. We found 47 significant differentially expressed (SDE) genes associated with reaching an LSMred>50% after achieving HCV eradication, 42 upregulated and 5 downregulated in the LSMred>50% group. Ten and five of these upregulated genes were classified into two significantly enriched KEGG pathways: cell cycle and progesterone-mediated oocyte maturation (q-value <0.05), respectively. Two SDE genes achieved excellent discrimination ability: NCAPG had an AUROC of 0.908, NHLRC1 of 0.879, and a logistic regression model with these two genes of 0.955. A pre-treatment gene expression signature in PBMCs was associated with liver fibrosis regression (LSMred>50%) after achieving HCV clearing with HCV therapy in HIV/HCV-coinfected patients, where two SDE genes ( and ) showed the greatest predictive capacity, which could be used as a noninvasive marker of liver fibrosis regression.

The sperm nucleus is prone to sustain DNA damage before and after ejaculation. Distribution of the damage is not homogeneous, and the factors determining differential sensitivity among nuclear regions have not yet been characterized. Human sperm chromatin contains three structural domains, two of which are considered the most susceptible to DNA damage: the histone bound domain, harboring developmental related genes, and the domain associated with nuclear matrix proteins. Using a quantitative polymerase chain reaction (qPCR) approach, we analyzed the number of lesions in genes homeobox A3 (HOXA3), homeobox B5 (HOXB 5), sex-determining region Y (SRY)-box 2 (SOX2), β-GLOBIN, rDNA 18S, and rDNA 28S in human sperm after ultraviolet irradiation (400 μW cm−2, 10 min), H2O2treatment (250 mmol l−1, 20 min), and cryopreservation, which showed differential susceptibility to genetic damage. Differential vulnerability is dependent on the genotoxic agent and independent of the sperm nuclear proteins to which the chromatin is bound and of accessibility to the transcription machinery. Immunodetection of 8-hydroxy-2'-deoxyguanosine (8-OHdG) showed that the highest level of oxidation was observed after H2O2treatment. The distribution of oxidative lesions also differed depending on the genotoxic agent. 8-OHdG did not colocalize either with histone 3 (H3) or with type IIα + β topoisomerase (TOPO IIα + β) after H2O2treatment but matched perfectly with peroxiredoxin 6 (PRDX6), which is involved in H2O2metabolism. Our study reveals that the characteristics of the sperm head domains are responsible for access of the genotoxicants and cause differential degree of damage to nuclear areas, whereas chromatin packaging has a very limited relevance. The histone-enriched genes analyzed cannot be used as biomarkers of oxidative DNA damage.

Lipids of different unsaturation degree were added to dairy ewe diet to test the hypothesis that unsaturated oils would modulate milk fatty acid (FA) profile without impairing or even improving feed efficiency. To this aim, we examined milk FA profile and efficiency metrics (feed conversion ratio (FCR), energy conversion ratio (ECR), residual feed intake (RFI), and residual energy intake (REI)) in 40 lactating ewes fed a diet with no lipid supplementation (Control) or supplemented with 3 fats rich in saturated, monounsaturated and polyunsaturated FA (i.e., purified palmitic acid (PA), olive oil (OO), and soybean oil (SBO)). Compared with PA, addition of OO decreased milk medium-chain saturated FA and improved the concentration of potentially health-promoting FA, such as cis-9 18:1, trans-11 18:1, cis-9 trans-11 CLA, and 4:0, with no impact on feed efficiency metrics. Nevertheless, FA analysis and decreases in FCR and ECR suggested that SBO supplementation would be a better nutritional strategy to further improve milk FA profile and feed efficiency in dairy ewes. The paradox of differences observed depending on the metric used to estimate feed efficiency (i.e., the lack of variation in RFI and REI vs. changes in FCR and ECR) does not allow solid conclusions to be drawn in this regard.