We have identified a 99-base pair (bp) tandem repeat consisting of two modules/repeat: a 40-bp-long d(CA.GT)20 potential Z-DNA sequence and a 59-bp-long unique sequence. This repeat is located between and differentially regulates two transcription units, rat alpha-tropomyosin and N5, organized in "head-to-head" orientation. Transient expression experiments showed orientation- and position-independent enhancer activity of the 99-bp repeat in a tissue-specific and developmental manner. Deletion analysis revealed a hierarchical organization establishing the two modules as protoenhancers. Southwestern blot analysis of crude nuclear extracts identified at least six C2C12 myotube nuclear proteins binding to the 99-bp repeat. These observations demonstrate a mammalian gene regulatory sequence structurally and functionally organized like the simian virus 40 viral enhancer and confirm in a specific gene context the contribution of a d(CA.GT)20 tract in transcriptional regulatory mechanisms as a protoenhancer.
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Health Aff (Millwood)
January 2025
Michael E. Chernew, Harvard University.
A core problem with the current risk-adjustment system in Medicare Advantage and accountable care organization (ACO) programs-the Hierarchical Condition Categories (HCC) model-is that the inputs (coded diagnoses) can be influenced for gain by risk-bearing plans or providers. Using existing survey data on health status (which provide less manipulable inputs), we found that the use of a hybrid risk score drawing from survey data and a scaled-back set of HCCs would, in addition to mitigating coding incentives, modestly lessen risk-selection incentives, strengthen payment incentives to deliver efficient care, allocate payment across ACOs more efficiently according to markers of population health that are not as affected by practice patterns or coding efforts, and redistribute payment in a manner that supports equity goals. Although sampling error and survey nonresponse present challenges, analyses suggest that these should not be prohibitive.
View Article and Find Full Text PDFCureus
January 2025
Department of Psychiatry, University of Health Sciences, Erzurum Faculty of Medicine, Erzurum, TUR.
Objective People's attitudes about aging are formed in early childhood, develop in adulthood, and are fully shaped in old age. Our study aimed to investigate the effect of self-esteem on attitudes toward aging in the elderly. Method A total of 264 people over the age of 65 without any known psychiatric or neurologic disease were included in the study.
View Article and Find Full Text PDFBr J Anaesth
January 2025
Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Auckland City Hospital Department of Anaesthesia and Perioperative Medicine, Auckland, New Zealand; Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia. Electronic address:
Operating theatres are steeply hierarchical, and yet the hierarchy between surgeons and anaesthetists is unclear, even blurry. Both the steep hierarchy and the blurriness at the top can present a risk to patient safety through inhibiting speaking up with concerns and negotiating safe patient care. A recent study in the British Journal of Anaesthesia explores hierarchy in the surgeon-anaesthesia dyad in China, in particular, the effect of increased seniority gap between surgeons and anaesthetists on anaesthesia-related adverse outcomes.
View Article and Find Full Text PDFInt J Biol Macromol
January 2025
School of Chemistry and Chemical Engineering, Guangxi University, Nanning 530004, China.
Al(III)-based adsorbents have a strong affinity for F, but suffer from problems such as poor structural stability, easy decomposition, and recycling difficulties in the powdered form. Herein, for the efficient removal of F from wastewater, magnetic chitosan/AlOOH/polyethyleneimine (MCAlP) adsorbents with a hierarchical porous structure, multifunctional groups, and structural stability were constructed through chelation, cross-linking, and immobilization strategies using chitosan as a carrier. The adsorption capacity of MCAlP for F was found to be 14.
View Article and Find Full Text PDFWomens Health Nurs
December 2024
College of Nursing & Research Institute of Nursing Innovation, Kyungpook National University, Daegu, Korea.
Purpose: Cultural competency is a very important ability of nurses in women's hospitals in providing nursing care during pregnancy and childbirth. This study explored how multicultural attitudes, multicultural efficacy, intercultural communicative competency, and hospital support for cultural competency influence the cultural competency of nurses in women's hospitals.
Methods: A cross-sectional correlational study design was used.
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