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Depression is a serious mental disorder that affects more than 300 million people worldwide. Due to the lack of effective treatment methods, the pathogenesis of depression is necessary to study in order to understand its development and find new therapies. The review describes the main mechanisms of depression, including the monoamine hypothesis, impairment of the hipotalamic-pituitary-adrenal axis, decreased production of neurotropic factors, and neuroinflammation. Genetic correlations, gene polymorphisms, and epigenetic mechanisms are also considered. Common and different features of the etiology are analyzed for depression and depressive conditions associated with other pathologies (schizophrenia, Parkinson disease, and Alzheimer's disease). Modern experimental methods used to investigate the molecular mechanisms of depressive conditions are described with a focus on gene knockouts in laboratory animals and the CRISPR/Cas technology. Consideration is given to optogenetic and chemogenetic methods and analyses of genetic polymorphisms and their combinations. The data may provide for a better integral understanding of the modern ideas about the pathogenesis of depression as an isolated or comorbid disorder and the prospects in studying the mechanisms of depressive conditions.Long nonconding RNAs (lncRNAs) perform a variety of functions they are involved in chromatin organization, regulation of gene expression at the transcriptional and post-transcriptional levels, and regulation of activity and stability of some proteins. The majority of known lncRNAs contain sequences of mobile genetic elements (MGEs) in a sense or antisense orientation. According to several studies, MGE may serve as functional modules responsible for interactions between the lncRNA and certain proteins, DNA regions, or other RNAs. The available data make it possible to describe groups of lncRNAs that possess common structural features and contain certain MGEs and to predict the characteristics of new lncRNAs. The review summarizes the data on the role that MGE sequences play in lncRNA functions.It is commonly known that the antiviral activity of the TRIM5α protein, the intracellular retrovirus restriction factor, underlies the resistance of the Old World monkeys to HIV-1. This fact suggests that TRIM5α can potentially be used to cure HIV-1 infection in humans. The present review considers the mechanisms of HIV-1 replication inhibition by the TRIM5a protein and the prospects for using it in gene therapy of HIV infection.Living through a pandemic and social upheaval suggests the importance of revisiting the intersections of the art and activism of Felix Gonzalez-Torres and Gregg Bordowitz. These artists' works express their experiences of living through a pandemic and subsequent social change and draw out key human rights themes. The works' materials, poetics, and invitations to interact offer opportunities for audiences to reflect on complex and ethically relevant social and cultural dynamics that surface during global crises, such as negotiating personal and collective interests, the politics of touch and coexistence, and cultivating resilience and strength.White coats are symbols of power that express historically entrenched ideals of clinical purity, sterility, and control. Akt inhibitor These ideals tend to oversimplify ethical and clinical complexities inherent in evolutions constantly taking place in health care practice. This pen and ink drawing interrogates these ideals visually and reimagines the white coat in the context of more realistic dynamism.This comic visually conveys the absurdity of overreliance on symptom measures and excessive testing in contemporary clinical decision making and health care practice.Good health care for elders requires acute ethical attention to the role of ageism as a pervasive source of bias. A charcoal drawing of one older woman's hand visually examines the nature and scope of younger caregivers' responsibilities to geriatric patients and their loved ones.This photograph depicts a gateway at the Oud Sint-Janshospitaal, a medieval Flemish hospital. This hospital was open to the poor and sick, helping to make health care accessible to the surrounding community. Just as it was in the Middle Ages, health care access is a salient issue today.Behind the immediate pathophysiology of a medical condition often lies the emotional turmoil of an uncertain patient. As a result, many patients suffer from distressing thoughts and emotions, and their caregivers play an important role in comforting them. But to comfort a patient one must first have some framework to understand thoughts, emotions, and the relationship between the two. In this piece, the author draws from a collection of essays, Serious Noticing, written by the literary critic James Wood, to provide such a framework. In his work, Wood writes of 2 methods of reading literature, both embodied in the question "What is at stake in this passage?" This framework is useful for both the analysis of literature and the understanding of psychological turmoil.Diffusion of responsibility describes how individuals can underperform in circumstances of shared accountability. While not well studied in health care settings, this phenomenon is an unintended consequence of the health care sector's complexity and fragmentation. This article considers 3 ways in which monetary and nonmonetary incentives can mitigate negative consequences of diffusion of responsibility. First, incentives should be finite and focused. Second, health care organizations can incentivize both individual and team performance. Third, organizations can use peer comparison feedback to amplify effective incentivizing strategies.Nudges are subtle changes to the design of the environment or the framing of information that can influence our behaviors. There is significant potential to use nudges in health care to improve patient outcomes and transform health care delivery. However, these interventions must be tested and implemented using a systematic approach. In this article, we describe several ways to design nudges for success by focusing on optimizing and fitting them into the clinical workflow, engaging the right stakeholders, and rapid experimentation.Most women requesting pregnancy termination have already decided to undergo an abortion. Physicians are required to obtain informed consent after offering objective and accurate descriptions of abortion and its risks and benefits. Some jurisdictions also require concurrent counseling and ultrasound viewing. This article discusses potential benefits and harms of providing emotionally charged or biased content about abortions at the time of service, considers what constitutes ethical content, and explores when ethical content should be part of abortion decision making.Many health systems have adopted online patient portals that allow patients to easily view their health records. As a result, notes written by health care professionals are increasingly read by both clinicians and patients, and clinicians in specialties that routinely involve sensitive information (eg, mental health care) have had to construct notes in a manner that respectfully promotes therapeutic relationships with patients. This article discusses whether ethics consultation services should share notes with patients through online portals and ways to handle practical implementation challenges. In support of sharing notes, this article appeals to an existing right that patients have to access their health record and suggests that sharing ethics consultation notes might help patients understand key clinical ethics concepts and practices.Because human errors should be regarded as expected events, health care organizations should routinize processes aimed at human error prevention, limit negative consequences when human errors do occur, and support and educate those who have erred. A just culture perspective suggests that responding punitively to those who err should be reserved for those who have willfully and irremediably caused harm, because punishment creates blame-based workplace cultures that deter error reporting, which makes patients less safe.Like all humans, health professionals are subject to cognitive biases that can render diagnoses and treatment decisions vulnerable to error. Learning effective debiasing strategies and cultivating awareness of confirmation, anchoring, and outcomes biases and the affect heuristic, among others, and their effects on clinical decision making should be prioritized in all stages of education.A nudge is an intervention designed to prompt people to "voluntarily" make the choice intended by those who altered the choice environment or situation, and therefore using nudges is thought to undermine self-determination. Evidence for this assumption is weak, however, and sets aside much of what we know about human conduct sociologically. This paper argues that the practical consciousness that people have about their own actions and reasons for executing those actions can inform our thinking about motivating compliance with treatments in clinical settings and the ethical issues involved.Behavioral interventions have been shown to have powerful effects on human behavior both outside of and within the context of health care. As organizations increasingly adopt behavioral architecture, care must be taken to consider its potential negative consequences. An evidenced-based approach is best, whereby interventions that might have a significant deleterious effect on patients' health outcomes are first tested and rigorously evaluated before being systematically rolled out. In the case of clinical decision support, brief and thorough instructions should be provided for use. Physician performance when using these systems is best measured relatively, in the context of peers with similar training. Responsibility for errors must be shared with clinical team members and system designers.Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa. We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC). Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary). Of 766 confirmed COVID-19 cases, 500 (65.6%) were male, with a median (interquartile range [IQR]) age of 46 (34-58) years. One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU). Six hundred twenty patients (80.9%) improved and were discharged within 30 days of admission. Overall in-hospital mortality was 13.2% (95% CI 10.9-15.8), and almost 50% among those in the ICU. Independent risk factors for death were age less then 20 years (adjusted hazard ratio [aHR] = 6.62, 95% CI 1.85-23.64), 40-59 years (aHR = 4.45, 95% CI 1.83-10.79), and ≥ 60 years (aHR = 13.63, 95% CI 5.70-32.60) compared with those aged 20-39 years, with obesity (aHR = 2.30, 95% CI 1.24-4.27), and with chronic kidney disease (aHR = 5.33, 95% CI 1.85-15.35). In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1.53, 95% CI 0.88-2.67, P = 0.132) nor risk of death (aOR = 0.65, 95% CI 0.35-1.20) when comparing the use of chloroquine/azithromycin versus other treatments. In this DRC study, the high mortality among patients aged less then 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions.