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ossibly due to more frequent interaction with the healthcare system and/or appropriate management of those at greater cardiovascular risk.Eukaryotic transcription requires the assembly of a multisubunit preinitiation complex (PIC) composed of RNA polymerase II (Pol II) and the general transcription factors. The coactivator Mediator is recruited by transcription factors, facilitates the assembly of the PIC, and stimulates phosphorylation of the Pol II C-terminal domain (CTD) by the TFIIH subunit CDK7. Here, we present the cryo-electron microscopy structure of the human Mediator-bound PIC at a resolution below 4 angstroms. Transcription factor binding sites within Mediator are primarily flexibly tethered to the tail module. CDK7 is stabilized by multiple contacts with Mediator. Two binding sites exist for the Pol II CTD, one between the head and middle modules of Mediator and the other in the active site of CDK7, providing structural evidence for Pol II CTD phosphorylation within the Mediator-bound PIC.
Electric scooters are personal mobility devices that have risen in popularity worldwide since 2017. Zamaporvint in vitro Emerging reports suggest that both riders and other road users, such as pedestrians and cyclists, have been injured in electric scooter-associated incidents. We undertook a scoping review of the current literature to evaluate the injury patterns and circumstances of electric scooter-associated injuries.
A scoping review of literature published from 2010 to 2020 was undertaken following accepted guidelines. Relevant articles were identified in Medline, Embase, SafetyLit and Transport Research International Documentation using terms related to electric scooters, injuries and incident circumstances. Supplemental searches were conducted to identify relevant grey literature (non-peer-reviewed reports).
Twenty-eight peer-reviewed studies and nine grey literature records were included in the review. The current literature surrounding electric scooter-associated injuries mainly comprises retrospective case seriesand key clinical variables. Research on interventions to prevent electric scooter injuries is also needed to address this growing area of concern.
The act of waiting in health care is becoming increasingly prevalent worldwide. Waiting in health care is not a neutral activity; it is filled with expectations marked by cultural and social norms. In this article, we consider the performative nature of waiting by reflecting on the experiences of two participants in a narrative inquiry study.
Drawing on a narrative inquiry study focused on the experiences of three women who disclosed illegal substance use during their pregnancy or early postnatal period, we inquired into two participants' experiences of waiting. The study which took place in a large urban center in Western Canada, where the researcher connected with participants who faced numerous challenges due to poverty, stigma, and discrimination.
Sharing the narratives of Georgia Dewart, and participants Renate, and Marilynn, we explore the performative act of waiting in their interactions with health care. We consider the political and social implications of the act in order to explore the subtleties and overlooked consequences of waiting. This work encourages the nursing profession to address overlooked aspects of care, such as the act of waiting.
Our findings draw attention to the normative expectations within participants' experiences of waiting. This work offers methodological considerations for those engaging with Butler's concept of performativity when considering everyday acts. We also challenge care providers to reflect on their experiences working with clients, families, and communities to consider both the relational and performative nature of these interactions.
Our findings draw attention to the normative expectations within participants' experiences of waiting. This work offers methodological considerations for those engaging with Butler's concept of performativity when considering everyday acts. We also challenge care providers to reflect on their experiences working with clients, families, and communities to consider both the relational and performative nature of these interactions.
Fatigue is the most commonly reported symptom of the liver disease primary biliary cholangitis (PBC). It affects 40%-80% of patients, has no effective treatment and is associated with heightened mortality risk. The pathogenesis is unknown, but muscle bioenergetic abnormalities have been proposed to contribute. Directly observed exercise has been shown to attenuate symptoms in small groups; however, due to the rare nature of the disease, home-based interventions need to be evaluated for feasibility, safety and efficacy.
This is a phase 1/pilot, single-arm, open-label clinical trial evaluating a novel home-based exercise programme in patients with PBC with severe fatigue. Forty patients with moderate-severe fatigue (PBC40 fatigue domain score >33; other causes of fatigue excluded) will be selected using a convenience sampling method. A 12-week home-based exercise programme, consisting of individualised resistance, aerobic exercises and telephone health calls (first 6 weeks only), will be delivered. Measures of fatigue (PBC40 fatigue domain; fatigue impact scale), quality of life, sleep (Epworth Sleep Score), physical activity, anxiety and depression, aerobic exercise capacity (incremental shuttle walk test; Duke Activity Status Index) and functional capacity (short physical performance battery) will be assessed at baseline and at 6 and 12 weeks following the intervention.
The protocol is approved by the National Research Ethics Service Committee London (IRAS 253115). Recruitment commenced in April 2019 and ended in March 2020. Participant follow-up is due to finish by December 2020. Findings will be disseminated through peer-reviewed publication, conference presentation and social media.
NCT04265235.
NCT04265235.The COVID-19 pandemic has changed peoples' lives in unexpected ways, especially how they allocate their time between work and other activities. Demand for online learning has surged during a period of mass layoffs and transition to remote work and schooling. Can this uptake in online learning help close longstanding skills gaps in the US workforce in a sustainable and equitable manner? We answer this question by analyzing individual engagement data of DataCamp users between October 2019 and September 2020 (n = 277,425). Exploiting the staggered adoption of actions to mitigate the spread of COVID-19 across states, we identify the causal effect at the neighborhood level. The adoption of nonessential business closures led to a 38% increase in new users and a 6% increase in engagement among existing users. We find that these increases are proportional across higher- and lower-income neighborhoods and neighborhoods with a high or low share of Black residents. This demonstrates the potential for online platforms to democratize access to knowledge and skills that are in high demand, which supports job security and facilitates social mobility.
