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Probabilistic genotype-phenotype maps reveal mutational robustness of RNA folding, spin glasses, and quantum circuits

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Physical Review Research 2025年第1期7卷 013118-013118页

作者： Anna Sappington Vaibhav Mohanty Department of Electrical Engineering and Computer Science Massachusetts Institute of Technology Cambridge Massachusetts 02139 USA Harvard-MIT Program in Health Sciences and Technology Harvard Medical School Boston Massachusetts 02115 USA and Massachusetts Institute of Technology Cambridge Massachusetts 02139 USA Harvard/MIT MD-PhD Program Harvard Medical School Boston Massachusetts 02115 USA and Massachusetts Institute of Technology Cambridge Massachusetts 02139 USA Department of Chemistry and Chemical Biology Harvard University Cambridge Massachusetts 02138 USA

Recent studies of genotype-phenotype maps have reported universally enhanced phenotypic robustness to genotype mutations, a feature essential to evolution. Virtually all of these studies make a simplifying assumption that each genotype—represented as a sequence—maps deterministically to a single phenotype, such as a discrete structure. Here we introduce probabilistic genotype-phenotype (PrGP) maps, where each genotype maps to a vector of phenotype probabilities, as a more realistic and universal language for investigating robustness in a variety of physical, biological, and computational systems. We study three model systems to show that PrGP maps offer a generalized framework which can handle uncertainty emerging from various physical sources: (1) thermal fluctuation in RNA folding, (2) external field disorder in the spin-glass ground state search problem, and (3) superposition and entanglement in quantum circuits, which are realized experimentally on IBM quantum computers. In all three cases, we observe a biphasic robustness scaling which is enhanced relative to random expectation for more frequent phenotypes and approaches random expectation for less frequent phenotypes. We derive an analytical theory for the behavior of PrGP robustness, and we demonstrate that the theory is highly predictive of empirical robustness.

关键词： Quantum computers

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MiR-1 Is Regulated by Hydrogen Peroxide via MAPK and Limits Cell Migration and Invasion

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Environmental Toxicology 2025年 2025 May 16页

作者： Pacurari, Maricica Cox, Irmanecia Farah, Ibrahim Department of Biology College of Science Engineering and Technology Jackson State University Jackson MS United States RCMI Center for Environmental Health College of Science Engineering and Technology Jackson State University Jackson MS United States Environmental Science PhD Program College of Science Engineering and Technology Jackson State University Jackson MS United States

MicroRNA-1 (miR-1) is a conserved microRNA that is highly expressed in skeletal and cardiac muscle tissues. Moreover, miR-1 regulates genes and has critical roles in cell migration and invasion. Downregulation of miR-1 has been found in many pathologies of numerous organs, including the lungs. What exactly contributes to the downregulation of miR-1 is not fully understood, and in the present study, we investigated whether ROS regulate miR-1 and its role in cell migration and invasion. A549 cells were grown and maintained in DMEM:F12 (1:1) and supplemented with 10% FBS and 1000 U of Penicillin/Streptomycin and maintained as recommended by the manufacturer (ATCC). Cell migration and invasion, IHC, Western blot, qPCR, ROS, miR-1 transfection, and qPCR were used to determine miR-1 regulation and its role in cell migration. Exogenous miR-1 decreased the formation of ROS and inhibited cell migration and invasion, whereas inhibition of miR-1 increased ROS formation and stimulated cell migration and invasion. Inhibition of miR-1 induced the formation of actin filaments contractile structures, whereas exogenous miR-1 limited the formation of these structures. Hydrogen peroxide significantly decreased miR-1 level, whereas inhibition of Nox4 had no effect on miR-1 level. Alpha amanitin did not decrease miR-1 level, whereas inhibition of NF-кB temporally decreased miR-1 level. This study demonstrates that ROS suppress miR-1 and that miR-1 is posttranscriptionally regulated via MAPK. Endogenous Nox4-dependent ROS are not involved in miR-1 regulation, whereas exogenous ROS regulates miR-1. NF-κB plays a key role in miR-1 regulation in both redox and nonredox environments. Moreover, Mir-1 limits cell migration and invasion even in the presence of ROS. TSP-1 is a major regulator of TGFβ and its expression is upregulated by ROS. Our work indicates ROS is a major regulator of miR-1 and TSP-1 and could be a potential therapeutic target to limit ROS- and non-ROS-mediated processes in l

关键词： cell migration MAPK miR-1 NF-кB Nox4 posttranscriptional ROS TSP-1

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Influence of the metabolic and inflammatory profile in patients with frozen shoulder – systematic review and meta-analysis

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BMC Musculoskeletal Disorders 2025年第1期26卷 1-25页

作者： Hamed-Hamed, Dina Rodríguez-Pérez, Celia Pruimboom, Leo Navarro-Ledesma, Santiago Clinical Medicine and Public Health PhD Program Faculty of Health Sciences University of Granada Granada Spain Hospital Universitario de Melilla C. Luis de Ostáriz 12 Melilla 52005 Spain Department of Nutrition and Food Science University of Granada Granada Spain Institute of Nutrition and Food Technology ‘José Mataix’ (INYTA) Biomedical Research Centre (CIBM) University of Granada Avda. del Conocimiento S/N Granada 18016 Spain Instituto de Investigación Biosanitaria Ibs.GRANADA Granada 18012 Spain University Chair in Clinical Psychoneuroimmunology (University of Granada and PNI Europe) Melilla Spain Faculty of Health Sciences Campus of Melilla. Querol Street 5 Melilla 52004 Spain

Background: Frozen Shoulder (FS), also known as adhesive shoulder capsulitis, is characterized by a fibrotic inflammatory process of unknown origin, with the most prominent symptoms being pain, stiffness, and reduced joint mobility. Methods: The systematic review and meta-analysis presented herein provide insights into the pathogenesis of this condition, as well as common metabolic biomarkers potentially implicated in FS, such as glycated hemoglobin (HbA1c), and inflammatory biomarkers, including interleukins (IL-1, IL-6) and tumor necrosis factor alpha (TNF-α). Dyslipidemia and hormonal factors, such as thyroid dysfunctions, are also examined. Results: A total of 7,499 individuals were included in the meta-analysis, and one additional study collected 28,416 blood samples from individuals with FS from biobanks. The meta-analysis of metabolic variables showed that HbA1c was the most significantly elevated marker in FS, with a standardized mean difference (SMD) of μ^ = 0.3970 (95% CI: 0.0998 to 0.6943), indicating a moderate effect. Glucose showed a mean difference of -0.28 (95% CI: -0.60 to 0.05), which was not statistically significant, suggesting that short-term fluctuations in glucose levels may not be as relevant as long-term metabolic control. Cholesterol had a standardized difference of 0.278 (95% CI: 0.171 to 0.385), being significantly higher in FS. For triglycerides, the SMD was μ^ = 1.0318 (95% CI: -1.0027 to 3.0664), indicating high heterogeneity and preventing a clear conclusion. Hypothyroidism was also evaluated, with a total SMD of 0.067, a total variance of 0.0021, and a 95% confidence interval of -0.024 to 0.158, confirming no association between FS and thyroid function. Regarding inflammatory biomarkers, IL-1β was the most predominant, showing significantly higher levels in FS, with an SMD of μ^ = 2.2671 (95% CI: 0.5750 to 3.9591). TNF-α had a mean difference of μ^ = 0.7814 (95% CI: 0.1013 to 1.4615), reflecting a significant difference from zero (z

关键词： Biomarkers Cytokines Frozen shoulder Inflammation Interleukins Metabolism

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Self-assembling protein nanoparticles for cytosolic delivery of nucleic acids and proteins

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Nature Biotechnology 2025年 1-14页

作者： Eweje, Feyisayo Ibrahim, Vanessa Shajii, Aram Walsh, Michelle L. Ahmad, Kiran Alrefai, Assma Miyasato, Dominie Davis, Jessie R. Ham, Hyunok Li, Kaicheng Roehrl, Michael Haller, Carolyn A. Liu, David R. Chen, Jiaxuan Chaikof, Elliot L. Department of Surgery Beth Israel Deaconess Medical Center Harvard Medical School BostonMA United States Harvard and MIT Division of Health Science and Technology Massachusetts Institute of Technology CambridgeMA United States Harvard/MIT MD–PhD Program BostonMA United States Wyss Institute of Biologically Inspired Engineering Harvard University BostonMA United States Department of Chemistry and Chemical Biology Harvard University CambridgeMA United States Howard Hughes Medical Institute Harvard University CambridgeMA United States Merkin Institute of Transformative Technologies in Healthcare Broad Institute of MIT and Harvard CambridgeMA United States Department of Pathology Beth Israel Deaconess Medical Center Harvard Medical School BostonMA United States

Intracellular delivery of biomacromolecules is hampered by low efficiency and cytotoxicity. Here we report the development of elastin-based nanoparticles for therapeutic delivery (ENTER), a recombinant elastin-like polypeptide (ELP)-based delivery system for effective cytosolic delivery of biomacromolecules in vitro and in vivo. Through iterative design, we developed fourth-generation ELPs fused to cationic endosomal escape peptides (EEPs) that self-assemble into pH-responsive micellar nanoparticles and enable cytosolic entry of cargo following endocytic uptake. In silico screening of α-helical peptide libraries led to the discovery of an EEP (EEP13) with 48% improved protein delivery efficiency versus a benchmark peptide. Our lead ELP–EEP13 showed similar or superior performance compared to lipid-based transfection reagents in the delivery of mRNA-encoded, DNA-encoded and protein-form Cre recombinase and CRISPR gene editors as well as short interfering RNAs to multiple cell lines and primary cell types. Intranasal administration of ELP–EEP13 combined with Cre protein achieved efficient editing of lung epithelial cells in reporter mice. © The Author(s), under exclusive licence to Springer Nature America, Inc. 2025.

关键词： Glycoproteins

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Changing life expectancy in European countries 1990–2021: a subanalysis of causes and risk factors from the Global Burden of Disease Study 2021

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The Lancet Public health 2025年第3期10卷 e172-e188页

作者： Steel, Nicholas Bauer-Staeb, Clarissa Maria Mercedes Ford, John A. Abbafati, Cristiana Abdalla, Mohammed Altigani Abdelkader, Atef Abdi, Parsa Zuñiga, Roberto Ariel Abeldaño Abiodun, Olugbenga Olusola Abolhassani, Hassan Abu-Gharbieh, Eman Abukhadijah, Hana J. Abu-Zaid, Ahmed Addo, Isaac Yeboah Addolorato, Giovanni Adekanmbi, Victor Adetunji, Juliana Bunmi Adeyeoluwa, Temitayo Esther Agardh, Emilie E. Agyemang-Duah, Williams Ahmad, Danish Ahmed, Ayman Ahmed, Syed Anees Akinosoglou, Karolina Akkaif, Mohammed Ahmed Al Awaidy, Salah Al Hasan, Syed Mahfuz Al Zaabi, Omar Ali Mohammed Aldridge, Robert W. Algammal, Abdelazeem M. Al-Gheethi, Adel Ali Saeed Ali, Abid Ali, Mohammed Usman Ali, Syed Shujait Ali, Waad Alicandro, Gianfranco Alif, Sheikh Mohammad Al-Jumaily, Adel Allebeck, Peter Alrawashdeh, Ahmad Al-Rifai, Rami H. Alsabri, Mohammed A. Alshahrani, Najim Z. Aluh, Deborah Oyine Al-Wardat, Mohammad Al-Zyoud, Walid A. Amiri, Sohrab Anderlini, Deanna Andrei, Catalina Liliana Anil, Abhishek Anvari, Saeid Anyasodor, Anayochukwu Edward Appiah, Seth Christopher Yaw Aquilano, Michele Arabloo, Jalal Arafat, Mosab Areda, Demelash Aremu, Abdulfatai Armani, Keivan Armocida, Benedetta Ärnlöv, Johan Asaduzzaman, Muhammad Astell-Burt, Thomas Aujayeb, Avinash Ausloos, Marcel Azadnajafabad, Sina Aziz, Shahkaar Azzam, Ahmed Y. Babu, Giridhara Rathnaiah Badache, Andreea Corina Badiye, Ashish D. Bahramian, Saeed Baig, Atif Amin Baker, Jennifer L. Bansal, Hansi Bärnighausen, Till Winfried Barone, Mark Thomaz Ugliara Barrow, Amadou Barteit, Sandra Bashir, Shahid Bashiru, Hameed Akande Basso, João Diogo Bastan, Mohammad-Mahdi Basu, Sanjay Batra, Kavita Bauckneht, Matteo Baune, Bernhard T. Beghi, Massimiliano Beiranvand, Maryam Béjot, Yannick Bell, Michelle L. Bello, Olorunjuwon Omolaja Belo, Luis Beloukas, Apostolos Beneke, Alice A. Bettencourt, Paulo J.G. Bhagavathula, Akshaya Srikanth Bhala, Neeraj Bhaskar, Sonu Bisulli, Francesca Bjørge, Tone Bodunrin, Aadam Olalekan Carvajal, Alejandro Botero Bouaoud, Souad Brayne, Carol Brenner, H Department of Primary Care and Public Health University of East Anglia Norwich United Kingdom Office for Health Improvement and Disparities Department of Health and Social Care London United Kingdom Department of Legal and Economic Studies La Sapienza University Rome Italy Rome Italy Hull York Medical School University of Hull Hull United Kingdom Department of Mathematics and Sciences Ajman University Ajman United Arab Emirates Department of Medicine Memorial University St. John's NL Canada Postgraduate Department University of Sierra Sur Miahuatlan de Porfirio Diaz Mexico Yhteiskuntadatatieteen keskus (Centre for Social Data Science) Helsinki Finland Department of Internal Medicine Federal Medical Centre Abuja Nigeria Research Center for Immunodeficiencies Tehran University of Medical Sciences Tehran Iran Department of Medical Biochemistry and Biophysics Karolinska Institutet (Karolinska Institute) Stockholm Sweden Department of Clinical Sciences University of Sharjah Sharjah United Arab Emirates Department of Biopharmaceutics and Clinical Pharmacy University of Jordan Amman Jordan Medical Research Center Hamad Medical Corporation Doha Qatar Department of Biochemistry and Molecular Medicine Alfaisal University Riyadh Saudi Arabia College of Graduate Health Sciences University of Tennessee Memphis TN United States School of Medicine Sydney NSW Australia Centre for Social Research in Health University of New South Wales Sydney NSW Australia Internal Medicine and Alcohol Related Disease Unit Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy Department of Medical and Surgical Sciences Università Cattolica di Roma (Catholic University of Rome) Rome Italy Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston TX United States Department of Biochemistry Osun State University Osogbo Nigeria Department of Pharmacology and Therapeutics University of Medical Sciences Ondo Ondo Nigeria Department of Veteri

Background: Decades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic. Methods: We used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy. Findings: All countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy a

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An expandable chamber for safe brain retraction: new technologies in the field of transcranial endoscopic surgery

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2023年第4期24卷 326-335页

作者： Elena ROCA Anna GOBETTI Giovanna CORNACCHIA Oscar VIVALDI Barbara BUFFOLI Giorgio RAMORINO Head and Neck Department NeurosurgeryIstituto Ospedaliero Fondazione Poliambulanza25124 BresciaItaly Technology for Health PhD Program University of Brescia25124 BresciaItaly Materials Science and Technology at Department of Mechanical and Industrial Engineering University of Brescia25123 BresciaItaly Metallurgy at Department of Mechanical and Industrial Engineering University of Brescia25123 BresciaItaly Anatomy and Physiopathology Division Department of Clinical and Experimental SciencesUniversity of Brescia25123 BresciaItaly

Neurosurgery is a highly specialized field:it often involves surgical manipulation of noble structures and cerebral retraction is frequently necessary to reach deep-seated brain *** are still no reliable methods preventing possible retraction *** objective of this study was to design work chambers well suited for transcranial endoscopic surgery while providing safe retraction of the surrounding brain *** chamber is designed to be inserted close to the intracranial point of interest;once it is best placed it can be *** should guarantee an appreciable workspace similar to that of current neurosurgical *** experimental aspect of this study involved the use of a force sensor to evaluate the pressures exerted on the brain tissue during the retraction *** pterional craniotomy,pressure measurements were made during retraction with the use of a conventional metal spatula with different *** that,although the force values necessary for retraction and exerted on the spatula by the neurosurgeon are the same,the local pressure exerted on the parenchyma at the edge of the spatula at different inclinations varied greatly.A new method of cerebral retraction using a chamber retractor(CR)has been designed to avoid any type of complication due to spatula edge overpressures and to maintain acceptable pressure values exerted on the parenchyma.

关键词： Brain retraction Spatula Brain retractor design Brain retraction injury Retraction complication Transcranial endoscopic surgery

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Interferon-γ orchestrates leptomeningeal anti-tumour response

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Nature 2025年 1-10页

作者： Remsik, Jan Tong, Xinran Kunes, Russell Z. Li, Min Jun Estrera, Rachel Snyder, Jenna Thomson, Clark Osman, Ahmed M. Chabot, Kiana Sener, Ugur T. Wilcox, Jessica A. Isakov, Danielle Wang, Helen Bale, Tejus A. Chaligné, Ronan Sun, Joseph C. Brown, Chrysothemis Pe’er, Dana Boire, Adrienne Human Oncology & Pathogenesis Program Memorial Sloan Kettering Cancer Center New York NY United States Laboratory for Immunology of Metastatic Ecosystems Center for Cancer Biology VIB Leuven Belgium Department of Oncology KU Leuven Leuven Belgium BCMB Allied Program Graduate School of Medical Sciences Weill Cornell Medicine New York NY United States Program for Computational and Systems Biology Sloan Kettering Institute Memorial Sloan Kettering Cancer Center New York NY United States Department of Statistics Columbia University New York NY United States Gerstner Sloan Kettering Graduate School of Biomedical Sciences Memorial Sloan Kettering Cancer Center New York NY United States Department of Neurology Memorial Sloan Kettering Cancer Center New York NY United States Department of Pathology and Laboratory Medicine Memorial Sloan Kettering Cancer Center New York NY United States Immunology Program Sloan Kettering Institute Memorial Sloan Kettering Cancer Center New York NY United States Department of Pediatrics Memorial Sloan Kettering Cancer Center New York NY United States Immunology and Microbial Pathogenesis Program Weill Cornell Medical College New York NY United States Howard Hughes Medical Institute Memorial Sloan Kettering Cancer Center New York NY United States Medical Scientist Training Program University of California San Diego La Jolla CA United States Department of Women’s and Children’s Health Karolinska Institutet Solna Sweden College of Osteopathic Medicine New York Institute of Technology Glen Head NY United States Department of Neurology & Department of Medical Oncology Mayo Clinic Rochester MN United States Tri-Institutional MD-PhD Program Weill Cornell Medicine New York NY United States

Metastasis to the cerebrospinal-fluid-filled leptomeninges, or leptomeningeal metastasis, represents a fatal complication of solid tumours1. Multimodal analyses of clinical specimens reveal substantial inflammatory in...

Metastasis to the cerebrospinal-fluid-filled leptomeninges, or leptomeningeal metastasis, represents a fatal complication of solid tumours¹. Multimodal analyses of clinical specimens reveal substantial inflammatory infiltrate in leptomeningeal metastases with enrichment of IFNγ and resulting downstream signalling. Here, to investigate and overcome this futile anti-tumour response within the leptomeninges, we developed syngeneic lung cancer, breast cancer and melanoma leptomeningeal-metastasis mouse models. We show that transgenic host mice lacking IFNγ or its receptor fail to control the growth of leptomeningeal metastases growth. Leptomeningeal overexpression of Ifng through a targeted adeno-associated-virus-based system controls cancer cell growth independent of adaptive immunity. Using a suite of transgenic hosts, we demonstrate that leptomeningeal T cells generate IFNγ to actively recruit and activate peripheral myeloid cells, generating a diverse spectrum of dendritic cell subsets. Independent of antigen presentation, migratory CCR7⁺ dendritic cells orchestrate the influx, proliferation and cytotoxic action of natural killer cells to control cancer cell growth in the leptomeninges. This study identifies unique, leptomeninges-specific IFNγ signalling and suggests an immune-therapeutic approach against tumours within this space. © The Author(s) 2025.

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Discovery of Z1362873773: a novel fascin inhibitor from a large chemical library for colorectal cancer

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Scientific Reports 2025年第1期15卷 1-15页

作者： Rodríguez-Martínez, Alejandro Giraldo-Ruiz, Lucía Ramos, María C. Luque, Irene Ribeiro, Diogo Postigo-Corrales, Fátima Alburquerque-González, Begoña Montoro-García, Silvia Arroyo-Rodríguez, Ana Belén Conesa-Zamora, Pablo Hurtado, Ana María Luengo-Gil, Ginés Pérez-Sánchez, Horacio Structural Bioinformatics and High Performance Computing Research Group (BIO-HPC) UCAM Universidad Católica de Murcia (UCAM) HiTech Innovation Hub Murcia 30107 Spain Departamento de Química Física Instituto de Biotecnología y Unidad de Excelencia de Química aplicada a Biomedicina y Medioambiente Universidad de Granada Campus Fuentenueva s/n Granada 18071 Spain Fundación MEDINA PTS Health Sciences Technology Park Avenida del Conocimiento 34 Granada 18016 Spain Genetics Molecular Pathology and Rare Diseases Research Group Universidad Católica de Murcia (UCAM) Guadalupe 30107 Spain Molecular Pathology and Pharmacogenetics Research Group Instituto Murciano de Investigación Biosanitaria (IMIB) Hospital General Universitario Santa Lucía Cartagena 30202 Spain Health Sciences PhD Program Universidad Católica de Murcia UCAM Campus de los Jerónimos nº135 Guadalupe Murcia 30107 Spain

Metastasis is one of the leading causes of cancer-related death worldwide. Fascin, a protein that bundles actin filaments to produce protrusions in cancer cells, plays a significant role in the enhancement of cell migration. This protein has been shown that the overexpression of this protein is related to the appearance of different types of cancer, such as colorectal cancer. In this study, we conducted in silico screening of the Enamine library, a compound library with a broad chemical space. Using a ligand-based virtual screening approach based on the pharmacophore model of G2, we identified the predicted inhibitors. First, these compounds were validated by physicochemical analysis. Differential scanning calorimetry (DSF) was used to study the binding between the predicted compounds and fascin protein, followed by an F-actin bundling assay to determine which compounds inhibited the bundling function of fascin. Z1362873773, which exhibited binding to fascin and inhibited F-actin bundling, was further tested in cell cultures to assess its effects on cancer cell viability and migration as well as in organoid models to evaluate potential cytotoxicity. Finally, we established a protocol that can be applied to discover anti-fascin agents from diverse compound libraries. A new molecule has been identified with considerable fascin inhibitory and migration-arresting capacity, which may lead to the development of new therapies to treat cancer. © The Author(s) 2025.

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How can health literacy influence outcomes in heart failure patients? mechanisms and interventions

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Current Heart Failure Reports 2013年第3期10卷 232-243页

作者： Westlake, Cheryl Sethares, Kristen Davidson, Patricia Nursing PhD Program Azusa Pacific University Azusa CA 91702 720 E. Foothill Boulevard United States College of Nursing University of Massachusetts Dartmouth MA United States Faculty of Health University of Technology Sydney Australia St Vincent's Hospital Sydney Australia

health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy. Specifically, health literacy is the mechanism by which individuals obtain and use health information to make health decisions about individual treatments in the home, access care in the community, promote provider-patient interactions, structure self-care, and navigate health care programs both locally and nationally. Further, health literacy is a key determinant of health and a critical dimension for assessing individuals' needs, and, importantly, their capacity for self-care. Poorer health knowledge/status, more medication errors, costs, and higher rates of morbidity, readmissions, emergency room visits, and mortality among patients with health illiteracy have been demonstrated. Individuals at high risk for low health literacy include the elderly, disabled, Blacks, those with a poverty-level income, some or less high school education, either no insurance or Medicare or Medicaid, and those for whom English is a second language. As a consequence, health literacy is a complex, multifaceted, and evolving construct including aspects of social, psychological, cultural and economic circumstances. The purpose of this paper is to describe the mechanisms and consequences of health illiteracy. Specifically, the prevalence, associated demographics, and models of health literacy are described. The mechanism of health illiteracy's influence on outcomes in heart failure is proposed. Tools for health literacy assessment are described and compared. Finally, the health outcomes and general interventions to enhance the health outcomes in heart failure are discussed. © 2013 Springer Science+Business Media New York.

关键词： health literacy health outcomes Heart failure

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Geographic Distribution of Physician Manpower: the GMENAC Legacy

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The Journal of Rural health 1991年第4期7卷 427-436页

作者： Jacoby, Itzhak ITZHAK JACOBY PhD is professor and director of the Division of Health Services Administration at the Uniformed Services University of the Health Sciences. His primary teaching responsibilities center on the Master's of Public Health program. Before accepting this position Jacoby was director of the Health Resources Administration's Office of Graduate Medical Education. In that capacity he directed the staff work of the Graduate Medical Education National Advisory Commit- tee. His main research interests are in health manpower analysis and health technology assessment.

The Graduate Medical Education National Advisory Committee (GMENAC) projected the need for and supply of physicians and other providers, recommended time and access standards for health care services, and developed guidelines for the geographic distribution of physicians. Since this study, analysts have given scant attention to national problems of physician geographic distribution. The issue deserves additional scrutiny in light of the current continuing problems of underservice in rural areas. The emergence of geographic information systems offers a unique opportunity to acquire data on provider distribution and provide a framework for developing and testing redistribution policy. Copyright © 1991, Wiley Blackwell. All rights reserved

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