Explore the vast range of titles available.

IntroductionElderly patients after hospitalisation for acute events on account of age-related diseases (eg, joint or heart valve replacement surgery) are often characterised by a remarkably reduced functional health. Multicomponent rehabilitation (MR) is considered an appropriate approach to restore the functioning of these patients. However, its efficacy in improving functioning-related outcomes such as care dependency, activities of daily living (ADL), physical function and health-related quality of life (HRQL) remains unclarified. We outline the research framework of a scoping review designed to map the available evidence of the effects of MR on the independence and functional capacity of elderly patients hospitalised for age-related diseases in four main medical specialties beyond geriatrics.Methods and analysisThe biomedical databases (PubMed, Cochrane Library, ICTRP Search Platform, ClinicalTrials) and additionally Google Scholar will be systematically searched for studies comparing centre-based MR with usual care in patients ≥75 years of age, hospitalised for common acute events due to age-related diseases (eg, joint replacement, stroke) in one of the specialties of orthopaedics, oncology, cardiology or neurology. MR is defined as exercise training and at least one additional component (eg, nutritional counselling), starting within 3 months after hospital discharge. Randomised controlled trials as well as prospective and retrospective controlled cohort studies will be included from inception and without language restriction. Studies investigating patients <75 years, other specialties (eg, geriatrics), rehabilitation definition or differently designed will be excluded. Care dependency after at least a 6-month follow-up is set as the primary outcome. Physical function, HRQL, ADL, rehospitalisation and mortality will be additionally considered. Data for each outcome will be summarised, stratified by specialty, study design and type of assessment. Furthermore, quality assessment of the included studies will be performed.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented at national and/or international congresses.Trial registration numberhttps://doi.org/10.17605/OSF.IO/GFK5C.

Background JHS is a nonprofit academic medical system consisting of seven acute hospitals along with a network of primary care, specialty care and urgent care centers, long-term care nursing facilities and a team of corrections health services personnel. A key aspect to enhance scorecard adoption during deployment was applying change management concepts.5 At the time of deployment, the JHS senior executive vice president/COO (SEVP/COO) communicated to all hospital executives the new process and the reason for change (Table 1). Efficient throughput is foundational to improving patients' quality of care and experience, as well as a more efficient hospital course.6 He emphasized the need for departmental leaders to be engaged in owning their processes and feel empowered to make improvements. [...]each hospital receives its metrics, allowing for greater discernment of its trends.

A novel method for localized delivery of therapeutic agents to the injured spinal cord was investigated. The strategy consists of a collagen solution that gels after injection into the subarachnoid space (SAS). By dispersing growth factors (GFs) in the collagen solution, a method is provided for localized delivery to the spinal cord. The initial goal was to determine the safety of implantation of the novel drug delivery system (DDS) in vivo by injecting collagen into the SAS of uninjured and spinal cord injured (SCI) rats. At 8 weeks post-implantation, the injected collagen did not elicit an inflammatory reaction in either uninjured or injured animals and did not affect the animals' functional behavior. After verification of the safety of the DDS, the therapeutic value and efficiency of localized delivery of epidermal growth factor (EGF) and basic fibroblast growth factor (FG-2) were investigated. The DDS was injected intrathecaily at the site of injury in rats after compressive SCI. Animals receiving the GFs had a greater percentage of tissue spared at the lesion epicenter compared to controls which did not receive any injections. Moreover, there was greater ependymal cell proliferation immediately rostral and caudal to the injury. The efficiency of localized delivery of the GFs was evaluated by following their temporal and spatial distribution in vivo in both uninjured and SCI rodents for 30 minutes to 7 days after implantation of the DDS. EGF readily penetrated the spinal cord within 30 minutes post-injection. There was greater dispersion and more sustained penetration of EGF in SCI animals compared to uninjured rats at 6 hours post-injection. In contrast, the release of FGF-2 was slower and could only be detected in the pia and dura at the injection site at all time points examined. Improved functional recovery of SCI rats was not observed in animals receiving the DDS with GFs compared to control animals. However, the localized delivery of EGF and FGF-2 improved some outcome measures, such as decreased cavitation and increased ependymal cell proliferation. Thus, this novel DDS is a promising alternative method for localized delivery of therapeutic agents to the injured spinal cord.

Esta tesis pretende demostrar que el nuevo sujeto generado por la sociedad virtual se está convirtiendo en un objeto cada vez menos capaz de establecer vínculos sociales o de pareja, ya que está controlado por la tecnología, el mercado y los medios de comunicación. Esta condición de objeto lo inserta en un mundo de simulacro que lo induce a creer que los afectos también pueden fabricarse y comprarse, y que el otro es totalmente reemplazable. El mandato al goce permanente, propio del capitalismo, ha ido construyendo una sociedad cínica, hedonista y narcisista, donde el modo de inserción social ya no se logra por identificación con el otro, sino prescindiendo de este.Para argumentar estas afirmaciones se tomará como materia de estudio un fenómeno social que se está produciendo en algunas partes del mundo, mediante el cual ciertas personas establecen complejas relaciones, no solo sexuales sino afectivas y hasta matrimoniales, con diferentes objetos tales como las Real Dolls, unas muñecas de silicona de aspecto real; las Real Botix y su prototipo Harmony, un robot con inteligencia artificial que cumple la función de pareja sexual y de compañía; y un conocido simulador de citas virtuales, creado en Japón, llamado Love Plus mediante el cual muchos jóvenes están estableciendo relaciones emocionales (a través de la pantalla) con un dibujo anime. Mediante el análisis de los objetos previamente mencionados y de las distintas categorías de pensadores tales como Baudrillard, Jameson, Lacan, Han, Zizek, Badiou, entre otros, se irá evidenciando cómo se ha producido progresivamente este cambio en la estructuración del lazo social y cómo el hombre se ha ido alejando cada vez más del otro y de sí mismo como sujeto. Asimismo, se irá demostrando que el ser humano puede llegar a confundir de tal modo la realidad con lo virtual que es capaz de proyectar rasgos humanos en estas muñecas, robots y animes, y de sentir afecto por ellos.Veremos cómo, en la actualidad, la tecnología nos obliga a pensar en estas hibridaciones innegables: lo humano que se une con la máquina, lo real que se une con lo virtual. Finalmente, se demostrará que el desmesurado uso de la tecnología deviene en un aislamiento y soledad progresivos, menguando las relaciones interpersonales y asociando al amor como algo que tiene un precio en el mercado.

Mushroom tyrosinase was immobilized on nylon 66 through covalent crosslinking with glutaraldehyde. Its cresolase and catecholase activities were studied in order to assess the efficiency of the method. Sixty-seven percent of the cresolase activity was transferred onto the support. However, studies designed to examine L-DOPA production via immobilized tyrosinase were unsuccessful. XPS studies of the support indicated that the substrate was covalently bound to the support, and therefore, L-DOPA was most likely produced in situ, and not released into the medium. Fifty percent of the catecholase activity was transferred onto the support. Since the catecholase activity is known to be subject to rapid inactivation, studies were conducted to compare the relative stability of the immobilized and soluble enzyme. At 21 kPa, the immobilized enzyme produced 2.2 times more benzoquinone than soluble tyrosinase and was inactivated at one-tenth the rate of soluble tyrosinase. Both the production of benzoquinone and the inactivation rate were observed to increase with oxygen partial pressure. At 100 kPa, 1.3 times more benzoquinone is produced, and immobilized tyrosinase is inactivated 3.6 times faster than at 21 kPa. Preliminary evidence suggests that there is a change in the affinity of the inactivating species for immobilized tyrosinase compared to soluble tyrosinase. In conclusion, covalent crosslinking of mushroom tyrosinase onto nylon 66 seems favorable for stabilizing the catecholase activity of tyrosinase. However, a more efficient method of immobilization is needed to express the cresolase activity of tyrosinase, avoiding irreversible binding of the substrate to the matrix.

La disertación que presento hoy para optar por el Grado de Magister comprende dos partes: la primera es una breve aproximación, a modo de marco teórico, sobre la concepción del cuerpo humano en la escultura a través de las diferentes etapas de la historia del arte occidental, y sus implicancias. En la segunda parte, selecciono esculturas de diferentes etapas para elaborar una reflexión sobre mi aproximación al cuerpo humano como eje de mi propuesta escultórica. Aunque mi acento se torne categórico por momentos, quiero dejar en claro que esta interpretación parte de una reflexión desde mi situación particular al momento de realizar las obras. Y cómo es que este ejercicio del crear, plantea, fluye, se despliega, libera. Mi proyecto escultórico es también un medio para abrir nuevas brechas, a través de la reflexión, en ese misterio que es el cuerpo humano, sin que ello signifique que el problema estético quede resuelto totalmente. Por el contrario, los cabos sueltos se entrelazarán de muchas maneras y también “esos nudos”, esos amarres se soltarán.

Microglia nodules (HLA-DR + cell clusters) are associated with brain pathology. In this post-mortem study, we investigated whether they represent the first stage of multiple sclerosis (MS) lesion formation. We show that microglia nodules are associated with more severe MS pathology. Compared to microglia nodules in stroke, those in MS show enhanced expression of genes previously found upregulated in MS lesions. Furthermore, genes associated with lipid metabolism, presence of T and B cells, production of immunoglobulins and cytokines, activation of the complement cascade, and metabolic stress are upregulated in microglia nodules in MS. Compared to stroke, they more frequently phagocytose oxidized phospholipids and possess a more tubular mitochondrial network. Strikingly, in MS, some microglia nodules encapsulate partially demyelinated axons. Taken together, we propose that activation of microglia nodules in MS by cytokines and immunoglobulins, together with phagocytosis of oxidized phospholipids, may lead to a microglia phenotype prone to MS lesion formation. Microglia nodules are associated with brain pathology. Here, the authors show demyelination in microglia nodules in multiple sclerosis (MS), likely due to oxidized phospholipid phagocytosis and immune activation, suggesting that nodules could be involved in MS lesion formation.

The authors describe a new demographic phenomenon: the settlement of Latino families in areas of the United States where previously there has been little Latino presence.This New Latino Diaspora places pressures on host communities, both to develop conceptualizations of Latino newcomers and to provide needed services.These pressures are particularly felt in schools; in some New Latino Diaspora locations the percentage of Latino students in local public schools has risen from zero to 30 or even 50 percent in less than a decade.Latino newcomers, of course, bring their own language and their own cultural conceptions of parenting, education, inter-ethnic relations and the like. Through case studies of Latino Diaspora communities in Georgia, North Carolina, Maine, Colorado, Illinois, and Indiana, the eleven chapters in this volume describe what happens when host community conceptions of and policies toward newcomer Latinos meet Latinos' own conceptions. The chapters focus particularly on the processes of educational policy formation and implementation, processes through which host communities and newcomer Latinos struggle to define themselves and to meet the educational needs and opportunities brought by new Latino students.Most schools in the New Latino Diaspora are unsure about what to do with Latino children, and their emergent responses are alternately cruel, uninformed, contradictory, and inspirational.By describing how the challenges of accommodating the New Latino Diaspora are shared across many sites the authors hope to inspire others to develop more sensitive ways of serving Latino Diaspora children and families.

Targeted protein degradation via small-molecule modulation of cereblon offers vast potential for the development of new therapeutics. Cereblon-binding therapeutics carry the safety risks of thalidomide, which caused an epidemic of severe birth defects characterized by forelimb shortening or phocomelia. Here we show that thalidomide is not teratogenic in transgenic mice expressing human cereblon, indicating that binding to cereblon is not sufficient to cause birth defects. Instead, we identify SALL4 as a thalidomide-dependent cereblon neosubstrate. Human mutations in SALL4 cause Duane-radial ray, IVIC, and acro-renal-ocular syndromes with overlapping clinical presentations to thalidomide embryopathy, including phocomelia. SALL4 is degraded in rabbits but not in resistant organisms such as mice because of SALL4 sequence variations. This work expands the scope of cereblon neosubstrate activity within the formerly ‘undruggable’ C2H2 zinc finger family and offers a path toward safer therapeutics through an improved understanding of the molecular basis of thalidomide-induced teratogenicity.

Previous studies have shown increased expression of stromal markers in synovial tissue (ST) of patients with established rheumatoid arthritis (RA). Here, ST expression of stromal markers in early arthritis in relationship to diagnosis and prognostic outcome was studied. ST from 56 patients included in two different early arthritis cohorts and 7 non-inflammatory controls was analysed using immunofluorescence to detect stromal markers CD55, CD248, fibroblast activation protein (FAP) and podoplanin. Diagnostic classification (gout, psoriatic arthritis, unclassified arthritis (UA), parvovirus associated arthritis, reactive arthritis and RA), disease outcome (resolving vs persistent) and clinical variables were determined at baseline and after follow-up, and related to the expression of stromal markers. We observed expression of all stromal markers in ST of early arthritis patients, independent of diagnosis or prognostic outcome. Synovial expression of FAP was significantly higher in patients developing early RA compared to other diagnostic groups and non-inflammatory controls. In RA FAP protein was expressed in both lining and sublining layers. Podoplanin expression was higher in all early inflammatory arthritis patients than controls, but did not differentiate diagnostic outcomes. Stromal marker expression was not associated with prognostic outcomes of disease persistence or resolution. There was no association with clinical or sonographic variables. Stromal cell markers CD55, CD248, FAP and podoplanin are expressed in ST in the earliest stage of arthritis. Baseline expression of FAP is higher in early synovitis patients who fulfil classification criteria for RA over time. These results suggest that significant fibroblast activation occurs in RA in the early window of disease.