Regenerative Medicine Strategies for Treating Neurogenic Bladder

Neurogenic bladder is a general term encompassing various neurologic dysfunctions of the bladder and the external urethral sphincter. These can be caused by damage or disease. Therapeutic management options can be conservative, minimally invasive, or surgical. The current standard for surgical management is bladder augmentation using intestinal segments. However, because intestinal tissue possesses different functional characteristics than bladder tissue, numerous complications can ensue, including excess mucus production, urinary stone formation, and malignancy. As a result, investigators have sought after alternative solutions. Tissue engineering is a scientific field that uses combinations of cells and biomaterials to encourage regeneration of new, healthy tissue and offers an alternative approach for the replacement of lost or deficient organs, including the bladder. Promising results using tissue-engineered bladder have already been obtained in children with neurogenic bladder caused by myelomeningocele. Human clinical trials, governed by the Food and Drug Administration, are ongoing in the United States in both children and adults to further evaluate the safety and efficacy of this technology. This review will introduce the principles of tissue engineering and discuss how it can be used to treat refractory cases of neurogenic bladder

Is Peru a Great Place for A&W?

Statement of the problem. Peru has the ideal market for A&W restaurants. Methods. The literature review would be done with the help of a questionnaire that had three different sections and with an interview with the president of A&W Mr. Feltenstein. The questionnaire proved that Peruvians want the presence of A&W, an American fast food restaurant in Lima, the capital of Peru. This researcher reviewed the literature concerning Peru. Results. The final results have been very positive, Peru has economic stabilization and is recognized internationally as a star. It was bankrupt five years ago and now is growing very fast. Inflation was the lowest in two decades, only 5%. and the government has almost defeated terrorism attacks. Peru is a safe and stable place for A&W to invest. People in Peru are willing to have A&W because they want to have more places to choose from. \u27l\u27hey liked the menu and found it excellent in comparison to the existing competitors in Peru. 65% of the people that goes frequently to a fast food restaurant goes to Burger King an American hamburger chain or Bembos which is a national hamburger chain. This means A&W can serve this part of the market that is very big and served by only two companies, one local and one American. Recommendations. It is an excellent idea to invest in an .4&W in Peru because the results from the questionnaire were very positive and show people in Peru are desperate to have an A&W because of its excellent menu and because they want more American chains to invest in Peru. Peru has a potential market. for growth, and they may open their second outlet after six months of their first outlet, like Burger King has done since they opened their first outlet; After one year, A&W can expand to other important cities such as Arequipa which is the second largest city of Peru in size and tourism and Cusco which is the first touristic city of Peru, where you can find Macchu Picchu one of the seven wonders of the world and be the first fast food chain that opens in those places. A&W should open immediately their first outlet in Peru for future expansion not only in Lima the capital of Peru and other important cities, but also in other neighboring countries to start building name recognition in South America, where people are desperate to have more consumer goods they did not have one decade ago

Las sulamitas, un linaje espiritual

Màster en Estudis de la Diferència Sexual, Universitat de Barcelona. DUODA, Centre de recerca de dones, curs: 2015-2016, Tutora: Gemma del Olmo Campill

Floquet topological transitions in a driven one-dimensional topological insulator

The Su-Schrieffer-Heeger model of polyacetylene is a paradigmatic Hamiltonian exhibiting non-trivial edge states. By using Floquet theory we study how the spectrum of this one-dimensional topological insulator is affected by a time-dependent potential. In particular, we evidence the competition among different photon-assisted processes and the native topology of the unperturbed Hamiltonian to settle the resulting topology at different driving frequencies. While some regions of the quasienergy spectrum develop new gaps hosting Floquet edge states, the native gap can be dramatically reduced and the original edge states may be destroyed or replaced by new Floquet edge states. Our study is complemented by an analysis of Zak phase applied to the Floquet bands. Besides serving as a simple example for understanding the physics of driven topological phases, our results could find a promising test-ground in cold matter experiments

Euro-Med And Intercultural Management

As technological inventions and innovations are bewildering the human mind, destroying barriers between peoples, cultures, time and space, globalization trends are sweeping civilizations, nations, nationalisms and other ethnic narrow circles. The winds of human revolutions overwhelm governments, leaders and citizens in pursuit of a better world, based on human freedoms and rights, economic well-being, peace and sustainable ecosystem. This positive cultural change is subjected to many obstacles and much dichotomy, whereby some do promote a negatively extreme pole of violence, terror and death. The objective of this research is to deeply explore the inner venues of both trends, embraced by a new breed of international mangers, leaders, and further determine their impact upon the birth of a world culture, primarily adopted by international businesses. The proposed methodology of research relies, primarily on data gathering from many thinkers and organizations aiming at laying a possible foundation for promoting intercultural management between Europe and the Middle Eastern countries

Measuring topological invariants and chiral Meissner currents with ultracold bosonic atoms

Topologische Invarianten sind von zentraler Bedeutung für die Interpretation vieler Phänomene kondensierter Materie. In dieser Arbeit wird die erste Messung einer solchen Invarianten vorgestellt. Dazu wird ein neu entwickeltes Messprotokoll mit ultrakalten bosonischen Atomen in einem eindimensionalen optischen Gitter verwendet. Außerdem wird die Messung chiraler Meissner-Ströme in einer Leitergeometrie in einem künstlichen Magnetfeld sowie die Präparation sogenannter "Resonating Valence Bond"-Zustände (RVB) in vier Gitterplätze umfassenden Plaketten präsentiert. Das Hauptmerkmal des experimentellen Aufbaus ist ein Paar orthogonaler Übergitter-Potentiale, die es ermöglichen eine Vielzahl verschiedener Systeme zu simulieren. Die Modulation des Übergitters mit einem weiteren Paar interferierender Strahlen ermöglicht zu dem die Realisierung eines künstlichen Magnetfelds. Die Zak-Phase ist eine Invariante, welche die topologischen Eigenschaften eines Energiebandes charakterisiert. Sie ist definiert als die Berry-Phase eines Teilchens bei adiabatischem Durchlaufen eines Pfades im Quasiimpulsraum durch die Brillouinzone. Ein einfaches Beispiel für ein System mit zwei verschiedenen topologischen Klassen ist eine eindimensionale Kette mit alternierender Tunnelkopplungsstärke. Im Experiment können diese Klassen durch Messung der Differenz zwischen ihren Zak-Phasen \Deta\Phi_\text{Zak}\approx\pi unter Verwendung von Bloch-Oszillationen und Ramsey-Interferometrie in Übergittern unterschieden werden. Der zweite Teil dieser Arbeit befasst sich mit der Messung chiraler Meissner-Ströme von Bosonen in einer Leitergeometrie mit magnetischem Fluss, welche eines der einfachsten Modelle zur Beobachtung von Orbitaleffekten ist. Obwohl die Atome ladungsneutral sind und daher keine Lorentzkraft auf sie wirkt, kann durch eine externe Modulation im Übergitter ein künstliches Magnetfeld erzeugt werden. Die dadurch hervorgerufenen Wahrscheinlichkeitsströme auf beiden Seiten der Leiter wurden separat mit einer Projektionsmethode gemessen. Beim Ändern der Tunnelkopplung entlang der Leitersprossen wurde, in Analogie zu einem Typ-II Supraleiter, ein Übergang zwischen einer Meissner-artigen Phase mit gesättigtem maximalen chiralen Strom und einer Vortex-Phase mit abnehmendem Strom beobachtet. Dieses System mit ultrakalten Atomen kann auch als Analogon zur Spin-Bahn-Kopplung betrachtet werden. RVB-Zustände gelten als fundamental für das Verständnis von Hochtemperatursupraleitern. Der dritte Teil der Arbeit widmet sich mit der Realisierung eines Minimalbeispiels solcher Zustände auf einer Plakette bei halber Füllung. In diesem System wurden die zwei RVB-Zustände mit s- und d-Wellen-Symmetrie sowie Superpositionen der beiden Zustände präpariert. Die in dieser Arbeit vorgestellten Experimente stellen einen neuen Ansatz dar, die topologischen Eigenschaften von Bloch-Bändern in optischen Gittern zu untersuchen; sie öffnen die Türen zur Erforschung von wechselwirkenden Teilchen in niedrigdimensionalen Systemen in einem homogenen Magnetfeld sowie der Eigenschaften des Grundzustandes des Heisenberg-Modells.The determination of topological invariants is of fundamental importance to interpret many condensed-matter phenomena. This thesis reports on the implementation of a newly developed protocol to measure these invariants for the first time, using ultracold bosonic atoms in one-dimensional optical lattices. In addition, it deals with the measurement of chiral Meissner currents in a ladder-like lattice geometry exposed to an artificial magnetic field, and presents results on the preparation of Resonating Valence Bond (RVB) states on plaquettes. The key feature of the experimental setup is a pair of orthogonal superlattice potentials that permit a rich variety of systems to be simulated, and that when combined with a pair of interfering beams which periodically modulate the lattice allow the realization of artificial magnetic fields. The Zak phase is an invariant that characterizes the topological properties of an energy band, and is defined as the Berry phase that a particle acquires as it adiabatically moves in the quasimomentum space across the Brillouin zone. A dimerized lattice -- a one-dimensional chain with alternating couplings -- is a simple example of a system that possesses two different topological classes. Using a combination of Bloch oscillations and Ramsey interferometry in superlattices we measured the difference of the Zak phase $\approx\pi$ for the two possible polyacetylene phases, which directly indicates that they belong to different topological classes. The second part of this thesis deals with the measurement of chiral Meissner currents in bosonic ladders with magnetic flux, one of the simplest models to observe orbital effects. Although charge neutrality prevents atoms from experiencing the Lorentz force when they are exposed to a magnetic field, employing lattice modulation techniques we implemented an artificial magnetic field on a ladder created with optical lattices. By using a projection technique, we were able to measure the probability currents on each side of the ladder. When changing the coupling strengths along the rungs of the ladder, we found, in analogy to type-II superconductors, a transition between a Meissner-like phase with saturated maximum chiral current and a vortex phase with decreasing currents. Additionally, the flux ladder realizes spin-orbit coupling with ultracold atoms. It is believed that RVB states are fundamental for the understanding of high-T$_c$ superconductivity. The third part of this work describes our measurements on the preparation of minimum instances of RVB states with bosonic atoms in isolated four-site plaquettes at half filling. These small systems possess two RVB states with $s$- and $d$-wave symmetry. Using atom manipulation techniques we prepared these two states, as well as a quantum resonance between them. The experiments in this thesis establish a new general approach for probing the topological structure of Bloch bands in optical lattices. Moreover, they open up the pathway to exploring interacting particles in low dimensions exposed to uniform magnetic fields and to studying ground state properties of the Heisenberg Hamiltonian

Insulin resistance and metabolic syndrome in type 1 diabetes mellitus

Insulin resistance (IR) plays a larger role in the type 1 diabetes mellitus (T1DM) disease process than commonly recognized. Overweight and physical inactivity have increased steadily for the last 20-30 years in children and adolescents in many populations, concurrently with a rising incidence of T1DM. The role of IR in T1DM has only recently been gaining acceptance. This review will focus on how IR influences our current understanding of disease development and metabolic syndrome (MS) in T1DM. Increases in IR by weight gain and sedentarism, associated to decreased beta cell mass by autoimmune process, may disrupt normoglycemia in pre-T1DM individuals. IR may reflect a more aggressive form of autoimmune disease mediated by immuno-inflammatory factors that also mediate beta cell destruction (TNF-alpha and IL-6). These concepts are included in the accelerator hypothesis. Moreover, family history of T2DM and chronic hyperglycemia (glucotoxicity), occurring after T1DM diagnosis, contribute to decrease peripheral glucose uptake. The onset of diabetic nephropathy (DN) might also contribute to IR and metabolic syndrome (MS) via low-grade inflammation and increased oxidative stress. MS is found between 12 to 40% in T1DM, especially in patients with advanced DN and poor glycemic control. These findings have therapeutic and cardiovascular prognostic implications as children make the transition toward adolescence and young adulthood T1DM.A resistência à insulina (RI) pode desempenhar um papel, na história natural do diabetes melito do tipo 1 (DM1), maior do que o habitualmente reconhecido. Nas últimas décadas, este papel se tornou mais evidente com o aumento da obesidade e da diminuição da atividade física nos jovens. Esta revisão tem como objetivo apresentar e discutir a RI nas diferentes fases do DM1, bem como a prevalência da Síndrome Metabólica (SM) nessa condição. O aumento na RI, concomitante a uma diminuição da massa de células beta, pode alterar o equilíbrio entre a sensibilidade à insulina e a secreção de insulina, e precipitar a hiperglicemia nos indivíduos com pré-DM1. A RI poderia refletir uma forma mais agressiva de doença autoimune, mediada por fatores imuno-inflamatórios, comuns a ambos os processos, que também mediassem a destruição das células beta (TNF-alfa e IL-6). Estes conceitos fazem parte da Hipótese Aceleradora. A história familiar de DM2 e a hiperglicemia crônica (glicotoxicidade), durante a fase clínica do DM1, estão associadas a uma diminuição da captação periférica de glicose. A nefropatia diabética (ND), através da inflamação subclínica e do aumento no estresse oxidativo, contribui para a RI e o desenvolvimento da SM. A prevalência da SM no DM1 varia entre 12 a 40%, sendo mais freqüente nos pacientes com ND e controle glicêmico insatisfatório. Estes achados possuem implicações na terapêutica e no prognóstico cardiovascular dos pacientes com DM1.UNIFESP-EPM Departamento de MedicinaUNIFESP, EPM, Depto. de MedicinaSciEL

Automonitoração da glicemia no diabetes mellitus do tipo 1: um investimento com retorno garantido

Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de MedicinaUNIFESP, EPM, Depto. de MedicinaSciEL