Early hospital readmissions post‐kidney transplantation are associated with inferior clinical outcomes

Unplanned hospital readmissions are common early post‐kidney transplantation. We investigated the relationship between early hospital readmissions and clinical outcomes in a single‐center retrospective study that included all adult kidney transplant patients between 2004 and 2008 with follow‐up to December 2012. The early hospital readmissions within the first 30 d were numbered and the diagnosis ascertained. Patients were grouped as none, once, and twice or more readmissions. Predictors of early readmissions were assessed, and clinical outcomes and patient and death‐censored kidney survival were compared. Among 1064 patients, 203 (19.1%) patients had once and 83 (7.8%) patients had twice or more readmissions within 30 d. Surgical complications, infections, and acute kidney injuries/acute rejection were three most common diagnoses. The length of initial hospital stay and African American race were among the variables associated significantly with readmissions. Patients with early readmissions had lower baseline renal function (p < 0.01) and more early acute rejection (p < 0.01). During follow‐up, only frequent readmissions, twice or more, within 30 d were associated with increased risk of death ( AHR 1.75, p   =   0.01) and death‐censored kidney failure ( AHR 2.20, p < 0.01). Frequent early hospital readmissions post‐transplantation identify patients at risk for poor long‐term outcomes, and more studies are needed to understand the mechanisms.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106830/1/ctr12347.pd

A psychosocial pathway to paranoia : The interplay between social connectedness and self-esteem

Altres ajuts: acords transformatius de la UABThe quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness toperceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis

The impact of family environment on self-esteem and symptoms in early psychosis

Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients' SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients' SE mediated the effect of relatives' EE on patients' positive symptoms and paranoia; (2) patients' perceived EE mediated the effect of relatives' EE on patients' SE; (3) patients' SE mediated between patients' perceived EE and patients' symptomatology; and (4) patients' perceived EE and patients' SE serially mediated the effect of relatives' EE on patients' positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients' perceived EE mediated the link between relatives' EE and patients' negative, but not positive, SE; (2) patients' negative SE mediated the effect of patients' perceived EE on positive symptoms and paranoia; (3) the association of relatives' EE with positive symptoms and paranoia was serially mediated by an increased level of patients' perceived EE leading to increases in negative SE; (4) high levels of patients' distress moderated the effect of relatives' EE on symptoms through patients' perceived EE and negative SE. Findings emphasize that patients' SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients' negative SE and symptoms

Vías pecuarias y recursos pascícolas en rutas trashumantes de ovino de la provincia de Huesca

La trashumancia es un sistema de producción animal que evita periodos críticos de la producción vegetal mediante movimientos estacionales del ganado, que se realizan tradicionalmente desde la zona llana hasta la montaña, al inicio de la época estival, y a la inversa al inicio del otoño. Los objetivos de este artículo fueron: (I) desarrollar una metodología de seguimiento del ganado para analizar las rutas recorridas por cuatro rebaños de ovino trashumantes entre la hoya de Huesca y el Pirineo aragonés; (II) caracterizar los tipos de viales que utilizan los rebaños durante sus desplazamientos; (III) comparar las rutas seguidas con las vías pecuarias registradas por la Administración; (IV) caracterizar los recursos pascícolas disponibles y el tiempo de permanencia del rebaño en cada tipo de pasto. Para ello, se utilizó un sistema creado ad hoc, consistente en la incorporación de un GPS comercial, modificado mediante la adición de una batería, a un collar colocado alrededor del cuello de varios animales del rebaño, y programado para registrar datos de posición cada 30 segundos para su posterior procesado mediante un sistema de información geográfica, el software QGIS. Mediante este programa informático, las rutas descritas por los rebaños se superpusieron con información cartográfica para la identificación de los viales y se intersectaron con la capa de vías pecuarias registradas por la Administración y con el mapa de pastos. Una vez obtenidos y sintetizados los resultados, se analizaron estadísticamente (test de Friedman y test de Kruskal Wallis) mediante el software SPSS. El vial más utilizado durante estas rutas fueron las pistas y las carreteras secundarias, que son las que menos trabas ponen al desplazamiento de los rebaños. Entre las longitudes de avance diarias de cada rebaño no se observaron diferencias significativas. Tres de las rutas estudiadas utilizan vías pecuarias de mayor entidad, puesto que las ovejas recorren fundamentalmente cañadas reales. En cuanto a los recursos pascícolas, el ganado transita por distintos tipos de pastos de monte, fundamentalmente “erizonales prepirenaicos”, “romerales y aliagares prepirenaicos”, “pastos con arbolado de Pinus sylvestris en masas puras y mixtas del Prepirineo” y “pastizales prepirenaicos”, aunque son reseñables también los porcentajes de tiempo sobre los barbechos y rastrojos elegidos en ocasiones para el reposo y las pernoctas del ganado. El valor pastoral (VP) promedio de cada ruta, que indica la calidad forrajera de los recursos pascícolas utilizados, no mostró diferencias significativas entre las cuatro rutas analizadas. La metodología puesta a punto proporcionó información con una alta precisión, adecuándose satisfactoriamente a los objetivos del artículo

Resolution of complex fluorescence spectra of lipids and nicotinic acetylcholine receptor by multivariate analysis reveals protein-mediated effects on the receptor's immediate lipid microenvironment

Analysis of fluorescent spectra from complex biological systems containing various fluorescent probes with overlapping emission bands is a challenging task. Valuable information can be extracted from the full spectra, however, by using multivariate analysis (MA) of measurements at different wavelengths. We applied MA to spectral data of purified Torpedo nicotinic acetylcholine receptor (AChR) protein reconstituted into liposomes made up of dioleoylphosphatidic acid (DOPA) and dioleoylphosphatidylcholine (DOPC) doped with two extrinsic fluorescent probes (NBD-cholesterol/pyrene-PC). Förster resonance energy transfer (FRET) was observed between the protein and pyrene-PC and between pyrene-PC and NBD-cholesterol, leading to overlapping emission bands. Partial least squares analysis was applied to fluorescence spectra of pyrene-PC in liposomes with different DOPC/DOPA ratios, generating a model that was tested by an internal validation (leave-one-out cross-validation) and was further used to predict the apparent lipid molar ratio in AChR-containing samples. The values predicted for DOPA, the lipid with the highest Tm, indicate that the protein exerts a rigidifying effect on its lipid microenvironment. A similar conclusion was reached from excimer formation of pyrene-PC, a collisional-dependent phenomenon. The excimer/monomer ratio (E/M) at different DOPC/DOPA molar ratios revealed the restricted diffusion of the probe in AChR-containing samples in comparison to pure lipid samples devoid of protein. FRET from the AChR (donor) to pyrene-PC (acceptor) as a function of temperature was found to increase with increasing temperature, suggesting a shorter distance between AChR and pyrene PC. Taken together, the results obtained by MA on complex spectra indicate that the AChR rigidifies its surrounding lipid and prefers DOPA rather than DOPC in its immediate microenvironment

Transhumant GPS tracked sheep flocks from lowlands to highlands in Spain: grazing resources use and difficulties of walking/herding

The need for preserving walking/herding transhumance drove roads on the Iberian Peninsula hasbeen widely recognized, as they provide a wide range of ecosystem services. In spite of the decline of walkingtranshumance in Spain, some drove roads are being reactivated due mainly to the high price of lorrytransport and feeds for livestock. The objectives of this work were: (i) develop a method to track the transhumantflocks in order to know the route followed and detail the type of pastures that the sheep use during thetrip; (ii) know the main difficulties of the activity, either technical, economic or social. Collars with GPS wereinstalled around the neck of some animals of five transhumant flocks. The data provided by GPS were analyzedby a GIS and overlapped with pastures/vegetation maps. For each flock, interviews with the farmersprovided data in terms of difficulties for the activity to be continued. The method provided highly accurate dataof the routes. The main types of vegetation used by sheep and main difficulties perceived by the farmers tocontinue the activity are summarized

What Else (Besides the Syllabus) Should Students Learn in Introductory Physics?

We have surveyed what various groups of instructors and students think students should learn in introductory physics. We started with a Delphi Study based on interviews with experts, then developed orthogonal responses to “what should we teach non‐physics majors besides the current syllabus topics?” AAPT attendees, atomic researchers, and PERC08 attendees were asked for their selections. All instructors rated “sense‐making of the answer” very highly and expert problem solving highly. PERers favored epistemology over problem solving, and atomic researchers “physics comes from a few principles.” Students at three colleges had preferences anti‐aligned with their teachers, preferring more modern topics, and the relationship of physics to everyday life and also to society (the only choice with instructor agreement), but not problem solving or sense‐making. Conclusion #1: we must show students how old physics is relevant to their world. Conclusion #2: significant course reform must start by reaching consensus on what to teach and how to hold students’ interest (then discuss techniques to teach it).National Science Foundation (U.S.) (NSF grant PHY-0757931

Tree Species Effects on Soil Properties in Experimental Plantations in Tropical Moist Forest

We resampled one of the earliest replicated experimental sites used to investigate the impacts of native tropical tree species on soil properties, to examine longer term effects to 1-m depth. The monodominant stands, established in abandoned pasture in 1988 at La Selva Biological Station, Costa Rica, contained six species, including one exotic, Pinus patula ssp. tecunumanii (Eguiluz & J.P. Perry) Styles, and five native species: Pentaclethra macroloba (Willd.) Ktze (N2-fixing); Hyeronima alchorneoides Allemao; Virola koschnyi Warb.; Vochysia ferruginea Mart.; and Vochysia guatemalensis J.D. Smith. Soil organic carbon (SOC) differed significantly among species in the surface (0–15-cm) layer, ranging from 44.5 to 55.1 g kg1, compared with 46.6 and 50.3 g kg1 in abandoned pasture and mature forest, respectively. The change in surface SOC over 15 yr ranged from 0.03 to 0.66 Mg C ha1 yr1. The species differed in the quantity and chemical composition of their detrital production. Soil organic C was significantly correlated with fine-root growth, but not with aboveground detrital inputs. Soil organic C increased with potential C mineralization on a grams of C basis, indicating that species influenced both the quality and quantity of SOC. Contrary to expectations, SOC declined with increasing fine-root lignin concentrations, indicating that ligninderived C did not dominate refractory SOC pools. We hypothesize that differences among species in the capacity to increase SOC stocks involved fine-root traits that promoted soil microbial turnover and, thus, greater production of recalcitrant, microbial-derived C fractions

Beneficios ambientales de la trashumancia: la raza merina (variedad de los Montes Universales) apuesta por el medio ambiente

La trashumancia, entendida como la forma de actividad ganadera más extensiva, en la que el ganado se desplaza a través de las vías pecuarias de forma estacional de unas zonas a otras para el aprovechamiento alternativo de la diversidad de pastos en el momento óptimo de su producción (VVAA, 2013), sigue estando presente en el territorio nacional, aunque de una forma muy residual. Y es que, la cabaña ganadera trashumante se ha reducido enormemente desde el siglo pasado, debido fundamentalmente a causas sociales y económicas. Sin embargo, los movimientos trashumantes conllevan una serie de beneficios tanto de carácter histórico-cultural, por la amplia tradición pastoral existente a lo largo de la historia de España, como de carácter ambiental, a través de los denominados servicios ecosistémicos, en los cuales se ha centrado este estudio. Además, en la mayoría de las ocasiones, dichos movimientos son realizados por rebaños de razas autóctonas, como la Raza Merina (variedad de los Montes Universales), con la rentabilidad económica, social y ambiental que ello conlleva..

Disclosure of cholesterol recognition motifs in transmembrane domains of the human nicotinic acetylcholine receptor

Cholesterol influences ion-channel function, distribution and clustering in the membrane, endocytosis, and exocytic sorting of the nicotinic acetylcholine receptor (AChR). We report the occurrence of a cholesterol recognition motif, here coined “CARC”, in the transmembrane regions of AChR subunits that bear extensive contact with the surrounding lipid, and are thus optimally suited to convey cholesterol-mediated signaling from the latter. Three cholesterol molecules could be docked on the transmembrane segments of each AChR subunit, rendering a total of 15 cholesterol molecules per AChR molecule. The CARC motifs contribute each with an energy of interaction between 35 and 52 kJ.mol−1, adding up to a total of about 200 kJ.mol−1 per receptor molecule, i.e. ∼40% of the lipid solvation free energy/ AChR molecule. The CARC motif is remarkably conserved along the phylogenetic scale, from prokaryotes to human, suggesting that it could be responsible for some of the above structural/functional properties of the AChR