IdeS: A Bacterial Proteolytic Enzyme with Therapeutic Potential

Background: IdeS, a proteinase from Streptococcus pyogenes, cleaves immunoglobulin (Ig)G antibodies with a unique degree of specificity. Pathogenic IgG antibodies constitute an important clinical problem contributing to the pathogenesis of a number of autoimmune conditions and acute transplant rejection. To be able to effectively remove such antibodies is therefore an important clinical challenge. Methodology/Principal Findings: IdeS was found to specifically and efficiently cleave IgG in human blood in vitro (20 mg of IdeS caused a complete degradation of IgG in one ml of human whole blood in 15 minutes) and to clear IgG from the blood stream of rabbits in vivo (no IgG was detected six hours following an intravenous injection of 5 mg of IdeS) without any side effects. In a mouse model of immune thrombocytopenic purpura (ITP), polyclonal IgG antibodies against platelet surface antigens were used to induce a lethal disease. These profoundly thrombocytopenic animals were treated and cured by a single injection of IdeS. Conclusions/Significance: Novel information is provided concerning the IgG-cleaving activity of IdeS in vitro and in vivo. The highly specific and rapid elimination of IgG in vivo, the dramatic effect in a mouse model of ITP, and the lack of sid

A Randomized Trial of a Physical Conditioning Program to Enhance the Driving Performance of Older Persons

BACKGROUND: As the number of older drivers increases, concern has been raised about the potential safety implications. Flexibility, coordination, and speed of movement have been associated with older drivers’ on road performance. OBJECTIVE: To determine whether a multicomponent physical conditioning program targeted to axial and extremity flexibility, coordination, and speed of movement could improve driving performance among older drivers. DESIGN: Randomized controlled trial with blinded assignment and end point assessment. Participants randomized to intervention underwent graduated exercises; controls received home, environment safety modules. PARTICIPANTS: Drivers, 178, age ≥ 70 years with physical, but without substantial visual (acuity 20/40 or better) or cognitive (Mini Mental State Examination score ≥24) impairments were recruited from clinics and community sources. MEASUREMENTS: On-road driving performance assessed by experienced evaluators in dual-brake equipped vehicle in urban, residential, and highway traffic. Performance rated three ways: (1) 36-item scale evaluating driving maneuvers and traffic situations; (2) evaluator’s overall rating; and (3) critical errors committed. Driving performance reassessed at 3 months by evaluator blinded to treatment group. RESULTS: Least squares mean change in road test scores at 3 months compared to baseline was 2.43 points higher in intervention than control participants (P = .03). Intervention drivers committed 37% fewer critical errors (P = .08); there were no significant differences in evaluator’s overall ratings (P = .29). No injuries were reported, and complaints of pain were rare. CONCLUSIONS: This safe, well-tolerated intervention maintained driving performance, while controls declined during the study period. Having interventions that can maintain or enhance driving performance may allow clinician–patient discussions about driving to adopt a more positive tone, rather than focusing on driving limitation or cessation

Change in the Gender Division of Domestic Work after Mummy or Daddy Took Leave: An Examination of Alternative Explanations

This study investigates how the duration of child care leave taken by mothers and fathers relates to changes in couples' division of housework and child care after postnatal labour market return in Germany. It explores whether take-up of child care related leave may impact the gender division of domestic work beyond the period of leave and examines three theoretical explanations: 1) development of domestic work skills, 2) bargaining power based on economic resources, and 3) adaptations in gender role or parenting identities. Using data from the German Socio-Economic Panel (1992-2012) on 797 and 762 couples with a first or second birth, respectively, we applied OLS regression models with lagged dependent variables in combination with Heckman selection correction. The results suggested that dual-earner couples where mothers took longer leaves experienced a greater shift towards a gender-traditional division of domestic labour after childbirth even in the medium-term after labour market return. The linear relationship and stronger effects on the division of child care than for housework lent support to identity-based explanations. Paternal leave take-up was associated with a more equal division of housework and child care after first births but not after second birth transitions. The relationship with the leave duration was less clear. In terms of explaining the mechanisms for fathers, the findings provided greatest support for explanations relating to domestic skills development possibly in combination with changes in fathering identities

Leave the Drama on the Stage: The Effect of Cultural Participation on Health

The aim of this study is to estimate the causal effect of cultural participation on health status. Cultural activities may directly impact upon health through palliative coping or substituting health-compromising behaviors. Cultural engagement may also facilitate the development of social networks, which can improve health via social support and the dissemination of social health norms. Previous estimates on the arts-health relationship are potentially biased due to reverse causality and unobserved heterogeneity. Using individual-level data from Germany, we employ propensity-score matching methods. The treatment group is confined to individuals that visit cultural events at least once a month. The participation equation includes a rich set of personal characteristics that cover the respondents' demographic and social background, social capital and leisure-time activities, health-related lifestyle, personality and childhood environment. We explicitly consider reverse causality by including the pre-treatment trends in health outcomes among the covariates. To deal with time-fixed unobserved heterogeneity, we combine the matching model with a difference-indifference approach. We find that frequent cultural-event visits are unrelated to health once we account for unobserved persistent differences across individuals. However, examining the dose-response relationship we find positive mental-health effects of low levels of cultural participation compared to non-attendance. Our results may thus yield important insights on the effectiveness of arts participation as a means to reduce social inequalities in health

Fathers Taking Leave Alone in the UK – A Gift Exchange Between Mother and Father?

Over the last decade there has been a gradual enhancement of British fathers’ rights in the workplace, even though the UK has one of the longest maternity leaves in OECD countries. From April 2003, for the first time, British fathers were given a legal right to take a 2 week paid paternity leave after the birth of a child, building on a 3 month unpaid parental leave entitlement available since 1999. In April 2011 a new right to allow fathers to take up to 6 months Additional Paternity Leave (APL) during the child’s first year, if the mother returns to work before the end of her maternity leave, was introduced. This chapter examines the experiences of six British fathers who were some of the first to take up this opportunity. The study as a whole explored couples’ negotiations and experiences of leave divisions, drawing on the proposition that intimacy is a mediating factor in gender and parenting roles. The accounts portray how, despite men’s lack of formal individual entitlement to leave, they tended to be positioned as the decision makers in taking leave. Women’s structural agency, as higher earners and as holders of the policy entitlement, was often underplayed. Drawing on Hochschild’s writings on the ‘gift economy’ of couples, we suggest that couple negotiations around APL can be conceptualised as a form of gift exchange

Employment Protection and Parental Child Care

I examine if employment protection affects parental childcare. I find that a softer employment protection has a substantial effect on how parents use and divide paid childcare between them. The identification relies on a reform that made it easier for employers in Sweden to dismiss workers in small firms. I estimate that a softer employment protection reduces the total days of parental childcare in targeted firms, measured as total days of parental leave or temporary parental leave. Both a sorting effect and a behavioral effect can explain the reduced childcare. I also find evidence of a redistribution effect of paid parental childcare within households if only one partner was affected by the reform. I interpret the redistribution effect as a way of evading an external cost on the child

Social Relationships and Mortality Risk: A Meta-analytic Review

In a meta-analysis, Julianne Holt-Lunstad and colleagues find that individuals' social relationships have as much influence on mortality risk as other well-established risk factors for mortality, such as smoking