Household Responses to Public Home Care Programs

A choice-theoretic model of household decision-making with respect to care-giving time allocations and the use of publicly and privately financed home care services is proposed. Predictions concerning the effect of increased availability of publicly financed home care services on home care utilization, informal care-giving, and health status are derived. These predictions are assessed through use of Canadian inter-provincial survey data on home care use and care-giving that are matched with data on home care funding for the period 1992 to 1998. Increased availability of publicly financed home care is associated with an increase in its utilization and a decline in informal care-giving, with this effect more pronounced among lower income Canadians. While self-reported health status was positively correlated with the increased availability of publicly financed home care, the perceived need for home care was invariant to this change.

Role of distinct natural killer cell subsets in anticancer response

Natural killer (NK) cells, the prototypic member of innate lymphoid cells, are important effectors of anticancer immune response. These cells can survey and control tumor initiation due to their capability to recognize and kill malignant cells and to regulate the adaptive immune response via cytokines and chemokines release. However, several studies have shown that tumor-infiltrating NK cells associated with advanced disease can have profound functional defects and display protumor activity. This evidence indicates that NK cell behavior undergoes crucial alterations during cancer progression. Moreover, a further level of complexity is due to the extensive heterogeneity and plasticity of these lymphocytes, implying that different NK cell subsets, endowed with specific phenotypic and functional features, may be involved and play distinct roles in the tumor context. Accordingly, many studies reported the enrichment of selective NK cell subsets within tumor tissue, whereas the underlying mechanisms are not fully elucidated. A malignant microenvironment can significantly impact NK cell activity, by recruiting specific subpopulations and/or influencing their developmental programming or the acquisition of a mature phenotype; in particular, neoplastic, stroma and immune cells, or tumor-derived factors take part in these processes. In this review, we will summarize and discuss the recently acquired knowledge on the possible contribution of distinct NK cell subsets in the control and/or progression of solid and hematological malignancies. Moreover, we will address emerging evidence regarding the role of different components of tumor microenvironment on shaping NK cell response

GIS without GPS: new opportunities in technology and survey research to link people and place

This paper presents innovative ways to relate survey data to GIS maps, thereby making the connection of people and place more accessible for the research community. Based on data from rural areas in the Brazilian Amazon, we describe a successful effort to sample households while linking farm-level data to property boundaries, these boundaries generated from subjects’ interpretations of satellite images on a computer screen. The sampling framework is based on legislation requiring farmers to report to a government agency in a four-week period, and the farmers’ input allows for a more efficient means of identifying property boundaries as compared to GPS. We show that the resulting sampling is statistically representative. We discuss the potential of this association of institutional design and low-cost methods of data collection to allow for more cost-effective generation of spatial data and of geospatial analysis

The Newtonian Limit of F(R) gravity

A general analytic procedure is developed to deal with the Newtonian limit of $f(R)$ gravity. A discussion comparing the Newtonian and the post-Newtonian limit of these models is proposed in order to point out the differences between the two approaches. We calculate the post-Newtonian parameters of such theories without any redefinition of the degrees of freedom, in particular, without adopting some scalar fields and without any change from Jordan to Einstein frame. Considering the Taylor expansion of a generic $f(R)$ theory, it is possible to obtain general solutions in term of the metric coefficients up to the third order of approximation. In particular, the solution relative to the $g_{tt}$ component gives a gravitational potential always corrected with respect to the Newtonian one of the linear theory $f(R)=R$. Furthermore, we show that the Birkhoff theorem is not a general result for $f(R)$-gravity since time-dependent evolution for spherically symmetric solutions can be achieved depending on the order of perturbations. Finally, we discuss the post-Minkowskian limit and the emergence of massive gravitational wave solutions.Comment: 16 page

Effects of balloon injury on neointimal hyperplasia in steptozotocin-induced diabetes and in hyperinsulinemic nondiabetic pancreatic islet-transplanted rats.

BACKGROUND: The mechanisms of increased neointimal hyperplasia after coronary interventions in diabetic patients are still unknown. METHODS AND RESULTS: Glucose and insulin effects on in vitro vascular smooth muscle cell (VSMC) proliferation and migration were assessed. The effect of balloon injury on neointimal hyperplasia was studied in streptozotocin-induced diabetic rats with or without adjunct insulin therapy. To study the effect of balloon injury in nondiabetic rats with hyperinsulinemia, pancreatic islets were transplanted under the kidney capsule in normal rats. Glucose did not increase VSMC proliferation and migration in vitro. In contrast, insulin induced a significant increase in VSMC proliferation and migration in cell cultures. Furthermore, in VSMC culture, insulin increased MAPK activation. A reduction in neointimal hyperplasia was consistently documented after vascular injury in hyperglycemic streptozotocin-induced diabetic rats. Insulin therapy significantly increased neointimal hyperplasia in these rats. This effect of hyperinsulinemia was totally abolished by transfection on the arterial wall of the N17H-ras-negative mutant gene. Finally, after experimental balloon angioplasty in hyperinsulinemic nondiabetic islet-transplanted rats, a significant increase in neointimal hyperplasia was observed. CONCLUSIONS: In rats with streptozotocin-induced diabetes, balloon injury was not associated with an increase in neointimal formation. Exogenous insulin administration in diabetic rats and islet transplantation in nondiabetic rats increased both blood insulin levels and neointimal hyperplasia after balloon injury. Hyperinsulinemia through activation of the ras/MAPK pathway, rather than hyperglycemia per se, seems to be of crucial importance in determining the exaggerated neointimal hyperplasia after balloon angioplasty in diabetic animals

TAVI nel trattamento della stenosi aortica degenerativa: stato dell’arte e prospettive

Degenerative aortic stenosis is the most common form of heart valve disease in developed countries and predominantly affects the elderly. Aortic valve replacement (AVR) has been the gold standard, but recently, transcatheter aortic valve implantation has emerged as an effective therapeutic alternative to conventional AVR for high-risk patients. This review analyzed the literature about AVR, with the objective of evaluating the outcomes of transcatheter aortic valve implantation in patients who are not eligible for surgery showing an improvement in quality of life and middle-term outcomes. The crucial point is the lack of studies with long-term follow-up that could give therapeutic importance to percutaneous valve replacemen

Stabilized Weighted Reduced Basis Methods for Parametrized Advection Dominated Problems with Random Inputs

In this work, we propose viable and efficient strategies for stabilized parametrized advection dominated problems, with random inputs. In particular, we investigate the combination of wRB (weighted reduced basis) method for stochastic parametrized problems with stabilized reduced basis method, which is the integration of classical stabilization methods (SUPG, in our case) in the Offline--Online structure of the RB method. Moreover, we introduce a reduction method that selectively enables online stabilization; this leads to a sensible reduction of computational costs, while keeping a very good accuracy with respect to high fidelity solutions. We present numerical test cases to assess the performance of the proposed methods in steady and unsteady problems related to heat transfer phenomena

POD‐identification reduced order model of linear transport equations for control purposes

Intrusive reduced order modeling techniques require access to the solver's discretization and solution algorithm, which are not available for most computational fluid dynamics codes. Therefore, a nonintrusive reduction method that identifies the system matrix of linear fluid dynamical problems with a least-squares technique is presented. The methodology is applied to the linear scalar transport convection-diffusion equation for a 2D square cavity problem with a heated lid. The (time-dependent) boundary conditions are enforced in the obtained reduced order model (ROM) with a penalty method. The results are compared and the accuracy of the ROMs is assessed against the full order solutions and it is shown that the ROM can be used for sensitivity analysis by controlling the nonhomogeneous Dirichlet boundary conditions