La educación superior, agente del desarrollo humano y social: el punto de vista de la UNESCO

Abordar sucintamente la cuestión del papel de la educación superior para el desarrollo humano y el desarrollo social, acompañada por el punto de vista de la UNESCO, supone un reto debido al repertorio de argumentos que existen a nivel de diversidad y complejidad. Apoyándose en sus ciento noventa y dos estados miembros, la UNESCO se siente obligada a proponer, a través del diálogo y la confrontación, la visión más objetiva posible de las realidades y las perspectivas de la educación superior en el mundo. Esta visión debe basarse en tres factores temporales bien definidos pero profundamente vinculados. El primero concierne al pasado o la historia, el segundo al tiempo presente o la actualidad y el tercero al tiempo futuro o el porvenir.Peer Reviewe

COMMAND VOICES AND AGGRESSION IN A LEBANESE SAMPLE PATIENTS WITH SCHIZOPHRENIA

Background: The impact of command voices (CV) on violent behaviors in patients with schizophrenia remains unclear. The literature has produced mixed results, with no research existing on CV and violence among the Lebanese population. The study objecttives were to (1) evaluate the association between voice beliefs, psychosis severity, treatment, demographic factors and command voices, and (2) evaluate the association between command voices and violence among patients with schizophrenia in Lebanon. Methods: A cross-sectional study, conducted between April and August 2019, enrolled 280 patients with schizophrenia. Results: The results showed that 111 (39.6%) patients with schizophrenia had auditory hallucinations, among whom 93 (83.8%) patients had command voices; from these 93 patients, 53 (57.0%) were compliant with voices. Higher positive (ORa=1.09) and general psychopathology (ORa=1.04) PANSS subscales scores were significantly associated with higher compliance to voices. A higher resistance to beliefs about voices (ORa=0.91) was significantly associated with lower compliance to voices. Conclusions: The prevalence of CV in patients with schizophrenia that report auditory hallucinations, was high in our sample. The vast majority of violent acts committed by patients was in compliance to CV, with a significantly high rate of the violence committed being directed towards property. Our findings were able to connect positive symptoms to higher probability of compliance to CV

Adverse Effects of Botulinum Toxin type-A injections in masticatory muscles on underlying bone and cartilage: a literature review

Botulinum toxin type A (BTA) injections in masticatory muscles are used to treat numerous clinical conditions. This neurotoxin causes atrophy and transient paralysis of the concerned muscles.The aim of this review is to gather and define the effects of BTA injections in masticatory muscles on the underlying cartilage and bone structures.Electronic search of Medline and Google scholar databases covering the period between January 2007 and July 2019 was carried out. Eligible articles were selected according to the inclusion/exclusion criteria. Fourteen articles were included. BTA injections may cause short term reduction of cortical bone thickness and trabeculation. On the long term, cartilage volume reduction and bone volume loss were evident on the condyle and mandibular angle, at bothinjected and non-injected mandibular bone structures. Bone mineral density remained unaffected when only one masticatory muscle was injected but was reduced when several masticatory muscles were treated with BTA. Several cellular and molecular alterations were noticed in some articles.Because of evidence of irreversible negative effects of BTA on the underlying structures, possible muscle, bone and cartilage volume reduction should be communicated to the patients prior to any intervention. Further studies are needed to fully understand the cellular mechanisms and molecular responses behind this phenomenon

Études de type structure fonction du couplage électromécanique et de la coopérativité sous-unitaire chez les canaux potassiques dépendants du voltage

Les canaux potassiques voltage-dépendants forment des tétramères dont chaque sous-unité comporte six segments transmembranaires (S1 à S6). Le pore, formé des segments S5-S6 de chaque sous-unité, est entouré de quatre domaines responsables de la sensibilité au potentiel membranaire, les senseurs de voltage (VS; S1-S4). Lors d’une dépolarisation membranaire, le mouvement des résidus chargés situés dans le VS entraine un mouvement de charges détectable en électrophysiologie, le courant de « gating ». L’activation du VS conduit à l'ouverture du pore, qui se traduit par un changement de conformation en C-terminal du segment S6. Pour élucider les principes qui sous-tendent le couplage électromécanique entre ces deux domaines, nous avons étudié deux régions présumées responsables du couplage chez les canaux de type Shaker K+, soit la région carboxy-terminale du segment S6 et le lien peptidique reliant les segments transmembranaire S4-S5 (S4-5L). Avec la technique du « cut-open voltage clamp fluorometry » (COVCF), nous avons pu déterminer que l’interaction inter-sous-unitaire RELY, formée par des acides aminés situés sur le lien S4-5L et S6 de deux sous-unités voisines, est impliquée dans le développement de la composante lente observée lors du retour des charges de « gating » vers leur état de repos, le « OFF-gating ». Nous avons observé que l’introduction de mutations dans la région RELY module la force de ces interactions moléculaires et élimine l’asymétrie observée dans les courants de « gating » de type sauvage. D’ailleurs, nous démontrons que ce couplage inter-sous-unitaire est responsable de la stabilisation du pore dans l’état ouvert. Nous avons également identifié une interaction intra-sous-unitaire entre les résidus I384 situé sur le lien S4-5L et F484 sur le segment S6 d’une même sous-unité. La déstabilisation de cette interaction hydrophobique découple complètement le mouvement des senseurs de voltage et l'ouverture du pore. Sans cette interaction, l’énergie nécessaire pour activer les VS est moindre en raison de l’absence du poids mécanique appliqué par le pore. De plus, l’abolition du couplage électromécanique élimine également le « mode shift », soit le déplacement de la dépendance au voltage des charges de transfert (QV) vers des potentiels hyperpolarisants. Ceci indique que le poids mécanique du pore imposé au VS entraine le « mode shift », en modulant la conformation intrinsèque du VS par un processus allostérique.Voltage-gated potassium channels are tetramers and each subunit is formed of six transmembrane segments (S1 to S6). The pore, formed by the S5-S6 segments of each subunit, is surrounded by four modules responsible for sensitivity to the membrane potential, the voltage sensors (VS, S1-S4). During membrane depolarization, the movement of charged residues located in the VS causes a detectable charge movement called the gating current. The activation of the VS led to the opening of the pore, resulting in a conformational change in the C-terminal segment of S6. To elucidate the principles underlying the electromechanical coupling between these two domains, we examined two regions presumed responsible for the coupling among channels of the Shaker K + family: the carboxy-terminal region of S6 and the peptide bond linking the transmembrane segments S4-S5 (S4-5L). Using the cut-open voltage clamp fluorometry (COVCF), we have determined that the RELY inter-subunit interaction, formed by amino acids located on the S4-5L linker and S6 of two neighboring subunits, is involved in the development of the slow component observed during the return of the gating charges (OFF-gating) to their resting state. The introduction of mutations in the RELY region modulates the strength of these molecular interactions and eliminates the asymmetry observed in the wild type gating currents. Moreover, we demonstrate that this inter-subunit coupling is responsible for stabilizing the pore in the open state. We have also identified an intra-subunit interaction between residues I384 located on the S4-5L linker and F484 on the S6 segment of the same subunit. The destabilization of this hydrophobic interaction uncouples completely the movement of voltage sensors from pore opening. Without this interaction, the energy required to activate the VS is diminished due to the absence of mechanical weight applied by the pore. Furthermore, this uncoupling also eliminates the "mode shift", defined as an amplified shift of the voltage dependence of gating charge (QV) to hyperpolarizing potentials during prolonged depolarization, thus indicating that the mechanical load of the pore influences the entry of the VS into this shifted mode by modulating the conformation of the VS threw an intrinsic allosteric process

Managing acutely aggressive or agitated people in a psychiatric setting: a survey in Lebanon

Background: Violent patients constitute 10% of all psychiatric admissions. Treatment options and clinical practice interventions vary across the globe and no survey of practice in a Middle Eastern setting exists. Surveying treatments in Lebanon will show treatment interventions used in this part of the world and, most importantly, provide the treatment options that could potentially be used for clinical trials pertaining to emergency psychiatry. Methods: A survey of clinicians’ opinions and practice was conducted between July and August 2017 at the largest psychiatric hospital in Lebanon. Results: Five of seven experienced psychiatrists provided opinions when interviewed of their preferred intervention when dealing with an emergency psychiatric episode. Whilst this varied in detail, there was a consistent view that there should first be verbal control, then use of medications, and finally physical restrain of the patient. A total of 39 emergency episodes (28 people) occurred in the one month (64% men in their 30s). Bipolar disorder was the most frequent single diagnosis behind the aggression (n=16, 41%; 12 people 43%) but the combined schizophrenia-like illnesses underlay 18 of the 39 episodes (46%; 13/28 people 46%). In clinical life, we found evidence of high family involvement, but little attempts made at initial verbal control in the hospital. All 39 episodes involved administration of pharmacological interventions. Medications were used in 29 of cases (74%) and non-medication interventions used in the remaining 10/39 (26%). Conclusion: This survey provides some evidence that clinicians’ preferences may not fully reflect clinical practice but also that experienced clinicians are using several clearly effective techniques to manage these very difficult situations. However, as for other parts of the world, treatment in Lebanon has limited or no underpinning by evidence from well-designed, conducted and reported evaluative studies

Natural Health Products, Modulation of Immune Function and Prevention of Chronic Diseases

The immune system is increasingly found to be involved in the development of several chronic illnesses, for which allopathic medicine has provided limited tools for treatment and especially prevention. In that context, it appears worthwhile to target the immune system in order to modulate the risk of certain chronic illnesses. Meanwhile, natural health products (NHPs) are generating renewed interest, particularly in the prevention and treatment of several chronic diseases. Over 20 scientists from fields related to immune function and NHPs were thus convened to establish the state of knowledge on these subjects and to explore future research directions. This review summarizes the result of discussions held during the symposium. It thus seeks to be thought provoking rather than to comprehensively cover such broad areas of research. Notably, a brief overview of the immune system is presented, including potentially useful targets and strategies to keep it in an equilibrated state, in order to prevent certain disorders. The pertinence and limitations of targeting the immune system to prevent chronic diseases is also discussed. The paper then discusses the usefulness and limitations of current experimental tools available to study the immune modulating effects of NHPs. Finally, a concise review of some of the most studied NHPs showing promising immunomodulatory activity is given, and avenues for future research are described

Effects of IGF-1 on IK and IK1 Channels via PI3K/Akt Signaling in Neonatal Cardiac Myocytes

Previous studies suggest that sarcolemmal potassium currents play important roles in cardiac hypertrophy. IGF-1 contributes to cardiac hypertrophy via activation of PI3K/Akt signaling. However, the relationships between IGF-1, PI3K/Akt signaling and sarcolemmal potassium currents remain unknown. Therefore, we tested the hypothesis that IGF-1 and PI3K/Akt signaling, independently, decrease sarcolemmal potassium currents in cardiac myocytes of neonatal rats. We compared the delayed outward rectifier (IK) and the inward rectifier (IK) current densities resulting from IGF-1 treatments to those resulting from simulation of PI3K/Akt signaling using adenoviral (Ad) BD110 and wild-type Akt and to those resulting from inhibition of PI3K signaling by LY294002. Ad.BD110 and Ad.Akt decreased IK and these decrements were attenuated by LY 294002. The IGF-1 treatments decreased both IK and IK1 but only the IK decrement was attenuated by LY294002. These findings demonstrate that IGF-1 may contribute to cardiac hypertrophy by PI3K/Akt signal transduction mechanisms in neonatal rat cardiomyocytes. Failure of LY294002 to effectively antagonize IGF-1 induced decrements in IK1 suggests that a signal pathway adjunct to PI3K/Akt contributes to IGF-1 protection against arrhythmogenesis in these myocytes. Our findings imply that sarcolemmal outward and inward rectifier potassium channels are substrates for IGF-1/PI3K/Akt signal transduction molecules