Are Perceived Barriers to Exercise and Level of Interest in Fitness Programs Different Between Preoperative and Postoperative Bariatric Surgery Groups?

Background: Exercise following bariatric surgery is associated with better outcomes. We aimed to assess the level of interest in fitness programs, self-reported exercise duration, and perceived obstacles for exercising in bariatric patients. Materials and Methods: All patients who presented to our hospital for any bariatric clinic visit were administered a questionnaire, which explored their interest in a free 10-min DVD-based workout (DW) versus an internet-based workout (IW), average duration of exercise per week, and two perceived obstacles to exercise. Results: One hundred fifty-nine preoperative and 135 postoperative patients were surveyed. Overall, there was more interest in DW than in IW. The mean duration of exercise in the preop group was 89 ± 92.1 min/week, whereas the postop group reported 84.4 ± 103.7 min/week (p = 0.717). Time was the most frequent obstacle in both groups, whereas orthopedic discomfort was reported less frequently in the postoperative compared with the preoperative population (7% vs. 18.1%, respectively, p = 0.001). Conclusions: Despite the postoperative group reporting less orthopedic pain, mean exercise time per week was the same as the preoperative group. Time constraints were the most frequently reported barrier in both groups, suggesting a pathway for intervention

Fundamental characterization, photophysics and photocatalysis of a base metal iron(II)-cobalt(III) dyad

A new base metal iron-cobalt dyad has been obtained by connection between a heteroleptic tetra-NHC iron(II) photosensitizer combining a 2,6-bis[3-(2,6-diisopropylphenyl)imidazol-2-ylidene]pyridine with 2,6-bis(3-methyl-imidazol-2-ylidene)-4,4′-bipyridine ligand, and a cobaloxime catalyst. This novel iron(II)-cobalt(III) assembly has been extensively characterized by ground- and excited-state methods like X-ray crystallography, X-ray absorption spectroscopy, (spectro-)electrochemistry, and steady-state and time-resolved optical absorption spectroscopy, with a particular focus on the stability of the molecular assembly in solution and determination of the excited-state landscape. NMR and UV/Vis spectroscopy reveal dissociation of the dyad in acetonitrile at concentrations below 1 mM and high photostability. Transient absorption spectroscopy after excitation into the metal-to-ligand charge transfer absorption band suggests a relaxation cascade originating from hot singlet and triplet MLCT states, leading to the population of the $^{3}$MLCT state that exhibits the longest lifetime. Finally, decay into the ground state involves a $^{3}$MC state. Attachment of cobaloxime to the iron photosensitizer increases the $^{3}$MLCT lifetime at the iron centre. Together with the directing effect of the linker, this potentially makes the dyad more active in photocatalytic proton reduction experiments than the analogous two-component system, consisting of the iron photosensitizer and Co(dmgH)$_2$(py)Cl. This work thus sheds new light on the functionality of base metal dyads, which are important for more efficient and sustainable future proton reduction systems

Pilot Study of Delayed ICOS/ICOS-L Blockade With alphaCD40 to Modulate Pathogenic Alloimmunity in a Primate Cardiac Allograft Model

Background: Inducible costimulator (ICOS) is rapidly upregulated with T-cell stimulation and may represent an escape pathway for T-cell costimulation in the setting of CD40/CD154 costimulation blockade. Induction treatment exhibited no efficacy in a primate renal allograft model, but rodent transplant models suggest that the addition of delayed ICOS/ICOS-L blockade may prolong allograft survival and prevent chronic rejection. Here, we ask whether ICOS-Ig treatment, timed to anticipate ICOS upregulation, prolongs NHP cardiac allograft survival or attenuates pathogenic alloimmunity. Methods: Cynomolgus monkey heterotopic cardiac allograft recipients were treated with alphaCD40 (2C10R4, d0-90) either alone or with the addition of delayed ICOS-Ig (d63-110). Results: Median allograft survival was similar between ICOS-Ig + alphaCD40 (120 days, 120-125 days) and alphaCD40 (124 days, 89-178 days) treated animals, and delayed ICOS-Ig treatment did not prevent allograft rejection in animals with complete CD40 receptor coverage. Although CD4(+) TEM cells were decreased in peripheral blood (115 +/- 24) and mLNs (49 +/- 1.9%) during ICOS-Ig treatment compared with monotherapy (214 +/- 27%, P = 0.01; 72 +/- 9.9%, P = 0.01, respectively), acute and chronic rejection scores and kinetics of alloAb elaboration were similar between groups. Conclusions: Delayed ICOS-Ig treatment with the reagent tested is probably ineffective in modulating pathogenic primate alloimmunity in this model

Dyskusja redakcyjna. Polityka publiczna wobec opiekunów osób niesamodzielnych

During the discussion, the panellists analyzed several main issues: I. The role of the family and public institutions in long-term care. II. System solutions in the policy of supporting carers of dependent people. III. The method of financing care for elderly dependent people (including the role of social insurance). IV. The ability to provide care to dependent people and public expenditure on it, forms of support for carers. V. The role of the market in providing care and state activities. Outsourcing of carers of dependent people. Relationship between bottom-up actions and top-down actions taken by central authorities. VI. Reconciling the role of a caregiver with work on the free market.Paneliści podczas dyskusji analizowali kilka głównych zagadnień: I. Rolę rodziny i instytucji publicznych w opiece długoterminowej. II. Rozwiązania systemowe w polityce wsparcia opiekunów osób niesamodzielnych. III. Sposób finansowania opieki nad osobami niesamodzielnymi w wieku senioralnym (w tym rola ubezpieczeń społecznych). IV. Zdolność do zapewniania opieki osobom niesamodzielnym i wydatki publiczne na nią, formy wsparcia opiekunów. V. Rolę rynku w zapewnianiu opieki i działania państwa. Outsourcing opiekunów osób niesamodzielnych. Relację między działaniami oddolnymi a działaniami odgórnymi podejmowanymi przez władze centralne. VI. Godzenie roli opiekuna z pracą na wolnym rynku

Dyskusja redakcyjna. Polityka publiczna wobec opiekunów osób niesamodzielnych

During the discussion, the panellists analyzed several main issues: I. The role of the family and public institutions in long-term care. II. System solutions in the policy of supporting carers of dependent people. III. The method of financing care for elderly dependent people (including the role of social insurance). IV. The ability to provide care to dependent people and public expenditure on it, forms of support for carers. V. The role of the market in providing care and state activities. Outsourcing of carers of dependent people. Relationship between bottom-up actions and top-down actions taken by central authorities. VI. Reconciling the role of a caregiver with work on the free market.Paneliści podczas dyskusji analizowali kilka głównych zagadnień: I. Rolę rodziny i instytucji publicznych w opiece długoterminowej. II. Rozwiązania systemowe w polityce wsparcia opiekunów osób niesamodzielnych. III. Sposób finansowania opieki nad osobami niesamodzielnymi w wieku senioralnym (w tym rola ubezpieczeń społecznych). IV. Zdolność do zapewniania opieki osobom niesamodzielnym i wydatki publiczne na nią, formy wsparcia opiekunów. V. Rolę rynku w zapewnianiu opieki i działania państwa. Outsourcing opiekunów osób niesamodzielnych. Relację między działaniami oddolnymi a działaniami odgórnymi podejmowanymi przez władze centralne. VI. Godzenie roli opiekuna z pracą na wolnym rynku

Pilot Study of Delayed ICOS/ICOS-L Blockade With αCD40 to Modulate Pathogenic Alloimmunity in a Primate Cardiac Allograft Model

Background. Inducible costimulator (ICOS) is rapidly upregulated with T-cell stimulation and may represent an escape pathway for T-cell costimulation in the setting of CD40/CD154 costimulation blockade. Induction treatment exhibited no efficacy in a primate renal allograft model, but rodent transplant models suggest that the addition of delayed ICOS/ICOS-L blockade may prolong allograft survival and prevent chronic rejection. Here, we ask whether ICOS-Ig treatment, timed to anticipate ICOS upregulation, prolongs NHP cardiac allograft survival or attenuates pathogenic alloimmunity. Methods. Cynomolgus monkey heterotopic cardiac allograft recipients were treated with αCD40 (2C10R4, d0-90) either alone or with the addition of delayed ICOS-Ig (d63-110). Results. Median allograft survival was similar between ICOS-Ig + αCD40 (120 days, 120-125 days) and αCD40 (124 days, 89-178 days) treated animals, and delayed ICOS-Ig treatment did not prevent allograft rejection in animals with complete CD40 receptor coverage. Although CD4+ TEM cells were decreased in peripheral blood (115 ± 24) and mLNs (49 ± 1.9%) during ICOS-Ig treatment compared with monotherapy (214 ± 27%, P = 0.01; 72 ± 9.9%, P = 0.01, respectively), acute and chronic rejection scores and kinetics of alloAb elaboration were similar between groups. Conclusions. Delayed ICOS-Ig treatment with the reagent tested is probably ineffective in modulating pathogenic primate alloimmunity in this model

White matter abnormalities across the lifespan of schizophrenia: a harmonized multi-site diffusion MRI study.

Several prominent theories of schizophrenia suggest that structural white matter pathologies may follow a developmental, maturational, and/or degenerative process. However, a lack of lifespan studies has precluded verification of these theories. Here, we analyze the largest sample of carefully harmonized diffusion MRI data to comprehensively characterize age-related white matter trajectories, as measured by fractional anisotropy (FA), across the course of schizophrenia. Our analysis comprises diffusion scans of 600 schizophrenia patients and 492 healthy controls at different illness stages and ages (14-65 years), which were gathered from 13 sites. We determined the pattern of age-related FA changes by cross-sectionally assessing the timing of the structural neuropathology associated with schizophrenia. Quadratic curves were used to model between-group FA differences across whole-brain white matter and fiber tracts at each age; fiber tracts were then clustered according to both the effect-sizes and pattern of lifespan white matter FA differences. In whole-brain white matter, FA was significantly lower across the lifespan (up to 7%; p < 0.0033) and reached peak maturation younger in patients (27 years) compared to controls (33 years). Additionally, three distinct patterns of neuropathology emerged when investigating white matter fiber tracts in patients: (1) developmental abnormalities in limbic fibers, (2) accelerated aging and abnormal maturation in long-range association fibers, (3) severe developmental abnormalities and accelerated aging in callosal fibers. Our findings strongly suggest that white matter in schizophrenia is affected across entire stages of the disease. Perhaps most strikingly, we show that white matter changes in schizophrenia involve dynamic interactions between neuropathological processes in a tract-specific manner