Self-Transformations of Health Professionals in the Field

 Health does not arise from health care. Perhaps we are facing an impasse and should we reconsider and reconceptualize the mandate of the health system. In order to improve our influence on the culture that often prevails in our institutions as well as the health of those institutions. This article examines the changes to the mandate of the health system seen in the light of self-transformations. This vision is based on a model that illustrates the transformations experienced by physicians following a mind-body training, i.e. Awakening the Sensible Being (ASB). The model shows the transformation process reported by physicians, after experiencing self-awareness of what they are doing, through experiencing the ASB, while developing a closer relationship with themselves. As it turned out, the training was beneficial for their health. Their expanded sense of self-awareness and quality of “savoir-être” brought on by the training contributes to their impression of “feeling whole” and provides them with a quality of presence that influences the type of care they can provide to their patients by considering the individual as a whole. This point of view could bring about a shift in the mandate of the health system and improve the health of caregivers and care-receivers as well, while contributing to widen the concept of health

Prospectives

Tiré de: Prospectives, vol. 17, no 3, oct. 1981Titre de l'écran-titre (visionné le 24 janv. 2013

Teledermatology Before, During, and After Covid-19: A Vital Tool to Improve Access and Equity in Specialty Care

Since the onset of the COVID-19 pandemic, telemedicine has rapidly expanded across the nation as medical systems have had to shift to providing care through virtual modalities to ensure the safety of patients and staff. Teledermatology, in particular, is wellsuited for telemedicine, with literature supporting its efficacy, equitable quality and accuracy, and cost-effectiveness in comparison to in-person visits. Teledermatology holds great potential in continuing to increase access to patients and ensuring continuity of care, particularly for those from rural and underserved areas. Although introduced decades ago, the adoption of virtual visits has previously been limited by restrictive coverage policies, lack of reimbursement, and maintenance costs. While the Centers for Medicare and Medicaid Services and most private payers have ensured broad coverage for telehealth since the start of the pandemic, many of these policy changes are temporary and set to expire at the end of the public health emergency. Continued advocacy efforts and future studies highlighting teledermatology’s impact, particularly on minorities and underserved patient populations, are critical for long-term legislative changes to occur and to provide coverage to our most vulnerable patients. In this article, we highlight the state of teledermatology prior to the pandemic, the legislative changes that permitted teledermatology to rapidly expand during the pandemic, and the importance of continued coverage after the pandemic

Novel analysis of global DNA methylation in the limbic system of the bovine brain

Citation: Cantrell, B. A., McKay, S. D., Weaber, R. L., Funston, R. N., & Lachance, H. (2016). Novel analysis of global DNA methylation in the limbic system of the bovine brain. Journal of Animal Science, 94, 43-43. doi:10.2134/jas2016.94supplement443xThere has been limited research focusing on the genetic-environmental interactions in bovine brains. Global DNA methylation has been measured in brains of several species, but has yet to be examined in bovine. The objective of this study was to characterize global DNA methylation in 9 regions of the limbic system in the bovine brain: amygdala, bed nucleus of the stria terminalis, cingulate gyrus, dorsal raphe, hippocampus, hypothalamus, nucleus accumbens, periaqueductal gray, and prefrontal cortex. DNA was extracted from brain and blood samples of 6 Red Angus × Simmental steers (less than 20 mo of age), using the DNA Extraction Kit from Agilent Technologies (Santa Clara, CA) and a phenol chloroform extraction. Percent of global DNA methylation was determined using the MethylFlash Methylated DNA Quantification Kit (Colormetric) from Epigentek (Farmingdale, NY). Varying amounts of global DNA methylation were observed among the 9 functionally distinct regions of the bovine limbic system. Amygdala, bed nucleus of the stria terminalis, cingulate gyrus, dorsal raphe, periaqueductal gray, prefrontal cortex, and nucleus accumbens are all significantly different (P < 0.05) from 1 or more brain tissue type, using a paired t test in SPSS (IBM, Armonk, NY). Conversely, global DNA methylation of blood was not significantly different (P < 0.05) from any brain tissue type. This study shows significant differences in global DNA methylation among different tissue types in the limbic system of the bovine brain. Understanding the differences in global DNA methylation within different tissues in the brain will facilitate future research involving the effects of differential methylation with regard to economically important traits

La régionalisation des précipitations : une revue bibliographique des développements récents

L'estimation de l'intensité de précipitations extrêmes est un sujet de recherche en pleine expansion. Nous présentons ici une synthèse des travaux de recherche sur l'analyse régionale des précipitations. Les principales étapes de l'analyse régionale revues sont les méthodes d'établissement de régions homogènes, la sélection de fonctions de distributions régionales et l'ajustement des paramètres de ces fonctions.De nombreux travaux sur l'analyse régionale des précipitations s'inspirent de l'approche développée en régionalisation des crues. Les méthodes de types indice de crues ont été utilisées par plusieurs auteurs. Les régions homogènes établies peuvent être contiguës ou non-contiguës. L'analyse multivariée a été utilisée pour déterminer plusieurs régions homogènes au Canada. L'adéquation des sites à l'intérieur d'une région homogène a souvent été validée par une application des L-moments, bien que d'autres tests d'homogénéité aient aussi été utilisés.La loi générale des valeurs extrêmes (GEV) est celle qui a le plus souvent été utilisée dans l'analyse régionale des précipitations. D'autres travaux ont porté sur la loi des valeurs extrêmes à deux composantes (TCEV), de même que sur des applications des séries partielles.Peu de travaux ont porté sur les relations intensité durée dans un contexte régional, ni sur les variations saisonnières des paramètres régionaux. Finalement, les recherches ont débuté sur l'application des concepts d'invariance d'échelle et de loi d'échelle. Ces travaux sont jugés prometteurs.Research on the estimation of extreme precipitation events is currently expanding. This field of research is of great importance in hydraulic engineering not only for the design of dams and dikes, but also for municipal engineering designs. In many cases, local data are scarce. In this context, regionalization methods are very useful tools. This paper summarizes the most recent work on the regionalization of precipitation. Steps normally included in any regionalization work are the delineation of homogenous regions, selection a regional probability distribution function and fitting the parameters.Methods to determine homogenous regions are first reviewed. A great deal of work on precipitation was inspired by methods developed for regional flow analysis, especially the index flood approach. Homogenous regions can be contiguous, but in many cases they are not. The region of influence approach, commonly used in hydrological studies, has not been often applied to precipitation data. Homogenous regions can be established using multivariate statistical approaches such as Principal Component Analysis or Factorial Analysis. These approaches have been used in a number of regions in Canada. Sites within a homogenous region may be tested for their appropriateness by calculating local statistics such as the coefficient of variation, coefficient of skewness and kurtosis, and by comparing these statistics to the regional statistics. Another common approach is the use of L-moments. L-moments are linear combinations of ordered statistics and hence are not as sensitive to outliers as conventional moments. Other homogeneity tests have also been used. They include a Chi-squared test on all regional quantiles associated with a given non-exceedance probability, and a Smirnoff test used to validate the inclusion of a station in the homogenous region.Secondly, we review the distributions and fitting methods used in regionalization of precipitation. The most popular distribution function used is the General Extreme Value (GEV) distribution. This distribution has been recommended for precipitation frequency analysis in the United Kingdom. For regional analysis, the GEV is preferred to the Gumbel distribution, which is often used for site-specific frequency analysis of precipitation extremes. L-moments are also often used to calculate the parameters of the GEV distribution. Some applications of the Two-Component Extreme Value (TCEV) distribution also exist. The TCEV has mostly been used to alleviate the concerns over some of the theoretical and practical restrictions of the GEV.Applications of the Partial Duration Series or Peak-Over-Threshold (POT) approach are also described. In the POT approach, events with a magnitude exceeding a certain threshold are considered in the analysis. The occurrence of such exceedances is modelled as a Poisson process. One of the drawbacks of this method is that it is sometimes necessary to select a relatively high threshold in order to comply with the assumption that observations are independent and identically distributed (i.i.d.). The use of a re-parameterised Generalised Pareto distribution has also been suggested by some researchers.Research on depth-duration relations on a regional scale is also discussed. Empirical approaches used in Canada and elsewhere are described. In most cases, the method consists of establishing a non-linear relationship between a quantile associated with a given duration and its return period to a reference quantile, such as a 1-hour rainfall with a 10-year return period. Depth duration relationships cannot be applied uniformly across Canada for events with durations exceeding two hours. Seasonal variability studies in regionalization are relatively scarce, but are required because of the obvious seasonality of precipitation. In many cases, seasonal regimes may lead to different regionalization approaches for the wet and the dry season. Some research has focused on the use of periodic functions to model regional parameters. Another approach consists of converting the occurrence data of a given event in an angular measurement and developing seasonal indices based on this angular measurement.Other promising avenues of research include the scaling approach. The debate over the possibility of scale invariance for precipitation is ongoing. Simple scaling was studied on a number of precipitation data, but the fact that intermittence is common in precipitation regimes and the presence of numerous zero values in the series does not readily lead to proper application of this approach. Recent research has shown that multiple scaling is likely a more promising avenue

Prospectives

Tiré de: Prospectives, vol. 17, no 3, oct. 1981Titre de l'écran-titre (visionné le 24 janv. 2013

Functional expression of human cathepsin S in Saccharomyces cerevisiae. Purification and characterization of the recombinant enzyme.

A cDNA encoding the human lysosomal cysteine proteinase cathepsin S precursor has been expressed in yeast using the pVT100-U expression vector containing the alpha-factor promoter. The procathepsin S gene was expressed either as a fusion protein with the pre-region or with the prepro-region of the yeast alpha-factor precursor gene. Following in vitro processing both constructs gave an identical active mature enzyme with a molecular weight of 24,000. After prolonged cultivation of the cells the recombinant protein is also found as an active proteinase in the culture supernatant. The precursor can be activated in vitro at pH 4.5 and 40 degrees C under reducing conditions. The in vitro activated enzyme has a 6-amino acid NH2-terminal extension when compared with the native bovine enzyme. The purified enzyme displays a bell-shaped pH activity profile with a pH optimum of 6.5 and pK values of 4.5 and 7.8. The isoelectric point of the recombinant human cathepsin S is between 8.3 and 8.6 and about 1.5 pH units higher than for the bovine enzyme. The kinetic data for several synthetic substrates and inhibitors reveal a preference for smaller amino acid residues in the binding subsites S2 and S3 of cathepsin S. Like the bovine enzyme, the recombinant human cathepsin S is characterized by a broader range of pH stability (pH 5-7.5) than cathepsins B and L

Cavity Magnonics

Cavity magnonics deals with the interaction of magnons - elementary excitations in magnetic materials - and confined electromagnetic fields. We introduce the basic physics and review the experimental and theoretical progress of this young field that is gearing up for integration in future quantum technologies. Much of its appeal is derived from the strong magnon-photon coupling and the easily-reached nonlinear regime in microwave cavities. The interaction of magnons with light as detected by Brillouin light scattering is enhanced in magnetic optical resonators, which can be employed to manipulate magnon distributions. The cavity photon-mediated coupling of a magnon mode to a superconducting qubit enables measurements in the single magnon limit

Stereospecific Allylic Functionalization:The Reactions of Allylboronate Complexes with Electrophiles

Allylboronic esters react readily with carbonyls and imines (π-electrophiles), but are unreactive toward a range of other electrophiles. By addition of an aryllithium, the corresponding allylboronate complexes display enhanced nucleophilicity, enabling addition to a range of electrophiles (tropylium, benzodithiolylium, activated pyridines, Eschenmoser's salt, Togni's reagent, Selectfluor, diisopropyl azodicarboxylate (DIAD), MeSX) in high regio- and stereocontrol. This protocol provides access to key new functionalities, including quaternary stereogenic centers bearing moieties such as fluorine and the trifluoromethyl group. The allylboronate complexes were determined to be 7 to 10 orders of magnitude more reactive than the parent boronic ester.</p