Working with Homeless Women and Children: Opportunities for Training

The diversity of the homeless population allows for unique training opportunities in psychiatry, especially for child and adolescent psychiatry fellows. The prevalence of psychopathology both existing in and as a result of displacement and disenfranchisement requires a specialized knowledge of this population and provides an extraordinary education in community outreach, emergency psychiatry and social service delivery systems. The authors review their experience of working with homeless women and children in the community. Possibilities for more comprehensive training and research are also presented

Empiricism and Philosophy

Though Quine's argument against the analytic-synthetic distinction is widely disputed, one of the major effects of his argument has been to popularise the belief that there is no sharp distinction between science and philosophy. This thesis begins by distinguishing reductive from holistic empiricism, showing why reductive empiricism is false, refuting the major objections to holistic empiricism and stating the limits on human knowledge it implies. Quine's arguments (and some arguments that have been mistakenly attributed to him) from holism against the analytic-synthetic are considered, and while many of them are found wanting one good argument is presented. Holism does not, however, imply that there is no sharp distinction between science and philosophy, and indeed implies that the distinction between scientific and philosophical disputes is perfectly sharp. The grounds upon which philosophical disputes may be resolved are then sought for and deliniated

PPARδ binding to heme oxygenase 1 promoter prevents angiotensin II-induced adipocyte dysfunction in Goldblatt hypertensive rats

Abstract: OBJECTIVE: Renin–angiotensin system (RAS) regulates adipogenic response with adipocyte hypertrophy by increasing oxidative stress. Recent studies have shown the role of peroxisome proliferator-activated receptor-d (PPARδ) agonist in attenuation of angiotensin II-induced oxidative stress. The aim of this study was to explore a potential mechanistic link between PPARδ and the cytoprotective enzyme heme oxygenase-1 (HO-1) and to elucidate the contribution of HO-1 to the adipocyte regulatory effects of PPARδ agonism in an animal model of enhanced RAS, the Goldblatt 2 kidney 1 clip (2K1C) model. METHOD: We first established a direct stimulatory effect of the PPARδ agonist (GW 501516) on the HO-1 gene by demonstrating increased luciferase activity in COS-7 cells transfected with a luciferase-HO-1 promoter construct. Sprague-Dawley rats were divided into four groups: sham-operated animals, 2K1C rats and 2K1C rats treated with GW 501516, in the absence or presence of the HO activity inhibitor, stannous mesoporphyrin (SnMP). RESULTS: 2K1C animals had increased visceral adiposity, adipocyte hypertrophy, increased inflammatory cytokines, increased circulatory and adipose tisssue levels of renin and Ang II along with increased adipose tissue gp91 phox expression (Po0.05) when compared with sham-operated animals. Treatment with GW 501516 increased adipose tissue HO-1 and adiponectin levels (Po0.01) along with enhancement of Wnt10b and b-catenin expression. HO-1 induction was accompanied by the decreased expression of Wnt5b, mesoderm specific transcript (mest) and C/EBPa levels and an increased number of small adipocytes (Po0.05). These effects of GW501516 were reversed in 2K1C animals exposed to SnMP (Po0.05). CONCLUSION: Taken together, our study demonstrates, for the first time, that increased levels of Ang II contribute towards adipose tissue dysregulation, which is abated by PPARδ-mediated upregulation of the heme-HO system. These findings highlight the pivotal role and symbiotic relationship of HO-1, adiponectin and PPARδ in the regulation of metabolic homeostasis in adipose tissues

Experimental characterization of continuous-variable entanglement

We present an experimental analysis of quadrature entanglement produced from a pair of amplitude squeezed beams. The correlation matrix of the state is characterized within a set of reasonable assumptions, and the strength of the entanglement is gauged using measures of the degree of inseparability and the degree of Einstein-Podolsky-Rosen (EPR) paradox. We introduce controlled decoherence in the form of optical loss to the entangled state, and demonstrate qualitative differences in the response of the degrees of inseparability and EPR paradox to this loss. The entanglement is represented on a photon number diagram that provides an intuitive and physically relevant description of the state. We calculate efficacy contours for several quantum information protocols on this diagram, and use them to predict the effectiveness of our entanglement in those protocols

BMO spaces associated with semigroups of operators

We study BMO spaces associated with semigroup of operators and apply the results to boundedness of Fourier multipliers. We prove a universal interpolation theorem for BMO spaces and prove the boundedness of a class of Fourier multipliers on noncommutative Lp spaces for all 1 < p < \infty, with optimal constants in p.Comment: Math An

Loss-of-function mutations in UDP-Glucose 6-Dehydrogenase cause recessive developmental epileptic encephalopathy

Developmental epileptic encephalopathies are devastating disorders characterized by intractable epileptic seizures and developmental delay. Here, we report an allelic series of germline recessive mutations in UGDH in 36 cases from 25 families presenting with epileptic encephalopathy with developmental delay and hypotonia. UGDH encodes an oxidoreductase that converts UDP-glucose to UDP-glucuronic acid, a key component of specific proteoglycans and glycolipids. Consistent with being loss-of-function alleles, we show using patients’ primary fibroblasts and biochemical assays, that these mutations either impair UGDH stability, oligomerization, or enzymatic activity. In vitro, patient-derived cerebral organoids are smaller with a reduced number of proliferating neuronal progenitors while mutant ugdh zebrafish do not phenocopy the human disease. Our study defines UGDH as a key player for the production of extracellular matrix components that are essential for human brain development. Based on the incidence of variants observed, UGDH mutations are likely to be a frequent cause of recessive epileptic encephalopathy

Origins of and implementation concepts for upper airway stimulation therapy for obstructive sleep apnea

Porođaj je fiziološki proces kojim se događa ekspulzija ploda, plodovih ovoja i posteljice na kraju trudnoće.Čin poroda se u svojoj srži dijeli na 4 porodna doba. Prvo doba se naziva i razdoblje otvaranja cervikalnog ušća, a traje od 10 do 16 sati. U prvom porodnom dobu tim primalje i liječnika pomaže rodilji da što lakše i bezbolnije dođe do samog čina poroda. Doba otvaranja cervikalnog ušća karakterizira konstantan kardiotokografski nadzor, praćenje vitalnih funkcija trudnice, fizička i psihološka priprema za porod. Drugo porodno doba naziva se doba istiskivanja ili izgona djeteta u kojem se kroz potpuno otvoreno cervikalno ušće rađa dijete. Zadaća primalje u drugom porodnom dobu je porođaj djeteta, izvođenje epiziotomije ukoliko se ukaže potreba za istom i prva skrb novorođenčeta uz omogućavanje kontakta koža na kožu. Nakon toga slijedi treće porodno doba ili porođaj sekundina, tj. posteljice i plodovih ovoja. Nakon porođaja djeteta, pod djelovanjem hormona i hormonskih pripravaka, posteljica se ljušti s unutarnje stjenke maternice koja se kontrahira. Zadaća primalje je prepoznati znakove odljuštenja posteljice i istu poroditi, te u suradnji s liječnikom obaviti pregled posteljice.Po porođaju posteljice započinje doba involucijskih procesa, ujedno i posljednje porodno doba nakon kojeg započinje razdoblje babinja.The delivery itself consists out of four stages. The first stage is also known as the cervical dilatation stage, and it lasts from 10 to 16 hours. In the first stage, the medical team takes care of the woman giving birth and helps her ease the pain. It is followed with constant cardiotocographic supervision. The second stage of labour is the stage of giving birth. The duty of a midwife in the second stage of labor is the delivery of the newborn. It is very important for the mother and her child to make skin to skin contactimmediately after birth, and it is midwives duty to provide that contact. The third stage of labor is the placental stage. Two hours after the placenta is born, begins the period of involution, the forth and also the last stage of labor