Structure and Function of the Hair Cell Ribbon Synapse

Faithful information transfer at the hair cell afferent synapse requires synaptic transmission to be both reliable and temporally precise. The release of neurotransmitter must exhibit both rapid on and off kinetics to accurately follow acoustic stimuli with a periodicity of 1 ms or less. To ensure such remarkable temporal fidelity, the cochlear hair cell afferent synapse undoubtedly relies on unique cellular and molecular specializations. While the electron microscopy hallmark of the hair cell afferent synapse — the electron-dense synaptic ribbon or synaptic body — has been recognized for decades, dissection of the synapse’s molecular make-up has only just begun. Recent cell physiology studies have added important insights into the synaptic mechanisms underlying fidelity and reliability of sound coding. The presence of the synaptic ribbon links afferent synapses of cochlear and vestibular hair cells to photoreceptors and bipolar neurons of the retina. This review focuses on major advances in understanding the hair cell afferent synapse molecular anatomy and function that have been achieved during the past years

Patient Centered Design : Challenges and Lessons Learned from Working with Health Professionals and Schizophrenic Patients in e-Therapy Contexts

Patient Centered Design (PCD) is a particular type of User Centered Design (UCD) where the end-user is a patient that will use an Information and Communications Technology (ICT) solution for healthcare. It focuses on needs, wants and skills of the product’s primary user and implies involving end-users in the decision-making and development process of the solution. e-Therapy aims to provide support to therapy sessions through ICT solutions. In the mental health arena is being used for specific therapeutic contexts and is an especially difficult environment due to specificities of the patients' conditions; the physical access to patients is restricted and, sometimes, not even possible. Thus, a PCD approach can be accomplished through the health professionals involved, applying some of the most well-known methods of UCD: interviews, questionnaires, focus groups and participatory design. eSchi is an e-Therapy tool that complements traditional practices for the cognitive rehabilitation and training of schizophrenic patients and was successfully developed using a PCD approach

As atividades expressivas e recreativas em crianças com fissura labiopalatina hospitalizadas: visão dos familiares Expressive and recreational activities in inpatient children with cleft lip and palate: family point of view

Este estudo teve por objetivo verificar a visão dos familiares a respeito da importância das atividades expressivas e recreativas na hospitalização e recuperação cirúrgica de crianças com fissura labiopalatina (FLP), procurando identificar os benefícios dessas atividades nos períodos pré e pós-operatório. Foram entrevistados 138 familiares de crianças com FLP, na faixa etária de sete a 12 anos, hospitalizados no Hospital de Reabilitação de Anomalias Craniofaciais (HRAC/USP). Os resultados mostraram que a grande maioria dos entrevistados preferia desenvolver alguma atividade com a criança enquanto aguardava a cirurgia, tendo expressado sentimentos positivos durante esse período. Segundo os entrevistados, as atividades expressivas e recreativas no período pré-operatório deixam a criança mais calma, observando melhora na condição emocional da mesma. Essas atividades distraem, divertem, acalmam e contribuem para o desenvolvimento da criança, sendo importantes para a recuperação cirúrgica, amenizando os efeitos negativos da hospitalização. As atividades na brinquedoteca foram as preferidas pelas crianças e pelos familiares. Na visão dos familiares, as atividades expressivas e recreativas favorecem a criança e os pais, reduzindo o estresse, proporcionando sentimentos positivos a ambos e auxiliando a adaptação e o restabelecimento físico e emocional. Evidenciam a importância do brincar durante a hospitalização, contribuindo para um atendimento humanizado, principalmente no caso de crianças com fissura labiopalatina, sujeitas a um grande número de procedimentos cirúrgicos e hospitalizações.<br>This study aims to verify the family's point of view regarding the importance of expressive and recreational activities during hospitalization and recovery from surgery of children with cleft lip and palate (CLP), so as to identify how such activities are beneficial during pre and postoperative period. Interviews were conducted with family members of 138 children with CLP, ages between 7 and 12 years, who were hospitalized at the Hospital of Rehabilitation of Craniofacial Anomalies (HRAC/USP). The results show that most of the interviewees preferred that some kind of activity be conducted with the children while waiting for surgery, because they were conducive to the expression of positive feelings during this period. According to those interviewed, recreational and expressive activities during preoperative treatment helped the children feel calmer, and they observed improvement in the children's emotional state. Such activities entertain, redirect attention, pacify the children and contribute to the children's development. They are important for recovery from surgery, and they ease the negative effects of hospitalization. Activities carried out in the Play Library are the favorite of the children and family members alike. From the family members' point of view, recreational and expressive activities are beneficial both to the children and to their parents, as they reduce stress, promote positive feelings for both and enhance adaptation and physical and emotional recovery. They demonstrate the importance of play during hospitalization, and contribute to humanization in care, especially in the case of children with cleft lip and palate, that are submitted to a large number of surgeries and hospitalizations

Osteopontin Deficiency Produces Osteoclast Dysfunction Due to Reduced CD44 Surface Expression

Osteopontin (OPN) was expressed in murine wild-type osteoclasts, localized to the basolateral, clear zone, and ruffled border membranes, and deposited in the resorption pits during bone resorption. The lack of OPN secretion into the resorption bay of avian osteoclasts may be a component of their functional resorption deficiency in vitro. Osteoclasts deficient in OPN were hypomotile and exhibited decreased capacity for bone resorption in vitro. OPN stimulated CD44 expression on the osteoclast surface, and CD44 was shown to be required for osteoclast motility and bone resorption. Exogenous addition of OPN to OPN−/− osteoclasts increased the surface expression of CD44, and it rescued osteoclast motility due to activation of the α(v)β(3) integrin. Exogenous OPN only partially restored bone resorption because addition of OPN failed to produce OPN secretion into resorption bays as seen in wild-type osteoclasts. As expected with these in vitro findings of osteoclast dysfunction, a bone phenotype, heretofore unappreciated, was characterized in OPN-deficient mice. Delayed bone resorption in metaphyseal trabeculae and diminished eroded perimeters despite an increase in osteoclast number were observed in histomorphometric measurements of tibiae isolated from OPN-deficient mice. The histomorphometric findings correlated with an increase in bone rigidity and moment of inertia revealed by load-to-failure testing of femurs. These findings demonstrate the role of OPN in osteoclast function and the requirement for OPN as an osteoclast autocrine factor during bone remodeling