Therapeutic touch and therapeutic alliance in pediatric care and neonatology: An active inference framework

Therapeutic affective touch has been recognized as essential for survival, nurturing supportive interpersonal interactions, accelerating recovery—including reducing hospitalisations, and promoting overall health and building robust therapeutic alliances. Through the lens of active inference, we present an integrative model, combining therapeutic touch and communication, to achieve biobehavioural synchrony. This model speaks to how the brain develops a generative model required for recovery, developing successful therapeutic alliances, and regulating allostasis within paediatric manual therapy. We apply active inference to explain the neurophysiological and behavioural mechanisms that underwrite the development and maintenance of synchronous relationships through touch. This paper foregrounds the crucial role of therapeutic touch in developing a solid therapeutic alliance, the clinical effectiveness of paediatric care, and triadic synchrony between health care practitioner, caregiver, and infant in a variety of clinical situations. We start by providing a brief overview of the significance and clinical role of touch in the development of social interactions in infants; facilitating a positive therapeutic alliance and restoring homeostasis through touch to allow a more efficient process of allostatic regulation. Moreover, we explain the role of CT tactile afferents in achieving positive clinical outcomes and updating prior beliefs. We then discuss how touch is implemented in treatment sessions to promote cooperative interactions in the clinic and facilitate theory of mind. This underwrites biobehavioural synchrony, epistemic trust, empathy, and the resolution of uncertainty. The ensuing framework is underpinned by a critical application of the active inference framework to the fields of pediatrics and neonatology

Compaction control and related stress–strain behaviour of off-shore land reclamations with calcareous sands

AbstractWhen constructing off-shore land reclamations, one aims to ensure that the final soil mass fulfills certain minimal criteria related to shear strength, stiffness and resistance against liquefaction. In general, these characteristics improve with increasing density of the soil mass, which means that the above criteria are usually condensed into a single one: ‘adequate densification’.Quality control of reclamation constructions therefore focuses on the latter. Technical requirements are written based on one single parameter: the relative density Dr. On the site, this parameter is commonly determined indirectly using correlations with the cone penetration resistance qc, making the CPT the main tool for quality control.The paper presents data gathered during the design and construction of an off-shore land reclamation using calcareous sands. For this specific project, density control had to be done through the use of CPT.Calibration chamber tests were performed to establish the CPT qc–Dr correlation for the specific soil material. This correlation was used to analyse CPT results during construction of the site in order to determine the quality of compaction.In a further stage, an elaborate laboratory study was performed to establish additional correlations between soil parameters and the stress–strain parameters. Furthermore, seismic CPT tests were executed on the site to test the relevance of the laboratory correlations and the ‘relative density approach’ in general.It is shown that off-shore land reclamations have a very erratic stress-history, due to the different processes of depositing the soil material and the various densification methods. This stress-history is of great importance in the stress–strain behaviour of the site. Results also suggest that the CPT does not provide enough data to reliably predict soil stiffness when dealing with crushable materials. Specifically, in situ measurements show that there is no direct correlation between the small strain shear modulus G0 and qc

Activity of a trinuclear platinum complex in human ovarian cancer cell lines sensitive and resistant to cisplatin: cytotoxicity and induction and gene-specific repair of DNA lesions

A collateral sensitivity or a very modest cross-resistance to BBR 3464 was found in 2 ovarian cancer cell lines with experimentally induced resistance to cisplatin. Loss of mismatch repair proteins (hMLH1, hPMS2) or overexpression of nucleotide excision repair proteins (ERCC1) was not detrimental for the cellular sensitivity to BBR 3464. Moreover, interesting differences in the kinetics of formation and removal of DNA lesions at the single-gene (N- ras) level were observed between BBR 3464 and CDDP. © 2001 Cancer Research Campaign www.bjcancer.co

OVOL2 impairs RHO GTPase signaling to restrain mitosis and aggressiveness of Anaplastic Thyroid Cancer

Background: Anaplastic Thyroid Cancer (ATC) is an undifferentiated and aggressive tumor that often originates from well-Differentiated Thyroid Carcinoma (DTC) through a trans-differentiation process. Epithelial-to-Mesenchymal Transition (EMT) is recognized as one of the major players of this process. OVOL2 is a transcription factor (TF) that promotes epithelial differentiation and restrains EMT during embryonic development. OVOL2 loss in some types of cancers is linked to aggressiveness and poor prognosis. Here, we aim to clarify the unexplored role of OVOL2 in ATC. Methods: Gene expression analysis in thyroid cancer patients and cell lines showed that OVOL2 is mainly associated with epithelial features and its expression is deeply impaired in ATC. To assess OVOL2 function, we established an OVOL2-overexpression model in ATC cell lines and evaluated its effects by analyzing gene expression, proliferation, invasion and migration abilities, cell cycle, specific protein localization through immunofluorescence staining. RNA-seq profiling showed that OVOL2 controls a complex network of genes converging on cell cycle and mitosis regulation and Chromatin Immunoprecipitation identified new OVOL2 target genes. Results: Coherently with its reported function, OVOL2 re-expression restrained EMT and aggressiveness in ATC cells. Unexpectedly, we observed that it caused G2/M block, a consequent reduction in cell proliferation and an increase in cell death. This phenotype was associated to generalized abnormalities in the mitotic spindle structure and cytoskeletal organization. By RNA-seq experiments, we showed that many pathways related to cytoskeleton and migration, cell cycle and mitosis are profoundly affected by OVOL2 expression, in particular the RHO-GTPase pathway resulted as the most interesting. We demonstrated that RHO GTPase pathway is the central hub of OVOL2-mediated program in ATC and that OVOL2 transcriptionally inhibits RhoU and RhoJ. Silencing of RhoU recapitulated the OVOL2-driven phenotype pointing to this protein as a crucial target of OVOL2 in ATC. Conclusions: Collectively, these data describe the role of OVOL2 in ATC and uncover a novel function of this TF in inhibiting the RHO GTPase pathway interlacing its effects on EMT, cytoskeleton dynamics and mitosis

Sistema de conciliación electrónico de medicación

El Proceso de Conciliación de Medicación se desarrolló para prevenir los errores en las transiciones asistenciales. Desde el Área de Calidad y Seguridad del Paciente se trabajó con los diferentes servicios médicos del Hospital Alemán en la confección de una ficha papel adosable a la historia clínica de internación con resultados dispares en cuanto al llenado de la misma. Este trabajo describirá el proceso de pasaje de un formato de registro en papel a digital, que decisiones se tomaron y que producto final se obtuvo. Durante el período marzo de 2013 teniendo en cuenta solamente los ingresos de Clínica Médica, se realizó el 78% de las conciliaciones de medicación de los pacientes ingresados, de las cuales 61% eran electrónicas. Los errores de posología fueron eliminados por el proceso y permanecieron los relacionados a marcado de medicación como que continuaba o no durante la internación. El total de esos errores fue de 3% de todas las indicaciones realizadas en el período. El gran desafío es lograr la carga de la conciliación de medicación de todos los pacientes de internación sin interrumpir el flujo de trabajo de los profesionales durante el ingreso de los pacientes a las diferentes áreas del hospital.Sociedad Argentina de Informática e Investigación Operativ

Sistema de conciliación electrónico de medicación

El Proceso de Conciliación de Medicación se desarrolló para prevenir los errores en las transiciones asistenciales. Desde el Área de Calidad y Seguridad del Paciente se trabajó con los diferentes servicios médicos del Hospital Alemán en la confección de una ficha papel adosable a la historia clínica de internación con resultados dispares en cuanto al llenado de la misma. Este trabajo describirá el proceso de pasaje de un formato de registro en papel a digital, que decisiones se tomaron y que producto final se obtuvo. Durante el período marzo de 2013 teniendo en cuenta solamente los ingresos de Clínica Médica, se realizó el 78% de las conciliaciones de medicación de los pacientes ingresados, de las cuales 61% eran electrónicas. Los errores de posología fueron eliminados por el proceso y permanecieron los relacionados a marcado de medicación como que continuaba o no durante la internación. El total de esos errores fue de 3% de todas las indicaciones realizadas en el período. El gran desafío es lograr la carga de la conciliación de medicación de todos los pacientes de internación sin interrumpir el flujo de trabajo de los profesionales durante el ingreso de los pacientes a las diferentes áreas del hospital.Sociedad Argentina de Informática e Investigación Operativ