Group-based memory rehabilitation for people with multiple sclerosis: subgroup analysis of the ReMiND trial

Background/Aim: Memory problems are frequently reported in people with multiple sclerosis (MS). These can be debilitating and affect individuals and their families. This sub-group analysis focused on the effectiveness of memory rehabilitation in patients with MS. Methods: Data were extracted from a single blind randomised controlled trial, the ReMiND trial, which also included participants with traumatic brain injury and stroke. Participants were randomly allocated to compensation or restitution treatment programmes, or a self-help control. The programmes were manual-based and comprised two individual and ten group sessions. Outcome measures included assessments of memory, mood and activities of daily living. A total of 39 patients with MS participated in this study (ten males (26%), 29 females (74%); mean±SD age: 48.3±10.8 years). Results: Comparison of groups showed no significant effect of treatment on memory, but there were significant differences between compensation and restitution on self-report symptoms of emotional distress at both 5- (p=0.04) and 7-month (p=0.05) follow-up sessions. The compensation group showed less distress than the restitution group. Conclusions: Individuals with MS who received compensation memory rehabilitation reported significantly less emotional distress than those who received restitution. Further research is needed to explore why self-reported memory problems did not differ between groups

Structural Disorder Provides Increased Adaptability for Vesicle Trafficking Pathways

Vesicle trafficking systems play essential roles in the communication between the organelles of eukaryotic cells and also between cells and their environment. Endocytosis and the late secretory route are mediated by clathrin-coated vesicles, while the COat Protein I and II (COPI and COPII) routes stand for the bidirectional traffic between the ER and the Golgi apparatus. Despite similar fundamental organizations, the molecular machinery, functions, and evolutionary characteristics of the three systems are very different. In this work, we compiled the basic functional protein groups of the three main routes for human and yeast and analyzed them from the structural disorder perspective. We found similar overall disorder content in yeast and human proteins, confirming the well-conserved nature of these systems. Most functional groups contain highly disordered proteins, supporting the general importance of structural disorder in these routes, although some of them seem to heavily rely on disorder, while others do not. Interestingly, the clathrin system is significantly more disordered (,23%) than the other two, COPI (,9%) and COPII (,8%). We show that this structural phenomenon enhances the inherent plasticity and increased evolutionary adaptability of the clathrin system, which distinguishes it from the other two routes. Since multi-functionality (moonlighting) is indicative of both plasticity and adaptability, we studied its prevalence in vesicle trafficking proteins and correlated it with structural disorder. Clathrin adaptors have the highest capability for moonlighting while also comprising the most highly disordered members. The ability to acquire tissue specific functions was also used to approach adaptability: clathrin route genes have the most tissue specific exons encoding for protein segments enriched in structural disorder and interaction sites. Overall, our results confirm the general importance of structural disorder in vesicle trafficking and suggest major roles for this structural property in shaping the differences of evolutionary adaptability in the three routes

Opening Spaces for the Development of Human Agency with Problem Based Learning in Palestinian Higher Education

This paper appraises the impact of Problem Based Learning (PBL) implementations within the (2016-19) Erasmus Plus "Methods" Project (Modernization of Teaching Methodologies in Higher Education: EU experience for Jordan and Palestinian territory) which introduced a range of learning modalities into formal learning contexts in higher education settings in Jordan (4 Universities) and Palestine (4 Universities). The project was jointly led by the Universities of Jordan and Birzeit, Palestine and there were six European partner universities. The paper focuses on the impact of PBL approaches on learners and university teachers through an analysis of semi-structured group interviews with students and individual staff interviews across a range of courses in the arts and sciences within the Palestinian context. The results of this small-scale research study are presented within a thematic framework focusing on participation, collaboration, agency, knowledge creation, problem solving and identity modification. It explores how far the adoption of student-centred PBL designs can open spaces for the development of human agency and capabilities within an existing orthodoxy of practice in Higher Education Settings in Palestine. It locates these student-centred practices within the context of higher education under occupation and examines what contribution they make to developing individuals’ capacity to act effectively for change within the power dynamics and limits of their context

Simpatectomia lombar retroperitoneal endoscópica

In the last few years, there has been an increase in the indication of lumbar sympathectomy for plantar hyperhidroses. There are few reports of the laparoscopic access for this operation, even when it seems to be a very apropriate method. A case of a left lumbar sympathectomy through the retroperitoneal endoscopic approach is presented. The total control of left plantar hiperhidroses was achieved, showing the effectiveness of this operation, completely feasible through extraperitoneal endoscopic route

Endocytosis-Independent Function of Clathrin Heavy Chain in the Control of Basal NF-kappaB Activation

BACKGROUND: Nuclear factor-kappaB (NF-kappaB) is a transcription factor that regulates the transcription of genes involved in a variety of biological processes, including innate and adaptive immunity, stress responses and cell proliferation. Constitutive or excessive NF-kappaB activity has been associated with inflammatory disorders and higher risk of cancer. In contrast to the mechanisms controlling inducible activation, the regulation of basal NF-kappaB activation is not well understood. Here we test whether clathrin heavy chain (CHC) contributes to the regulation of basal NF-kappaB activity in epithelial cells. METHODOLOGY: Using RNA interference to reduce endogenous CHC expression, we found that CHC is required to prevent constitutive activation of NF-kappaB and gene expression. Immunofluorescence staining showed constitutive nuclear localization of the NF-kappaB subunit p65 in absence of stimulation after CHC knockdown. Elevated basal p65 nuclear localization is caused by constitutive phosphorylation and degradation of inhibitor of NF-kappaB alpha (IkappaBalpha) through an IkappaB kinase alpha (IKKalpha)-dependent mechanism. The role of CHC in NF-kappaB signaling is functionally relevant as constitutive expression of the proinflammatory chemokine interleukin-8 (IL-8), whose expression is regulated by NF-kappaB, was found after CHC knockdown. Disruption of clathrin-mediated endocytosis by chemical inhibition or depletion of the mu2-subunit of the endocytosis adaptor protein AP-2, and knockdown of clathrin light chain a (CHLa), failed to induce constitutive NF-kappaB activation and IL-8 expression, showing that CHC acts on NF-kappaB independently of endocytosis and CLCa. CONCLUSIONS: We conclude that CHC functions as a built-in molecular brake that ensures a tight control of basal NF-kappaB activation and gene expression in unstimulated cells. Furthermore, our data suggest a potential link between a defect in CHC expression and chronic inflammation disorde and cancer