Anemia profile in critical septic patients hospitalized in the ICU

This article is part of the supplement: 31st International Symposium on Intensive Care and Emergency MedicineThe aim was to describe the anemia profile of medical or surgical patients with severe sepsis or septic shock in the ICU, assessing severity scale, length of stay and mortality. The prevalence of microcytic anemia is more than one-half of our septic patients. There are iron metabolism disorders without significant differences between medical and surgical patients. Transferrin, a protein related to malnutrition, inflammatory response and organ dysfunction, is significantly lower in the most severe patients with higher organ dysfunction scores.Ye

Remote pulmonary rehabilitation for interstitial lung disease: developing the model using experience-based codesign

Data availability statement: Data are available on reasonable request.Supplementary Data: This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content : https://bmjopenrespres.bmj.com/content/bmjresp/suppl/2024/02/21/11.1.e002061.DC1/bmjresp-2023-002061supp001_data_supplement.pdf .Background Remote delivery may improve access to pulmonary rehabilitation (PR). Existing studies are largely limited to individuals with COPD, and the interventions have lacked codesign elements to reflect the needs and experiences of people with chronic respiratory disease, their carers/families and healthcare professionals. The aim of this study was, using experience-based codesign (EBCD), to collaborate with people with interstitial lung disease (ILD), their carers/families and healthcare professionals, to codesign a remote PR programme ready for testing in a future study. Methods EBCD comprises interviews, stakeholder workshops and codesign meetings. One-to-one videorecorded interviews with purposively selected people with ILD with experience of PR, their carers/families and healthcare professionals, were edited into a 20 min film. The film was shown at three audiorecorded stakeholder feedback events to identify key themes and touchpoints, and short-list key programme components. The programme was finalised at two further codesign workshops. Results Ten people with ILD, four carers/families and seven healthcare professionals were interviewed. Participants in the codesign workshops included service-user group: n=14 and healthcare professional group: n=11; joint event: n=21. Final refinements were made with small codesign teams, one comprising three people with ILD and one carer/family member, one with five healthcare professionals. The final codesigned model is a group based, supervised programme delivered by videoconference. Key elements of programme specific to ILD include recommendations to ensure participant safety in the context of desaturation risk, dedicated time for peer support and adaption of the education programme for ILD needs, including signposting to palliative care. Conclusion In this EBCD project, a remote PR programme for people with ILD was codesigned by service-users, their carers/families and multidisciplinary healthcare professionals. Future research should explore the feasibility and acceptability of this intervention.Royal Brompton and Harefield Charity Research Management Fun

The Snail repressor recruits EZH2 to specific genomic sites through the enrollment of the lncRNA HOTAIR in epithelial-to-mesenchymal transition

The transcription factor Snail is a master regulator of cellular identity and epithelial-to-mesenchymal transition (EMT) directly repressing a broad repertoire of epithelial genes. How chromatin modifiers instrumental to its activity are recruited to Snail-specific binding sites is unclear. Here we report that the long non-coding RNA (lncRNA) HOTAIR (for HOX Transcript Antisense Intergenic RNA) mediates a physical interaction between Snail and enhancer of zeste homolog 2 (EZH2), an enzymatic subunit of the polycomb-repressive complex 2 and the main writer of chromatin-repressive marks. The Snail-repressive activity, here monitored on genes with a pivotal function in epithelial and hepatic morphogenesis, differentiation and cell-type identity, depends on the formation of a tripartite Snail/HOTAIR/EZH2 complex. These results demonstrate an lncRNA-mediated mechanism by which a transcriptional factor conveys a general chromatin modifier to specific genes, thereby allowing the execution of hepatocyte transdifferentiation; moreover, they highlight HOTAIR as a crucial player in the Snail-mediated EMT.Oncogene advance online publication, 25 July 2016; doi:10.1038/onc.2016.260

Comparison of flipped learning and traditional lecture method for teaching digestive system diseases in undergraduate medicine: A prospective non-randomized controlled trial

Introduction: This study examined the effects of a large-scale flipped learning (FL) approach in an undergraduate course of Digestive System Diseases. Methods: This prospective non-randomized trial recruited 404 students over three academic years. In 2016, the course was taught entirely in a Traditional Lecture (TL) style, in 2017 half of the course (Medical topics) was replaced by FL while the remaining half (Surgical topics) was taught by TL and in 2018, the whole course was taught entirely by FL. Academic performance, class attendance and student’s satisfaction surveys were compared between cohorts. Results: Test scores were higher in the FL module (Medical) than in the TL module (Surgical) in the 2017 cohort but were not different when both components were taught entirely by TL (2016) or by FL (2018). Also, FL increased the probability of reaching superior grades (scores >7.0) and improved class attendance and students’ satisfaction. Conclusion: The holistic FL model is more effective for teaching undergraduate clinical gastroenterology compared to traditional teaching methods and has a positive impact on classroom attendances

Involvement of Raft Aggregates Enriched in Fas/CD95 Death-Inducing Signaling Complex in the Antileukemic Action of Edelfosine in Jurkat Cells

BACKGROUND: Recent evidence suggests that co-clustering of Fas/CD95 death receptor and lipid rafts plays a major role in death receptor-mediated apoptosis. METHODOLOGY/PRINCIPAL FINDINGS: By a combination of genetic, biochemical, and ultrastructural approaches, we provide here compelling evidence for the involvement of lipid raft aggregates containing recruited Fas/CD95 death receptor, Fas-associated death domain-containing protein (FADD), and procaspase-8 in the induction of apoptosis in human T-cell leukemia Jurkat cells by the antitumor drug edelfosine, the prototype compound of a promising family of synthetic antitumor lipids named as synthetic alkyl-lysophospholipid analogues. Co-immunoprecipitation assays revealed that edelfosine induced the generation of the so-called death-inducing signaling complex (DISC), made up of Fas/CD95, FADD, and procaspase-8, in lipid rafts. Electron microscopy analyses allowed to visualize the formation of raft clusters and their co-localization with DISC components Fas/CD95, FADD, and procaspase-8 following edelfosine treatment of Jurkat cells. Silencing of Fas/CD95 by RNA interference, transfection with a FADD dominant-negative mutant that blocks Fas/CD95 signaling, and specific inhibition of caspase-8 prevented the apoptotic response triggered by edelfosine, hence demonstrating the functional role of DISC in drug-induced apoptosis. By using radioactive labeled edelfosine and a fluorescent analogue, we found that edelfosine accumulated in lipid rafts, forming edelfosine-rich membrane raft clusters in Jurkat leukemic T-cells. Disruption of these membrane raft domains abrogated drug uptake and drug-induced DISC assembly and apoptosis. Thus, edelfosine uptake into lipid rafts was critical for the onset of both co-aggregation of DISC in membrane rafts and subsequent apoptotic cell death. CONCLUSIONS/SIGNIFICANCE: This work shows the involvement of DISC clusters in lipid raft aggregates as a supramolecular and physical entity responsible for the induction of apoptosis in leukemic cells by the antitumor drug edelfosine. Our data set a novel framework and paradigm in leukemia therapy, as well as in death receptor-mediated apoptosis

Mexican design of a tokamak experimental facility

Mexico presents its proposal Tokamak Experimental Facility design under the necessary effort to develop Science and Technology into the thermonuclear magnetic confinement fusion area. This Research and Development Project (R+D) was approved by the Mexican Education Ministry (SEP, spanish acronyms) in 2007 for its actual development stage at Facultad de Ingenier´ıa Mec´anica y El´ectrica (FIME) - Universidad Aut´onoma de Nuevo Le´on (UANL).We have made this effort in order to unify and consolidate under a tokamak experimental configuration the Mexican Energy Fusion Program and generate an attractive scientific technological proposal to the mexican research centres with main objective to participate in ITER (International Thermonuclear Experimental Reactor) development. This present design aims to generate, innovate, understand and develop scientific and technological fusion knowledge, also to form researchers in fusion confinement area. We consider at this time that nuclear fusion represents an attractive, powerful and clean energy source. This R+D Project involves multidisciplinary physics and engineering areas that coexists into a nuclear fusion reactor, science and technology works together to establish a natural symbiosis between theory and experiments. Our tokamak facility design, at this time, is being developed and simulated under the use of COMSOL Multiphysics and 3D CAD software, all programs running under Gentoo GNU/Linux installed in our SGI Altix XE250 Platform. With this resources we can develop entirely systems involved in our magnetic confinement fusion research line, focused in the stronger application of engineering, technology and science concepts, developing systems and devices into this energy source generation. Taking advantage of this computational infrastructure we have proposed the possibility to participate throught this tokamak facility, studying and developing research over plasmas stability, confinement regimes and resonant magnetic field perturbation

The Seventh Data Release of the Sloan Digital Sky Survey

This paper describes the Seventh Data Release of the Sloan Digital Sky Survey (SDSS), marking the completion of the original goals of the SDSS and the end of the phase known as SDSS-II. It includes 11663 deg^2 of imaging data, with most of the roughly 2000 deg^2 increment over the previous data release lying in regions of low Galactic latitude. The catalog contains five-band photometry for 357 million distinct objects. The survey also includes repeat photometry over 250 deg^2 along the Celestial Equator in the Southern Galactic Cap. A coaddition of these data goes roughly two magnitudes fainter than the main survey. The spectroscopy is now complete over a contiguous area of 7500 deg^2 in the Northern Galactic Cap, closing the gap that was present in previous data releases. There are over 1.6 million spectra in total, including 930,000 galaxies, 120,000 quasars, and 460,000 stars. The data release includes improved stellar photometry at low Galactic latitude. The astrometry has all been recalibrated with the second version of the USNO CCD Astrograph Catalog (UCAC-2), reducing the rms statistical errors at the bright end to 45 milli-arcseconds per coordinate. A systematic error in bright galaxy photometr is less severe than previously reported for the majority of galaxies. Finally, we describe a series of improvements to the spectroscopic reductions, including better flat-fielding and improved wavelength calibration at the blue end, better processing of objects with extremely strong narrow emission lines, and an improved determination of stellar metallicities. (Abridged)Comment: 20 pages, 10 embedded figures. Accepted to ApJS after minor correction

Attitude control for satellites flying in VLEO using aerodynamic surfaces

This paper analyses the use of aerodynamic control surfaces, whether passive or active, in order to carry out very low Earth orbit (VLEO) attitude maneuver operations. Flying a satellite in a very low Earth orbit with an altitude of less than 450 km, namely VLEO, is a technological challenge. It leads to several advantages, such as increasing the resolution of optical payloads or increase signal to noise ratio, among others. The atmospheric density in VLEO is much higher than in typical low earth orbit altitudes, but still free molecular flow. This has serious consequences for the maneuverability of a satellite because significant aerodynamic torques and forces are produced. In order to guarantee the controllability of the spacecraft they have to be analyzed in depth. Moreover, at VLEO the density of atomic oxygen increases, which enables the use of air-breathing electric propulsion (ABEP). Scientists are researching in this field to use ABEP as a drag compensation system, and consequently an attitude control based on aerodynamic control could make sense. This combination of technologies may represent an opportunity to open new markets. In this work, several satellite geometric configurations were considered to analyze aerodynamic control: 3-axis control with feather configuration and 2-axis control with shuttlecock configuration. The analysis was performed by simulating the attitude of the satellite as well as the disturbances affecting the spacecraft. The models implemented to simulate the disturbances were the following: Gravitational gradient torque disturbance, magnetic dipole torque disturbance (magnetic field model IGRF12), and aerodynamic torque disturbances (aerodynamic model DTM2013 and wind model HWM14).The maneuvers analyzed were the following: detumbling or attitude stabilization, pointing and demisability. Different VLEO parameters were analyzed for every geometric configuration and spacecraft maneuver. The results determined which of the analyzed geometric configurations suits better for every maneuver

TRY plant trait database - enhanced coverage and open access

Plant traits-the morphological, anatomical, physiological, biochemical and phenological characteristics of plants-determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait-based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits-almost complete coverage for 'plant growth form'. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait-environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Expenditure Reform in Industrialised Countries: A Case Study Approach

This study examines reforms of public expenditure in industrialised countries over the past two decades. We distinguish ambitious and timid reformers and analyse in detail reform experiences in eight case studies of ambitious reform episodes. We find that ambitious reform countries reduce spending on transfers, subsidies and public consumption while largely sparing education spending. Such expenditure retrenchment is also typically part of a comprehensive reform package that includes improvements in fiscal institutions as well as structural and other macroeconomic reforms. The study finds that ambitious expenditure retrenchment and reform coincides with large improvements in fiscal and economic growth indicators