Predictors of inappropriate hospital days in a department of internal medicine

Background This study aimed to identify predictors of inappropriate hospital days in a deparUnent of internal medicine, as a basis for quality improvement interventions. Methods The appropriateness of 5665 hospital days contributed by 500 patients admitted to the Department of Internal Medicine, Geneva University Hospitals, Switzerland, was assessed by means of the Appropriateness Evaluation Protocol. Predictor variables included patient's age and sex, manner of admission and discharge, and characteristics of hospital days (weekend, holiday, sequence). Results Overall, 15% of hospital admissions and 28% of hospital days were rated as inappropriate. In multivariate models, inappropriate hospital days were more frequent among patients whose admission was inappropriate (odds ratio [OR] = 5.3, 95% CI: 3.1-8.4) and among older patients (80-95 years: OR = 3.6. 95% CI: 1.7-7.0, versus <50 years). The likelihood of inappropriateness also increased with each subsequent hospital day, culminating on the day of discharge, regardless of the total length of stay. Conclusions This study identified both the admission and the discharge processes as important sources of inappropriate hospital use in a department of internal medicine. The oldest patients were also at high risk of remaining in the hospital inappropriately. Surprisingly, long hospital stays did not generate a higher proportion of inappropriate days than short hospital stays. This information proved useful in developing interventions to improve the hospitalization proces

Calcium and the control of C4 photosynthesis

http://www.sherpa.ac.uk/romeo/search.ph

Segregation of Fluorescent Membrane Lipids into Distinct Micrometric Domains: Evidence for Phase Compartmentation of Natural Lipids?

Background: We recently reported that sphingomyelin (SM) analogs substituted on the alkyl chain by various fluorophores (e.g. BODIPY) readily inserted at trace levels into the plasma membrane of living erythrocytes or CHO cells and spontaneously concentrated into micrometric domains. Despite sharing the same fluorescent ceramide backbone, BODIPY-SM domains segregated from similar domains labelled by BODIPY-D-e-lactosylceramide (D-e-LacCer) and depended on endogenous SM. Methodology/Principal Findings. We show here that BODIPY-SM further differed from BODIPY-D-e-LacCer or -glucosylceramide (GlcCer) domains in temperature dependence, propensity to excimer formation, association with a glycosylphosphatidylinositol (GPI)-anchored fluorescent protein reporter, and lateral diffusion by FRAP, thus demonstrating different lipid phases and boundaries. Whereas BODIPY-D-e-LacCer behaved like BODIPY-GlcCer, its artificial stereoisomer, BODIPY-L-t-LacCer, behaved like BODIPY- and NBD-phosphatidylcholine (PC). Surprisingly, these two PC analogs also formed micrometric patches yet preferably at low temperature, did not show excimer, never associated with the GPI reporter and showed major restriction to lateral diffusion when photobleached in large fields. This functional comparison supported a three-phase micrometric compartmentation, of decreasing order: BODIPY-GSLs > -SM > -PC (or artificial L-t-LacCer). Co-existence of three segregated compartments was further supported by double labelling experiments and was confirmed by additive occupancy, up to ~70% cell surface coverage. Specific alterations of BODIPY-analogs domains by manipulation of corresponding endogenous sphingolipids suggested that distinct fluorescent lipid partition might reflect differential intrinsic propensity of endogenous membrane lipids to form large assemblies. Conclusions/Significance. We conclude that fluorescent membrane lipids spontaneously concentrate into distinct micrometric assemblies. We hypothesize that these might reflect preexisting compartmentation of endogenous PM lipids into non-overlapping domains of differential order: GSLs > SM > PC, resulting into differential self-adhesion of the two former, with exclusion of the latter

Analyse phylogénétique d'Homo luzonensis : taxon, caractères, phylogénie et évolution insulaire

Homo luzonensis is a species that lived 50 to 67 ka BP in northern Philippines, East of the Wallace line. Likely to have been isolated on an island for hundreds of thousands of years, they show both archaic features (i.e., occurring in the Australopithecines) and derived characters (i.e., occurring in the upper Pleistocene Homo species). Their archaic features could result either from a close phylogenetic relationship with the Australopithecines or the early members of the genus Homo. It may also result from the effects of insular evolution that favored reversals (i.e., return to primitive characters), correlated with a close relationship with a more derived species as the Asian Homo erectus. To test these two hypotheses, we carry out a cladistic analysis based on the dental and postcranial remains of adult H. luzonensis. The various trees obtained indicate that both hypotheses are possible. The phylogenetic hypotheses where H. luzonensis is derived from H. erectus are supported by higher retention index and average group support after symmetric resampling. However, those where H. luzonensis is basal to the whole Homo genus are obtained using implied weighting, a method whose relevance is discussed when island taxa are analyzed. Moreover, H. luzonensis probably had reduced body dimensions and adaptations of his locomotor repertoire also observed in other insular mammals. Besides, the tropical forest environment present on Luzon Island seems to have favored the development of these features. Combining our results with the state of the art concerning insular evolution and the environmental context of H. luzonensis, we conclude that H. luzonensis most probably results from an insular evolution with an Asian H. erectus ancestor.Homo luzonensis est une espèce ayant vécu il y a 50 à 67 ka BP dans le Nord des Philippines, à l’Est de la ligne de Wallace. Potentiellement isolée sur l’île pendant plusieurs centaines de milliers d’années, elle présente à la fois des caractères archaïques (i.e. présents chez les australopithèques) et dérivés (i.e. présents chez les représentants du genre Homo du Pléistocène supérieur). Ses caractères archaïques peuvent résulter soit d’une proche parenté avec des australopithèques ou des premiers représentants du genre Homo, soit d’une évolution dans un contexte insulaire, qui favorise les réversions (i.e. retour à des états de caractère primitifs), à partir d’un ancêtre Homo erectus asiatique. Pour tenter de trancher entre ces deux hypothèses, nous menons une étude cladistique à partir des restes dentaires et postcrâniens d’H. luzonensis adultes. Les divers arbres obtenus indiquent que les deux hypothèses sont plausibles. Les arbres où H. luzonensis est dérivé d’H. erectus sont soutenus par des indices de rétention et des moyennes de différences de fréquence après rééchantillonnage symétrique plus élevés. En revanche, ceux qui donnent à H. luzonensis une position basale au genre Homo sont obtenus par l’utilisation de la pondération implicite, une méthode dont nous discutons la pertinence dans le cas de la présence de taxons insulaires dans les analyses phylogénétiques. En outre, H. luzonensis montre des dimensions corporelles probablement réduites et des adaptations du système locomoteur observées chez d’autres mammifères insulaires. Par ailleurs, l’environnement de forêt tropicale présent sur l’île de Luçon pourrait également avoir favorisé le développement de ces caractéristiques. Grâce au croisement de nos résultats avec l’état des connaissances actuelles sur l’évolution insulaire et sur le contexte environnemental, nous concluons qu’H. luzonensis est probablement le résultat d’une évolution insulaire à partir d’un ancêtre H. erectus asiatiqu

L’ASSOCIATION TDS. Quand les voyageurs deviennent des villageois

National audienceSouvent citée en exemple, l’association TDS mène une expérience pilote de tourisme équitable et solidaire au Burkina Faso et au Bénin et fonde son action sur des “villages d’accueil”. Elle fait désormais voyager 200 personnes par an et reverse les bénéfices à des fonds de développement villageois

Myo10 is a key regulator of TNT formation in neuronal cells.

Cell-to-cell communication is essential in multicellular organisms. Tunneling nanotubes (TNTs) have emerged as a new type of intercellular spreading mechanism allowing the transport of various signals, organelles and pathogens. Here, we study the role of the unconventional molecular motor myosin-X (Myo10) in the formation of functional TNTs within neuronal CAD cells. Myo10 protein expression increases the number of TNTs and the transfer of vesicles between co-cultured cells. We also show that TNT formation requires both the motor and tail domains of the protein, and identify the F2 lobe of the FERM domain within the Myo10 tail as necessary for TNT formation. Taken together, these results indicate that, in neuronal cells, TNTs can arise from a subset of Myo10-driven dorsal filopodia, independent of its binding to integrins and N-cadherins. In addition our data highlight the existence of different mechanisms for the establishment and regulation of TNTs in neuronal cells and other cell types