Ethical and legal aspects of research involving older people with cognitive impairment: A survey of dementia researchers in Australia

© 2019 Elsevier Ltd People with dementia are under-represented in clinical research, in part due to the ethical and legal complexities of involving people in studies who may lack capacity to consent. Excluding this population from research limits the evidence to inform care. The attitudes and practices of researchers are key to the inclusion of people with dementia in research, however, there are few empirical studies on researchers' perspectives in this area. A cross-sectional study involved researchers in Australia who had experience in the ethical aspects of conducting dementia-related studies with human participants (n = 70). Data were collected via an online survey from November 2017 to January 2018. Most respondents (97%) agreed with the importance of including people at all stages of dementia in research, yet around three-quarters of respondents perceived ethical and legal rules and processes as unduly restrictive or time-consuming. Researchers reported variable practices in assessing prospective participants' capacity to consent to their studies. Various tools are used for this purpose, ranging from tools designed for research (eg, MacArthur Competence Assessment Tool for Clinical Research) to more general cognitive function screens (eg, Mini Mental State Exam). Few respondents (14%) routinely exclude people from studies who are unable to give their own consent, but instead seek permission from proxy decision-makers, such as legally appointed guardians or family carers. Respondents reported positive and negative outcomes of ethics review processes. Positive outcomes included strengthening the protections for participants with cognitive impairment while negative outcomes included delays and inconsistent decisions from different ethics committees. The findings suggest a need for improved strategies in the research context to assess and enhance the decision-making capacity of people with dementia to support appropriate opportunities for inclusion. Education for ethics committees, proxy decision-makers and other gatekeepers is also needed to reduce barriers to participation in research

Suppression of epithelial folding at actomyosin-enriched compartment boundaries downstream of Wingless signalling

Epithelial folding shapes embryos and tissues during development. Here, we investigate the coupling between epithelial folding and actomyosin-enriched compartmental boundaries. The mechanistic relationship between the two is unclear, because actomyosin-enriched boundaries are not necessarily associated with folds. Also, some cases of epithelial folding occur independently of actomyosin contractility. We investigated the shallow folds called parasegment grooves that form at boundaries between anterior and posterior compartments in the early Drosophila embryo. We demonstrate that formation of these folds requires the presence of an actomyosin enrichment along the boundary cell-cell contacts. These enrichments, which require Wingless signalling, increase interfacial tension not only at the level of the adherens junctions but also along the lateral surfaces. We find that epithelial folding is normally under inhibitory control because different genetic manipulations, including depletion of the Myosin II phosphatase Flapwing, increase the depth of folds at boundaries. Fold depth correlates with the levels of Bazooka (Baz), the Par-3 homologue, along the boundary cell-cell contacts. Moreover, Wingless and Hedgehog signalling have opposite effects on fold depth at the boundary that correlate with changes in Baz planar polarity.This work was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) [BB/J010278/1] and the Wellcome Trust [099234/Z/12/Z to B.S.; 099130/Z/12/Z to CAIC]. J.M.U. was supported by a Postdoctoral Fellowship [I-D+i 2008-2011] from Ministerio de Educación, Cultura y Deporte (Spanish Ministry of Education), E.S. by a University of Cambridge Herchel Smith Postdoctoral Fellowship and L.M. by an Engineering and Physical Sciences Research Council (EPSRC) Research Software Engineer Fellowship. Deposited in PMC for immediate release

Effect of doping and oxygen vacancies on the octahedral tilt transitions in the BaCeO3 perovskite

We present a systematic study of the effect of Y doping and hydration level on the structural transformations of BaCeO3 based on anelastic spectroscopy experiments. The temperature of the intermediate transformation between rhombohedral and orthorhombic Imma phases rises with increasing the molar fraction x of Y roughly as (500 K)x in the hydrated state, and is depressed of more than twice that amount after complete dehydration. This is explained in terms of the effect of doping on the average (Ce/Y)-O and Ba-O bond lengths, and of lattice relaxation from O vacancies. The different behavior of the transition to the lower temperature Pnma orthorhombic phase is tentatively explained in terms of progressive flattening of the effective shape of the OH ion and ordering of the O vacancies during cooling.Comment: 8 pages, 5 figure

Quark matter contribution to the heat capacity of magnetized neutron stars

In this paper, we find the heat capacity of the magnetic dual chiral density wave (MDCDW) phase of dense quark matter and use it to explore the feasibility of this phase for a neutron star interior. MDCDW is a spatially inhomogeneous phase of quark matter known to be favored at intermediate densities over the chirally symmetric phase and the color-flavor-locked superconducting phase. By comparing our result to the lower limit of the core heat capacity established from observations of transiently accreting neutron stars, we show that the heat capacity of MDCDW quark matter is well above that lower limit and hence cannot be ruled out. This result adds to a wealth of complementary investigations, all of which has served to strengthen the viability of a neutron star interior made of MDCDW quark matter. For completeness, we review the contributions to the heat capacity of the main neutron star ingredients at low, high and intermediate densities, with and without the presence of a magnetic field.Comment: To appear in PR

Estudo histológico prospectivo da epiderme e dos folículos pilosos na doença do enxerto contra o hospedeiro aguda após transplante de medula óssea

Orientador: Ricardo PasquiniCo-orientador: Giovanni LoddoDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências da Saúde, Programa de Pós-Graduação em Medicina InternaResumo: A detecção precoce da Doença do Enxerto contra o Hospedeiro (DECH) aguda, atualmente a principal complicação do transplante de medula óssea, é busca constante em pacientes submetidos a esta técnica de tratamento. A identificação de alterações morfológicas precoces na pele, o órgão mais acessível para biópsia, que possam predizer o desenvolvimento da Doença do Enxerto contra o Hospedeiro (DECH) aguda, é baseada na necessidade da urgência no diagnóstico, pois dele depende a orientação terapêutica. Estudos retrospectivos prévios foram realizados baseados principalmente em achados morfológicos, entretanto, nestes estudos, não foi possível verificar, por meio de dados de prontuário, a correlação entre as datas de biópsia e das primeiras manifestações clínicas. Baseados nisso, neste trabalho prospectivo foram estudadas 190 biópsias de pele, realizadas nos primeiros 28 dias após o transplante, em 38 pacientes submetidos ao transplante de medula óssea alogênico, no Hospital de Clínicas da Universidade Federal do Paraná, em Curitiba, entre março e dezembro de 1996. Os objetivos do estudo consistiram em: 1) identificar alterações morfológicas precoces, dos folículos pilosos, correlacionados ao diagnóstico de Doença do Enxerto Contra o Hospedeiro (DECH) aguda, complicação freqüente nestes pacientes, mediante biópsias cutâneas seqüenciais, e acompanhamento clínico e laboratorial simultâneo; 2) identificar quais os achados morfológicos que teriam maior valor para este diagnóstico, tentando correlacionar as alterações encontradas com o surgimento das manifestações cutâneas e gerais dos pacientes; 3) verificar se as alterações morfológicas dos folículos pilosos são suficientes e específicas para predizer o aparecimento das lesões cutâneas e gerais da Doença do Enxerto Contra o Hospedeiro (DECH) aguda. Cabe assinalar que foram excluídos do trabalho quatro pacientes nos quais foram encontradas alterações histológicas descritas na literatura como específicas de DECH, no período pré-transplante, os mesmos pacientes que haviam sido submetidos à irradiação corporal total. Nos 34 pacientes que foram incluídos no trabalho não houve significância estatística na correlação entre as alterações histológicas isoladas e o desenvolvimento da DECH aguda. Agrupando-se estas alterações, segundo classificação sugerida por Loddo em 1993, também não observamos significância estatística na predição da DECH aguda. Finalmente concluiu-se que as alterações histológicas estudadas não são suficientes nem específicas para predição da DECH aguda.Abstract: Early detection of acute Graft Versus Host Disease (GVHD), currently the major complication in bone marrow transplantation (BMT), in patients submitted to such treatment is a constant endeavor. The detection of early morphological changes in the skin (the most accessible organ for a biopsy), which can be na indication of acute GVHD, is based on the need of na immediate diagnostic which, in turn, may provide therapeutic guidelines. Previous retrospective studies have been carried out, mainly based on morphological findings. However, in such studies it was not possible to observe, through data drawn from patient charts, a correlation between the dates on which the biopsies were performed and the first clinical manifestations of the disease. In this prospective study, 190 skin biopsies were analyzed, performed 28 days after the transplant, in 38 patients submitted to allogeneic BMT, at Hospital de Clínicas da Universidade Federal do Paraná (the university hospital of the Federal University of Paraná), in Curitiba, between March and December 1996. The study aimed at: 1) identifying early morphological changes, from hair follicles, correlated with the diagnosis of acute GVHD, a frequent complication in those patients, through sequential skin biopsies, plus simultaneous clinical and laboratory follow-up; 2) identifying which morphological findings would be more valuable to make this diagnosis, trying to correlate the changes encountered with the onset of the cutaneous and general manifestations in patients; 3) verifying if the morphological changes in the hair follicles are sufficient and specific enough to predict cutaneous and general lesions of acute GVHD. In the pre-BMT period, four patients presenting histological alterations described in the literature as specific of GVHD, were removed from the study; these patients had been submited to total body radiation. In the 34 patients that remained in the study, there was no statistically significant correlation between isolated histological alterations and acute GVHD. Grouping these alterations according to Loddo's classification (1993), we also failed to see any statistically significant prediction of acute GVHD. Finally, we concluded that the histological alterations analyzed are neither sufficient nor specific enough to predict acute GVHD

Prevalence of nursing diagnoses as a measure of nursing complexity in a hospital setting

Aims: To describe the prevalence of nursing diagnoses on admission among inpatient units and medical diagnoses and to analyse the relationship of nursing diagnoses to patient characteristics and hospital outcomes. Background: Nursing diagnoses classify patients according to nursing dependency and can be a measure of nursing complexity. Knowledge regarding the prevalence of nursing diagnoses on admission and their relationship with hospital outcomes is lacking. Design: Prospective observational study. Methods: Data were collected for 6 months in 2014 in four inpatient units of an Italian hospital using a nursing information system and the hospital discharge register. Nursing diagnoses with prevalence higher or equal to 20% were considered as \u2018high frequency.\u2019 Nursing diagnoses with statistically significant relationships with either higher mortality or length of stay were considered as \u2018high risk.\u2019 The high-frequency/high-risk category of nursing diagnoses was identified. Results: The sample included 2283 patients. A mean of 4\ub75 nursing diagnoses per patient was identified; this number showed a statistically significant difference among inpatient units and medical diagnoses. Six nursing diagnoses were classified as high frequency/high risk. Nursing diagnoses were not correlated with patient gender and age. A statistically significant perfect linear association (Spearman's correlation coefficient) was observed between the number of nursing diagnoses and both the length of stay and the mortality rate. Conclusion: Nursing complexity, as described by nursing diagnoses, was shown to be associated with length of stay and mortality. These results should be confirmed after considering other variables through multivariate analyses. The concept of high-frequency/high-risk nursing diagnoses should be expanded in further studies

Increasing Servers’ Tips: What Managers Can Do and Why They Should Do It

Tipping is generally regarded in the industry as more of a server concern than a managerial one. For this reason, it is the rare restaurant executive or manager who tries to actively influence the level of his or her servers’ tip incomes. I believe that is a mistake --that restaurant executives and managers can and should increase their servers’ tip incomes. First, I present several tactics that servers can use to increase their own tips. Then, I describe the role that executives and managers can play in encouraging servers’ use of these tactics. Finally, I explain how executives and managers will benefit from encouraging servers to try these tactics

Clasificación automática para la prevención del estrés de los suelos y la fatiga de soja en el noroeste argentino

El crecimiento de la soja y sus derivados en la Argentina en los últimos 30 años se ha constituido en un fenómeno trascendente y fundamental para el país, tanto desde el punto de vista económico como social. Para la campaña 2002/03, la soja representó más del 50% del total de los granos producidos, considerando los cinco cultivos mas difundidos en la pampa húmeda. Lo anterior implica que el sector agropecuario, especialmente en la pampa húmeda, ha tornado hacia un modelo de "especialización sojera", que se expande rápidamente hacia regiones extrapampeanas, al que muchos definen como el proceso de "sojificación", y el nuevo paradigma de la agricultura argentina basado en los materiales transgénicos y la siembra directa. [Begenisic, F; et al; 2004; Formento, N; de Souza, J.; 2007; Graciela, E; 2006; Sinavimo, 2008; Rearte, D; 2007]. Ante este presente las tecnologías informáticas han dado soporte desde lo las funciones esenciales del negocio y sin llegar a profundizar en la forma analítica-predictiva masivamente. El presente trabajo intenta acortar dicha brecha y de esa forma por ayudar a la industria agrícolaganadera del país, por el medio de ayudar en la prevención de la Roya de Soja y la Fatiga de los suelos. Para lograr este objetivo se utilizaran las mediciones meteorológicas en la zona noreste de la provincia de Córdoba.Eje: Ingeniería de Software y Base de DatosRed de Universidades con Carreras en Informática (RedUNCI

Antiviral Immunoglobulins of Chicken Egg Yolk for Potential Prevention of SARS-CoV-2 Infection

Background: Some viruses cause outbreaks, which require immediate attention. Neutralizing antibodies could be developed for viral outbreak management. However, the development of monoclonal antibodies is often long, laborious, and unprofitable. Here, we report the development of chicken polyclonal neutralizing antibodies against SARS-CoV-2 infection. Methods: Layers were immunized twice with 14-day intervals using the purified receptor-binding domain (RBD) of the S protein of SARS-CoV-2/Wuhan or SARS-CoV-2/Omicron. Eggs were harvested 14 days after the second immunization. Polyclonal IgY antibodies were extracted. Binding of anti-RBD IgYs was analyzed by immunoblot and indirect ELISA. Furthermore, the neutralization capacity of anti-RBD IgYs was measured in Vero-E6 cells infected with SARS-CoV-2-mCherry/Wuhan and SARS-CoV-2/Omicron using fluorescence and/or cell viability assays. In addition, the effect of IgYs on the expression of SARS-CoV-2 and host cytokine genes in the lungs of Syrian Golden hamsters was examined using qRT-PCR. Results: Anti-RBD IgYs efficiently bound viral RBDs in situ, neutralized the virus variants in vitro, and lowered viral RNA amplification, with minimal alteration of virus-mediated immune gene expression in vivo. Conclusions: Altogether, our results indicate that chicken polyclonal IgYs can be attractive targets for further pre-clinical and clinical development for the rapid management of outbreaks of emerging and re-emerging viruses.Peer reviewe

Equipamento de baixo custo para extração em fase sólida em amostras aquosas de grande volume utilizando pressão positiva de N

Extraction/concentration is a crucial step for the analysis of organic compounds at trace level concentrations and dispersed in complex matrices. Solid-phase extraction (SPE) is one of the techniques used for this purpose. In this work, a low cost apparatus for SPE was developed that uses nitrogen under positive pressure and ensures the maintenance of the sample flow, while also allows the simultaneous extraction of different samples without cross-contamination and sample contact with plastic materials. For the system set up, easily accessible materials were used such as hypodermic needles, stainless steel tubes, rubber stoppers, and 3-way valves from serum delivery apparatus