The histone deacetylase inhibitor valproic acid attenuates phospholipase Cγ2 and IgE-mediated mast cell activation.

Mast cell activation through the high-affinity IgE receptor (FcεRI) plays a central role in allergic reactions. FcεRI-mediated activation triggers multiple signaling pathways leading to degranulation and synthesis of different inflammatory mediators. IgE-mediated mast cell activation can be modulated by different molecules, including several drugs. Herein, we investigated the immunomodulatory activity of the histone deacetylase inhibitor valproic acid (VPA) on IgE-mediated mast cell activation. To this end, bone marrow-derived mast cells (BMMC) were sensitized with IgE and treated with VPA followed by FcεRI cross-linking. The results indicated that VPA reduced mast cell IgE-dependent degranulation and cytokine release. VPA also induced a significant reduction in the cell surface expression of FcεRI and CD117, but not other mast cell surface molecules. Interestingly, VPA treatment inhibited the phosphorylation of PLCγ2, a key signaling molecule involved in IgE-mediated degranulation and cytokine secretion. However, VPA did not affect the phosphorylation of other key components of the FcεRI signaling pathway, such as Syk, Akt, ERK1/2, or p38. Altogether, our data demonstrate that VPA affects PLCγ2 phosphorylation, which in turn decreases IgE-mediated mast cell activation. These results suggest that VPA might be a key modulator of allergic reactions and might be a promising therapeutic candidate

Confecció de materials i coordinació en el desenvolupament i l'aplicació dels programes de l'àmbit de l'organització de la titulació de Pedagogia

La construcció de l'espai europeu d'educació superior exigeix planificar els estudis universitaris partint de la base que el protagonista n'és l'estudiant. En aquest procés el col·lectiu de professors de l'Àrea de Didàctica i Organització Educativa que imparteix matèries en la titulació vinculades amb l'àmbit de l'organització ha desenvolupat diverses accions dirigides a afavorir la qualitat de la formació dels estudiants, a partir d'una major coordinació del professorat en la confecció i el desenvolupament dels programes. Això ha significat trencar amb l'aïllament acadèmic entre el professorat implicat i plantejar un treball continuat de col·laboració, donant peu a reflexionar sobre el procés d'ensenyament i aprenentatge dels estudiants, assumint per endavant la necessitat d'enriquir l'activitat a partir de les aportacions personals, plantejant inquietuds, aportant documents i ajudant a la recopilació sistemàtica de les bones pràctiques, amb la intenció de compartir-les i analitzar-ne les claus de l'èxit.La construcción del espacio europeo de educación superior exige planificar los estudios universitarios partiendo de la base de que su protagonista es el estudiante. En este proceso el colectivo de profesores del Área de Didáctica y Organización Educativa que imparte materias en la titulación vinculadas al ámbito de organización ha desarrollado diversas accionas dirigidas a favorecer la calidad de la formación de los estudiantes, a partir de una mayor coordinación del profesorado en la confección y el desarrollo de los programas. Ello ha significado romper con el aislamiento académico entre el profesorado implicado y plantear un trabajo continuado de colaboración, dando pie a reflexionar sobre el proceso de enseñanza-aprendizaje de los estudiantes, asumiendo de antemano la necesidad de enriquecer la actividad a partir de las aportaciones personales, planteando inquietudes, aportando documentos y ayudando en la recopilación sistemática de las buenas prácticas, con la intención de compartirlas y analizar las claves de su éxito.The consolidation of the European Higher Education Area requires us to plan university degrees starting from the premise that students take centre stage. In this process, the group of professors in the Area of Didactics and Educational Organisation who teach courses in the degree programme linked to the field of educational organisation have developed a variety of actions aimed at fostering the quality of students' education based on better coordination among all the faculty in drawing up and developing the curricula. This has entailed breaking with the academic isolation among the faculty involved and developing constant cooperative work, leading us to reflect on the process of teaching learnt by students, assuming beforehand the need to enrich the activity through personal contributions, expressing concerns, providing documents and helping to systematically compile good practices, all with the intention of sharing them and analysing the keys to their success

Global optical/infrared - X-ray correlations in X-ray binaries: quantifying disc and jet contributions

The optical/near-infrared (OIR) region of the spectra of low-mass X-ray binaries appears to lie at the intersection of a variety of different emission processes. In this paper we present quasi-simultaneous OIR - X-ray observations of 33 XBs in an attempt to estimate the contributions of various emission processes in these sources, as a function of X-ray state and luminosity. A global correlation is found between OIR and X-ray luminosity for low-mass black hole candidate XBs (BHXBs) in the hard X-ray state, of the form L_OIR is proportional to Lx^0.6. This correlation holds over 8 orders of magnitude in Lx and includes data from BHXBs in quiescence and at large distances (LMC and M31). A similar correlation is found in low-mass neutron star XBs (NSXBs) in the hard state. For BHXBs in the soft state, all the near-infrared (NIR) and some of the optical emission is suppressed below the correlation, a behaviour indicative of the jet switching off/on in transition to/from the soft state. We compare these relations to theoretical models of a number of emission processes. We find that X-ray reprocessing in the disc and emission from the jets both predict a slope close to 0.6 for BHXBs, and both contribute to the OIR in BHXBs in the hard state, the jets producing ~90 percent of the NIR emission at high luminosities. X-ray reprocessing dominates the OIR in NSXBs in the hard state, with possible contributions from the jets (only at high luminosity) and the viscously heated disc. We also show that the optically thick jet spectrum of BHXBs extends to near the K-band. (abridged)Comment: Accepted for publication in MNRAS; 19 pages, 7 figure

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol

<p>Abstract</p> <p>Background</p> <p>Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps).</p> <p>Methods/Design</p> <p>This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and functional status with secondary outcomes of 6-month changes in self-management behaviors/efficacy and patient-centered processes of care. We will also evaluate 6-month changes in cardiometabolic (HbA1c, blood pressure, and LDL) and utilization indicators for all participants.</p> <p>Discussion</p> <p>Outcomes will provide evidence regarding real-world implementation of ATSM within a Medicaid managed care plan serving safety net settings. The evaluation trial will provide insight into translating and scaling up health information technology interventions for linguistically and culturally diverse vulnerable populations with chronic disease.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00683020">NCT00683020</a></p

Association of a single nucleotide polymorphism combination pattern of the Klotho gene with non-cardiovascular death in patients with chronic kidney disease

Chronic kidney disease (CKD) is associated with an elevated risk of all-cause mortality, with cardiovascular death being extensively investigated. However, non-cardiovascular mortality represents the biggest percentage, showing an evident increase in recent years. Klotho is a gene highly expressed in the kidney, with a clear influence on lifespan. Low levels of Klotho have been linked to CKD progression and adverse outcomes. Single nucleotide polymorphisms (SNPs) of the Klotho gene have been associated with several diseases, but studies investigating the association of Klotho SNPs with noncardiovascular death in CKD populations are lacking. The main aim of this study was to assess whether 11 Klotho SNPs were associated with non-cardiovascular death in a subpopulation of the National Observatory of Atherosclerosis in Nephrology (NEFRONA) study (n ¼ 2185 CKD patients). After 48 months of follow-up, 62 cardiovascular deaths and 108 non-cardiovascular deaths were recorded. We identified a high non-cardiovascular death risk combination of SNPs corresponding to individuals carrying the most frequent allele (G) at rs562020, the rare allele (C) at rs2283368 and homozygotes for the rare allele (G) at rs2320762 (rs562020 GG/AG þ rs2283368 CC/CT þ rs2320762 GG). Among the patients with the three SNPs genotyped (n ¼ 1016), 75 (7.4%) showed this combination. Furthermore, 95 (9.3%) patients showed a low-risk combination carrying all the opposite genotypes (rs562020 AA þ rs2283368 TT þ rs2320762 GT/TT). All the other combinations [n ¼ 846 (83.3%)] were considered as normal risk. Using competing risk regression analysis, we confirmed that the proposed combinations are independently associated with a higher fhazard ratio [HR] 3.28 [confidence interval (CI) 1.51-7.12]g and lower [HR 6 × 10- (95% CI 3.3 × 10--1.1 × 10-)] risk of suffering a non-cardiovascular death in the CKD population of the NEFRONA cohort compared with patients with the normal-risk combination. Determination of three SNPs of the Klotho gene could help in the prediction of non-cardiovascular death in CKD

Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure

A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) a-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of “extra-target” RAS suggests the need for RAS screening in all three DAA target regions