Proopiomelanocortin Neurons in Nucleus Tractus Solitarius Are Activated by Visceral Afferents: Regulation by Cholecystokinin and Opioids

The nucleustractus solitarius (NTS) receives dense terminations from cranial visceral afferents, including those from the gastrointestinal (GI) system. Although the NTS integrates peripheral satiety signals and relays this signal to central feeding centers, little is known about which NTS neurons are involved or what mechanisms are responsible. Proopiomelanocortin (POMC) neurons are good candidates for GI integration, because disruption of the POMC gene leads to severe obesity and hyperphagia. Here, we used POMC– enhanced green fluorescent protein (EGFP) transgenic mice to identify NTS POMC neurons. Intraperitoneal administration of cholecystokinin (CCK) induced c-fos gene expression in NTS POMC–EGFP neurons, suggesting that they are activated by afferents stimulated by the satiety hormone. We tested the synaptic relationship of these neurons to visceral afferents and their modulation by CCK and opioids using patch recordings in horizontal brain slices. Electrical activation of the solitary tract (ST) evoked EPSCs in NTS POMC–EGFP neurons. The invariant latencies, low failure rates, and substantial paired-pulse depression of the ST-evoked EPSCs indicate that NTS POMC–EGFP neurons are second-order neurons directly contacted by afferent terminals. The EPSCs were blocked by the glutamate antagonist 2,3- dihydroxy-6-nitro-7-sulfonyl-benzo[f]quinoxaline. CCK increased the amplitude of the ST-stimulated EPSCs and the frequency of miniature EPSCs, effects attenuated by the CCK1 receptor antagonist lorglumide. In contrast, the orexigenic opioid agonists [D-Ala(2), N-Me-Phe(4), Gly-ol(5)]-enkephalin and met-enkephalin inhibited both ST-stimulated EPSCs and the frequency of miniature EPSCs. These findings identify a potential satiety pathway in which visceral afferents directly activate NTS POMC–EGFP neurons with excitatory inputs that are appropriately modulated by appetite regulators

Interaction Effects in a One-Dimensional Constriction

We have investigated the transport properties of one-dimensional (1D) constrictions defined by split-gates in high quality GaAs/AlGaAs heterostructures. In addition to the usual quantized conductance plateaus, the equilibrium conductance shows a structure close to $0.7(2e^2/h)$, and in consolidating our previous work [K.~J. Thomas et al., Phys. Rev. Lett. 77, 135 (1996)] this 0.7 structure has been investigated in a wide range of samples as a function of temperature, carrier density, in-plane magnetic field $B_{\parallel}$ and source-drain voltage $V_{sd}$. We show that the 0.7 structure is not due to transmission or resonance effects, nor does it arise from the asymmetry of the heterojunction in the growth direction. All the 1D subbands show Zeeman splitting at high $B_{\parallel}$, and in the wide channel limit the $g$-factor is $\mid g \mid \approx 0.4$, close to that of bulk GaAs. As the channel is progressively narrowed we measure an exchange-enhanced $g$-factor. The measurements establish that the 0.7 structure is related to spin, and that electron-electron interactions become important for the last few conducting 1D subbands.Comment: 8 pages, 7 figures (accepted in Phys. Rev. B

Commensurability oscillations in the rf conductivity of unidirectional lateral superlattices: measurement of anisotropic conductivity by coplanar waveguide

We have measured the rf magnetoconductivity of unidirectional lateral superlattices (ULSLs) by detecting the attenuation of microwave through a coplanar waveguide placed on the surface. ULSL samples with the principal axis of the modulation perpendicular (S_perp) and parallel (S_||) to the microwave electric field are examined. For low microwave power, we observe expected anisotropic behavior of the commensurability oscillations (CO), with CO in samples S_perp and S_|| dominated by the diffusion and the collisional contributions, respectively. Amplitude modulation of the Shubnikov-de Haas oscillations is observed to be more prominent in sample S_||. The difference between the two samples is washed out with the increase of the microwave power, letting the diffusion contribution govern the CO in both samples. The failure of the intended directional selectivity in the conductivity measured with high microwave power is interpreted in terms of large-angle electron-phonon scattering.Comment: 8 pages, 5 figure

Some Uses and Potentials of Qualitative Methods in Planning

Planners use methods borrowed from many disciplines. These are usually modified and adapted to meet planner's needs to acquire and sift through many diverse information sources helpful in dealing with complex problems. The quantitative methods which planners use are well known, well established in practice, and acknowledged by most as tools of the planners' trade. In contrast to this, most planners also use qualitative methods but these are rarely explicitly acknowledged.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68912/2/10.1177_0739456X8600600110.pd

Monitoring international migration flows in Europe. Towards a statistical data base combining data from different sources

The paper reviews techniques developed in demography, geography and statistics that are useful for bridging the gap between available data on international migration flows and the information required for policy making and research. The basic idea of the paper is as follows: to establish a coherent and consistent data base that contains sufficiently detailed, up-to-date and accurate information, data from several sources should be combined. That raises issues of definition and measurement, and of how to combine data from different origins properly. The issues may be tackled more easily if the statistics that are being compiled are viewed as different outcomes or manifestations of underlying stochastic processes governing migration. The link between the processes and their outcomes is described by models, the parameters of which must be estimated from the available data. That may be done within the context of socio-demographic accounting. The paper discusses the experience of the U.S. Bureau of the Census in combining migration data from several sources. It also summarizes the many efforts in Europe to establish a coherent and consistent data base on international migration. The paper was written at IIASA. It is part of the Migration Estimation Study, which is a collaborative IIASA-University of Groningen project, funded by the Netherlands Organization for Scientific Research (NWO). The project aims at developing techniques to obtain improved estimates of international migration flows by country of origin and country of destination

Fertility, Living Arrangements, Care and Mobility

There are four main interconnecting themes around which the contributions in this book are based. This introductory chapter aims to establish the broad context for the chapters that follow by discussing each of the themes. It does so by setting these themes within the overarching demographic challenge of the twenty-first century – demographic ageing. Each chapter is introduced in the context of the specific theme to which it primarily relates and there is a summary of the data sets used by the contributors to illustrate the wide range of cross-sectional and longitudinal data analysed

Multidisciplinary Collaboration in the Treatment of Patients With Type 2 Diabetes in Primary Care: Analysis Using Process Mining

[EN] Background: Public health in several countries is characterized by a shortage of professionals and a lack of economic resources. Monitoring and redesigning processes can foster the success of health care institutions, enabling them to provide a quality service while simultaneously reducing costs. Process mining, a discipline that extracts knowledge from information system data to analyze operational processes, affords an opportunity to understand health care processes. Objective: Health care processes are highly flexible and multidisciplinary, and health care professionals are able to coordinate in a variety of different ways to treat a diagnosis. The aim of this work was to understand whether the ways in which professionals coordinate their work affect the clinical outcome of patients. Methods: This paper proposes a method based on the use of process mining to identify patterns of collaboration between physician, nurse, and dietitian in the treatment of patients with type 2 diabetes mellitus and to compare these patterns with the clinical evolution of the patients within the context of primary care. Clustering is used as part of the preprocessing of data to manage the variability, and then process mining is used to identify patterns that may arise. Results: The method is applied in three primary health care centers in Santiago, Chile. A total of seven collaboration patterns were identified, which differed primarily in terms of the number of disciplines present, the participation intensity of each discipline, and the referrals between disciplines. The pattern in which the three disciplines participated in the most equitable and comprehensive manner had a lower proportion of highly decompensated patients compared with those patterns in which the three disciplines participated in an unbalanced manner. Conclusions: By discovering which collaboration patterns lead to improved outcomes, health care centers can promote the most successful patterns among their professionals so as to improve the treatment of patients. Process mining techniques are useful for discovering those collaborations patterns in flexible and unstructured health care processes.This paper was partially funded by the National Commission for Scientific and Technological Research, the Formation of Advanced Human Capital Program and the National Fund for Scientific and Technological Development (CONICYT-PCHA/Doctorado Nacional/2016-21161705 and CONICYT-FONDECYT/1150365; Chile). The authors would like to thank Ancora UC primary health care centers for their help with this research. The founding sponsors had no role in the design of the study in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.Conca, T.; Saint Pierre, C.; Herskovic, V.; Sepulveda, M.; Capurro, D.; Prieto, F.; Fernández Llatas, C. (2018). Multidisciplinary Collaboration in the Treatment of Patients With Type 2 Diabetes in Primary Care: Analysis Using Process Mining. JOURNAL OF MEDICAL INTERNET RESEARCH. 20(4). https://doi.org/10.2196/jmir.8884S204Chen, C.-C., Tseng, C.-H., & Cheng, S.-H. (2013). Continuity of Care, Medication Adherence, and Health Care Outcomes Among Patients With Newly Diagnosed Type 2 Diabetes. Medical Care, 51(3), 231-237. doi:10.1097/mlr.0b013e31827da5b9International Diabetes FederationIDF20152018-03-19IDF Diabetes Atlas 7th Edition (2015) https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes-atlas-seventh-edition.htmlMinisterio de Salud de Chileminsal.cl20102018-03-23Encuesta Nacional de Salud ENS Chile 2009-2010 http://www.minsal.cl/estudios_encuestas_salud/Ministerio de Salud de Chileminsal.cl20102018-03-20Guía Clinica Diabetes Mellitus Tipo 2 http://www.minsal.cl/portal/url/item/72213ed52c3e23d1e04001011f011398.pdfSapunar Z., J. (2016). EPIDEMIOLOGÍA DE LA DIABETES MELLITUS EN CHILE. Revista Médica Clínica Las Condes, 27(2), 146-151. doi:10.1016/j.rmclc.2016.04.003World Health Organizationwho.int2018-03-20Global Report on Diabetes http://www.who.int/diabetes/global-report/en/Poblete, F., Glasinovic, A., Sapag, J., Barticevic, N., Arenas, A., & Padilla, O. (2015). 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(2012). The influence of power dynamics and trust on multidisciplinary collaboration: a qualitative case study of type 2 diabetes mellitus. BMC Health Services Research, 12(1). doi:10.1186/1472-6963-12-63Gucciardi, E., Espin, S., Morganti, A., & Dorado, L. (2016). Exploring interprofessional collaboration during the integration of diabetes teams into primary care. BMC Family Practice, 17(1). doi:10.1186/s12875-016-0407-1Caron, F., Vanthienen, J., Vanhaecht, K., Limbergen, E. V., De Weerdt, J., & Baesens, B. (2014). Monitoring care processes in the gynecologic oncology department. Computers in Biology and Medicine, 44, 88-96. doi:10.1016/j.compbiomed.2013.10.015Rothman, A. A., & Wagner, E. H. (2003). Chronic Illness Management: What Is the Role of Primary Care? Annals of Internal Medicine, 138(3), 256. doi:10.7326/0003-4819-138-3-200302040-00034Organisation for Economic Co-operation and DevelopmentOECD20162018-03-20OECD Health Policy Overview: Health Policy in Chile http://www.oecd.org/els/health-systems/health-policy-in-your-country.htmRojas, E., Munoz-Gama, J., Sepúlveda, M., & Capurro, D. (2016). Process mining in healthcare: A literature review. Journal of Biomedical Informatics, 61, 224-236. doi:10.1016/j.jbi.2016.04.007Fernandez-Llatas, C., Lizondo, A., Monton, E., Benedi, J.-M., & Traver, V. (2015). Process Mining Methodology for Health Process Tracking Using Real-Time Indoor Location Systems. Sensors, 15(12), 29821-29840. doi:10.3390/s151229769Mans, R. S., van der Aalst, W. M. P., & Vanwersch, R. J. B. (2015). Process Mining in Healthcare. SpringerBriefs in Business Process Management. doi:10.1007/978-3-319-16071-9Van der Aalst, W. M. P. (2011). 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Childhood sexual trauma and subsequent parenting beliefs and behaviors

Using propensity-matched controls, the present study examines the long-term adjustment of women reporting Childhood Sexual Trauma (CST) at or before the age of 14 in terms of parenting efficacy and parenting behavior. Data for these analyses were obtained from mother reports and from observational protocols from a longitudinal study of low-income, rural families. The novel use of propensity-matched controls to create a control group matched on family of origin variables provides evidence that, when women with CST are compared with the matched comparison women, females who experienced CST show poorer functioning across multiple domains of parenting (sensitivity, harsh intrusiveness, boundary dissolution), but not in parenting efficacy. Follow up moderation analyses suggest that the potential effects of trauma on parenting behaviors are not attenuated by protective factors such as higher income, higher education, or stable adult relationships. Implications for interventions with childhood sexual trauma histories and directions for future study are proposed

Objective and subjective indicators: Effects of scale discordance on interrelationships

Researchers in the social indicator movement are increasingly aware of the value of obtaining both subjective and objective measures. At the same time there is a recognition of the need to understand relationships between the types of measures. Studies utilizing both subjective and objective measures indicate that while relationships between them exist, relationships are often not strong. This paper suggests several explanations for such imperfect relationships. One is scale discordance, a term used to recognize that the territorial base of an individual's subjective evaluation may not coincide with the boundaries of the unites used for the collection of objective data. Using data from a metropolitan area study, relationships between objective measures of crime and respondents' feelings of safety are examined for people whose perceptions of neighborhoods vary in size. The hypothesis that the relationship between the objective and subjective measures is stronger among individuals whose view of neighborhood size is in line with the relatively large territorial base for objective crime statistics is tested and found to be correct. Implications of the findings for research and policy making are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/43701/1/11205_2004_Article_BF00364601.pd