Implementation of geriatric assessment and decision support in residential care homes: facilitating and impeding factors.

Background: Successfully introducing and maintaining care innovations may depend on the interplay between care setting, the intervention and specific circumstances. We studied the factors influencing the introduction and maintenance of a Multidisciplinary Integrated Care model in 10 Dutch residential care homes. Methods. Facilitating and impeding factors were studied and compared at the time of introduction of the interRAI-LTCF assessment method in residential care homes as well as three years later, by surveys and semi structured interviews among nurse staff, managers, and physicians. Results: Facilitating factors at introduction were positive opinions of staff and family physicians about the changes of the process of care and the anticipated improvement of quality of care. Staff was positive about the applicability of the software to support the interRAI-LTCF assessments. Impeding factors were time constraints to complete interRAI-LTCF assessments and insufficient computer equipment.In the maintenance phase, the positive attitude of the location manager and the perceived benefits of the care model and the interRAI-LTCF assessment method were most important. Impeding factors after 3 years remained the lack of time to complete the assessments and lack of sufficient computer equipment. Conclusions: Impeding and facilitating factors were comparable in the initial and maintenance phase. Adoption of the interRAI-LTCF assessment method depended on positive opinions of staff and management, continuing support of staff and the availability of sufficient computer equipment. © 2013 Boorsma et al.; licensee BioMed Central Ltd

Overview of RS-25 Adaptation Hot-Fire Test Series for SLS, Status and Lessons Learned

No abstract availabl

Cytokinin response factors regulate PIN-FORMED auxin transporters

Auxin and cytokinin are key endogenous regulators of plant development. Although cytokinin-mediated modulation of auxin distribution is a developmentally crucial hormonal interaction, its molecular basis is largely unknown. Here we show a direct regulatory link between cytokinin signalling and the auxin transport machinery uncovering a mechanistic framework for cytokinin-auxin cross-talk. We show that the CYTOKININ RESPONSE FACTORS (CRFs), transcription factors downstream of cytokinin perception, transcriptionally control genes encoding PIN-FORMED (PIN) auxin transporters at a specific PIN CYTOKININ RESPONSE ELEMENT (PCRE) domain. Removal of this cis-regulatory element effectively uncouples PIN transcription from the CRF-mediated cytokinin regulation and attenuates plant cytokinin sensitivity. We propose that CRFs represent a missing cross-talk component that fine-tunes auxin transport capacity downstream of cytokinin signalling to control plant development

Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study

A B S T R A C T The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60-85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45 • fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities. A computer-assisted method was used to measure retinal vessel diameters. Total plasma homocysteine was inversely associated with retinal arteriolar diameters {standardized β, − 0.20 [95 % CI (confidence interval), − 0.33 to − 0.07]} or a decrease of 3.78 μm CRAEs (central retinal arteriolar equivalents) per 1 S.D. increase in homocysteine level (= 4.6 μmol/l). In addition, the SAM/SAH ratio in plasma was inversely associated with retinal sclerotic vessel abnormalities and retinopathy [odds ratios, 0.61 (95 % CI, 0.39-0.96) and 0.50 (95 % CI, 0.30-0.83) per 1 S.D. respectively]. The associations were independent of age, sex, glucose tolerance status, other homocysteine metabolism components and cardiovascular risk factors. In conclusion, the results of the present study support the concept that total plasma homocysteine and a low SAM/SAH ratio in plasma, which may reflect reduced transmethylation reactions, may contribute to the pathogenesis of (retinal) microangiopathy

Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study

The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60-85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45° fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities. A computer-assisted method was used to measure retinal vessel diameters. Total plasma homocysteine was inversely associated with retinal arteriolar diameters {standardized β, -0.20 [95% CI (confidence interval), -0.33 to - 0.07]} or a decrease of 3.78 μm CRAEs (central retinal arteriolar equivalents) per 1 S.D. increase in homocysteine level (= 4.6 μmol/l). In addition, the SAM/SAH ratio in plasma was inversely associated with retinal sclerotic vessel abnormalities and retinopathy [odds ratios, 0.61 (95% CI, 0.39-0.96) and 0.50 (95% CI, 0.30-0.83) per 1 S.D. respectively]. The associations were independent of age, sex, glucose tolerance status, other homocysteine metabolism components and cardiovascular risk factors. In conclusion, the results of the present study support the concept that total plasma homocysteine and a low SAM/SAH ratio in plasma, which may reflect reduced transmethylation reactions, may contribute to the pathogenesis of (retinal) microangiopathy. © The Authors

Molecular Layer Deposition of Zeolitic Imidazolate Framework‑8 Films [Dataset]

24 pages. -- Methods. -- Summary of some of the reported vapor-phase processes for the layer-by-layer deposition of MOFs6. -- Synchrotron GIXRD reciprocal space maps of direct ZIF-8 MLD show crystallinity even at a very low number of cycles. -- Vapor pressure determination of 2-methylimidazole (HmIM) via thermogravimetry: Knudsen effusion method. -- Direct ZIF-8 MLD linker exposure times. -- Direct ZIF-8 MLD films on Si are pinhole-free. -- AFM image of a MOF-CVD ZIF-8 “layer”, i.e., scattered crystallites. -- Photograph of a 200 mm wafer with 30 MLD ZIF-8 cycles and the corresponding 100-point ellipsometry thickness mapping. -- Film characterization of direct ZIF-8 MLD with a missing water pulse. -- Effect of no water pulses in direct ZIF-8 MLD. -- Direct ZIF-8 MLD with water completely or partially substituted by methanol. -- Humidified conditions HmIM post-deposition treatment of direct ZIF-8 MLD. -- HAXPES survey scans. -- HAXPES peak fitting. -- Study of aging effect due to exposure to atmospheric gasses. -- Direct ZIF-8 MLD on (100) oriented supercrystals. -- ZIF-67 crystals powder characterization. -- SEM images ZIF-67. -- Direct ZIF-8 MLD schematic representation of the protocol. -- Two-step ZIF-8 MLD schematic representation of the protocol. -- The optimized temperature gradient in the MOF-MLD reactor. -- MOF-MLD optimization of the temperature gradient. -- Ellipsometry of HmIM post-deposition treatment and activation in two-step ZIF-8 MLD. -- Ellipsometric porosimetry as a function of time. -- Supporting Information References.Vapor-phase film deposition of metal–organic frameworks (MOFs) would facilitate the integration of these materials into electronic devices. We studied the vapor-phase layer-by-layer deposition of zeolitic imidazolate framework 8 (ZIF-8) by consecutive, self-saturating reactions of diethyl zinc, water, and 2-methylimidazole on a substrate. Two approaches were compared: (1) Direct ZIF-8 “molecular layer deposition” (MLD), which enables a nanometer-resolution thickness control and employs only self-saturating reactions, resulting in smooth films that are crystalline as-deposited, and (2) two-step ZIF-8 MLD, in which crystallization occurs during a postdeposition treatment with additional linker vapor. The latter approach resulted in a reduced deposition time and an improved MOF quality, i.e., increased crystallinity and probe molecule uptake, although the smoothness and thickness control were partially lost. Both approaches were developed in a modified atomic layer deposition reactor to ensure cleanroom compatibility.Peer reviewe

Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium

Source at http://doi.org/10.1371/journal.pone.0170791Background:Vitamin D deficiency may be a risk factor for mortality but previous meta-analyses lacked standardization of laboratory methods for 25-hydroxyvitamin D (25[OH]D) concentrations and used aggregate data instead of individual participant data (IPD). We therefore performed an IPD meta-analysis on the association between standardized serum 25(OH)D and mortality.Methods:In a European consortium of eight prospective studies, including seven general population cohorts, we used the Vitamin D Standardization Program (VDSP) protocols to standardize 25(OH)D data. Meta-analyses using a one step procedure on IPD were performed to study associations of 25(OH)D with all-cause mortality as the primary outcome, and with cardiovascular and cancer mortality as secondary outcomes. This meta-analysis is registered at ClinicalTrials.gov, number NCT02438488.Findings:We analysed 26916 study participants (median age 61.6 years, 58% females) with a median 25(OH)D concentration of 53.8 nmol/L. During a median follow-up time of 10.5 years, 6802 persons died. Compared to participants with 25(OH)D concentrations of 75 to 99.99 nmol/L, the adjusted hazard ratios (with 95% confidence interval) for mortality in the 25(OH)D groups with 40 to 49.99, 30 to 39.99, and Interpretation:In the first IPD meta-analysis using standardized measurements of 25(OH)D we observed an association between low 25(OH)D and increased risk of all-cause mortality. It is of public health interest to evaluate whether treatment of vitamin D deficiency prevents premature deaths

Activity-based protein profiling reveals off-target proteins of the FAAH inhibitor BIA 10-2474

A recent phase 1 trial of the fatty acid amide hydrolase (FAAH) inhibitor BIA 10-2474 led to the death of one volunteer and produced mild-to-severe neurological symptoms in four others. Although the cause of the clinical neurotoxicity is unknown, it has been postulated, given the clinical safety profile of other tested FAAH inhibitors, that off-target activities of BIA 10-2474 may have played a role. Here we use activity-based proteomicmethods to determine the protein interaction landscape of BIA 10-2474 in human cells and tissues. This analysis revealed that the drug inhibits several lipases that are not targeted by PF04457845, a highly selective and clinically tested FAAH inhibitor. BIA 10-2474, but not PF04457845, produced substantial alterations in lipid networks in human cortical neurons, suggesting that promiscuous lipase inhibitors have the potential to cause metabolic dysregulation in the nervous system

Analysing the impact of alternative network structures on resource-constrained schedules: Artificial and empirical experiments

In this research, we investigate an extension of the resource-constrained project scheduling problem (RCPSP) with alternatives in the project structure, the so-called RCPSP with alternative subgraphs (RCPSP-AS). The RCPSP-AS consists of a selection subproblem to decide amongst the alternatives in the project structure and a scheduling subproblem to schedule the selected activities in the resulting project structure. In case of a high number of alternatives, however, the selection subproblem might become very complex. In this research, we therefore present a two-step procedure to reduce the complexity of the selection subproblem of the RCPSP-AS. First, we construct a set of high-quality schedules and, subsequently, we analyse the selected alternatives in this set of schedules. Based on two thresholds, defined as the schedule diversity and choice frequency thresholds, we aim at reducing the number of alternatives in the problem. In doing so, the selection subproblem becomes easier to solve thanks to the lower number of alternatives to choose from, and consequently, the solution procedure to solve the RCPSP-AS should now focus on the scheduling subproblem. However, the computational experiments show that both thresholds should be set with care since the low complexity of the selection subproblem might result in some side effects. More precisely, we investigate the impact of both thresholds on the quality of the final schedule as they impact the stop criterion and the size of the neighbourhood in a solution procedure. We have developed our approach based on empirical case studies and validated the results on a large set of artificial projects.We acknowledge the support provided by the Nationale Bank van Belgie (NBB) and the Bijzonder Onderzoeksfonds (BOF) for the project, under contract number BOF12GOA021

Zorgen dat het werkt. : Werkzame factoren in de zorg voor jeugd

Evidence based werken in de zorg voor jeugd? Prima! Maar wat doen we met vragen als: - In wiens handen werken interventies; wat kenmerkt effectieve professionals? - Wat is de invloed van de werkalliantie van professionals en cliënten? - Waarom werken interventies, en onder welke condities? -Hoe kunnen we steunfactoren benutten in de leefomgeving van jeugdigen en opvoeders? - Wat betekent dit alles voor de manier waarop we hulp moeten organiseren en beroepskrachten moeten opleiden? Vijf bijdragen maken dit boek waardevol voor jeugdzorgprofessionals en studenten. Vijf auteurs die thuis zijn in veld en wetenschap laten hun licht schijnen over: - De samenhang tussen werkzame factoren, met nadruk op kenmerken van effectieve professionals en het belang van cliënt-hulpverlener-alliantie (Huub Pijnenburg) - Vernieuwende opvattingen over inrichting van contextuele jeugdzorg en niet-vrijblijvende samenwerking bij complexe hulpvragen (Jo Hermanns) - Mogelijkheden voor effectiviteitsverbetering, waaronder aandacht voor implementatie van effectieve interventies (Tom van Yperen) - Recente ontwikkelingen in het denken over evidence based practice en de zoektocht naar een werkzame alliantie tussen praktijk en wetenschap (Giel Hutschemaekers) - De samenhang tussen een integrale visie op jeugdzorg, belangen van overheden, en dimensies in werk en opleiding van beroepskrachten (Adri van Montfoort) De eerste bijdrage is een bewerking van de intreerede van Huub Pijnenburg bij de aanvaarding van zijn lectoraat Werkzame Factoren in de Zorg voor Jeugd aan de Hogeschool van Arnhem en Nijmegen. Dit lectoraat zoekt samen met de praktijk naar antwoorden op vragen over werkzaamheid van zorg voor jeugd, en wat dit betekent voor beroepskrachten en instellingen. De factoren die de werkzaamheid van de psychosociale zorg voor jeugd beïnvloeden, laten zich kennen als een bonte familie. Meer kennis over de leden van deze familie en hun onderlinge band zal de werkzaamheid van de jeugdzorg vergroten. Want dat is en blijft de grote uitdaging: zorgen dat het werkt