Educating Health Professionals about Disability: A Review of Interventions

Health professionals need to understand the human rights and health needs of disabled people. This review of evidence on interventions demonstrates that a range of often innovative approaches have been trialled. Lectures by faculty are less effective in changing attitudes than contact with disabled people themselves. Existing examples of good practice need to be scaled up, and better and more long-term evaluations of impact are required

Long-term multi-source precipitation estimation with high resolution (RainGRS Clim)

This paper explores the possibility of using multi-source precipitation estimates for climatological applications. A data-processing algorithm (RainGRS Clim) has been developed to work on precipitation accumulations such as daily or monthly totals, which are significantly longer than operational accumulations (generally between 5 min and 1 h). The algorithm makes the most of additional opportunities, such as the possibility of complementing data with delayed data, access to high-quality data that are not operationally available, and the greater efficiency of the algorithms for data quality control and merging with longer accumulations. Verification of the developed algorithms was carried out using monthly accumulations through comparison with precipitation from manual rain gauges. As a result, monthly accumulations estimated by RainGRS Clim were found to be significantly more reliable than accumulations generated operationally. This improvement is particularly noticeable for the winter months, when precipitation estimation is much more difficult due to less reliable radar estimates.</p

26 Efekty uboczne kompleksowej raodioterapii u chorych na nowotwory narządów płciowych

Radioterapia jest jedną z podstawowych metod leczenia onkologicznego w raku szyjki i błony śluzowej macicy. Ze względu na różną radiowrażliwość narządów miednicy mniejszej autorzy pracy zwrócili szczególną uwagę na ewentualną obecność objawów uszkodzenia przewodu pokarmowego, układu moczowego i szpiku kostnego.W okresie 1998–2000 w Klinice Ginekologii Operacyjnej poddano obserwacji 40 chorych poddanych kompleksowej radioterapii. Wszystkie pacjentki w trakcie teleterapii otrzymały całkowitą dawkę 28 Gy na guz w okresie 4 tygodni oraz poddane zostały brachyterapii. W zależności od stopnia zaawansowania klinicznego nowotworu zastosowano:-u 25 chorych ze stopniem klinicznym nowotworu I i II – brachyterapię dopochwową w dawce 24 Gy (w 3 cotygodniowych frakcjach);-u 15 chorych ze stopniem zaawansowania II, III i IV – brachyterapię domaciczną w dawce 40 Gy (w 5 cotygodniowych frakcjach).Brachyterapię stosowano za pomocą microSelectronu HDR firmy Nucletron z użyciem żródła irydowego Ir192 z nominalną aktywnością 10 Ci (370GBq).Zaobserwowano:[[tgroup cols="3"]][[colspec colname="col1"/]][[colspec colname="col2"/]][[colspec colname="col3"/]][[tbody]][[row]][[entry align="left"]]1. Objawy uszkodzenia przewodu pokarmowego:[[/entry]][[entry align="left"]]nudności i wymioty[[/entry]][[entry align="left"]]− 4(10%)[[/entry]][[/row]][[row]][[entry/]][[entry align="left"]]biegunka[[/entry]][[entry align="left"]]− 6(15%)[[/entry]][[/row]][[row]][[entry align="left"]]2. Objawy podrażnienia układu moczowego (objawy dyzuryczne + zmiany w badaniu ogó1nym moczu):[[/entry]][[entry/]][[entry align="left"]]− 22 (55%)[[/entry]][[/row]][[row]][[entry align="left"]]3. Objawy uszkodzenia szpiku kostnego:[[/entry]][[entry align="left"]]niedokrwistość :[[/entry]][[entry align="left"]]− 3 (7,5%)[[/entry]][[/row]][[row]][[entry/]][[entry align="left"]]leukopenia:[[/entry]][[entry align="left"]]− 9 (22,5%)[[/entry]][[/row]][[/tbody]][[/tgroup]]Uzyskane wyniki potwierdzają względnie niski odsetek notowanych powikłań. Jest to dowodem na to, że tylko właściwa ocena kliniczna i prawidłowo prowadzona dozymetria przy kompleksowej radioterapii umożliwiają minimalizację objawów ubocznych

Coxsackievirus-Induced Proteomic Alterations in Primary Human Islets Provide Insights for the Etiology of Diabetes

Enteroviral infections have been associated with the development of type 1 diabetes (T1D), a chronic inflammatory disease characterized by autoimmune destruction of insulin-producing pancreatic beta cells. Cultured human islets, including the insulin-producing beta cells, can be infected with coxsackievirus B4 (CVB4) and thus are useful for understanding cellular responses to infection. We performed quantitative mass spectrometry analysis on cultured primary human islets infected with CVB4 to identify molecules and pathways altered upon infection. Corresponding uninfected controls were included in the study for comparative protein expression analyses. Proteins were significantly and differentially regulated in human islets challenged with virus compared with their uninfected counterparts. Complementary analyses of gene transcripts in CVB4-infected primary islets over a time course validated the induction of RNA transcripts for many of the proteins that were increased in the proteomics studies. Notably, infection with CVB4 results in a considerable decrease in insulin. Genes/proteins modulated during CVB4 infection also include those involved in activation of immune responses, including type I interferon pathways linked to T1D pathogenesis and with antiviral, cell repair, and inflammatory properties. Our study applies proteomics analyses to cultured human islets challenged with virus and identifies target proteins that could be useful in T1D interventions

Component-level residential building material stock characterization using computer vision techniques

Residential building material stock constitutes a significant part of the built environment, providing crucial shelter and habitat services. The hypothesis concerning stock mass and composition has garnered considerable attention over the past decade. While previous research has mainly focused on the spatial analysis of building masses, it often neglected the component-level stock analysis or where heavy labor cost for onsite survey is required. This paper presents a novel approach for efficient component-level residential building stock accounting in the United Kingdom, utilizing drive-by street view images and building footprint data. We assessed four major construction materials: brick, stone, mortar, and glass. Compared to traditional approaches that utilize surveyed material intensity data, the developed method employs automatically extracted physical dimensions of building components incorporating predicted material types to calculate material mass. This not only improves efficiency but also enhances accuracy in managing the heterogeneity of building structures. The results revealed error rates of 5 and 22% for mortar and glass mass estimations and 8 and 7% for brick and stone mass estimations, with known wall types. These findings represent significant advancements in building material stock characterization and suggest that our approach has considerable potential for further research and practical applications. Especially, our method establishes a basis for evaluating the potential of component-level material reuse, serving the objectives of a circular economy

Semiresorbable biologic hybrid meshes for ventral abdominal hernia repair in potentially contaminated settings: lower risk of recurrence

In case of potential contamination, implantation of synthetic meshes in hernia and abdominal wall surgery is problematic due to a higher risk of mesh infection. As an alternative, a variety of different biologic meshes have been used. However, relevant data comparing outcome after implantation of these meshes are lacking. Between January 2012 and October 2021, biologic meshes were used for reconstruction of the abdominal wall in 71 patients with preoperative or intraoperative abdominal contamination. In this retrospective study, semiresorbable biologic hybrid meshes (BHM) and completely resorbable meshes (CRM) were compared and analyzed using a Castor EDC database. In 28 patients, semiresorbable biologic hybrid meshes were used; in 43 patients, completely resorbable meshes were used. Both groups showed no difference in age, gender, BMI, operation duration, hernia size and Charlson comorbidity index. The risk degree of surgical-site occurrences was graded according to the Ventral Hernia Working Group (VHWG) classification, and the median value was 3 (range 2–4) in the BHM group and 3 (range 2–4) in the CRM group. Hernia recurrence within 24 months after hernia repair was significantly lower in the BHM group (3.6% vs. 28.9%; p = 0.03), while postoperative complication rate, with respect to seromas in need of therapy (61.4% vs. 55.5%, p = 0.43) and operative revision (28.6% vs. 16.3%, p = 0.22) was not different in either group. Biologic hybrid meshes can be used safely in case of possible contamination. BHM seems to reduce the risk of hernia recurrence compared to completely resorbable biologic meshes, but this has to be investigated further

Nuclear factor κB-inducing kinase activation as a mechanism of pancreatic β cell failure in obesity

The nuclear factor κB (NF-κB) pathway is a master regulator of inflammatory processes and is implicated in insulin resistance and pancreatic β cell dysfunction in the metabolic syndrome. Whereas canonical NF-κB signaling is well studied, there is little information on the divergent noncanonical NF-κB pathway in the context of pancreatic islet dysfunction. Here, we demonstrate that pharmacological activation of the noncanonical NF-κB-inducing kinase (NIK) disrupts glucose homeostasis in zebrafish in vivo. We identify NIK as a critical negative regulator of β cell function, as pharmacological NIK activation results in impaired glucose-stimulated insulin secretion in mouse and human islets. NIK levels are elevated in pancreatic islets isolated from diet-induced obese (DIO) mice, which exhibit increased processing of noncanonical NF-κB components p100 to p52, and accumulation of RelB. TNF and receptor activator of NF-κB ligand (RANKL), two ligands associated with diabetes, induce NIK in islets. Mice with constitutive β cell-intrinsic NIK activation present impaired insulin secretion with DIO. NIK activation triggers the noncanonical NF-κB transcriptional network to induce genes identified in human type 2 diabetes genome-wide association studies linked to β cell failure. These studies reveal that NIK contributes a central mechanism for β cell failure in diet-induced obesity

Deficiency in origin licensing proteins impairs cilia formation: implications for the aetiology of meier-gorlin syndrome

Mutations in ORC1, ORC4, ORC6, CDT1, and CDC6, which encode proteins required for DNA replication origin licensing, cause Meier-Gorlin syndrome (MGS), a disorder conferring microcephaly, primordial dwarfism, underdeveloped ears, and skeletal abnormalities. Mutations in ATR, which also functions during replication, can cause Seckel syndrome, a clinically related disorder. These findings suggest that impaired DNA replication could underlie the developmental defects characteristic of these disorders. Here, we show that although origin licensing capacity is impaired in all patient cells with mutations in origin licensing component proteins, this does not correlate with the rate of progression through S phase. Thus, the replicative capacity in MGS patient cells does not correlate with clinical manifestation. However, ORC1-deficient cells from MGS patients and siRNA-mediated depletion of origin licensing proteins also have impaired centrosome and centriole copy number. As a novel and unexpected finding, we show that they also display a striking defect in the rate of formation of primary cilia. We demonstrate that this impacts sonic hedgehog signalling in ORC1-deficient primary fibroblasts. Additionally, reduced growth factor-dependent signaling via primary cilia affects the kinetics of cell cycle progression following cell cycle exit and re-entry, highlighting an unexpected mechanism whereby origin licensing components can influence cell cycle progression. Finally, using a cell-based model, we show that defects in cilia function impair chondroinduction. Our findings raise the possibility that a reduced efficiency in forming cilia could contribute to the clinical features of MGS, particularly the bone development abnormalities, and could provide a new dimension for considering developmental impacts of licensing deficiency