Respiratory muscle training in patients recovering recent open cardio-thoracic surgery: a randomized-controlled trial.

Objectives- To evaluate the clinical efficacy and feasibility of an expiratory muscle training (EMT) device (Respilift™) applied to patients recovering from recent open cardio-thoracic surgery (CTS). Design- Prospective, double-blind, 14-day randomised-controlled trial. Participants and setting- 60 inpatients recovering from recent CTS and early admitted to a pulmonary rehabilitation program. Interventions- Chest physiotherapy plus EMT with a resistive load of 30 cm H2O for active group and chest physiotherapy plus EMT with a sham load for control group. Measures- Changes in maximal expiratory pressure (MEP) was considered as primary outcome, while maximal inspiratory pressures (MIP), dynamic and static lung volumes, oxygenation, perceived symptoms of dyspnoea, thoracic pain and well being (evaluated by visual analogic scale-VAS) and general health status were considered secondary outcomes. Results- All outcomes recorded showed significant improvements in both groups; however, the change of MEP (+34.2 mmHg, p<0.001 and +26.1%, p<0.001 for absolute and % of predicted, respectively) was significantly higher in Active group. Also VAS-dyspnoea improved faster and more significantly (p<0.05) at day 12 and 14 in Active group when compared with Control. The drop out rate was 6%, without differences between groups. Conclusions- In patients recovering from recent CTS specific EMT by Respilift™ is feasible and effective

Nanostructure and strain properties of core-shell GaAs/AlGaAs nanowires

GaAs/AlGaAs core–shell nanowires (NWs) were grown on Si(111) by Ga-assisted molecular beam epitaxy via the vapor–liquid–solid mechanism. High-resolution and scanning transmission electron microscopy observations showed that NWs were predominantly zinc-blende single crystals of hexagonal shape, grown along the [111] direction. GaAs core NWs emerged from the Si surface and subsequently, the NW growth front advanced by a continuous sequence of (111) rotational twins, while the AlGaAs shell lattice was perfectly aligned with the core lattice. Occasionally, single or multiple stacking faults induced wurtzite structure NW pockets. The AlGaAs shell occupied at least half of the NW's projected diameter, while the average Al content of the shell, estimated by energy dispersive x-ray analysis, was x = 0.35. Furthermore, molecular dynamics simulations of hexagonal cross-section NW slices, under a new parametrization of the Tersoff interatomic potential for AlAs, showed increased atom relaxation at the hexagon vertices of the shell. This, in conjunction with the compressively strained Al0.35Ga0.65As shell close to the GaAs core, can trigger a kinetic surface mechanism that could drive Al adatoms to accumulate at the relaxed sites of the shell, namely along the diagonals of the shell's hexagon. Moreover, the absence of long-range stresses in the GaAs/Al0.35Ga0.65As core–shell system may account for a highly stable heterostructure. The latter was consolidated by temperature-dependent photoluminescence spectroscopy

Accountability, Strategy, and International Non-Governmental Organizations

Increased prominence and greater influence expose international non-governmental development and environmental organizations (INGOs) to increased demands for accountability from a wide variety of stakeholdersdonors, beneficiaries, staffs, and partners among others. This paper focuses on developing the concept of INGO accountability, first as an abstract concept and then as a strategic idea with very different implications for different INGO strategies. We examine those implications for INGOs that emphasize service delivery, capacity-building, and policy influence. We propose that INGOs committed to service delivery may owe more accountability to donors and service regulators; capacity-building INGOs may be particularly obligated to clients whose capacities are being enhanced; and policy influence INGOs may be especially accountable to political constituencies and to influence targets. INGOs that are expanding their activities to include new initiatives may need to reorganize their accountability systems to implement their strategies effectively. This publication is Hauser Center Working Paper No. 7. The Hauser Center Working Paper Series was launched during the summer of 2000. The Series enables the Hauser Center to share with a broad audience important works-in-progress written by Hauser Center scholars and researchers

Hypertrophy of mature xenopus muscle fibres in culture induced by synergy of albumin and insulin

The aim of this study was to investigate effects of albumin and insulin separately as well as in combination on mature muscle fibres during long-term culture. Single muscle fibres were dissected from m. iliofibularis of Xenopus laevis and attached to a force transducer in a culture chamber. Fibres were cultured in a serum-free medium at slack length (mean sarcomere length 2.3 μm) for 8 to 22 days. The medium was supplemented with (final concentrations): (1) bovine insulin (6 nmol/L or 200-600 nmol/L), (2) 0.2% bovine albumin or (3) 0.2% bovine albumin in combination with insulin (120 nmol/L). In culture medium with insulin, 50% of the muscle fibres became in-excitable within 7-12 days, whereas the other 50% were stable. Caffeine contractures of in-excitable muscle fibres produced 80.4±2.4% of initial peak tetanic force, indicating impaired excitation-contraction (E-C) coupling in in-excitable fibres. In the presence of albumin, all cultured muscle fibres were stable for at least 10 days. Muscle fibres cultured in medium with insulin or albumin exclusively did not hypertrophy or change the number of sarcomeres in series. In contrast, muscle fibres cultured with both albumin and insulin showed an increase in tetanic force and fibre cross-sectional area of 19.6±2.8% and 32.5±4.9%, respectively, (means±SEM.; P=0.007) after 16.3±1.7 days, whereas the number of sarcomeres in series remained unchanged. We conclude that albumin prevents muscle fibre damage and preserves E-C coupling in culture. Furthermore, albumin is important in regulating muscle fibre adaptation by a synergistic action with growth factors like insulin. © 2008 The Author(s)

Decarbonisation and its discontents: a critical energy justice perspective on four low-carbon transitions

Low carbon transitions are often assumed as normative goods, because they supposedly reduce carbon emissions, yet without vigilance there is evidence that they can in fact create new injustices and vulnerabilities, while also failing to address pre-existing structural drivers of injustice in energy markets and the wider socio-economy. With this in mind, we examine four European low-carbon transitions from an unusual normative perspective: that of energy justice. Because a multitude of studies looks at the co-benefits renewable energy, low-carbon mobility, or climate change mitigation, we instead ask in this paper: what are the types of injustices associated with low-carbon transitions? Relatedly, in what ways do low-carbon transitions worsen social risks or vulnerabilities? Lastly, what policies might be deployed to make these transitions more just? We answer these questions by first elaborating an “energy justice” framework consisting of four distinct dimensions—distributive justice (costs and benefits), procedural justice (due process), cosmopolitan justice (global externalities), and recognition justice (vulnerable groups). We then examine four European low-carbon transitions—nuclear power in France, smart meters in Great Britain, electric vehicles in Norway, and solar energy in Germany—through this critical justice lens. In doing so, we draw from original data collected from 64 semi-structured interviews with expert partisans as well as five public focus groups and the monitoring of twelve internet forums. We document 120 distinct energy injustices across these four transitions, including 19 commonly recurring injustices. We aim to show how when low-carbon transitions unfold, deeper injustices related to equity, distribution, and fairness invariably arise

No more secrets?: Policy implications of commercial remote sensing satellites

This paper was originally written for the conference on "No More Secrets? Policy Implications of Commercial Remote Sensing Satellites," held at the Carnegie Endowment on May 26, 1999.</p

Understanding non-governmental organizations in world politics: the promise and pitfalls of the early ‘science of internationalism’

The years immediately preceding the First World War witnessed the development of a significant body of literature claiming to establish a ‘science of internationalism’. This article draws attention to the importance of this literature, especially in relation to understanding the roles of non-governmental organizations in world politics. It elaborates the ways in which this literature sheds light on issues that have become central to twenty-first century debates, including the characteristics, influence, and legitimacy of non-governmental organizations in international relations. Amongst the principal authors discussed in the article are Paul Otlet, Henri La Fontaine and Alfred Fried, whose role in the development of international theory has previously received insufficient attention. The article concludes with evaluation of potential lessons to be drawn from the experience of the early twentieth century ‘science of internationalism’

C1-Ten Is a Protein Tyrosine Phosphatase of Insulin Receptor Substrate 1 (IRS-1), Regulating IRS-1 Stability and Muscle Atrophy

Muscle atrophy occurs under various catabolic conditions, including insulin deficiency, insulin resistance, or increased levels of glucocorticoids. This results from reduced levels of insulin receptor substrate 1 (IRS-1), leading to decreased phosphatidylinositol 3-kinase activity and thereby activation of FoxO transcription factors. However, the precise mechanism of reduced IRS-1 under a catabolic condition is unknown. Here, we report that C1-Ten is a novel protein tyrosine phosphatase (PTPase) of IRS-1 that acts as a mediator to reduce IRS-1 under a catabolic condition, resulting in muscle atrophy. C1-Ten preferentially dephosphorylated Y612 of IRS-1, which accelerated IRS-1 degradation. These findings suggest a novel type of IRS-1 degradation mechanism which is dependent on C1-Ten and extends our understanding of the molecular mechanism of muscle atrophy under catabolic conditions. C1-Ten expression is increased by catabolic glucocorticoid and decreased by anabolic insulin. Reflecting these hormonal regulations, the muscle C1-Ten is upregulated in atrophy but downregulated in hypertrophy. This reveals a previously unidentified role of C1-Ten as a relevant PTPase contributing to skeletal muscle atrophy.open2

The Concept of Transparency in International Relations: towards a critical approach

Transparency is an important concept in International Relations. The possibility of realizing transparency in practice operates as a central analytical axis defining distinct positions on core theoretical problems within the field, from the security dilemma to the function of international institutions and beyond. As a political practice the pursuit of transparent governance is a dominant feature of global politics, promoted by a wide range of actors across a vast range of issue areas, from nuclear proliferation to Internet governance to the politics of foreign aid. Yet, despite its importance, precisely what transparency means or how the concept is understood is frequently ill-defined by academics and policy-makers alike. As a result, the epistemological and ontological underpinnings of approaches to transparency in IR often sit in tension with their wider theoretical commitments. This article will examine the three primary understandings of transparency used in IR in order to unpack these commitments. It finds that while transparency is often explicitly conceptualized as a property of information, particularly within rationalist scholarship, this understanding rests upon an unarticulated set of sociological assumptions. This analysis suggests that conceptualizing ‘transparency-as-information’ without a wider sociology of knowledge production is highly problematic, potentially obscuring our ability to recognize transparent practices in global governance. Understanding transparency as dialogue, as a social practice rooted in shared cognitive capacities and epistemic frameworks, provides a firmer analytical ground from which to examine transparency in International Relations

Changes in clinical characteristics and outcomes of patients admitted to inpatient cardiac rehabilitation

Aims: Cardiac rehabilitation (CR) have proven to be effective and beneficial in middle-aged and older patients. However, solid data in large cohorts of elderly individuals are yet to be explored. This retrospective study investigated the general characteristics, outcomes, and the level of re-sponse of patients referred to CR over 13 consecutive years. Methods: We reviewed the medical records of patients admitted to Villa Pineta Rehabilitation Hospital for exercise-based CR from 2006 to 2018. Patients’ baseline characteristics and changes following CR in upper limb weight-lifting test (ULW), 30-second sit-to-stand test (30STS), and the 6-minute walking test (6MWT) with associated Borg-related dyspnea (D) and fatigue (F) were collected. We also calculated the number of individuals reaching the minimal clinically relevant change (MCRC) following CR for each outcome. Results: 1551 patients (70.2 ± 9.7 years, 66% men) with complete data set were in-cluded in the analysis. Coronary artery bypass graft and cardiac valve replacement surgery were the most frequent surgical procedures leading to CR referral (41.1% and 35.8%, respectively). The patients’ age (p = 0.03), number of total comorbidities (p &lt; 0.0001), and post-surgical complica-tions (p = 0.02) significantly increased over time. In contrast, the average absolute changes in ULW, 30STS and 6MWT with associated D and F, and the proportion of patients reaching the re-spective MCRC, remained constant over the same period. Conclusion: Patients admitted to exer-cise-based CR were older and had more comorbidities and complications over time. Outcomes, however, were not influenced in terms of absolute change nor clinically meaningful response