Implementation of a patient-assisted teledermatology model in the Veteran Health Administration

Owing to the inherently visual nature of the field of dermatology, advances in imaging and communication technology have resulted in wide-spread application of teledermatology since its introduction in the mid-1990s. In the last 20 years, studies have repetitively shown that teledermatology provides effective and efficient quality care for patients. It also increases access to underserved patients and reduces traveling costs, wait times, and unnecessary referrals. In this letter the authors seek to analyze implementation of a direct patient to dermatologist model in a Veteran Health Administration (VHA) patient population, referred to as patient-assisted teledermatology. This population is largely over the age of 65 and a significant portion are either without internet or have the minimum technology necessary to participate in the studied model. Owing to these observations and personal experiences, the authors found the implementation process of a patient-assisted model to be challenging in this population

Self-monitoring of Blood Glucose in Black Caribbean and South Asian Canadians with Non-insulin Treated Type 2 Diabetes Mellitus: A Qualitative Study of Patients’ Perspectives.

Abstract Background:To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus. Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis. Results: The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficialto their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients. Conclusion:While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others

Games for a new climate: experiencing the complexity of future risks

This repository item contains a single issue of the Pardee Center Task Force Reports, a publication series that began publishing in 2009 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future.This report is a product of the Pardee Center Task Force on Games for a New Climate, which met at Pardee House at Boston University in March 2012. The 12-member Task Force was convened on behalf of the Pardee Center by Visiting Research Fellow Pablo Suarez in collaboration with the Red Cross/Red Crescent Climate Centre to “explore the potential of participatory, game-based processes for accelerating learning, fostering dialogue, and promoting action through real-world decisions affecting the longer-range future, with an emphasis on humanitarian and development work, particularly involving climate risk management.” Compiled and edited by Janot Mendler de Suarez, Pablo Suarez and Carina Bachofen, the report includes contributions from all of the Task Force members and provides a detailed exploration of the current and potential ways in which games can be used to help a variety of stakeholders – including subsistence farmers, humanitarian workers, scientists, policymakers, and donors – to both understand and experience the difficulty and risks involved related to decision-making in a complex and uncertain future. The dozen Task Force experts who contributed to the report represent academic institutions, humanitarian organization, other non-governmental organizations, and game design firms with backgrounds ranging from climate modeling and anthropology to community-level disaster management and national and global policymaking as well as game design.Red Cross/Red Crescent Climate Centr

Mitotic activity of survivin is regulated by acetylation at K129

Survivin is a cancer-associated protein regulated by multiple factors, including acetylation at K129 within its C-terminal alpha-helical tail. Acetylation of survivin is being pursued as a potential prognostic marker in breast cancer. This modification at K129 may cause nuclear accumulation of survivin in interphase cells; however, whether this affects its essential role during mitosis has not been addressed. We posited whether mimicking acetylation of survivin at K129 alters its activity during mitosis. Fluorescence microscopy and time-lapse imaging showed that, mutating this site to an alanine to act as a constitutive acetyl mimetic, K129A, causes defects in chromosome segregation and cytokinesis. As a non-acetylatable version, K129R, also has difficulty during mitotic exit, we conclude that cyclical acetylation and deacetylation is required for fully functional survivin during mitosis

Symptoms associated with victimization in patients with schizophrenia and related disorders

Background: Patients with psychoses have an increased risk of becoming victims of violence. Previous studies have suggested that higher symptom levels are associated with a raised risk of becoming a victim of physical violence. There has been, however, no evidence on the type of symptoms that are linked with an increased risk of recent victimization. Methods: Data was taken from two studies on involuntarily admitted patients, one national study in England and an international one in six other European countries. In the week following admission, trained interviewers asked patients whether they had been victims of physical violence in the year prior to admission, and assessed symptoms on the Brief Psychiatric Rating Scale (BPRS). Only patients with a diagnosis of schizophrenia or related disorders (ICD-10 F20–29) were included in the analysis which was conducted separately for the two samples. Symptom levels assessed on the BPRS subscales were tested as predictors of victimization. Univariable and multivariable logistic regression models were fitted to estimate adjusted odds ratios. Results: Data from 383 patients in the English sample and 543 patients in the European sample was analysed. Rates of victimization were 37.8% and 28.0% respectively. In multivariable models, the BPRS manic subscale was significantly associated with victimization in both samples. Conclusions: Higher levels of manic symptoms indicate a raised risk of being a victim of violence in involuntary patients with schizophrenia and related disorders. This might be explained by higher activity levels, impaired judgement or poorer self-control in patients with manic symptoms. Such symptoms should be specifically considered in risk assessments

Ephemeral Rollups are All you Need

In the realm of open and composable gaming, we envision platforms where users actively expand, create, engage, and immerse themselves in a rich world of entertainment. One promising avenue for achieving this vision is through fully on-chain (FOC) games, where both game state and logic reside on the blockchain, maximizing composability. However, we must grapple with inherent limitations and trade-offs, particularly in terms of costs and scalability. This paper proposes a framework that leverages the Solana Virtual Machine (SVM) to scale FOC games without state fragmentation or compromised trust assumptions. The framework introduces a systematic approach for discovering, utilizing, and publishing modular pieces of logic as components deeply rooted in the Entity-Component-System (ECS) pattern. To enhance scalability and resource optimization, we introduce the concept of Ephemeral Rollups (ERs) that overcome the tradeoffs of L2s horizontal scaling. These dedicated runtimes can be customized to provide higher operational speed, configurable ticking mechanisms, provable sessions and gasless transactions without composability-scalability tradeoffs

Multimethodological study of molecular recognition phenomena

The study of the bio-recognition phenomena behind a biological process is nowadays considered a useful tool to deeply understand physiological mechanisms allowing the discovery of novel biological target and the development of new lead candidates. Moreover, understanding this kind of phenomena can be helpful in characterizing absorption, distribution, metabolism, elimination and toxicity properties of a new drug (ADMET parameters). Recent estimations show that about half of all drugs in development fail to make it to the market because of ADMET deficiencies; thus a rapid determination of ADMET parameters in early stages of drug discovery would save money and time, allowing to choose the better compound and to eliminate any losers. The monitoring of drug binding to plasma proteins is becoming essential in the field of drug discovery to characterize the drug distribution in human body. Human serum albumin (HSA) is the most abundant protein in plasma playing a fundamental role in the transport of drugs, metabolites and endogenous factors; so the study of the binding mechanism to HSA has become crucial to the early characterization of the pharmacokinetic profile of new potential leads. Furthermore, most of the distribution experiments carried out in vivo are performed on animals. Hence it is interesting to determine the binding of new compounds to albumins from different species to evaluate the reliability of extrapolating the distribution data obtained in animals to humans. It is clear how the characterization of interactions between proteins and drugs determines a growing need of methodologies to study any specific molecular event. A wide variety of biochemical techniques have been applied to this purpose. High-performance liquid affinity chromatography, circular dichroism and optical biosensor represent three techniques that can be able to elucidate the interaction of a new drug with its target and with others proteins that could interfere with ADMET parameters

STRUCTURAL FACTORS FOR A THIRD-GENERATION PORT: PLANNING INTERVENTIONS FOR MECHANICAL LOGISTICS IN GIOIA TAURO, ITALY

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Intracellular targets of RGDS peptide in melanoma cells

<p>Abstract</p> <p>Background</p> <p>RGD-motif acts as a specific integrins-ligand and regulates a variety of cell-functions via extracellular action affecting cell-adhesion properties. However, increasing evidence identifies additional RGDS-functions at intracellular level. Previous reports show RGDS-internalization in endothelial cells, cardiomyocytes and lymphocytes, indicating intracellular targets such as caspase-8 and caspase-9, and suggest RGDS specific activity at cytoplasmic level. Given the role RGDS-peptides play in controlling proliferation and apoptosis in several cell types, investigating intracellular targets of RGDS in melanoma cells may un-reveal novel molecular targets and key pathways, potentially useful for a more effective approach to melanoma treatment.</p> <p>Results</p> <p>In the present study we show for the first time that RGDS-peptide is internalized in melanoma cells in a time-dependent way and exerts strong anti-proliferative and pro-apoptotic effects independently from its extracellular anti-adhesive action. RGES control-peptide did not show biological effects, as expected; nevertheless it is internalized, although with slower kinetics. Survivin, a known cell-cycle and survival-regulator is highly expressed in melanoma cells. Co-immunoprecipitation assays in cell lysates and overlay assays with the purified proteins showed that RGDS interacts with survivin, as well as with procaspase-3, -8 and -9. RGDS-peptide binding to survivin was found to be specific, at high affinity (Kd 27.5 μM) and located at the survivin C-terminus. RGDS-survivin interaction appeared to play a key role, since RGDS lost its anti-mitogenic effect in survivin-deprived cells with a specific siRNA.</p> <p>Conclusions</p> <p>RGDS inhibits melanoma growth with an adhesion-independent mechanism; it is internalized in melanoma cells and specifically interacts with survivin. The present data may indicate a novel role of RGDS-containing peptides physiologically released from the extracellular matrix and may suggest a possible novel anti-proliferation strategy in melanoma.</p