Islet transplantation as a clinical tool: present state and future perspectives

O transplante de ilhotas é um procedimento em desenvolvimento, como alternativa para o tratamento do diabetes tipo 1 que está na fronteira entre o experimental e o clínico. É uma terapia celular na qual as células são implantadas em território diferente do fisiológico em que apenas determinado número incerto conseguirá se adaptar. Aperfeiçoar este processo para obter os mesmos resultados que no transplante de pâncreas, representa um desafio para o qual convergem contribuições da biologia celular, da imunologia e das técnicas de laboratório que se entrelaçam de maneira extremamente complexa. Este trabalho revisa a literatura expondo a evolução do procedimento, a sua metodologia atual e os resultados clínicos obtidos. As perspectivas futuras do transplante diante dos recentes avanços também são discutidas.Islet transplant is an innovative treatment for type 1 diabetic patients, which still lies between experimental and approved transplant therapy. Islet cells are seeded in a non-physiological territory where an uncertain fraction will be able to adapt and survive. Thus, the challenge lies in improving the whole procedure, employing the tools of cell biology, immunology and laboratory techniques, in order to reach the results obtained with whole organ transplant. This review describes the procedure, its progress to the present methodology and clinical results obtained. Future perspectives of islet transplantation in the light of recent biotechnological advances are also focused

Algunos aspectos no cartesianos del racionalismo de Spinoza y de Leibniz. Sobre la naturaleza de los cuerpos

Tras recordar en la primera parte algunos vestigios de la herencia neoplatónica y cabalística de la tradición animista en las obras de Spinoza y del joven Leibniz, analizo en la segunda parte aspectos del conatus, que son comunes a ambos filósofos: mens idea corporis y mens harmonia conatuum respectivamente. Por fin, en una tercera parte, describo la «transvaloración » que del conatus de Hobbes y de Spinoza, así como de las regulae motus de Huygens, trató de hacer Leibniz: por una parte, de la resistencia o inertia naturalis de los cuerpos a la vis insita rebus: i. e. potentia absoluta corporum; y por otra parte, de la relatividad del movimiento de los experimentos mecánicos a la universalidad del principio de la equipolencia de la causa plena y del efecto entero, cuyo último fundamento es el principio de individuación: la universalidad de todas las leyes mecánicas y la singularidad de cada suceso del universo.Després de recordar en la primera part alguns vestigis de l'herència neoplatònica i cabalística de la tradició animista en les obres de Spinoza i del jove Leibniz, analitzo en la segona part aspectes del conatus, que són comuns a ambdós filòsofs: mens idea corporis i mens harmonia conatuum respectivament. Finalment, en una tercera part, descric la «transvaloració» que del conatus de Hobbes i de Spinoza, així com de les regulae motus de Huygens, va tractar de fer Leibniz: d'una banda, de la resistència o inertia naturalis dels cossos a la vis insita rebus: i. e. potentia absoluta corporum; i de l'altra, de la relativitat del moviment dels experiments mecànics a la universalitat del principi de l'equipol·lència de la causa plena i de l'efecte enter, l'últim fonament del qual és el principi d'individuació: la universalitat de totes les lleis mecàniques i la singularitat de cada succés de l'univers.Remembering in the first part some vestiges of the neoplatonic and kabbalistic heritage of the animistic tradition in the work of Spinoza and the young Leibniz, I analyze in the second part the common aspects of the conatus in both philosophers: mens idea corporis and mens harmonia conatuum, respectively. Finally, in the third part, I describe the "transvaloration" of Hobbes's and Spinoza's conatus and Huygens's regulae motus Leibniz intended to add: from the "resistance or inertia naturalis" of bodies to the vis insita rebus (i.e., potentia absoluta corporum) and from the "relativity" of motion of mechanical experiments to the "universality" of the principle of equipolentia causae plenae et effectus integri grounded in the principle of individuation, that is, the universality of all mechanical rules and the singularity of every fact of the universe

I Can't Seem To Cope, So I Paint

My thesis statement explains in-depth how the deaths of my grandparents have had an influential impact on my painting and drawings, and how it has also shaped my outlook on my future towards my degree in art therapy.Purchase College SUNYPainting and DrawingBachelor of Fine ArtsSnyder, Tova L

Behavioral determinants as predictors of return to work after long-term sickness absence: an application of the theory of planned behavior

Background The aim of this prospective, longitudinal cohort study was to analyze the association between the three behavioral determinants of the theory of planned behavior (TPB) model-attitude, subjective norm and self-efficacy-and the time to return-to-work (RTW) in employees on long-term sick leave. Methods The study was based on a sample of 926 employees on sickness absence (maximum duration of 12 weeks). The employees filled out a baseline questionnaire and were subsequently followed until the tenth month after listing sick. The TPB-determinants were measured at baseline. Work attitude was measured with a Dutch language version of the Work Involvement Scale. Subjective norm was measured with a self-structured scale reflecting a person's perception of social support and social pressure. Self-efficacy was measured with the three subscales of a standardised Dutch version of the general self-efficacy scale (ALCOS): willingness to expend effort in completing the behavior, persistence in the face of adversity, and willingness to initiate behavior. Cox proportional hazards regression analyses were used to identify behavioral determinants of the time to RTW. Results Median time to RTW was 160 days. In the univariate analysis, all potential prognostic factors were significantly associated (P < 0.15) with time to RTW: work attitude, social support, and the three subscales of self-efficacy. The final multivariate model with time to RTW as the predicted outcome included work attitude, social support and willingness to expend effort in completing the behavior as significant predictive factors. Conclusions This prospective, longitudinal cohort-study showed that work attitude, social support and willingness to expend effort in completing the behavior are significantly associated with a shorter time to RTW in employees on long-term sickness absence. This provides suggestive evidence for the relevance of behavioral characteristics in the prediction of duration of sickness absence. It may be a promising approach to address the behavioral determinants in the development of interventions focusing on RTW in employees on long-term sick leave

A large ongoing outbreak of hepatitis A predominantly affecting young males in Lazio, Italy; August 2016 - March 2017

The hepatitis A virus (HAV) is mainly transmitted through the faecal-oral route. In industrialized countries HAV infection generally occurs as either sporadic cases in travelers from endemic areas, local outbreak within closed/semi-closed population and as foodborne community outbreak. Recently, an increasing number of HAV infection clusters have been reported among young men-who-have-sex-with-men (MSM). The Lazio Regional Service for the epidemiology and control for infectious diseases (SeRESMI) has noticed an increase of acute hepatitis A (AHA) since September 2016. Temporal analysis carried out with a discrete Poisson model using surveillance data between January 2016 and March 2017 evidenced an ongoing outbreak of AHA that started at the end of August. Molecular investigation carried out on 130 out of 513 cases AHA reported until March 2017 suggests that this outbreak is mainly supported by an HAV variant which is currently spreading within MSM communities across Europe (VRD_521_2016). The report confirms that AHA is an emerging issue among MSM. In addition through the integration of standard (case based) surveillance with molecular investigation we could discriminate, temporally concomitant but epidemiologically unrelated, clusters due to different HAV variants. As suggested by the WHO, in countries with low HAV circulation, vaccination programmes should be tailored on the local epidemiological patterns to prevent outbreaks among high risk groups and eventual spillover of the infection in the general population

A method for generating a quasi-linear convective system suitable for observing system simulation experiments

To understand the impact of different assimilated observations on convection-allowing model forecast skill, a diverse range of observing system simulation experiment (OSSE) case studies are required (different storm modes and environments). Many previous convection-allowing OSSEs predicted the evolution of an isolated supercell generated via a warm air perturbation in a horizontally homogenous environment. This study introduces a new methodology in which a quasi-linear convective system is generated in a highly sheared and modestly unstable environment. Wind, temperature, and moisture perturbations superimposed on a horizontally homogeneous environment simulate a cold front that initiates an organized storm system that spawns multiple mesovortices. Mature boundary layer turbulence is also superimposed onto the initial environment to account for typical convective-scale uncertainties. Creating an initial forecast ensemble remains a challenge for convection-allowing OSSEs because mesoscale uncertainties are difficult to quantify and represent. The generation of the forecast ensemble is described in detail. The forecast ensemble is initialized by 24 h full-physics simulations (e.g., radiative forcing, surface friction, and microphysics). The simulations assume different surface conditions to alter surface moisture and heat fluxes and modify the effects of friction. The subsequent forecast ensemble contains robust non-Gaussian errors that persist until corrected by the data assimilation system. This purposely degraded initial forecast ensemble provides an opportunity to assess whether assimilated environmental observations can improve, e.g., the wind profile. An example OSSE suggests that a combination of radar and conventional (surface and soundings) observations are required to produce a skilled quasi-linear convective system forecast, which is consistent with real-world case studies. The OSSE framework introduced in this study will be used to understand the impact of assimilated environmental observations on forecast skill.</p

Urban Voids After the Pandemic. A New Chance for Greenway

Our proposal deals with the meaning of urban voids in the post-COVID-19 period to suggest new understandings of how urban green corridors can positively affect design for healthier and more sustainable cities. According to Secchi (1986), planning through the void involves a profound revision of the way we think about the city, reversing the points of interest, proposing as polarities the spaces that do not usually emerge. The void thus becomes an opportunity, a chance to improve the structure of our urban landscape (Lopez-Pineiro, 2020). A city is a powerful place, always in motion and transformation. It has an artificial spirit full of surprises and vague limits. It is the scene of remarkable transformations that in their wildness are partially ungovernable by the designers themselves. The desire to control them leaves a series of abandoned and unfinished spaces, “holes” that live from their discontinuity with the surroundings (Labriola, 2021). During a period of crisis, like the one that we are still living with COVID-19 (Fabris et al, 2020), it is common to re-think our cities to create better places for the community. After the long period of forced distance that we lived, an evolution of public space is recommended. During the pandemic, the emptiness of our cities permitted Nature to re-appropriate its spaces. Following this trend and thinking about a new kind of public space where Nature and its inside processes are the protagonists, it is possible to intervene in our cities. The porosity of the urban fabric in towns without humans, blocked at home by the never-ending lockdowns, became a new green corridor that revealed the presence of wildlife (both fauna and flora) as part of a forgotten urban layer that turned visible again. The preservation of this new asset should be possible. The spaces to allow this change can be the abandoned and empty areas present in the contemporary city’s sick body that we can finally heal. The so-called wastelands, voids, or terrain vague, have a significant value independent from the environment in which they are inserted, showing a relationship with the contemporary city extraneous to its rhythms. For this reason, they are the perfect place for experimentation in terms of greenways, a possible starting point to re-think how green can be part of the urban texture and how to conceive public and open spaces after the nowadays crisis. The paper considers the Metropolitan City of Milan as a remarkable case study to understand the pivotal role played by urban voids in the formation of greenways and their capacity of reshaping the environmental, aesthetic and healthy dimensions of urban landscapes

Chronic kidney disease and arrhythmias: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Patients with chronic kidney disease (CKD) are predisposed to heart rhythm disorders, including atrial fibrillation (AF)/atrial flutter, supraventricular tachycardias, ventricular arrhythmias, and sudden cardiac death (SCD). While treatment options, including drug, device, and procedural therapies, are available, their use in the setting of CKD is complex and limited. Patients with CKD and end-stage kidney disease (ESKD) have historically been under-represented or excluded from randomized trials of arrhythmia treatment strategies,1 although this situation is changing.2 Cardiovascular society consensus documents have recently identified evidence gaps for treating patients with CKD and heart rhythm disorders [...