Validation of PARADISE 24 and Development of PARADISE-EDEN 36 in Patients with Dementia.

Dementia was one of the conditions focused on in an EU (European Union) project called "PARADISE" (Psychosocial fActors Relevant to brAin DISorders in Europe) that later produced a measure called PARADISE 24, developed within the biopsychosocial model proposed in the International Classification of Functioning Disability and Health (ICF). The aims of this study are to validate PARADISE 24 on a wider sample of patients with mild to moderate dementia to expand PARADISE 24 by defining a more specific scale for dementia, by adding 18 questions specifically selected for dementia, which eventually should be reduced to 12. We enrolled 123 persons with dementia, recruited between July 2017 and July 2019 in home care and long-term care facilities, in Italy, and 80 participants were recruited in Warsaw between January and July 2012 as part of a previous cross-sectional study. The interviews with the patient and/or family were conducted by health professionals alone or as a team by using the Paradise data collection protocol. The psychometric analysis with the Rasch analysis has shown that PARADISE 24 and the selection of 18 additional condition-specific items can be expected to have good measurement properties to assess the functional state in persons with dementia.

High pressure systems as sustainable extraction and pre-treatment technologies for a holistic corn stover biorefinery.

This mini-review assesses supercritical carbon dioxide (scCO2) extraction and high-pressure carbon dioxide pre-treatment technologies for valorisation of corn stover agricultural residues with particular focus on showing how these can aid in the creation of a holistic biorefineries. Corn stover is currently the largest source of agriculture residues in the USA, as such there is significant potential for exploitation to yield valuable chemicals. ScCO2 extraction could lead to the recovery of a variety of different chemicals which include flavonoids, sterols, steroid ketones, hydrocarbons, saturated fatty acids, unsaturated fatty acids, fatty alcohols, phenolics and triterpenoids. Importantly, recent studies have not only demonstrated that supercritical extraction can be utilized for the recovery of plant lipids for use in consumer products, including nutraceuticals and personal care, but the processing of treated biomass can lead to enhanced yields and recovery of other products from biorefinery processes. Despite the great potential and opportunities for using scCO2 and high-pressure systems in a biorefinery context their real-world application faces significant challenges to overcome before it is widely applied. Such challenges have also been discussed in the context of this mini-review.

The normalization of deviance: do we (un)knowingly accept doing the wrong thing?

There are many elements that contribute to errors within an industry or profession. Several human factors associated with safety breakdowns are outlined in Table 2. Experience and root-cause analyses usually document that 2 or more of these factors coalesce to form a "perfect storm" leading to a mishap. For example, expecting a fatigued provider to care for an emergency patient with concurrent production pressure to maintain the elective schedule, while using new and unfamiliar equipment, is a potent mix of risk factors. As Gaba et al. pointed out, production pressure "is a reality for many anesthesiologists and is perceived in some cases to have resulted in unsafe actions." One solution is to integrate standard protocols and expectations for safe practice and expected behavior throughout the practice. Other potential solutions may involve the design of better and "smarter" monitors that will reduce the noise pollution and attendant distractions in the OR, and variable priority training that helps clinicians focus on "optimal distribution of attention when performing multiple tasks simultaneously with the goal of flexible allocation of attention." We have also observed the phenomenon of intersecting curves of knowledge versus experience. When we exit our organized training period, our knowledge base is strong. We have studied for specialty examinations, experienced the idealized purity of an academic environment, and have been taught the "right way" to practice by our mentors and role models. As the years pass, our minute, detailed knowledge may decrease, but our practical experience increases greatly, and patient care and safety are assured. However, as we are increasingly challenged to "do more with less," the temptation will arise to "cut a few comers" where we can to achieve productivity and efficiency benchmarks. To that end, we caution our colleagues to avoid the slippery slope of accepting a decrease in vigilance and safety while striving for "faster, better, cheaper." We encourage every individual to maintain vigilance, advocate for patient safety, aim for excellence and efficiency, and avoid the temptation of normalizing deviance from accepted safety standards.

Regulation of ß-cell function by RNA-binding proteins.

ß-cells of the pancreatic islets are highly specialized and high-throughput units for the production of insulin, the key hormone for maintenance of glucose homeostasis. Elevation of extracellular glucose and/or GLP-1 levels triggers a rapid upregulation of insulin biosynthesis through the activation of post-transcriptional mechanisms. RNA-binding proteins are emerging as key factors in the regulation of these mechanisms as well as in other aspects of ß-cell function and glucose homeostasis at large, and thus may be implicated in the pathogenesis of diabetes. Here we review current research in the field, with a major emphasis on RNA-binding proteins that control biosynthesis of insulin and other components of the insulin secretory granules by modulating the stability and translation of their mRNAs.

Tamoxifen-independent recombination in the RIP-CreER mouse.

BACKGROUND: The inducible Cre-lox system is a valuable tool to study gene function in a spatial and time restricted fashion in mouse models. This strategy relies on the limited background activity of the modified Cre recombinase (CreER) in the absence of its inducer, the competitive estrogen receptor ligand, tamoxifen. The RIP-CreER mouse (Tg (Ins2-cre/Esr1) 1Dam) is among the few available ß-cell specific CreER mouse lines and thus it has been often used to manipulate gene expression in the insulin-producing cells of the endocrine pancreas. PRINCIPAL FINDINGS: Here, we report the detection of tamoxifen-independent Cre activity as early as 2 months of age in RIP-CreER mice crossed with three distinct reporter strains. SIGNIFICANCE: Evidence of Cre-mediated recombination of floxed alleles even in the absence of tamoxifen administration should warrant cautious use of this mouse for the study of pancreatic ß-cells.

Percepção do hipertenso não-aderente à terapêutica medicamentosa em relação a sua doença / Non-compliant hypertensive patients perception to medical treatment in relation to their disease

A hipertensão arterial sistêmica é uma doença multifatorial, que pode ser desencadeada de forma isolada ou ser associada ao agravamento de diversas doenças. Por ser assintomática e de evolução silenciosa, pode levar indivíduos aparentemente sadios a descobertas inesperadas. A proposta deste estudo é identificar o significado da doença para o paciente hipertenso não-aderente: verificar os sentimentos do paciente em relação à doença, e identificar as dificuldades no seguimento do tratamento medicamentoso e os fatores que poderiam faciliatar a aderência ao tratamento. A população foi composta por 30 pacientes hipertensos não-aderentes em regime de internação no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidadde de São Paulo, identificados previamente por meio de um formulário específico, que estivessem com recomendação de tratamento medicamentoso há pelo menos seis meses. Os dados foram obtidos por meio de um segundo formulário, utilizando-se a técnica de entrevista...