RESUMO
A woman in her 60s initially presented with rapid-onset left-sided hemiparesis with later development of slurred speech and left-sided facial droop. Despite ruling out common causes, her condition rapidly progressed with the development of bilateral proximal weakness, ophthalmoplegia, ataxia, and pyramidal signs eventually leading to a cardiorespiratory arrest. Extensive investigations, including computerised tomography (CT), magnetic resonance imaging (MRI), and lumbar puncture (LP), were negative for infectious or vascular aetiologies. Nerve conduction studies (NCS) revealed severe peripheral nerve damage, and despite a provisional diagnosis of Guillain-Barré Syndrome (GBS), the clinical picture aligned more with Bickerstaff Brainstem Encephalitis (BBE) given the central nervous system (CNS) involvement, despite negative anti-GM1 and anti-GQ1b autoantibodies. Treatment involved ventilatory support, immunoglobulins, and steroids. This case report describes a rare and challenging presentation of BBE and reminds clinicians to have a systematic approach to a patient presenting with rapid onset neurological symptoms and that BBE is a clinical diagnosis.
RESUMO
The use of self-tracking devices has increased dramatically in recent years with enthusiasm from the public as well as public health officers, healthcare providers and workplaces seeking to instigate behaviour change in populations. Analysis of the ontological principles informing the design and implementation of the Apple Watch and corporate wellness programmes using self-tracking technologies shows that their primary focus is on the capture and control of attention rather than material health outcomes. Health, wellness and happiness have been conflated with productivity, which is now deemed to be dependent on the harnessing of libidinal as well as physical energy. In this context, self-tracking technologies and related corporate wellness interventions have been informed by 'emotional design', neuroscientific and behavioural principles which target the 'pre subjective' consciousness of individuals through manipulating their habits and neurological functioning. This article draws on the work of Bernard Stiegler to suggest framing self-tracking as 'industrial temporal objects', which capture and 'short circuit' attention. It is proposed that a central aim is to 'accumulate the consciousnesses' of subjects consistent with the methods of a contemporary 'attention economy'. This new logic of accumulation informs the behaviour change strategies of designers of self-tracking devices, and corporate wellness initiatives, taking the form of 'psychotechnologies' which attempt to reconstruct active subjects as automatic and reactive 'nodes' as part of managed networks.
Assuntos
Promoção da Saúde/organização & administração , Monitorização Fisiológica/instrumentação , Saúde Ocupacional , Tecnologia Assistiva , Local de Trabalho/organização & administração , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Desenvolvimento de Programas , Avaliação de Programas e Projetos de SaúdeRESUMO
N-degron pathways of ubiquitin-mediated proteolysis (formerly known as the N-end rule pathway) control the stability of substrate proteins dependent on the amino-terminal (Nt) residue. Unlike yeast or mammalian N-recognin E3 ligases, which each recognize several different classes of Nt residues, in Arabidopsis thaliana, N-recognin functions of different N-degron pathways are carried out independently by PROTEOLYSIS (PRT)1, PRT6, and other unknown proteins. PRT1 recognizes type 2 aromatic Nt-destabilizing residues and PRT6 recognizes type 1 basic residues. These two N-recognin functions diverged as separate proteins early in the evolution of plants, before the conquest of the land. We demonstrate that loss of PRT1 function promotes the plant immune system, as mutant prt1-1 plants showed greater apoplastic resistance than WT to infection by the bacterial hemi-biotroph Pseudomonas syringae pv tomato (Pst) DC3000. Quantitative proteomics revealed increased accumulation of proteins associated with specific components of plant defense in the prt1-1 mutant, concomitant with increased accumulation of salicylic acid. The effects of the prt1 mutation were additional to known effects of prt6 in influencing the immune system, in particular, an observed over-accumulation of pipecolic acid (Pip) in the double-mutant prt1-1 prt6-1. These results demonstrate a potential role for PRT1 in controlling aspects of the plant immune system and suggest that PRT1 limits the onset of the defense response via degradation of substrates with type 2 Nt-destabilizing residues.