Anti-glomerular basement membrane glomerulonephritis: Characterization of an epitope, antibody response, and the potential role of IL-4Ralpha in disease progression

Anti-Glomerular Basement Membrane Glomerulonephritis (anti-GBM GM) is one of the earliest described autoimmune disorders. Patients present with proteinuria, anti-GBM antibodies, and renal failure. Studies have implicated a T Helper 1 (TH1) response in disease induction and a T Helper 2 (TH2) response for disease progression. A 13 amino acid long peptide sequence spanning residues 28 through 40 [pCol(28–40)] of the Collagen IV α3 non-collagen domain (Col IV α3 NCD) is immunogenic and induces anti-GBM GN. In order to fully understand disease initiation, this peptide was further characterized. Peptides were created containing one amino acid substitution for the entire length of pCol(28–40) and induction of anti-GBM GN was monitored. When residues 31, 33, or 34 contained the substitution, anti-GBM GN was unable to be induced. Thus, residues 31, 33, and 34 of pCol(28–40) are required for induction of anti-GBM. Glomerular injury is observed as early as 14 days post anti-GBM GN induction. However, the presence of anti-GBM antibodies is not observed until 20 days post immunization. An enlarged lymph node adjacent to the diseased kidney exhibits B cell activation after renal injury and produces antibodies toward GBM. Thus, anti-GBM antibodies are a consequence of the initial renal injury. Differences between disease susceptible and disease resistant rat strains exist in the expression of IL-4Rα, a major player in the TH2 response. IL-4Rα signaling is regulated by soluble IL-4Rα (sIL-4Rα). Low expression levels of sIL-4Rα result in the stabilization of IL-4 binding, while elevated expression sequesters IL-4. Quantitative PCR experiments noted low siL-4Rα expression levels in disease susceptible rats. Induction of an immune response toward sIL-4Rα in this strain was responsible for delayed disease progression in 15 out of the 17 experimental animals. Antibody transfer and in vivo biological activity experiments confirmed that delayed disease development was due to anti-sIL-4Rα antibodies. Together these experiments indicate that a T-cell epitope is required for activation of a TH1 autoimmune response and anti-GBM antibodies are a consequence of renal injury. More importantly, a role for IL-4Rα signaling is implicated in the progression of anti-GBM GN. ^

Understanding and Characterizing Shared Decision-Making and Behavioral Intent in Medical Uncertainty

Applying Theoretical Constructs to Address Medical Uncertainty Situations involving medical reasoning usually include some level of medical uncertainty. Despite the identification of shared decision-making (SDM) as an effective technique, it has been observed that the likelihood of physicians and patients engaging in shared decision making is lower in those situations where it is most needed; specifically in circumstances of medical uncertainty. Having identified shared decision making as an effective, yet often a neglected approach to resolving a lack of information exchange in situations involving medical uncertainty, the next step is to determine the way(s) in which SDM can be integrated and the supplemental processes that may facilitate its integration. SDM involves unique types of communication and relationships between patients and physicians. Therefore, it is necessary to further understand and incorporate human behavioral elements - in particular, behavioral intent - in order to successfully identify and realize the potential benefits of SDM. This paper discusses the background and potential interaction between the theories of shared decision-making, medical uncertainty, and behavioral intent. Identifying Shared Decision-Making Elements in Medical Encounters Dealing with Uncertainty A recent summary of the state of medical knowledge in the U.S. reported that nearly half (47%) of all treatments were of unknown effectiveness, and an additional 7% involved an uncertain tradeoff between benefits and harms. Shared decision-making (SDM) was identified as an effective technique for managing uncertainty when two or more parties were involved. In order to understand which of the elements of SDM are used most frequently and effectively, it is necessary to identify these key elements, and understand how these elements related to each other and the SDM process. The elements identified through the course of the present research were selected from basic principles of the SDM model and the “Data, Information, Knowledge, Wisdom” (DIKW) Hierarchy. The goal of this ethnographic research was to identify which common elements of shared decision-making patients are most often observed applying in the medical encounter. The results of the present study facilitated the understanding of which elements patients were more likely to exhibit during a primary care medical encounter, as well as determining variables of interest leading to more successful shared decision-making practices between patients and their physicians. Understanding Behavioral Intent to Participate in Shared Decision-Making in Medically Uncertain Situations Objective: This article describes the process undertaken to identify and validate behavioral and normative beliefs and behavioral intent of men between the ages of 45-70 with regard to participating in shared decision-making in medically uncertain situations. This article also discusses the preliminary results of the aforementioned processes and explores potential future uses of this information which may facilitate greater understanding, efficiency and effectiveness of doctor-patient consultations.Design: Qualitative Study using deductive content analysisSetting: Individual semi-structure patient interviews were conducted until data saturation was reached. Researchers read the transcripts and developed a list of codes.Subjects: 25 subjects drawn from the Philadelphia community.Measurements: Qualitative indicators were developed to measure respondents’ experiences and beliefs related to behavioral intent to participate in shared decision-making during medical uncertainty. Subjects were also asked to complete the Krantz Health Opinion Survey as a method of triangulation.Results: Several factors were repeatedly described by respondents as being essential to participate in shared decision-making in medical uncertainty. These factors included past experience with medical uncertainty, an individual’s personality, and the relationship between the patient and his physician.Conclusions: The findings of this study led to the development of a category framework that helped understand an individual’s needs and motivational factors in their intent to participate in shared decision-making. The three main categories include 1) an individual’s representation of medically uncertainty, 2) how the individual copes with medical uncertainty, and 3) the individual’s behavioral intent to seek information and participate in shared decision-making during times of medically uncertain situations.

Chairmanship in ASEAN+3:A Shared Rule of Behavior

ASEAN+3 is a cooperative framework among ASEAN members and the countries of Japan, China and Korea. It functions at the senior official, ministerial and summit levels. This article concerns how institutions in ASEAN+3 affect development of the direction and nature of this framework. ASEAN+3 is regarded as a loose framework that has regularized meetings as its main activity but has no organizational settings such as the secretariat. Little institutional analysis has been conducted on the development of this framework. This article introduces 'Chairmanship' as an analytical concept in which the chair or chairing member plays an important role in preparing and managing meetings. 'Chairmanship' is therefore an institution with an organizational element. It is also a shared rule of behavior among member states in that the chair's roles are not explicitly written in documents. Thus, it can be argued that the ASEAN+3 framework has an institution with an organizational element that affects development of its characteristics.

Educating in Project Management: an innovative approach. A shared-experience among Spanish Universities

This work presents an educational formal initiative aimed to monitor the acquisition and strengthening of competences by students that are being taught in project management subject. Groups of students belonging to three universities, embracing different knowledge areas such as engineering, biology, etc., were selected to run the experience. All of them had nevertheless a common and basic starting point: inexperience in project management field. In this scenario, we propose a new theoretical and practical approach oriented to reinforce problem-solving and related competences in a project management subject context. For this purpose, a Project-Based Learning (PjBL) initiative has been specifically designed and developed. The main idea is to bring a real world engineering project management case into the classroom, where students must face up to a completely new learning approach –groups in different locations, collaborative mode and unspecific solution, supported by a powerful internet platform:.project.net (http://www.Project.net). Other relevant aspects such as project climate, knowledge increasing, have also been monitored during the course. Results show and overall improvement in key competences. The obtained information will be used in two ways: to feed the students back about personal opportunities for improvement in specific competences, and to fine-tune the experience for further initiatives.

Artificial cognitive control system based on the shared circuits model of sociocognitive capacities. A first approach

sharedcircuitmodels is presented in this work. The sharedcircuitsmodelapproach of sociocognitivecapacities recently proposed by Hurley in The sharedcircuitsmodel (SCM): how control, mirroring, and simulation can enable imitation, deliberation, and mindreading. Behavioral and Brain Sciences 31(1) (2008) 1–22 is enriched and improved in this work. A five-layer computational architecture for designing artificialcognitivecontrolsystems is proposed on the basis of a modified sharedcircuitsmodel for emulating sociocognitive experiences such as imitation, deliberation, and mindreading. In order to show the enormous potential of this approach, a simplified implementation is applied to a case study. An artificialcognitivecontrolsystem is applied for controlling force in a manufacturing process that demonstrates the suitability of the suggested approach

Concurrency in prolog using threads and a shared database

Concurrency in Logic Programming has received much attention in the past. One problem with many proposals, when applied to Prolog, is that they involve large modifications to the standard implementations, and/or the communication and synchronization facilities provided do not fit as naturally within the language model as we feel is possible. In this paper we propose a new mechanism for implementing synchronization and communication for concurrency, based on atomic accesses to designated facts in the (shared) datábase. We argüe that this model is comparatively easy to implement and harmonizes better than previous proposals within the Prolog control model and standard set of built-ins. We show how in the proposed model it is easy to express classical concurrency algorithms and to subsume other mechanisms such as Linda, variable-based communication, or classical parallelism-oriented primitives. We also report on an implementation of the model and provide performance and resource consumption data.

Memory performance of and-parallel prolog on shared-memory architectures

The goal of the RAP-WAM AND-parallel Prolog abstract architecture is to provide inference speeds significantly beyond those of sequential systems, while supporting Prolog semantics and preserving sequential performance and storage efficiency. This paper presents simulation results supporting these claims with special emphasis on memory performance on a two-level sharedmemory multiprocessor organization. Several solutions to the cache coherency problem are analyzed. It is shown that RAP-WAM offers good locality and storage efficiency and that it can effectively take advantage of broadcast caches. It is argued that speeds in excess of 2 ML IPS on real applications exhibiting medium parallelism can be attained with current technology.

Replication types: towards a shared taxonomy

Context: The software engineering community is becoming more aware of the need for experimental replications. In spite of the importance of this topic, there is still much inconsistency in the terminology used to describe replications. Objective: Understand the perspectives of empirical researchers about various terms used to characterize replications and propose a consistent taxonomy of terms. Method: A survey followed by plenary discussion during the 2013 International Software Engineering Research Network meeting. Results: We propose a taxonomy which consolidates the disparate terminology. This taxonomy had a high level of agreement among workshop attendees. Conclusion: Consistent terminology is important for any field to progress. This work is the first step in that direction. Additional study and discussion is still necessary.

De la cápsula comunitaria al espacio compartido. La búsqueda del post-espacio público en la vivienda de ACM = From community capsules to shared intervals. The search of the post-public space In the housing developments by ACM

Arquitectos y no arquitectos como Rossi, Grassi, Jacobs, Sennett o Lefebvre, denunciaron críticamente durante los 50, 50 y 70 la ruptura entre la calle y el espacio doméstico y el consiguiente declive del dominio público urbano a escala de ciudad y a escala de barrio. La crítica a la "Ville Contemporaine" no solo se escribía, también se dibujaba y a veces, incluso, se construía. La primera generación post-CIAM trabajó intensamente en desmentir con palabras y obras al Oud que ya en los años 20 del pasado siglo, tomando la delantera a Le Corbusier y desde su mejor sentido práctico y estético afirmaba: "Las calles para el negocio, los patios interiores para la vida. Los dos estrictamente separados y con un carácter contradictorio".

Definition of MHC and T cell receptor contacts in the HLA-DR4restricted immunodominant epitope in type II collagen and characterization of collagen-induced arthritis in HLA-DR4 and human CD4 transgenic mice

Rheumatoid arthritis (RA) is an autoimmune disease associated with the HLA-DR4 and DR1 alleles. The target autoantigen(s) in RA is unknown, but type II collagen (CII) is a candidate, and the DR4- and DR1-restricted immunodominant T cell epitope in this protein corresponds to amino acids 261–273 (CII 261–273). We have defined MHC and T cell receptor contacts in CII 261–273 and provide strong evidence that this peptide corresponds to the peptide binding specificity previously found for RA-associated DR molecules. Moreover, we demonstrate that HLA-DR4 and human CD4 transgenic mice homozygous for the I-Abβ0 mutation are highly susceptible to collagen-induced arthritis and describe the clinical course and histopathological changes in the affected joints.

The MAPKKK Ste11 regulates vegetative growth through a kinase cascade of shared signaling components

In haploid Saccharomyces cerevisiae, the mating and invasive growth (IG) pathways use the same mitogen-activated protein kinase kinase kinase kinase (MAPKKKK, Ste20), MAPKKK (Ste11), MAPKK (Ste7), and transcription factor (Ste12) to promote either G1 arrest and fusion or foraging in response to distinct stimuli. This exquisite specificity is the result of pathway-specific receptors, G proteins, scaffold protein, and MAPKs. It is currently not thought that the shared signaling components function under the basal conditions of vegetative growth. We tested this hypothesis by searching for mutations that cause lethality when the STE11 gene is deleted. Strikingly, we found that Ste11, together with Ste20, Ste7, Ste12, and the IG MAPK Kss1, functions in a third pathway that promotes vegetative growth and is essential in an och1 mutant that does not synthesize mannoproteins. We term this pathway the STE vegetative growth (SVG) pathway. The SVG pathway functions, in part, to promote cell wall integrity in parallel with the protein kinase C pathway. During vegetative growth, the SVG pathway is inhibited by the mating MAPK Fus3. By contrast, the SVG pathway is constitutively activated in an och1 mutant, suggesting that it senses intracellular changes arising from the loss of mannoproteins. We predict that general proliferative functions may also exist for other MAPK cascades thought only to perform specialized functions.

Evidence for protein X binding to a discontinuous epitope on the cellular prion protein during scrapie prion propagation

Studies on the transmission of human (Hu) prions to transgenic (Tg) mice suggested that another molecule provisionally designated protein X participates in the formation of nascent scrapie isoform of prion protein (PrPSc). We report the identification of the site at which protein X binds to the cellular isoform of PrP (PrPC) using scrapie-infected mouse (Mo) neuroblastoma cells transfected with chimeric Hu/MoPrP genes even though protein X has not yet been isolated. Substitution of a Hu residue at position 214 or 218 prevented PrPSc formation. The side chains of these residues protrude from the same surface of the C-terminal α-helix and form a discontinuous epitope with residues 167 and 171 in an adjacent loop. Substitution of a basic residue at positions 167, 171, or 218 also prevented PrPSc formation: at a mechanistic level, these mutant PrPs appear to act as “dominant negatives” by binding protein X and rendering it unavailable for prion propagation. Our findings seem to explain the protective effects of basic polymorphic residues in PrP of humans and sheep and suggest therapeutic and prophylactic approaches to prion diseases.

A G protein γ subunit-like domain shared between RGS11 and other RGS proteins specifies binding to Gβ5 subunits

Regulators of G protein signaling (RGS) proteins act as GTPase-activating proteins (GAPs) toward the α subunits of heterotrimeric, signal-transducing G proteins. RGS11 contains a G protein γ subunit-like (GGL) domain between its Dishevelled/Egl-10/Pleckstrin and RGS domains. GGL domains are also found in RGS6, RGS7, RGS9, and the Caenorhabditis elegans protein EGL-10. Coexpression of RGS11 with different Gβ subunits reveals specific interaction between RGS11 and Gβ5. The expression of mRNA for RGS11 and Gβ5 in human tissues overlaps. The Gβ5/RGS11 heterodimer acts as a GAP on Gαo, apparently selectively. RGS proteins that contain GGL domains appear to act as GAPs for Gα proteins and form complexes with specific Gβ subunits, adding to the combinatorial complexity of G protein-mediated signaling pathways.

Efficient loading of HLA-DR with a T helper epitope by genetic exchange of CLIP

The HLA class II-associated invariant chain (Ii)-derived peptide (CLIP) occupies the peptide binding groove during assembly in the endoplasmic reticulum, travels with HLA class II to endosomal compartments, and is subsequently released to allow binding of antigenic peptides. We investigated whether the exchange of CLIP with a known T helper epitope at the DNA level would lead to efficient loading of this helper epitope onto HLA class II. For this purpose, a versatile Ii-encoding expression vector was created in which CLIP can be replaced with a helper epitope of choice. Upon supertransfection of HLA-DR1-transfected 293 cells with an Ii vector encoding a known T helper epitope (HA307–319), predominantly length variants of this epitope were detected in association with the HLA-DR1 molecules of these cells. Moreover, this transfectant was efficiently recognized by a peptide-specific T helper clone (HA1.7). The results suggest that this type of Ii vector can be used to create potent class II+ cellular vaccines in which defined T cell epitopes are continuously synthesized.