A telehealth system for Parkinson's disease remote monitoring. The PERFORM approach.

This paper summarizes the experience and the lessons learned from the European project PERFORM (A sophisticated multi-parametric system FOR the continuous effective assessment and monitoring of motor status in Parkinson's disease and other neurodegenerative diseases). PERFORM is aimed to provide a telehealth system for the remote monitoring of Parkinson's disease patients (PD) at their homes. This paper explains the global experience with PERFORM. It summarizes the technical performance of the system and the feedback received from the patients in terms of usability and wearability.

A telehealth system for Parkinson's disease remote monitoring. The PERFORM approach

This paper summarizes the experience and the lessons learned from the European project PERFORM (A sophisticated multi-parametric system FOR the continuous effective assessment and monitoring of motor status in Parkinson s disease and other neurodegenerative diseases). PERFORM is aimed to provide a telehealth system for the remote monitoring of Parkinson s disease patients (PD) at their homes. This paper explains the global experience with PERFORM. It summarizes the technical performance of the system and the feedback received from the patients in terms of usability and wearability.

Metaphor and Genre: An Approach to improve the learning process of English for Aeronautics

This study suggests a theoretical framework for improving the teaching/ learning process of English employed in the Aeronautical discourse that brings together cognitive learning strategies, Genre Analysis and the Contemporary theory of Metaphor (Lakoff and Johnson 1980; Lakoff 1993). It maintains that cognitive strategies such as imagery, deduction, inference and grouping can be enhanced by means of metaphor and genre awareness in the context of content based approach to language learning. A list of image metaphors and conceptual metaphors which comes from the terminological database METACITEC is provided. The metaphorical terms from the area of Aeronautics have been taken from specialised dictionaries and have been categorised according to the conceptual metaphors they respond to, by establishing the source domains and the target domains, as well as the semantic networks found. This information makes reference to the internal mappings underlying the discourse of aeronautics reflected in five aviation accident case studies which are related to accident reports from the National Transportation Safety Board (NTSB) and provides an important source for designing language teaching tasks. La Lingüística Cognitiva y el Análisis del Género han contribuido a la mejora de la enseñanza de segundas lenguas y, en particular, al desarrollo de la competencia lingüística de los alumnos de inglés para fines específicos. Este trabajo pretende perfeccionar los procesos de enseñanza y el aprendizaje del lenguaje empleado en el discurso aeronáutico por medio de la práctica de estrategias cognitivas y prestando atención a la Teoría del análisis del género y a la Teoría contemporánea de la metáfora (Lakoff y Johnson 1980; Lakoff 1993). Con el propósito de crear recursos didácticos en los que se apliquen estrategias metafóricas, se ha elaborado un listado de metáforas de imagen y de metáforas conceptuales proveniente de la base de datos terminológica META-CITEC. Estos términos se han clasificado de acuerdo con las metáforas conceptuales y de imagen existentes en esta área de conocimiento. Para la enseñanza de este lenguaje de especialidad, se proponen las correspondencias y las proyecciones entre el dominio origen y el dominio meta que se han hallado en los informes de accidentes aéreos tomados de la Junta federal de la Seguridad en el Transporte (NTSB)

ITIL in Small to Medium-Sized Enterprises: toward a proposal based on an ITIL processes implementation sequence and a pofile scheme strategy for implementing the first process in the sequence

The backdrop of actual problematic about the implementation of Information Technology (IT) services management in Small and Medium Enterprises (SMEs) will be described. It will be exposed the reasons why reaching a maturity/capability level through well-known standards or the implementation of good software engineering practices by means of IT infrastructure Library are really difficult to achieve by SMEs. Also, the solutions to the exposed problems will be explained. Also master thesis goals are presented in terms of: purpose, research questions, research goals, objectives and scope. Finally, thesis structure is described.

La memoria en el proceso creativo de Juan Muñoz = Memory in the creative process of Juan Muñoz

Esta tesis integra un estudio reflexivo sobre la relación de dependencia entre la creación y la memoria a través del análisis de la última obra del escultor Juan Muñoz: Double Bind (Tate Modern, Londres, 2001). Desde esta posición es obligado replantear el análisis de la obra, lo que hace necesario su estudio cubriendo el mayor espectro posible de información accesible más allá de la obra en sí, para aproximarse a la convergencia entre memoria y creación. La perspectiva de análisis propuesta abre camino a nuevas consideraciones so¬bre la relevancia del conocimiento en el desarrollo del proceso creativo. Este análisis no debe tan sólo suponer una aportación al conocimiento del trabajo de Juan Muñoz. Debe también desprenderse de él la innegable participación y necesaria lectura del pasado en el presente. La amnesia de los tiempos pasados impide completar el atlas de imágenes en las que se apoya la creación impidiendo el conocimiento del origen de las fuentes de inspi¬ración y las bases de la creación de una determinada obra. Este hecho limita y distorsiona sus posibles interpretaciones. Pretendo un acercamiento al entendimiento de la forma de mirar y de crear a través del tiempo que es memoria. La memoria tiene un cometido de crucial importancia para la actividad mental y juega un papel fundamental en la conducta y en la creación. La obra es el resultado de la búsqueda de una idea que exprese algo que el creador no puede ex¬presar de otra manera. Es la necesidad de expresar las ideas mediante un lenguaje que se desarrolla en el tiempo y en el espacio, reflejo del ser que responde al pensamiento. Es una forma de experiencia donde subyacen las sendas del pasado y donde se plantea el futuro. Sólo el creador accede a la obra desde dentro, el observador llega a ella desde el exterior y mediante su propia subjetividad. Las obras son formas de experiencia de sus autores, comunicar el mensaje de dicha experiencia supone por tanto interpretar. Persiguiendo la necesidad de saber y entender, pretender explicar el sentido de una cosa implica una apreciación intencionada asociada al entendimiento del intérprete. Las obras son produc¬tos que portan un mensaje y que contienen en su estructura las trazas del tiempo vivido por su creador. Si se quiere adquirir un acercamiento que represente la posición de un autor, será necesario no solo mirar a través de ella, si no introducirse en el contexto de su historia. Mirar hacia atrás, hacia la profundidad del presente para tener conciencia del pensamiento presente y futuro. Recorrer de este modo la instalación Double Bind de Juan Muñoz proporciona una síntesis de sus preocupaciones e intereses a la vez que aporta un conocimiento no necesariamente inmediato, pero relevante y trascendente de la obra, su creador y la historia. ABSTRACT This thesis comprises a reflective study of the dependence relationship between creation and memory through the analysis of the latest work by the sculptor Juan Muñoz: Double Bind (Tate Modern, London, 2001). From this position, it is mandatory to rethink the analysis of the work, making it necessary to cover the widest possible range of information available beyond the work itself, in order to obtain a closer view of the convergence between memory and creation. The proposed analytical approach opens up new considerations on the relevance of knowledge during the development of the creative process. This analysis should not only make a contribution to the knowledge of the work of Juan Muñoz. It should also infer the undeniable involvement and the necessary reading of the past in the present. Amnesia regarding past makes it impossible to complete the atlas of images on which the creation is based, blocking knowledge of the origin of the sources of inspiration and the basis for the creation of a specific work. This fact limits and distorts its possible interpretations. My intention is an approach to how to understand memory as the way of looking and creating over time. Memory has a crucial role to mental activity and plays a key role in behaviour and creation. The work is the result of finding an idea that expresses something that the creator can not express otherwise. It is the need to express ideas by means of a language that develops throughout time and space, a reflection of the being that responds to the thought. It is a way of experience underlying the paths of the past and where the future is set out. Only the creator can access the work from the inside. The observer sees it from the outside and in accordance with his/her own subjectivity. The works form a part of the experience of their authors, thus implying the interpretation of the message of their experience being passed on. The pursuit of knowledge and understanding, and trying to explain the meaning of something implies a deliberate appreciation associated with the understanding of the interpreter. The works are products bearing a message and containing in their structure traces of the time lived by their creator. If one wants to come close to what the author’s posture represents, it will not only be necessary to penetrate it, but also to introduce oneself into the context of its history. Take a look back, towards the depth of the present in order to become aware of present and future thinking. To go across the installation of Double Bind by Juan Muñoz in this way offers a synthesis of his concerns and interests while also providing a not necessarily immediate knowledge, but one which is relevant and important to the work, its creator and history.

Use of infrared thermography as a tool to monitor skin temperature along the recovery process of an anterior cruciate ligament surgery

Infrared thermography (IRT) is a safe and non-invasive tool used for examining physiological functions based on skin temperature (Tsk) control. Thermograms from 25 anterior cruciate ligament (ACL) surgically operated patients (2 female, 23 male) were taken with a FLIR infrared camera according to the protocol established by the International Academy of Clinical Thermology (IACT). This work consists of 4 studies. Studies 1 and 3 were related to establish the probable thermal difference among different moments of an ACL rupture after surgery: before starting the rehabilitation (P0), at the end of rehabilitation (P1) and 18 months from the end of rehabilitation (P2). For this purpose, on the other hand, studies 2 and 4 were related to establish the skin thermal difference (Tsk) between the injured and the non-injured leg in P0, P1 and P2. Results of the first study showed significant temperature increases in the posterior thigh area between P0 and P1 probably due to a compensatory mechanism. According to this, we can conclude that temperature of the posterior area of the injured and noninjured leg has increased from the first to the last day of the rehabilitation process. In the second study we found significant temperature differences between the injured and non-injured leg in both stages of rehabilitation (p<.01). On the one hand, the temperature of the injured leg is higher in the anterior view and the temperature of the non-injured leg is higher in the posterior view. By the time the patients had recovered from the reconstruction, thermal imbalances should have not been shown between symmetrical parts, but differences seemed to be still latent.. Study 3 shows that temperatures seem to be higher after a year and a half (P2) than in P1. Study 4 shows how thermal values 18 months later seemed to be normalized between both legs. No significant differences were found between the injured leg and the noninjured leg after one year and a half of the rehabilitation process. Considering results from Study 3 and 4 we can conclude that patients seemed to have recovered from a thermal point of view. The temperature in P2 was higher but symmetrical. RESUMEN La termografía infrarroja (IRT) es una herramienta segura y no invasiva utilizada para examinar funciones fisiológicas que se basan en el control de temperatura de la piel (Tsk). Termogramas de 25 pacientes intervenidos quirúrgicamente del ligamento cruzado anterior (LCA) (2 mujeres, 23 hombres) fueron tomadas con una cámara de infrarrojos FLIR de acuerdo con el protocolo establecido por la Academia Internacional de Termología Clínica (IACT). Este trabajo consiste en 4 estudios. Los estudios 1 y 3 describen la diferencia térmica entre los diferentes momentos tras la operación del ligamento cruzado anterior: antes de comenzar la rehabilitación (P0), al final de la rehabilitación (P1) y 18 meses tras finalizar la rehabilitación (P2). Por otra parte, los estudios 2 y 4 describen la diferencia de temperatura de la piel (Tsk) entre la pierna lesionada y la pierna no lesionada en P0, P1 y P2. Los resultados del primer estudio mostraron aumentos significativos de temperatura en la zona posterior de los muslos entre P0 y P1, probablemente debido a un mecanismo de compensación. De acuerdo con esto, se puede concluir que la temperatura de la zona posterior de la pierna lesionada y no lesionada se ha incrementado desde el primero hasta el último día del proceso de rehabilitación. En el segundo estudio se encontraron diferencias significativas de temperatura entre la pierna lesionada y no lesionada en ambas etapas de la rehabilitación (p<.01). Por un lado, la temperatura de la pierna lesionada es mayor en la vista anterior. Por otro lado, la temperatura de la pierna no lesionada es mayor en la vista posterior. Una vez que los pacientes se han recuperado de todo el proceso, no deberían existir desequilibrios térmicos entre partes simétricas del cuerpo, pero las diferencias todavía estaban latentes. El tercer estudio muestra que la temperatura es más alta en P2 que en P1. El cuarto estudio muestra cómo los valores térmicos entre ambas piernas en P2 se han normalizado entre ambas piernas. No se encontraron diferencias significativas entre la pierna lesionada y la pierna no lesionada después de 18 meses tras el proceso de rehabilitación. Considerando los resultados del studio 3 y 4, podemos concluir que se ha llegado a la recuperación total desde un punto de vista térmico. La temperatura es más elevada en P2 pero simétrica.

Two-dimensional IR correlation spectroscopy: Sequential events in the unfolding process of the λ Cro-V55C repressor protein

A question often posed in protein folding/unfolding studies is whether the process is fully cooperative or whether it contains sequential elements. To address this question, one needs tools capable of resolving different events. It seems that, at least in certain cases, two-dimensional (2D) IR correlation spectroscopy can provide answers to this question. To illustrate this point, we have turned to the Cro-V55C dimer of the λ Cro repressor, a protein known to undergo thermal unfolding in two discrete steps through a stable equilibrium intermediate. The secondary structure of this intermediate is compatible with that of a partially unfolded protein and involves a reorganization of the N terminus, whereas the antiparallel β-ribbon formed by the C-terminal part of each subunit remains largely intact. To establish whether the unfolding process involves sequential events, we have performed a 2D correlation analysis of IR spectra recorded over the temperature range of 20–95°C. The 2D IR correlation analysis indeed provides evidence for a sequential formation of the stable intermediate, which is created in three (closely related) steps. A first step entails the unfolding of the short N-terminal β-strand, followed by the unfolding of the α-helices in a second step, and the third step comprises the reorganization of the remaining β-sheet and of some unordered segments in the protein. The complete unfolding of the stable intermediate at higher temperatures also undergoes sequential events that ultimately end with the breaking of the H bonds between the two β-strands at the dimer interface.

Monitoring the assembly of Ig light-chain amyloid fibrils by atomic force microscopy

Aggregation of Ig light chains to form amyloid fibrils is a characteristic feature of light-chain amyloidosis, a light-chain deposition disease. A recombinant variable domain of the light chain SMA was used to form amyloid fibrils in vitro. Fibril formation was monitored by atomic force microscopy imaging. Single filaments 2.4 nm in diameter were predominant at early times; protofibrils 4.0 nm in diameter were predominant at intermediate times; type I and type II fibrils 8.0 nm and 6.0 nm in diameter, respectively, were predominant at the endpoints. The increase in number of fibrils correlated with increased binding of the fluorescent dye thioflavin T. The fibrils and protofibrils showed a braided structure, suggesting that their formation involves the winding of protofibrils and filaments, respectively. These observations support a model in which two filaments combine to form a protofibril, two protofibrils intertwine to form a type I fibril, and three filaments form a type II fibril.

Retinoic acid (RA) and As2O3 treatment in transgenic models of acute promyelocytic leukemia (APL) unravel the distinct nature of the leukemogenic process induced by the PML-RARα and PLZF-RARα oncoproteins

Acute promyelocytic leukemia (APL) is associated with chromosomal translocations always involving the RARα gene, which variably fuses to one of several distinct loci, including PML or PLZF (X genes) in t(15;17) or t(11;17), respectively. APL in patients harboring t(15;17) responds well to retinoic acid (RA) treatment and chemotherapy, whereas t(11;17) APL responds poorly to both treatments, thus defining a distinct syndrome. Here, we show that RA, As2O3, and RA + As2O3 prolonged survival in either leukemic PML-RARα transgenic mice or nude mice transplanted with PML-RARα leukemic cells. RA + As2O3 prolonged survival compared with treatment with either drug alone. In contrast, neither in PLZF-RARα transgenic mice nor in nude mice transplanted with PLZF-RARα cells did any of the three regimens induce complete disease remission. Unexpectedly, therapeutic doses of RA and RA + As2O3 can induce, both in vivo and in vitro, the degradation of either PML-RARα or PLZF-RARα proteins, suggesting that the maintenance of the leukemic phenotype depends on the continuous presence of the former, but not the latter. Our findings lead to three major conclusions with relevant therapeutic implications: (i) the X-RARα oncoprotein directly determines response to treatment and plays a distinct role in the maintenance of the malignant phenotype; (ii) As2O3 and/or As2O3 + RA combination may be beneficial for the treatment of t(15;17) APL but not for t(11;17) APL; and (iii) therapeutic strategies aimed solely at degrading the X-RARα oncoprotein may not be effective in t(11;17) APL.

RAD51 supports spontaneous non-homologous recombination in mammalian cells, but not the corresponding process induced by topoisomerase inhibitors

The RAD51 protein has been shown to participate in homologous recombination by promoting ATP-dependent homologous pairing and strand transfer reactions. In the present study, we have investigated the possible involvement of RAD51 in non-homologous recombination. We demonstrate that overexpression of CgRAD51 enhances the frequency of spontaneous non-homologous recombination in the hprt gene of Chinese hamster cells. However, the rate of non-homologous recombination induced by the topoisomerase inhibitors campothecin and etoposide was not altered by overexpression of RAD51. These results indicate that the RAD51 protein may perform a function in connection with spontaneous non-homologous recombination that is not essential to or not rate-limiting for non-homologous recombination induced by camptothecin or etoposide. We discuss the possibility that the role played by RAD51 in non-homologous recombination observed here may not be linked to non-homologous end-joining.

Monitoring the structure of Escherichia coli RNase P RNA in the presence of various divalent metal ions

Lead(II)-induced cleavage can be used as a tool to probe conformational changes in RNA. In this report, we have investigated the conformation of M1 RNA, the catalytic subunit of Escherichia coli RNase P, by studying the lead(II)-induced cleavage pattern in the presence of various divalent metal ions. Our data suggest that the overall conformation of M1 RNA is very similar in the presence of Mg2+, Mn2+, Ca2+, Sr2+ and Ba2+, while it is changed compared to the Mg2+-induced conformation in the presence of other divalent metal ions, Cd2+ for example. We also observed that correct folding of some M1 RNA domains is promoted by Pb2+, while folding of other domain(s) requires the additional presence of other divalent metal ions, cobalt(III) hexamine or spermidine. Based on the suppression of Pb2+ cleavage at increasing concentrations of various divalent metal ions, our findings suggest that different divalent metal ions bind with different affinities to M1 RNA as well as to an RNase P hairpin–loop substrate and yeast tRNAPhe. We suggest that this approach can be used to obtain information about the relative binding strength for different divalent metal ions to RNA in general, as well as to specific RNA divalent metal ion binding sites. Of those studied in this report, Mn2+ is generally among the strongest RNA binders.

Monitoring the GAP catalyzed H-Ras GTPase reaction at atomic resolution in real time

The molecular reaction mechanism of the GTPase-activating protein (GAP)-catalyzed GTP hydrolysis by Ras was investigated by time resolved Fourier transform infrared (FTIR) difference spectroscopy using caged GTP (P3-1-(2-nitro)phenylethyl guanosine 5′-O-triphosphate) as photolabile trigger. This approach provides the complete GTPase reaction pathway with time resolution of milliseconds at the atomic level. Up to now, one structural model of the GAP⋅Ras⋅GDP⋅AlFx transition state analog is known, which represents a “snap shot” along the reaction-pathway. As now revealed, binding of GAP to Ras⋅GTP shifts negative charge from the γ to β phosphate. Such a shift was already identified by FTIR in GTP because of Ras binding and is now shown to be enhanced by GAP binding. Because the charge distribution of the GAP⋅Ras⋅GTP complex thus resembles a more dissociative-like transition state and is more like that in GDP, the activation free energy is reduced. An intermediate is observed on the reaction pathway that appears when the bond between β and γ phosphate is cleaved. In the intermediate, the released Pi is strongly bound to the protein and surprisingly shows bands typical of those seen for phosphorylated enzyme intermediates. All these results provide a mechanistic picture that is different from the intrinsic GTPase reaction of Ras. FTIR analysis reveals the release of Pi from the protein complex as the rate-limiting step for the GAP-catalyzed reaction. The approach presented allows the study not only of single proteins but of protein–protein interactions without intrinsic chromophores, in the non-crystalline state, in real time at the atomic level.

Crystal structure of the catalytic domain of Pseudomonas exotoxin A complexed with a nicotinamide adenine dinucleotide analog: implications for the activation process and for ADP ribosylation.

The catalytic, or third domain of Pseudomonas exotoxin A (PEIII) catalyzes the transfer of ADP ribose from nicotinamide adenine dinucleotide (NAD) to elongation factor-2 in eukaryotic cells, inhibiting protein synthesis. We have determined the structure of PEIII crystallized in the presence of NAD to define the site of binding and mechanism of activation. However, NAD undergoes a slow hydrolysis and the crystal structure revealed only the hydrolysis products, AMP and nicotinamide, bound to the enzyme. To better define the site of NAD binding, we have now crystallized PEIII in the presence of a less hydrolyzable NAD analog, beta-methylene-thiazole-4-carboxamide adenine dinucleotide (beta-TAD), and refined the complex structure at 2.3 angstroms resolution. There are two independent molecules of PEIII in the crystal, and the conformations of beta-TAD show some differences in the two binding sites. The beta-TAD attached to molecule 2 appears to have been hydrolyzed between the pyrophosphate and the nicotinamide ribose. However molecule 1 binds to an intact beta-TAD and has no crystal packing contacts in the vicinity of the binding site, so that the observed conformation and interaction with the PEIII most likely resembles that of NAD bound to PEIII in solution. We have compared this complex with the catalytic domains of diphtheria toxin, heat labile enterotoxin, and pertussis toxin, all three of which it closely resembles.

Extraordinary divergence and positive Darwinian selection in a fusagenic protein coating the acrosomal process of abalone spermatozoa.

During fertilization in marine invertebrates, fusion between sperm and egg cell membranes occurs at the tip of the sperm acrosomal process. In abalone sperm the acrosomal process is coated with an 18-kDa protein. In situ, this protein has no effect on the egg vitelline envelope, but in vitro it is a potent fusagen of liposomes. Thus, the 18-kDa protein may mediate membrane fusion between the gametes, a step in gamete recognition known to restrict heterospecific fertilization in other species. The cDNA and deduced amino acid sequences of the 18-kDa protein were determined for five species of California abalone. The deduced amino acid sequences exhibit extraordinary divergence; the percent identity varies from 27% to 87%. Analysis of nucleotide substitution shows extremely high frequencies of amino acid-altering substitution compared to silent substitution, demonstrating that positive Darwinian selection promotes the divergence of this protein. However, amino acid replacement is conservative with respect to size and polarity of residue. The data support the developing idea that in free-spawning marine invertebrates, the proteins mediating fertilization may be subjected to intense, and as yet unknown, selective forces. The extraordinary divergence of fertilization proteins may be related to the establishment of barriers to heterospecific fertilization.

Once Upon a Time in Therapy: Crafting Therapeutic Narratives to Help Familiarize Children with the Therapeutic Process.

Young children often harbor misconceptions about psychotherapy and the role of psychologists. These misconceptions are ignited by rumors and misinformation that are provided to the child by a variety of sources and can compromise both the effectiveness of therapy and the therapeutic dyad. In this paper we explore how recent trends in patient engagement in child psychotherapy, cultural dynamics between patients and practitioners, and children's lack of knowledge surrounding mental health services can negatively impact therapy. Wednesday Afternoons with Dr. J. (WADJ) is a whimsical fictional therapeutic narrative created to inform children about aspects of the therapeutic process while providing adults with tangible structure surrounding how to talk to children about mental healthcare. The advantages of utilizing this narrative to prime children for therapy are discussed, as are methods for promoting the narrative to the greater community.