814 resultados para Advanced cardiac life support


Relevância:

30.00% 30.00%

Publicador:

Resumo:

Graft loss from chronic rejection has become the major obstacle to the long-term success of whole organ transplantation. In cardiac allografts, chronic rejection is manifested as a diffuse and accelerated form of arteriosclerosis, termed cardiac allograft vasculopathy. It has been suggested that T-cell recognition of processed alloantigens (allopeptides) presented by recipient antigen-presenting cells through the indirect pathway of allorecognition plays a critical role in the development and progression of chronic rejection. However, definitive preclinical evidence to support this hypothesis is lacking. To examine the role of indirect allorecognition in a clinically relevant large animal model of cardiac allograft vasculopathy, we immunized MHC inbred miniature swine with synthetic polymorphic peptides spanning the α1 domain of an allogeneic donor-derived swine leukocyte antigen class I gene. Pigs immunized with swine leukocyte antigen class I allopeptides showed in vitro proliferative responses and in vivo delayed-type hypersensitivity responses to the allogeneic peptides. Donor MHC class I disparate hearts transplanted into peptide-immunized cyclosporine-treated pigs not only rejected faster than unimmunized cyclosporine-treated controls (mean survival time = 5.5 +/−1.7 vs. 54.7 +/−3.8 days, P < 0.001), but they also developed obstructive fibroproliferative coronary artery lesions much earlier than unimmunized controls (<9 vs. >30 days). These results definitively link indirect allorecognition and cardiac allograft vasculopathy.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

The accelerated protein accumulation characteristic of cardiomyocyte hypertrophy results from increased cellular protein synthetic capacity (elevated ribosome content). The rate limiting step in ribosome accumulation is transcription of the rRNA genes. During neonatal cardiomyocyte hypertrophy induced by norepinephrine or spontaneous contraction, changes in the expression of a ribosomal DNA transcription factor, UBF, correlated with increased rates of ribosome biogenesis. We hypothesized that elevated expression of UBF was part of the mechanism by which these hypertrophic stimuli effected increases in the rate of transcription from the rDNA promoter. In this study, we have examined directly the effect of overexpressing UBF on rDNA transcription in neonatal cardiomyocytes in culture. In control experiments, a novel reporter construct for rDNA transcription (pSMECAT) showed similar increases in activity in response to hypertrophic stimuli (10(-4) M phenylephrine, 10(-7) M endothelin, and spontaneous contraction) as did the endogenous rRNA genes. When contraction-arrested cardiomyocytes were cotransfected with pSMECAT and increasing amounts of a UBF1 expression vector; a dose-dependent (3-5 fold) increase in rDNA transcription was observed. Western blot analysis confirmed that the overexpressed, FLAG-tagged UBF accumulated in the cardiomyocyte nuclei. The observation that overexpression of UBF1 is sufficient to increase rDNA transcription in neonatal cardiomyocytes provides evidence in support of the hypothesis that the regulation of UBF is a key component of the increased ribosome biogenesis and protein accumulation associated with cardiomyocyte hypertrophy.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

A symbiosis-based phylogeny leads to a consistent, useful classification system for all life. "Kingdoms" and "Domains" are replaced by biological names for the most inclusive taxa: Prokarya (bacteria) and Eukarya (symbiosis-derived nucleated organisms). The earliest Eukarya, anaerobic mastigotes, hypothetically originated from permanent whole-cell fusion between members of Archaea (e.g., Thermoplasma-like organisms) and of Eubacteria (e.g., Spirochaeta-like organisms). Molecular biology, life-history, and fossil record evidence support the reunification of bacteria as Prokarya while subdividing Eukarya into uniquely defined subtaxa: Protoctista, Animalia, Fungi, and Plantae.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Universal trees based on sequences of single gene homologs cannot be rooted. Iwabe et al. [Iwabe, N., Kuma, K.-I., Hasegawa, M., Osawa, S. & Miyata, T. (1989) Proc. Natl. Acad. Sci. USA 86, 9355-9359] circumvented this problem by using ancient gene duplications that predated the last common ancestor of all living things. Their separate, reciprocally rooted gene trees for elongation factors and ATPase subunits showed Bacteria (eubacteria) as branching first from the universal tree with Archaea (archaebacteria) and Eucarya (eukaryotes) as sister groups. Given its topical importance to evolutionary biology and concerns about the appropriateness of the ATPase data set, an evaluation of the universal tree root using other ancient gene duplications is essential. In this study, we derive a rooting for the universal tree using aminoacyl-tRNA synthetase genes, an extensive multigene family whose divergence likely preceded that of prokaryotes and eukaryotes. An approximately 1600-bp conserved region was sequenced from the isoleucyl-tRNA synthetases of several species representing deep evolutionary branches of eukaryotes (Nosema locustae), Bacteria (Aquifex pyrophilus and Thermotoga maritima) and Archaea (Pyrococcus furiosus and Sulfolobus acidocaldarius). In addition, a new valyl-tRNA synthetase was characterized from the protist Trichomonas vaginalis. Different phylogenetic methods were used to generate trees of isoleucyl-tRNA synthetases rooted by valyl- and leucyl-tRNA synthetases. All isoleucyl-tRNA synthetase trees showed Archaea and Eucarya as sister groups, providing strong confirmation for the universal tree rooting reported by Iwabe et al. As well, there was strong support for the monophyly (sensu Hennig) of Archaea. The valyl-tRNA synthetase gene from Tr. vaginalis clustered with other eukaryotic ValRS genes, which may have been transferred from the mitochondrial genome to the nuclear genome, suggesting that this amitochondrial trichomonad once harbored an endosymbiotic bacterium.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

INTRODUZIONE: L’integrazione mente-corpo applicata ad un ambito patologico predominante in questi tempi, come il cancro, è il nucleo di questa tesi. Il background teorico entro cui è inserita, è quello della Psiconeuroendocrinoimmunologia (Bottaccioli, 1995) e Psico-Oncologia. Sono state identificate, nella letteratura scientifica, le connessioni tra stati psicologici (mente) e condizioni fisiologiche (corpo). Le variabili emerse come potenzialmente protettive in pazienti che si trovano ad affrontare il cancro sono: il supporto sociale, l’immagine corporea, il coping e la Qualità della Vita, insieme all’indice fisiologico Heart Rate Variability (HRV; Shaffer & Venner, 2013). Il potenziale meccanismo della connessione tra queste variabili potrebbe essere spiegato dall’azione del Nervo Vago, come esposto nella Teoria Polivagale di Stephen Porges (2007; 2009). OBIETTIVI: Gli obiettivi principali di questo studio sono: 1. Valutare l’adattamento psicologico alla patologia in termini di supporto sociale percepito, immagine corporea, coping prevalente e qualità della vita in donne con cancro ovarico; 2. Valutare i valori di base HRV in queste donne; 3. Osservare se livelli più elevati di HRV sono associati ad un migliore adattamento psicologico alla patologia; 4. Osservare se una peggiore percezione dell’immagine corporea e l’utilizzo di strategie di coping disadattive sono associate ad una Qualità della Vita più scarsa. METODO: 38 donne affette da cancro ovarico, al momento della valutazione libere da patologia, sono state reclutate presso la clinica oncologica del reparto di Ginecologia dell’Azienda Ospedaliero-Universitaria di Parma, Italia. Ad ogni partecipante è stato chiesto di compilare una batteria di test composta da: MSPSS, per la valutazione del supporto sociale percepito; DAS-59, per la valutazione dell’immagine corporea; MAC, per la valutazione delle strategie di coping prevalenti utilizzate verso il cancro; EORTC-QLQ30, per la valutazione della Qualità della Vita. Per ogni partecipante è stato registrato HRV di base utilizzando lo strumento emWave (HeartMath). RISULTATI PRINCIPALI: Rispondendo agli obiettivi 1 e 2, in queste donne si è rilevato una alto tasso di supporto sociale percepito, in particolare ricevuto dalla persona di riferimento. L’area rivelatasi più critica nel supporto sociale è quella degli amici. Per quanto riguarda l’immagine corporea, la porzione di campione dai 30 ai 61 anni, ha delle preoccupazioni globali legate all’immagine corporea paragonabili ai dati provenienti dalla popolazione generale con preoccupazioni riguardo l’aspetto corporeo. Invece, nella porzione di campione dai 61 anni in su, il pattern di disagio verso l’aspetto fisico sembra decisamente peggiorare. Inoltre, in questo campione, si è rilevato un disagio globale verso l’immagine corporea significativamente più alto rispetto ai valori normativi presenti in letteratura riferiti a donne con cancro al seno con o senza mastectomia (rispettivamente t(94)= -4.78; p<0.000001; t(110)= -6.81;p<0.000001). La strategia di coping più utilizzata da queste donne è lo spirito combattivo, seguito dal fatalismo. Questo campione riporta, inoltre, una Qualità della Vita complessivamente soddisfacente, con un buon livello di funzionamento sociale. L’area di funzionalità più critica risulta essere il funzionamento emotivo. Considerando i sintomi prevalenti, i più riferiti sono affaticamento, disturbi del sonno e dolore. Per definire, invece, il pattern HRV, sono stati confrontati i dati del campione con quelli presenti in letteratura, riguardanti donne con cancro ovarico. Il campione valutato in questo studio, ha un HRV SDNN (Me=28.2ms) significativamente più alto dell’altro gruppo. Tuttavia, confrontando il valore medio di questo campione con i dati normativi sulla popolazione sana (Me=50ms), i nostri valori risultano drasticamente più bassi. In ultimo, donne che hanno ricevuto diagnosi di cancro ovarico in età fertile, sembrano avere maggiore HRV, migliore funzionamento emotivo e minore sintomatologia rispetto alle donne che hanno ricevuto diagnosi non in età fertile. Focalizzando l’attenzione sulla ricerca di relazioni significative tra le variabili in esame (obiettivo 3 e 4) sono state trovate numerose correlazioni significative tra: l’età e HRV, supporto percepito , Qualità della Vita; Qualità della Vita e immagine corporea, supporto sociale, strategie di coping; strategie di coping e immagine corporea, supporto sociale; immagine corporea e supporto sociale; HRV e supporto sociale, Qualità della Vita. Per verificare la possibile connessione causale tra le variabili considerate, sono state applicate regressioni lineari semplici e multiple per verificare la bontà del modello teorico. Si è rilevato che HRV è significativamente positivamente influenzata dal supporto percepito dalla figura di riferimento, dal funzionamento di ruolo, dall’immagine corporea totale. Invece risulta negativamente influenzata dal supporto percepito dagli amici e dall’uso di strategie di coping evitanti . La qualità della vita è positivamente influenzata da: l’immagine corporea globale e l’utilizzo del fatalismo come strategia di coping prevalente. Il funzionamento emotivo è influenzato dal supporto percepito dalla figura di riferimento e dal fatalismo. DISCUSSIONI E CONCLUSIONI: Il campione Italiano valutato, sembra essere a metà strada nell’adattamento dello stato psicologico e dell’equilibrio neurovegetativo al cancro. Sicuramente queste donne vivono una vita accettabile, in quanto sopravvissute al cancro, ma sembra anche che portino con sé preoccupazioni e difficoltà, in particolare legate all’accettazione della loro condizione di sopravvissute. Infatti, il migliore adattamento si riscontra nelle donne che hanno avuto peggiori condizioni in partenza: stadio del cancro avanzato, più giovani, con diagnosi ricevuta in età fertile. Pertanto, è possibile suggerire che queste condizioni critiche forzino queste donne ad affrontare apertamente il cancro e la loro situazione di sopravvissute al cancro, portandole ad “andare avanti” piuttosto che “tornare indietro”. Facendo riferimento alle connessioni tra variabili psicologiche e fisiologiche in queste donne, si è evidenziato che HRV è influenzata dalla presenza di figure significative ma, in particolare, è presumibile che sia influenzata da un’appropriata condivisione emotiva con queste figure. Si è anche evidenziato che poter continuare ad essere efficaci nel proprio contesto personale si riflette in un maggiore HRV, probabilmente in quanto permette di preservare il senso di sé, riducendo in questo modo lo stress derivante dall’esperienza cancro. Pertanto, HRV in queste donne risulta associato con un migliore adattamento psicologico. Inoltre, si è evidenziato che in queste donne la Qualità della Vita è profondamente influenzata dalla percezione dell’immagine corporea. Si tratta di un aspetto innovativo che è stato rilevato in questo campione e che, invece, nei precedenti studi non è stato indagato. In ultimo, la strategia di coping fatalismo sembra essere protettiva e sembra facilitare il processo di accettazione del cancro. Si spera sinceramente che le ricerche future possano superare i limiti del presente studio, come la scarsa numerosità e l’uso di strumenti di valutazione che, per alcuni aspetti come la scala Evitamento nel MAC, non centrano totalmente il target di indagine. Le traiettorie future di questo studio sono: aumentare il numero di osservazioni, reclutando donne in diversi centri specialistici in diverse zone d’Italia; utilizzare strumenti più specifici per valutare i costrutti in esame; valutare se un intervento di supporto centrato sul miglioramento di HRV (come HRV Biofeedback) può avere una ricaduta positiva sull’adattamento emotivo e la Qualità della Vita.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Cancer in a parent or caregiver is an event that affects the whole family. The roles and responsibilities of the diagnosed parent, as well as those of each family member, are affected at the time of diagnosis and throughout the progression of the illness. According to the American Cancer Society, there will be an estimated 1,665,540 new cancer cases diagnosed and 585,720 cancer deaths in 2014. This staggering statistic means there are a number of cancer diagnoses that will directly affect thousands of parents and their children. Past research suggests this upheaval in the system is particularly stressful on children and can lead to a number of responses including anxiety, depression, distress, and other negative reactions. Despite the large number of parents and caregivers diagnosed with cancer in the United States each year, there are relatively few support groups aimed at supporting children affected by parental cancer. Support groups provide opportunities to serve this population in a number of advantageous ways by providing safety, support, and a sense of community. Additionally, support groups allow this population of young people to express their fears and worries, connect to others going through similar circumstances, and explore their parent's diagnosis in a context that is helpful and developmentally appropriate. Past research has found that children who do not receive support during this life-changing event can be negatively affected throughout the life span. On the other hand, this event can be a time to build a child's resilience and provide the structure through which they may thrive in adversity. Support groups offer the opportunity to address this difficult event and lead to positive results. Kids Alive! is one such group that has been proactive in support for children of parents diagnosed with cancer since 1995. Kids Alive!, a support group that runs out of Porter Hospital in Denver Colorado, uses Joseph Campbell's Hero's Journey to structure monthly groups. The Hero's Journey, described in Campbell's The Hero with a Thousand Faces (1949), focuses on a set pattern that all heroes must go through during their journey towards an ultimate victory and self-discovery. Kids Alive! incorporates this journey into a curriculum aimed at helping children explore their thoughts and feelings around their parent's cancer and leads to a realization that they are not alone on this journey. Over the course of eight months, children in Kids Alive! receive support and solidarity that leads to life-changing experiences and an understanding of what a diagnosis of cancer in a parent can mean. Kids Alive! consists of professionals and volunteers who take time to recognize and support this underserved population. The program has led to positive outcomes for nearly two decades and consistently increases the numbers of children and families served. The purpose of this paper is to describe the Kids Alive! program as an exemplar program that addresses these problems by utilizing protective factors research has found in this population. Further, this paper will discuss areas of future research while providing the model of an effective program aimed at serving an important population. Additionally, the model of Kids Alive! will be described through this paper in a way that allows for other oncology settings to consider this relatively simple program that provides consistently positive results.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

This article presents an interactive Java software platform which enables any user to easily create advanced virtual laboratories (VLs) for Robotics. This novel tool provides both support for developing applications with full 3D interactive graphical interface and a complete functional framework for modelling and simulation of arbitrary serial-link manipulators. In addition, its software architecture contains a high number of functionalities included as high-level tools, with the advantage of allowing any user to easily develop complex interactive robotic simulations with a minimum of programming. In order to show the features of the platform, the article describes, step-by-step, the implementation methodology of a complete VL for Robotics education using the presented approach. Finally, some educational results about the experience of implementing this approach are reported.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Poster presented in the 24th European Symposium on Computer Aided Process Engineering (ESCAPE 24), Budapest, Hungary, June 15-18, 2014.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

In this work, we analyze the effect of incorporating life cycle inventory (LCI) uncertainty on the multi-objective optimization of chemical supply chains (SC) considering simultaneously their economic and environmental performance. To this end, we present a stochastic multi-scenario mixed-integer linear programming (MILP) coupled with a two-step transformation scenario generation algorithm with the unique feature of providing scenarios where the LCI random variables are correlated and each one of them has the desired lognormal marginal distribution. The environmental performance is quantified following life cycle assessment (LCA) principles, which are represented in the model formulation through standard algebraic equations. The capabilities of our approach are illustrated through a case study of a petrochemical supply chain. We show that the stochastic solution improves the economic performance of the SC in comparison with the deterministic one at any level of the environmental impact, and moreover the correlation among environmental burdens provides more realistic scenarios for the decision making process.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

In this qualitative study we explored how gender shapes the women´s experiences of living with Fibromyalgia and how it affects their private lives. Through thematic analysis of data from 13 in-depth interviews in Spain, we identified 7 themes which reflect that these women feel remorse and frustration for not being able to continue to fulfil the gender expectation of caring for others and for the home. This research contributes to a better understanding into what suffering from fibromyalgia implies for women and provides insights into how family and providers can support women with fibromyalgia in order to achieve a beneficial lifestyle.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

The purpose of this paper is to analyse the economic basis of mass support for, and opposition to the European Community. In other words the main question is: to what extent, and in what ways, is popular support or opposition to the EC dependent upon economic circumstances and considerations? Behind this research question lies the matter of the legitimacy of the EC in the eyes of citizens across Europe. In some respects the results of this study are frustrating and inconclusive. In other respects, however, the results suggest some clear generalizations and conclusions. First, we have found rather little evidence that the EC or European unification are evaluated in primarily economic terms. Secondly, support seems to be associated more strongly with social and attitudinal variables of a non-economic kind. Thirdly, the figures suggest that diffuse and somewhat idealistic reasons for supporting unification and EC membership tend to outweigh more specific reasons. Fourthly, a solid foundation of inertia, custom, and national tradition seem to maintain support and make it grow.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Essai doctoral d’intégration présenté à la Faculté des études supérieures et postdoctorales en vue de l’obtention du grade Psychologiae Doctor (D.Psy) en psychologie clinique, option clinique.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

This report aims at understanding how persons aged 50 years and older are and can be integrated into the working society in Belgium. We are interested in how people in this age group can be induced to engage in various forms of employment and lifelong learning. Based on secondary literature, descriptive databases as well as interviews with experts and focus groups, we find that the discussion on active ageing in Belgium is well advanced with numerous contributions by academics, stakeholders, social partners, the public administration and interest groups. The wish to retire at 60 is widely shared, but at the same time the majority of Belgium’s elderly are able and would be willing to work under specific conditions. Therefore, we recommend that Belgium should invest in more flexible systems including a revision of the tax scheme, such as the part-time retirement system proposed by the insurance company Delta Lloyd. An equally relevant recommendation would be to ensure that public employment agencies, employers and agencies that provide training encourage all workers to work and learn regardless of their age.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

At the height of the financial crisis, the Western welfare state prevented a repeat of the Great Depression. But there were also suggestions that social policy had contributed to the crisis, particularly by promoting households’ access to credit in pursuit of welfare goals. Others claim that it was the withdrawal of state welfare that led to the disaster. Against this background that motivated our interest, we propose a systematic way of assessing the relationship between financial market and public welfare provisions. We use structural vector auto-regression to establish the causal link and its direction. Two hypotheses about this relationship can be inferred from the literature. First, the notion that welfare states ‘decommodify’ livelihoods or that there is an equity-efficiency tradeoff would suggest that welfare states substitute to varying degrees for financial market offers of insurance and savings. By contrast, welfare states may support private interests selectively and/or help markets for households to function better; thus the nexus would be one of complementarity. Our empirical strategy is to spell out the causal mechanisms that can account for a substitutive or complementary relationship and then to see whether advanced econometric techniques find evidence for the existence of either of these mechanisms in six OECD countries. We find complementarity between public welfare (spending and tax subsidies) and life insurance markets for four out of our six countries, notably even for the United States. Substitution between welfare and finance is the more plausible interpretation for France and the Netherlands, which is surprising. Data availability constrains us from testing the implications for the welfare state contribution to the crisis directly but our findings suggest that the welfare state cannot generally be blamed for the financial crisis.

Relevância:

30.00% 30.00%

Publicador:

Resumo:

Mechanotransduction refers to the conversion of mechanical forces into biochemical or electrical signals that initiate structural and functional remodeling in cells and tissues. The heart is a kinetic organ whose form changes considerably during development and disease. This requires cardiomyocytes to be mechanically durable and able to mount coordinated responses to a variety of environmental signals on different time scales, including cardiac pressure loading and electrical and hemodynamic forces. During physiological growth, myocytes, endocardial and epicardial cells have to adaptively remodel to these mechanical forces. Here we review some of the recent advances in the understanding of how mechanical forces influence cardiac development, with a focus on fluid flow forces. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Develomental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.