978 resultados para Comorbidity, Claims Data, Stage of IIllness


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Viral fusion protein trimers can play a critical role in limiting lipids in membrane fusion. Because the trimeric oligomer of many viral fusion proteins is often stabilized by hydrophobic 4-3 heptad repeats, higher-order oligomers might be stabilized by similar sequences. There is a hydrophobic 4-3 heptad repeat contiguous to a putative oligomerization domain of Autographa californica multicapsid nucleopolyhedrovirus envelope glycoprotein GP64. We performed mutagenesis and peptide inhibition studies to determine if this sequence might play a role in catalysis of membrane fusion. First, leucine-to-alanine mutants within and flanking the amino terminus of the hydrophobic 4-3 heptad repeat motif that oligomerize into trimers and traffic to insect Sf9 cell surfaces were identified. These mutants retained their wild-type conformation at neutral pH and changed conformation in acidic conditions, as judged by the reactivity of a conformationally sensitive mAb. These mutants, however, were defective for membrane fusion. Second, a peptide encoding the portion flanking the GP64 hydrophobic 4-3 heptad repeat was synthesized. Adding peptide led to inhibition of membrane fusion, which occurred only when the peptide was present during low pH application. The presence of peptide during low pH application did not prevent low pH–induced conformational changes, as determined by the loss of a conformationally sensitive epitope. In control experiments, a peptide of identical composition but different sequence, or a peptide encoding a portion of the Ebola GP heptad motif, had no effect on GP64-mediated fusion. Furthermore, when the hemagglutinin (X31 strain) fusion protein of influenza was functionally expressed in Sf9 cells, no effect on hemagglutinin-mediated fusion was observed, suggesting that the peptide does not exert nonspecific effects on other fusion proteins or cell membranes. Collectively, these studies suggest that the specific peptide sequences of GP64 that are adjacent to and include portions of the hydrophobic 4-3 heptad repeat play a dynamic role in membrane fusion at a stage that is downstream of the initiation of protein conformational changes but upstream of lipid mixing.

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Stories, fables, and myths have been used for a long time in human history. They serve as a way for cultures and people to communicate, preserve important cultural values, and create meaning. The use of narratives has been recognized as a helpful technique in the field of psychology and can be found in many orientations and intervention techniques (Dwivedi, 2006; Roberts, 2000). Narrative therapy, bibliotherapy, trauma narratives, and Therapeutic Assessment (TA) are some of the areas in which the benefits of using written stories are incorporated into work with clients. In this paper, the clinical utility of using Therapeutic Assessment style fables in the termination phase of psychotherapy is explored. The termination phase is a challenging time for both therapists and clients. The use of rituals in the process of termination has been found to have a positive impact on the experience (Gutheil, 1993). This paper presents several case studies and examines the subsequent impact and clinical benefits of using termination fables in psychotherapy.

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This study provides support to the characteristics of participatory and anticipatory stages in secondary school pupils’ abstraction of mathematical conceptions. We carried out clinical task-based interviews with 71 secondary-school pupils to obtain evidence of the different constructed mathematical conceptions (Participatory Stage) and how they were used (Anticipatory Stage). We distinguish two moments in the Participatory Stage based on the coordination of information from particular cases by activity-effect reflection which, in some cases, lead to a change of focus enabling secondary-school pupils to achieve a reorganization of their knowledge. We argue that (a) the capacity of perceiving regularities in sets of particular cases is a characteristic of activity-effect reflection in the abstraction of mathematical conceptions in secondary school, and (b) the coordination of information by pupils provides opportunities for changing the attention-focus from the particular results to the structure of properties.

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Participation trends in 6-hour ultra-marathons held word-wide were investigated to gain basic demographic data on 6-hour ultra-marathoners and where these races took place. Participation trends and the association between nationality and race performance were investigated in all 6-hour races held worldwide between 1991 and 2010. Participation increased linearly in both women and men across years. The annual number of finishes was significantly higher in men than in women (P=0.013). The male-to-female ratio remained stable at ~4 since 1991. Runners in age group 45-49 years showed the largest increase in participation for both men (800 participants in 18 years) and women (208 participants in 16 years). Europe attracted most of the runners from other continents (166 runners), more than all other continents combined (55 runners). European runners also showed the best top ten performances (73±3 km for women and 77±11 km for men), while African (with 65±9 km for men) and South American (54±4 km for women and 65±2 km for men) runners showed the weakest. To summarize, participation in 6-hour ultra-marathons increased across years. Most of the development took place in Europe and in athletes in the age group 45-49 years. Europe also attracted the most diverse field of athletes with runners from all other continents. European runners accounted for the most runners and achieved the best top ten performances.