The experience of transplantation for patients and their significant ones: A difficult encounter of two worlds

Objectives This paper reports on a longitudinal qualitative study exploring concerns of 60 patients before and after transplantation. Methods Semi-structured interviews were conducted without time constraints in a protected space out of the hospital. Qualitative analysis was performed. Results Prior to transplantation, all patients talked freely about negative feelings, stigmatisation, being misunderstood by others, loneliness and culpability caused by increasing physical dependency or abandoned roles. They mentioned alternative ways to cope (magic, spirituality), and even expressed their right to let go. In a subset of 13 patients, significant ones allowed themselves in the interview, or were integrated on the request of the patients. In this modified setting, two illness-worlds were confronted. If common themes were mentioned (e.g., modified life plans, restricted space, physical and psychological barriers), they were experienced differently. Fear of transplantation or guilt towards the donors was overtly expressed, often for the first time. Mutual hiding of anxiety in order to protect loved ones or to prevent loss of control was disclosed. The significant ones talked about accumulated stress and exhaustion related to the physical degradation of the patient, fear of the unpredictable evolution of illness and financial problems, and stressed their difficulty to adapt adequately to the fluctuating state of the patient. After transplantation, other themes emerged, where difficulty in disclosure was observed: intensive care and near death experiences, being a transplanted person, debt to the donor and his/her family, fear of rejection. Conclusions With the self-imposed strategy of hiding concerns to protect one another, a discrepancy between two illness-worlds was created. When concerns were confronted during the interviews, a new mutual understanding emerged. Patients and their families stated the need for sharing concerns in the course of illness.

"Classicisme versus Medievalisme a l'Anglaterra Victoriano-Eduardina; "A Room with a View" d'E. M. Forster com a exemple

L'objectiu d'aquest article és il·lustrar la ben coneguda oposició classicisme / medievalisme a l'Anglaterra Victoriano-Eduardina tot analitzant acuradament A Room with a View d'E. M. Forster des de la perspectiva de la Tradició Clàssica i, consegüentment, parant esment especial en el significant i la importància del conjunt de les seves referències clàssiques -grecollatines.

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Protein destabilization by mutations or external stresses may lead to misfolding and aggregation in the cell. Often, damage is not limited to a simple loss of function, but the hydrophobic exposure of aggregate surfaces may impair membrane functions and promote the aggregation of other proteins. Such a "proteinacious infectious" behavior is not limited to prion diseases. It is associated to most protein-misfolding neurodegenerative diseases and to aging in general. With the molecular chaperones and proteases, cells have evolved powerful tools that can specifically recognize and act upon misfolded and aggregated proteins. Whereas some chaperones passively prevent aggregate formation and propagation, others actively unfold and solubilize stable aggregates. In particular, ATPase chaperones and proteases serve as an intracellular defense network that can specifically identify and actively remove by refolding or degradation potentially infectious cytotoxic aggregates. Here we discuss two types of molecular mechanisms by which ATPase chaperones may actively solubilize stable aggregates: (1) unfolding by power strokes, using the Hsp100 ring chaperones, and (2) unfolding by random movements of individual Hsp70 molecules. In bacteria, fungi, and plants, the two mechanisms are key for reducing protein damages from abiotic stresses. In animals devoid of Hsp100, Hsp70 appears as the core element of the chaperone network, preventing the formation and actively removing disease-causing protein aggregates.

PRODUTIVIDADE DO TRIGO IRRIGADO SUBMETIDO À APLICAÇÃO DE NITROGÊNIO E À INOCULAÇÃO COM AZOSPIRILLUM BRASILENSE

Inocular sementes de trigo com Azospirillum brasilense pode ser benéfico à cultura do trigo, bem como reduzir a necessidade de aplicação de N. No entanto, são escassos trabalhos que mensurem o benefício dessa prática no trigo irrigado com expectativa de alta produtividade e demanda de N. Objetivou-se com este trabalho avaliar a produtividade e o conteúdo de N na planta do trigo irrigado, submetido a doses de N, com ou sem a inoculação com A. brasilense. Foram conduzidos dois experimentos em 2011 e repetidos em 2012. Em cada ano de cultivo, instalou-se um experimento na área considerada de baixa disponibilidade de N no solo (cultivo em sucessão ao milho) e outro na com alta disponibilidade (cultivo em sucessão à soja ou cenoura). Os tratamentos consistiram de cinco doses de N e da inoculação ou não com A. brasilense. As doses de N testadas foram 20, 60, 100, 140 e 180 kg ha-1 na área com baixa disponibilidade de N e 20, 50, 80, 110 e 140 kg ha-1 na com alta disponibilidade. O teor de N na folha índice foi aumentado pela inoculação com A. brasilense. Entretanto, o N absorvido não foi influenciado pela inoculação da bactéria. As doses de N aumentaram a produtividade do trigo e esse aumento foi mais evidente no cultivo na área com baixa disponibilidade de N no solo.

Permeabilidade ao Ar da Cama de Semeadura do Solo em Sistema Semeadura Direta

A permeabilidade ao ar pode ser utilizada como indicador da qualidade física do solo. O objetivo deste trabalho foi determinar a permeabilidade ao ar e os índices de continuidade de poros para a cama de semeadura em um Latossolo Vermelho distrófico cultivado no sistema semeadura direta e submetido à escarificação mecânica e escarificação biológica, utilizando a cultura do nabo forrageiro. O estudo foi conduzido em área experimental da Universidade Estadual de Ponta Grossa, Estado do Paraná. Os tratamentos implantados foram: sistema semeadura direta por 18 anos consecutivos (SD); semeadura direta submetido à escarificação mecânica (SDE); e semeadura direta submetido à escarificação biológica por meio da cultura do nabo forrageiro (SDNF). O delineamento experimental utilizado foi em blocos casualizados com quatro repetições. As amostragens de solo foram feitas aos seis e 18 meses após a implantação dos tratamentos, correspondentes às semeaduras das culturas do milho (outubro de 2009) e da soja (novembro de 2010), respectivamente, nas camadas de 0,00-0,05 e 0,05-0,10 m de profundidade. A permeabilidade ao ar foi determinada pelo permeâmetro de carga constante nos potenciais mátricos -6, -10, -30 e -100 kPa. Foram definidos os seguintes índices de continuidade de poros: índice N, índice K1 e volume de poros bloqueados; e a porosidade de aeração. Os resultados foram submetidos à análise de variância e, quando significativos, as médias dos tratamentos foram comparadas pelo teste Tukey (p<0,05). Para a camada de 0,00-0,05 m, a permeabilidade ao ar e o índice K1 no SDNF no potencial mátrico de -6 kPa foram significativamente maiores que em SD e SDE. O índice N, o volume de poros bloqueados e a porosidade de aeração não apresentaram diferenças significativas entre os tratamentos em ambas as profundidades. Os efeitos benéficos da escarificação biológica na permeabilidade do solo ao ar e no índice de continuidade de poros K1 persistiram aos 18 meses após sua aplicação. A escarificação mecânica resultou em maior continuidade do sistema poroso do solo, avaliado pelo índice K1, com persistência desse efeito aos 18 meses após sua aplicação.

De novo LMNA mutations cause a new form of congenital muscular dystrophy.

OBJECTIVE: To describe a new entity of congenital muscular dystrophies caused by de novo LMNA mutations. METHODS: Fifteen patients presenting with a myopathy of onset in the first year of life were subjected to neurological and genetic evaluation. Histopathological and immunohistochemical analyses were performed for all patients. RESULTS: The 15 patients presented with muscle weakness in the first year of life, and all had de novo heterozygous LMNA mutations. Three of them had severe early-onset disease, no motor development, and the rest experienced development of a "dropped head" syndrome phenotype. Despite variable severity, there was a consistent clinical pattern. Patients typically presented with selective axial weakness and wasting of the cervicoaxial muscles. Limb involvement was predominantly proximal in upper extremities and distal in lower extremities. Talipes feet and a rigid spine with thoracic lordosis developed early. Proximal contractures appeared later, most often in lower limbs, sparing the elbows. Ten children required ventilatory support, three continuously through tracheotomy. Cardiac arrhythmias were observed in four of the oldest patients but were symptomatic only in one. Creatine kinase levels were mild to moderately increased. Muscle biopsies showed dystrophic changes in nine children and nonspecific myopathic changes in the remaining. Markedly atrophic fibers were common, most often type 1, and a few patients showed positive inflammatory markers. INTERPRETATION: The LMNA mutations identified appear to correlate with a relatively severe phenotype. Our results further broaden the spectrum of laminopathies and define a new disease entity that we suggest is best classified as a congenital muscular dystrophy (LMNA-related congenital muscular dystrophy, or L-CMD).

Fabricants, comerciants i banquers. Les estructures comercials de la indústria cotonera catalana en el mercat español (1840-1936)

Aquesta tesi analitza la integració vertical entre fabricació, comercialització i finançament a la indústria catalana del període 1840-1936. L¿evidència obtinguda de les fonts arxivístiques confirma la visió tradicional quant a la descripció dels fets, però ofereix una interpretació alternativa, més optimista, de les causes i de les conseqüències. Els fabricants s¿implicaren en la comercialització perquè ells eren els coordinadors entre oferta i demanda (no com en el cas britànic, on ho eren els comerciants), i per tant havien de tenir un peu a cada banda. A més, els fabricants eren els més ben situats per a ser uns banquers eficients dels seus clients.

Contemporary approach to neurologic prognostication of coma after cardiac arrest.

Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

Local character of magnetic coupling in ionic solids

Magnetic interactions in ionic solids are studied using parameter-free methods designed to provide accurate energy differences associated with quantum states defining the Heisenberg constant J. For a series of ionic solids including KNiF3, K2NiF4, KCuF3, K2CuF4, and high- Tc parent compound La2CuO4, the J experimental value is quantitatively reproduced. This result has fundamental implications because J values have been calculated from a finite cluster model whereas experiments refer to infinite solids. The present study permits us to firmly establish that in these wide-gap insulators, J is determined from strongly local electronic interactions involving two magnetic centers only thus providing an ab initio support to commonly used model Hamiltonians.

Hsp70 chaperones accelerate protein translocation and the unfolding of stable protein aggregates by entropic pulling.

Hsp70s are highly conserved ATPase molecular chaperones mediating the correct folding of de novo synthesized proteins, the translocation of proteins across membranes, the disassembly of some native protein oligomers, and the active unfolding and disassembly of stress-induced protein aggregates. Here, we bring thermodynamic arguments and biochemical evidences for a unifying mechanism named entropic pulling, based on entropy loss due to excluded-volume effects, by which Hsp70 molecules can convert the energy of ATP hydrolysis into a force capable of accelerating the local unfolding of various protein substrates and, thus, perform disparate cellular functions. By means of entropic pulling, individual Hsp70 molecules can accelerate unfolding and pulling of translocating polypeptides into mitochondria in the absence of a molecular fulcrum, thus settling former contradictions between the power-stroke and the Brownian ratchet models for Hsp70-mediated protein translocation across membranes. Moreover, in a very different context devoid of membrane and components of the import pore, the same physical principles apply to the forceful unfolding, solubilization, and assisted native refolding of stable protein aggregates by individual Hsp70 molecules, thus providing a mechanism for Hsp70-mediated protein disaggregation.

Art i ciència: converses

A la infància, Enric Canadell químic teòric i Àlex Nogué artista visual comparteixen pupitre i jocs de carrer a Castellfollit de la Roca, un poble de la Garrotxa, Girona. Segueixen trajectes vitals ben diferents i desenvolupen una ampla experiència professional internacional en la ciència i l'art. Quaranta-cinc anys més tard es retroben novament sota el projecte "En comptes de la revolució, converses" promogut per Cafè Central i l'Associació per les Arts Contemporànies H.ACC per tal de cercar coincidències en les seves activitats professionals aparentment tan dispars i en la seva forma de viure-les.

Prat i Cambó: la maduresa d'un projecte polític

El text explica el procés pel qual el conglomerat electoral de la Lliga Regionalista es va convertir en un partit polític modern, amb uns quadres estables, una ideologia ben definida, uns portaveus i una estratègia electoral complexa (per a Barcelona, la resta de Catalunya i el conjunt de la política espanyola); així mateix, i coincidint amb aquest moment d¿aparició del noucentisme polític, es va formular el seu programa de govern (posat després en pràctica per la Mancomunitat). També s¿analitza com aquesta conjuntura va permetre que la Lliga assolís un contacte real amb capes àmplies de la societat i se situa el final d¿aquesta etapa en l¿esclat de la Setmana Tràgica.

Lorblanchet, M.: "La grotte ornéee de Pergouset (Saint-Géry, Lot), un sanctuaire secret paléolithique" , ed. de la Maison des Sciences de l"Homme, París 2001

El treball que ens presenta el prestigiós especialista en art paleolític Michel Lorblanchet és el fruit de deu anys de feina en una petita cova amb gravats de la zona de la vall del Lot, ben a prop de la famosa cova amb pintures de Pech-Merle.

Instrumentum Domesticum romà del Museu Episcopal de Vic. La col·lecció de segells en àmfora, tegula i morter

Les 39 marques que presentem pertanyen al fons del Museu Episcopal de Vico Es tracta, basicament, de marques ben conservades en petits fragments de ceramica, majoritariament pertanyen a àmfora, pero també existeix un petit grup en tegula, i una sola marca en mortero.

Les meules rotatives du site ibérique d'Alorda Park (Calafell, Baix Penedès, Tarragona)

El jaciment iberic d'Alorda Park esta situat a la costa central de Catalunya, a uns 30 km al nordest de Tarragona. El jaciment, l'ocupació del qual es data principalment entre el s. VI i el III aC, ha estat excavat extensament des de 1983. Els treballs d'excavació han lliurat sis metae i disset catilli de molins rotatius, la major part deis quals han estat reutilitzats per a usos secundaris. D' altra banda, cap molí rotatiu ha estat trobat in situ a l'interior d'una casa, de manera que es dedueix que la molta amb aquests instruments era probablement una activitat practicada en instaHacions communals o bé per especialistes. Pel que fa a la funcionalitat d'aquestes peces, les analisis de residus indiquen que eren utilitzades per a la molta de cereal s i, en un sol cas, de faves. Pel que fa a la cronologia, el més antic d'aquests exemplars data de mitjan segle V aC, i la utilització deis molins de rotació continua fins a finals de 1'0- cupació de I'assentament. AIllarg d'aquests tres segles, els molins rotatius d' Alorda Park sofreixen una evolució morfologica els trets essencials de la qual han pogut ser establerts. Els exemplars presentats són morfologicament similars a altres molins iberics de la costa central de Catalunya, pero es diferencien considerablement deis models documentats al País Valencia, a Ullastret i a la Gal'lia meridional. Aquest fet sembla indicar I'existencia de tradicions locals ben caracteritzades, que hauran de ser precisades per les recerques futures. Finalment, cal observar que, segons les analisis de residus, els altres instruments lítics o de triturat descoberts al jaciment (molins de vaivé, morters) han estat utilitzats per a la transformació de materies primeres.