Globalization and technological change are transforming the ways in which buildings are being designed and built. An overlooked aspect of this development is its impact on construction labor, and the significance of l...Globalization and technological change are transforming the ways in which buildings are being designed and built. An overlooked aspect of this development is its impact on construction labor, and the significance of labor for assessing the work of architecture. The paper draws upon the sociological concept of the “glocal” to analyse the construction site as the product of the tension between global and local conditions of architectural production and consumption. The construction of Preston Scott Cohen’s 2010 Tel Aviv Museum Addition serves as its case study for theorizing the “glocal” dynamics of digital architecture, building technology and construction labor. This methodological approach highlights the role of migrant guest workers and technological transfer in contemporary construction culture. To realize with precision the complex design under local constraints, the contractor developed a hybrid work process that interspersed labor saving automated manufacturing techniques with artisanal, skilled construction work. In addition, workers and contractors exercised a high level of control over the pace and method of construction, and devised building solutions which improved upon the architect’s design. In conclusion, the paper argues that construction activity differs from broader trends in manufacturing due to the self-reflexivity of architectural design to its condition of production, but that at the same time, this critical capacity is enabled by the globalization of construction labor.展开更多
Translation regulation is an important layer of gene expression:Generation of genome-wide expression datasets at multi-omics levels in spatial,temporal,and cell-type resolution is essential for deciphering brain compl...Translation regulation is an important layer of gene expression:Generation of genome-wide expression datasets at multi-omics levels in spatial,temporal,and cell-type resolution is essential for deciphering brain complexity.Regulation of gene expression is a highly dynamic process aiming at the production of precise levels of gene products to guarantee optimal cellular function,in response to physiological cues.Speedy advances in next-generation sequencing enabled the understanding of epigenomic and transcriptomic dynamic landscapes of different brain regions along development,aging,and disease progression.However,the correlation of the“transcriptome”with protein levels is poor because numerous mRNAs are subjected to manipulation of their translation efficiency,to warrant a favorable result under certain conditions.Hence,it is widely accepted that regulation at the translation level is a vital layer of gene expression.Quantification of actively translated mRNA populations(i.e.,“translatome”)is a more reliable predictor of the“proteome”(Wang et al.,2020).展开更多
Colorectal cancer (CRC) is caused by a series of genetic or epigenetic changes, and in the last decade there has been an increased awareness that there are multiple forms of colorectal cancer that develop through di...Colorectal cancer (CRC) is caused by a series of genetic or epigenetic changes, and in the last decade there has been an increased awareness that there are multiple forms of colorectal cancer that develop through different pathways. Microsatellite instability is involved in the genesis of about 15% of sporadic colorectal cancers and most of hereditary nonpolyposis cancers. Tumors with a high frequency of microsatellite instability tend to be diploid, to possess a mucinous histology, and to have a surrounding lymphoid reaction. They are more prevalent in the proximal colon and have a fast pass from polyp to cancer. Nevertheless, they are associated with longer survival than stage-matched tumors with microsateUite stability. Resistance of colorectal cancers with a high frequency of microsatellite instability to 5-fluorouracilbased chemotherapy is well established. Silencing the MLH1 gene expression by its promoter methylation stops the formation of MLH1 protein, and prevents the normal activation of the DNA repair gene. This is an important cause for genomic instability and cell proliferation to the point of colorectal cancer formation. Better knowledge of this process will have a huge impact on colorectal cancer management, prevention, treatment and prognosis.展开更多
BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide.The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe...BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide.The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur.A major challenge is to diagnose advanced fibrosis as early as possible,using simple and non-invasive diagnostics tools.Thrombocytopenia represents advanced fibrosis and portal hypertension(HTN)and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor.However,little is known about the association between longitudinal changes in platelet counts(PTC),when still within the normal range,and the risk of cirrhosis.AIM To explore whether platelet counts trajectories over time,can predict advanced liver fibrosis across the different etiologies of liver diseases.METHODS A nested case-control study utilizing a large computerized database.Cirrhosis cases(n=5258)were compared to controls(n=15744)matched for age and sex at a ratio of 1:3.All participants had multiple laboratory measurements prior to enrollment.We calculated the trends of PTC,liver enzymes,bilirubin,international normalized ratio,albumin and fibrosis scores(fibrosis-4 and aspartate transaminase-to-platelet ratio index)throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls.The association between PTC,cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated.RESULTS The mean age in both groups was 56(SD 15.8).Cirrhotic patients were more likely to be smokers,diabetic with chronic kidney disease and had a higher prevalence of HTN.The leading cirrhosis etiologies were viral,alcoholic and fatty liver disease.The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL.This trend was consistent regardless of sex,cirrhosis etiology and was more pronounced in patients who developed varices and ascites.Compared to controls whose values remained in the normal range,in the cirrhosis group aspartate aminotransferase and alanine aminotransferase,increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis.In multivariable regression analysis,a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis(95%CI 1.25-1.35).CONCLUSION In the preceding years before the diagnosis of cirrhosis,there is a progressive decline in PTC,within the normal range,matched to a gradual increase in fibrosis scores.展开更多
AIM: To evaluate daclatasvir vs telaprevir, each combined with peginterferon alfa-2a/ribavirin(peg IFN/RBV), in treatment-naive hepatitis C virus(HCV) genotype(GT) 1-infected patients.METHODS: In this phase 3, randomi...AIM: To evaluate daclatasvir vs telaprevir, each combined with peginterferon alfa-2a/ribavirin(peg IFN/RBV), in treatment-naive hepatitis C virus(HCV) genotype(GT) 1-infected patients.METHODS: In this phase 3, randomized, open-label, noninferiority study, 602 patients were randomly assigned(2:1) to daclatasvir vs telaprevir, stratified by IL28 B rs12979860 host genotype(CC vs non-CC), cirrhosis status(compensated cirrhosis vs no cirrhosis), and HCV GT1 subtype(GT1a vs GT1b). Patients were selected by study inclusion criteria from a total of 793 enrolled patients. Patients received daclatasvir 60 mg once daily or telaprevir 750 mg 3 times daily plus peg IFN/RBV. Daclatasvir recipients received 24 wk of daclatasvir plus peg IFN/RBV; those without an extended rapid virologic response(e RVR; undetectable HCV-RNA at weeks 4 and 12) received an additional 24 wk of peg IFN/RBV. Telaprevir-treated patients received 12 wk of telaprevir plus peg IFN/RBV followed by 12(with e RVR) or 36(no e RVR) wk of peg IFN/RBV. The primary objective was to compare for noninferiority of sustained virologic response rates at posttreatment week 12(SVR12) in GT1b-infected patients. Key secondary objectives were to demonstrate that the rates of anemia(hemoglobin < 10 g/d L) and rashrelated events, through week 12, were lower with daclatasvir + peg IFN/RBV than with telaprevir + peg IFN/RBV among GT1b-infected patients. Resistance testing was performed using population-based sequencing of the NS5 A region for all patients at baseline, and for patients with virologic failure or relapse and HCV-RNA ≥ 1000 IU/m L, to investigate any link between NS5 A polymorphisms associated with daclatasvir resistance and virologic outcome. RESULTS: Patient demographics and disease characteristics were generally balanced across treatment arms; however, there was a higher proportion of black/African Americans in the daclatasvir groups(6.0% and 8.2% in the GT1 b and GT1 a groups, respectively) than in the telaprevir groups(2.2% and 3.0%). Among GT1 binfected patients, daclatasvir plus peg IFN/RBV was noninferior to telaprevir plus peg IFN/RBV for SVR12 [85%(228/268) vs 81%(109/134); difference, 4.3%(95%CI:-3.3% to 11.9%)]. Anemia(hemoglobin < 10 g/d L) was significantly less frequent with daclatasvir than with telaprevir [difference,-29.1%(95%CI:-38.8% to-19.4%)]. Rash-related events were also less common with daclatasvir than with telaprevir, but the difference was not statistically significant. In GT1 ainfected patients, SVR12 was 64.9% with daclatasvir and 69.7% with telaprevir. Among both daclatasvir and telaprevir treatment groups, across GT1b- or GT1a-infected patients, lower response rates were observed in patients with IL28 B non-CC and cirrhosis- factors known to affect response to peg IFN/RBV. Consistent with these observations, a multivariate logistic regression analysis in GT1b-infected patients d e m o n s t ra t e d t h a t S V R 1 2 wa s a s s o c i a t e d w i t h IL28 B host genotype(CC vs non-CC, P = 0.011) and cirrhosis status(absent vs present, P = 0.031). NS5 A polymorphisms associated with daclatasvir resistance(at L28, R30, L31, or Y93) were observed in 17.3% of GT1b-infected patients at baseline; such variants did not appear to be absolute predictors of failure since 72.1% of these patients achieved SVR12 compared with 86.9% without these polymorphisms. Among GT1b-infected patients, treatment was completed by 85.4%(229/268) in the daclatasvir group, and by 85.1%(114/134) in the telaprevir group, and among GT1a-infected patients, by 67.2%(90/134) and 69.7%(46/66), respectively. Discontinuations(of all 3 agents) due to an AE were more frequent with telaprevir than with daclatasvir, whereas discontinuations due to lack of efficacy were more frequent with daclatasvir, due, in part, to differences in futility criteria. CONCLUSION: Daclatasvir plus peg IFN/RBV demonstrated noninferiority to telaprevir plus peg IFN/RBV for SVR12 and was well-tolerated in treatment-naive GT1 binfected patients, supporting the use of daclatasvir with other direct-acting antivirals.展开更多
Accumulating evidence indicates that ataxia-telangiectasia mutated kinase is critical for maintaining cellular homeostasis and that it has both nuclear and cytoplasmic functions.However,the functions of ataxia-telangi...Accumulating evidence indicates that ataxia-telangiectasia mutated kinase is critical for maintaining cellular homeostasis and that it has both nuclear and cytoplasmic functions.However,the functions of ataxia-telangiectasia mutated that when lost lead to cerebellar degeneration are still unknown.In this review,we first describe the role of ataxia-telangiectasia mutated in cerebellar pathology.In addition to its canonical nuclear functions in DNA damage response circuits,ataxia-telangiectasia mutated functions in various cytoplasmic and mitochondrial processes that are critically important for cellular homeostasis.We discuss these functions with a focus on the role of ataxia-telangiectasia mutated in maintaining the homeostatic redox state.Finally,we describe the unique functions of ataxia-telangiectasia mutated in various types of neuronal and glial cells including cerebellar granule neurons,astrocytes,and microglial cells.展开更多
A detailed analysis of the influence of Rydberg states to the behavior of GPS satellite signals in the D and E atmospheric layers has been carried out. It is demonstrated that these states are the main reason for the ...A detailed analysis of the influence of Rydberg states to the behavior of GPS satellite signals in the D and E atmospheric layers has been carried out. It is demonstrated that these states are the main reason for the GPS signal distortion. It is shown that the behavior of satellite signals is associated with the spectral characteristics of the UHF radiation of the Rydberg states depending on the geomagnetic conditions of ionosphere. The foundations of the quantum theory of distortion and delay of GPS satellite signal propagation through D and E atmospheric layers are analyzed and expounded. The problem reduces to the resonant scattering of photons, moving in the electromagnetic field of the signal, to the Rydberg complexes populated in a two-temperature non-equilibrium plasma. The processes of creation of additional photons because of stimulated emission and resonance scattering of photons are considered. In the present work, the quantum theory of the propagation of a satellite signal in the Earth’s upper atmosphere, firstly earlier proposed by the same authors, is described in detail. The general problems of the theory and possible theoretical and applied consequences are discussed. It is explained that two main processes occurring here, are directly related to the resonant quantum properties of the propagation medium. The first process leads to a direct increase in the power of the received signal, and second—to a shift in the signal carrier frequency??and the time delay??of its propagation. The main reasons of the processes are scattering of the Rydberg electron by the ion core and presence of the neutral medium molecule in the intermediate autoionization states of the composite system populated by the strong non-adiabatic coupling of electron and nuclear motions. The main purposes of our investigation are the physical justification of the formation of parameters ?and??using the quantum dynamics of the electron behavior in the intermediate state of the Rydberg complex A**M and the estimation of the quantities of??and??in the elementary act of elastic (Rayleigh) photon scattering.展开更多
Background: Hereditary hemorrhagic telangiectasia (HHT) is a relatively common, albeit under-recognized autosomal-dominant multisystemic vascular disorder. Epistaxis due to telangiectases in the nasal mucosa is the mo...Background: Hereditary hemorrhagic telangiectasia (HHT) is a relatively common, albeit under-recognized autosomal-dominant multisystemic vascular disorder. Epistaxis due to telangiectases in the nasal mucosa is the most common and often the earliest symptom of HHT. As many as 90% of affected individuals eventually experience recurrent epistaxis, with a mean frequency of 18 episodes per month. Prompted by the limitations of invasive treatment, researchers have directed attention to laser photocoagulation as an alternative nonsurgical treatment modality with promising results. Purpose: The purpose of the present study was to describe our experience with the state-of-the-art 980 nm diode laser for the treatment of bleeding lesions of the skin, nasal and oral mucosa in patients with HHT. Methodology/Principal: We treated 16 HHT patients with intractable bleeding from telangiectasias using the 980-nm diode laser as an office procedure using local anesthesia. We recorded hemoglobin levels before and after treatment and used disability questionnaires. Results: All patients treated had an improvement in hemoglobin levels and disability scores. In patients with multiple lesions hemoglobin levels improved from a mean of 8.4 to 11.2 (p = 0.008). The disability index in this group improved from a mean of 5.3 to 2.8 (p = 0.007). Follow-up ranged between 4 and 12 months. Conclusions: The 980-nm diode laser is a good office based solution for bleeding in HHT.展开更多
Three-dimensional(3D)printing has attracted increasing research interest as an emerging manufacturing technology for devel-oping sophisticated and exquisite architecture through hierarchical printing.It has also been ...Three-dimensional(3D)printing has attracted increasing research interest as an emerging manufacturing technology for devel-oping sophisticated and exquisite architecture through hierarchical printing.It has also been employed in various advanced industrial areas.The development of intelligent biomedical engineering has raised the requirements for 3D printing,such as flexible manufacturing processes and technologies,biocompatible constituents,and alternative bioproducts.However,state-of-the-art 3D printing mainly involves inorganics or polymers and generally focuses on traditional industrial fields,thus severely limiting applications demanding biocompatibility and biodegradability.In this regard,peptide architectonics,which are self-assembled by programmed amino acid sequences that can be flexibly functionalized,have shown promising potential as bioinspired inks for 3D printing.Therefore,the combination of 3D printing and peptide self-assembly poten-tially opens up an alternative avenue of 3D bioprinting for diverse advanced applications.Israel,a small but innovative nation,has significantly contributed to 3D bioprinting in terms of scientific studies,marketization,and peptide architectonics,including modulations and applications,and ranks as a leading area in the 3D bioprinting field.This review summarizes the recent progress in 3D bioprinting in Israel,focusing on scientific studies on printable components,soft devices,and tissue engineering.This paper further delves into the manufacture of industrial products,such as artificial meats and bioinspired supramolecular architectures,and the mechanisms,physicochemical properties,and applications of peptide self-assembly.Undoubtedly,Israel contributes significantly to the field of 3D bioprinting and should thus be appropriately recognized.展开更多
The ramifications of global climate change and resource scarcities have made it imperative to re-examine the definition of sustainable energy-storage systems.It is crucial to recognize that not all renewable resources...The ramifications of global climate change and resource scarcities have made it imperative to re-examine the definition of sustainable energy-storage systems.It is crucial to recognize that not all renewable resources are inherently sustainable,and their full impact on the environment must be assessed.With the proliferation of invasive jellyfish species wreaking havoc on marine ecosystems and economies worldwide,utilizing overabundant jellyfish as a carbon source presents an opportunity to create energy-storage systems that are both financially beneficial and environmentally remediating.Accordingly,a comprehensive approach to sustainability also requires eco-friendly solutions throughout the entire lifecycle,from material sourcing to battery production,without compromising highperformance requirements.Currently,most electrode syntheses for lithium-ion batteries(LIBs) employed are energy-intensive,multiple-steps,complex,and additive-heavy.In response,this work pioneers the straightforward use of low-energy laser irradiation of a jellyfish biomass/silicon nanoparticle blend to encapsulate the silicon nanoparticles in-situ within the as-forming conductive carbonized matrix,creating sustainable and additive-free composite anodes.The self-standing anode is directly synthesized under ambient conditions and requires no post-processing.Here,a laser-synthesized conductive threedimensional porous carbon/silicon composite anode from raw jellyfish biomass for LIBs is presented,displaying outstanding cyclic stability(>1000 cycles),excellent capacity retention(>50% retention after1000 cycles),exceptional coulombic efficiency(>99%),superb reversible gravimetric capacity(>2000 mAh/g),and high rate performance capability(>1.6 A/g),paving a new path to future sustainable energy production.展开更多
Recent technological advancements,such as portable electronics and electric vehicles,have created a pressing need for more efficient energy storage solutions.Lithium-ion batteries(LIBs)have been the preferred choice f...Recent technological advancements,such as portable electronics and electric vehicles,have created a pressing need for more efficient energy storage solutions.Lithium-ion batteries(LIBs)have been the preferred choice for these applications,with graphite being the standard anode material due to its stability.However,graphite falls short of meeting the growing demand for higher energy density,possessing a theoretical capacity that lags behind.To address this,researchers are actively seeking alternative materials to replace graphite in commercial batteries.One promising avenue involves lithiumalloying materials like silicon and phosphorus,which offer high theoretical capacities.Carbon-silicon composites have emerged as a viable option,showing improved capacity and performance over traditional graphite or pure silicon anodes.Yet,the existing methods for synthesizing these composites remain complex,energy-intensive,and costly,preventing widespread adoption.A groundbreaking approach is presented here:the use of a laser writing strategy to rapidly transform common organic carbon precursors and silicon blends into efficient“graphenic silicon”composite thin films.These films exhibit exceptional structural and energy storage properties.The resulting three-dimensional porous composite anodes showcase impressive attributes,including ultrahigh silicon content,remarkable cyclic stability(over 4500 cycles with∼40%retention),rapid charging rates(up to 10 A g^(-1)),substantial areal capacity(>5.1 mAh cm^(-2)),and excellent gravimetric capacity(>2400 mAh g^(-1) at 0.2 A g^(-1)).This strategy marks a significant step toward the scalable production of high-performance LIB materials.Leveraging widely available,cost-effective precursors,the laser-printed“graphenic silicon”composites demonstrate unparalleled performance,potentially streamlining anode production while maintaining exceptional capabilities.This innovation not only paves the way for advanced LIBs but also sets a precedent for transforming various materials into high-performing electrodes,promising reduced complexity and cost in battery production.展开更多
AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career...AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.展开更多
Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidat...Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.展开更多
The key point in studying or teaching the history of Chinese medicine is on the doctrines underlying it and on its perception of the body,physiology,pathology,and its treatment.Namely,there is often a tendency to focu...The key point in studying or teaching the history of Chinese medicine is on the doctrines underlying it and on its perception of the body,physiology,pathology,and its treatment.Namely,there is often a tendency to focus on reading and analysing the classical canons and therapy-related texts including formularies and materia medica collections.However,focusing on these sources provides us with a one-sided presentation of Chinese medicine.These primary sources lack the clinical down-to-earth know-how that encompasses medical treatment,which are represented,for instance,in the clinical rounds of modern medical schools.Our traditional focus on the medical canons and formularies provides almost no clinical knowledge,leaving us with a one-sided narrative that ignores how medicine and healing are actually practiced in the field.This paper focuses on the latter aspect of medicine from a historical perspective.Using written and visual sources dating to the Song dynasty,clinical encounters between doctors and patients including their families are depicted based on case records recorded by a physician,members of the patient’s family,and bystanders.This array of case records or case stories will enable us to narrate the interaction between physicians and patients both from the clinical perspective and from the social interaction.This paper will also discuss visual depictions of the medical encounter to provide another perspective for narrating medicine during the Song dynasty.Medical case records and paintings depicting medical encounters are exemplary of the potential of Chinese primary sources for narrative medicine.展开更多
Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as de...Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as depression,anxiety,sleep disturbances,and fatigue(Bloem et al.,2021).展开更多
BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education ...BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.展开更多
The skin’s primary function is to protect the body against a spectrum of environmental stressors, including mechanical insults, microorganisms, chemicals, and allergens. Located in the outermost layers, the primary s...The skin’s primary function is to protect the body against a spectrum of environmental stressors, including mechanical insults, microorganisms, chemicals, and allergens. Located in the outermost layers, the primary structures and components responsible for the skin’s barrier function are susceptible to environmental variables, dermatological conditions, and the aging process. The ensuing alterations to structure, composition, and organizational attributes of the epidermal barrier can impact its integrity and functionality. The aim of this study was to assess the effect of a novel complex composed of a ceramide, energizing peptide, and Camu Camu extract (SUPCERAT<sup>TM</sup> complex) on specific markers of epidermal barrier integrity, as well as epidermal and dermal function. All the experiments were conducted on fresh human abdominal skin explants. Intradermal production of hyaluronic acid, epidermal claudin-1, and ceramide synthase 3 expressions, as well as epidermal lipids content were assessed using specific fluorescent stainings on ex vivo skin after the application of the complex or placebo. Additionally, dermal elastase and collagenase activities were assessed using in tubo enzymatic assays. Lastly, the effect of a cosmetic cream containing SUPCERAT<sup>TM</sup> complex was assessed using subjective Global Aesthetic Improvement Scale (GAIS) in a small cohort of patients after 60 days of use. The application of the SUPCERAT<sup>TM</sup> complex on ex vivo skin led to significant increase in dermal hyaluronic acid content and epidermal activity of claudin-1, ceramide synthase 3 and epidermal ceramide content. Furthermore, in tubo enzymatic assays demonstrated inhibition of both dermal elastase and collagenase activities. In addition, the patient-reported results indicated significant improvements in skin quality and appearance. .展开更多
文摘Globalization and technological change are transforming the ways in which buildings are being designed and built. An overlooked aspect of this development is its impact on construction labor, and the significance of labor for assessing the work of architecture. The paper draws upon the sociological concept of the “glocal” to analyse the construction site as the product of the tension between global and local conditions of architectural production and consumption. The construction of Preston Scott Cohen’s 2010 Tel Aviv Museum Addition serves as its case study for theorizing the “glocal” dynamics of digital architecture, building technology and construction labor. This methodological approach highlights the role of migrant guest workers and technological transfer in contemporary construction culture. To realize with precision the complex design under local constraints, the contractor developed a hybrid work process that interspersed labor saving automated manufacturing techniques with artisanal, skilled construction work. In addition, workers and contractors exercised a high level of control over the pace and method of construction, and devised building solutions which improved upon the architect’s design. In conclusion, the paper argues that construction activity differs from broader trends in manufacturing due to the self-reflexivity of architectural design to its condition of production, but that at the same time, this critical capacity is enabled by the globalization of construction labor.
基金funded by the Israel Science Foundation(grants No.1036/12 and 1228/20)(to OES).
文摘Translation regulation is an important layer of gene expression:Generation of genome-wide expression datasets at multi-omics levels in spatial,temporal,and cell-type resolution is essential for deciphering brain complexity.Regulation of gene expression is a highly dynamic process aiming at the production of precise levels of gene products to guarantee optimal cellular function,in response to physiological cues.Speedy advances in next-generation sequencing enabled the understanding of epigenomic and transcriptomic dynamic landscapes of different brain regions along development,aging,and disease progression.However,the correlation of the“transcriptome”with protein levels is poor because numerous mRNAs are subjected to manipulation of their translation efficiency,to warrant a favorable result under certain conditions.Hence,it is widely accepted that regulation at the translation level is a vital layer of gene expression.Quantification of actively translated mRNA populations(i.e.,“translatome”)is a more reliable predictor of the“proteome”(Wang et al.,2020).
文摘Colorectal cancer (CRC) is caused by a series of genetic or epigenetic changes, and in the last decade there has been an increased awareness that there are multiple forms of colorectal cancer that develop through different pathways. Microsatellite instability is involved in the genesis of about 15% of sporadic colorectal cancers and most of hereditary nonpolyposis cancers. Tumors with a high frequency of microsatellite instability tend to be diploid, to possess a mucinous histology, and to have a surrounding lymphoid reaction. They are more prevalent in the proximal colon and have a fast pass from polyp to cancer. Nevertheless, they are associated with longer survival than stage-matched tumors with microsateUite stability. Resistance of colorectal cancers with a high frequency of microsatellite instability to 5-fluorouracilbased chemotherapy is well established. Silencing the MLH1 gene expression by its promoter methylation stops the formation of MLH1 protein, and prevents the normal activation of the DNA repair gene. This is an important cause for genomic instability and cell proliferation to the point of colorectal cancer formation. Better knowledge of this process will have a huge impact on colorectal cancer management, prevention, treatment and prognosis.
文摘BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide.The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur.A major challenge is to diagnose advanced fibrosis as early as possible,using simple and non-invasive diagnostics tools.Thrombocytopenia represents advanced fibrosis and portal hypertension(HTN)and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor.However,little is known about the association between longitudinal changes in platelet counts(PTC),when still within the normal range,and the risk of cirrhosis.AIM To explore whether platelet counts trajectories over time,can predict advanced liver fibrosis across the different etiologies of liver diseases.METHODS A nested case-control study utilizing a large computerized database.Cirrhosis cases(n=5258)were compared to controls(n=15744)matched for age and sex at a ratio of 1:3.All participants had multiple laboratory measurements prior to enrollment.We calculated the trends of PTC,liver enzymes,bilirubin,international normalized ratio,albumin and fibrosis scores(fibrosis-4 and aspartate transaminase-to-platelet ratio index)throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls.The association between PTC,cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated.RESULTS The mean age in both groups was 56(SD 15.8).Cirrhotic patients were more likely to be smokers,diabetic with chronic kidney disease and had a higher prevalence of HTN.The leading cirrhosis etiologies were viral,alcoholic and fatty liver disease.The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL.This trend was consistent regardless of sex,cirrhosis etiology and was more pronounced in patients who developed varices and ascites.Compared to controls whose values remained in the normal range,in the cirrhosis group aspartate aminotransferase and alanine aminotransferase,increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis.In multivariable regression analysis,a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis(95%CI 1.25-1.35).CONCLUSION In the preceding years before the diagnosis of cirrhosis,there is a progressive decline in PTC,within the normal range,matched to a gradual increase in fibrosis scores.
文摘AIM: To evaluate daclatasvir vs telaprevir, each combined with peginterferon alfa-2a/ribavirin(peg IFN/RBV), in treatment-naive hepatitis C virus(HCV) genotype(GT) 1-infected patients.METHODS: In this phase 3, randomized, open-label, noninferiority study, 602 patients were randomly assigned(2:1) to daclatasvir vs telaprevir, stratified by IL28 B rs12979860 host genotype(CC vs non-CC), cirrhosis status(compensated cirrhosis vs no cirrhosis), and HCV GT1 subtype(GT1a vs GT1b). Patients were selected by study inclusion criteria from a total of 793 enrolled patients. Patients received daclatasvir 60 mg once daily or telaprevir 750 mg 3 times daily plus peg IFN/RBV. Daclatasvir recipients received 24 wk of daclatasvir plus peg IFN/RBV; those without an extended rapid virologic response(e RVR; undetectable HCV-RNA at weeks 4 and 12) received an additional 24 wk of peg IFN/RBV. Telaprevir-treated patients received 12 wk of telaprevir plus peg IFN/RBV followed by 12(with e RVR) or 36(no e RVR) wk of peg IFN/RBV. The primary objective was to compare for noninferiority of sustained virologic response rates at posttreatment week 12(SVR12) in GT1b-infected patients. Key secondary objectives were to demonstrate that the rates of anemia(hemoglobin < 10 g/d L) and rashrelated events, through week 12, were lower with daclatasvir + peg IFN/RBV than with telaprevir + peg IFN/RBV among GT1b-infected patients. Resistance testing was performed using population-based sequencing of the NS5 A region for all patients at baseline, and for patients with virologic failure or relapse and HCV-RNA ≥ 1000 IU/m L, to investigate any link between NS5 A polymorphisms associated with daclatasvir resistance and virologic outcome. RESULTS: Patient demographics and disease characteristics were generally balanced across treatment arms; however, there was a higher proportion of black/African Americans in the daclatasvir groups(6.0% and 8.2% in the GT1 b and GT1 a groups, respectively) than in the telaprevir groups(2.2% and 3.0%). Among GT1 binfected patients, daclatasvir plus peg IFN/RBV was noninferior to telaprevir plus peg IFN/RBV for SVR12 [85%(228/268) vs 81%(109/134); difference, 4.3%(95%CI:-3.3% to 11.9%)]. Anemia(hemoglobin < 10 g/d L) was significantly less frequent with daclatasvir than with telaprevir [difference,-29.1%(95%CI:-38.8% to-19.4%)]. Rash-related events were also less common with daclatasvir than with telaprevir, but the difference was not statistically significant. In GT1 ainfected patients, SVR12 was 64.9% with daclatasvir and 69.7% with telaprevir. Among both daclatasvir and telaprevir treatment groups, across GT1b- or GT1a-infected patients, lower response rates were observed in patients with IL28 B non-CC and cirrhosis- factors known to affect response to peg IFN/RBV. Consistent with these observations, a multivariate logistic regression analysis in GT1b-infected patients d e m o n s t ra t e d t h a t S V R 1 2 wa s a s s o c i a t e d w i t h IL28 B host genotype(CC vs non-CC, P = 0.011) and cirrhosis status(absent vs present, P = 0.031). NS5 A polymorphisms associated with daclatasvir resistance(at L28, R30, L31, or Y93) were observed in 17.3% of GT1b-infected patients at baseline; such variants did not appear to be absolute predictors of failure since 72.1% of these patients achieved SVR12 compared with 86.9% without these polymorphisms. Among GT1b-infected patients, treatment was completed by 85.4%(229/268) in the daclatasvir group, and by 85.1%(114/134) in the telaprevir group, and among GT1a-infected patients, by 67.2%(90/134) and 69.7%(46/66), respectively. Discontinuations(of all 3 agents) due to an AE were more frequent with telaprevir than with daclatasvir, whereas discontinuations due to lack of efficacy were more frequent with daclatasvir, due, in part, to differences in futility criteria. CONCLUSION: Daclatasvir plus peg IFN/RBV demonstrated noninferiority to telaprevir plus peg IFN/RBV for SVR12 and was well-tolerated in treatment-naive GT1 binfected patients, supporting the use of daclatasvir with other direct-acting antivirals.
文摘Accumulating evidence indicates that ataxia-telangiectasia mutated kinase is critical for maintaining cellular homeostasis and that it has both nuclear and cytoplasmic functions.However,the functions of ataxia-telangiectasia mutated that when lost lead to cerebellar degeneration are still unknown.In this review,we first describe the role of ataxia-telangiectasia mutated in cerebellar pathology.In addition to its canonical nuclear functions in DNA damage response circuits,ataxia-telangiectasia mutated functions in various cytoplasmic and mitochondrial processes that are critically important for cellular homeostasis.We discuss these functions with a focus on the role of ataxia-telangiectasia mutated in maintaining the homeostatic redox state.Finally,we describe the unique functions of ataxia-telangiectasia mutated in various types of neuronal and glial cells including cerebellar granule neurons,astrocytes,and microglial cells.
文摘A detailed analysis of the influence of Rydberg states to the behavior of GPS satellite signals in the D and E atmospheric layers has been carried out. It is demonstrated that these states are the main reason for the GPS signal distortion. It is shown that the behavior of satellite signals is associated with the spectral characteristics of the UHF radiation of the Rydberg states depending on the geomagnetic conditions of ionosphere. The foundations of the quantum theory of distortion and delay of GPS satellite signal propagation through D and E atmospheric layers are analyzed and expounded. The problem reduces to the resonant scattering of photons, moving in the electromagnetic field of the signal, to the Rydberg complexes populated in a two-temperature non-equilibrium plasma. The processes of creation of additional photons because of stimulated emission and resonance scattering of photons are considered. In the present work, the quantum theory of the propagation of a satellite signal in the Earth’s upper atmosphere, firstly earlier proposed by the same authors, is described in detail. The general problems of the theory and possible theoretical and applied consequences are discussed. It is explained that two main processes occurring here, are directly related to the resonant quantum properties of the propagation medium. The first process leads to a direct increase in the power of the received signal, and second—to a shift in the signal carrier frequency??and the time delay??of its propagation. The main reasons of the processes are scattering of the Rydberg electron by the ion core and presence of the neutral medium molecule in the intermediate autoionization states of the composite system populated by the strong non-adiabatic coupling of electron and nuclear motions. The main purposes of our investigation are the physical justification of the formation of parameters ?and??using the quantum dynamics of the electron behavior in the intermediate state of the Rydberg complex A**M and the estimation of the quantities of??and??in the elementary act of elastic (Rayleigh) photon scattering.
文摘Background: Hereditary hemorrhagic telangiectasia (HHT) is a relatively common, albeit under-recognized autosomal-dominant multisystemic vascular disorder. Epistaxis due to telangiectases in the nasal mucosa is the most common and often the earliest symptom of HHT. As many as 90% of affected individuals eventually experience recurrent epistaxis, with a mean frequency of 18 episodes per month. Prompted by the limitations of invasive treatment, researchers have directed attention to laser photocoagulation as an alternative nonsurgical treatment modality with promising results. Purpose: The purpose of the present study was to describe our experience with the state-of-the-art 980 nm diode laser for the treatment of bleeding lesions of the skin, nasal and oral mucosa in patients with HHT. Methodology/Principal: We treated 16 HHT patients with intractable bleeding from telangiectasias using the 980-nm diode laser as an office procedure using local anesthesia. We recorded hemoglobin levels before and after treatment and used disability questionnaires. Results: All patients treated had an improvement in hemoglobin levels and disability scores. In patients with multiple lesions hemoglobin levels improved from a mean of 8.4 to 11.2 (p = 0.008). The disability index in this group improved from a mean of 5.3 to 2.8 (p = 0.007). Follow-up ranged between 4 and 12 months. Conclusions: The 980-nm diode laser is a good office based solution for bleeding in HHT.
基金supported by the National Key R&D Program of China within the China-Israel Cooperative Scientific Research(No.2022YFE0100800)(Israeli No.3-18130)the National Natural Science Foundation of China(Nos.52175551,22072181)+1 种基金the Leading Innovative and Entrepreneur Team Introduction Program of Zhejiang Province,China(No.2022R01001)the Zhejiang University Global Partnership Fund and Open Foundation of the State Key Laboratory of Fluid Power and Mechatronic Systems(No.GZKF-202224).
文摘Three-dimensional(3D)printing has attracted increasing research interest as an emerging manufacturing technology for devel-oping sophisticated and exquisite architecture through hierarchical printing.It has also been employed in various advanced industrial areas.The development of intelligent biomedical engineering has raised the requirements for 3D printing,such as flexible manufacturing processes and technologies,biocompatible constituents,and alternative bioproducts.However,state-of-the-art 3D printing mainly involves inorganics or polymers and generally focuses on traditional industrial fields,thus severely limiting applications demanding biocompatibility and biodegradability.In this regard,peptide architectonics,which are self-assembled by programmed amino acid sequences that can be flexibly functionalized,have shown promising potential as bioinspired inks for 3D printing.Therefore,the combination of 3D printing and peptide self-assembly poten-tially opens up an alternative avenue of 3D bioprinting for diverse advanced applications.Israel,a small but innovative nation,has significantly contributed to 3D bioprinting in terms of scientific studies,marketization,and peptide architectonics,including modulations and applications,and ranks as a leading area in the 3D bioprinting field.This review summarizes the recent progress in 3D bioprinting in Israel,focusing on scientific studies on printable components,soft devices,and tissue engineering.This paper further delves into the manufacture of industrial products,such as artificial meats and bioinspired supramolecular architectures,and the mechanisms,physicochemical properties,and applications of peptide self-assembly.Undoubtedly,Israel contributes significantly to the field of 3D bioprinting and should thus be appropriately recognized.
文摘The ramifications of global climate change and resource scarcities have made it imperative to re-examine the definition of sustainable energy-storage systems.It is crucial to recognize that not all renewable resources are inherently sustainable,and their full impact on the environment must be assessed.With the proliferation of invasive jellyfish species wreaking havoc on marine ecosystems and economies worldwide,utilizing overabundant jellyfish as a carbon source presents an opportunity to create energy-storage systems that are both financially beneficial and environmentally remediating.Accordingly,a comprehensive approach to sustainability also requires eco-friendly solutions throughout the entire lifecycle,from material sourcing to battery production,without compromising highperformance requirements.Currently,most electrode syntheses for lithium-ion batteries(LIBs) employed are energy-intensive,multiple-steps,complex,and additive-heavy.In response,this work pioneers the straightforward use of low-energy laser irradiation of a jellyfish biomass/silicon nanoparticle blend to encapsulate the silicon nanoparticles in-situ within the as-forming conductive carbonized matrix,creating sustainable and additive-free composite anodes.The self-standing anode is directly synthesized under ambient conditions and requires no post-processing.Here,a laser-synthesized conductive threedimensional porous carbon/silicon composite anode from raw jellyfish biomass for LIBs is presented,displaying outstanding cyclic stability(>1000 cycles),excellent capacity retention(>50% retention after1000 cycles),exceptional coulombic efficiency(>99%),superb reversible gravimetric capacity(>2000 mAh/g),and high rate performance capability(>1.6 A/g),paving a new path to future sustainable energy production.
文摘Recent technological advancements,such as portable electronics and electric vehicles,have created a pressing need for more efficient energy storage solutions.Lithium-ion batteries(LIBs)have been the preferred choice for these applications,with graphite being the standard anode material due to its stability.However,graphite falls short of meeting the growing demand for higher energy density,possessing a theoretical capacity that lags behind.To address this,researchers are actively seeking alternative materials to replace graphite in commercial batteries.One promising avenue involves lithiumalloying materials like silicon and phosphorus,which offer high theoretical capacities.Carbon-silicon composites have emerged as a viable option,showing improved capacity and performance over traditional graphite or pure silicon anodes.Yet,the existing methods for synthesizing these composites remain complex,energy-intensive,and costly,preventing widespread adoption.A groundbreaking approach is presented here:the use of a laser writing strategy to rapidly transform common organic carbon precursors and silicon blends into efficient“graphenic silicon”composite thin films.These films exhibit exceptional structural and energy storage properties.The resulting three-dimensional porous composite anodes showcase impressive attributes,including ultrahigh silicon content,remarkable cyclic stability(over 4500 cycles with∼40%retention),rapid charging rates(up to 10 A g^(-1)),substantial areal capacity(>5.1 mAh cm^(-2)),and excellent gravimetric capacity(>2400 mAh g^(-1) at 0.2 A g^(-1)).This strategy marks a significant step toward the scalable production of high-performance LIB materials.Leveraging widely available,cost-effective precursors,the laser-printed“graphenic silicon”composites demonstrate unparalleled performance,potentially streamlining anode production while maintaining exceptional capabilities.This innovation not only paves the way for advanced LIBs but also sets a precedent for transforming various materials into high-performing electrodes,promising reduced complexity and cost in battery production.
文摘AIM:To evaluate residents’perceptions and attitudes toward the various aspects of a comprehensive ophthalmic examination,and to determine if these factors correlate with their choices for fellowship and future career plans.METHODS:This is a cross-sectional study.A questionnaire on the perception of the ophthalmic exam was sent via SurveyMonkey to ophthalmology residents throughout Israel.Eighty of them(one-half of all ophthalmology residents in 2019)completed it.The first part related to how they perceived each component of the ophthalmic evaluation.The second part related to their future fellowship plans.The Chi-squared test was used to compare categorical variables and Student’s t-test and One-way ANOVA were used to compare continuous variables.Multivariate logistic regression analysis was applied as needed to detect interactions between variables and to exclude confounder effects.RESULTS:Slit-lamp examination of the anterior and posterior segments ranked as the most likeable aspects,whereas gonioscopy,ocular motility examination and visual acuity assessment were least likeable.Anterior segment and retina subspecialties were the ones most sought after.Forty-nine respondents(61.3%)noted a direct correlation between their preferred parts of comprehensive ophthalmic evaluations and their choice of subspecialty.Perceptions of selected components of those evaluations were significantly associated with responders’intentions to pursue anterior segment,retina,or oculoplastic fellowships(P<0.05).CONCLUSION:Perspectives of residents toward the ophthalmic examination,and most specifically its individual components,play an important role in their choice of subspecialty training.
基金European Sequencing and Genotyping Institutes(ESGI),Grant/Award Number:075491/Z/04,085906/Z/08/Z and 090532/Z/09/ZTel-Aviv University(TAU)。
文摘Background:Aspergillus fumigatus(Af)is one of the most ubiquitous fungi and its infection potency is suggested to be strongly controlled by the host genetic back-ground.The aim of this study was to search for candidate genes associated with host susceptibility to Aspergillus fumigatus(Af)using an RNAseq approach in CC lines and hepatic gene expression.Methods:We studied 31 male mice from 25 CC lines at 8 weeks old;the mice were infected with Af.Liver tissues were extracted from these mice 5 days post-infection,and next-generation RNA-sequencing(RNAseq)was performed.The GENE-E analysis platform was used to generate a clustered heat map matrix.Results:Significant variation in body weight changes between CC lines was ob-served.Hepatic gene expression revealed 12 top prioritized candidate genes differ-entially expressed in resistant versus susceptible mice based on body weight changes.Interestingly,three candidate genes are located within genomic intervals of the previ-ously mapped quantitative trait loci(QTL),including Gm16270 and Stox1 on chromo-some 10 and Gm11033 on chromosome 8.Conclusions:Our findings emphasize the CC mouse model's power in fine mapping the genetic components underlying susceptibility towards Af.As a next step,eQTL analysis will be performed for our RNA-Seq data.Suggested candidate genes from our study will be further assessed with a human cohort with aspergillosis.
基金This study is financed by the grants from Israel Science Foundation(No.ISF-1199/16)Chiang Ching-kuo Foundation for International Scholarly Exchange(No.RG001-U-19).
文摘The key point in studying or teaching the history of Chinese medicine is on the doctrines underlying it and on its perception of the body,physiology,pathology,and its treatment.Namely,there is often a tendency to focus on reading and analysing the classical canons and therapy-related texts including formularies and materia medica collections.However,focusing on these sources provides us with a one-sided presentation of Chinese medicine.These primary sources lack the clinical down-to-earth know-how that encompasses medical treatment,which are represented,for instance,in the clinical rounds of modern medical schools.Our traditional focus on the medical canons and formularies provides almost no clinical knowledge,leaving us with a one-sided narrative that ignores how medicine and healing are actually practiced in the field.This paper focuses on the latter aspect of medicine from a historical perspective.Using written and visual sources dating to the Song dynasty,clinical encounters between doctors and patients including their families are depicted based on case records recorded by a physician,members of the patient’s family,and bystanders.This array of case records or case stories will enable us to narrate the interaction between physicians and patients both from the clinical perspective and from the social interaction.This paper will also discuss visual depictions of the medical encounter to provide another perspective for narrating medicine during the Song dynasty.Medical case records and paintings depicting medical encounters are exemplary of the potential of Chinese primary sources for narrative medicine.
基金supported by the Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),No.424778381-TRR 295(to MM)。
文摘Parkinson’s disease(PD)is a complex neurodegenerative disorder characterized by a range of motor symptoms such as bradykinesia,resting tremor,rigidity,and postural instability,as well as non-motor symptoms,such as depression,anxiety,sleep disturbances,and fatigue(Bloem et al.,2021).
文摘BACKGROUND Global education in psychiatry is heavily influenced by knowledge from Western,high-income countries,which obscures local voices and expertise.AIM To adapt a human simulation model to psychiatric education in a context that is specific to local languages and cultures.METHODS We conducted an observational study consisting of six human simulation sessions with standardized patients from two host countries,speaking their native languages,and following an adaptation of the co-constructive patient simulation(CCPS)model.As local faculty became increasingly familiar with the CCPS approach,they took on the role of facilitators—in their country’s native language.RESULTS Fifty-three learners participated:19 child and adolescent psychiatry trainees and 3 faculty members in Türkiye(as a group that met online during 3 consecutive months);and 24 trainees and 7 faculty in Israel(divided into 3 groups,in parallel in-person sessions during a single training day).Each of the six cases reflected local realities and clinical challenges,and was associated with specific learning goals identified by each case-writing trainee.CONCLUSION Human simulation has not been fully incorporated into psychiatric education:The creation of immersive clinical experiences and the strengthening of reflective practice are two areas ripe for development.Our adaptations of CCPS can also strengthen local and regional networks and psychiatric communities of practice.Finally,the model can help question and press against hegemonies in psychiatric training that overshadow local expertise.
文摘The skin’s primary function is to protect the body against a spectrum of environmental stressors, including mechanical insults, microorganisms, chemicals, and allergens. Located in the outermost layers, the primary structures and components responsible for the skin’s barrier function are susceptible to environmental variables, dermatological conditions, and the aging process. The ensuing alterations to structure, composition, and organizational attributes of the epidermal barrier can impact its integrity and functionality. The aim of this study was to assess the effect of a novel complex composed of a ceramide, energizing peptide, and Camu Camu extract (SUPCERAT<sup>TM</sup> complex) on specific markers of epidermal barrier integrity, as well as epidermal and dermal function. All the experiments were conducted on fresh human abdominal skin explants. Intradermal production of hyaluronic acid, epidermal claudin-1, and ceramide synthase 3 expressions, as well as epidermal lipids content were assessed using specific fluorescent stainings on ex vivo skin after the application of the complex or placebo. Additionally, dermal elastase and collagenase activities were assessed using in tubo enzymatic assays. Lastly, the effect of a cosmetic cream containing SUPCERAT<sup>TM</sup> complex was assessed using subjective Global Aesthetic Improvement Scale (GAIS) in a small cohort of patients after 60 days of use. The application of the SUPCERAT<sup>TM</sup> complex on ex vivo skin led to significant increase in dermal hyaluronic acid content and epidermal activity of claudin-1, ceramide synthase 3 and epidermal ceramide content. Furthermore, in tubo enzymatic assays demonstrated inhibition of both dermal elastase and collagenase activities. In addition, the patient-reported results indicated significant improvements in skin quality and appearance. .