Platt College

We describe the characteristics, content, and effectiveness of digital self-management (SM) education programs for lupus and other chronic conditions to identify gaps and inform the improvement of future programs in lupus. Three bibliographic databases were searched for articles published between May 2012 and April 2022. The search was cast to capture the breadth of digital SM education programs in the following conditions: lupus, epilepsy, fibromyalgia, multiple sclerosis, sickle cell anemia, Sjögren syndrome, psoriatic arthritis, and rheumatoid arthritis. Title and abstract screening, as well as full-text review, was conducted by two independent reviewers. Data extraction was first completed by one author charting all studies and then, a second time, by four members of the research team charting collaboratively. Of the 1,969 articles identified through the search, 14 met inclusion criteria. Two additional articles were included following bibliography review. The 16 articles represented 12 unique digital SM education programs. Programs covered five conditions: epilepsy (n = 3), fibromyalgia (n = 2), multiple sclerosis (n = 4), lupus (n = 1), and rheumatoid arthritis (n = 2). Most programs were asynchronous and internet-based (n = 9) with a prescribed sequence of content (n = 8). Peer, technical, or specialist support was offered in seven programs. Most programs demonstrated statistically significant improvement of symptoms in the intervention group (n = 8). This scoping review summarizes the current landscape for digital SM education programs in lupus and similar conditions. In lupus, further investigation will fill in the gaps around digital SM education needs, user experience, and evaluation of outcomes.

Abstract In order to achieve maximum transparency of the buildings, architects plan large facades and large window areas. These glass surfaces have the disadvantage that they form a cold surface in winter and the sun heats the room in summer. It is desirable to use the potential of the huge surfaces of the glass for controlled heating and cooling. To be able to use an insulating glass unit as a heater, the temperature must be distributed uniformly over the glass. Existing solutions rely on heating wires between the panes of a laminated glass, but these are visible for the user. To create an invisible system, the cavity of the insulating glass can be used. The idea is to fill the cavity with helium instead of argon or krypton. Due to the good thermal conductivity of helium, temperatures in the cavity can be distributed over the whole glass. Content of this paper is the basics research, experimental research of the gas tightness with helium in the cavity and the first functional tests for heating and cooling with helium. The results give a first look at the heating and cooling capability of and insulating glass unit and include the basics for further researches on this topic. These are the first results of a current research project of the Institute of Building Construction at the TU Dresden.

Hypertrophic cardiomyopathy (HCM) has multiple etiologies, including hypertension, cardiac valve disease or genetic defects. Most inherited HCM results from defects in sarcomere proteins, but ~25% are caused by aberrant cardiac signal transduction genes. RASopathies are developmental disorders with multiple variably penetrant features, including HCM, which are caused by mutations in genes encoding RAS/extracellular signal-regulated kinase (ERK) pathway components. The most common RASopathy, Noonan Syndrome (NS), results from gain-of-function alleles in PTPN11, KRAS, SHOC2, SOS1/2, RAF1 and RIT1. Activating mutations in RAF1 are strongly (~95%) associated with HCM. Global knock-in mice harboring the NS allele Raf1L613V recapitulate the features of NS-associated HCM, including ventricular chamber dilatation, enhanced cardiac contractility, and exacerbation of pressure-overload induced fibrosis. Here, using inducible Raf1L613V knock-in mice and lineage-specific Cre lines, we show that RAF1 mutant-associated HCM is caused by a complex interplay of multiple cardiac cell types. Surprisingly, cardiomyocyte-specific Raf1L613V expression caused minimal hypertrophy, yet markedly increased cardiac contractility. By contrast, endocardial/cardiac endothelial (EC)-specific Raf1L613V expression promoted cardiomyocyte hypertrophy without affecting contractility. In direct or Transwell co-cultures, Raf1L613V-expressing ECs increased the size of normal cardiomyocytes. Cytokine arrays revealed increased IL6 secretion from isolated Raf1L613V-expressing ECs, and JAK-STAT, PI3K, and MEK/ERK activation were enhanced in EC-Raf1L613V hearts. Blocking IL6 action with neutralizing anti-IL6 antibodies reversed cardiomyocyte hypertrophy in EC/cardiomyocyte co-cultures. Finally, Raf1L613V expression in cardiomyocytes or cardiac fibroblasts, but not in ECs, exacerbated fibrosis upon pressure-overload. Taken together, our data indicate that NS HCM requires complex, cell-autonomous and -non-autonomous interactions between cardiomyocytes, ECs, and fibroblasts. Furthermore, we identify the IL6 pathway as a potential therapeutic target for RASopathy-associated HCM.

To evaluate the radiographic changes of the alveolar ridge following application of different ridge preservation techniques 6 months after tooth extraction. Four treatment modalities were randomly assigned in 40 patients: β-tricalcium-phosphate-particles with polylactid coating (β-TCP), demineralized bovine bone mineral with 10% collagen covered with a collagen matrix (DBBM-C/CM), DBBM-C covered with an autogenous soft-tissue graft (DBBM-C/PG) and spontaneous healing (control). Cone-beam computed tomography scans were performed after treatment and 6 months later. After 6 months, the vertical changes ranged between -0.6 mm (-10.2%) for control and a gain of 0.3 mm (5.6%) for DBBM-C/PG on the lingual side, and between -2.0 mm (-20.9%) for β-TCP and a gain of 1.2 mm (8.1%) for DBBM-C/PG on the buccal side. The most accentuated ridge width changes were recorded 1 mm below the crest: -3.3 mm (-43.3%, C), -6.1 mm (-77.5%, β-TCP), -1.2 mm (-17.4%, DBBM-C/CM) and -1.4 mm (-18.1%, DBBM-C/PG). At all three levels, DBBM-C with either CM or PG was not significantly differing (p > 0.05), while most other differences between the groups reached statistical significance (p < 0.05). Application of DBBM-C, covered with CM or PG, resulted in less vertical and horizontal changes of the alveolar ridge as compared with controls 6 months after extraction.

Cooperative benefits depend on a variety of ecological factors. Many cooperative bacteria increase the population size of their groups by making a public good available. Increased local population size can alleviate the constraints of kin competition on the evolution of cooperation by enhancing the between-group fitness of cooperators. The cooperative pathogenesis of Agrobacterium tumefaciens causes infected plants to exude opines--resources that provide a nearly exclusive source of nutrient for the pathogen. We experimentally demonstrate that opines provide cooperative A. tumefaciens cells a within-group fitness advantage over saprophytic agrobacteria. Our results are congruent with a resource-consumer competition model, which predicts that cooperative, virulent agrobacteria are at a competitive disadvantage when opines are unavailable, but have an advantage when opines are available at sufficient levels. This model also predicts that freeloading agrobacteria that catabolize opines but cannot infect plants competitively displace the cooperative pathogen from all environments. However, we show that these cooperative public goods also promote increased local population size. A model built from the Price Equation shows that this effect on group size can contribute to the persistence of cooperative pathogenesis despite inherent kin competition for the benefits of pathogenesis.

Menopause: March 2009 - Volume 16 - Issue 2 - p 422 doi: 10.1097/gme.0b013e318199d06c

Aims and MethodThere is interest in how outcome measures routinely used in mental health settings compare with each other in assessing risk and emotional disturbance. The relation between the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE–OM), a client-completed measure, and the Health of the Nation Outcome Scale (HoNOS), a clinician-completed measure, was explored using data from 297 clients referred to secondary services by a primary care mental health liaison team.ResultsThe correlation between CORE–OM and HoNOS was 0.50, with cluster and factor analyses revealing overlap between the measures in assessing risk to self and others and general emotional issues.Clinical ImplicationsAlthough the measures are typically used in different settings, the overlap suggests that both might be useful in any setting where assessment for mental health problems and risk is needed.