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Es wird uber den Fall einer Kardiomyopathie bei einem 22-jahrigen Patienten mit langjahrigem Methamphetaminkonsum berichtet. Echokardiographisch zeigte sich eine dilatative Kardiomyopathie mit hochgradig eingeschrankter Pumpfunktion und hochgradiger Mitralklappeninsuffizienz. Durch Inotropika und Implantation zweier MitraClips® (Abbott Vascular, Santa Clara, CA, USA) konnte eine hamodynamische Stabilisierung erreicht werden. Die zunehmende Verbreitung des Methamphetaminkonsums sollte Anlass geben, in Fallen mit unklarer Kardiomyopathie bei jungen Patienten eine gezielte Anamnese und gegebenenfalls Urinanalyse durchzufuhren.

Microbial denitrification occurs in anaerobic soil microsites and aquatic environments leading to production of N 2 O and N 2 gases, which eventually escape to the atmosphere. Atmospheric concentrations of N 2 O have been on the rise since the beginning of the industrial revolution due to large-scale manipulations of the N cycle in managed ecosystems, especially the use of synthetic nitrogenous fertilizer. Here we document and test a microbial denitrification model identified as IMWJ and implemented as a submodel in the EPIC terrestrial ecosystem model. The IMWJ model is resolved on an hourly time step using the concept that C oxidation releases electrons that drive a demand for electron acceptors such as O 2 and oxides of N (NO 3 − , NO 2 − , and N 2 O). A spherical diffusion approach is used to describe O 2 transport to microbial surfaces while a cylindrical diffusion method is employed to depict O 2 transport to root surfaces. Oxygen uptake by microbes and roots is described with Michaelis-Menten kinetic equations. If insufficient O 2 is present to accept all electrons generated, the deficit for electron acceptors may be met by oxides of nitrogen, if available. The movement of O 2 , CO 2 and N 2 O through the soil profile is modeled using the gas transport equation solved on hourly or sub-hourly time steps. Bubbling equations also move N 2 O and N 2 through the liquid phase to the soil surface under highly anaerobic conditions. We used results from a 2-yr field experiment conducted in 2007 and 2008 at a field site in southwest Michigan to test the ability of EPIC, with the IMWJ option, to capture the non-linear response of N 2 O fluxes as a function of increasing rates of N application to maize [ Zea mays L.]. Nitrous oxide flux, soil inorganic N, and ancillary data from 2007 were used for EPIC calibration while 2008 data were used for independent model validation. Overall, EPIC reproduced well the timing and magnitude of N 2 O fluxes and NO 3 − mass in surficial soil layers after N fertilization. Although similar in magnitude, daily and cumulative simulated N 2 O fluxes followed a linear trend instead of the observed exponential trend. Further model testing of EPIC + IMWJ, alone or in ensembles with other models, using data from comprehensive experiments will be essential to discover areas of model improvement and increase the accuracy of N 2 O predictions under a wide range of environmental conditions.

Resume Les droits des personnes âgees residant en etablissement medicosocial (EMS) dependent en Suisse de dispositions legales relatives notamment au droit de la protection de l’adulte et aux droits des patients, ainsi que de conventions internationales sur les droits humains. Leur mise en œuvre est fortement liee a la maniere dont ils sont percus et compris par les differents acteurs concernes, a savoir : les residents, leurs proches, ainsi que les differents professionnels. Cet article vise a analyser les transformations historiques de ces droits – tant sur le plan formel que dans l’acception subjective qu’en ont les divers individus engages dans une interaction de soin –, et a s’interroger sur les facons dont ces prescriptions sont percues, comprises et mises en pratique par les acteurs sociaux. La prise en compte de la perspective des acteurs concernes revet un interet particulier du point de vue ethique. Il s’agit de mettre en lumiere les regards croises de chacun, en fonction des interets en jeu, et de se donner les moyens de rendre visibles les eventuels points de tension qui peuvent survenir entre les droits et devoirs des uns et des autres. La combinaison d’une methodologie historique et d’une methode de recherche qualitative par focus groups a permis de documenter et de contextualiser les changements principaux au niveau des textes de loi ou des chartres ethiques, tout en mettant en evidence la facon dont les residents, leurs proches ainsi que les professionnels d’EMS s’approprient de tels changements.

The assessment of osteoporosis regarding bone mass and microarchitecture “quality” contributes in determining fracture risk. Therefore, the crystalline structure of hydroxyapatite may indicate the quality of trabecular bones through the identification of crystallite sizes, microhardness and microdeformation values and calcium and phosphorous proportions in the three types of bones: normal, osteopenic, and osteoporotic. Nine L1 vertebrae-dried trabecular bones from human cadavers were used. The characterization of the three types of bones was made through scanning electron microscopy, EDS, microhardness, and X-ray diffractometry with the Rietveld refinement method. The results show that the microstructural characterization possibilities the identification of the three types of bones: normal, osteopenic, and osteoporotic, allowing the detection of osteoporosis based on bone quality.

This article presents the case of a 22-year-old male patient with cardiomyopathy associated with a long history of methamphetamine abuse. Echocardiography revealed a dilated cardiomyopathy with highly reduced systolic pump function and severe mitral valve regurgitation. Inotropic treatment and MitraClip® (Abbott Vascular, Santa Clara, CA, USA) implantation resulted in enhancement of hemodynamics. The rising prevalence of methamphetamine abuse should give reason to raise awareness for the diagnostic work-up and patient history particularly in cases of unexplained cardiomyopathy in young patients.

The Senior Living Lab has run a number of participatory workshops with seniors with a view to brainstorming and developing products and services to improve the quality of life of ageing populations in Switzerland. This project aims to combine and adapt design thinking and living lab methodologies to be suitable with elderly participants. It gathers various qualitative techniques and deploys an interdisciplinary methodology based on community-based participatory research. This living lab project highlights the key success factors and the challenges in order to successfully involve seniors during complex innovation processes, such as time essential to tackle logistic issues and the ability to adapt participatory initiatives to an elderly public.

The term crystal structure is understood as a set of atoms periodically distributed in space, forming a lattice. The composite material, bone, contains an organic part consisted of collagen and an inorganic part consisted predominantly of hydroxyapatite crystals, having the molecular formula Ca10(PO4)6(OH)2 in its unit cell. The crystal structure of hydroxyapatite can indicate the trabecular bone quality, by the identification of crystallite size, microhardness, microstrain and ratio of calcium and phosphorus in bones of three types: normal, osteopenic or osteoporotic. Osteoporosis is defined by the National Institute of Health as a skeletal disorder characterized by compromised bone strength and increased risk of fracture. Dried trabecular bones of vertebrae L1 columns of nine human cadavers from the São Paulo City Morgue were used. Before sample collection, they were pre-divided into three groups: normal, osteopenic or osteoporotic, through quantitative ultrasound of the calcaneus. The characterization of the three types of bones was made by electron microscopy scanning, microanalysis by energy dispersive spectrometry, microhardness and powder X-ray diffraction with application of the Rietveld method. The results showed a decrease of the crystallite size, hardness, ratio of calcium and phosphorus, trabecular number and bone density and an increase in microstrain values suggesting greater fragility and disruption in the crystalline structure of hydroxyapatite in osteopenic and osteoporotic bone. Microstructural characterization of hydroxyapatite crystals in dry trabecular bone could differentiate the three types of bones (normal, osteopenic and osteoporotic) and supplement assessment of osteoporosis, with an emphasis on bone quality.

The downregulation of β-adrenergic receptors (β-AR) and decreased cAMP-dependent protein kinase activity in failing hearts results in decreased phosphorylation and inactivation of phosphatase-inhibitor-1 (I-1), a distal amplifier element of β-adrenergic signaling, leading to increased protein phosphatase 1 activity and dephosphorylation of key phosphoproteins, including phospholamban. Downregulated and hypophosphorylated I-1 likely contributes to β-AR desensitization; therefore its modulation is a promising approach in heart failure treatment. Aim of our study was to assess the effects of adeno-associated virus serotype 9 (AAV9) - mediated cardiac-specific expression of constitutively active inhibitor-1 (I-1c) and to investigate whether I-1c is able to attenuate the development of heart failure in mice subjected to transverse aortic constriction (TAC). 6-8 week old C57BL/6 N wild-type mice were subjected to banding of the transverse aorta (TAC). Two days later 2.8 × 1012 AAV-9 vector particles harbouring I-1c cDNA under transcriptional control of a human troponin T-promoter (AAV9/I-1c) were intravenously injected into the tail vein of these mice (n=12). AAV9 containing a Renilla luciferase reporter (AAV9/hRluc) was used as a control vector (n=12). Echocardiographic analyses were performed weekly to evaluate cardiac morphology and function. 4 weeks after TAC pressure- volume measurements were performed and animals were sacrificed for histological and molecular analyses. Both groups exhibited progressive contractile dysfunction and myocardial remodeling. Surprisingly, echocardiographic assessment and histological analyses showed significantly increased left ventricular hypertrophy in AAV9/I-1c treated mice compared to AAV9/hRluc treated controls as well as reduced contractility. Pressure-volume loops revealed significantly impaired contractility after AAV9/I-1c treatment. At the molecular level, hearts of AAV9/I-1c treated TAC mice showed a hyperphosphorylation of the SR Ca2+-ATPase inhibitor phospholamban. In contrast, expression of AAV9/I-1c in unchallenged animals resulted in selective enhancement of phospholamban phosphorylation and augmented cardiac contractility. Our data suggest that AAV9-mediated cardiac-specific overexpression of I-1c, previously associated with enhanced calcium cycling, improves cardiac contractile function in unchallenged animals but failed to protect against cardiac remodeling induced by hemodynamic stress questioning the use of I-1c as a potential strategy to treat heart failure in conditions with increased afterload.