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The aim of this short narrative review was to evaluate the existing literature regarding the clinical use of ketamine among individuals with dementia, especially those with behavioral disturbances. PubMed, Cochrane, and Ovid (Embase, APA PsycINFO, and MEDLINE) databases were searched for abstracts using the search terms “ketamine” AND “dementia.” Only articles describing the use of ketamine in individuals with dementia were included. Articles that did not include individuals with dementia, did not use ketamine, were published in a non-English language, primarily described animal studies, or were reviews were excluded. Three case reports met the inclusion criteria. One described the use of subcutaneous ketamine for depression, one described the use of intramuscular ketamine for acute agitation, and one described the use of S-ketamine as anesthesia during electroconvulsive therapy for depression and catatonia. No significant adverse effects were reported in any of the cases. Although the use of ketamine in the treatment of depression and agitation associated with dementia has potential, the current evidence remains limited. High-quality prospective studies are needed to confirm the observations of these case reports before ketamine can be used to treat behavioral disturbances in individuals with dementia.

A nivel global, diversos movimientos sociales surgieron en respuesta al aumento de la xenofobia en el marco de la pandemia de COVID-19. Para el caso específico de Chile, fue posible identificar la aparición de una comunidad chileno-asiática en redes sociales, en el marco del movimiento #StopAsianHate. Este artículo aborda la aparición de esta comunidad a partir del análisis de diez cuentas de Instagram de personas chilenas-asiáticas, e informado por investigaciones previas sobre “lo chino” en Chile, para examinar sus desafíos en contraste con otros grupos racializados en el país. Se propone que la configuración de personas chilenas que también se identifican como chinas, coreanas o asiáticas se puede interpretar como redefiniciones más diversas e inclusivas de la sociedad chilena.

Objectives Direct comparisons between COVID-19 and influenza A in the critical care setting are limited. The objective of this study was to compare their outcomes and identify risk factors for hospital mortality.Design and setting This was a territory-wide, retrospective study on all adult (≥18 years old) patients admitted to public hospital intensive care units in Hong Kong. We compared COVID-19 patients admitted between 27 January 2020 and 26 January 2021 with a propensity-matched historical cohort of influenza A patients admitted between 27 January 2015 and 26 January 2020. We reported outcomes of hospital mortality and time to death or discharge. Multivariate analysis using Poisson regression and relative risk (RR) was used to identify risk factors for hospital mortality.Results After propensity matching, 373 COVID-19 and 373 influenza A patients were evenly matched for baseline characteristics. COVID-19 patients had higher unadjusted hospital mortality than influenza A patients (17.5% vs 7.5%, p

In this conversation, Claire Alexander discusses the overlap between her social research and biographical trajectories, showing us how shifts in academic work are linked to broader transformations, in this case, linked to the politics of identity, ethnicity, and race in the United Kingdom. Alexander also tells us about the meaning and value of ethnographic work, including her experience of “revisiting” places and maintaining links with her research participants over time. Strongly influenced by Stuart Hall, Claire also talks about the importance of communicating ideas to and generating dialogues with those outside of academia. She reflects on her interdisciplinary academic collaborations and work with civil society organizations, and invites us to be committed to and engaged with our contexts and social transformation.

En la última década los estudios acerca de la convivencia y la multiculturalidad cotidiana han cobrado renovada importancia en los estudios étnicos, migratorios y urbanos. Esta entrevista recoge las voces de la investigadora australiana Amanda Wise, y su par singapurense Selvaraj Velayutham, quienes en solitario y en colaboración han generado notables aportes para el estudio de la experiencia de vivir juntos a través de la diferencia cultural en contextos urbanos diversos. En esta conversación, junto con discutir su marco conceptual, se recogen aspectos relativos a su formación, aproximación interdisciplinaria, y su trabajo colaborativo y comparado. Además, ambos esbozan reflexiones iniciales en torno a las particularidades de los procesos de diversidad y convivencia en la ciudad de Santiago; reflexiones basadas en observaciones y discusiones llevadas a cabo durante una estadía académica en Chile.

This paper reports on the continual effort of the Knowledge Building Community (KBC) connecting teachers within and across schools for knowledge creation and community building during the COVID-19 disruptions. During this crisis, schools around the world are challenged with the issues of implementing online learning. Three areas of misalignment were identified: disjoint in learning with home-school separation, piecemeal technologies to mimic physical teaching, and disconnect between teacher professional development and classroom practices and we discussed emerging realignment efforts for transformative learning. Through analyzing the three case examples of how teachers responded to COVID-19 challenges in inter-related areas of curriculum, pedagogy, technology and community, we identified several themes on emerging alignments conducive for transformative pedagogy and technology through community advancement. These themes include: innovating practice around the centrality of ideas; perceiving knowledge building as pervasive; transformative use of technology, and symmetrical advancement of knowledge. These case examples show that in these disruptive times, the teachers were more actively building new practices supported by community dynamics and systemic processes of the KBC. Consequently, the interactions between stakeholders shifted from disjointed relations in different hierarchical levels to a networked community of people, ideas, and resources, and teachers continually advancing their knowledge-building practice in these challenging times.

Este artículo propone que los intermediarios han sido poco considerados o ignorados en las discusiones políticas y académicas sobre migración internacional en América Latina. Rescatando el rol histórico de los intermediarios o brokers en la migración global, se busca desafiar el énfasis sobre la agencia de migrantes y el rol del Estado en explicar migración regional, presentando el estado del arte sobre infraestructura de migración y su relevancia. Finalmente, se muestra que los diversos casos de migraciones asiáticas en Chile evidencian la importancia política del concepto y el fenómeno del uso de intermediarios.

This article examines the relationship between the Indonesian government’s discourse on “migrant-victims” and the promotion of migration as a pathway to development. The discussion revolves around two dominant representations of Indonesian migrants: as national heroes that contribute to the country’s economic development and as victims of labor exploitation. In analyzing speeches of state representatives and publications by local media and NGOs, it argues that both representations emphasize individual responsibility in terms of gender morality. For this purpose it proposes the category of immoral victims, which distinguishes between tolerable violence and legitimate violence, according to which those who do not qualify in terms of the moral standard of ideal women are believed to deserve their circumstances. An approach based on the (im)morality of the individual downplays the responsibility of the states and institutions for the protection of migrant workers and the social welfare of the population.

We developed methodology and built a portable reader to assess light transmittance in paper-based microfluidic devices in a highly sensitive, user-friendly and field-appropriate manner. By sandwiching the paper assay between micro-light-emitting diodes and micro-photodetectors, the reader quantifies light transmittance through the paper independent of ambient light conditions. To demonstrate the utility of the reader, we created a single-use paper-based microfluidic assay for measurement of alanine aminotransferase, an indicator of liver health in blood. The paper assay and reader system accurately differentiated alanine aminotransferase levels across the human reference range and demonstrated significant differences at clinically relevant cutoff values. Results were provided within 10 min and were automatically generated without complex image analysis. Performance of this point-of-care diagnostic rivals the accuracy of lab-based spectrometer tests at a fraction of the cost, while matching the timeliness of low-cost portable assays, which have historically shown lower accuracy. This combination of features allows flexible deployment of low cost and quantitative diagnostics to resource-poor settings. Keywords: Paper microfluidics, Colorimetric, Light transmission, Alanine aminotransferase, Enzymatic reactions, Continuous monitoring

Background The current behind armor blunt trauma (BABT) injury criterion uses a single penetration limit of 44 mm in Roma Plastilina clay and is not specific to thoracoabdominal regions. However, different regions in the human body have different injury tolerances. This manuscript presents a matched-pair hybrid test paradigm with different experimental models and candidate metrics to develop regional human injury criteria.Methods Live and cadaver swine were used as matched pair experimental models. An impactor simulating backface deformation profiles produced by body armor from military-relevant ballistics was used to deliver BABT loading to liver and lung regions in cadaver and live swine. Impact loading was characterized using peak accelerations and energy. For live swine, physiological parameters were monitored for 6 hours, animals were euthanized, and a detailed necropsy was done to identify injuries to skeletal structures, organs and soft tissues. A similar process was used to identify injuries to the cadaver swine for targeted thoracoabdominal regions.Results Two cadavers and one live swine were subjected to BABT impacts to the liver. One cadaver and one live swine were subjected to BABT impacts to the left lung. Injuries to both regions were similar at similar energies between the cadaver and live models.Conclusions Swine is an established animal for thoracoabdominal impact studies in automotive standards, although at lower insult levels. Similarities in BABT responses between cadaver and live swine allow for extending testing protocols to human cadavers and for the development of scaling relationships between animal and human cadavers, acting as a hybrid protocol between species and live and cadaver models. Injury tolerances and injury risk curves from live animals can be converted to human tolerances via structural scaling using these outcomes. The present experimental paradigm can be used to develop region-based BABT injury criteria, which are not currently available.

National Association of Education for Young Children (NAEYC) (2009) stated early childhood education (ECE) practitioners are key agents who develop quality assured curriculum and conduct teaching through developmentally-appropriate practice (DAP). They play the vital role in providing quality education for enhancing children's whole-person development in early years, in the sense that, their importance and significance towards children's development is an undeniable fact. In order to retain and maintain a stable teaching team in kindergartens, whether or not ECE practitioners' salary could be guaranteed with statutory increment are the key concerns of different stakeholders in ECE, where appropriate, the Government of Hong Kong Special Administrative Region (HKSAR) plays a pre-dominant role in policy-making on the subsidy of ECE in Hong Kong. This paper therefore examined the key initiative on the salary adjustment for kindergarten practitioners through the implementation of the Free Quality Kindergarten Education Scheme (Scheme) starting from 2017/18 school year (Education Bureau, 2017b). The latest three policy addresses on the direct subsidy to kindergartens joining the Scheme (Scheme-KGs), announced by the Government of HKSAR in 2016, 2017 and 2018, were extracted for examining the fault-lines in terms of direct subsidies for Scheme-KGs via content analysis. Developed by Walker (2006), the Five Reform Disconnections were adopted as theoretical framework for analyzing the disconnection between the Scheme and teachers' expectation on their salary adjustment. Practical recommendations were provided for alleviating the said disconnection. [ABSTRACT FROM AUTHOR]

Abstract Background KRAS mutations are prevalent in 40–45% of patients with colorectal cancer (CRC) and targeting this gene has remained elusive. Viruses are well known immune sensitizing agents. The therapeutic efficacy of oncolytic reovirus in combination with chemotherapy is examined in a phase 1 study of metastatic CRC. This study evaluates the nature of immune response by determining the cytokine expression pattern in peripheral circulation along with the distribution of antigen presenting cells (APCs) and activated T lymphocytes. Further the study evaluates the alterations in exosomal and cellular microRNA levels along with the effect of reovirus on leukocyte transcriptome. Methods Reovirus was administered as a 60-min intravenous infusion for 5 consecutive days every 28 days, at a tissue culture infective dose (TCID50) of 3 × 1010. Peripheral blood mononuclear cells (PBMC) were isolated from whole blood prior to reovirus administration and post-reovirus on days 2, 8, and 15. The expression profile of 25 cytokines in plasma was assessed (post PBMC isolation) on an EMD Millipore multiplex Luminex platform. Exosome and cellular levels of miR-29a-3p was determined in pre and post reovirus treated samples. Peripheral blood mononuclear cells were stained with fluorophore labelled antibodies against CD4, CD8, CD56, CD70, and CD123, fixed and evaluated by flow cytometry. The expression of granzyme B was determined on core biopsy of one patient. Finally, Clariom D Assay was used to determine the expression of 847 immune-related genes when compared to pre reovirus treatment by RNA sequencing analysis. A change was considered if the expression level either doubled or halved and the significance was determined at a p value of 0.001. Results Cytokine assay indicated upregulation at day 8 for IL-12p40 (2.95; p = 0.05); day 15 for GM-CSF (3.56; p = 0.009), IFN-y (1.86; p = 0.0004) and IL-12p70 (2.42; p = 0.02). An overall reduction in IL-8, VEGF and RANTES/CCL5 was observed over the 15-day period. Statistically significant reductions were observed at Day 15 for IL-8 (0.457-fold, 53.3% reduction; p = 0.03) and RANTES/CC5 (0.524-fold, 47.6% reduction; p = 0.003). An overall increase in IL-6 was observed, with statistical significance at day 8 (1.98- fold; 98% increase, p = 0.00007). APCs were stimulated within 48 h and activated (CD8+ CD70+) T cells within 168 h as determine by flow cytometry. Sustained reductions in exosomal and cellular levels of miR-29a-3p (a microRNA upregulated in CRC and associated with decreased expression of the tumor suppressor WWOX gene) was documented. Reovirus administration further resulted in increases in KRAS (33x), IFNAR1 (20x), STAT3(5x), and TAP1 (4x) genes after 2 days; FGCR2A (23x) and CD244 (3x) after 8 days; KLRD1 (14x), TAP1 (2x) and CD244(2x) after 15 days. Reductions (> 0.5x) were observed in VEGFA (2x) after 2 days; CXCR2 (2x), ITGAM (3x) after 15 days. Conclusions Reovirus has profound immunomodulatory properties that span the genomic, protein and immune cell distribution levels. This is the first study with reovirus in cancer patients that demonstrates these multi- layered effects, demonstrating how reovirus can function as an immune stimulant (augmenting the efficacy of immuno-chemo-therapeutic drugs), and an oncolytic agent. Reovirus thus functions bimodally as an oncolytic agent causing lysis of tumor cells, and facilitator of immune-mediated recognition and destruction of tumor cells. Graphical abstract

BACKGROUND: The objective of this study is to evaluate the effects of the Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) Program on reducing chronic disability among injured workers and improving efficiency of work rehabilitation process. METHODS:A cohort of patients with workplace injuries in the lower back were recruited from orthopaedics clinics and assigned to either MORE group (n = 139) or control group (n = 106). Patients in MORE group received an early MRI screening and a coordinated multi-disciplinary management, while patients in the control group received conventional care. Outcome variables are time to return-to-work (RTW) from date of injury, waiting time for MRI screening and time to medical assessment board (MAB). RESULTS: Patients in the MORE Program had significantly shorter duration for RTW (MORE: 6.1 months, Control: 12.8 months, p < 0.01), and more RTW cases (n = 64, 46.0%) compared to Control group (n = 29, 27.4%). The MORE group also had much shorter waiting time for MRI scans (91.85 vs. 309.2 days, p <0.001) and MAB referral after MRI scans (97.2 vs. 178.9 days, p = 0.001) compared to Control group. CONCLUSIONS: The MORE Program which emphasizes early intervention and early MRI screening, is shown to be effective in shortening sick leave and improving RTW outcomes of injured workers. [ABSTRACT FROM AUTHOR]

We investigated the flow dynamics of biotin-conjugated microgel capsules in avidin-conjugated microchannel constrictions. Microgels were prepared using a microfluidic assembly approach. Biotinylated microgels passing through avidin-modified constrictions slowed relative to several control systems. This effect was observed below a critical velocity of the microgels in the channel-at-large. The reduction in microgel velocity in the constriction occurred for several different sizes of microgels and orifices. Soft compliant microgels showed a lower velocity in the constriction relative to rigid microgels with the same concentration of biotin on the surface, due to the ability of the softer microgels to deform in the orifice and maximize their surface area when in contact with the orifice wall. [ABSTRACT FROM AUTHOR]

Objectives Primary healthcare internationally is facing a workforce crisis with fewer junior doctors choosing general practice (GP) as a career. In the UK, a national report on GP careers highlighted adverse influences during medical school on students’ career choices. The authors explored these influences in two urban UK medical schools, both with relatively low numbers of students entering GP training.Design Using a phenomenological approach, the authors thematically analysed the reflective diaries of four medical students who were recruited as ‘participant researchers’ over a period of 10 months. These students made regular reflexive notes about their experiences related to GP career perceptions in their academic and personal environments, aiming to capture both positive and negative perceptions of GP careers. The research team discussed emerging data and iteratively explored and developed themes.Setting Two UK medical schoolsParticipants Undergraduate medical studentsResults Seven key themes were identified: the lack of visibility and physicality of GP work, the lack of aspirational GP role models, students’ perceptions of a GP career as default, the performativity of student career choice with the perceptions of success linked to specialism, societal perceptions of GP careers, gender stereotyping of career choices and the student perception of life as a GP.Conclusions Students overwhelmingly reflected on negative cues to GP careers, particularly through their experience of the hidden curriculum. Three recommendations are made: the need for increased representation of GP role models in clinical curricula content delivery and senior leadership; ensuring GP clerkships involve an active and authentic student role with patients, enabling students to experience GP’s ‘work’ including managing complexity, uncertainty and risk. Finally, institutions need to consider students’ experiences of the hidden curriculum and the effect this can have on students’ perception of careers, alongside the challenges of rankings and perceived hierarchical positioning of disciplines.