bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep brain stimulation of posterior hypothalamic area for cluster headache
Authors: Huotarinen Antti , Kallela Mikko , Artto Ville , Laakso Aki , Kivisaari Riku
Published: May 2018

Background:

Deep brain stimulation of the posterior hypothalamic area is one of the neuromodulation treatments used for chronic cluster headache, but the number of published patients remains low.

Aim:

The aim of this article was to present the retrospective results of 12 consecutive chronic cluster headache patients treated with deep brain stimulation at Helsinki University Hospital.

Materials and Methods:

All chronic cluster headache patients treated with deep brain stimulation between 2004 and 2012 were included in the study. Patients were interviewed and their hospital files analyzed. Treatment effect was classified as good, partial, or no effect.

Results:

Of the 12 patients, four had a good treatment effect, five had partial, and three had no effect of deep brain stimulation. In contrast to previous studies, our patients reported an almost immediate benefit after the onset of stimulation.

Conclusions:

Deep brain stimulation provides clinically meaningful benefit to a subgroup of chronic cluster headache patients.
Theoretical analysis of roll-over-web coating of a micropolar fluid under lubrication approximation theory
Authors: Atif Hafiz M , Ali Nasir , Javed Muhammad A , Abbas Fazal
Published: May 2018

The theoretical model of roll coating onto a moving sheet is developed based on micropolar fluid constitutive equations and lubrication approximation. Closed form expressions for velocity, microrotation and pressure gradient are obtained. Runge-Kutta method is used to calculate the engineering quantities of interest such as, pressure, roll-separating (load-carrying) force and power input. The separation point is numerically calculated using Newton’s iterative method together with generalized Leibniz rule. The effects of involved parameters on the pressure gradient, velocity, pressure and other mechanical quantities are displayed through various graphs. Extreme pressure is observed in the nip region for larger coupling numbers and microrotation parameters. This leads to increased load-carrying force and power input for micropolar fluid when compared to a Newtonian fluid. Moreover, the separation point decreases from its Newtonian value with increasing [Formula: see text]
Ubiquitin-dependent degradation of CDK2 drives the therapeutic differentiation of AML by targeting PRDX2
Authors: Ying Meidan , Shao Xuejing , Jing Hui , Liu Yujia , Qi Xiaotian , Cao Ji , Chen Yingqian , Xiang Senfeng , Song Hua , Hu Ronggui , Wei Guoqing , Yang Bo , He Qiaojun
Published: May 2018

Key Points

CDK2 is ubiquitinated by KLHL6 and undergoes ubiquitin-dependent proteasome degradation in the therapeutic differentiation process of AML. CDK2 arrests myeloid cell differentiation via activating PRDX2, and CDK2 inhibition drives differentiation in 5 major subtypes of AML.
Sustained clonal hematopoiesis by HLA-lacking hematopoietic stem cells without driver mutations in aplastic anemia
Authors: Imi Tatsuya , Katagiri Takamasa , Hosomichi Kazuyoshi , Zaimoku Yoshitaka , Hoang Nguyen Viet , Nakagawa Noriharu , Tajima Atsushi , Yoshizato Tetsuichi , Ogawa Seishi , Nakao Shinji
Published: May 2018

Key Points

HSPCs that lack HLA class I alleles can sustain clonal hematopoiesis without driver mutations or telomere attrition in AA patients. 6pLOH may confer a survival advantage to HSPCs with age-related somatic mutations, leading to the clonal expansion of mutant HSPCs.
Exercise training and endothelial function in patients with type 2 diabetes: a meta-analysis
Authors: Qiu Shanhu , Cai Xue , Yin Han , Sun Zilin , Zügel Martina , Steinacker Jürgen Michael , Schumann Uwe
Published: May 2018

Background and aims

Exercise training is considered a cornerstone in the management of type 2 diabetes, which is associated with impaired endothelial function. However, the association of exercise training with endothelial function in type 2 diabetes patients has not been fully understood. This meta-analysis aimed to investigate their associations with focus on exercise types.

Methods

Databases were searched up to January 2018 for studies evaluating the influences of exercise training with durations ≥ 8 weeks on endothelial function assessed by flow-mediated dilation (FMD) among type 2 diabetes patients or between type 2 diabetics and non-diabetics. Data were pooled using random-effects models to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs).

Results

Sixteen databases were included. Exercise training resulted in an overall improvement in FMD by 1.77% (95% CI 0.94–2.59%) in type 2 diabetes patients. Specifically, both aerobic and combined aerobic and resistance exercise increased FMD by 1.21% (95% CI 0.23–2.19%) and 2.49% (95% CI 1.17–3.81%), respectively; but resistance exercise only showed a trend. High-intensity interval aerobic exercise did not significantly improve FMD over moderate-intensity continuous exercise. Notably, the improvement in FMD among type 2 diabetes patients was smaller compared with non-diabetics in response to exercise training (WMD − 0.72%, 95% CI − 1.36 to − 0.08%) or specifically to aerobic exercise (WMD − 0.65%, 95% CI − 1.31 to 0.01%).

Conclusions

Exercise training, in particular aerobic and combined exercise, improves endothelial function in type 2 diabetes patients, but such an improvement appears to be weakened compared with non-diabetics.

Trial registration PROSPERO CRD42018087376
Efficacy of postoperative pain management in head and neck cancer patients
Authors: Hinther Ashley , Nakoneshny Steven C. , Chandarana Shamir P. , Wayne Matthews T. , Dort Joseph C.
Published: May 2018

Background

Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay.

Methods

A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 – December 31, 2015. Pain scores were recorded prospectively. Primary outcomes were frequency of postoperative pain assessments and pain intensity using the numeric rating scale.

Results

The cohort included 41 patients. Analysis was limited to pain scores recorded from postoperative days 1–14. There was an average of 7.3 pain measurements per day (SD 4.6, range 1–24) with the most frequent monitoring on postoperative days 1–4. Median pain scores ranged from 0 to 4.5 with the highest median score on postoperative day 6. The daily maximum pain scores recorded ranged from 8 to 10 with scores of 10 recorded on postoperative days 1, 2, 3, 5, 7, 8, and 10. Patients most frequently had inadequate pain control on postoperative days 1, 2, 4, and 5 with the majority occurring on postoperative day 1.

Conclusions

Postoperative pain control could be improved at our centre. The frequency of pain assessments is also highly variable. Ongoing measurement, audit, and feedback of analgesic protocol effectiveness is an excellent first step in improving perioperative pain management in patients undergoing major head and neck cancer surgery with free flap reconstruction.
Advanced cancer patients’ construction of self during oncology consultations: a transitivity concordance analysis
Authors: Karimi Neda , Lukin Annabelle , Moore Alison Rotha , Walczak Adam , Butow Phyllis
Published: May 2018

This paper explores advanced cancer patients’ self-identification from a grammatical-concordance perspective. It combines corpus linguistics tool of concordance and transitivity analysis to investigate the grammatical choices that advanced cancer patients make to identify and construct themselves during an oncology consultation. The data comprises 69 oncology consultations between advanced cancer patients (and in some consultations a companion or companions) and their oncologist. Findings reveal that these advanced cancer patients identified themselves with an active and informed role in terms of self-care, decision-making and other administrative activities; they identified their everyday life as an indispensable part of the domain of medicine; and they did not associate themselves with emotive mental processes during the consultation.
Prevalence of vitamin D deficiency in adult patients admitted to a psychiatric hospital
Authors: Patel Dipen , Minajagi Manjunath
Published: May 2018

Aims and method

Vitamin D deficiency is increasing in the general population, and is linked with physical and mental illness. However, evidence on its prevalence in people with mental illness is limited. This study investigated vitamin D deficiency in 104 adult patients admitted to a psychiatric hospital in the UK.

Results

Forty-nine per cent were vitamin D deficient (serum 25(OH)D <30 nmol/L), and a further 42.3% were vitamin D insufficient (<50 nmol/L). On admission, 8.7% of patients were vitamin D sufficient (>50 nmol/L). There were no statistically significant differences in mean serum vitamin D between different subgroups of mental illness.

Clinical implications

Vitamin D deficiency is highly prevalent among individuals with severe mental illness admitted to hospital. Assessment and treatment of vitamin D deficiency should be considered in in-patients to protect musculoskeletal health. Further epidemiological and intervention studies are needed to investigate the role of vitamin D in the pathophysiology of mental disorders.

Declaration of interest

None.
A Younger Man With Localized Prostate Cancer Asks, “Which Type of Radiation Is Right for Me?”
Authors: Bekelman Justin E.
Published: May 2018

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology, to patients seen in their own clinical practice.

A 61-year-old man presents with stage II prostate cancer after a period of active surveillance. Work-up reveals T1cN0M0 carcinoma, a prostate-specific antigen (PSA) level of 4.8 ng/mL, and Grade Group II (highest Gleason 3+4) in three cores of 12 taken, at the right mid-gland and right apex. The patient has been on active surveillance for the past 16 months. He was originally diagnosed after biopsy for an elevated PSA with stage I prostate cancer, T1cN0M0; PSA, 4.5 ng/mL; Grade Group 1 (Gleason 3+3) in one core of 12 taken, also at the right mid-gland. A multiparametric magnetic resonance imaging scan showed a heterogeneous peripheral zone without a dominant lesion and a calculated prostate volume of 28 mL. His medical history includes hypercholesterolemia, for which he takes atorvastatin. He is otherwise healthy and has no other significant medical or surgical history. His father had prostate cancer in his 70s and died of other causes at 89 years of age. The patient reports 2- to 3-hour urinary frequency and 0 to 1 nocturia, and has no difficulty obtaining or maintaining an erection. After meeting with his urologist, he sees a radiation oncologist.
Pro-FHH: A Risk Equation to Facilitate the Diagnosis of Parathyroid-Related Hypercalcemia
Authors: Bertocchio Jean-Philippe , Tafflet Muriel , Koumakis Eugénie , Maruani Gérard , Vargas-Poussou Rosa , Silve Caroline , Nissen Peter H , Baron Stéphanie , Prot-Bertoye Caroline , Courbebaisse Marie , Souberbielle Jean-Claude , Rejnmark Lars , Cormier Catherine , Houillier Pascal
Published: May 2018

Context

Parathyroid-related hypercalcemia is due to primary hyperparathyroidism (PHPT) or to familial hypocalciuric hypercalcemia (FHH). PHPT can lead to complications that necessitate parathyroidectomy. FHH is a rare genetic disease resembling PHPT; surgery is ineffective. A reliable method for distinguishing FHH from PHPT is needed.

Objective

To develop an easy-to-use tool to predict if a patient has PHPT.

Design

Retrospective analysis of two prospective cohorts. Development of an unsupervised risk equation (Pro-FHH).

Setting

University hospitals in Paris, France, and Aarhus, Denmark.

Participants

Patients (Paris: 65 with FHH, 85 with PHPT; Aarhus: 38 with FHH, 55 with PHPT) were adults with hypercalcemia and PTH concentration within normal range.

Main Outcome Measures

Performance of Pro-FHH to predict PHPT.

Results

Pro-FHH takes into account plasma calcium, PTH, and serum osteocalcin concentrations, and calcium-to-creatinine clearance ratio calculated from 24-hour urine collection (24h-CCCR). In the Paris cohort, area under the receiver operating characteristic curve (AUROC) of Pro-FHH was 0.961, higher than that of 24h-CCCR. With a cutoff value of 0.928, Pro-FHH had 100% specificity and 100% positive predictive value for the diagnosis of PHPT; it correctly categorized 51 of 85 patients with PHPT; the remaining 34 were recommended to undergo genetic testing. No patients with FHH were wrongly categorized. In an independent cohort from Aarhus, AUROC of Pro-FHH was 0.951, higher than that of 24h-CCCR.

Conclusion

Pro-FHH effectively predicted whether a patient has PHPT. A prospective trial is necessary to assess its usefulness in a larger population and in patients with elevated PTH concentration.
Melanocortin 4 Receptor Pathway Dysfunction in Obesity: Patient Stratification Aimed at MC4R Agonist Treatment
Authors: Ayers Kristin L , Glicksberg Benjamin S , Garfield Alastair S , Longerich Simonne , White Joseph A , Yang Pengwei , Du Lei , Chittenden Thomas W , Gulcher Jeffery R , Roy Sophie , Fiedorek Fred , Gottesdiener Keith , Cohen Sarah , North Kari E , Schadt Eric E , Li Shuyu D , Chen Rong , Van der Ploeg Lex H T
Published: May 2018

Context

The hypothalamic melanocortin 4 receptor (MC4R) pathway serves a critical role in regulating body weight. Loss of function (LoF) mutations in the MC4R pathway, including mutations in the pro-opiomelanocortin (POMC), prohormone convertase 1 (PCSK1), leptin receptor (LEPR), orMC4R genes, have been shown to cause early-onset severe obesity.

Methods

Through a comprehensive epidemiological analysis of known and predicted LoF variants in thePOMC, PCSK1, andLEPR genes, we sought to estimate the number of US individuals with biallelic MC4R pathway LoF variants.

Results

We predict ~650α-melanocyte-stimulating hormone (MSH)/POMC, 8500PCSK1, and 3600LEPR homozygous and compound heterozygous individuals in the United States, cumulatively enumerating >12,800 MC4R pathway–deficient obese patients. Few of these variants have been genetically diagnosed to date. These estimates increase when we include a small subset of less rare variants:β-MSH/POMC,PCSK1 N221D, and aPCSK1 LoF variant (T640A). To further define the MC4R pathway and its potential impact on obesity, we tested associations between body mass index (BMI) and LoF mutation burden in thePOMC, PCSK1, andLEPR genes in various populations. We show that the cumulative allele burden in individuals with two or more LoF alleles in one or more genes in the MC4R pathway are predisposed to a higher BMI than noncarriers or heterozygous LoF carriers with a defect in only one gene.

Conclusions

Our analysis represents a genetically rationalized study of the hypothalamic MC4R pathway aimed at genetic patient stratification to determine which obese subpopulations should be studied to elucidate MC4R agonist (e.g., setmelanotide) treatment responsiveness.
Puzzle—Solving the n-Fractions Puzzle as a Constraint Programming Problem
Authors: Malapert Arnaud , Provillard Julien
Published: May 2018

The aim in solving puzzles is to find the solution using several clues and restrictions. In this paper, we solve a numerical puzzle, the n-fractions puzzle, by constraint programming. The n-fractions puzzle is problem 41 of the CSPLib, a library of test problems for constraint solvers. Models referenced in the CSPLib return invalid solutions as soon as the number n of fractions exceeds five. To solve the n-fractions puzzle, we first provide an upper bound for the unsatisfiability inspired by constraint filtering techniques. Then we propose two new constraint programming models that exploit the integer factorization of the fractions’ denominators and their lowest common multiple. The proposed models can solve up to the 19-fractions puzzle within a few minutes and without returning invalid solutions. Some restrictions of the models that eliminate invalid solutions still allow them to solve larger n-fractions puzzles, even if the solving times increase. At the end, only six n-fractions puzzles remain open.
Showrooming and Webrooming: Information Externalities Between Online and Offline Sellers
Authors: Jing Bing
Published: May 2018

In a product market where consumers are open to uninformed purchases, we study competition between a traditional and an online retailer in the presence of showrooming. Several results are obtained. First, showrooming intensifies competition and lowers both firms’ profits, thus supporting traditional and online retailers’ recent strategy of carrying more exclusive varieties. Second, lowering consumer search costs may aggravate showrooming and decrease the traditional retailer’s profits for intermediate search costs. Third, opening an online store expands the demand of the traditional retailer but intensifies competition, thus lowering its profits under certain conditions. Fourth, a return policy by the online retailer alleviates showrooming and relaxes competition but weakly reduces its demand, increasing its profits only for intermediate search costs. The return policy (weakly) increases the traditional retailer’s profits. Fifth, when search cost is not high enough, price matching by the traditional retailer may also intensify competition and hurt its profits. We then examine how webrooming interacts with showrooming. When webrooming resolves partial match uncertainty, it may increase both firms’ profits by inducing more consumers to participate.

The online appendix is available at https://doi.org/10.1287/mksc.2018.1084 .
Sourcing Innovation: On Feedback in Contests
Authors: Mihm Jürgen , Schlapp Jochen
Published: May 2018

It is notoriously difficult to provide outside parties with adequate incentives for innovation. Contests—in which solvers compete for a prize offered by the contest holder—have been shown to be an effective incentive mechanism. Despite considerable interest in this concept, we lack a thorough understanding of important aspects of contests; in particular, feedback from the contest holder to the solvers has received only limited attention. This paper discusses how contest holders can improve contest outcomes by devising an optimal information structure for their feedback policies. We first identify when, and when not, to give feedback as well as which type of feedback to give: public (which all solvers can observe) or private (which only the focal solver can observe). We uncover a nontrivial relationship between contest characteristics and optimal feedback choices. Second, we examine whether the contest holder should mandate interim feedback or instead allow solvers to seek feedback at their own discretion. Third, we discuss how changing the granularity of feedback information affects its value to solvers.

This paper was accepted by Ashish Arora, entrepreneurship and innovation.
Interbank Networks and Backdoor Bailouts: Benefiting from Other Banks’ Government Guarantees
Authors: Eisert Tim , Eufinger Christian
Published: May 2018

This paper explains why banks derive a benefit from being highly interconnected. We show that when banks are protected by government guarantees, they can significantly increase their expected returns by channeling funds through the interbank market before these funds are invested in real assets. If banks that are protected by implicit or explicit government guarantees act as intermediaries between other banks and real investments, there is the possibility that these intermediary banks will be rescued by their governments if the real assets fail. This additional hedge increases the likelihood that banks and their creditors are repaid relative to a direct investment in those same real assets. We show that this incentive to exploit the government guarantees of other banks leads to long intermediation chains and a degree of interconnectedness that is above the welfare-optimal level, which justifies regulatory intervention.

This paper was accepted by Amit Seru, finance.
The Price of Financial Precarity: Organizational Costs of Employees’ Financial Concerns
Authors: Meuris Jirs , Leana Carrie
Published: May 2018

Personal finances are becoming an increasingly prominent source of distress for a substantial proportion of the population in many developed economies. In this paper, we examine the organizational consequences of this trend by proposing that financial precarity can undermine a person’s ability to perform at work. Across two studies, we demonstrate that people who are worried about their financial situation have less cognitive capacity available to them, which subsequently spills over into their work performance. In Study 1, we demonstrate this relationship in a field study with short-haul truck drivers where we combine survey responses with lagged archival data on preventable accidents. We find that a one-standard-deviation increase in financial worry is associated with a 0.4% increase in the probability of a preventable accident because of its detrimental effects on cognitive capacity. In Study 2, we establish the causal ordering among the variables by manipulating financial worry in a laboratory environment using a driving simulation task, confirming the results of Study 1. We discuss the implications of the research findings for organizational theory and workplace practice, arguing that it may be in employers’ self-interest to undertake initiatives that reduce employees’ financial precarity.
Noema, Idealismo e Metafísica na Fenomenologia de Husserl
Authors: Vieira Allan Josué
Published: May 2018

O presente estudo se propõe abordar o estatuto do idealismo transcendental-fenomenológico de Husserl em sua relação com possíveis implicações metafísicas (ou a ausência destas). Para tanto, procuraremos situar o debate a partir de dois famosos artigos de Harrison Hall (1982; 1989) que apresentam a tese de que o idealismo de Husserl é metafisicamente neutro, e que mesmo o uso da expressão ‘idealismo’ seria potencialmente enganadora. A fim de discutir esta interpretação, colocaremos sob escrutínio o conceito husserliano de noema, visto que é sob a chancela de uma determinada concepção desta noção que a leitura de Hall é desenvolvida. O resultado alcançado será o de que há uma ambiguidade na resposta à pergunta sobre o caráter metafísico do idealismo husserliano, o que faz com que certo sentido de ‘metafísica’ seja abandonado por Husserl; mas, como o filósofo assinala nas Meditações cartesianas, não há a denegação de toda e qualquer metafísica. É a este respeito que procuraremos, por meio da investigação do conceito de noema, alcançar maior clareza.
A Maquinação Virtual: da subjetividade egoica à subjetividade incondicionada da técnica moderna
Authors: Sendra de Assis André
Published: May 2018

O presente trabalho discute o processo paulatino da virtualização do mundo a partir da exposição de Martin Heidegger sobre a era da técnica moderna. Para tanto, será acompanhado o trabalho do filósofo na descrição dos elementos fundamentais do pensamento moderno, a saber, o advento da subjetividade egoica e o posicionamento do mundo como pura representabilidade do sujeito, até o momento no qual ocorre a autonomização de tal esquema posicionador, para além do sujeito e do objeto, de modo a instituir o caráter essencial do mundo contemporâneo: a subjetividade incondicionada.  Acompanhando este processo, o trabalho visa trazer à tona a determinação específica de um mundo no qual tudo vira nada e, consequentemente, tudo se torna passível de ser produzido pela maquinação (Machenschaft). Neste ponto, a ciência cibernética ocupa um lugar central, pois é a partir dela que pode ocorrer, às últimas consequências, a produção de um mundo virtual.
BJM's birth story
Authors: Allen Mark
Published: May 2018

From spotting a gap in the market, to leading it, Mark Allen recalls how British Journal of Midwifery was born
Parents' experiences of clinical care during second trimester miscarriage
Authors: Cullen Sarah , Coughlan Barbara , McMahon Anne , Casey Brenda , Power Sheila , Brosnan Mary
Published: May 2018

Background

Second trimester miscarriage is defined as pregnancy loss after 12 weeks and before 24 weeks gestation. The care that parents receive has been shown to greatly influence the woman's recovery after pregnancy.

Aims

To explore parents' experiences of hospital care during a second trimester miscarriage, from the time of diagnosis through to follow-up care.

Methods

A focused ethnographic design to conduct semi-structured interviews with 14 bereaved parents before thematic data analysis.

Findings

Parents highlighted the need for effective medical care in relation to medical treatment, pain relief and length of hospital stay, going home to prepare for the delivery and follow-up care. Parents emphasised the importance of appropriate facilities and being separate from other parents and babies. Clear communication and finding a cause for their miscarriage was also important for parents.

Conclusion

Second trimester miscarriage is a significant life event for parents. Effective, individualised clinical care is needed to meet the medical needs of bereaved parents.
Cyanobacteria (blue-green algae) exposure in dogs
Authors: Bates Nicola
Published: May 2018

Blue-green algae are cyanobacteria that grow in fresh, brackish or sea water. Under certain environmental conditions they form blooms in water bodies and these often colour the water blue-green (or brown, black or red). These blooms have long been known to be associated with animal deaths, occasionally resulting in mass mortality events of wildlife. Cyanotoxins produced by these organisms are neurotoxic, hepatotoxic or, less commonly, dermatotoxic. Gastrointestinal effects may also occur. Signs can be very rapid in onset, particularly with neurotoxic compounds, with death following soon after. Hepatic effects generally occur within 24 hours. Aggressive and rapid treatment is essential with decontamination, liver protectants and supportive care. Survival is rare in animals with significant clinical signs. Not all algal blooms are toxic, however, and confirmation of exposure is rarely available and not within a clinically relevant time frame. Illness and deaths in dogs associated with suspected blue-green algae exposure are signal events and should be reported to the relevant environmental authority to safeguard public and animal health.
Spasticity management with botulinum toxin: A comparison of UK physiotherapy and rehabilitation medicine injectors
Authors: Ashford Stephen , Nair Ajoy , Williams Heather , Esdon James , Steed Aideen , Nyein Kyaw , Turner-Stokes Lynne
Published: May 2018

Background/Aims:

To compare patient outcomes following botulinum toxin (BoNT) injection by either physiotherapy or rehabilitation medicine (medical) professionals over a 3-year period.

Methods:

A retrospective, observational cohort study was conducted in a specialised rehabilitation service providing spasticity management including BoNT injection and physical therapy (group therapy, individual therapy, self-exercise, and physical management programmes). Individualised goals were established before treatment using goal attainment scaling (GAS) by the multidisciplinary team. The Arm Activity measure (ArmA) was used to evaluate upper limb function and the Modified Ashworth Scale (MAS) used to evaluate spasticity.

Findings:

A total of 262 patients were injected. Mean GAS T-score after treatment for the group was 50.2 ± 6.7. GAS T-score for physiotherapy injectors (n=214 (82% of participants)) was 50.2 ± 6.4 and for rehabilitation medicine injectors (n=48 (18%)) 50.3 ± 7.9. No significant differences were identified in terms of goal achievement, upper limb passive function, or spasticity reduction between physiotherapy and rehabilitation medicine injectors. Differences were identified at both baseline (physiotherapist mean 49.7; rehabilitation medicine mean 46.6) and follow-up for active function (physiotherapist mean=49.7; rehabilitation medicine mean=47.8) (ArmA active function subscale; p=0.03). No reportable adverse effects were recorded. No difference in the complexity of injection (such as complex clinical presentation, anticoagulation, or technical difficulty) between the injector groups was identified.

Conclusions:

Clinical outcomes were comparable between physiotherapy and rehabilitation medicine injectors. No difference in side effect profile or complexity of injection was identified. In this cohort, injection of BoNT by a physiotherapist was as effective in terms of GAS as that undertaken by a rehabilitation medicine physician.
Management of recurrent wheeze in pre-school children with a high risk of developing asthma
Authors: Moore-Crouch Rachael
Published: May 2018

Wheeze occurs in around one-third of children under 5 years. Rachael Moore-Crouch explains how to manage wheeze in children at a high risk of developing asthma

Wheeze is common in pre-school children, with up to one-third of all children developing symptoms. Of these children, one-third will go on to develop asthma by school age. Asthma is difficult to diagnose in pre-school children due to the inability to undertake reliable assessments of lung function to demonstrate reversible airflow obstruction or airway inflammation. The lack of objective testing can lead to over-diagnosis of asthma and inappropriate treatment with inhaled corticosteroids. Where asthma is highly suspected, treatment should be commenced with a carefully observed trial focusing on managing current symptoms with the lowest dose and minimal treatment. Parents should receive clear education and plans for escalation of care.
Régimen jurídico de la situación administrativa de segunda actividad: una perspectiva iuslaboralista
Authors: Ortiz González-Conde Francisco Miguel
Published: May 2018

Se entiende por situación administrativa de segunda actividad aquella consistenteen la reubicación de la persona funcionaria en otro puesto de trabajo distintoen razón de sus aptitudes psicofísicas, salvaguardándole las condiciones salariales, deantigüedad, o de expectativa de pensión que viniese disfrutando. Su regulación nocuenta con una normativa uniforme ni homogénea, constituyendo una particularidaden el régimen de determinados cuerpos de las Administraciones Públicas. Estetrabajo se centrará en destacar las dificultades de su aplicación, las incoherencias derivadasde sus distintas configuraciones, así como su relación con medidas de protección social, en una institución jurídica a medio camino entre el Derecho Administrativoy el Derecho del Trabajo.
Hitzaurrea
Authors: López Rubia M. Edurne
Published: May 2018

Hamar urte igaro dira emakumeen eta gizonen berdintasun eraginkorra lortzeko3/2007 Lege Organikoa, martxoaren 22koa, aprobatu zenetik. Arau horrenurteurrena ospatzeko eta emakumeen eta gizonen arteko berdintasunarenalde lan egiten jarraitzeko dagoen beharra agirian uzteko, 2017ko irailaren21ean eta 22an, Nafarroako Unibertsitate Publikoaren babespean, Nuevos retosen materia de igualdad laboral tras diez años de aprobación de la LOI izenburuazeraman Udako Ikastaroa ospatu zen.
Políticas de empleo y enfoque de género.
Authors: Pérez del Prado Daniel
Published: May 2018

La crisis económica ha relativizado la posición de las mujeres en el mercado laboral.La Gran recesión ha afectado en nuestro país principalmente a sectores altamentemasculinizados, incrementando el número de desempleados varones relativamentesi se comparan con el de las mujeres. El resultado final es una suerte de «efectoeclipsamiento», en el que la atención dispensada a las mujeres se ha debilitado. Larecuperación nos está mostrando que los problemas de las mujeres en lo que hace alretorno al mercado de trabajo ni mucho menos se han disipado.El objetivo del presente artículo es mostrar cuál es la situación de las mujeres en elmercado de trabajo en España en la actualidad y qué tipo de herramientas nos proporcionanla Economía y, muy especialmente, el Derecho para hacer frente a los particularesproblemas que caracterizan al desempleo femenino.
Desigualdad por causa de género en la Seguridad Social:carreras de cotización y prestaciones.
Authors: Rodríguez González Sarai
Published: May 2018

Las interrupciones en las carreras de cotización padecidas por las mujeres suponenun reto para la igualdad en el ámbito de la Seguridad Social y un auténtico desafíopara la garantía de la independencia económica de las mujeres, especialmentedurante la vejez, momento en que éstas afrontan un mayor riesgo de pobreza. Deeste modo, este trabajo toma como punto de partida el estudio y la delimitación delas causas de la persistente brecha de género en el Sistema de Seguridad Social, paraluego analizar de manera crítica las principales estrategias y mecanismos correctoresde esta situación existentes en nuestro ordenamiento jurídico, y que se destinan acompensar, de forma particular, la mayor dedicación al trabajo no retribuido de loscuidados por parte de las mujeres que les dificulta, en muchos casos, desarrollar suspropias carreras de seguro o las aboca a pensiones insuficientes durante la vejez.
IMPACTOS DAS RELAÇÕES DE HOSPITALIDADE E HOSTILIDADE ENTRE STAKEHOLDERS SOBRE A COMPETITIVIDADE DE DESTINOS TURÍSTICOS
Authors: Santos Aristides Faria Lopes dos , Wada Elizabeth Kyoko
Published: May 2018

As relações de hospitalidade/hostilidade entre stakeholders exerce influência sobre a competitividade dos destinos turísticos? Para responder a este problema foi desenvolvido estudo de casos múltiplos com abordagem qualitativa que considerou o poder público enquanto organização gestora do destino (DMO), atuando como líder na gestão local. Foram tomados como objetos de estudo os municípios de Cubatão, Itanhaém e Santos, localizados no litoral do estado de São Paulo, região sudeste brasileira. Como técnica de coleta de dados foi feita pesquisa bibliográfica, pesquisa documental, foram aplicadas entrevistas pessoais semiestruturadas com dirigentes municipais de turismo e stakeholders indicados por estes. Verificou-se que quão mais colaborativas forem as relações entre a DMO e seus stakeholders, maiores serão os impactos sobre a competitividade da destinação, entretanto, foi identificado que nos casos analisados a DMO não pratica a gestão do relacionamento com seus stakeholders de modo sistemático, o que parece ser contrário aos objetivos setoriais.
MÉDICO DESCANSA? Uma análise sociocultural do lazer e turismo de médicos em Dourados/MS
Authors: Clemente Correia Larissa , Pillon Ribeiro Alice , Dias de Oliveira Taisa Ellen , Brito Quadros Lara Camila de
Published: May 2018

O presente artigo tem como temática a análise sociocultural das práticas de lazer e de turismo de um grupo de médicos da cidade de Dourados/MS. O objetivo geral da pesquisa foi verificar como esses médicos utilizam seu tempo livre e quanto desse tempo é utilizado com prática de atividades de lazer e de turismo, além da autoavaliação sobre o lazer praticado pelos respondentes. A metodologia utilizada pautou-se na pesquisa bibliográfica inicial sobre o tema, confecção e aplicação do instrumento de pesquisa de campo, tendo como método o questionário e a análise qualitativa dos dados. Nesse sentido, entende-se como fundamental para o profissional do turismo, compreender o lazer dos diferentes grupos sociais com os quais irá trabalhar e, no caso desta pesquisa, pensar em atividades de lazer e de turismo que sejam adequadas à rotina dos médicos, além de despertar a consciência para a importância do lazer enquanto qualidade de vida.
Robot-assisted surgical ward rounds: virtually always there
Authors: Croghan Stefanie M. , Carroll Paul , Ridgway Paul F. , Gillis Amy E. , Reade Sarah
Published: May 2018

Background

While an explosion in technological sophistication has revolutionised surgery within the operating theatre, delivery of surgical ward-based care has seen little innovation. Use of telepresence allowing offsite clinicians communicate with patients has been largely restricted to outpatient settings or use of complex, expensive and static devices. We designed a prospective study ascertaining feasibility and face validity of a remotely controlled mobile audiovisual drone (LUCY) to access inpatients. This device is, uniquely, lightweight, freely mobile and emulates ‘human’ interaction by swiveling and adjusting height to patients’ eye-level.

Methods

Robot-assisted ward rounds (RASWRs) were conducted over 3 months. A remotely located consultant surgeon communicated with patients/bedside teams via encrypted audiovisual telepresence robot (DoubleRobotics, Burlingame, CA). Likert-scale satisfaction questionnaires, incorporating free-text sections for mixed-methods data collection, were disseminated to patient and staff volunteers following RASWRs. The same cohort completed a linked questionnaire following conventional (gold-standard) rounds, acting as a control group. Data were paired and non-parametric analysis was performed.

Results

RASWRs are feasible (>90% completed without technical difficulty). The RASWR (n= 52 observations) demonstrated face validity with strong correlations (r> 0.7; Spearman,p-value < 0.05) between robotic and conventional ward rounds among patients and staff on core themes, including dignity/confidentiality/communication/satisfaction with management plan. Patients (96.08%,n= 25) agreed RASWR were a satisfactory alternative when consultant physical presence was not possible. There was acceptance of nursing/non-consultant hospital doctor cohort [100% (n= 11) willing to regularly partake in RASWR].

Conclusion

RASWRs receive high levels of patient and staff acceptance, and offer a valid alternative to conventional ward rounds when a consultant cannot be physically present.
Actividad bactericida in vitro de miel sobre Escherichia coli y Staphylococcus aureus. Comparación con la actividad de cefalosporinas.
Authors: DELL'ELCE Antonella , AGUIRRE Soledad , PATRICELLI Paula , FORMENTINI Enrique
Published: May 2018

Se realizó un estudio comparativo entre la actividad antibacteriana de miel y cefalexina sobre una cepa de Escherichia coli y de miel y cefquinoma sobre una cepa de Staphylococcus aureus mediante ensayos de curva de muerte modificada. En todos los ensayos, la máxima actividad antibacteriana de la miel se observó a una dilución del 50% v/v. Respecto de la eficacia comparativa entre la miel y los antibióticos, se observó que sobre E. coli, cefalexina logró una reducción del conteo de bacterias viables compatible con un efecto bactericida (< 500 ufc/mL), mientras que la miel no logró superar este punto de corte. Lo opuesto se observó para S. aureus, donde la miel logró una reducción del conteo de bacterias viables compatible con un efecto de erradicación bacteriana (< 50 ufc/mL) respecto del efecto bactericida obtenido con cefquinoma (< 500 ufc/mL). Estos resultados preliminares, corroboran la necesidad de revalorar la actividad antibacteriana de productos naturales, cuya eficacia -aunque de manera empírica- ya era conocida desde la antigüedad y que fuera olvidada a partir de la aparición de los antibióticos.
Dialect comprehension and identification in L2 Spanish: Familiarity and type of exposure
Authors: Schoonmaker-Gates Elena
Published: May 2018

Previous work has shown that both native and nonnative listeners’ production and perception of regional variation changes with an individual’s residential history, social ties, and exposure to different dialects. The present study investigates the relationship between L2 learners’ dialect familiarity and their ability to understand and identify regional varieties in the read speech of native speakers from six different regions. The source and depth of participants’ past dialect exposure, as well as a measure of their proficiency in Spanish, were also accounted for in this investigation of 60 L1 English speakers’ performance on a transcription task and a dialect identification task. Results revealed that familiarity was a significant predictor of learners’ dialect identification regardless of level, and it also predicted the dialect comprehension of more advanced students. Comprehension but not identification was also more accurate when multiple types of exposure were reported and when exposure was through native instructors, study abroad, and media from a specific region. Ultimately, the present findings shed light on second language learners’ comprehension and identification of different regional varieties of Spanish with and without prior exposure to each dialect, including the effects of different sources of exposure on participants’ perception.
Short-Term Plasticity Combines with Excitation–Inhibition Balance to Expand Cerebellar Purkinje Cell Dynamic Range
Authors: Grangeray-Vilmint Anais , Valera Antoine M. , Kumar Arvind , Isope Philippe
Published: May 2018

The balance between excitation (E) and inhibition (I) in neuronal networks controls the firing rate of principal cells through simple network organization, such as feedforward inhibitory circuits. Here, we demonstrate in male mice, that at the granule cell (GrC)-molecular layer interneuron (MLI)-Purkinje cell (PC) pathway of the cerebellar cortex, E/I balance is dynamically controlled by short-term dynamics during bursts of stimuli, shaping cerebellar output. Using a combination of electrophysiological recordings, optogenetic stimulation, and modeling, we describe the wide range of bidirectional changes in PC discharge triggered by GrC bursts, from robust excitation to complete inhibition. At high frequency (200 Hz), increasing the number of pulses in a burst (from 3 to 7) can switch a net inhibition of PC to a net excitation. Measurements of EPSCs and IPSCs during bursts and modeling showed that this feature can be explained by the interplay between short-term dynamics of the GrC-MLI-PC pathway and E/I balance impinging on PC. Our findings demonstrate that PC firing rate is highly sensitive to the duration of GrC bursts, which may define a temporal-to-rate code transformation in the cerebellar cortex.

SIGNIFICANCE STATEMENTSensorimotor information processing in the cerebellar cortex leads to the occurrence of a sequence of synaptic excitation and inhibition in Purkinje cells. Granule cells convey direct excitatory inputs and indirect inhibitory inputs to the Purkinje cells, through molecular layer interneurons, forming a feedforward inhibitory pathway. Using electrophysiological recordings, optogenetic stimulation, and mathematical modeling, we found that presynaptic short-term dynamics affect the balance between synaptic excitation and inhibition on Purkinje cells during high-frequency bursts and can reverse the sign of granule cell influence on Purkinje cell discharge when burst duration increases. We conclude that short-term dynamics may play an important role in transforming the duration of sensory inputs arriving on cerebellar granule cells into cerebellar cortical output firing rate.
R-Ras1 and R-Ras2 Are Essential for Oligodendrocyte Differentiation and Survival for Correct Myelination in the Central Nervous System
Authors: Sanz-Rodriguez Miriam , Gruart Agnès , Escudero-Ramirez Juan , de Castro Fernando , Delgado-García José María , Wandosell Francisco , Cubelos Beatriz
Published: May 2018

Rapid and effective neural transmission of information requires correct axonal myelination. Modifications in myelination alter axonal capacity to transmit electric impulses and enable pathological conditions. In the CNS, oligodendrocytes (OLs) myelinate axons, a complex process involving various cellular interactions. However, we know little about the mechanisms that orchestrate correct myelination. Here, we demonstrate that OLs express R-Ras1 and R-Ras2. Using female and male mutant mice to delete these proteins, we found that activation of the PI3K/Akt and Erk1/2-MAPK pathways was weaker in mice lacking one or both of these GTPases, suggesting that both proteins coordinate the activity of these two pathways. Loss of R-Ras1 and/or R-Ras2 diminishes the number of OLs in major myelinated CNS tracts and increases the proportion of immature OLs. InR-Ras1−/−andR-Ras2−/−-null mice, OLs show aberrant morphologies and fail to differentiate correctly into myelin-forming phenotypes. The smaller OL population and abnormal OL maturation induce severe hypomyelination, with shorter nodes of Ranvier inR-Ras1−/−and/orR-Ras2−/−mice. These defects explain the slower conduction velocity of myelinated axons that we observed in the absence of R-Ras1 and R-Ras2. Together, these results suggest that R-Ras1 and R-Ras2 are upstream elements that regulate the survival and differentiation of progenitors into OLs through the PI3K/Akt and Erk1/2-MAPK pathways for proper myelination.

SIGNIFICANCE STATEMENTIn this study, we show that R-Ras1 and R-Ras2 play essential roles in regulating myelinationin vivoand control fundamental aspects of oligodendrocyte (OL) survival and differentiation through synergistic activation of PI3K/Akt and Erk1/2-MAPK signaling. Mice lacking R-Ras1 and/or R-Ras2 show a diminished OL population with a higher proportion of immature OLs, explaining the observed hypomyelination in main CNS tracts.In vivoelectrophysiology recordings demonstrate a slower conduction velocity of nerve impulses in the absence of R-Ras1 and R-Ras2. Therefore, R-Ras1 and R-Ras2 are essential for proper axonal myelination and accurate neural transmission.
What do we Want for the Next 10 Years?
Authors: Gómez Aitor , Zapata-Sepúlveda Pamela
Published: May 2018

This article introduces the special issue to celebrate the 11th International Congress of Qualitative Inquiry at Urbana-Champaign in 2015. The theme of the congress was “Constructing a New Critical Qualitative Inquiry.” The best way to introduce this special issue is with a T.S. Eliot quote Norman Denzin used to welcome the ICQI participants to the congress in 2015: “We shall not cease from exploration/And the end of all our exploring/Will be to arrive where we started/And know the place for the first time.” In this special issue, scholars from different views, perspectives, frameworks, and places reflect on what we want for the next 10 years. We invite you to listen to them.
Freire in a Changing World
Authors: Tilley-Lubbs Gresilda A.
Published: May 2018

This article presents critical autoethnography as a socially just way of conducting research in marginalized, vulnerable communities. Combining autoethnography, ethnography, and critical pedagogy, the researcher becomes a participant/collaborator in the study, turning inward to examine the Self and the complexities of cultural perspectives through the lens of critical pedagogy. Through intense reflexivity and introspection, the researcher can examine Self as participant, not trying to present facts as objectively as possible, as occurs with autobiography, but rather acknowledging that the interpretation of facts reflects cultural perspectives shaped by years of sociocultural, sociohistorical, sociopolitical, and socioeconomic events and circumstances. Subsequently, the researcher, more than likely a member of the dominant culture in some categories, is able to understand herself as an oppressor.
Constructing New Critical Inquiry through Performance Autoethnography
Authors: Denzin Norman K.
Published: May 2018

The assumptions of a reflexive performative autoethnography are outlined. A new genealogy is sought, new literatures must be engaged, and a reborn critical theory is imagined.