Extra Forces induced by wide-pulse, high-frequency electrical stimulation: Occurrence, magnitude, variability and underlying mechanisms.

OBJECTIVE: In contrast to conventional (CONV) neuromuscular electrical stimulation (NMES), the use of "wide-pulse, high-frequencies" (WPHF) can generate higher forces than expected by the direct activation of motor axons alone. We aimed at investigating the occurrence, magnitude, variability and underlying neuromuscular mechanisms of these "Extra Forces" (EF). METHODS: Electrically-evoked isometric plantar flexion force was recorded in 42 healthy subjects. Additionally, twitch potentiation, H-reflex and M-wave responses were assessed in 13 participants. CONV (25Hz, 0.05ms) and WPHF (100Hz, 1ms) NMES consisted of five stimulation trains (20s on-90s off). RESULTS: K-means clustering analysis disclosed a responder rate of almost 60%. Within this group of responders, force significantly increased from 4% to 16% of the maximal voluntary contraction force and H-reflexes were depressed after WPHF NMES. In contrast, non-responders showed neither EF nor H-reflex depression. Twitch potentiation and resting EMG data were similar between groups. Interestingly, a large inter- and intrasubject variability of EF was observed. CONCLUSION: The responder percentage was overestimated in previous studies. SIGNIFICANCE: This study proposes a novel methodological framework for unraveling the neurophysiological mechanisms involved in EF and provides further evidence for a central contribution to EF in responders.

The Outcry of the Periphery? An Analysis of Ticino's No to Immigration

When the popular initiative "against mass immigration" was accepted by the Swiss people and cantons on 9 February 2014, Ticino had by far the highest approval rate. The Italian-speaking canton thus once more confirmed its singular position, assumed since the 1990s, on popular votes regarding immigration and foreign policy. This seems to be indicative of wider crises and changes in both the economic and political spheres that have favoured the emergence of a political opposition between centre and periphery. The results of a survey among 1400 citizens of Ticino after the vote of 9 February confirm this. In essence, on top of the question of immigration, the vote was influenced by a fearful perception of Ticino as a "double periphery" vis-à-vis both Berne and Lombardy.

Sublingual sugar for infant hypoglycaemia

Refers To Deborah L Harris, Philip J Weston, Matthew Signal, J Geoffrey Chase, Jane E Harding Dextrose gel for neonatal hypoglycaemia (the Sugar Babies Study): a randomised, double-blind, placebo-controlled trial The Lancet, Volume 382, Issue 9910, 21 December 2013-3 January 2014, Pages 2077-2083 Referred to by Jane E Harding, Deborah L Harris, Philip J Weston, Matthew Signal, Geoffrey Chase Sublingual sugar for infant hypoglycaemia - Authors' reply The Lancet, Volume 383, Issue 9924, 5-11 April 2014, Pages 1208-1209

The pseudo-high-risk prevention strategy

Key Messages: A fundamental failure of high-risk prevention strategies is their inability to prevent disease in the large part of the population at a relatively small average risk and from which most cases of diseases originate. The development of individual predictive medicine and the widening of high-risk categories for numerous (chronic) conditions lead to the application of pseudo-high-risk prevention strategies. Widening the criteria justifying individual preventive interventions and the related pseudo-high-risk strategies lead to treating, individually, ever healthier and larger strata of the population. The pseudo-high-risk prevention strategies raise similar problems compared with high-risk strategies, however on a larger scale and without any of the benefit of population-based strategies. Some 30 years ago, the strengths and weaknesses of population-based and high-risk prevention strategies were brilliantly delineated by Geoffrey Rose in several seminal publications (Table 1).1,2 His work had major implications not only for epidemiology and public health but also for clinical medicine. In particular, Rose demonstrated the fundamental failure of high-risk prevention strategies, that is, by missing a large number of preventable cases.

Dial M for Murder: A Case of Passion Killing, Criminal Evidence and Sultanic Power in Medieval India

This paper considers the structures and applications of the criminal judicial system in the Islamic Later Middle Period as it developed in India under the sultans of Delhi (1200-1400 CE). A fundamental issue in crime and punishment is the relationship between sultanic power and religious authority. Particularly at stake in this relationship is the question of who can sanction the highest form of punishment, i.e. the death penalty (siyāsa). Contemporary historians and scholars in the study of religion investigating the relationship between sharīʿa and siyāsa to reveal the extent and limits of sultanic power show a system of governance that allowed for the delegation of authority, particularly in the area of the judiciary, from the sultan down to viziers and judges. Some scholars depict the relationship between the ʿulamāʾ and the sultan as a kind of stand off. The actual dynamics of legal jurisdiction were much more complex. This study proposes a new interpretive framework for understanding the relationship between political power and religious authority through a critical analysis of the criminal judicial system, law, and historical narrative. In particular, I consider a murder case described by Shams al-dīn Sirāj ʿAfīf in one of the most significant histories written in the later Delhi Sultanate, the Tārīkh-i Fīrūzshāhī.