Benzodiazepine overtreatment in status epilepticus is related to higher need of intubation and longer hospitalization.

Benzodiazepine (BDZ), a widely recognized first-line status epilepticus (SE) treatment, may lead to respiratory depression. This cohort study investigates the effect of BDZ doses in SE patients in terms of morbidity and mortality. It considers incident SE episodes from a prospective registry (2009-2012), comparing patients receiving standard BDZ dose to those receiving exceeding doses (>30% above recommended dose), in terms of likelihood to receive intubation, morbidity, and mortality. Duration of hospitalization was assessed for subjects needing intubation for airways protection (not for refractory SE treatment) versus matched subjects not admitted to the intensive care unit (ICU). We identified 29 subjects receiving "excessive" and 173 "standard" BDZ dose; 45% of the overtreated patients were intubated for airways protection, but only 8% in the standard-dose group (p < 0.001). However, both groups presented similar clinical outcomes: 50% returned to baseline, 40% acquired a new handicap, and 10% died. Orotracheal intubation due to airways protection was associated with significantly longer hospitalization (mean 2 weeks vs. 1 week, p = 0.008). In conclusion, although administration of excessive BDZ doses in SE treatment does not seem to influence outcome, it is related to higher respiratory depression risk and longer hospitalization, potentially exposing patients to additional complications and costs.

Disentangling water usage in the European Union: A decomposition analysis

The Water Framework Directive (WFD) defines common objectives for water resources throughout the European Union (EU). Given this general approach to water preservation and water policy, the objective of this paper is to analyse whether common patterns of water consumption exist within Europe. In particular, our study uses two methods to reveal the reasons behind sectoral water use in all EU countries. The first method is based on an accounting indicator that calculates the water intensity of an economy as the sum of sectoral water intensities. The second method is a subsystem input‐output model that divides total water use into different income channels within the production system. The application uses data for the years 2005 and 2009 on water consumption in the production system of the 27 countries of the EU. From our analysis it emerges that EU countries are characterized by very different patterns of water consumption. In particular water consumption by the agriculture sector is extremely high in Central/Eastern Europe, relative to the rest of Europe. In most countries, the water used by the fuel, power and water sector is consumed to satisfy domestic final demand. However, our analysis shows that for some countries exports from this sector are an important driver of water consumption. Focusing on the agricultural sector, the decomposition analysis suggests that water usage in Mediterranean countries is mainly driven by final demand for, and exports of, agricultural products. In Central/Eastern Europe domestic final demand is the main driver of water consumption, but in this region the proportion of water use driven by demand for exports is increasing over time. Given these heterogeneous water consumption patterns, our analysis suggests that Mediterranean and Central/Eastern European countries should adopt specific water policies in order to achieve efficient levels of water consumption in the European Union. JEL codes: N5; C67 Keywords: Water use, Subsystem input–output model; Water intensity, European Union.

Transferring control demands across incidental learning tasks - Stronger sequence usage in serial reaction task after shortcut option in letter string checking

After incidentally learning about a hidden regularity, participants can either continue to solve the task as instructed or, alternatively, apply a shortcut. Past research suggests that the amount of conflict implied by adopting a shortcut seems to bias the decision for vs. against continuing instruction-coherent task processing. We explored whether this decision might transfer from one incidental learning task to the next. Theories that conceptualize strategy change in incidental learning as a learning-plus-decision phenomenon suggest that high demands to adhere to instruction-coherent task processing in Task 1 will impede shortcut usage in Task 2, whereas low control demands will foster it. We sequentially applied two established incidental learning tasks differing in stimuli, responses and hidden regularity (the alphabet verification task followed by the serial reaction task, SRT). While some participants experienced a complete redundancy in the task material of the alphabet verification task (low demands to adhere to instructions), for others the redundancy was only partial. Thus, shortcut application would have led to errors (high demands to follow instructions). The low control demand condition showed the strongest usage of the fixed and repeating sequence of responses in the SRT. The transfer results are in line with the learning-plus-decision view of strategy change in incidental learning, rather than with resource theories of self-control.

Alteration and recovery of arm usage in daily activities after rotator cuff surgery.

BACKGROUND: The objective measurement of dominant/nondominant arm use proportion in daily life may provide relevant information on healthy and pathologic arm behavior. This prospective case-control study explored the potential of such measurements as indicators of upper limb functional recovery after rotator cuff surgery. METHODS: Data on dominant/nondominant arm usage were acquired with body-worn sensors for 7 hours. The postsurgical arm usage of 21 patients was collected at 3, 6, and 12 months after rotator cuff surgery in the sitting, walking, and standing postures and compared with a reference established with 41 healthy subjects. The results were calculated for the dominant and nondominant surgical side subgroups at all stages. The correlations with clinical scores were calculated. RESULTS: Healthy right-handed and left-handed dominant arm usage was 60.2% (±6.3%) and 53.4% (±6.6%), respectively. Differences in use of the dominant side were significant between the right- and left-handed subgroups for sitting (P = .014) and standing (P = .009) but not for walking (P = .328). The patient group showed a significant underuse of 10.7% (±8.9%) at 3 months after surgery (P < .001). The patients recovered normal arm usage within 12 months, regardless of surgical side. The arm underuse measurement was weakly related to function and pain scores. CONCLUSION: This study provided new information on arm recovery after rotator cuff surgery using an innovative measurement method. It highlighted that objective arm underuse measurement is a valuable indicator of upper limb postsurgical outcome that captures a complementary feature to clinical scores.

Clinical evaluation of enalapril maleate and furosemide usage in dogs with degenerative myxomatous mitral valve, CHF functional class Ib

Degenerative myxomatous mitral valve (DMMV) is a heart disease of high incidence in small animal clinical medicine, affecting mainly older dogs and small breeds. Thus, a scientific investigation was performed in order to evaluate the clinical use of the medicines furosemide and enalapril maleate in dogs with this disease in CHF functional class Ib before and after the treatment was established. For this purpose 16 dogs with the given valve disease were used, separated into two groups: the first received furosemide (n=8) and the second received enalapril maleate (n=8) throughout 56 days. The dogs were evaluated in four stages (T0, T14, T28 and T56 day) in relation to clinical signs, hematological, biochemical and serum assessment, which included serum angiotensin converting enzyme (ACE) and aldosterone, as well as radiography, electrocardiography, Doppler-echocardiography and blood pressure. The results regarding the clinical, hematological and serum chemistry evaluations revealed no significant changes in both groups, but significant reductions in the values of ACE and aldosterone in the group receiving enalapril maleate were verified. The radiographic examination revealed reductions of VHS values and variable Pms wave of the electrocardiogram in both groups, but no changes in blood pressure values were identified. The echocardiogram showed a significant decrease of the variables LVDd/s in the studied groups and the FS% in animals that received only enalapril. Therefore, analysis of results showed that monotherapy based on enalapril maleate showed better efficiency of symptoms control in patients with CHF functional class Ib.

The requirements and needs of global data usage in product lifecycle management

This study was done for ABB Ltd. Motors and Generators business unit in Helsinki. In this study, global data movement in large businesses is examined from a product data management (PDM) and enterprise resource planning (ERP) point-of-view. The purpose of this study was to understand and map out how a large global business handles its data in a multiple site structure and how it can be applied in practice. This was done by doing an empirical interview study on five different global businesses with design locations in multiple countries. Their master data management (MDM) solutions were inspected and analyzed to understand which solution would best benefit a large global architecture with many design locations. One working solution is a transactional hub which negates the effects of multisite transfers and reduces lead times. Also, the requirements and limitations of the current MDM architecture were analyzed and possible reform ideas given.  

Consumers' opinions on scent marketing usage in retail environment

Tutkielman tarkoituksena on tutkia suomalaisten kuluttajien mielipiteitä ja käsityksiä tuoksumarkkinoinnin käytöstä vähittäistavarakauppa olosuhteissa. Tutkielma keskittyy tuoksumarkkinoinnin kahteen pääasialliseen osa-alueeseen vähittäistavarakaupassa; tuoksumarkkinointiin osana brändäystä ja tuoksumarkkinoinnin alitajuntaiseen käyttöön. Tutkielma on laadullinen tutkimus. Aineisto kerättiin viideltä suomalaiselta kuluttajalta ja aineistonkeruumenetelmänä toimi haastattelu. Tutkimuksen tulokset osoittavat kuluttajien mielipiteiden olevan positiivisia tuoksumarkkinoinnin käyttöä kohtaan. Tuloksien mukaan kuluttajat suosivat tuoksumarkkinoinnin käyttöä ennemmin brändäyksessä kuin tuoksumarkkinoinnin alitajuista käyttöä. Tuoksumarkkinoinnin alitajuista käyttöä ei kuitenkaan todettu täysin negatiiviseksi, sillä kuluttajat uskovat, että ostopäätös tehdään perustuen tärkeämpiin asioihin kuin tuoksuun, kuten esimerkiksi tuotteen hintaan perustuen. Kuluttajat uskovat, että alitajuisella käytöllä ei ole suurta vaikutusta asiakkaan ostopäätökseen muulloin kuin joissakin yksittäisissä heräteostoksissa.

Increased expression of "peripheral-type" benzodiazepine receptors in human temporal lobe epilepsy: implications for PET imaging of hippocampal sclerosis.

Increased binding sites for "peripheral-type" benzodiazepine receptor (PTBR) ligands have been described in a wide range of neurological disorders including both human and experimental epilepsy. This study was undertaken to assess PTBR expression in relation to the presence of hippocampal sclerosis in human temporal lobe epilepsy (TLE). For this purpose, hippocampal CA1 subfields were dissected from surgical samples from patients with therapy-refractive TLE with (n = 5) or without (n = 2) hippocampal sclerosis and from age-matched nonepileptic postmortem controls (n = 5). PTBR expression was assessed by immunohistochemistry and reverse-transcription polymerase chain reaction. Receptor sites were evaluated using an in vitro binding assay and the selective PTBR ligand [3H]PK11195. Epileptic patients with hippocampal sclerosis showed increases in PTBR binding sites, immunoreactivity, and mRNA expression compared to both nonsclerotic TLE patients and postmortem nonepileptic controls. Induction of PTBR expression and binding sites were directly correlated with the presence of hippocampal sclerosis and the accompanying reactive gliosis.

Mild hypothermia prevents brain edema and attenuates up-regulation of the astrocytic benzodiazepine receptor in experimental acute liver failure.

BACKGROUND/AIMS: Mild hypothermia has proven useful in the clinical management of patients with acute liver failure. Acute liver failure in experimental animals results in alterations in the expression of genes coding for astrocytic proteins including the "peripheral-type" (astrocytic) benzodiazepine receptor (PTBR), a mitochondrial complex associated with neurosteroid synthesis. To gain further insight into the mechanisms whereby hypothermia attenuates the neurological complications of acute liver failure, we investigated PTBR expression in the brains of hepatic devascularized rats under normothermic (37 degrees C) and hypothermic (35 degrees C) conditions. METHODS: PTBR mRNA was measured using semi-quantitative RT-PCR in cerebral cortical extracts and densities of PTBR sites were measured by quantitative receptor autoradiagraphy. Brain pregnenolone content was measured by radioimmunoassay. RESULTS: At coma stages of encephalopathy, animals with acute liver failure manifested a significant increase of PTBR mRNA levels. Brain pregnenolone content and [(3)H]PK 11195 binding site densities were concomitantly increased. Mild hypothermia prevented brain edema and significantly attenuated the increased receptor expression and pregnenolone content. CONCLUSIONS: These findings suggest that an attenuation of PTBR up-regulation resulting in the prevention of increased brain neurosteroid content represents one of the mechanisms by which mild hypothermia exerts its protective effects in ALF.

Wastewater usage in urban and peri-urban agricultural production systems: scenarios from India

The role urban and peri-urban agriculture (UPA) plays in reducing urban poverty and ensuring environmental sustainability was recognized by the Millennium Development Goals (MGDs). India is the world’s largest democratic nation with a population of 1.2 billion. The rapid urbanization and high proportion of people below the poverty line along with higher migration to urban areas make India vulnerable to food crisis and urbanization of poverty. Ensuring jobs and food security among urban poor is a major challenge in India. The role of UPA can be well explained and understood in this context. This paper focuses on the current situation of UPA production in India with special attention to wastewater irrigation. This question is being posed about the various human health risks from wastewater irrigation which are faced by farmers and labourers, and, secondly by consumers. The possible health hazards involve microbial pathogens as well as helminth (intestinal parasites). Based on primary and secondary data, this paper attempts to confirm that UPA is one of the best options to address increasing urban food demand and can serve to complement rural supply chains and reduce ecological food prints in India. “Good practice urban and peri-urban agriculture” necessitates an integrated approach with suitable risk reduction mechanisms to improve the efficiency and safety of UPA production.

Analysis of Michael Porter’s generic strategies and its usage in a globalized business environment

Michael Porter reconocido como una autoridad en estrategia nos ha motivado a entrar a analizar profundamente sus propuestas e ideas en el campo de su dominio, con el objetivo de analizarlas y validarlas en el actual ambiente de negocios, caracterizado por ser turbulento y dinámico. El método elegido fue contratar éste ambiente con el ambiente bajo el cual se crearon las propuestas estratégicas de Michael Porter. Para esto, nos enfocamos en su propuesta para la estrategia de negocio, específicamente, las Tres Estrategias Genéricas. Tomando el caso de estudio de ZARA y su trayectoria empresarial como una investigación empírica para obtener resultados y discutirlos bajo parámetros que surgen desde las críticas desarrolladas por otros autores. Tomando como fuente de información libros, ensayos, publicaciones en Internet, noticias, entrevistas a clientes y a sus empleados.