Vestibular and oculomotor influences on visual dependency

The degree to which a person relies on visual stimuli for spatial orientation is termed visual dependency (VD). VD is considered a perceptual trait or cognitive style influenced by psychological factors and mediated by central re-weighting of the sensory inputs involved in spatial orientation. VD is often measured using the rod-and-disk test, wherein participants align a central rod to the subjective visual vertical (SVV) in the presence of a background that is either stationary or rotating around the line of sight - dynamic SVV. Although this task has been employed to assess VD in health and vestibular disease, it is unknown what effect torsional nystagmic eye movements may have on individual performance. Using caloric ear irrigation, 3D video-oculography and the rod-and-disk test, we show that caloric torsional nystagmus modulates measures of visual dependency and demonstrate that increases in tilt after irrigation are positively correlated with changes in ocular torsional eye movements. When the direction of the slow phase of the torsional eye movement induced by the caloric is congruent with that induced by the rotating visual stimulus, there is a significant increase in tilt. When these two torsional components are in opposition there is a decrease. These findings show that measures of visual dependence can be influenced by oculomotor responses induced by caloric stimulation. The findings are of significance for clinical studies as they indicate that VD, which often increases in vestibular disorders, is not only modulated by changes in cognitive style but also by eye movements, in particular nystagmus.

A Game of Horns: Transnational Flows of Rhino Horn

A multi-sectorial regime of protection including international treaties, conservation and security measures, demand reduction campaigns and quasi-military interventions has been established to protect rhinos. Despite these efforts, the poaching of rhinos and trafficking of rhino horn continue unabated. This dissertation asks why the illegal market in rhinoceros horn is so resilient in spite of the myriad measures employed to disrupt it. A theoretical approach grounded in the sociology of markets is applied to explain the structure and functioning of the illegal market. The project follows flows of rhino horn from the source in southern Africa to illegal markets in Southeast Asia. The multi-sited ethnography included participant observations, interviews and focus groups with 416 informants during fourteen months of fieldwork. The sample comprised of, amongst others, convicted and active rhino poachers, smugglers and kingpins, private rhino breeders and hunting outfitters, African and Asian law enforcement officials, as well as affected local communities and Asian consumers. Court files, CITES trade data, archival materials, newspaper reports and social media posts were also analysed to supplement findings and to verify and triangulate data from interviews, focus groups and observations. Central to the analysis is the concept of “contested illegality”, a legitimization mechanism employed by market participants along the different segments of the horn supply chain. These actors' implicit or explicit contestation of the state-sponsored label of illegality serves as a legitimising and enabling mechanism, facilitating participation in gray or illegal markets for rhino horn. The research identified fluid interfaces between legal, illegal and gray markets, with recurring actors who have access to transnational trade structures, and who also possess market and product knowledge, as well as information about the regulatory regime and its loopholes. It is against the background of colonial, apartheid and neoliberal exploitation and marginalization of local communities that a second argument is introduced: the path dependency of conservation paradigms. Underpinning rhino conservation and regulation are archaic and elitist conservation regimes that discount the potential for harmonious relationships between local communities and wildlife. The increasing militarization of anti-poaching measures and green land grabs are exacerbating the rhino problem by alienating communities further from conservation areas and wild animals. The third argument looks at how actors deal with coordination problems in transnational illegal markets. Resolving the coordination problems of cooperation, value and competition are considered essential to the operation of formal markets. It is argued that the problem of security provides an additional and crucial obstacle to actors transacting in markets. The systematic analysis of flows between the researched sites of production, distribution and consumption of rhino horn shows that the social embeddedness of actors facilitates the flourishing of illegal markets in ways that escape an effective enforcement of CITES regulations.

Off-label prescription of drugs at hospital

Objectives: To develop a procedure for management of off-label medications, and to analyze the treatments, indications, and hospital units which will request them more frequently, as well as which variables will have an impact on the authorization decision, and its economic impact. Methods: A procedure was designed where clinicians would complete request forms and the Hospital Unit would prepare reports assessing their efficacy, safety, convenience, and cost. The request forms for the past five years were analyzed. Results: A total of 834 applications were received, and 88.1% of these were accepted. The authorization rates were higher for Paediatric Units (95.7% vs. 86.6%; p<0.05). The reasons for considering prescriptions as off-label were: different indication (73.2%), different combination (10.2%), different line of treatment (8.6%) and different age (8%). A 73.4% of requests were for antineoplastic drugs, and the most frequently prescribed were rituximab (120) and bevacizumab (103). The quality of evidence supporting the prescriptions was moderate-low, though no direct relationship with the likelihood of approval was demonstrated (p = 0.413). The cost of the approved medications was 8,567,537 €, and the theoretical savings for those drugs rejected was of 2,268,642 €. There was a statistically significant decrease in the authorization rate (p < 0.05, Student's t test) when spending increased. Conclusions: The responsibility for assessing off-label prescriptions has fallen on the Pharmacy Unit. It has not been demonstrated that the quality of evidence represents a decisive variable for approval of treatment; on the other hand, age and cost have demonstrated a significant impact.

Between path dependency and contingency: new challenges for the geography of port system evolution.

Seaports play a critical role as gateways and facilitators of economic interchange and logistics processes and thus have become crucial nodes in globalised production networks andmobility systems. Both the physical port infrastructure and its operational superstructure have undergone intensive evolution processes in an effort to adapt to changing economic environments, technological advances,maritime industry expectations and institutional reforms. The results, in terms of infrastructure, operator models and the role of an individual port within the port system, vary by region, institutional and economic context. While ports have undoubtedly developed in scale to respond to the changing volumes and structures in geographies of trade (Wilmsmeier, 2015), the development of hinterland access infrastructure, regulatory systems and institutional structures have in many instances lagged behind. The resulting bottlenecks reflect deficits in the interplay between the economic system and the factors defining port development (e.g. transport demand, the structure of trade, transport services, institutional capacities, etc. cf. Cullinane and Wilmsmeier, 2011). There is a wide range of case study approaches and analyses of individual ports, but analyses from a port system perspective are less common, and those that exist are seldom critical of the dominant discourse assuming the efficiency of market competition (cf. Debrie et al., 2013). This special section aims to capture the spectrum of approaches in current geography research on port system evolution. Thus, the papers reach from the traditional spatial approach (Rodrigue and Ashar, this volume) to network analysis (Mohamed-Chérif and Ducruet, this volume) to institutional discussions (Vonck and Notteboom, this volume; Wilmsmeier and Monios, this volume). The selection of papers allows an opening of discussion and reflection on current research, necessary critical analysis of the influences on port systemevolution and,most importantly, future directions. The remainder of this editorial aims to reflect on these challenges and identify the potential for future research.

Prescripción off-label inducida: responsabilidad ¿compartida?

La prescripción off-label es una práctica tan frecuente como incorrectamente manejada por los pediatras. Solo dos de cada diez pediatras completan todos los pasos necesarios para el registro correcto del uso off-label de medicamentos para niños. Es necesario conocer conceptos básicos relacionados con esta práctica, especialmente cuando se trata de una prescripción inducida, por sus connotaciones éticas y legales.

Life-Threatening Adverse Reaction after Self-Initiated, Off-Label Use of High Dose Nicotinamide for the Treatment of Friedreich’s Ataxia

A 40-year old woman, previously known for Friedreich’s ataxia, presented with shock, profound lactic acidosis and hepatic failure after ingestion of a high dose of nicotinamide, the amide form of vitamin B3. On her own initiative, she was taking up to 4.4 g per day of nicotinamide, after having learned the results of a phase 2 study suggesting a potential benefit in Friedreich’s ataxia. The outcome was good with supportive care and withdrawal of nicotinamide.

OnabotulinumtoxinA for hemicrania continua: open label experience in 9 patients

BACKGROUND: Hemicrania continua is a strictly unilateral, continuous headache, typically mild to moderate in severity, with severe exacerbations commonly accompanied by cranial autonomic features and migrainous symptoms. It is exquisitely responsive to Indomethacin. However, some patients cannot tolerate treatment, often due to gastrointestinal side effects. Therapeutic alternatives are limited and controlled evidence lacking. METHODS: We present our experience of nine patients treated with OnabotulinumtoxinA for hemicrania continua. All patients were injected using the PREEMPT (Phase 3 REsearch Evaluating Migraine Prophylaxis Therapy) protocol for migraine. RESULTS: Five of nine patients demonstrated a 50% or more reduction in moderate to severe headache days with OnabotulinumtoxinA with a median reduction in moderate to severe headache days of 80%. Patient estimate of response was 80% or more in five subjects. The median and mean duration of response in the five responders was 11 and 12 weeks (range 6-20 weeks). Improvements were also seen in headache-associated disability CONCLUSIONS: OnabotulinumtoxinA adds a potential option to the limited therapeutic alternatives available in hemicrania continua.

Pre-announcement of symbiotic guests: transcriptional reprogramming by mycorrhizal lipochitooligosaccharides shows a strict co-dependency on the GRAS transcription factors NSP1 and RAM1

BACKGROUND: More than 80 % of all terrestrial plant species establish an arbuscular mycorrhiza (AM) symbiosis with Glomeromycota fungi. This plant-microbe interaction primarily improves phosphate uptake, but also supports nitrogen, mineral, and water aquisition. During the pre-contact stage, the AM symbiosis is controled by an exchange of diffusible factors from either partner. Amongst others, fungal signals were identified as a mix of sulfated and non-sulfated lipochitooligosaccharides (LCOs), being structurally related to rhizobial nodulation (Nod)-factor LCOs that in legumes induce the formation of nitrogen-fixing root nodules. LCO signals are transduced via a common symbiotic signaling pathway (CSSP) that activates a group of GRAS transcription factors (TFs). Using complex gene expression fingerprints as molecular phenotypes, this study primarily intended to shed light on the importance of the GRAS TFs NSP1 and RAM1 for LCO-activated gene expression during pre-symbiotic signaling. RESULTS: We investigated the genome-wide transcriptional responses in 5 days old primary roots of the Medicago truncatula wild type and four symbiotic mutants to a 6 h challenge with LCO signals supplied at 10(-7/-8) M. We were able to show that during the pre-symbiotic stage, sulfated Myc-, non-sulfated Myc-, and Nod-LCO-activated gene expression almost exclusively depends on the LysM receptor kinase NFP and is largely controled by the CSSP, although responses independent of this pathway exist. Our results show that downstream of the CSSP, gene expression activation by Myc-LCOs supplied at 10(-7/-8) M strictly required both the GRAS transcription factors RAM1 and NSP1, whereas those genes either co- or specifically activated by Nod-LCOs displayed a preferential NSP1-dependency. RAM1, a central regulator of root colonization by AM fungi, controled genes activated by non-sulfated Myc-LCOs during the pre-symbiotic stage that are also up-regulated in areas with early physical contact, e.g. hyphopodia and infecting hyphae; linking responses to externally applied LCOs with early root colonization. CONCLUSIONS: Since both RAM1 and NSP1 were essential for the pre-symbiotic transcriptional reprogramming by Myc-LCOs, we propose that downstream of the CSSP, these GRAS transcription factors act synergistically in the transduction of those diffusible signals that pre-announce the presence of symbiotic fungi.

Context dependency of trait repeatability and its relevance for management and conservation of fish populations

Repeatability of behavioural and physiological traits is increasingly a focus for animal researchers, for which fish have become important models. Almost all of this work has been done in the context of evolutionary ecology, with few explicit attempts to apply repeatability and context dependency of trait variation toward understanding conservation-related issues. Here, we review work examining the degree to which repeatability of traits (such as boldness, swimming performance, metabolic rate and stress responsiveness) is context dependent. We review methods for quantifying repeatability (distinguishing between within-context and across-context repeatability) and confounding factors that may be especially problematic when attempting to measure repeatability in wild fish. Environmental factors such temperature, food availability, oxygen availability, hypercapnia, flow regime and pollutants all appear to alter trait repeatability in fishes. This suggests that anthropogenic environmental change could alter evolutionary trajectories by changing which individuals achieve the greatest fitness in a given set of conditions. Gaining a greater understanding of these effects will be crucial for our ability to forecast the effects of gradual environmental change, such as climate change and ocean acidification, the study of which is currently limited by our ability to examine trait changes over relatively short time scales. Also discussed are situations in which recent advances in technologies associated with electronic tags (biotelemetry and biologging) and respirometry will help to facilitate increased quantification of repeatability for physiological and integrative traits, which so far lag behind measures of repeatability of behavioural traits.

Caracterização da tecnologia de frio comercial e profissional

Hoje em dia a preocupação ambiental e a economia são fatores de sustentabilidade que são tidos em conta em países desenvolvidos, especialmente no seio da União Europeia. Reduzir os consumos de energia é, portanto, um ponto-chave para a redução das emissões de gases com efeito de estufa e aumentar a dependência das energias renováveis. Consequentemente surge então a necessidade de aumentar a eficiência dos equipamentos, em particular no presente caso, equipamentos de refrigeração. Para isso foi adotado pela Comissão Europeia uma rotulagem nos produtos consumidores de energia, em particular na refrigeração, os frigoríficos e congeladores domésticos permitindo informar o consumidor para os equipamentos mais eficientes. Mais recentemente, frigoríficos comerciais e profissionais também terão obrigatoriedade de incluir um rótulo energético na parte externa dos mesmos. Nesses rótulos estão incluídas várias informações técnicas do aparelho representadas de uma forma compreensível e lúdica aos olhos do consumidor mais leigo, entre as quais as classes de eficiência energética. As classes de eficiência energética caracterizam-se pela componente tecnológica dos frigoríficos. Perceber quais os componentes e materiais em particular que promovem uma melhor eficiência, quantificar a sua influência e avaliar os seus custos de integração torna-se assim essencial para toda a cadeia envolvida na produção destes equipamentos. Os fluídos frigorigénios e compressores aparentam ser os que mais exercem influência na eficiência de frigoríficos de baixa potência. Tubos capilares com trocador de calor são uma escolha mais eficiente comparado com o tubo capilar padrão que é utilizado nestes frigoríficos. Por forma a obter informação adicional e relevante do ponto de vista da análise energética realizaram-se simulações para determinação do consumo elétrico anual com recurso ao software Pack Calculation Pro. Entre os fluídos frigorigénios R-134a, R-22 e R-410a, os compressores scroll apresentaram consumos mais reduzidos (no máximo de 16%) do que os compressores alternativos. No caso do amoníaco (R-717) os compressores alternativos consumiram em média 14% menos do que os compressores parafuso. O recurso a velocidade variável em compressores permite reduzir o consumo na ordem dos 25%. Válvulas de expansão eletrónicas trazem reduções no consumo de 1,5% quando comparadas com válvulas de expansão termostáticas em compressores de velocidade variável. O propano (R-290) é um gás que mostra ter um melhor desempenho do que o R-134a e R404a em vários compressores, consumindo 16% menos do que o R-404a. Em função da temperatura exterior, o R-290 também apresentou um bom desempenho consumindo em climas quentes (Belém, Brasil) 24% menos do que o R-404a.

The social construction of “Feeling of Burden”: Narrative on dependency and care in old age

In a society in which ambivalent positions of old age coexist, suffering from limitations in the basic functions of the human being disrupts the identity of old people and the social perception that is held of them. The impact of the deterioration and the physical incapacity affects not only old adults but also those who take care of them; it entails repercussions of instrumental, emotional and social types. Within the social and subjective dimension of aging arise stereotypes and negative images from being considered dependent subjects; one of most important of these is the “feeling of being a burden”. During the in-depth interviews, the diverse implications of this negative image in advanced old age are identified in old adults and their carers in the city of Durango, Mexico. The analysis of narratives shows results pertaining to the interrelation between the subjective aspects of the identity, the beliefs, and the power of social discourses.

Open-label placebo treatment in chronic low back pain: A randomized controlled trial

This randomized controlled trial was performed to investigate whether placebo effects in chronic low back pain could be harnessed ethically by adding open-label placebo (OLP) treatment to treatment as usual (TAU) for 3 weeks. Pain severity was assessed on three 0- to 10-point Numeric Rating Scales, scoring maximum pain, minimum pain, and usual pain, and a composite, primary outcome, total pain score. Our other primary outcome was back-related dysfunction, assessed on the Roland-Morris Disability Questionnaire. In an exploratory follow-up, participants on TAU received placebo pills for 3 additional weeks. We randomized 97 adults reporting persistent low back pain for more than 3 months' duration and diagnosed by a board-certified pain specialist. Eighty-three adults completed the trial. Compared to TAU, OLP elicited greater pain reduction on each of the three 0- to 10-point Numeric Rating Scales and on the 0- to 10-point composite pain scale (P < 0.001), with moderate to large effect sizes. Pain reduction on the composite Numeric Rating Scales was 1.5 (95% confidence interval: 1.0-2.0) in the OLP group and 0.2 (-0.3 to 0.8) in the TAU group. Open-label placebo treatment also reduced disability compared to TAU (P < 0.001), with a large effect size. Improvement in disability scores was 2.9 (1.7-4.0) in the OLP group and 0.0 (-1.1 to 1.2) in the TAU group. After being switched to OLP, the TAU group showed significant reductions in both pain (1.5, 0.8-2.3) and disability (3.4, 2.2-4.5). Our findings suggest that OLP pills presented in a positive context may be helpful in chronic low back pain.

Fruit juice label: what matters to the consumer?

2014