Pial and arachnoid welding for restoration of normal cord anatomy after excision of intramedullary spinal cord tumors.

A significant postoperative problem in patients undergoing excision of intramedullary tumors is painful dysesthesiae, attributed to various causes, including edema, arachnoid scarring and cord tethering. The authors describe a technique of welding the pia and arachnoid after the excision of intramedullary spinal cord tumors used in seven cases. Using a fine bipolar forcep and a low current, the pial edges of the myelotomy were brought together and welded under saline irrigation. A similar method was used for closing the arachnoid while the dura was closed with a running 5-0 vicryl suture. Closing the pia and arachnoid restores normal cord anatomy after tumor excision and may reduce the incidence of postoperative painful dysesthesiae.

A wearable system for multi-segment foot kinetics measurement.

This study aims to design a wearable system for kinetics measurement of multi-segment foot joints in long-distance walking and to investigate its suitability for clinical evaluations. The wearable system consisted of inertial sensors (3D gyroscopes and 3D accelerometers) on toes, forefoot, hindfoot, and shank, and a plantar pressure insole. After calibration in a laboratory, 10 healthy elderly subjects and 12 patients with ankle osteoarthritis walked 50m twice wearing this system. Using inverse dynamics, 3D forces, moments, and power were calculated in the joint sections among toes, forefoot, hindfoot, and shank. Compared to those we previously estimated for a one-segment foot model, the sagittal and transverse moments and power in the ankle joint, as measured via multi-segment foot model, showed a normalized RMS difference of less than 11%, 14%, and 13%, respectively, for healthy subjects, and 13%, 15%, and 14%, for patients. Similar to our previous study, the coronal moments were not analyzed. Maxima-minima values of anterior-posterior and vertical force, sagittal moment, and power in shank-hindfoot and hindfoot-forefoot joints were significantly different between patients and healthy subjects. Except for power, the inter-subject repeatability of these parameters was CMC>0.90 for healthy subjects and CMC>0.70 for patients. Repeatability of these parameters was lower for the forefoot-toes joint. The proposed measurement system estimated multi-segment foot joints kinetics with acceptable repeatability but showed difference, compared to those previously estimated for the one-segment foot model. These parameters also could distinguish patients from healthy subjects. Thus, this system is suggested for outcome evaluations of foot treatments.

Identificação de estruturas de processos multi-escala em ecossistemas marinhos utilizando ondaletas

Ecossistemas marinhos de upwelling são muito heterogêneos e apresentam uma intensa atividade de mesoescala de dimensão de dezenas de quilômetros e submesoescala que variam de centenas de metros até quilômetros dos processos físicos. A importância das estruturas dos processos físicos está na estruturação que eles exercem sob a biomassa de zooplâncton. O presente trabalho está relacionado a um estudo realizado a cabo no Norte do Sistema da Corrente de Humboldt (Peru). Utilizou-se duas variáveis, a profundidade do limite superior da zona de mínimo oxigênio (ZMO) e a biomassa de zooplâncton. É desenvolvida uma metodologia de análise baseada no uso de ondaletas para a identi cação das estruturas dos processos físicos em suas diferentes escalas. O método foi aplicado aos dados de ZMO. Estudos de simula ção mostraram que o método tem a capacidade de identi car as estruturas de interesse, tendo erro de estimação nas bordas do espectro da potência de ondaleta. A tipologia das estruturas identi cadas mostraram que existe três tipos de estruturas, estruturas maiores de mesoescala, duas estruturas pequenas de submesoescala com profundidades diferentes. Outro resultado importante foi que dentro das estruturas pequenas e mais profundas existe maior biomassa de zooplâncton, principalmente nas estruturas de downwelling.

The long-run and intergenerational education impacts of intergovernmental transfers

This paper provides regression discontinuity evidence on long-run and intergenerational education impacts of a temporary increase in federal transfers to local governments in Brazil. Revenues and expenditures of the communities benefiting from extra transfers temporarily increased by about 20% during the 4 year period from 1982 to the end of 1985. Schooling and literacy gains for directly exposed cohorts established in previous work that used the 1991 census are attenuated but persist in the 2000 and 2010 censuses. Children and adolescents of the next generation --born after the extra funding had disappeared-- show gains of about 0.08 standard deviation across the entire score distribution of two nationwide exams at the end of the 2000s. While we find no evidence of persistent improvements in school resources, we document discontinuities in education levels, literacy rates and incomes of test takers' parents that are consistent with intergenerational human capital spillovers.

Invasive mould infections: a multi-disciplinary update.

Systemic fungal infections remain a significant cause of mortality in neutropenic and immunocompromised patients, despite advances in their diagnosis and treatment. The incidence of such infections is rising due to the use of intensive chemotherapy regimens in patients with solid tumours or haematological cancers, the increasing numbers of allogeneic haematopoietic stem cell and solid organ transplants, and the use of potent immunosuppressive therapy in patients with autoimmune disorders. In addition, the epidemiology of systemic fungal infections is changing, with atypical species such as Aspergillus terreus and zygomycetes becoming more common. Treatment has traditionally focused on empirical therapy, but targeted pre-emptive therapy in high-risk patients and prophylactic antifungal treatment are increasingly being adopted. New treatments, including lipid formulations of amphotericin B, second-generation broad-spectrum azoles, and echinocandins, offer effective antifungal activity with improved tolerability compared with older agents; the potential impact of these treatments is reflected in their inclusion in current treatment and prophylaxis guidelines. New treatment strategies, such as aerosolized lipid formulations of amphotericin B, may also reduce the burden of mortality associated with systemic fungal infections. The challenge is to identify ways of coupling potentially effective treatments with early and reliable identification of patients at highest risk of infection.

La Multi-metodología Autobiográfica Extendida (MAE). Una estrategia cualitativa para estudiar la identidad, los fondos de conocimiento y las formas de vida

La multi-metodología autobiográfica es una aproximación cualitativa que combina distintas técnicas para estudiar la construcción narrativa de la identidad. El objetivo de este artículo es ofrecer una revisión de dicho enfoque a partir de una expansión de los distintos instrumentos cualitativos utilizados. Más concretamente, la multi-metodología autobiográfica extendida (MAE) consta de cuatro grupos de técnicas: entrevistas en profundidad (historia de vida, entrevista de fondos de conocimiento y la entrevista de Durand), el retrato o dibujo identitario revisado (dibujo identitario, auto-definición, tarea identitaria de las diez definiciones), el análisis de los artefactos-rutinas-formas de vida (diario de una semana, detección de artefactos, rutinas a través de fotografías, rutinas educativas a través de fotografías ) y la utilización de distintos “mapas psicológicos o psicogeográficos” (cronograma, genograma, ecomapa, geomapa y mapa relacional). Después de definir la identidad, los fondos de conocimiento y las formas de vida como posibles objetos de estudio en ciencias sociales, el artículo describe e ilustra las distintas técnicas que componen la metodología propuesta. Se concluye recomendando la triangulación de técnicas cualitativas narrativas basadas en el lenguaje, el caso de las tradicionales entrevistas en profundidad, con determinados procedimientos visuales, a partir de la utilización de fotografías o representaciones gráficas

Multi-modal assessment of long-term erythropoietin treatment after neonatal hypoxic-ischemic injury in rat brain.

Erythropoietin (EPO) has been recognized as a neuroprotective agent. In animal models of neonatal brain injury, exogenous EPO has been shown to reduce lesion size, improve structure and function. Experimental studies have focused on short course treatment after injury. Timing, dose and length of treatment in preterm brain damage remain to be defined. We have evaluated the effects of high dose and long-term EPO treatment in hypoxic-ischemic (HI) injury in 3 days old (P3) rat pups using histopathology, magnetic resonance imaging (MRI) and spectroscopy (MRS) as well as functional assessment with somatosensory-evoked potentials (SEP). After HI, rat pups were assessed by MRI for initial damage and were randomized to receive EPO or vehicle. At the end of treatment period (P25) the size of resulting cortical damage and white matter (WM) microstructure integrity were assessed by MRI and cortical metabolism by MRS. Whisker elicited SEP were recorded to evaluate somatosensory function. Brains were collected for neuropathological assessment. The EPO treated animals did not show significant decrease of the HI induced cortical loss at P25. WM microstructure measured by diffusion tensor imaging was improved and SEP response in the injured cortex was recovered in the EPO treated animals compared to vehicle treated animals. In addition, the metabolic profile was less altered in the EPO group. Long-term treatment with high dose EPO after HI injury in the very immature rat brain induced recovery of WM microstructure and connectivity as well as somatosensory cortical function despite no effects on volume of cortical damage. This indicates that long-term high-dose EPO induces recovery of structural and functional connectivity despite persisting gross anatomical cortical alteration resulting from HI.

Inpatient diabetes care in a Swiss multi-site hospital: is there room for improvement?

Background and objective: Optimal care of diabetic patients (DPs) decreases the risk of complications. Close blood glucose monitoring can improve patient outcomes and shorten hospital stay. The objective of this pilot study was to evaluate the treatment of hospitalized DPs according to the current standards, including their diabetic treatment and drugs to prevent diabetes related complications [=guardian drugs: angiotensin converting enzyme inhibitors (ACEI) or Angiotensin II Receptor Blockers (ARB), antiplatelet drugs, statins]. Guidelines of the American Diabetes Association (ADA) [1] were used as reference as they were the most recent and exhaustive for hospital care. Design: Observational pilot study: analysis of the medical records of all DPs seen by the clinical pharmacists during medical rounds in different hospital units. An assessment was made by assigning points for fulfilling the different criteria according to ADA and then by dividing the total by the maximum achievable points (scale 0-1; 1 = all criteria fulfilled). Setting: Different Internal Medicine and Geriatric Units of the (multi-site) Ho^pital du Valais. Main outcome measures: - Completeness of diabetes-related information: type of diabetes, medical history, weight, albuminuria status, renal function, blood pressure, (recent) lipid profile. - Management of blood glucose: Hb1Ac, glycemic control, plan for treating hyper-/hypoglycaemia. - Presence of guardian drugs if indicated. Results: Medical records of 42 patients in 10 different units were analysed (18 women, 24 men, mean age 75.4 ± 11 years). 41 had type 2 diabetes. - Completeness of diabetes-related information: 0.8 ± 0.1. Information often missing: insulin-dependence (43%) and lipid profile (86%). - Management of blood glucose: 0.5 ± 0.2. 15 patients had suboptimal glycemic balance (target glycaemia 7.2-11.2 mmol/ l, with values[11.2 or\3.8 mmol/l, or Hb1Ac[7%), 10 patients had a deregulated balance (more than 10 values[11.2 mmol/l or \3.8 mmol/l and even values[15 mmol/l). - Presence of guardian drugs if indicated: ACEI/ARB: 19 of 23 patients (82.6%), statin: 16 of 40 patients (40%), antiplatelet drug: 16 of 39 patients (41%). Conclusions: Blood glucose control was insufficient in many DPs and prescription of statins and antiplatelet drugs was often missing. If confirmed by a larger study, these two points need to be optimised. As it is not always possible and appropriate to make those changes during hospital stay, a further project should assess and optimise diabetes care across both inpatient and outpatient settings.

Changes in leg-spring behavior during a 5000 m self-paced run in differently trained athletes

Summary Aims.-To explore whether fatigue-induced changes in spring-mass behavior during a 5000m self-paced run varied according to the runner's training status. Methods and results.-Six highly- and six well-trained triathletes completed a 5000m time trial. Running velocity and vertical stiffness decreased significantly (P < 0.05) with fatigue, whereas leg stiffness remained constant. None of these parameters displayed a significant interaction between fatigue and training status, despite vertical stiffness being higher (P < 0.05) in highly-trained triathletes. Conclusions.-During a 5000m self-paced run, impairments in leg-spring behavior that occur with fatigue are not affected by athletes' training status. © 2009 Elsevier Masson SAS. All rights reserved. Objectifs.-Étudier, chez des athlètes de niveaux différents, les modifications de raideur mécanique liées à l'apparition de la fatigue lors d'une course de 5000 m. Synthèse des faits.-Six triathlètes très entraînés et six autres bien entraînés ont réalisé une course de 5000 m. La vitesse de course et la raideur verticale diminuaient significativement (p < 0,05) avec la fatigue, alors que la raideur de la jambe demeurait inchangée. Aucune interaction entre la fatigue et le niveau d'entraînement n'a été détectée, malgré des niveaux de raideur verticale plus élevés (p < 0,05) chez les sujets les mieux entraînés.

Reliure de : Isaaci Casauboni animadversionum in Athenaei Dipnosophistas libri XV, opus nunc primum in lucem editum, quo non solum Athenaei libri quindecem @ recensentur... verum etiam multorum aliorum scriptorum loci multi qua explicantur, qua corriguntur...

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Public infrastructure and the performance of manufacturing industries: short-and long-run

We present a theoretical framework for determining the short- and long-run effects of infrastructure. While the short-run effects have been the focus of most previous studies, here we derive long-run elasticities by taking into account the adjustment of quasi-fixed inputs to their optimum levels. By considering the impact of infrastructure on private investment decisions, we observe how, apart from the direct effect on costs in the short-run, infrastructure exerts an indirect source of influence in the long-run through their effect on private capital. The model is applied to manufacturing industries in the Spanish regions

Comparative gene finding in chicken indicates that we are closing in on the set of multi-exonic widely expressed human genes.

The recent availability of the chicken genome sequence poses the question of whether there are human protein-coding genes conserved in chicken that are currently not included in the human gene catalog. Here, we show, using comparative gene finding followed by experimental verification of exon pairs by RT-PCR, that the addition to the multi-exonic subset of this catalog could be as little as 0.2%, suggesting that we may be closing in on the human gene set. Our protocol, however, has two shortcomings: (i) the bioinformatic screening of the predicted genes, applied to filter out false positives, cannot handle intronless genes; and (ii) the experimental verification could fail to identify expression at a specific developmental time. This highlights the importance of developing methods that could provide a reliable estimate of the number of these two types of genes.