Conservative management of significant epidural haematomas in children

Objective: A significant epidural haematoma (EDH) is generally treated by craniotomy and evacuation. This is a report of conservative management following an EDH on computerized tomography (CT) in a paediatric population. The authors examined whether conservative treatment of radiologically significant EDH is a successful and safe therapeutic option. Methods: Retrospective data were collected from charts of patients with conservatively treated EDH in the Department of Surgery of the University Children's Hospital Zurich between September 1993 and January 2004. Included were patients without focal neurological deficits, with a Glasgow Coma Scale (GCS) of 15 and an initial CT demonstrating an EDH with a minimal thickness of 1cm. Mild clinical symptoms of raised intracranial pressure such as headache, nausea or vomiting were treated symptomatically. Follow-up included a standardized interview, a neuropaediatric examination and CT. Results: Thirteen children with EDH had successful conservative management. Only one 12-year-old female patient with a delayed diagnosed frontal EDH required surgical intervention 24h after admission and 5 days after the accident. Clinical follow-up showed patients without neurological deficits, a Glasgow Outcome Scale of 5 and no post-traumatic sequelae over an average of 4 4/12 years (range 4 months to 10 4/12 years). Follow-up CT showed complete resolution of the EDH within 2 to 3 months. Conclusions: Our results demonstrate that significant EDH can be treated non-operatively in neurologically normal children. We recommend that such treatment be performed in specialised paediatric centres under adequate neurological observation since prompt emergency operation in case of neurological deterioration should be provide

The corporate brand and strategic direction: Senior business school managers’ cognitions of corporate brand building and management

This revelatory study focuses on top Financial Times (FT) ranked British business school managers cognitions of corporate brand building and management. The study insinuates there is a prima facie bilateral link between corporate branding and strategic direction. Among this genus of business school, the data revealed corporate brand building entailed an on-going concern with strategic management, stakeholder management, corporate communications, service focus, leadership, and commitment. These empirical findings, chime with the early conceptual scholarship on corporate brand management dating back to the mid-1990s. These foundational articles stressed the multi-disciplinary and strategic nature of corporate brand management and stressed the significant role of the CEO. As such, this research adds further credence to the above in terms of best-practice vis-à-vis corporate brand management. Curiously, whilst senior managers espouse a corporate brand orientation, corporate brand management is seemingly not accorded a similar status in the curriculum. Drawing on general embedded case study methodological approach, data was collected within eight leading (FT-ranked) business schools in Great Britain at Oxford, Cambridge, Durham, Bradford, Cranfield, Warwick, Lancaster and City (London) Universities. Each of these eight British business schools can be deemed as ‘top’ business schools by virtue of their inclusion in the influential Financial Times (FT) worldwide list of top business schools. The primary mode of qualitative data collection was the 37 in-depth interviews with business school Deans, Associate Deans and other senior faculty members and other managers

Public and dental professionals' use of social media to discuss amelogenesis imperfecta

Background Amelogenesis imperfecta (AI) is an inherited disorder of enamel development that is challenging to treat and often associated with negative patient and parental outcomes. Social media provides a valuable perspective on patients' and dental professionals' experience of AI and dental care. Aim To explore how the public and dental professionals use social media to discuss AI. Design A cross-sectional study involving a systemic search of eight social media platforms using the search term ‘amelogenesis imperfecta’. Relevant posts were selected using predefined eligibility criteria. Word content of eligible posts was qualitatively analysed using a thematic framework approach. Results A total of 555 posts were identified, of which 144 were eligible for analysis. For dental professionals, the posts included case reports and seeking and sharing of information. For the public, the posts were related to individuals' experience of AI, dental treatment and outcome of treatment. Conclusions Posts from individuals affected by AI suggest a need for better distribution of reliable information and greater support. Case reports indicate that dental professionals find it challenging to recognise AI and determine appropriate treatment options. Social media could potentially be used to inform and support people with AI and allow dental professionals to share information and learning with peers

Reliability of mean power recorded during indoor and outdoor self-paced 40km cycling time-trials

The purpose of this study was to assess reliability of both indoor and outdoor 40 km time-trial cycling performance. Eight trained cyclists completed three indoor 40 km time-trials on an air-braked ergometer (KingcycleTM) and three outdoor 40 km time-trials on a local course. Power output was measured for all trials using the SRM powermeter. Mean performance time across three indoor trials was 54.21 ± 2.59 (min : sec) and was significantly different (P < 0.05) to mean time across three outdoor trials (57.29 ± 3.22 min : sec). However, there was no significant difference (P = 0.34) for mean power across three indoor trials (303 ± 35 W) when compared to outdoor performances (312 ± 23 W). Within-subject variation for mean power output expressed as a coefficient of variation (CV) improved in both indoors and outdoors for trials 2 and 3 (CV = 1.9 %, 95 % CI 1.0 - 3.4 and CV = 2.1 %, 95 % CI 1.1 - 3.8) when compared to trials 1 and 2 (CV = 2.1 %, 95 % CI 1.2 - 3.8 and CV = 2.4 %, 95 % CI 1.3 - 4.3). These findings indicate that power output measured using the SRM powermeter is highly reproducible for both laboratory-based and actual 40 km time-trial cycling performanc

An agent-based approach to assess drivers’ interaction with pre-trip information systems.

This article reports on the practical use of a multi-agent microsimulation framework to address the issue of assessing drivers’ responses to pretrip information systems. The population of drivers is represented as a community of autonomous agents, and travel demand results from the decision-making deliberation performed by each individual of the population as regards route and departure time. A simple simulation scenario was devised, where pretrip information was made available to users on an individual basis so that its effects at the aggregate level could be observed. The simulation results show that the overall performance of the system is very likely affected by exogenous information, and these results are ascribed to demand formation and network topology. The expressiveness offered by cognitive approaches based on predicate logics, such as the one used in this research, appears to be a promising approximation to fostering more complex behavior modelling, allowing us to represent many of the mental aspects involved in the deliberation process

Biodiversität im Kulturland – vom Nebenprodukt zum Marktvorteil

Zusammenfassung Die in der Schweiz getroffenen Maßnahmen gegen den Rückgang der Biodiversität im Kulturland zeigen wenig Erfolg. Die Gründe dürften einerseits in der gängigen Subventionspolitik, andererseits beim ökologischen Wissen der Landwirte liegen. Das 2008 gestartete Projekt „Mit Vielfalt punkten – Bauern beleben die Natur“ will an diesen beiden Punkten ansetzten. Vorerst wurde ein Punktesystem entwickelt, mit dem die Leistungen der Betriebe für die Biodiversität ermittelt werden können. Der Zusammenhang Punkte – Biodiversität wird geprüft. In Zukunft werden 30 Betriebe intensiv mit dem Ziel beraten, dass mehr Maßnahmen zu Gunsten der Biodiversität umgesetzt werden. Für die Beratung werden Leitartenkarten entwickelt, denn es hat sich gezeigt, dass Landwirte besser auf konkrete Arten ansprechen als auf theoretische Konzepte. Die Auswirkungen der Beratung werden geprüft, sowohl auf der Ebene Biodiversität als auch auf der sozio-ökonomischen Ebene. Bereits zu Beginn des Projektes hat die IP-SUISSE (Verein der integriert produzierenden Landwirte) das Punktesystem in ihre Richtlinien aufgenommen und mit einer Mindestpunktezahl versehen. Die Migros (Vermarkter) übernimmt einen großen Teil dieser Produkte und zahlt den Landwirten einen Bonus aus. Sie gibt die Produkte unter dem Label TerraSuisse den Konsumierenden weiter. So wird die Biodiversität zu einem Marktfaktor

Trypanosoma brucei gambiense group 1 is distinguished by a unique amino acid substitution in the HpHb receptor implicated in human serum resistance

Trypanosoma brucei rhodesiense (Tbr) and T. b. gambiense (Tbg), causative agents of Human African Trypanosomiasis (sleeping sickness) in Africa, have evolved alternative mechanisms of resisting the activity of trypanosome lytic factors (TLFs), components of innate immunity in human serum that protect against infection by other African trypanosomes. In Tbr, lytic activity is suppressed by the Tbr-specific serum-resistance associated (SRA) protein. The mechanism in Tbg is less well understood but has been hypothesized to involve altered activity and expression of haptoglobin haemoglobin receptor (HpHbR). HpHbR has been shown to facilitate internalization of TLF-1 in T.b. brucei (Tbb), a member of the T. brucei species complex that is susceptible to human serum. By evaluating the genetic variability of HpHbR in a comprehensive geographical and taxonomic context, we show that a single substitution that replaces leucine with serine at position 210 is conserved in the most widespread form of Tbg (Tbg group 1) and not found in related taxa, which are either human serum susceptible (Tbb) or known to resist lysis via an alternative mechanism (Tbr and Tbg group 2). We hypothesize that this single substitution contributes to reduced uptake of TLF and thus may play a key role in conferring serum resistance to Tbg group 1. In contrast, similarity in HpHbR sequence among isolates of Tbg group 2 and Tbb/Tbr provides further evidence that human serum resistance in Tbg group 2 is likely independent of HpHbR functio

Climate change vulnerability for species—Assessing the assessments

Climate change vulnerability assessments are commonly used to identify species at risk from global climate change, but the wide range of methodologies available makes it difficult for end users, such as conservation practitioners or policymakers, to decide which method to use as a basis for decision-making. In this study, we evaluate whether different assessments consistently assign species to the same risk categories and whether any of the existing methodologies perform well at identifying climate threatened species. We compare the outputs of 12 climate change vulnerability assessment methodologies, using both real and simulated species, and validate the methods using historic data for British birds and butterflies (i.e. using historical data to assign risks and more recent data for validation). Our results show that the different vulnerability assessment methods are not consistent with one another; different risk categories are assigned for both the real and simulated sets of species. Validation of the different vulnerability assessments suggests that methods incorporating historic trend data into the assessment perform best at predicting distribution trends in subsequent time periods. This study demonstrates that climate change vulnerability assessments should not be used interchangeably due to the poor overall agreement between methods when considering the same species. The results of our validation provide more support for the use of trend-based rather than purely trait-based approaches, although further validation will be required as data become available

Home advantage in the Winter Paralympic Games 1976–2014

Purpose: There is a limited amount of home advantage research concerned with winter sports. There is also a distinct lack of studies that investigate home advantage in the context of para-sport events. This paper addresses this gap in the knowledge by examining home advantage in the Winter Paralympic Games. Methods: Using a standardised measure of success, we compared the performances of host nations at home with their own performances away from home between 1976 and 2014. Both country level and individual sport level analysis is conducted for this time period. Comparisons are also drawn with the Winter Olympic Games since 1992, the point from which both the Winter Olympic Games and the Winter Paralympic Games have been hosted by the same nations and in the same years. Results: Clear evidence of a home advantage effect in the Winter Paralympic Games was found at country level. When examining individual sports, only alpine skiing and cross country skiing returned a significant home advantage effect. When comparing home advantage in the Winter Paralympic Games with the Winter Olympic Games for the last seven host nations (1992–2014), we found that home advantage was generally more pronounced (although not a statistically significant difference) in the case of the former. Conclusion: The causes of home advantage in the Winter Paralympic Games are unclear and should be investigated further

Excess of cardiovascular mortality among node-negative breast cancer patients irradiated for inner-quadrant tumors

Background: Radiotherapy of the left breast is associated with higher cardiovascular mortality linked to cardiotoxic effect of irradiation. Radiotherapy of inner quadrants can be associated with greater heart irradiation, but no study has evaluated the effect of inner-quadrant irradiation on cardiovascular mortality. Patients and methods: We identified 1245 women, the majority with breast-conserving surgery, irradiated for primary node-negative breast cancer from 1980 to 2004 registered at the Geneva Cancer Registry. We compared breast cancer-specific and cardiovascular mortality between inner-quadrant (n = 393) versus outer-quadrant tumors (n = 852) by multivariate Cox regression analysis. Results: After a mean follow-up of 7.7 years, 28 women died of cardiovascular disease and 91 of breast cancer. Patients with inner-quadrant tumors had a more than doubled risk of cardiovascular mortality compared with patients with outer-quadrant tumors (adjusted hazard ratio 2.5; 95% confidence interval 1.1-5.4). Risk was particularly increased in the period with higher boost irradiation. Patients with left-sided breast cancer had no excess of cardiovascular mortality compared with patients with right-sided tumors. Conclusions: Radiotherapy of inner-quadrant breast cancer is associated with an important increase of cardiovascular mortality, a possible result of higher irradiation of the heart. For patients with inner-quadrant tumors, the heart should be radioprotecte