Complementary and alternative medicine use in narcolepsy

BackgroundManagement of narcolepsy includes behavior strategies and symptomatic pharmacological treatment. In the general population, complementary and alternative medicine (CAM) use is common in Europe (30%), also in chronic neurological disorders (10–20%). The aim of our study was to evaluate frequency and characteristics of CAM use in German narcolepsy patients.MethodsDemographic, disease-related data frequency and impact of CAM use were assessed in an online survey. Commonly used CAM treatments were predetermined in a questionnaire based on the National Center for Complementary and Alternative Medicine and included the domains: (1) alternative medical systems; (2) biologically based therapies; (3) energy therapies; (4) mind-body interventions, and (5) manipulative and body-based therapies.ResultsWe analyzed data from 254 questionnaires. Fifteen percent of participants were at the time of survey administration using CAM for narcolepsy, and an additional 18% of participants reported past use. Among the 33% of CAM users, vitamins/trace elements (54%), homoeopathy (48%) and meditation (39%) were used most frequently. 54% of the users described CAM as helpful. CAM users more frequently described having side effects from their previous medication (p = 0.001), and stated more frequently not to comply with pharmacological treatment than non-CAM users (21% vs. 8%; p = 0.024).DiscussionThe use of CAM in narcolepsy patients is common. Our results indicate that many patients still feel the need to improve their symptoms, sleepiness and psychological well-being in particular. Frequent medication change, the experience of adverse events and low adherence to physician-recommended medication appears more frequent in CAM users. The impact of CAM however seems to be limited.Paroxysmal Cerebral Disorder

Physical Processes in Star Formation

© 2020 Springer-Verlag. The final publication is available at Springer via https://doi.org/10.1007/s11214-020-00693-8.Star formation is a complex multi-scale phenomenon that is of significant importance for astrophysics in general. Stars and star formation are key pillars in observational astronomy from local star forming regions in the Milky Way up to high-redshift galaxies. From a theoretical perspective, star formation and feedback processes (radiation, winds, and supernovae) play a pivotal role in advancing our understanding of the physical processes at work, both individually and of their interactions. In this review we will give an overview of the main processes that are important for the understanding of star formation. We start with an observationally motivated view on star formation from a global perspective and outline the general paradigm of the life-cycle of molecular clouds, in which star formation is the key process to close the cycle. After that we focus on the thermal and chemical aspects in star forming regions, discuss turbulence and magnetic fields as well as gravitational forces. Finally, we review the most important stellar feedback mechanisms.Peer reviewedFinal Accepted Versio

Investigation of outcomes following recombinant activated FVII use for refractory bleeding during abdominal aortic aneurysm repair

ObjectiveTo evaluate the outcomes following recombinant activated factor VII (rFVIIa) use during abdominal aortic aneurysms (AAA) repair.DesignAAA patients were selected from the Australian and New Zealand Haemostasis Registry (ANZHR) who received off-licence rFVIIa to control critical bleeding.MethodsPatient characteristics and outcomes were compared between responders (bleeding stopped/attenuated) and non-responders (bleeding continued) to rFVIIa, stratified by aneurysm status (ruptured (r-AAA) vs. non-ruptured (nr-AAA)). Patients were also scored using POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and Hardman Index mortality predictive models.ResultsIn total, 77 AAA patients were included in the analysis. Approximately 73% (n = 56) of them had ruptured aneurysms and about 50% (n = 35/70 with known data) responded positively to rFVIIa. Eleven incidents of thromboembolic adverse events were reported in 9 patients (6 r-AAA and 3 nr-AAA). Responders in both ruptured and non-ruptured groups had significantly lower 28-day mortality than non-responders (r-AAA: 40% (10/25) vs. 92% (24/26); P ConclusionPatients who responded to rFVIIa had a lower mortality than those who did not respond to the treatment.R.K. Kandane-Rathnayake, C.D. Willis, C.B. Beiles, B.M. Bourke, P.A. Cameron, P. McCall, L.E. Phillip

Impacts of information technology on mass customization capability of manufacturing plants

Purpose: The impact of information technology (IT) on mass customization (MC) capability has been implied in the literature but seldom subjected to empirical examination. This study seeks to theoretically relate four types of IT applications with MC capability and empirically examines these relationships. Design/methodology/approach: This study identifies four types of IT that potentially support MC capability, including product configurator IT, new product development IT, manufacturing IT, and supplier collaboration IT. Drawing on organizational information processing theory, this study associates the four IT types with a manufacturer\u27s MC capability. A structural equation model is tested using survey data collected from a sample of manufacturing plants that focus on product customization. Findings: The empirical results indicate that two of the four IT types strongly support a manufacturer\u27s MC capability. Research limitations/implications: No strong relationship between configurator IT and MC was observed, which calls for further investigation. Data used are cross-sectional in nature. A set of refined IT measures should be developed in future studies. In addition, future studies could control for the effects of more variables that may impact IT use by mass customizers. Practical implications: The paper identifies managerial opportunities for investing in IT to support or enhance MC capability. Originality/value: This study provides a theoretical foundation for the IT-MC relationship and develops a classification framework of IT applications in manufacturing plants. The study is one of the first efforts that empirically examines the impact of multiple types of IT applications on MC. © Emerald Group Publishing Limited