To stimulate or not to stimulate? A rapid systematic review of repetitive sensory stimulation for the upper-limb following stroke

Abstract: Background: Repetitive sensory stimulation (RSS) is a therapeutic approach which involves repeated electrical stimulation of the skin’s surface to improve function. This rapid systematic review aimed to describe the current evidence for repetitive sensory stimulation (RSS) in rehabilitation of the upper-limb for people who have had a stroke. Main text: Methods: Relevant studies were identified in a systematic search of electronic databases and hand-searching in February 2020. The findings of included studies were synthesized to describe: the safety of RSS, in whom and when after stroke it has been used, the doses used and its effectiveness. Results: Eight studies were included. No serious adverse events were reported. The majority of studies used RSS in participants with mild or moderate impairments and in the chronic stage after stroke. Four studies used RSS in a single treatment session, reporting significant improvements in strength and hand function. Findings from longitudinal studies showed few significant differences between control and experimental groups. Meta-analysis was not possible due to the heterogeneity of included studies. Conclusions: This review suggests that there is insufficient evidence to support the use of RSS for the upper-limb after stroke in clinical practice. However, this review highlights several clear research priorities including establishing the mechanism and in whom RSS may work, its safety and optimal treatment parameters to improve function of the upper-limb after stroke

Recall patterns and risk of primary liver cancer for subcentimeter ultrasound liver observations: a multicenter study

BACKGROUND: Patients with cirrhosis and subcentimeter lesions on liver ultrasound are recommended to undergo short-interval follow-up ultrasound because of the presumed low risk of primary liver cancer (PLC). AIMS: The aim of this study is to characterize recall patterns and risk of PLC in patients with subcentimeter liver lesions on ultrasound. METHODS: We conducted a multicenter retrospective cohort study among patients with cirrhosis or chronic hepatitis B infection who had subcentimeter ultrasound lesions between January 2017 and December 2019. We excluded patients with a history of PLC or concomitant lesions ≥1 cm in diameter. We used Kaplan Meier and multivariable Cox regression analyses to characterize time-to-PLC and factors associated with PLC, respectively. RESULTS: Of 746 eligible patients, most (66.0%) had a single observation, and the median diameter was 0.7 cm (interquartile range: 0.5-0.8 cm). Recall strategies varied, with only 27.8% of patients undergoing guideline-concordant ultrasound within 3-6 months. Over a median follow-up of 26 months, 42 patients developed PLC (39 HCC and 3 cholangiocarcinoma), yielding an incidence of 25.7 cases (95% CI, 6.2-47.0) per 1000 person-years, with 3.9% and 6.7% developing PLC at 2 and 3 years, respectively. Factors associated with time-to-PLC were baseline alpha-fetoprotein \u3e10 ng/mL (HR: 4.01, 95% CI, 1.85-8.71), platelet count ≤150 (HR: 4.90, 95% CI, 1.95-12.28), and Child-Pugh B cirrhosis (vs. Child-Pugh A: HR: 2.54, 95% CI, 1.27-5.08). CONCLUSIONS: Recall patterns for patients with subcentimeter liver lesions on ultrasound varied widely. The low risk of PLC in these patients supports short-interval ultrasound in 3-6 months, although diagnostic CT/MRI may be warranted for high-risk subgroups such as those with elevated alpha-fetoprotein levels

Inclusive ideologies and passive performances: Exploring masculinities and attitudes toward gay peers among boys in an elite youth football academy

Drawing on data generated from semi-structured, one-to-one interviews in 2012, this article focuses on the attitudinal disposition toward homosexuality of 12 English academy level football players aged 14-15. Results highlight the presence of progressive attitudes toward homosexuality even though some of the youth feel they lack the agency to contest homophobia when espoused in their schools. Using a blend of two dominating masculinities theories we use these interviews to highlight that boys in this setting are best understood as a complex imbrication of inclusivity yet socially-passive acceptance. We suggest that boys of this age are now primed for learning agency to contest the social marginalisation of others

The Business Model: Recent Developments and Future Research

This article provides a broad and multifaceted review of the received literature on business models in which the authors examine the business model concept through multiple subject-matter lenses. The review reveals that scholars do not agree on what a business model is and that the literature is developing largely in silos, according to the phenomena of interest of the respective researchers. However, the authors also found emerging common themes among scholars of business models. Specifically, (1) the business model is emerging as a new unit of analysis; (2) business models emphasize a system-level, holistic approach to explaining how firms “do business”; (3) firm activities play an important role in the various conceptualizations of business models that have been proposed; and (4) business models seek to explain how value is created, not just how it is captured. These emerging themes could serve as catalysts for a more unified study of business models

Going the Distance: Locative Dating Technology and Queer Male Practice-Based Identities

Hybridisation of digital and physical space is now a reality for geographies of sexualities in the digital age. ‘This chapter builds on such an understanding by exploring how digital–physical hybridisation mediated by locative dating apps can shape queer male ‘practice-based’ identities, and how these typologies in turn inform physical queer encounters. Drawing from a qualitative research project with men who have sex with men (MSM), I examine the impact of online connection on different ‘routes’ to physical meeting. I argue that certain modes of behaviour help to identify a range of practice-based identities, implicitly linked to different forms of hybridisation. Three typologies exemplify practice-based identities: the ‘Embracer’, the ‘Time-waster’ and the ‘Minimalist’. These fluid typologies overlap and are even evident within a single identity across time, depending on personal motivation, the ‘market’ of available online matches, and app genre. Such typologies demonstrate the range of user engagement that becomes bound up in, and mediated by, the digital and physical hybridisation enabled by popular mobile media platforms. The development of practice-based identities can be extrapolated beyond thinking about online and offline spaces to new questions about future sexualities, identities and digital geographies