Respiratory therapies for amyotrophic lateral sclerosis: A primer

Respiratory complications are a common cause of morbidity and mortality in amyotrophic lateral sclerosis (ALS). Treatment of respiratory insufficiency with noninvasive ventilation (NIV) improves ALS patients' quality of life and survival. Evidence‐based practice guidelines for the management of ALS patients recommend treatment of respiratory insufficiency with NIV as well as consideration of insufflation/exsufflation to improve clearance of airway secretions. Despite these recommendations respiratory therapies remain underused. In this review we provide a practical guide for the clinician to prescribe and manage respiratory therapies for the patient with ALS. Muscle Nerve 46: 313–331, 2012Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93524/1/23282_ftp.pd

The risk of hematoma following extensive electromyography of the lumbar paraspinal muscles

Introduction: The purpose of this study is to provide a controlled trial looking at the risk of paraspinal hematoma formation following extensive paraspinal muscle electromyography. Methods: 54 subjects ages 55–80 underwent MRI of the lumbar spine before or shortly after electromyography using the paraspinal mapping technique. A neuroradiologist, blinded to the temporal relationship between the EMG and MRI, reviewed the MRIs to look for hematomas in or around the paraspinal muscles. Results: Two MRIs demonstrated definite paraspinal hematomas, while 10 were found to have possible hematomas. All hematomas were < 15 mm, and none were close to any neural structures. There was no relationship between MRI evidence of hematoma and either the timing of the EMG or the use of aspirin or other nonsteroidal anti‐inflammatory drugs. Conclusions: Paraspinal electromyography can be considered safe in the general population and those taking nonsteroidal anti‐inflammatory drugs. Muscle Nerve 46:26–30, 2012Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92008/1/23288_ftp.pd

Exploring Four Modes of Responding to Undergraduate Writing

A study exploring four modes of giving feedback to student writing in a first-year composition course. The focus discusses ways the different modes impact student writing and revision. It also examines one classroom where each of these modes were implemented, how these different modes were implemented, and the outcome of each mode on student attitudes toward the writing and revision process

Studying intra-organizational dynamics in implementing supply chain partnering: a case study about work floor experiences in a Dutch housing association

This study aims at uncovering intra-organizational dynamics in implementing supply chain partnering. Narrative techniques are used in a qualitative case study in a Dutch housing association. This study shows how project leaders of a Dutch Housing Association perceive relationships in the internal supply chain and the strategies that they develop to cope with these relationships. Furthermore, it is argued that key values of SCP as understood by the project leaders - such as sharing responsibilities and addressing feedback towards each other openly - are not applied in intraorganizational relationships

Association of MC1R Variants and host phenotypes with melanoma risk in CDKN2A mutation carriers: a GenoMEL study

&lt;p&gt;&lt;b&gt;Background&lt;/b&gt; Carrying the cyclin-dependent kinase inhibitor 2A (CDKN2A) germline mutations is associated with a high risk for melanoma. Penetrance of CDKN2A mutations is modified by pigmentation characteristics, nevus phenotypes, and some variants of the melanocortin-1 receptor gene (MC1R), which is known to have a role in the pigmentation process. However, investigation of the associations of both MC1R variants and host phenotypes with melanoma risk has been limited.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods&lt;/b&gt; We included 815 CDKN2A mutation carriers (473 affected, and 342 unaffected, with melanoma) from 186 families from 15 centers in Europe, North America, and Australia who participated in the Melanoma Genetics Consortium. In this family-based study, we assessed the associations of the four most frequent MC1R variants (V60L, V92M, R151C, and R160W) and the number of variants (1, &#8805;2 variants), alone or jointly with the host phenotypes (hair color, propensity to sunburn, and number of nevi), with melanoma risk in CDKN2A mutation carriers. These associations were estimated and tested using generalized estimating equations. All statistical tests were two-sided.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results&lt;/b&gt; Carrying any one of the four most frequent MC1R variants (V60L, V92M, R151C, R160W) in CDKN2A mutation carriers was associated with a statistically significantly increased risk for melanoma across all continents (1.24 × 10−6 &#8804; P &#8804; .0007). A consistent pattern of increase in melanoma risk was also associated with increase in number of MC1R variants. The risk of melanoma associated with at least two MC1R variants was 2.6-fold higher than the risk associated with only one variant (odds ratio = 5.83 [95% confidence interval = 3.60 to 9.46] vs 2.25 [95% confidence interval = 1.44 to 3.52]; Ptrend = 1.86 × 10−8). The joint analysis of MC1R variants and host phenotypes showed statistically significant associations of melanoma risk, together with MC1R variants (.0001 &#8804; P &#8804; .04), hair color (.006 &#8804; P &#8804; .06), and number of nevi (6.9 × 10−6 &#8804; P &#8804; .02).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusion&lt;/b&gt; Results show that MC1R variants, hair color, and number of nevi were jointly associated with melanoma risk in CDKN2A mutation carriers. This joint association may have important consequences for risk assessments in familial settings.&lt;/p&gt

Towards successful partnering in housing refurbishment - an assessment of six Dutch dyads

Supply chain partnering is seen as one method of handling the need for more efficient and transparent building processes. Although it has received considerable attention from practitioners and researchers, supply chain partnering is still in its formative phase within the construction industry. There have been a number of studies that focus on ‘success factors’ in partnering, but relatively few studies have focused on whether and how these factors are applied in practice. Moreover, almost no studies have been completed into supply chain partnering in housing refurbishment projects. An assessment was made of the partnerships between six Dutch housing associations and general contractors, on the basis of the success factors identified in literature: trust, leadership, partner capabilities, commitment, conflict resolution, coordination and communication. The conclusion is that most of these factors play a role, although there are considerable differences in the way in which the dyads used these factors in their partnering process. Conflict resolution techniques and coordination measures have not yet been developed. This may be due to the experimental stage of the dyads and/or the level of trust within the dyads, but it also implies a risk for the further development of the partnering process, should conflicts arise

Implementing supply chain partnering in the construction industry

Although much research has been conducted about advantages and challenges for supply chain partnering (SCP) in the construction sector, focus has been mostly on formal aspects of implementation within organizations. Understanding social aspects, however, might be just as crucial to implementation of SCP as understanding managerial and intraorganizational dynamics. Therefore, this paper presents the results of a study in which a work floor professional together with a researcher tried to contribute to the implementation of SCP within the maintenance and refurbishment processes of a Dutch housing association. The results showed that stakeholders could not come to shared understanding of strategic needs, and that that pattern influences and was influenced by social aspects such as leadership and trust, which confirms the importance of explicit attention for social interactions at work floor level for successful implementation of supply chain partnering

Innovation in housing refurbishment through adopting a partnering approach

Housing associations own 32 % of housing stock in the Netherlands, making them major actors in maintaining and improving the quality of life in the urban environment. The building stock requires effective innovation to keep pace with the needs of today’s tenants. Moreover, the current financial circumstances and political environment have pushed housing associations to innovate in their (re)construction processes, for example by adopting a partnering approach. Several studies indicate that the implementation of innovations could benefit from partnering approaches in the construction supply chain. An evaluation of refurbishment projects that have been carried out using a partnering approach, however, indicates that the innovation process itself was seen as the major innovation and may (initially) even hamper innovations that aim to upgrade the dwelling to current standards. This effect should be taken into account when developing innovations in dwellings

Germline TERT promoter mutations are rare in familial melanoma.

Germline CDKN2A mutations occur in 40 % of 3-or-more case melanoma families while mutations of CDK4, BAP1, and genes involved in telomere function (ACD, TERF2IP, POT1), have also been implicated in melanomagenesis. Mutation of the promoter of the telomerase reverse transcriptase (TERT) gene (c.-57 T>G variant) has been reported in one family. We tested for the TERT promoter variant in 675 multicase families wild-type for the known high penetrance familial melanoma genes, 1863 UK population-based melanoma cases and 529 controls. Germline lymphocyte telomere length was estimated in carriers. The c.-57 T>G TERT promoter variant was identified in one 7-case family with multiple primaries and early age of onset (earliest, 15 years) but not among population cases or controls. One family member had multiple primary melanomas, basal cell carcinomas and a bladder tumour. The blood leukocyte telomere length of a carrier was similar to wild-type cases. We provide evidence confirming that a rare promoter variant of TERT (c.-57 T>G) is associated with high penetrance, early onset melanoma and potentially other cancers, and explains <1 % of UK melanoma multicase families. The identification of POT1 and TERT germline mutations highlights the importance of telomere integrity in melanoma biology.The authors would like to thank the families for their willingness to participate; and Rajiv Kumar for the provision of mutation positive samples. The collection of samples in the UK population-ascertained sample set was funded by Cancer Research UK (awards C588/A19167 and C8216/A6129) and by the NIH (CA83115). The work of N.A.G. and R.v.D was supported by the Dutch Cancer Society (UL 2012-5489). D.J.A and C.D.R.E are supported by Cancer Research UK, ERC Combat Cancer and the Wellcome Trust. N.K.H is supported by a fellowship from the National Health and Medical Research Council of Australia. A.M.D. and K.A.P. were supported by CRUK grant (C8197/A16565) and The Isaac Newton Trust. K.M.B. is supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics; National Cancer Institute; National Institutes of Health.This is the final version of the article. It first appeared from Springer via http://dx.doi.org/10.1007/s10689-015-9841-

Sustainable Neighbourhood Transformation

Urban renewal through the large-scale restructuring of post-war neighbourhoods is a major challenge throughout Europe in the decades ahead. Current urban restructuring programmes in the Netherlands focus on the demolition and replacement of the existing housing stock. The motivation behind this strategy is creating a better social mix between ‘poor’ and ‘better-off’ households, to improve the general quality of the housing stock and to create a financially viable restructuring programme. The general aim is to improve various aspects of sustainability in urban neighbourhoods. Are demolition and replacement strategies the most effective and efficient way to achieve this objective? In this book, we examine the effects of demolition and replacement strategies on sustainability from different perspectives. An economic perspective: the market position and the value of the neighbourhoods, a social perspective: the levels of social capital and residential stability, and an environmental perspective: the energy efficiency and the use of materials in restructuring strategies