Favorable outcome of early treatment of new onset child and adolescent migraine-implications for disease modification.

There is evidence that the prevalence of migraine in children and adolescents may be increasing. Current theories of migraine pathophysiology in adults suggest activation of central cortical and brainstem pathways in conjunction with the peripheral trigeminovascular system, which ultimately results in release of neuropeptides, facilitation of central pain pathways, neurogenic inflammation surrounding peripheral vessels, and vasodilatation. Although several risk factors for frequent episodic, chronic, and refractory migraine have been identified, the causes of migraine progression are not known. Migraine pathophysiology has not been fully evaluated in children. In this review, we will first discuss the evidence that early therapeutic interventions in the child or adolescent new onset migraineur, may halt or limit progression and disability. We will then review the evidence suggesting that many adults with chronic or refractory migraine developed their migraine as children or adolescents and may not have been treated adequately with migraine-specific therapy. Finally, we will show that early, appropriate and optimal treatment of migraine during childhood and adolescence may result in disease modification and prevent progression of this disease

Focus: Implementing participation - Advancement of social services in analog and digital spaces

Digitale Informations- und Kommunikationstechnologien gewinnen als fester Bestandteil zunehmend Bedeutung in den alltäglichen Lebenswelten einer wachsenden Zahl von Menschen. Ihre Entwicklung und selbstverständliche Nutzung schreiten in einem immer rasanteren Tempo voran; die vielfältigen Anwendungsmöglichkeiten adressieren längst alle Lebensbereiche. Während der Digitalisierung von Kommunikationsprozessen zuweilen demokratisierende Kräfte zugesprochen werden, scheint eine kritische Reflexion möglicher Potentiale und Auswirkungen digitaler Informations- und Kommunikationstechnologien auf Teilhabedynamiken in unterschiedlichen Lebensbereichen dringend erforderlich. Die Autorinnen und Autoren möchten mit dieser SI:SO-Schwerpunktausgabe einen Beitrag zu einer kritischen Reflexion digitaler Innovationen und ihrer Auswirkungen auf die zukünftige Gestaltung sozialer Dienste leisten. Mit der zweisprachigen Ausgabe ist zudem die Hoffnung verbunden, diesen Beitrag auch einem europäischen und weltweiten Publikum zugänglich zu machen.Digital information and communications technologies are becoming an increasingly important part in everyday life of a growing number of people. Their development and natural use are progressing even faster with a wide range of possible applications addressing all areas of life. While the digitization of communication processes is sometimes said to have democratizing forces, critical reflection on the potential and impact of digital information and communication technologies on participation dynamics in different areas of life seems urgently needed. The Authors would like to contribute to a critical reflection on digital innovations and their impact on the future design of social services. The bilingual edition further aims to make this contribution accessible to a European and global audience

Does Market Competition Dampen Environmental Performance? Evidence from China

Departing from the extant literature which assumes that firms pursue strong environmental performance as a differentiation strategy, we analyse the general relationship between firms’ competitive strategy and their response to heightened market competition. We find that, using a large sample of Chinese manufacturing firms between 2000 and 2005, intensified market competition has an overall negative impact on firms’ environmental performance. The negative impact is exacerbated in firms adopting a cost-leadership strategy, but attenuated in those adopting a differentiation strategy. The results emphasize the importance of including an examination of the particular competitive strategies chosen by firms in seeking to understand the impact of intensified market competition

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

Recent advances quantifying the large wood dynamics in river basins: New methods and remaining challenges

Citation: Ruiz-Villanueva, V., Piégay, H., Gurnell, A. A., Marston, R. A., & Stoffel, M. (2016). Recent advances quantifying the large wood dynamics in river basins: New methods and remaining challenges. Reviews of Geophysics. doi:10.1002/2015RG000514Large wood is an important physical component of woodland rivers and significantly influences river morphology. It is also a key component of stream ecosystems. However, large wood is also a source of risk for human activities as it may damage infrastructure, block river channels, and induce flooding. Therefore, the analysis and quantification of large wood and its mobility are crucial for understanding and managing wood in rivers. As the amount of large-wood-related studies by researchers, river managers, and stakeholders increases, documentation of commonly used and newly available techniques and their effectiveness has also become increasingly relevant as well. Important data and knowledge have been obtained from the application of very different approaches and have generated a significant body of valuable information representative of different environments. This review brings a comprehensive qualitative and quantitative summary of recent advances regarding the different processes involved in large wood dynamics in fluvial systems including wood budgeting and wood mechanics. First, some key definitions and concepts are introduced. Second, advances in quantifying large wood dynamics are reviewed; in particular, how measurements and modeling can be combined to integrate our understanding of how large wood moves through and is retained within river systems. Throughout, we present a quantitative and integrated meta-analysis compiled from different studies and geographical regions. Finally, we conclude by highlighting areas of particular research importance and their likely future trajectories, and we consider a particularly underresearched area so as to stress the future challenges for large wood research. ©2016. American Geophysical Union

Untersuchung von mineralisch gebundenen Verstärkungsschichten für Stahlbetonplatten gegen Impaktbeanspruchungen

Thematisch befasst sich die Dissertation mit der Verstärkung von Stahlbetonkonstruktionen gegen eine Impaktbeanspruchung. Im Rahmen von Vorversuchen wurden grundlegende experimentelle Betrachtungen angestellt, um sich der Thematik der Verstärkung von Stahlbetonplatten gegen eine Impaktbeanspruchung zu nähern. Die Erkenntnisse dieser Vorversuche wurden für die weiterführenden Betrachtungen herangezogen. Um die Gesamtproblematik effizient zu bearbeiten, wurde der umfangreiche Themenkomplex aufgeteilt. Hierfür wurden zum einen Untersuchungen der Verstärkungsschicht mithilfe von kleinmaßstäblichen Probekörpern durchgeführt. Hierbei galt es, die Leistungsfähigkeit der zur Verfügung stehenden Verstärkungsmaterialien aufzuzeigen. Zum anderen wurden die Stahlbetonplatten, die es zu verstärken galt, unter einer Impaktbelastung untersucht. Durch diese Betrachtungen sollten die wirkenden Schädigungsmechanismen erforscht werden. Anschließend erfolgte der Zusammenschluss der gesammelten Erkenntnisse im Rahmen der Verstärkung von Stahlbetonplatten gegen eine Impaktbeanspruchung. Für die maximal 2 cm dicken Verstärkungsschichten wurden sowohl Carbonbeton als auch weitere vielversprechende Materialkombinationen verwendet. Die im Rahmen dieser Arbeit durchgeführten experimentellen Untersuchungen wurden in der Fallturmanlage des Otto-Mohr-Laboratoriums umgesetzt. Die Versuche wurden durch die Verwendung von numerischen Simulationen mithilfe des FEM- und DEM-Programms LS-Dyna unterstützt, um eine bessere Vorstellung von den komplexen Vorgängen im Bauteil im Moment des Impakts zu erhalten. Die angestellten numerischen Untersuchungen hatten hierbei vorrangig das Ziel, die während der Experimente gesammelten Beobachtungen phänomenologisch abzubilden, um prinzipielle Effekte besser verstehen zu können. Im Rahmen der Untersuchungen wurden zum einen die grundlegenden experimentellen Beobachtungen aufgearbeitet und systematisiert. Zum anderen wurde anhand dieser gesammelten Daten eine Schädigungsbeschreibung entwickelt, um eine Abschätzung bzw. Bewertung des Schädigungsgrades bzw. Schädigungsmaßes eines impaktbeaufschlagten Bauteils zu ermöglichen. Mithilfe der gesammelten Erkenntnisse wurde ein bestehendes Ingenieurmodell um die Wirkung der Verstärkungsschicht erweitert