Technical nuances of commonly used vascularised flaps for skull base reconstruction

Background and Methods: Reconstruction with a vascularised flap provides the most reliable outcome, with postoperative cerebrospinal fluid leak rates of less than 5 per cent. This article aims to review and summarise the critical technical aspects of the vascularised flaps most commonly used for skull base reconstruction. Results: Vascularised flaps are classified as intranasal or extranasal. The intranasal group includes the Hadad–Bassagaisteguy nasoseptal flap, the Caicedo reverse nasoseptal flap, the nasoseptal rescue flap, the posteriorly or anteriorly based lateral wall flaps, and the middle turbinate flap. Extranasal flaps include the transfrontal pericranial and transpterygoid temporoparietal flaps. Conclusion: The Hadad–Bassagaisteguy nasoseptal flap is overwhelmingly favoured for reconstructing extensive defects of anterior, middle and posterior cranial base. Its pertinent technical features are described. However, it is essential to master the skills required for the various extranasal or regional vascularised flaps because each can offer a reconstructive alternative for specific patients, especially when open approaches are needed and/or intranasal vascularised flaps are not feasible

Intra-European Movement: Multi-Level or Mismatched Governance?

The case of intra-EU mobility raises significant debate about multi-level governance (MLG) both in analytical terms – how multi-level is governance of intra-EU mobility, what actors are involved and how? – and normative terms – can intra-EU mobility be seen as ‘successful’ multi-level governance? Intra-EU mobility is an area that faces both issue complexity and institutional complexity (Stephenson, 2013, pp. 817) and as such, the governance arrangements are often correspondingly complex. This chapter will attempt to locate the case of intra-EU mobility within the broader literature on multi-level governance and try to draw out lessons for understanding MLG as a practical, analytical and normative concept. This is relevant to both the understanding of intra-EU mobility and the understanding of MLG. On the one hand, additional cases help to support or refute the robustness of our conceptualisation of multi-level governance; on the other hand, MLG as a concept can help us to understand the entanglement of a complex issue that cuts across political and policy bounds. The chapter will first develop a framework of multi-level governance that can be applied to intra-EU migration. Then, the structural, relational and policy factors that affect MLG will be explored in the context of this specific case. The final section will try to craft some answers about what intra-EU migration policy can tell us about multi-level governance, and vice versa

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

BACKGROUND: Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. METHODS: We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. RESULTS: Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. CONCLUSION: This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field

To which world regions does the valence–dominance model of social perception apply?

Over the past 10 years, Oosterhof and Todorov’s valence–dominance model has emerged as the most prominent account of how people evaluate faces on social dimensions. In this model, two dimensions (valence and dominance) underpin social judgements of faces. Because this model has primarily been developed and tested in Western regions, it is unclear whether these findings apply to other regions. We addressed this question by replicating Oosterhof and Todorov’s methodology across 11 world regions, 41 countries and 11,570 participants. When we used Oosterhof and Todorov’s original analysis strategy, the valence–dominance model generalized across regions. When we used an alternative methodology to allow for correlated dimensions, we observed much less generalization. Collectively, these results suggest that, while the valence–dominance model generalizes very well across regions when dimensions are forced to be orthogonal, regional differences are revealed when we use different extraction methods and correlate and rotate the dimension reduction solution.C.L. was supported by the Vienna Science and Technology Fund (WWTF VRG13-007); L.M.D. was supported by ERC 647910 (KINSHIP); D.I.B. and N.I. received funding from CONICET, Argentina; L.K., F.K. and Á. Putz were supported by the European Social Fund (EFOP-3.6.1.-16-2016-00004; ‘Comprehensive Development for Implementing Smart Specialization Strategies at the University of Pécs’). K.U. and E. Vergauwe were supported by a grant from the Swiss National Science Foundation (PZ00P1_154911 to E. Vergauwe). T.G. is supported by the Social Sciences and Humanities Research Council of Canada (SSHRC). M.A.V. was supported by grants 2016-T1/SOC-1395 (Comunidad de Madrid) and PSI2017-85159-P (AEI/FEDER UE). K.B. was supported by a grant from the National Science Centre, Poland (number 2015/19/D/HS6/00641). J. Bonick and J.W.L. were supported by the Joep Lange Institute. G.B. was supported by the Slovak Research and Development Agency (APVV-17-0418). H.I.J. and E.S. were supported by a French National Research Agency ‘Investissements d’Avenir’ programme grant (ANR-15-IDEX-02). T.D.G. was supported by an Australian Government Research Training Program Scholarship. The Raipur Group is thankful to: (1) the University Grants Commission, New Delhi, India for the research grants received through its SAP-DRS (Phase-III) scheme sanctioned to the School of Studies in Life Science; and (2) the Center for Translational Chronobiology at the School of Studies in Life Science, PRSU, Raipur, India for providing logistical support. K. Ask was supported by a small grant from the Department of Psychology, University of Gothenburg. Y.Q. was supported by grants from the Beijing Natural Science Foundation (5184035) and CAS Key Laboratory of Behavioral Science, Institute of Psychology. N.A.C. was supported by the National Science Foundation Graduate Research Fellowship (R010138018). We acknowledge the following research assistants: J. Muriithi and J. Ngugi (United States International University Africa); E. Adamo, D. Cafaro, V. Ciambrone, F. Dolce and E. Tolomeo (Magna Græcia University of Catanzaro); E. De Stefano (University of Padova); S. A. Escobar Abadia (University of Lincoln); L. E. Grimstad (Norwegian School of Economics (NHH)); L. C. Zamora (Franklin and Marshall College); R. E. Liang and R. C. Lo (Universiti Tunku Abdul Rahman); A. Short and L. Allen (Massey University, New Zealand), A. Ateş, E. Güneş and S. Can Özdemir (Boğaziçi University); I. Pedersen and T. Roos (Åbo Akademi University); N. Paetz (Escuela de Comunicación Mónica Herrera); J. Green (University of Gothenburg); M. Krainz (University of Vienna, Austria); and B. Todorova (University of Vienna, Austria). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.https://www.nature.com/nathumbehav/am2023BiochemistryGeneticsMicrobiology and Plant Patholog

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Disaster Vulnerability, Hazards And Resilience: Perspectives From Florida

This monograph provides valuable lessons in building disaster resilience for rural communities and beyond. With a focus on Florida, the authors present a comprehensive review of the current debates surrounding the study of resilience, from federal frameworks, state plans and local initiatives. They also review evaluation tools and feature first-hand accounts of county emergency managers as well as non-profit and community groups on key issues, including perspectives on vulnerable groups such as the elderly, children and farm workers. Readers will find insightful answers to such questions as: How can the concept of resilience be used as a framework to investigate the conditions that lead to stronger, more sustainable communities? What factors account for the variation across jurisdictions and geographic units in the ability to respond to and recover from a disaster? How does the recovery process impact the social, political and economic institutions of the stricken communities? How do communities, especially rural ones, collaborate with multiple stakeholders (local, regional, state, national) during the transition from recovery to resilience? Can the collaborative nature of disaster recovery help build resilient communities?. The primary audiences of this book are scholars in emergency and crisis management, planning and policy, disaster response and recovery, disaster sociology and environmental management and policy. This book can also be used as a textbook in graduate and advanced undergraduate programs /courses on disaster management, disaster studies, emergency and crisis management, environmental policy and management and public policy and administration

Mechatronic design and genetic-algorithm-based MIMO fuzzy control of adjustable-stiffness tendon-driven robot finger

This work presents a detailed design of a three-jointed tendon-driven robot finger with a cam/pulleys transmission and joint Variable Stiffness Actuator (VSA). The finger motion configuration is obtained by deriving the cam/pulleys transmission profile as a mathematical solution that is then implemented to achieve contact force isotropy on the phalanges. A VSA is proposed, in which three VSAs are designed to act as a muscle in joint space to provide firm grasping. As a mechatronic approach, a suitable type and number of force sensors and actuators are designed to sense the touch, actuate the finger, and tune the VSAs. The torque of the VSAs is controlled utilizing a designed Multi Input Multi Output (MIMO) fuzzy controller. The fuzzy controller input is the force sensors' signals that are used to set the appropriate VSA torque. The fuzzy controller parameters are then tuned using a genetic algorithm as an optimization technique. The objective function of the genetic algorithm is to avoid unbalance torque in the individual joints and to reduce the difference between the values of the supplied VSAs torques. Finally, the operation of the aforementioned finger system is organized through a simple control algorithm. The function of this algorithm is to enable the detection of the unknown object and simultaneously automatically activate the optimized fuzzy controller thus eliminating the necessity of any external control unit.</p