Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: a systematic review

Introduction Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Methods Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form – Quantitative Studies. Results Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10–100%) compared with MRND (range, 0–100%) and SND (range, 9–25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5–20%). The prevalence of reduced neck active range of motion after neck dissection was 1–13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. Conclusions The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications

Evaluating the named nurse understanding of recovery in forensic mental health

This article describes a service evaluation carried out on a personality disorder admission ward in a high-secure hospital to evaluate nurses understanding of recovery approaches in mental health. The study used semi-structured questionnaires to determine the participant’s understanding of recovery. The findings highlight that further development is required in staff training and education on recovery. Theories underpinning recovery principles also need to be disseminated to help nurses understand the relevance of current policy developments, and thus improve care

The Race Between Stars and Quasars in Reionizing Cosmic Hydrogen

The cosmological background of ionizing radiation has been dominated by quasars once the Universe aged by ~2 billion years. At earlier times (redshifts z>3), the observed abundance of bright quasars declined sharply, implying that cosmic hydrogen was reionized by stars instead. Here, we explain the physical origin of the transition between the dominance of stars and quasars as a generic feature of structure formation in the concordance LCDM cosmology. At early times, the fraction of baryons in galaxies grows faster than the maximum (Eddington-limited) growth rate possible for quasars. As a result, quasars were not able to catch up with the rapid early growth of stellar mass in their host galaxies.Comment: 5 pages, 1 figure, Accepted for publication in JCA

Coalitions of things: supporting ISR tasks via Internet of Things approaches

In the wake of rapid maturing of Internet of Things (IoT) approaches and technologies in the commercial sector, the IoT is increasingly seen as a key ‘disruptive’ technology in military environments. Future operational environments are expected to be characterized by a lower proportion of human participants and a higher proportion of autonomous and semi-autonomous devices. This view is reflected in both US ‘third offset’ and UK ‘information age’ thinking and is likely to have a profound effect on how multinational coalition operations are conducted in the future. Much of the initial consideration of IoT adoption in the military domain has rightly focused on security concerns, reflecting similar cautions in the early era of electronic commerce. As IoT approaches mature, this initial technical focus is likely to shift to considerations of interactivity and policy. In this paper, rather than considering the broader range of IoT applications in the military context, we focus on roles for IoT concepts and devices in future intelligence, surveillance and reconnaissance (ISR) tasks, drawing on experience in sensor-mission resourcing and human-computer collaboration (HCC) for ISR. We highlight the importance of low training overheads in the adoption of IoT approaches, and the need to balance proactivity and interactivity (push vs pull modes). As with sensing systems over the last decade, we emphasize that, to be valuable in ISR tasks, IoT devices will need a degree of mission-awareness in addition to an ability to self-manage their limited resources (power, memory, bandwidth, computation, etc). In coalition operations, the management and potential sharing of IoT devices and systems among partners (e.g., in cross-coalition tactical-edge ISR teams) becomes a key issue due heterogeneous factors such as language, policy, procedure and doctrine. Finally, we briefly outline a platform that we have developed in order to experiment with human-IoT teaming on ISR tasks, in both physical and virtual settings

PROTOCOL: The effectiveness of psychosocial interventions for reducing problematic substance use, improving mental health, and improving housing stability for adults experiencing homelessness: A systematic review and meta-analysis

This systematic review is part of a broader evidence synthesis which aims to produce two systematic reviews to address a significant gap in the evidence base identified by Luchenski et al. (2018) and by (White, 2018). The first review (which is the subject of this protocol) will use meta-analysis to examine the effectiveness of different psychosocial interventions in (1) reducing problematic substance use; (2) improving mental health; and (3) improving housing stability for adults experiencing homelessness. The second review (which is covered by a separate title registration and protocol) will be of the experiences of adults experiencing homelessness when accessing or using psychosocial interventions, and will be a qualitative evidence synthesis using thematic synthesis (Thomas & Harden, 2008)

Relationships of Cetacea (Artiodactyla) Among Mammals: Increased Taxon Sampling Alters Interpretations of Key Fossils and Character Evolution

BACKGROUND: Integration of diverse data (molecules, fossils) provides the most robust test of the phylogeny of cetaceans. Positioning key fossils is critical for reconstructing the character change from life on land to life in the water. METHODOLOGY/PRINCIPAL FINDINGS: We reexamine relationships of critical extinct taxa that impact our understanding of the origin of Cetacea. We do this in the context of the largest total evidence analysis of morphological and molecular information for Artiodactyla (661 phenotypic characters and 46,587 molecular characters, coded for 33 extant and 48 extinct taxa). We score morphological data for Carnivoramorpha, Creodonta, Lipotyphla, and the raoellid artiodactylan Indohyus and concentrate on determining which fossils are positioned along stem lineages to major artiodactylan crown clades. Shortest trees place Cetacea within Artiodactyla and close to Indohyus, with Mesonychia outside of Artiodactyla. The relationships of Mesonychia and Indohyus are highly unstable, however--in trees only two steps longer than minimum length, Mesonychia falls inside Artiodactyla and displaces Indohyus from a position close to Cetacea. Trees based only on data that fossilize continue to show the classic arrangement of relationships within Artiodactyla with Cetacea grouping outside the clade, a signal incongruent with the molecular data that dominate the total evidence result. CONCLUSIONS/SIGNIFICANCE: Integration of new fossil material of Indohyus impacts placement of another extinct clade Mesonychia, pushing it much farther down the tree. The phylogenetic position of Indohyus suggests that the cetacean stem lineage included herbivorous and carnivorous aquatic species. We also conclude that extinct members of Cetancodonta (whales+hippopotamids) shared a derived ability to hear underwater sounds, even though several cetancodontans lack a pachyostotic auditory bulla. We revise the taxonomy of living and extinct artiodactylans and propose explicit node and stem-based definitions for the ingroup

Resistance exercise initiates mechanistic target of rapamycin (mTOR) translocation and protein complex co-localisation in human skeletal muscle

This is the final version. Available from the publisher via the DOI in this record.The mechanistic target of rapamycin (mTOR) is a central mediator of protein synthesis in skeletal muscle. We utilized immunofluorescence approaches to study mTOR cellular distribution and protein-protein co-localisation in human skeletal muscle in the basal state as well as immediately, 1 and 3 h after an acute bout of resistance exercise in a fed (FED; 20 g Protein/40 g carbohydrate/1 g fat) or energy-free control (CON) state. mTOR and the lysosomal protein LAMP2 were highly co-localised in basal samples. Resistance exercise resulted in rapid translocation of mTOR/LAMP2 towards the cell membrane. Concurrently, resistance exercise led to the dissociation of TSC2 from Rheb and increased in the co-localisation of mTOR and Rheb post exercise in both FED and CON. In addition, mTOR co-localised with Eukaryotic translation initiation factor 3 subunit F (eIF3F) at the cell membrane post-exercise in both groups, with the response significantly greater at 1 h of recovery in the FED compared to CON. Collectively our data demonstrate that cellular trafficking of mTOR occurs in human muscle in response to an anabolic stimulus, events that appear to be primarily influenced by muscle contraction. The translocation and association of mTOR with positive regulators (i.e. Rheb and eIF3F) is consistent with an enhanced mRNA translational capacity after resistance exercise.Biotechnology and Biological Science Research Council (BBSRC)Natural Sciences and Engineering Research Council (NSERC)China Scholarship CouncilNational Institute of Arthritis and Musculoskeletal and Skin DiseasesDepartment of Defens

The Neutral Gas Dynamics of the Nearby Magellanic Irregular Galaxy UGCA 105

We present new low-resolution HI spectral line imaging, obtained with the Karl G. Jansky Very Large Array (JVLA), of the star-forming Magellanic irregular galaxy UGCA 105. This nearby (D = 3.39+/-0.25 Mpc), low mass [M_HI=(4.3+/-0.5)x10^8 Solar masses] system harbors a large neutral gas disk (HI radius ~7.2 kpc at the N_HI=10^20 cm^-2 level) that is roughly twice as large as the stellar disk at the B-band R_25 isophote. We explore the neutral gas dynamics of this system, fitting tilted ring models in order to extract a well-sampled rotation curve. The rotation velocity rises in the inner disk, flattens at 72+/-3 km/s, and remains flat to the last measured point of the disk (~7.5 kpc). The dynamical mass of UGCA 105 at this outermost point, (9+/-2)x10^9 Solar masses, is ~10 times as large as the luminous baryonic components (neutral atomic gas and stars). The proximity and favorable inclination (55 degrees) of UGCA 105 make it a promising target for high-resolution studies of both star formation and rotational dynamics in a nearby low-mass galaxy.Comment: The Astronomical Journal, in pres