Evidence-Based Guidelines and Clinical Pathways in Stroke Rehabilitation—An International Perspective

A high societal burden and a considerable increase in stroke-related disability was globally observed over the last 3 decades, and is expected to continue implying a major challenge for societies around the word. Structured multidisciplinary stroke rehabilitation reduces stroke-related disability both in older and younger stroke survivors of either sex and independent of stroke severity. In addition, there is rapidly increasing evidence to support the clinical effectiveness of specific stroke rehabilitation interventions. Evidence-based guidelines help to promote best possible clinical practice. Inherent difficulty for their provision is that it takes enormous efforts to systematically appraise the evidence for guidelines and their regular updates, if they should not be at risk of bias by incomplete evidence selection. A systematic review of the pertaining literature indicates that the currently published stroke rehabilitation guidelines have a national background and focus and represent the health care situations in high-income countries. Societies around the globe would benefit from central evidence sources that systematically appraise the available evidence and make explicit links to practice recommendations. Such knowledge could facilitate a more wide-spread development of valid comprehensive up-to-date evidence-based national guidelines. In addition, the development of genuine international evidence-based stroke rehabilitation guidelines that focus on therapeutic approaches rather than organizational issues, could be used by many to structure regional or local stroke rehabilitation pathways and to develop their resources in a way that will eventually achieve effective stroke rehabilitation. Such international practice recommendations for stroke rehabilitation are currently under development by the World Federation for NeuroRehabilitation (WFNR)

Amazonian-aged fluvial system and associated ice-related features in Terra Cimmeria, Mars

The Martian climate throughout the Amazonian is widely believed to have been cold and hyper-arid, very similar to the current conditions. However, ubiquitous evidence of aqueous and glacial activity has been recently reported, including channels that can be tens to hundreds of kilometres long, alluvial and fluvial deposits, ice-rich mantles, and glacial and periglacial landforms. Here we study a ∼340 km-long fluvial system located in the Terra Cimmeria region, in the southern mid-latitudes of Mars. The fluvial system is composed of an upstream catchment system with narrow glaciofluvial valleys and remnants of ice-rich deposits. We observe depositional features including fan-shaped deposits, and erosional features such as scour marks and streamlined islands. At the downstream section of this fluvial system is an outflow channel named Kārūn Valles, which displays a unique braided alluvial fan and terminates on the floor of the Ariadnes Colles basin. Our observations point to surface runoff of ice/snow melt as the water source for this fluvial activity. According to our crater size–frequency distribution analysis the entire fluvial system formed during early to middle Amazonian, between ∼1.8+0.2 −0.2 Ga to 510+40 −40 Ma. Hydraulic modelling indicates that the Kārūn Valles and consequently the alluvial fan formation took place in geologically short-term event(s). We conclude that liquid water was present in Terra Cimmeria during the early to middle Amazonian, and that Mars during that time may have undergone several episodic glacial-related events

Emotional Rollercoaster: The Inverted U-Shaped Relationship between CEO Emotions and Innovation Outcomes

While the literature suggests that CEOs’ emotions can affect organizational decision- making, leadership, and employee engagement, we know little about how they influence firms’ culture and outcomes of innovation. Acknowledging that innovation is a critical element for long-term success, we investigate the relationship between CEO emotions and firm innovation. The results of our analysis of 1,903 firm-year observations supports our theorizing of an inverted U-shaped relationship between CEO emotions and innovation outcomes. The findings show that moderate levels of emotions lead to the highest innovation outcomes, while extremely high or low levels decrease innovation. This study contributes to the literature by applying the Yerkes-Dodson law within upper echelon theory, demonstrating a non-linear relationship between CEO emotions and innovation, and utilizing a novel algorithm to measure CEO emotions more objectively

Atlanto-occipital dislocation: four case reports of survival in adults and review of the literature

Traumatic atlanto-occipital dislocation (AOD) is a rare cervical spine injury and in most cases fatal. Consequently, relatively few case reports of adult patients surviving this injury appeared in the literature. We retrospectively report four patients who survived AOD injury and were treated at our institution. A young man fell from height and a woman was injured in a traffic accident. Both patients survived the injury but died later in the hospital. The third patient had a motorcycle accident and survived with incomplete paraplegia. The last patient, a man involved in a working accident, survived without neurological deficit of the upper extremities. Rigid posterior fixation and complete reduction of the dislocation were applied in last two cases using Cervifix together with a cancellous bone grafting. Previously reported cases of patients surviving AOD are reviewed, and clinical features and operative stabilisation procedures are discusse