Future trends in reputation management

Companies must redefine their portfolio in such a way that people will perceive it as having added value for their personal lives, says RSM's Professor Cees van Riel, an expert in reputation management – and there's good reason for the world's biggest companies to believe him

Guidelines for initiation of anti-tumour necrosis factor therapy in rheumatoid arthritis: similarities and differences across Europe.

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Rigidity of unilateral external fixators-A biomechanical study

Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS (R) Standard Fixator (4 joints) with the Orthofix ProCallus Fixator (R) (2 joints), which differ in possibilities for adapting the configuration for clinical needs. Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10 N, loading was increased to a maximum of 160 N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated. Results: With a force of 100 N in parallel direction the mean translation resultant (Tr(mean)) of the Dynafix DFS (R) Standard Fixator (6.65 +/- 1.43 mm) was significantly higher than the ProCallus Fixator (R) (3.29 +/- 0.83 mm, p < 0.001; Student's t-test). With a maximum load of 60 N in transverse direction the Tr(mean) of the Dynafix DFS (R) Standard Fixator was significantly lower (8.14 +/- 1.20 mm versus 9.83 +/- 0.63 mm, p < 0.005). Translation was significantly higher with the Dynafix DFS Conclusions: Both fixators were most sensitive to transverse forces. The Dynafix DFS (R) Standard Fixator was less rigid with parallel and axial forces, whereas transverse forces and rotation at distraction forces favoured the Dynafix DFS (R) Standard Fixator. Repeated heavy loading did not influence the rigidity of both devices. (C) 2011 Elsevier Ltd. All rights reserved

Rigidity of unilateral external fixators-A biomechanical study

Introduction: External fixation is the primary choice of temporary fracture stabilisation for specific polytrauma patients. Adequate initial fracture healing requires sufficient stability at the fracture site. The purpose of this study was to compare the rigidity of the Dynafix DFS (R) Standard Fixator (4 joints) with the Orthofix ProCallus Fixator (R) (2 joints), which differ in possibilities for adapting the configuration for clinical needs. Materials and methods: Both devices were tested 10 times in a standardised model. In steps of 10 N, loading was increased to a maximum of 160 N in parallel, transversal and axial direction (distraction and compression). Translation resultant and rotation resultant were calculated. Results: With a force of 100 N in parallel direction the mean translation resultant (Tr(mean)) of the Dynafix DFS (R) Standard Fixator (6.65 +/- 1.43 mm) was significantly higher than the ProCallus Fixator (R) (3.29 +/- 0.83 mm, p < 0.001; Student's t-test). With a maximum load of 60 N in transverse direction the Tr(mean) of the Dynafix DFS (R) Standard Fixator was significantly lower (8.14 +/- 1.20 mm versus 9.83 +/- 0.63 mm, p < 0.005). Translation was significantly higher with the Dynafix DFS Conclusions: Both fixators were most sensitive to transverse forces. The Dynafix DFS (R) Standard Fixator was less rigid with parallel and axial forces, whereas transverse forces and rotation at distraction forces favoured the Dynafix DFS (R) Standard Fixator. Repeated heavy loading did not influence the rigidity of both devices. (C) 2011 Elsevier Ltd. All rights reserved

Novel avian-origin influenza A (H7N9) virus attaches to epithelium in both upper and lower respiratory tract of humans

Influenza A viruses from animal reservoirs have the capacity to adapt to humans and cause influenza pandemics. The occurrence of an influenza pandemic requires efficient virus transmission among humans, which is associated with virus attachment to the upper respiratory tract. Pandemic severity depends on virus ability to cause pneumonia, which is associated with virus attachment to the lower respiratory tract. Recently, a novel avian-origin H7N9 influenza A virus with unknown pandemic potential emerged in humans. We determined the pattern of attachment of two genetically engineered viruses containing the hemagglutinin of either influenza virus A/Shanghai/1/13 or A/Anhui/1/13 to formalin-fixed human respiratory tract tissues using histochemical analysis. Our results show that the emerging H7N9 virus attached moderately or abundantly to both upper and lower respiratory tract, a pattern not seen before for avian influenza A viruses. With the caveat that virus attachment is only the first step in the virus replication cycle, these results suggest that the emerging H7N9 virus has the potential both to transmit efficiently among humans and to cause severe pneumonia

A data-driven computational model for obesity-driven diabetes onset and remission through weight loss

Obesity is a major risk factor for the development of type 2 diabetes (T2D), where a sustained weight loss may result in T2D remission in individuals with obesity. To design effective and feasible intervention strategies to prevent or reverse T2D, it is imperative to study the progression of T2D and remission together. Unfortunately, this is not possible through experimental and observational studies. To address this issue, we introduce a data-driven computational model and use human data to investigate the progression of T2D with obesity and remission through weight loss on the same timeline. We identify thresholds for the emergence of T2D and necessary conditions for remission. We explain why remission is only possible within a window of opportunity and the way that window depends on the progression history of T2D, individual’s metabolic state, and calorie restrictions. These findings can help to optimize therapeutic intervention strategies for T2D prevention or treatment

Recommendations on scuba diving in Birt-Hogg-Dubé syndrome

Introduction: Although very uncommon, severe injury and death can occur during scuba diving. One of the main causes of scuba diving fatalities is pulmonary barotrauma due to significant changes in ambient pressure. Pathology of the lung parenchyma, such as cystic lesions, might increase the risk of pulmonary barotrauma. Areas covered: Birt–Hogg–Dubé syndrome (BHD), caused by pathogenic variants in the FLCN gene, is characterized by skin fibrofolliculomas, an increased risk of renal cell carcinoma, multiple lung cysts and spontaneous pneumothorax. Given the pulmonary involvement, in some countries patients with BHD are generally recommended to avoid scuba diving, although evidence-based guidelines are lacking. We aim to provide recommendations on scuba diving for patients with BHD, based on a survey of literature on pulmonary cysts and pulmonary barotrauma in scuba diving. Expert opinion: In our opinion, although the absolute risks are likely to be low, caution is warranted. Given the relative paucity of literature and the potential fatal outcome, patients with BHD with a strong desire for scuba diving should be informed of the potential risks in a personal assessment. If available a diving physician should be consulted, and a low radiation dose chest computed tomography (CT)-scan to assess pulmonary lesions could be considered.</p

In Silico Analysis Identifies Intestinal Transit as a Key Determinant of Systemic Bile Acid Metabolism

Bile acids fulfill a variety of metabolic functions including regulation of glucose and lipid metabolism. Since changes of bile acid metabolism accompany obesity, Type 2 Diabetes Mellitus and bariatric surgery, there is great interest in their role in metabolic health. Here, we developed a mathematical model of systemic bile acid metabolism, and subsequently performed in silico analyses to gain quantitative insight into the factors determining plasma bile acid measurements. Intestinal transit was found to have a surprisingly central role in plasma bile acid appearance, as was evidenced by both the necessity of detailed intestinal transit functions for a physiological description of bile acid metabolism as well as the importance of the intestinal transit parameters in determining plasma measurements. The central role of intestinal transit is further highlighted by the dependency of the early phase of the dynamic response of plasma bile acids after a meal to intestinal propulsion