Refractory chronic ankle pain controlled with pulsed radiofrequency: case report

JUSTIFICATIVA E OBJETIVOS: A radiofrequência (RF) é uma corrente alternada com frequência de oscilação de 500.000 Hz, que tem sido usada com sucesso no tratamento de algumas morbidades que cursam com dor crônica. O objetivo deste relato de caso foi mostrar o uso bem sucedido da RF pulsátil do nervo sural para o tratamento de dor crônica no tornozelo. RELATO DO CASO: Paciente do sexo feminino, 60 anos, que há 5 anos apresentava dor em tornozelo direito, refratária ao tratamento com opioides, anti-inflamatório não esteroides (AINES), dipirona, antidepressivos e anticonvulsivantes, fisioterapia, infiltrações localizadas, acupuntura e palmilha. A paciente foi submetida a aplicação de RF pulsátil de nervo sural direito. O local da inserção da agulha foi na linha entre o tendão de Aquiles e maléolo lateral, região inicial de tendão de Aquiles e final dos músculos sóleo e gastrocnêmio. A estimulação sensitiva para identificação do nervo sural foi com 0,5 volts e 50 Hz. A corrente pulsátil foi aplicada durante 140 segundos com 45 volts com temperatura de até 42º C. Foram realizadas duas aplicações, ocorrendo melhora de cerca de 80% da dor, permitindo que a paciente pudesse deambular ou permanecer em pé, sem maiores dificuldades. CONCLUSÃO: A RF pulsátil do nervo sural pode ser uma opção para o controle das dores crônicas em tornozelo

Influence of cycle stage, age and endometrial biopsy score on oxytocin receptor distribution and gene expression in the cervix and uterus of non-pregnant mares

Persistent breeding-induced endometritis (PBIE) or delayed uterine clearance (DUC) are major causes of mare subfertility. Oxytocin and its receptor are thought to play significant roles in the pathogenesis of DUC but the specific roles of oxytocin receptor (OR) distribution and gene expression remain undefined. In this study both OR distribution and gene expression in the endometrium, myometrium and cervix during both luteal and non-luteal phases in non-pregnant mares (n = 27) of differing age (young: 2–9 years, n = 17; old: > 10 years, n = 10) and endometrial biopsy score were described using immunohistochemistry (IHC) and quantitative reverse-transcription polymerase chain reaction (RT-qPCR), respectively. Immunohistochemistry showed a similar pattern of OR distribution in uterus and cervix, with the exception of the glandular epithelium, absent in the cervix. Uterine ORs were localized in endometrial luminal and glandular epithelia, transmural vascular endothelium, sub-epithelial and peri-glandular stromal cells and myometrial smooth muscle cells. The OR labeling intensity was consistently greatest in the vascular endothelium. Real-time qPCR showed a higher OR gene expression in myometrium compared to cervix (P = 0.001) and endometrium (P = 0.009). There was no difference in OR gene expression between cervix and endometrium (P = 1.0). Oxytocin receptor gene expression was significantly higher during the non-luteal phase in both combined uterine tissues (endometrium and myometrium) and myometrium. Oxytocin receptor distribution and gene expression were not influenced by a mare's age or endometrial biopsy score. As endometrial biopsy score and mare age were not predictors of OR gene expression, deficient OR gene expression is unlikely to be associated with DUC.http://www.theriojournal.com2019-10-15gl2018Companion Animal Clinical StudiesParaclinical SciencesProduction Animal StudiesVeterinary Tropical Disease

The Importance of Public Policy for Labour Standards in Apparel and Footwear Global Production Networks

The impact and efficacy of private governance on international labour standards remain variables which are extremely difficult to estimate, let alone measure. The debate surrounding relevant impact factors focusses on two main areas: the study of environmental variables regarding social and economic upgrading on the one hand, and the analysis of firm- and value-chain specific characteristics on the other hand. Both discourses aim at framing the success or failure of private governance initiatives in a more meaningful way. I argue in this paper that it is however only the combination of these two areas which can lead to a complete understanding of governance effects towards global labour standards. Using a dataset of over 1000 encoded tracking charts of the Fair Labour Association in the apparel- and footwear industry, this article examines in how far the success of private governance is dependent on the national regulatory system of supplier- and buyer-countries. Institutional variables are used to establish benchmark differences of compliance within national regulatory systems, whereas a deep-dive into some distinctive national cases within the data serves a more thorough qualitative understanding of regulatory systems. With this, the article aims to answer the following questions: Is there evidence indicating that certain national regulatory systems are more or less decisive for the success of private governance, and how do private and public governance interact? Is there a buyer related country-of-origin effect? And finally, in how far does international public regulation interact with the relationship between public and private governance

Firm Characteristics, Compliance and the Private Governance of Global Labour Standards

The impact and efficacy of private governance on international labour standards remain variables which are extremely difficult to estimate, let alone measure. The debate surrounding relevant impact factors focusses on two main areas: the study of environmental variables regarding social and economic upgrading on the one hand, and the analysis of firm-specific characteristics on the other hand. Both discourses aim at framing the success or failure of private governance initiatives in a more meaningful way. This paper aims to especially contribute to the latter debate, regarding buyer company characteristics, while also taking environmental variables into account which stem from the former debate. It will do so by observing and comparing relevant structural developments from an original, time sensitive data-set built from over 1000 encoded tracking charts of the Fair Labour Association, substituted with relevant buyer-company information on the one hand and selected economic indicators of production countries on the other hand. While the FLA data-set has its clear limitations, it nonetheless paints an interesting picture of compliance structures and the impact of private governance codes over an aggregate of factories and countries. Focussing on the Apparel, Sports- and Footwear industry, this article structures implicated impacts of the FLA data by company characteristics, while also controlling for economic indicators of the production countries. Central questions I focus on are therefore: Which are the main structural components of compliance regarding corporate characteristics shown by the FLA data, and are they conclusive with previous findings? Is there evidence indicating that certain types of company characteristics, such as value chain structures or brand recognition, are indeed decisive for the improvement of labour standards? Can we make out indications of country-of-origin effects? And finally, are there institutional environments conducive or obstructive to these effects

Business in times of crisis

Government bailouts of corporate sectors in the COVID-19 crisis are part of a tripartite arrangement between government, business and institutional investors. Business should respond to the changing preferences of customers, employees and societies by identifying value propositions that justify the provision of risk capital by institutional investors. Critical to this is the determination and implementation of corporate purposes by owners and board directors that focus on inter-generational horizons. Family owners are particularly well placed to do this, but institutional investors need to make it part of their stewardship function as well. Measurement is key and significant reforms are required in the areas of accounting, valuation and reporting. Consistent with these observations, companies that had strong environmental, social and governance records performed better during the initial stages of the crisis, as did family owned firms and those that avoided high levels of leverage prior to the crisis

Cutting edge: inhibition of IL-6 trans-signaling protects from Malaria-induced lethality in mice

Copyright © 2012 by The American Association of Immunologists, Inc

Simulation der Kohlenstaubverbrennung und Durchfuehrung von Vergleichsrechnungen fuer Kraftwerksfeuerungen Abschlusskolloquium

Simulation of industrial furnaces is one of the main applications of the CFD software KIVA that was developed in the context of the CRAY-TECFLAM project. Models for simulation of coal dust combustion have been integrated in the code. The new software was validated by experiments on a continuous dry brown coal flame of the coal dust fuelled experimental facility at IVD Stuttgart and a coal-fuelled power plant boiler produced by Messrs. L and C Steinmueller. In both cases, simulation calculations were carried out using both KIVA and the AIOLOS simulation code developed by IVD Stuttgart. The results are compared with each other and with measured valuesEin Hauptanwendungsgebiet der im Rahmen des CRAY-TECFLAM-Projekts entwickelten CFD-Software KIVA stellt die Simulation von industriellen Kraftwerksfeuerungen dar. Hierzu wurden die im Rahmen der AG TECFLAM am IVD Stuttgart entwickelten Teilmodelle zur Simulation der Kohlenstaubverbrennung in den Code integriert. Dabei handelt es sich um einen vierstufigen Ansatz zur Beschreibung der heterogenen Reaktionen waehrend der Pyrolyse und des Koksabbrandes sowie der homogenen Reaktionen beim Abbrand der fluechtigen Kohlenwasserstoffe und des Kohlenmonoxids. Bei der Pyrolyse, deren Reaktionsrate mit einem Arrhenius-Ansatz berechnet wird, werden die fluechtigen Bestandteile der Rohkohle freigesetzt. Der zurueckbleibende aschehaltige Kokskern reagiert mit Sauerstoff zu Kohlenmonoxid. Der Reaktionsfortschritt des Koksabbrandes wird zum einen limitiert durch die Diffusion von Sauerstoff zur Kornoberflaeche bzw. der Reaktionsprodukte in entgegengesetzter Richtung und zum anderen durch die Kinetik des chemischen Umsatzes, die wiederum mit einem Arrhenius-Ansatz beschrieben wird. Die Umsatzraten der homogenen Reaktionen werden aus Wirbelzerfallsmodellen bestimmt. Zur Validierung der in die neu entwickelte Software integrierten Modelle wird zunaechst eine ungestufte Trockenbraunkohleflamme der Kohlenstaub-Versuchsanlage des IVD Stuttgart herangezogen. Fuer diese Flamme liegen Messwerte der Temperatur und O_2-Konzentration auf mehreren Ebenen als Profile ueber den Radius der zylindrischen Brennkammer vor. Als weiterer Validierungsfall dient ein mit Steinkohle gefeuerter Kraftwerkskessel, dessen Feuerraum als Wandfeuerung mit sechs Drallbrennern auf drei Ebenen ausgefuehrt ist. Hierfuer wurden vom Kesselhersteller, der Fa. L. und C. Steinmueller, Messwerte der mittleren Temperatur ueber der Feuerraumhoehe zur Verfuegung gestellt. Fuer beide Testfaelle wurden Simulationsrechnungen sowohl mit KIVA als auch mit dem am IVD Stuttgart entwickelten Simulationsprogramm AIOLOS durchgefuehrt. Die Ergebnisse werden in Hinblick auf die Uebereinstimmung mit den Messwerten miteinander verglichen. (orig.)SIGLEAvailable from TIB Hannover: DtF QN1(75,60) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

The functional - 1019C/G HTR1A polymorphism and mechanisms of fear

Serotonin receptor 1A gene (HTR1A) knockout mice show pronounced defensive behaviour and increased fear conditioning to ambiguous conditioned stimuli. Such behaviour is a hallmark of pathological human anxiety, as observed in panic disorder with agoraphobia (PD/AG). Thus, variations in HTR1A might contribute to neurophysiological differences within subgroups of PD/AG patients. Here, we tested this hypothesis by combining genetic with behavioural techniques and neuroimaging. In a clinical multicentre trial, patients with PD/AG received 12 sessions of manualized cognitive-behavioural therapy (CBT) and were genotyped for HTR1A rs6295. In four subsamples of this multicentre trial, exposure behaviour (n = 185), defensive reactivity measured using a behavioural avoidance test (BAT; before CBT: n = 245; after CBT: n = 171) and functional magnetic resonance imaging (fMRI) data during fear conditioning were acquired before and after CBT (n = 39). HTR1A risk genotype (GG) carriers more often escaped during the BAT before treatment. Exploratory fMRI results suggest increased activation of the amygdala in response to threat as well as safety cues before and after treatment in GG carriers. Furthermore, GG carriers demonstrated reduced effects of CBT on differential conditioning in regions including the bilateral insulae and the anterior cingulate cortex. Finally, risk genotype carriers demonstrated reduced self-initiated exposure behaviour to aversive situations. This study demonstrates the effect of HTR1A variation on defensive behaviour, amygdala activity, CBT-induced neural plasticity and normalization of defence behaviour in PD/AG. Our results, therefore, translate evidence from animal studies to humans and suggest a central role for HTR1A in differentiating subgroups of patients with anxiety disorders