Healthcare employment as a risk factor for functional neurological disorder: A case-control study.

BACKGROUND AND PURPOSE Female gender, younger age and stressful life events are known predisposing factors for functional neurological disorders (FNDs). Employment in a healthcare profession has also been suggested to be a predisposing factor. We set out to conduct a large-scale case-control study to estimate the rate employment in a healthcare profession among people with FND. METHODS We included 200 consecutive patients with a confirmed diagnosis of FND, referred to our clinic at University Hospital Bern Switzerland between October 1, 2016, and August 1, 2019. In addition, we included a control group of 200 patients with a confirmed neurological disorder, matched for age and gender, seen during the same period. The primary endpoint was to compare the prevalence of healthcare professionals between the groups. We also describe the clinical manifestations and concomitant psychiatric diagnoses in the FND cohort. RESULTS Female gender was predominant (70%), and the participants' mean age was 37 years. The proportion of healthcare professionals in the FND patients was 18% (33/186), which was significantly higher than in the control group, in which it was 10.6% (17/189; p = 0.019, 95% confidence interval odds ratio 1.168-4.074). Most healthcare professionals in both cohorts were nurses (21/33 among FND patients, 10/17 among controls). Among FND patients, 140 (70%) had motor symptoms and 65 (32.5%) had a concomitant psychiatric diagnosis. CONCLUSION This case-control study confirmed a higher rate of employment in healthcare professions in patients with FND, suggesting two potential mechanisms of FND: exposure to models/specific knowledge about neurological symptoms or stress-related professional factors. This warrants further studies on underlying mechanisms and prevention

ESPECIFICIDADES NO CUIDADO AO NEONATO COM FISSURA LABIOPALATINA DURANTE O ALEITAMENTO MATERNO

OBJECTIVE: To emphasize and describe the need for specific care in the care of newborns with cleft lip and palate during breastfeeding. METHOD: The present work consists of an integrative literature review, in this sense, 6 methodological steps were stipulated that were followed in order to carry out the study, the filter used for the searches were with the descriptors: Neonate, Breastfeeding and Cleft Palate. RESULTS: The final sample consisted of 8 studies that resulted in the following categories for discussion: The role of the health professional in supporting breastfeeding and Specific care when breastfeeding babies with cleft palates. CONCLUSION: It was possible to conclude that it is extremely important that the nursing mother is advised on specific care when breastfeeding a baby with a cleft, taking into account the difficulties presented during breastfeeding.OBJETIVO: Enfatizar e descrever a necessidade de cuidados específicos no cuidado ao neonato com fissura labiopalatina durante o aleitamento materno. MÉTODO: O presente trabalho consiste em uma revisão de literatura integrativa, neste sentido, foram estipuladas 6 etapas metodológicas que foram seguidas ordenadamente para a realização do estudo, o filtro utilizado para as buscas foram com os descritores:  Neonato, Aleitamento Materno e Fissura Palatina. RESULTADOS: A amostra final foi constituída por 8 estudos que resultaram nas seguintes categorias para discussão:  O papel do profissional de saúde no apoio ao aleitamento materno e Cuidados específicos no aleitamento de bebês com fenda palatina. CONCLUSÃO: Foi possível concluir que é de extrema importância que a lactante seja orientada sobre os cuidados específicos durante a amamentação do bebê com fissura, levando em consideração as dificuldades apresentadas durante o aleitamento

Evaluation of Probabilistic Site-Specific Seismic-Hazard Methods and Associated Uncertainties, with Applications in the Po Plain, Northern Italy

Site-specific ground motion hazard assessed by a PSHA one-step approach that handles a single-site sigma and its uncertainties and uses a simple logic tree, is compared with a two-step approach that includes bedrock motion evaluation and wave propagation through a local soil profile with consideration of the main epistemic uncertainties. The one-step analysis relies on accelerometer data from the Po Plain, a sedimentary basin in Northern Italy where an earthquake sequence with two Mw ~6.0 events occurring in 2012 was extensively recorded. UH spectra on soil and exposed bedrock are evaluated at three deep-soil accelerometer sites (MRN, NVL and T0821), using residual measures available from other studies, by which uncertainties in site terms (S2S) and single-site sigma (ss,s) are estimated. Despite similarity in geologic conditions, at least one out of three sites displays in the one-step analysis substantial differences in mean level (T0821) or in the (84-16) percentile spread (NVL), depending on differences in site terms and single-site sigma, possibly caused by source-to site propagation effects. The two-step approach was applied to the single MRN site using as excitation carefully selected and broadband-matched acceleration signals and linear, equivalent-linear and nonlinear approaches in propagation analyses, finding that assumptions on soil degradation curves dominate the variability of results. The linear approach provided the best results, based on: (i) the similarity of the one-step non-ergodic UHS with the two-step result based on the linear approach; (ii) the comparison with observed records at MRN during the 2012 sequence mainshocks, showing PGA and short period spectral levels well beyond those predicted by different non-linear assumptions; (iii) a similar evidence from a set of 21 stations at deep soil sites of the Japanese Kik-net

Updated predictive equations for broadband (0.01-10s) horizontal response spectra and peak ground motions, based on a global dataset of digital acceleration records

Presented herein is an updated model for empirical prediction of 5%-damped elastic response spectra in the period range 0-10s, peak ground acceleration and velocity, based on a global dataset of digital acceleration records. The predictive model features saturation of the shaking parameters with both magnitude $$M_{W}$$ M W and distance $$R_{ RUP }$$ R R U P , magnitude-dependent distance attenuation, alternative parameterisations of the amplification effects due to local site conditions (based either on ground types or $$V_{S,30}$$ V S , 30 ) and corrective terms for style-of-faulting. The calibration dataset comprises more than $$1{,}880\times 2$$ 1 , 880 × 2 orthogonal horizontal accelerometer records with $$R_{ RUP }< 150$$ R R U P < 150 km from 98 global earthquakes with $$4.5\le M_{W}\le 7.9$$ 4.5 ≤ M W ≤ 7.9 . The processing technique applied to the acceleration data optimises the reliability of the predictions at long periods, as required by displacement-based design techniques. Developed independently of the recent NGA-West2 and RESORCE-based models, the new predictive tool effectively contributes to capturing the epistemic uncertainties associated with the prediction of seismic shaking levels for engineering applications

Updated predictive equations for broadband (0.01–10 s) horizontal response spectra and peak ground motions, based on a global dataset of digital acceleration records

Presented herein is an updated model for empirical prediction of 5 %-damped elastic response spectra in the period range 0–10 s, peak ground acceleration and velocity, based on a global dataset of digital acceleration records. The predictive model features saturation of the shaking parameters with both magnitude and distance , magnitude-dependent distance attenuation, alternative parameterisations of the amplification effects due to local site conditions (based either on ground types or ,30) and corrective terms for style-of-faulting. The calibration dataset comprises more than 1,880×2 orthogonal horizontal accelerometer records with <150 km from 98 global earthquakes with 4.5≤≤7.9. The processing technique applied to the acceleration data optimises the reliability of the predictions at long periods, as required by displacement-based design techniques. Developed independently of the recent NGA-West2 and RESORCE-based models, the new predictive tool effectively contributes to capturing the epistemic uncertainties associated with the prediction of seismic shaking levels for engineering applications.ISSN:1570-761XISSN:1573-145

Numerical prediction of low-frequency ground vibrations induced by high-speed trains at Ledsgaard, Sweden

none5R. Paolucci; A. Maffeis; L. Scandella; M. Stupazzini; M. VaniniPaolucci, Roberto; Maffeis, Andrea; L., Scandella; Stupazzini, Marco; Vanini, Manuel

On the reliability of long-period response spectral ordinates from digital accelerograms

Using records from co-located broad-band and digital strong motion instruments, it is first shown that the displacement waveforms obtained by double integration of the accelerogram need not be free of unrealistic baseline drift to yield reliable spectral ordinates up to at least 10 s. Secondly, to provide objective criteria for selecting reliable digital strong motion records for ground motion predictions at long periods, a set of synthetic accelerograms contaminated by random long period noise has been used and the difference between the original accelerograms and the spurious ones in terms of response spectra has been quantified, by introducing a noise index that can be easily calculated based on the velocity waveform of the record. The results of this study suggest that high-pass filtering the digital acceleration record from a cut-off period selected to suppress baseline drifts on the displacement waveform appears to be in most cases too conservative and unduly depletes reliable information on long period spectral ordinates

Genetic and phenotypic attributes of splenic marginal zone lymphoma

Altres ajuts: Swiss Cancer Research, ID 3746, 4395, 4660, and 4705; Swiss National Science Foundation, IDSplenic marginal zone B-cell lymphoma (SMZL) is a heterogeneous clinico-biological entity. The clinical course is variable, multiple genes are mutated with no unifying mechanism, and essential regulatory pathways and surrounding microenvironments are diverse. We sought to clarify the heterogeneity of SMZL by resolving different subgroups and their underlying genomic abnormalities, pathway signatures, and microenvironment compositions to uncover biomarkers and therapeutic vulnerabilities. We studied 303 SMZL spleen samples collected through the IELSG46 multicenter international study (NCT02945319) by using a multiplatform approach. We carried out genetic and phenotypic analyses, defined self-organized signatures, validated the findings in independent primary tumor metadata and in genetically modified mouse models, and determined correlations with outcome data. We identified 2 prominent genetic clusters in SMZL, termed NNK (58% of cases, harboring NF-κB, NOTCH, and KLF2 modules) and DMT (32% of cases, with DNA-damage response, MAPK, and TLR modules). Genetic aberrations in multiple genes as well as cytogenetic and immunogenetic features distinguished NNK- from DMT-SMZLs. These genetic clusters not only have distinct underpinning biology, as judged by differences in gene-expression signatures, but also different outcomes, with inferior survival in NNK-SMZLs. Digital cytometry and in situ profiling segregated 2 basic types of SMZL immune microenvironments termed immune-suppressive SMZL (50% of cases, associated with inflammatory cells and immune checkpoint activation) and immune-silent SMZL (50% of cases, associated with an immune-excluded phenotype) with distinct mutational and clinical connotations. In summary, we propose a nosology of SMZL that can implement its classification and also aid in the development of rationally targeted treatments