Effect of pulsed methylprednisolone on pain, in patients with HTLV-1-associated myelopathy

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is an immune mediated myelopathy caused by the human T-lymphotropic virus type 1 (HTLV-1). The efficacy of treatments used for patients with HAM/TSP is uncertain. The aim of this study is to document the efficacy of pulsed methylprednisolone in patients with HAM/TSP. Data from an open cohort of 26 patients with HAM/TSP was retrospectively analysed. 1g IV methylprednisolone was infused on three consecutive days. The outcomes were pain, gait, urinary frequency and nocturia, a range of inflammatory markers and HTLV-1 proviral load. Treatment was well tolerated in all but one patient. Significant improvements in pain were: observed immediately, unrelated to duration of disease and maintained for three months. Improvement in gait was only seen on Day 3 of treatment. Baseline cytokine concentrations did not correlate to baseline pain or gait impairment but a decrease in tumour necrosis factor-alpha (TNF-α) concentration after pulsed methylprednisolone was associated with improvements in both. Until compared with placebo, treatment with pulsed methylprednisolone should be offered to patients with HAM/TSP for the treatment of pain present despite regular analgesia

FWM-based wavelength conversion of 40 Gbaud PSK signals in a silicon germanium waveguide

We demonstrate four wave mixing (FWM) based wavelength conversion of 40 Gbaud differential phase shift keyed (DPSK) and quadrature phase shift keyed (QPSK) signals in a 2.5 cm long silicon germanium waveguide. For a 290 mW pump power, bit error ratio (BER) measurements show approximately a 2-dB power penalty in both cases of DPSK (measured at a BER of 10-9) and QPSK (at a BER of 10-3) signals that we examined

Rancang Bangun Aplikasi Pemetaan Gedung Universitas Palangka Raya pada Sub. Bag Barang Milik Negara (Bmn) Buk Universitas Palangka Raya

Sub. BagianBarang Milik Negara (BMN) Universitas Palangka Raya masih menggunakan sistemyang di anggap kurang efektif dan efisien. Data gedung, ruangan, barang dan kendaraan miliknegara yang masih disimpan dalam bentuk laporan excel, yang bias saja kemungkinan dapat hilangdan apabila data tersebut telah disimpan dalam computer hal itu tidak menunjang kemudahanpengolahan data untuk dapat digunakan dan dicetak pada sebuah laporan. Rancangan penelitianyang dibuat terdiri atas tiga tahap yaitu: (1) pengumpulan dan analisis data yang dilakukan dengancara studi pustaka dan observasi, (2) menerapkan metode waterfall yang sudah dimodifikasi dengantahap-tahapnya adalah analisis system,(3) pemodelan proses bisnismenggunakan DFD, danantarmuka, (4) implementasi menggunakan PHP dan Mysql sebagai database untuk menyimpandata. Selanjutnya pada tahapan testing Aplikasi ini menggunakan metode Black Box. Hasilpenelitian adalah aplikasi pemetaan gedung Universitas Palangka Raya pada Sub. BMN UniversitasPalangka Ray

Technological Monitoring on Recycled Paper

The origin of the papermaking took place in China in the year 105 (d.C), its creator, Ts'ai Lun used a process of disintegration of fibers of various materials which resulted in the final product called paper. The discovery of this product has brought humanity several benefits. As important as water and energy, paper, has become an indispensable product in our daily life, everything that is seen, touched and used, paper is constantly present, so much is its use on a world scale that there was a concern of as we would do so that this product could be reused to avoid an environmental catastrophe, polluting our ecosystem. After Law 12,305, the Brazilian National Solid Waste Policy - PNRS sanctioned in 2010, there was a marked increase in the selective collection of this material and a high stimulus to the consumption of recycled paper. The PNRS obliges all public agencies to consume recycled material and demand is increasing, the price of recycled paper tends to fall a lot and finally paper recycling becomes one of the best investments of the sector in Brazil. Nowadays, the paper is manufactured from the extraction of cellulose, through the recycling process. Cellulose can be obtained from any fibrous material, but only a few tree species have the appropriate quality and purity. In Brazil, the most appropriate species for paper production are eucalyptus and pine. Although recycling is considered the core of a circular economy for the return of materials to the supply chain, its procedures are poorly understood. Waste recycling is considered a major source of energy savings and a promoter of CO2 recovery. In addition, it generates jobs and changes markets around the world. This article presents a technological prospection of patent deposits that use paper recycling, as key words were used recycled paper. For the search of patents, the Espacenet database was used, obtaining a total of 244 patent documents, from 1980 to 2017. The results show that the year 2014 obtained the largest number of patent deposits, 17 records. The countries holding patents on recycling are Germany with 47 patent documents, China with 46, the United States with 42, Japan with 40. In short, patent applications in this technology branch have much to grow around the world , since the recycling industry has a high potential to generate innovation, making it an indispensable business in developed economies

Regulating the mobility of Cd, Cu and Pb in an acid soil with amendments of phosphogypsum, sugar foam, and phosphoric rock

11 pages, figures, and tables statistics.When acid soil has been contaminated by metals as a result of industrial discharges, accidental spills, or acid mine drainage it may be desirable to retain the metals in the soil rather than allow them to leach away. We have investigated the potential of phosphogypsum (PG), sugar foam (SF), and phosphoric rock (PR) to regulate the availability and mobility of Pb, Cd and Cu. We have also identified changes in attenuation during incubation for 1 year and the effect of aging on metal speciation in amended soils. We studied miscible displacement in columns of undisturbed soil previously treated with solutions of the amendments and soluble metals and, subsequently, single and sequential chemical metal extractions. All amendments increased the soil’s metal retention capacity. This, in turn, increased the amount of metal extractable by diethylenetriaminepentaacetic acid (DTPA). However, over time the amounts of DTPAextractable metal decreased, particularly for Cu and Pb. Both Cu and Cd were held preferentially within the acetic acid-extractable fraction (operationally defined exchangeable fraction – EX fraction), whereas Pb was associated mainly with the hydroxylammonium-extractable fraction (operationally defined bound to Fe and Al hydroxides – OX fraction). Both Pb and Cu in the oxide and organic fractions increased in the PG- and SF-treated soils. In general, the distribution of metal did not change in the PR-treated columns after the incubation. Finally, scanning electron microscopy in back-scattered electron mode (SEM–BSE) showed the formation of Al-hydroxy polymers which provides the soils with additional cation sorption capacity. In the PG- and PR-treated columns, P and S were associated with these formations. The three metals were associated with the Al polymers, probably through direct coordination or the formation of ternary complexes with the inorganic ligands phosphate and sulphate.This research was supported by the Spanish Ministry of Science and Technology within the framework of the research project AGL2002-04545-C03-01. We are especially grateful to Laura Barrios for her assistance in the statistical treatment of the data, to Fertiberia, S.A. and Azucarera Ebro, S.L. for supplying us with samples of phosphogypsum and sugar foam, respectively, and to Guoping Lu, anonymous referees and the Editors for their review and comments.Peer reviewe

Pre‐service teacher training and special educational needs in England 1970–2008: is government learning the lessons of the past or is it experiencing a groundhog day?

The paper outlines the findings from a literature review of the English government’s response to the issue of training pre‐service teachers in the delivery of effective special educational needs support. The review’s findings detail that although educational practice in mainstream classrooms has changed considerably since the 1970s the training of pre‐service teachers with regards to special educational needs has seemingly changed very little. The paper argues that the government needs to re‐think radically its policy of inclusion to ensure that a coherent plan is formulated which enables higher education institutions’ initial teacher training programmes to train students who are competent and confident in their abilities to work with children with special educational needs and/or disabilities

Physician decision making in selection of second-line treatments in immune thrombocytopenia in children.

Immune thrombocytopenia (ITP) is an acquired autoimmune bleeding disorder which presents with isolated thrombocytopenia and risk of hemorrhage. While most children with ITP promptly recover with or without drug therapy, ITP is persistent or chronic in others. When needed, how to select second-line therapies is not clear. ICON1, conducted within the Pediatric ITP Consortium of North America (ICON), is a prospective, observational, longitudinal cohort study of 120 children from 21 centers starting second-line treatments for ITP which examined treatment decisions. Treating physicians reported reasons for selecting therapies, ranking the top three. In a propensity weighted model, the most important factors were patient/parental preference (53%) and treatment-related factors: side effect profile (58%), long-term toxicity (54%), ease of administration (46%), possibility of remission (45%), and perceived efficacy (30%). Physician, health system, and clinical factors rarely influenced decision-making. Patient/parent preferences were selected as reasons more often in chronic ITP (85.7%) than in newly diagnosed (0%) or persistent ITP (14.3%, P = .003). Splenectomy and rituximab were chosen for the possibility of inducing long-term remission (P < .001). Oral agents, such as eltrombopag and immunosuppressants, were chosen for ease of administration and expected adherence (P < .001). Physicians chose rituximab in patients with lower expected adherence (P = .017). Treatment choice showed some physician and treatment center bias. This study illustrates the complexity and many factors involved in decision-making in selecting second-line ITP treatments, given the absence of comparative trials. It highlights shared decision-making and the need for well-conducted, comparative effectiveness studies to allow for informed discussion between patients and clinicians

‘Your CV looks amazing but I am sorry, you didn’t get the job’: analysing experiences of global majority physiotherapists aspiring to and working at consultant level practice in the UK

Introduction: Effective leadership shapes organisational culture to deliver world class healthcare. Racially minoritised individuals rarely access opportunities leading to leadership positions. This paper expands on themes from qualitative research which explored experiences of qualified physiotherapists from racially minoritised backgrounds aspiring to (or working at) consultant level and codesigned recommendations that challenge inequitable practices which perpetuate unearned privilege. Methods: The study used critical discourse analysis to understand the experiences of aspirants. Participants were recruited purposively using snowball sampling via professional diversity networks and social media. Semistructured interviews were conducted remotely. Externally facilitated focus groups supported cocreating research outcomes and strategies for action. Secondary analysis extends our initial analysis to focus on two themes, critically considering these in the context of the role of leadership. Results: Data drawn from 17 participants from self-identified racialised groups who were either in consultant level positions, or aspiring to be, were included in secondary analysis. Analysis identified structural racism as an enduring social wrong, existing within different levels of organisations. Managerial ‘gatekeepers’ created barriers to career progression by not recognising skills, knowledge and experience. Pathways to career progression were hidden and unwieldy, operated by managers in ways that restricted leadership opportunities disproportionately to white peers. These challenges created a sense of ‘un-belonging’ resulting in negative health impacts. Conclusion: Gatekeepers maintaining racist cultural practices and policies were key in upholding the hegemonic status quo. Collective strategies enabled a sense of ontological belonging and empowerment for participants and may be helpful for those experiencing similar concerns in their workplaces