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La pandemia COVID-19 ha impuesto una nueva realidad a los movimientos sociales y la participación ciudadana, al prohibir y restringir las protestas sociales y las manifestaciones en las calles, acciones tradicionales de los movimientos sociales. En este escenario se revigora el ciberactivismo o activismo digital, que tiene en la información el principal eje para tomar decisiones. Este artículo analiza el papel de los movimientos sociales durante los primeros meses de la pandemia COVID-19 a partir del contenido informativo del activismo digital de los movimientos sociales portugueses: União de Mulheres Alternativa e Resposta - UMAR y Casa do Brasil de Lisboa - CBL. A partir de la revisión de la literatura y siguiendo los preceptos metodológicos del Análisis de Contenidos, los resultados obtenidos indican que tanto UMAR como CBL ejercieron, fundamentalmente, un activismo digital centrado en redes de solidaridad y de apoyo mutuo, algo que estaba ya establecido en la trayectoria de actuación de cada movimiento. Los movimientos sociales continuaron usando la información para crear y fortalecer lazos, protestar, construir y difundir conocimiento y monitorear las acciones gubernamentales y sus políticas públicas. El reciente episodio de la pandemia mostró que aún quedan muchos desafíos por superar, pero las perspectivas son muy prometedoras para el activismo digital.

Are plateforms like Twitter or Facebook exercising a new kind of censorship? The deletion of Donald Trump’s Twitter account, following the Capitol riot, is the most recent episode in a long-term debate about the role of online platforms, and shows the need to adapt the law.

BACKGROUND: As the landscape of medical education evolves with emerging technologies and the COVID-19 pandemic, e-learning platforms continue to gain popularity. Orthopaedic podcasts, a burgeoning e-learning platform, continue to gain traction; however, there is a paucity of information regarding their coverage of topics and their distribution over time. Therefore, our analysis sought to (1) characterize podcast content related to orthopaedic surgery, and (2) evaluate the changes in the prevalence of orthopaedic podcasts over the past 15 years. METHODS: Three common podcasting platforms (Apple Podcasts, Google Podcasts, and Spotify) were queried using the key terms "orthopaedic," "orthopedic," and "ortho" in order to identify a list of podcasts that are related to orthopaedic surgery. For each unique orthopaedic podcast, the title, the show description, the number of episodes, the date of the first episode, the date of the most recent episode, and episode frequency were collected. Podcasts were then classified based on a predetermined list of podcast domains. The number of existing active (released within the last 3 months) orthopaedic podcasts was then trended on a monthly basis from 2011 to 2020. RESULTS: Ninety-four unique podcasts met inclusion criteria, 62 of which remained active as of October 25, 2020. The most common podcast domains were "general" (38 [40.4%]) and "clinical knowledge" (20 [21.3%]). Among the assessed podcasts, 90 (95.7%) utilized an exclusively audio format. The majority of podcasts were based in the United States (89.4%), included introductory music (72.3%), and included interviews (63.8%). Most podcast hosts were practicing orthopaedic surgeons (52.1%). Between January 2016 and October 2020, the number of active orthopaedic surgery podcasts grew more than twelvefold (1,240%) at an average rate of roughly 1 new podcast each month (average, 1.0 podcast; standard deviation, 1.8). DISCUSSION: The past decade has seen sizable growth in the number of readily available podcasts related to orthopaedic surgery. Additional research is required to independently assess the quality of these resources and their implications for remote trainee education.

In the context of change in global scenario of terrorism and economic competition, the risk of deliberate attack on agriculture is increasing. In a country, like India, whose economy is largely dependent on agriculture produce and exports, any such malicious attack can grossly destabilise the socio-economic structure. Additionally, an attack on major food crops can lead to potential threat to food security, subsequently, leading to destabilised law and order situation of a state. It is therefore very important to understand the risks and threats of agroterrorism for a given country in order to be prepared for any such circumstance. In this review we discuss different aspects of agroterrorism, its history, possibilities of such incidences in Indian scenario and mitigation strategies, which can be achieved through regular surveillance of pathogens in vulnerable crop ecosystems. We also describe a recent episode of outbreak of cotton leaf curl disease in the Northwest Indian cotton growing region and discuss it from the perspective of a possible threat on one of the most important economic crops of our country.

This article investigates the determinants of Dutch firms’ dividend policies in the twentieth century. We identify three distinct episodes and document shifts in dividend policies in the 1930s and 1980s, because firm managers cater to the changing preferences of shareholders. The first episode, prior to World War II, was characterised by dividends that were fixed contracts between shareholder and management and the payouts were mechanically determined by earnings. The second epoch of Dutch dividend policy, until the 1980s, was characterised by dividend smoothing. Dividends were still strongly related to earnings, but because of shareholder's preferences for stable dividend income, earnings changes are incorporated in dividends with a lag. Finally, dividend policy in the most recent episode is inspired by shareholder wealth maximisation, based on agency and signalling motives. In this period, dividends have become largely decoupled from earnings.

Why was recovery from the euro area crisis delayed for a decade? The explanation lies in the absence of credible and timely policies to backstop financial intermediaries and sovereign debt markets. In this paper we add light and color to this analysis, contrasting recent experience with the 1992–3 crisis in the European Monetary System, when national central banks and treasuries more successfully provided this backstop. In the more recent episode, the incomplete development of the euro area constrained the ability of the ECB and other European institutions to do likewise.

More than a year since we first entered lockdown, much has changed in terms of our working lives, as well as our personal or social lives (https://blogs.bmj.com/bmj/2021/03/23/one-year-on-since-lockdown-began-our-lives-have-changed-but-what-lessons-have-we-learned/). For many, this has led to a change in the dynamic of our work-life balance, as discussed on a recent episode of Sharp Scratch (Listen on Spotify or Apple pods ). In medical school it often feels like there is always a cohort in their own exam season at any given point in the year—and many of you may be receiving results from exams you sat in the winter. Assessments don’t always go the way we might have hoped, and the Sharp Scratch team discussed the taboo surrounding academic failure (Listen on Spotifyor Apple …

Objective: To evaluate the association of dental pain with time living on the street in a sample of homeless people in the city of Porto Alegre, Brazil. Methods: A cross-sectional study was carried out with homeless people who accessed social services in 2017. A questionnaire was administered covering socioeconomic variables and including questions about general health, use of tobacco/alcohol/drugs, use of dental services and history of dental pain. The decayed, missing, and filled teeth (DMFT) index was calculated in an oral examination. The association between socioeconomic characteristics, health status, time of homelessness and dental pain was evaluated using chi-square, t-, and Mann-Whitney tests. Results: A total sample of 214 homeless people was surveyed. Most were male (76.2%), had a low level of education (67.6%) and experienced many episodes of dental pain during life (91.0%). The last episode of pain was moderate or intense (79.7%) and do-it-yourself measures for pain relief were preferred (62.3%). Individuals who were homeless for longer than 1 year had more dental pain in the past (P < 0.001), more frequency of a recent episode of dental pain (P = 0.03), and sought a dentist or healthcare service to relieve pain less frequently (P = 0.03). Conclusions: Dental pain is frequent in the context of homelessness and does not necessarily result in seeking dental services, even where there is universal oral health care.

Context: Neuroleptic malignant syndrome (NMS) has been introduced as a rare but lethal and idiosyncratic reaction to neuroleptics/antipsychotics. The most obvious risk of this syndrome is the use of neuroleptics, especially high-potency ones. Metoclopramide is also known as an anti-nausea medication administered before surgery to manage digestive problems. Evidence Acquisition: Formerly, it had been assumed that metoclopramide was a type of chlorobenzamide that was not in the phenothiazine group but free of extrapyramidal side effects (EPSs). The sequential reports of complications indicate that metoclopramide can cause EPSs and drug-induced motor side effects. A total number of 5044 articles were obtained after the initial search. Then, two researchers independently screened out their titles, and abstracts and 20 articles were finally selected based on the inclusion criteria. Results: Of the 20 articles reporting metoclopramide-induced NMS, treatments had been successful in 16 (80%) cases, but it had led to death in four (20%) patients. There were 11 and 8 male and female patients, respectively, and gender was not mentioned for a patient in one article. The age range of the patients was from six months to 84 years, and the mean age was 50.92 years. Conclusions: Although NMS following metoclopramide intake is reported very rarely, it should be considered for any psychiatric symptoms with unexpected mental changes, muscle rigidity, and fever after being treated with metoclopramide. The neuroleptic malignant syndrome can occur following multiple doses or just one dose of metoclopramide. Also, metoclopramide use in patients affected with kidney failure is accompanied by a higher risk of NMS. A previous history of NMS, a recent episode of catatonia, and severe agitation are all taken into account as risk factors in this domain.

A 78 year-old woman has experienced multiple episodes of transient right third nerve palsy over the course of 15 years and has undergone multiple imaging studies as well as investigations for myasthenia gravis and giant cell arteritis in search for the diagnosis. When seen after the most recent episode, MRI with contrast and Fast-Imaging Employing Steady-State Acquisition protocol revealed a subtle enlargement and enhancement of the cisternal and proximal cavernous portions of the right third cranial nerve. An empiric diagnosis of schwannoma intrinsic to third cranial nerve was made. All patients with cyclical third nerve palsies should have appropriate neuroimaging to rule out subtle structural lesions before other investigations are undertaken.

Although medical debt has been associated with housing instability, almost no research has connected homelessness to medical debt. We interviewed 60 individuals experiencing homelessness in Seattle, selected from those participating in self-governed encampments organized by a homeless advocacy organization. Most respondents reported having at least one kind of debt, with two-thirds reporting current medical debt. Almost half reported trouble paying medical bills for themselves or family members. Almost one-third believed medical debt was in part responsible for their current housing situation. More than half with medical debt incurred this debt while they were covered under insurance. People who had trouble paying medical bills experienced a more recent episode of homelessness 2 years longer than those who did not have such trouble, even after controlling for race, education, age, gender, and health status. People of color who had trouble paying medical bills reported almost 1 year more homelessness than whites.

Objective: To determine whether the time lag between blood culture draw and the start of shaking chills is associated with blood culture positivity. Methods: A prospective observational study was undertaken from January 2013 to March 2015 at a referral center in Okinawa, Japan. All enrolled patients were adults with an episode of shaking chills who were newly admitted to the division of infectious diseases. The study exposure was the time lag between blood culture draw and the most recent episode of shaking chills. Results: Among patients whose blood cultures were obtained within 2 h after shaking chills started, the blood culture positivity was 53.6% (52/97), whereas among patients whose blood cultures were obtained after more than 2 h, the positivity was 37.6% (44/117) (p = 0.019). The adjusted odds ratio of blood culture positivity for samples drawn within 2 h after shaking chills was 1.88 (95% confidence interval 1.01–3.51, p = 0.046). Escherichia coli were the most frequently detected bacteria (58/105). Conclusions: The positivity of blood cultures obtained within 2 h after the start of the most recent shaking chills was higher than that for blood cultures obtained after 2 h. Keywords: Blood culture, Shaking chills, Bacteremia, Sepsis, Shivering

The yellow fever 17D vaccine contains live-attenuated virus. Initial efficacy and safety reports were favorable. Recently, however, neurologic and viscerotropic adverse events (AE) were described. We managed a 61-year-old man who experienced meningomyeloradiculitis 18 days after receiving the yellow fever 17D vaccine. The manifestations were atypical. The cerebrospinal fluid contained high titers of anti-yellow fever immunoglobulins M and G and of anti-flavivirus immunoglobulins G. After methylprednisolone (1 g/day for 3 days), intravenous human immunoglobulins (140 g over 5 days), and two plasma exchanges, the symptoms improved only slightly. Neurological adverse events after yellow fever vaccination are rare or underestimated. To our knowledge, this is the first reported case of meningomyeloradiculitis after yellow fever vaccination. A remarkable feature is the intrathecal production of yellow fever antibodies, which probably played a pathogenic role and may have been related to a recent episode of influenza.

Since February 2016, the equatorial quasi-biennial oscillation (QBO) in zonal wind of the lower stratosphere exhibited anomalous behavior. In more detail, it broke down from its typical pattern and the eastward stratospheric winds unexpectedly reversed to a westward direction. We herewith attempt to detect whether this unprecedented event could be considered as a result of plausible long-range correlations in the QBO temporal evolution. The analyses performed using all the available QBO data sets showed that such an interpretation could not be inferred, because the temporal evolution of the equatorial zonal wind in the lower stratosphere does not exhibit power-law behavior. Further, the natural time analysis of the QBO data indicates precursory behavior before the maximization of the zonal wind velocity and that the recent strong El Nino event might be related with the aforementioned unprecedented behavior.

Several studies have shown that a considerable proportion of horses are eliminated from endurance rides due to lameness and metabolic problems. Limited information is available on specific veterinary issues in endurance horses and there are no descriptive data on veterinary problems in a large population of endurance horses. The aim of this study was to describe veterinary problems occurring in endurance horses in England and Wales, the regions of the United Kingdom where endurance rides are organised and regulated by Endurance Great Britain (Endurance GB). A comprehensive online self-completed questionnaire was used for data collection (30th December 2015-29th February 2016) All members of Endurance GB who were the main rider of one or more endurance horses were eligible to participate. From the target population of 1209 horses, 190 questionnaires were completed by riders, resulting in a 15.7% response rate. The most common rider-reported veterinary problem was lameness, affecting 152/190 (80.0%) of endurance horses at some point during their careers and 101/190 (53.2%) of horses in the previous 12 months. Detailed information on the most recent episode of lameness was available for 147 horses. Seventy-six percent of these lameness episodes (112/147) had been initially identified by a veterinarian, but only 52% of these lameness episodes were investigated further by a veterinarian, despite the high proportion of horses affected by lameness and the proportion of horses with recurrent lameness episodes. The second most common veterinary problem was thoracolumbar region pain, followed by non-specific cough, skin disease and colic. Education of endurance riders may improve the number, quality and timing of veterinary investigations, especially for lameness and thoracolumbar region pain.

During the past three decades the global oil market has seen significant price volatility. Literature to date has not analysed the cross-country effect of the recent episode of price instability. Previous studies have either not considered this period or have not utilised panel data techniques and therefore have not provided a comparative analysis of developed and developing countries. This paper explores the income and price elasticities between these two country groups and discusses the economic implication of the results. We use a panel data analysis accounting for income and price asymmetry and apply the dynamic fixed-effects methodology to separate panels for developed and developing countries for the period 1980–2012. Sixteen countries are included in this analysis which account for over 65% of total global oil consumption. A particular focus is on the income and substitution effects. The results indicate heterogeneous response to oil price shocks. Developing countries have an income effect 6.3 times stronger than developed countries. The substitution effect in developed countries is 2.1 times stronger than in developing countries. Policy recommendations include the pursuing of oil-efficiency improving technology, and ensuring that regional consumption pattern variations are considered in policy formation.

Case summary A 9-year-old male neutered Maine Coon cat presented with a 6-month history of polyphagia and one recent episode of tremors and weakness. Blood work revealed profound hypoglycemia and results of a paired insulin glucose test were consistent with an insulinoma. Abdominal ultrasound revealed a solitary pancreatic mass, and results of a fine-needle aspirate (FNA) gave further support for the location of the neuroendocrine tumor. After unsuccessful medical management of the hypoglycemia, the mass was surgically removed. Immunohistochemistry confirmed that it was an insulinoma. At the time of writing, the patient had been in clinical remission for 9 months. Relevance and novel information Feline insulinomas are rare and there is very little information on their behavior, clinical course and histologic characteristics. This is the first reported case of an insulinoma in a Maine Coon cat and the first to describe results of an ultrasound-guided FNA of the mass. In addition, the progression of disease, histopathology and immunohistochemistry results add to the currently minimal database for feline insulinomas.

Introduction Macroscopic hematuria is considered a significant risk factor for urologic disease, and it is highly prevalent in people with hemophilia. Aim To determine whether prophylactic factor replacement therapy is associated with reduced occurrence of macroscopic hematuria in people with hemophilia in a post hoc analysis using data from a cross‐sectional study conducted by the Age‐Related Developments and Comobordities in Hemophilia (ADVANCE) Working Group that included males with hemophilia ≥40 years of age. Methods Data from 16 contributing centers, in 13 European countries and Israel, were analyzed using logistic regression. Of 532 recruited individuals, this analysis included 370 patients with moderate or severe hemophilia who received on‐demand or prophylactic therapy. Results For patients with a history of macroscopic hematuria, we analyzed the association between prophylaxis and reoccurrence of macroscopic hematuria within the past 5 years (n = 235 patients). Frequent (≥3 times/wk) prophylaxis was negatively associated with a recent episode of macroscopic hematuria (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.18‐0.76). We also analyzed whether prophylaxis corresponded to a lower lifetime number of macroscopic hematuria episodes (n = 285 patients). Frequent prophylaxis for >15 years was associated with a lower number of episodes compared to on‐demand treatment (OR, 0.29; 95% CI, 0.16‐0.54), whereas nonsteroidal anti‐inflammatory drugs (NSAIDs) and severe hemophilia were associated with a higher number. There was no association of prophylaxis

In the preface he wrote to his Elements of the Philosophy of Right, Hegel critically confronts his contemporaries and offers one of the main collaborations on the tasks of philosophy and of philosophers developed in the modern era, defending patience as an unavoidable attribute for philosophical reasoning. The text celebrates its bicentenary in the midst of the Covid-19 pandemic, when not only the virus, but also heated philosophical polemics spread on a global scale. Against the coronavirus outbreak backdrop, the preface's 200th anniversary raises the question: is it possible to do philosophy in the heat of the moment? Induced by this question, we seek to read the Hegelian text facing the diagnosis of present time developed by Günther Anders in his “Theses for the Atomic Age”, in order to reason about the proper time for philosophical reasoning and the difficulties faced by philosophy within a time of emergency, when the coronavirus is just the most recent episode of what Anders characterized as “End-time”. No prefácio que escreveu à sua Filosofia do Direito, Hegel debate criticamente com seus contemporâneos e oferece uma das principais colaborações sobre o papel da filosofia e dos filósofos desenvolvidas na modernidade, defendendo a paciência como atributo indispensável ao fazer filosófico. O texto completa 200 anos em meio à pandemia de Covid-19, quando não apenas o vírus, mas também acaloradas contendas filosóficas se alastram em escala global. Em meio a esse cenário, a comemoração do bicentenário do prefácio traz à tona a pergunta: será que é possível filosofar no calor da hora? Motivados por esta questão, buscamos contrapor a leitura do texto hegeliano ao diagnóstico do tempo presente desenvolvido por Günther Anders, em suas “Teses para a Era Atômica”, a fim de refletir acerca do tempo adequado ao exercício filosófico e das dificuldades enfrentadas pela filosofia em momentos de emergência, quadro em que o coronavírus é apenas o mais recente episódio daquilo que Anders caracterizou como “Tempo do Fim”.

Background Many self-harmers do not present in hospitals due to the self-harm. It is still unclear on the differences between medically treated and untreated self-harm in China. This study described the differences of the two groups of self-harmers using the largest psychological aid hotline data. Methods The present observational study recruited 3,403 hotline callers who reported episodes of self-harm before the call. In routine assessment, information about the most recent episode of self-harm was collected, including the method of self-harm, the wish to die, goals of the self-harm, and any medical treatment (irrespective of psychological services) in the hospital. The callers were divided into two groups: those who received hospital-based medical treatment due to the most recent self-harm (treated self-harm callers) and those who did not (untreated self-harm callers). Results In the most recent episode of self-harm, 65% (n = 2,217) of callers were untreated and 55% (1,226/2,217) of the untreated self-harm callers reported a wish to die. A total of 67% of the callers reported that their main goal of self-harm was to relieve suffering. The most common self-harm methods were using instruments (knife or rope) and overdosing on medicines. Compared with treated self-harm callers, the untreated self-harm callers were less likely to have a wish to die (OR = 0.57), engage in self-harm outside the home (OR = 0.71 and 0.78), and attribute their self-harm to romantic relationship problems (OR = 0.76); however, they were more likely to use instruments, to jump, or to choose other methods (OR = 3.73, 3.83, and 7.71, respectively). Conclusions Among hotline callers, many episodes of self-harm did not receive medical treatment, despite over half reporting a wish to die. Characteristics of self-harm behaviors were different between treated and untreated self-harm callers. Our findings suggest that more strategies should improve access to hospital-based medical treatment and coverage for post-intervention for self-harmers who are not presented in hospitals.

We analyse ALMA observations of the SO($J_K=6_5-5_4$) emission of the circumstellar envelope of oxygen-rich AGB star R Dor, probing distances between 20 and 100 au from the star where the nascent wind is building up. We give evidence for the slow wind to host, in addition to a previously observed rotating disc, a radial outflow covering very large solid angles and displaying strong inhomogeneity both in direction and radially: the former takes the form of multiple cores and the latter displays a radial dependence suggesting an episode of enhanced mass loss having occurred a century or so ago., 13 pages, 17 figures, submitted for publication in MNRAS

We report the case of a 36 year old male who demonstrated extensive high attenuation in the muscles of the chest wall and neck on a noncontrast chest CT. The high attenuation in the musculature was due to calcium, sequela from a recent episode of rhabdomyolysis. Although the diagnosis of rhabdomyolysis is made on clinical grounds, the imaging appearance can be confusing given the variability in appearance of rhabdomyolysis depending on the severity and the timeline of disease.

Aim To explore the prevalence of residual symptoms (both depressive and manic) and their correlates in subjects with bipolar disorder in clinical remission. Methodology This multicentric cross-sectional study included patients in clinical remission recruited across the 14 centers. The patients were evaluated on the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS) for the prevalence of residual symptoms. A score of ≤7 on both scales defined the presence of residual symptoms. Results Four-fifth (79.8%) of the participants had residual symptoms, with 130 (16.8%) having only residual depressive symptoms, 74 (9.6%) having only residual manic symptoms, and 413 (53.4%) having both depressive and manic residual symptoms, on HDRS and YMRS. The residual symptoms were related to the polarity of the most recent episode and the lifetime predominant polarity. Higher numbers of lifetime depressive episodes are associated with higher residual depressive symptoms, and higher numbers of lifetime manic episodes are associated with higher chances of having residual manic symptoms. Conclusions A large proportion of patients with bipolar disorder have residual symptoms during the remission phase. Clinicians need to make efforts to identify and address the same to improve the treatment outcome.

A 7-year-old girl presented with severe pallor, cough, and massive hemoptysis. She had been previously hospitalized twice within the time span of 2 years for severe pallor and hemoptysis, each time requiring 2U of blood transfusion. In the recent episode, blood examination was suggestive of iron deficiency anemia, chest radiograph yielded bilateral pulmonary infiltrate, computed tomography scan of lungs showed ground glass pattern, and bronchoalveolar lavage revealed hemosiderin-laden macrophages. Investigations to exclude any secondary causes of pulmonary hemosiderosis were negative. The child was diagnosed as a case of idiopathic pulmonary hemosiderosis and treated with prednisolone.

The current study examined event-level characteristics (e.g., contextual factors, risk behaviors) during the most recent episode of Molly use among a sample of college students who reported previously using Molly. Participants ( N = 151; 66.7% female) were drinkers aged 18 to 25 years. Data were collected from October to November 2014, February to April 2015, and September to November 2015. Participants completed measures regarding typical Molly use and items related to context and behaviors during their most recent episode of Molly use. Findings revealed that our sample most commonly reported using Molly earlier in the evening while hanging out with friends or at a party. In addition, sexual and other drug use behaviors commonly occurred when using Molly. Findings provide preliminary information in guiding future work exploring Molly use and potential substance-related issues associated with the context of when and how Molly is consumed.

Separate lines of research find that proaggressive attitudes promote peer aggression and that bystanders play a pivotal role in deterring or facilitating bullying behavior. The current study hypothesized that proaggressive attitudes in middle school would deter students from standing up to bullying and encourage them to reinforce bullying behavior. Middle school students (n = 28,765) in 423 schools completed a statewide school climate survey that included an aggressive attitudes scale and their bystander response to a recent episode of bullying, which was categorized as upstanding, reinforcing, or passive. Multilevel logistic regressions indicated that higher aggressive attitudes were associated with less upstanding behavior at the school level and less upstanding behavior and more reinforcing behavior at the individual level, while controlling for other school and student demographic variables. These findings suggest that antibullying programs might address student attitudes toward aggression as a means of boosting positive bystander intervention.

According to the Australian legal profession and media, law schools are producing too many graduates relative to the number of vacancies within the profession. This claim, however, is hardly new. This paper identifies a number of junctions at which there has been concern about the overproduction of law graduates, showing that this discourse appears during periods of major economic stress. It also shows that until the most recent episode of concern, the perception that there are too many law graduates relative to employment opportunities has not been supported by empirical evidence. In the past, the increasing supply of law graduates has been met with increasing demand. However, the legal profession is now facing unprecedented market competition and restructure, and opportunities in the profession for new graduates have declined. This still does not mean that the law schools are producing too many graduates. The current cohort of graduates is likely to continue into a professional occupation, altho...

A perimenopausal woman presented with a single recent episode of heavy vaginal bleeding and low hemoglobin level. She has been, however, spotting off and on for the last several years. On examination an ulcerated polypoid lesion was identified protruding through the external os. The lesion raised a clinical suspicion of an adenosarcoma in this perimenopausal patient. The current report describes this rare entity, documents the gross and microscopic features which may mimic adenosarcoma of the mullerian system. Keywords: Giant endocervical polyp, Adenosarcoma

In this paper we investigate the impact of changes in proved reserves on U.S. stock returns using firm level data of the largest U.S. oil and gas companies. The selected sample covers the period 2009 to 2018 incorporating the recent episode of the shale oil and gas revolution. In contrast to previous studies, our results show that changes in proved oil and gas reserves have no significant effect on stock returns. We also give evidence of the impact of reserves on financial returns being dependent on the level of oil prices. Since oil prices fell abruptly after 2014, we show a significantly lower effect of oil reserves in stock returns in this subperiod and, thus, partly explain the overall insignificant effect.

This study explores the most recent episode in the evolution of audit technology, namely the incorporation of Big Data and Data Analytics (BDA) into audit firm approaches. Drawing on twenty-two interviews with individuals with significant experience in developing, implementing or assessing the impact of BDA in auditing, together with publicly available documents on BDA published within the audit field, the paper provides a holistic overview of BDA-related changes in audit practice. In particular, the paper focuses on three key aspects, namely: the impact of BDA on the nature of the relationship between auditors and their clients; the consequences of the technology for the conduct of audit engagements; and the common challenges associated with embedding BDA in the audit context. The study’s empirical findings are then used to establish an agenda of areas suitable for further research on the topic. The study is one of the first empirical accounts providing a perspective on the rise of BDA in auditing.

This paper investigates the determinants of Dutch firms’ dividend policies in the 20th century. We identify three distinct episodes and document shifts in dividend policies in the 1930s and 1980s, because firm managers cater to the changing preferences of shareholders. The first episode, prior to the Second World War, was characterized by dividends that were fixed contracts between shareholder and management and the payouts were mechanically determined by earnings. The second epoch of Dutch dividend policy, until the 1980s, was characterized by dividend smoothing. Dividends were still strongly related to earnings, but because of shareholder’s preferences for stable dividend income, earnings changes are incorporated in dividends with a lag. Finally, dividend policy in the most recent episode is inspired by shareholder wealth maximization, based on agency and signalling motives. In this period, dividends have become largely decoupled from earnings.

The present work investigated episodic memories to identify influences on healthiness of everyday eating episodes carried out by members of the public. The sample included 128 healthy weight undergraduate students from an urban locality in midlands Mexico. Participants reported a recent episode when they ate either healthy or unhealthy food and what influenced them to eat that way. Reported influences were categorised and counted for testing differences in mentions between episodes of healthy and unhealthy eating. The most commonly reported influences on healthy eating episodes concerned wellbeing and weight control. The main reported influences on unhealthy eating episodes were food liking, hunger and convenience. The findings extend our understanding on the most prominent influences on eating choices, which could be useful for tailoring interventions to increase healthy eating and decrease unhealthy eating.

The first phase of an intervention on obsessive-compulsive disorder (OCD) calls for a reconstruction of the diagram of the disorder and subsequent sharing with the patient. This procedure facilitates a description of the patient’s conduct, by adopting a useful model for outlining the internal profile of the disorder in which to insert goals, intentions, and self-representations. For the patient affected by OCD, giving an explanation to his suffering through the recognition of the intentional component of his conduct helps him to get back some power over the possibility of reorienting his own behaviour in a different direction. To arrive at a graphic representation of the disorder, a good place to start is to have the patient describe a recent episode, preferably the one that most preoccupies the patient, in which an intrusive thought or image came to mind.

Background Although the influence of genetics on chronic low back pain (LBP) has been previously examined, few studies have investigated whether the impact of genetic factors on LBP depends on how the condition is assessed. Methods We investigated the contribution of genetics and environment on chronic LBP: lifetime prevalence, pain intensity (recent and worst) and activity limitation (anytime and recent) in a cross-sectional study with 1,598 adult twins. All twins answered a self-reported questionnaire about health-related questions. We conducted classic twin analyses using structural equation models to estimate the genetic and environmental influences in LBP phenotypes. Results We found a heritability of 26% (95%CI: 0.09-0.42) for lifetime chronic LBP; 36% (95%CI: 0.18-0.52) and 25% (95%CI: 0.03-0.46) for activity limitation due to chronic LBP, related to lifetime and most recent episode, respectively; and heritability of 35% (95%CI: 0.11-0.55) for pain intensity associated with the most recent episode. Genetics showed no significant influence in pain intensity experienced during the worst LBP episode. Conclusions Genetic factors appear to significantly contribute to the variance in chronic LBP including lifetime chronic LBP, activity limitation and pain intensity associated with more recent episodes of LBP, but not for pain intensity associated with people's report of the worst pain episode. Heritability estimates was fairly similar across different LBP outcomes in a population-based twin sample, and not dependent on how it is assessed or experienced. However, we could not detect any significant heritability for a report of intensity experienced during the worst LBP episode experienced. Significance Heritability estimates were similar for different low back pain definitions, and therefore not dependent on how chronic low back pain is experienced or assessed, in the same population-based sample.

The recent episode of the financial meltdown has drawn attention to global imbalances, raising concerns about inability to sustain low saving rates in the USA. The objective of this paper is to shed light on the downward trend in household savings in the USA starting in the mid-1990s. In addition to the theoretical determinants of household savings, the paper's innovation is in tracing the effect of the widely tracked consumer sentiment index on savings. Applying the dynamic autoregressive distributed lag model with bounds testing approach, the evidence confirms the relevance of the consumer sentiment index as an important factor that affects household savings, both in the short-run and long-run.

This paper examines the importance of house prices on the US business cycle since the mid-1970s. The point of departure is to construct and estimate a baseline Markov-switching common factor model in which the co-movement of several individual economic series and the inherently different behavior of the economy across expansion/recession phases are accommodated. The importance of house price variables is then evaluated by comparing the results of the baseline model and those of the extended models that have been augmented with the house price variables. Two strands of extended models are considered: one in which house prices directly affect the individual macroeconomic series (and thereby the business cycle) and another in which house prices affect the probabilities of transitions between expansion/recession phases. The results for the first extension support that only house price decreases have nontrivial effects on the movements in macroindicators (and consequently on the business cycle), while house price increases do not. In the second extension, we find strong evidence that changes in house prices significantly affect the transition of the US economy between the recession–expansion phases. It is also reaffirmed that the influence of house price decreases is more important than that of the increases. Finally, the above results are generally robust to using a different data frequency, a subsample of the data excluding the recent episode of housing boom–bust, replacing house price with housing permits, and incorporating financial variables as additional driver of the business cycle.

When more scientists describe independently the same species under different valid Latin names, a case of synonymy occurs. In such a case, the international nomenclature rules stipulate that the first name to appear on a peer-reviewed publication has priority over the others. Based on a recent episode involving priority determination between two competing names of the same fungal plant pathogen, this letter wishes to open a discussion on the ethics of scientific publications and points out the necessity of a correct management of the information provided through personal communications, whose traceability would prevent their fraudulent or accidental manipulation.

International audience; Pollen traps are used by beekeepers to collect pollen harvested by honeybees. Here, we set up an experiment to evaluate whether pollen traps are a risk factor involved in the development of the chronic bee paralysis, a viral honeybee disease affecting adult bees and transmitted by contact. After a recent episode of chronic bee paralysis in an apiary, pollen traps were installed on three hives while two hives without pollen traps were used as control. During the experiment, the chronic bee paralysis virus (CBPV) loads in foragers from the control hives remained lower than 108 equivalent copies of CBPV genome per bee but were higher than 1010 equivalent copies of CBPV genome per bee in the many symptomatic bees and in the hundreds of dead bees found in front of trap hives. Clinical signs of the disease persisted for 3 weeks at the entrance of the trap hives. These signs disappeared after the pollen traps were removed, accompanied by a decrease in the viral loads in foragers. Despite the small number of colonies examined, the results of this study suggest the impact of pollen traps on the relapse of chronic paralysis outbreaks in colonies infected by CBPV.

Precise risk stratification in heart failure (HF) patients enables clinicians to tailor the intensity of their management. The Seattle Heart Failure Model (SHFM), which uses conventional clinical variables for its prediction, is widely used. We aimed to externally validate SHFM in Japanese HF patients with a recent episode of acute decompensation requiring hospital admission.SHFM was applied to 2470 HF patients registered in the West Tokyo Heart Failure and National Cerebral And Cardiovascular Center Acute Decompensated Heart Failure databases from 2006 to 2016. Discrimination and calibration were assessed with the use of the c-statistic and calibration plots, respectively, in HF patients with reduced ejection fraction (HFrEF;40%) and preserved ejection fraction (HFpEF; ≥40%). In a perfectly calibrated model, the slope and intercept would be 1.0 and 0.0, respectively. The method of intercept recalibration was used to update the model. The registered patients (mean age 74 ± 13 y) were predominantly men (62%). Overall, 572 patients (23.2%) died during a mean follow-up of 2.1 years. Among HFrEF patients, SHFM showed good discrimination (c-statistic = 0.75) but miscalibration, tending to overestimate 1-year survival (slope = 0.78; intercept = -0.22). Among HFpEF patients, SHFM showed modest discrimination (c-statistic = 0.69) and calibration, tending to underestimate 1-year survival (slope = 1.18; intercept = 0.16). Intercept recalibration (replacing the baseline survival function) successfully updated the model for HFrEF (slope = 1.03; intercept = -0.04) but not for HFpEF patients.In Japanese acute HF patients, SHFM showed adequate performance after recalibration among HFrEF patients. Using prediction models to tailor the care for HF patients may improve the allocation of medical resources.

For more than a decade, the Veterans Health Administration (VHA) has offered MOVE!, a comprehensive lifestyle intervention for weight management. However, there is limited knowledge to inform resource allocation decisions at the health system level—for example, the choice between reaching new veterans with weight management treatment, re-engaging veterans who have stopped attending, and/or increasing contact with current MOVE! participants. To inform VHA policy and planning, this VHA-wide study examines the relationship between MOVE! participation and weight outcomes. A longitudinal observational study of veterans across VHA who participated in MOVE!. Veterans who initiated their most recent episode of MOVE! care between 2004 and 2014. Weight measurements were abstracted from VHA electronic health records. The primary outcome was the proportion of veterans with clinically relevant weight loss. The predictor of interest was number of MOVE! contacts during the 12 months following MOVE! initiation. The cohort consisted of 237,577 veterans (87.4% male; mean age 54.4 years), who had 5.3 contacts on average in the 12 months following initiation. Veterans with 2–5 contacts had the same odds of achieving clinically relevant weight loss as veterans with only one contact (adjusted OR: 1.00, 95% CI: 0.98–1.03). Veterans with 6–9, 10–13, 14–17, and 18 or more contacts had significantly higher odds of clinically relevant weight loss (adjusted OR: 1.17, 95% CI: 1.13–1.20; adjusted OR: 1.53, 95% CI: 1.47–1.59; adjusted OR: 1.84, 95% CI: 1.74–1.94; adjusted OR: 2.21, 95% CI: 2.12–2.31, respectively). Veterans with ≥6 MOVE! contacts in the year following treatment initiation were significantly more likely to achieve clinically relevant weight loss than those with one contact, with greater participation further increasing the odds of clinically relevant weight loss. While further characterization of weight loss predictors is needed, the VHA should provide policy guidance that supports increasing participation among veterans who have initiated MOVE!.

The U.S.-based Financial Accounting Standards Board (FASB) emphasizes that accounting standard-setting is not and should not be regarded as a �political process.� Employing the case of accounting for stock compensation, I examine a recent debate in which FASB appears to have successfully established and maintained a boundary between a technical accounting process and politics. This case is interesting because an earlier, failed effort to expense stock compensation was described as highly politicized. However, the boundary between technical and political processes was maintained in the more recent episode. I find that a focus on due process, characterizations of existing accounting requirements as anomalous and available measurement methods as reliable, and warnings about the dangers of injecting �politics� into standard-setting were important to this boundary work. I also find that the boundary work required considerable interpretive flexibility in selecting (or ignoring) the evidence to be used in justifying the standard-setting project and its conclusions. I conclude by suggesting that a different understanding of what it means to be involved in a �political process� might help all parties understand more fully what is taking place during the accounting standard-setting process. Attention could be turned to developing processes to facilitate debates over which values should guide decisions occurring throughout the standard-setting process. To this end, an enhanced standard-setting process might allow for increased participation in agenda setting, in framing and scoping standard-setting projects, and in providing opportunities for nonexperts to participate.

Objectives: In the Indian social structure, as in many other countries and regions across the globe, housewives form the nucleus of their family. They have a nonstop hectic full day assignment in the home, and yet their contribution has neither been adequately acknowledged, nor has it received due attention of researchers. The aim and objective of this study is to determine the prevalence of Low Back Pain (LBP) in non-working women of Kanpur city. Also, an attempt has been made to find the amount of social burden and its impact on LBP present in housewives of Kanpur city.Method: A sample of 300 non-working women of Kanpur city, aged 25 to 70 years, was selected. The Nordic Musculoskeletal Questionnaire, Oswestry Disability Index, and Zarit Burden Interview measuring musculoskeletal discomfort, low back disability and social burden respectively were given to all the women.Results: Descriptive analysis data reveal the recent episode of LBP were present in 93% of the women, 82% had chronic LBP and 71...

La reacción adversa más frecuentemente asociada al tratamiento con inhibidores del cotransportador sodio-glucosa es la infección micótica genital y en menor proporción la infección urinaria, esto no es dosis dependiente. Es más común en mujeres y en hombres antes de los 50 años de edad. Es infrecuente la necesidad de suspender el tratamiento por estas infecciones. Se recomienda evitar el uso en pacientes con historia de infecciones urinarias recurrentes o con episodio reciente de infección urinaria alta y especial cuidado al indicarla en aquellos con historia de hipertrofia prostática porque se han descripto casos de pielonefritis.

Purpose: We administered olanzapine to 24 outpatients with bipolar disorder who had experienced a depressive or mixed episode as their most recent episode to evaluate the efficacy and safety of olanzapine in clinical practice. Methods: The duration of study treatment was 8 weeks. Symptoms in each subject were assessed using the Montgomery Asberg Depression Rating Scale (MADRS) and the Clinical Global Impressions-Severity of Illness, Bipolar Version (CGI-BP) at the start of treatment with olanzapine and at Week 4 and Week 8 of treatment. Results: A total of 17 subjects underwent the assessments at Week 4, and 13 subjects completed the 8-week treatment regimen and the assessments at Week 8. The mean total score and each individual item score of the MADRS were significantly improved at Week 4 and Week 8 compared to those at the start of treatment. The mean CGI-BP Depression and CGI-BP Overall scores were significantly improved at Week 4 and Week 8, while the mean CGI-BP Mania score was not significantly different at Week 4 or Week 8 compared to that at the start of treatment. Adverse drug reactions were reported in 3 subjects during the study: hyperphagia in 2 subjects and light-headed feeling in 1 subject. No manic switches were observed. Discussion: The results of this study confirmed the efficacy and safety of olanzapine in outpatients with bipolar depression in clinical practice.

Federal Communications Commission (FCC) v. FOX Television Stations (FOX II, 2012) marked the most recent episode in the Supreme Court’s consideration of the regulation of indecency in the public broadcast medium. The Court’s decision in FOX II has given the FCC permission to revise, but not necessarily to abandon, its policies that interpret indecency in light of public interest and other legal requirements. We argue that the FCC should switch from a passive listener rationale to an active-listener/invited-guest rationale as a philosophical approach to the regulation of indecency. Consistent with such philosophy, the FCC should extend its rationale for exempting coverage of live public and news events to exempting live coverage of private events, while defining indecency as constitutive of a violation of principles pertaining to fair warning.

An elderly man had a recent episode of acute pancreatitis. A pancreatic mass was seen during evaluation of the pancreatitis.

56-old man with new onset diabetes mellitus and a history of alcohol abuse and two prior episodes of acute pancreatitis. The most recent episode of pancreatitis was 3 months ago.

We assessed sexually transmitted infection risk behaviours and desire to discuss mental health, as reported by 426 HIV-infected men who have sex with men receiving HIV care in eight urban clinics. Most of these patients (90%) had begun HIV care >1 year ago. In the past year, 74% had multiple sexual partners, 75% engaged in anal intercourse, 48% had >1 HIV-uninfected partner and 82% used illegal psychoactive drugs. Among those reporting anal intercourse, approximately 61 % reported using a condom during the most recent episode. Among all patients, 70% wanted to talk with their clinicians about how they felt mentally or emotionally. Using a two-tailed chi-squared test, we found that patients who engaged in unprotected receptive anal sex were more likely to want such a conversation than those who did not (80% versus 62%, P < 0.01); and those who engaged in unprotected insertive anal sex were also more likely to want such a conversation (81 % versus 63%, P < 0.01). The findings highlight the prevalence of risky sexual behaviour and of mental health concerns in the participating patient population. Patients reporting risky sexual behaviour were more likely to want to discuss how they felt mentally or emotionally than those not reporting such behaviour.