Important Changes Research Articles

Changing and unfinished narratives of the mental health impact of HIV in the UK

The mental health impacts of HIV have evolved significantly over the last four decades, in parallel with changes in the virus's overall health consequences. This study charts transformation in narratives about mental health problems associated with HIV over the course of the epidemic, as outlined by people with HIV (40%), professional carers (45%) and activists (25%) in the UK. In particular, our study examines evolving mental health impacts and changing service provision during three key periods: The early days of the epidemic; after the introduction of effective antiretroviral therapy (ART) in 1996; and in more recent times as HIV came to be regarded as a chronic manageable condition. Fifty-three participants were recruited: Male (68%), female (32%), White (90%), African/Afro Caribbean (6%) and South Asian (4%). Results indicate that despite important changes in the severity and nature of the mental health impacts of HIV, there were persistent challenges, related to the long-term mental health consequences of HIV among earlier generations of people with HIV. There were additional challenges associated with: ageing with HIV; the development of sexual dysfunction; and the possibility of neurocognitive impairment. The organization of mental health care for people with HIV moved from specialist teams to general practice, presenting challenges of mainstreaming care. The commissioning and delivery of mental health services need to be sensitive to the ever-changing social contexts and the potential for ‘left behind’ people living with HIV, despite the overall ‘naturalisation’ of HIV.

Minimal important change in the Berg Balance Scale in older women with vertebral compression fractures: A retrospective multicenter study.

Vertebral compression fractures, which are commonly associated with older age and osteoporotic fractures, have an increased risk of re-fracture. Therefore, improving balance is important to prevent falls. The minimal important change (MIC) has been recommended for interpreting clinically meaningful changes in rating scales. The MIC of the Berg Balance Scale (BBS) for use in older women with vertebral compression fractures has not been established. To identify the MIC of the BBS that can be used in older women with vertebral compression fractures using predictive modeling methods and the receiver-operating characteristic (ROC)-based method. A retrospective longitudinal multicenter study. Sixty older women (mean age ± standard deviation: 84.1 ± 7.0 years) with vertebral compression fractures who were unable to ambulate independently on a level surface. A change of one point in the Functional Ambulation Category (FAC) was used as an anchor to calculate the MIC of the BBS based on the change between admission and discharge. We calculated the MIC for the women whose FAC score improved by ≥1 point. We used three anchor-based methods to examine the MIC: the ROC-based method (MICROC ), the predictive modeling method (MICpred ), and the MICpred -based method adjusted by the rate of improvement and reliability of transition (MICadj ). Thirty-nine women comprised the "important change" group based on their FAC score improvement. In this group, the MICROC (95% confidence interval [CI]) value of the BBS was 10.0 points (5.5-15.5), with an area under the curve of 0.71. The MICpred (95% CI) value was 9.7 (8.1-11.0), and the MICadj (95% CI) was 7.0 (5.5-8.5) points. For women with vertebral compression fractures who are unable to ambulate independently, a 7.0-point improvement in the BBS score may be a useful indicator for reducing the amount of assistance required for walking.

The importance of cross-scale social relationships for dealing with social-ecological change in agricultural supply chains

Agricultural systems are important for the livelihoods and food security of millions of people. These systems are increasingly interconnected across scales and face challenges in responding to multiple, and coalescing types of environmental, social, and economic change. Most studies on how actors respond to change have focused on farmers and farming communities. In this study, we investigate the connectivity of farming systems to markets, to understand how social relationships across the supply chain influence how actors respond to multiple types of changes. We used a participatory network mapping method to interview actors across a fruit supply chain in the Western Cape, South Africa, that is connected to both global and national markets. We identified droughts, climatic variations, changes related to the COVID-19 pandemic, and other social shifts as the most important changes affecting the production and trade of fruit in this region. We also identified three types of responses to these changes: i) responses concerning the dynamics of trade relationships (e.g., changing or maintaining trade relationships); ii) responses based on changes at the individual level (e.g., changes in farm management); and iii) responses based on social relationships (categorized into four types, namely collaboration, knowledge transfer, financial assistance, and marketing coordination). Within these four types, we found that different types of social networks, that include actors operating at different scales and within and outside of supply chains, mediate responses to change. We also found that networks of collaboration, knowledge exchange and financial assistance show a positive correlation, where actors with an export orientation engage in multiple social relationships that enable responding to changes. However, we found limited participation of local market actors in most of these networks. Further investigating these social networks, and the actors participating in them, is essential to better understand and anticipate how and why agricultural systems respond to multiple types of changes, ultimately influencing their trajectory in an increasingly changing world.

The need to take into account the international experience of legal regulation in the field of protection of information about children

The article examines the relevance of personal data protection, in particular of children, in the context of the rapid development of the Internet and the information sphere. The author analyzes the principles and peculiarities of legal regulation of children's personal data protection as defined by the UN Convention and the Law of Ukraine "On Protection of Childhood".
 The author assesses the impact of the Data Protection Regulation on Ukrainian legislation and the need for harmonization with European standards for the full protection of children's personal data. Comparison of the provisions of the Regulation with the national legislation reveals significant differences, in particular, the absence of separate regulation of children's personal data and the principles of processing such data. The author expresses a position on the need to harmonize Ukrainian legislation with European standards as an important component of effective personal data protection. The author also analyzes the provisions of the Draft Law No. 8153 "On Personal Data Protection" and concludes that the Draft Law is aimed at establishing compliance with European standards, expanding the principles of data processing and establishing new consent requirements. Important changes relate to terminology, processing rules, protection of children's data, financial responsibility and other aspects, however, the issue of protection of children's personal data as a separate category has not been given due attention.
 The author concludes that today the issue of personal data protection, in particular of children, is regulated by numerous international and national legal acts. At the same time, it is noted that the EU Regulation provides for special protection of children's rights, which is different from the Law of Ukraine "On Personal Data Protection", and Draft Law No. 8153 leaves aside the issue of protection of personal data of a child specifically. As a result, it is noted that in order to reduce risks, it is necessary to take into account the principles of the Regulation in national legislation, in particular transparency and limitation of settings. It is also important to raise the legal culture of citizens in the field of personal data protection, contributing to the improvement of the regulatory environment.

Estimating anchor-based minimal important change using longitudinal confirmatory factor analysis.

The minimal important change (MIC) is defined as the smallest within-individual change in a patient-reported outcome measure (PROM) that patients on average perceive as important. We describe a method to estimate this value based on longitudinal confirmatory factor analysis (LCFA). The method is evaluated and compared with a recently published method based on longitudinal item response theory (LIRT) in simulated and real data. We also examined the effect of sample size on bias and precision of the estimate. We simulated 108 samples with various characteristics in which the true MIC was simulated as the mean of individual MICs, and estimated MICs based on LCFA and LIRT. Additionally, both MICs were estimated in existing PROMIS Pain Behavior data from 909 patients. In another set of 3888 simulated samples with sample sizes of 125, 250, 500, and 1000, we estimated LCFA-based MICs. The MIC was equally well recovered with the LCFA-method as using the LIRT-method, but the LCFA analyses were more than 50 times faster. In the Pain Behavior data (with higher scores indicating more pain behavior), an LCFA-based MIC for improvement was estimated to be 2.85 points (on a simple sum scale ranging 14-42), whereas the LIRT-based MIC was estimated to be 2.60. The sample size simulations showed that smaller sample sizes decreased the precision of the LCFA-based MIC and increased the risk of model non-convergence. The MIC can accurately be estimated using LCFA, but sample sizes need to be preferably greater than 125.

The Retreat from ‘High Technology’ in Post-War Britain

Abstract This article argues that the 1970s saw an important change in the attitude of the British state to civil technological projects. It focuses on supersonic aviation and nuclear power policy as its case-studies, which were the key areas of techno-nationalist investment in the post-war period. It shows that Whitehall became radically more sceptical about state-led Research and Development, scrapped many core long-term projects, and cut back others. The politics and timing of this shift matter for our wider understanding of post-war British history, the history of technology, and histories of ‘neo-liberalism’. Thatcherism is supposed to have brought with it the decisive move away from industrial intervention by the state. Such a characterisation, while containing important truths, makes it difficult to see that the retreat from the most spectacular industrial investments of the British state in fact occurred during the 1970s in what was an economic liberalism from within, rather than a ‘neo-liberalism’ from without. This paper also challenges the narrative that the ‘technological disillusion’ of the 1970s came via the New Left and environmentalists, demonstrating the importance of an expert critique focused on economic and industrial arguments that emerged from inside the state itself.

MATEMATİK ÖĞRETMEN ADAYLARININ OKUL DIŞI ÖĞRENME ORTAMLARINDA MATEMATİK ÖĞRETİMİNE YÖNELİK BAKIŞ AÇILARI

This study explored pre-service middle school mathematics teachers’ perspectives on teaching mathematics in out-of-school learning environments. The current study designed an online course on out-of-school mathematics education and investigated participants’ perspectives before and after the class. The phenomenology method, one of the qualitative methods, was employed. Participants of the study were 36 2nd and 3rd-year pre-service middle school teachers who enrolled in the course. The data sources of the study were participants’ open-ended responses to questionnaires. Open coding was used to analyze the data. The data analysis was carried out under four dimensions: (1) Identification of out-of-school mathematics education environments, (2) teaching contexts for teaching mathematics in out-of-school learning environments, (3) teaching purposes for teaching mathematics in out-of-school learning environments, and (4) frequency for using out-of-school education and their reasons. The findings of the study pointed to important changes in the participants' perspectives on teaching mathematics in out-of- school learning environments after taking the course. The findings of the study would shed light into studies on teacher education in the emerging field of out-of-school mathematics education.

Conceptosphere of cultural mediatisation

The purpose of the article is to clarify the essence of the concept of "mediatisation of culture" in the modern context, to analyse the range of its conceptual sphere and its impact on the socio-cultural space of Ukraine. Research methodology. To achieve this goal, a number of research methods were used. Thus, to consider the interaction of cultures in the traditional space of communication and the space of social networks, the method of comparative analysis was used. To identify the mechanisms of formation of cultural boundaries, as well as their overcoming, the method of analysing open sources of information which are information resources on the Internet was applied. For qualitative and quantitative study of documents characterising the modern content of the concept of "mediatisation of culture", analytical synthesis was used. The method of theoretical generalisation allowed summarising the data obtained in the course of the study. The scientific novelty of the study is due to the need for new scientific views on the processes that shape and characterise the mediatisation of the cultural sphere of our time. An attempt to do this by defining a number of related concepts, united by the concept of conceptosphere, is qualitatively new. This study, which is comprehensive, takes into account the changes taking place in the cultural environment under the influence of the media. It takes into account their role in shaping the modern socio-cultural space of Ukraine, especially in the context of Russia's military aggression against Ukraine. Conclusions. The study examines the concept of "mediatisation of culture" in the modern context and its impact on the socio-cultural space of Ukraine. The work takes into account important changes in the cultural environment caused by the influence of the media, in particular their role in shaping the modern socio-cultural space of Ukraine. Keywords: mediatisation of culture, conceptosphere, concepts, concept, modern media technologies, mass media, social networks, socio-cultural space of Ukraine, cultural environment, cultural freedom, media spaces.

Measures to Reconcile Work and Family Life for Public Administration Staff in Spain

This article aims to analyse the peculiarity of the measures encompassed under the concept of work-life balance within the scope of Public Administrations in Spain and in reference to the staff working in the service of these Administrations. The aim is not only to analyse the structure of these measures as a whole, but also to show how the complexity of the public employment model in Spain, together with the territorial and administrative organisation, is clearly reflected in the public employment model and, by extension, in the work-life balance measures from a legal point of view. Analysing this model, which aims to make work-life balance a reality in the field of public employment, is relevant at this time due to the important changes in terms of work-life balance which are taking place in the context of the European Union and which are consequently reflected in the internal legal system of the Member States, where the impact on public administration staff has a peculiarity, which needs to be analysed and highlighted in order to understand a dispersed, complex and unfinished model.

Memoir study: Investigating image memorability across developmental stages.

Images have been shown to consistently differ in terms of their memorability in healthy adults: some images stick in one's mind while others are forgotten quickly. Studies have suggested that memorability is an intrinsic, continuous property of a visual stimulus that can be both measured and manipulated. Memory literature suggests that important developmental changes occur throughout adolescence that have an impact on recognition memory, yet the effect that these changes have on image memorability has not yet been investigated. In the current study, we recruited adolescents ages 11-18 (n = 273, mean = 16) to an online visual memory experiment to explore the effects of developmental changes throughout adolescence on image memorability, and determine if memorability findings in adults can be generalized to the adolescent age group. We used the online experiment to calculate adolescent memorability scores for 1,000 natural images, and compared the results to the MemCat dataset-a memorability dataset that is annotated with adult memorability scores (ages 19-27). Our study finds that memorability scores in adolescents and adults are strongly and significantly correlated (Spearman's rank correlation, r = 0.76, p < 0.001). This correlation persists even when comparing adults with developmentally different sub-groups of adolescents (ages 11-14: r = 0.67, p < 0.001; ages 15-18: r = 0.60, p < 0.001). Moreover, the rankings of image categories by mean memorability scores were identical in both adolescents and adults (including the adolescent sub-groups), indicating that broadly, certain image categories are more memorable for both adolescents and adults. Interestingly, however, adolescents experienced significantly higher false alarm rates than adults, supporting studies that show increased impulsivity and reward-seeking behaviour in adolescents. Our results reveal that the memorability of images remains consistent across individuals at different stages of development. This consistency aligns with and strengthens prior research, indicating that memorability is an intrinsic property of images. Our findings open new pathways for applying memorability studies in adolescent populations, with profound implications in fields such as education, marketing, and psychology. Our work paves the way for innovative approaches in these domains, leveraging the consistent nature of image memorability across age groups.

Cost-effectiveness of a second opinion program on spine surgeries: an economic analysis

BackgroundIn this study we proposed a new strategy to measure cost-effectiveness of second opinion program on spine surgery, using as measure of effectiveness the minimal important change (MIC) in the quality of life reported by patients, including the satisfaction questionnaire regarding the treatment and direct medical costs.MethodsRetrospective analysis of patients with prior indication for spine surgery included in a second opinion program during May 2011 to May 2019. Treatment costs and outcomes were compared considering each patients’ recommended treatment before and after the second opinion. Costs were measured under the perspective of the hospital, including hospital stay, surgical room, physician and staff fees and other costs related to hospitalization when surgery was performed and physiotherapy or injection costs when a conservative treatment was recommended. Reoperation costs were also included. For comparison analysis, we used data based on our clinical practice, using data from patients who underwent the same type of surgical procedure as recommended by the first referral. The measure of effectiveness was the percentage of patients who achieved the MIC in quality of life measured by the EQ-5D-3 L 2 years after starting treatment. An incremental cost-effectiveness ratio (ICER) was calculated.ResultsBased upon the assessment of 1,088 patients that completed the entire second opinion process, conservative management was recommended for 662 (60.8%) patients; 49 (4.5%) were recommended to injection and 377 (34.7%) to surgery. Complex spine surgery, as arthrodesis, was recommended by second opinion in only 3.7% of cases. The program resulted in financial savings of -$6,705 per patient associated with appropriate treatment indication, with an incremental effectiveness of 0.077 patients achieving MIC when compared to the first referral, resulting in an ICER of $-87,066 per additional patient achieving the MIC, ranging between $-273,016 and $-41,832.ConclusionAfter 2 years of treatment, the second opinion program demonstrated the potential for cost-offsets associated with improved quality of life.

Effect of aquatic exercise versus standard care on paraspinal and gluteal muscles morphology in individuals with chronic low back pain: a randomized controlled trial protocol

BackgroundLow back pain (LBP) is one of the most disabling diseases and a major health issue. Despite the evidence of a link between paraspinal and gluteal muscle dysfunction and LBP, it is unknown whether aquatic exercises can lead to improvements in paraspinal and gluteal muscle morphology and function, and whether improvements in overall muscle health are associated with improvements in patients’ outcomes. The unique properties of water allow a water-based exercise program to be tailored to the needs of those suffering from LBP. This study uses magnetic resonance imaging (MRI) to investigate the effect of an aquatic exercise program versus standard exercise on 1) paraspinal and gluteal muscle size, quality and strength and 2) pain, disability, and psychological factors (pain related fear, depression, anxiety, sleep quality) in chronic LBP.MethodsThis study will include 34 participants with chronic non-specific LBP and moderate to severe disability, aged between 18 and 65, who will be randomly assigned (1:1) to the aquatic exercise group or land-based standard care exercise group. Both groups will receive 20 supervised sessions, twice per week over 10 weeks. MRIs will be obtained along the lumbosacral spine (L1-L5) and pelvis at the start and end of the intervention to assess the effect of each exercise intervention on paraspinal and gluteal muscle size and quality. Pre- to post-intervention changes in all outcomes between each group will be assessed, and the association between the changes in back muscle quality and clinical outcomes will be examined. Between-subjects repeated measure analysis of variance will be used to examine the changes in paraspinal muscle morphology over the different time points. Linear mixed models will be used to assess whether baseline scores can modify the response to the exercise therapy treatment.DiscussionThis study will determine if water-based exercises targeting the lower back and gluteal muscles can lead to important changes in muscle quality and function, and their possible relation with patients’ pain and functional improvements. Our findings will have strong clinical implications and provide preliminary data to design a community program to better support individuals with chronic LBP.Trial registrationNCT05823857, registered prospectively on April 27th, 2023.

Разработка имитационной модели влияния коммуникации с пользователями на управление и принятие решений по оценки инвестиционной привлекательности региона

Communication with users is of great importance for management and decision-making in assessing the investment attractiveness of the region. Most app users have little interest in updates to the financial situation of the regions or the adoption of new laws on subsidizing the regions. To better inform users, applications use various forms of notifications. Many Russian companies are considering the use of direct communication with users and most of them choose the communication channel – email. Informing about important changes via email is most convenient for users due to its conciseness and unobtrusiveness of the solution. The article presents the results of a study of the impact of sending email notifications on the investment activity of users of the application for assessing the investment attractiveness of the regions of the Russian Federation. From this study, conclusions were drawn that information based on the results of assessing the investment attractiveness of regions will become more widespread and popular, which will allow a greater number of private investors to participate in investment projects in the regions. If the application sends updated information on the investment attractiveness of the regions of the Russian Federation, new provisions in legislation and subsidies, this will increase private investment activity.

Fixation of Mandibular Fractures with Lag Screw: Integrative Review

Introduction: The mandible is the only movable bone of the face and plays a crucial role in masticatory, swallowing, phonation, and aesthetic functions. Mandibular fractures have the potential to cause numerous important changes. Angle, parasymphysis, body and condyle are the anatomical regions most affected by trauma. Rigid Internal Fixation (RIF) facilitated the process of treatment and recovery of mandibular functions. The Lag Screw fixation technique is based on the use of screws that manage to compress the bone fragments without the use of plates.Objective: This integrative review aims to review the fixation of mandibular fractures using the Lag Screw technique.Methods: Through a complete search in PubMed, Web of Science, Embase, and Cochrane databases, nine articles that contemplated the method of fixation of mandibular fractures using the Lag Screw technique were included.Results: The studies showed that the technique was associated with a lower number of intra and postoperative complications, provided safe RIF, greater compression between the stumps, facilitating primary bone healing, and presented a shorter surgical time, economic advantage. On the other hand, the technique proved to be sensitive and limited only to specific cases.Conclusion: The application of the Lag Screw fixation technique is an effective and stable RIF method that can be performed in the treatment of mandibular fractures.

Non-Destructive Testing Using Transmission Line-Based Microwave Sensors

In this study, some types of antennas and metamaterial structures have been designed and produced with the aim of determining and detecting ionized chlorine of sea sand in concrete. The first structure has a Loop-like resonator with the sample, the second structure has a Bowtie-shaped resonator with the sample and the third structure has double loop resonators on both sides of concrete samples also non-destructive method is applied for all structures. Different samples of concrete are produced with different proportions of ionized sea sand. Electrical properties of concrete samples for all structures are investigated in the frequency range of 1-9 GHz. The structures are designed in the CST Microwave Studio program. Also, the simulation study of the designed structures shows that the most important resonance frequency changes, considering the dielectric constant of concrete samples, for the Loop-like structure occur in the 1-8 GHz, Bowtie-shaped structure in 1-4 GHz and double Loop structure in 1-9 GHz of frequency band. The important point in this study is the changes of the waveform at the resonance frequency. The output waveform (reflection coefficient S11/ transmission coefficient S12) should change in linear form by considering the dielectric coefficient. We have used copper for the resonators and also the material with ℇ value of 3 as the substrate layers of the structures. We have simulated three types of designed structures with CST Microwave Software and then achieve the results and evaluate them. Both numerical and experimental tests have given approximately same results and are in good agreement with each other. These proposed structures can be used in many applications where it is necessary to determine the rate of ionized sea sand in cement-based composites such as concrete.

Sustainability Assessment of Tourism Destinations from the Lens of Green Digital Transformations

The rapid expansion of tourist destinations has important environmental, climate change, and socioeconomic impacts on countries. The main objectives of the paper are: to analyze sustainable tourism concepts, indicators, and frameworks of sustainability assessment in tourism; to develop a framework for sustainable tourism assessment of tourist destinations; to apply a developed framework for sustainability assessment of tourism destinations in Visegrad countries (Czech Republic, Hungary, Poland, and Slovakia) from the lens of green, digital transformations and boosting social-economic resilience. These are crucial policy pillars due to experiences during the COVID-19 pandemic. The main methods and data applied: several MCDM tools were applied to rank Visegrad countries on the progress achieved in sustainable tourism development. The data on indicators of the EU Tourism Dashboard were applied. The results of the ranking indicated that the best-performing country in terms of sustainable tourism development was Poland, following Hungary, the Czech Republic, and Slovakia. The main reason for this was the best results in digitalization and social-economic resilience shown by Poland and Hungary. The main policy implications for these countries are linked to the enhancement of environmental impact mitigation policies in tourism. The main contribution of this paper is a sustainability assessment of tourism destinations in Visegrad countries based on policy priorities and the newest available data by applying advanced MCDM tools.

The Concept of Lineage, Types of Lineage and a General Evaluation of the Establishment of Lineage

The aim of this study is to examine the legal and bioethical problems that arise in the field of lineage in our Civil Law. While these problems were examined, the concept of lineage, its types, the establishment of paternity and its provisions were discussed theoretically. Comparisons were made to better understand the development of the problems. With the entry into force of the new Turkish Civil Code(TCC) No. 4721 on January 1, 2002, very important changes were made. One of the most important changes among these changes is the changes made in the field of "lineage Law". With our new Civil Code, the concepts of valid lineage and non-authentic lineage have been abolished and only the concept of "lineage" has been included. An attempt has been made to envisage common provisions between the child born within marriage and the child born outside of marriage and to minimize privileges. In order for the provisions of lineage regulated in Articles(art.) 321-334 of the Turkish Civil Code to be implemented, lineage must be established between the child and the mother and father. In order to establish lineage in the Turkish Civil Code, a blood bond or an adoption relationship is required between the child and his/her parents. Family lineage based on blood ties; birth from the mother's side, paternal lineage between the child and the father; It can be established through marriage with the mother, recognition, judgement, and adoption. Paternity case; It is filed by the mother and/or the child against the man who is claimed to be the biological father of the child. If the child has a lineage relationship with another man, a lineage relationship cannot be established between the biological father and the child by recognition. In terms of the provisions of paternity in the Turkish Civil Code, no distinction is made according to the way in which the filiation based on blood ties was established between a person and his parents, and whether the person was born within or outside of marriage. Children born within marriage and children born outside of marriage are considered equal in rights and duties in terms of their relations with their parents and are subject to the same provisions. These provisions of the Turkish Civil Code regarding paternity are also applied to the adopted child in cases where there is no special provision regarding adoption. In the study, although it is not very detailed, it has been tried to clarify the solution of the problems related to the determination of lineage by making use of the new Civil Code and the views in the doctrine.

Industrial development of the Ural Federal District under the new conditions: Problems and prospects

Subject. This article discusses the economic potential of the Ural Federal District regions. Objectives. The article aims to analyze the structure and changes in imports and exports in the manufacturing industry of the Ural Federal District, and identify key foreign partners – suppliers of equipment and components. Methods. For the study, I used the methods of statistical, comparative and structural analyses. Results. The article finds that imports are of particular importance for the modernization of industry. Based on the analysis of the changes in and structure of imports and exports in the regions of the Ural Federal District, the article presents data showing that industrial regions, in particular the Sverdlovsk and Chelyabinsk Oblasts, depend on imports to the greatest extent. Conclusions. In modern conditions, domestic demand is becoming one of the drivers of industrial development. Effective measures within the framework of industrial policy are needed to develop import substitution processes.

Stream food webs in tropical mountains rely on allochthonous carbon regardless of land use

The relative importance of allochthonous and autochthonous carbon (C) as sources of energy for tropical stream food webs remains an open question. Allochthonous C might be the main energy source for small and shaded forest streams, while autochthonous C is more likely to fuel food webs draining land uses with less dense vegetation. We studied food webs in cloud forest streams draining watersheds with forests, coffee plantations, and pastures. Our goal was to assess the effects of those land uses on the C source and structure of stream food webs. The study took place in tropical montane streams in La Antigua Watershed, in eastern Mexico. We selected three streams per land use and sampled biofilm and leaf litter as the main food resources, and macroinvertebrates and aquatic vertebrates from different trophic guilds. Samples were analyzed for δ13C and δ15N isotopes. Using a Bayesian mixing model, we estimated the proportional assimilation of autochthonous and allochthonous carbon by each guild. We found that consumers were mostly using allochthonous C in all streams, regardless of watershed land use. Our findings indicate that montane cloud forest streams are dominated by allochthony even in watersheds dominated by pastures. Abundant precipitation in this life zone might facilitate the movement of allochthonous C into streams. While food webs of streams from coffee plantations and pastures also rely on allochthonous resources, other impacts do result in important changes in stream functioning.

Diagnostic accuracy of the upper limb neurodynamic test 1 using neurodynamic sequencing in diagnosis of carpal tunnel syndrome

BackgroundThe upper limb neurodynamic test 1 is used in the diagnosis of median nerve neuropathies such as carpal tunnel syndrome but its diagnostic validity remains limited. Neurodynamic sequencing has been suggested to increase the specificity of the neurodynamic tests, however, to date, information on the diagnostic accuracy of this variation in neurodynamic testing is required. ObjectivesThe aim of this study was to analyze the diagnostic validity of the local sequence of ULNT1 (LS-ULNT1) (i.e. a sequence that begins at the joint where the problem is (wrist) and progressively moves joints further away from it), in the diagnosis of CTS. A secondary aim was to describe the location of sensory responses to this modified neurodynamic test sequence. DesignA prospective diagnostic accuracy study was designed. MethodNerve conduction studies were used as the gold standard. The LS-ULNT1 was performed in 58 consecutive patients (17 men, 44 women) with suspected CTS. ResultsSensitivity of the LS-ULNT1 was 65.7% (CI 48.0–80.9%) and the specificity was 95.7% (CI 78.1–99.9%). The positive and negative likelihood ratios were >5 and < 0.5, respectively, indicating the ability of the test to generate small but sometimes important changes in post-test probability. ConclusionsThe overall results of this study showed that the LS-ULNT1 could be useful in confirming the diagnosis of CTS. The test demonstrated high specificity and the +LR indicated the ability of the test to generate changes in posttest probability, especially with a positive LS-ULNT1 result.