Evidence based guidelines for the treatment of primary headaches

Some patients suffering from headache require neurologic examination. The objective of the guidelines for the treatment of headaches is to help physicians in their daily care for headache patients. In most patients, the diagnosis of migraine has not been made by a physician and they have not received appropriate care to treat migraine attacks. New therapeutic methods (for acute and preventive treatment) have been introduced in the past fifteen years. Triptans should be offered to patients that fail to respond to usual analgesics, those with moderate to severe migraine in particular. Depending on comorbidity, preventive therapy should be recommended to individuals with frequent or prolonged migraine attacks. In patients with tension headaches, organic causes underlying the headache should be ruled out, while the treatment includes pharmacological and non-pharmacological measures. Although rare, patients with cluster headaches suffer severe pain; oxygen inhalation or triptans are recommended for acute attack, and preventive therapy may be indicated in some cases. The guidelines provide classification, diagnostic criteria and therapeutic principles for primary headaches. All recommendations listed in the guidelines are based on meta-analyses and recommendations from the world literature, with special reference to therapeutic options available in Croatia.     

Unusual open craniocerebral injury caused by sickle's tip

A nine years old girl suffered an unusual penetrating injury to the head caused by a sickle's tip sticked into the skull bones during a lavender harvest on island of Hvar. GCS score was 15. A sickle's blade and its handle were clearly seen coming out of the frontal bone, hanging free, while its tip was firmly sitting in the skull bones! After a neuroradiological diagnostical work up (skull x rays and CT scans) that confirmed intracranial penetration she was operated as an emergency. An osteoclastic craniotomy was done, a and a sickle thereafter easily extracted. Lacerated and contused brain and the penetrating canal were debrided and dura defect covered with a patch. Broad spectrum antibiotics were administered after antitetanic prophylaxis. Postoperative course was uneventful especially regarding infection. One year after the accident she goes normaly to school.     

Genetic delivery of an anti-RSV antibody to protect against pulmonary infection with RSV

Respiratory syncytial virus (RSV) is a common cause of severe lower respiratory tract infections. Protection against infection with RSV can be achieved by monthly administration of the humanized monoclonal antibody palivizumab. The present study analyzes if genetic delivery of a murine version of palivizumab by single administration would achieve high-level and sustained antibody expression to protect mice against pulmonary infection with RSV. A murine version of the palivizumab antibody was constructed by replacing the human sequences with sequences from the constant region of a murine IgG1 antibody, while preserving the complementarity-determining region. As a proof-of-principle to test the validity of the strategy, the coding sequence for the heavy and light chains were cloned into a replication-defective serotype 5 human adenovirus vector (AdalphaRSV). Antibody expression and specificity for RSV was confirmed by Western analysis. To determine if AdalphaRSV would mediate production of anti-RSV antibodies in vivo, 5x10(10) particle units of AdalphaRSV or a control vector without transgene (AdNull), were administered intravenously to BALB/c mice. RSV neutralizing antibodies were detected in the serum after 4 days in mice receiving AdalphaRSV but not in AdNull-infected or naive mice (p<0.05). The mice that had received AdalphaRSV had at least 5.4-fold lower RSV titers in the lung 4 days following intranasal challenge with RSV compared to the AdNull or naive group (p<0.01). To evaluate long-term protection, the antibody construct was expressed in a non-human primate serotype rh.10 adeno-associated virus vector (AAVrh.10alphaRSV). RSV neutralizing antibodies were detected in serum and bronchoalveolar lavage fluid for up to 21 wk following intrapleural administration of AAVrh.10alphaRSV, but not with a control AAV vector expressing an unrelated transgene (AAVrh.10alpha1AT). Following challenge with RSV at 7 or 21 wk, 14.3-fold and 10.6-fold lower RSV titers were observed after 4 days in the lungs of mice that had received AAVrh.10alphaRSV compared to AAVrh.10alpha1AT (p<0.05). Together these data demonstrate that a gene transfer strategy for delivery of an anti-RSV antibody can generate protective immunity in mice against RSV infection in the respiratory tract and may provide an alternative to the administration of the antibody itself.     

Surface Morphology of Textured Transparent Conductive Oxide Thin Film Seen by Various Probes: Visible Light,X-rays,Electron Scattering and Contact Probe

Fluorine-doped tin oxide thin films (SnO₂:F) are widely used as transparent conductive oxide electrodes in thin-film solar cells because of their appropriate electrical and optical properties. The surface morphology of these films influences their optical properties and therefore plays an important role in the overall efficiencies of the solar cells in which they are implemented. At rough surfaces light is diffusely scattered, extending the optical path of light inside the active layer of the solar cell, which in term improves light absorption and solar cell conversion efficiency. In this work, we investigated the surface morphology of undoped and doped SnO₂ thin films and their influence on the optical properties of the films. We have compared and analysed the results obtained by several complementary methods for thin-film surface morphology investigation: atomic force microscopy (AFM), transmission electron microscopy (TEM), and grazing-incidence small-angle X-ray scattering (GISAXS). Based on the AFM and TEM results we propose a theoretical model that reproduces well the GISAXS scattering patterns.     

Crystal Structure and Electrical Properties of Ruthenium-Substituted Calcium Copper Titanate

This paper reports a detailed study of crystal structure and dielectric properties of ruthenium-substituted calcium-copper titanates (CaCu₃Ti_4−xRu_xO₁₂, CCTRO). A series of three samples with different stoichiometry was prepared: CaCu₃Ti_4−xRu_xO₁₂, x = 0, 1 and 4, abbreviated as CCTO, CCT3RO and CCRO, respectively. A detailed structural analysis of CCTRO samples was done by the Rietveld refinement of XRPD data. The results show that, regardless of whether Ti⁴⁺ or Ru⁴⁺ ions are placed in B crystallographic position in AA’₃B₄O₁₂ (CaCu₃Ti_4−xRu_xO₁₂) unit cell, the crystal structure remains cubic with Im3¯ symmetry. Slight increases in the unit cell parameters, cell volume and interatomic distances indicate that Ru⁴⁺ ions with larger ionic radii (0.62 Å) than Ti⁴⁺ (0.605 Å) are incorporated in the CaCu₃Ti_4−xRu_xO₁₂ crystal lattice. The structural investigations were confirmed using TEM, HRTEM and ADF/STEM analyses, including EDXS elemental mapping. The effect of Ru atoms share in CaCu₃Ti_4−xRu_xO₁₂ samples on their electrical properties was determined by impedance and dielectric measurements. Results of dielectric measurements indicate that one atom of ruthenium per CaCu₃Ti_4−xRu_xO₁₂ unit cell transforms dielectric CCTO into conductive CCT3RO while preserving cubic crystal structure. Our findings about CCTO and CCT3RO ceramics promote them as ideal tandem to overcome the problem of stress on dielectric-electrode interfaces in capacitors.     

A novel homozygous synonymous variant further expands the phenotypic spectrum of POLR3A-related pathologies

Pathogenic biallelic variants in POL3RA have been associated with different disorders characterized by progressive neurological deterioration. These include the 4H leukodystrophy syndrome (hypomyelination, hypogonadotropic hypogonadism, and hypodontia) and adolescent-onset progressive spastic ataxia, as well as Wiedemann–Rautenstrauch syndrome (WRS), a recognizable neonatal progeroid syndrome. The phenotypic differences between these disorders are thought to occur mainly due to different functional effects of underlying POLR3A variants. Here we present the detailed clinical course of a 37-year-old woman in whom we identified a homozygous synonymous POLR3A variant c.3336G>A resulting in leaky splicing r.[3336ins192, =, 3243_3336del94]. She presented at birth with intrauterine growth retardation, lipodystrophy, muscular hypotonia, and several WRS-like facial features, albeit without sparse hair and prominent scalp veins. She had no signs of developmental delay or intellectual disability. Over the years, above characteristic facial features, she showed severe postnatal growth retardation, global lipodystrophy, joint contractures, thoracic hypoplasia, scoliosis, anodontia, spastic quadriplegia, bilateral hearing loss, aphonia, hypogonadotropic hypogonadism, and cerebellar peduncles hyperintensities in brain imaging. These manifestations partially overlap the clinical features of the previously reported POLR3A-associated disorders, mostly mimicking the WRS. Thus, our study expands the POLR3A-mediated phenotypic spectrum and suggests existence of a phenotypic continuum underlying biallelic POLR3A variants.     

影响商务专业学生进行贸易的决定因素 ——基于前南斯拉夫7 国民族成见以及 民族距离的研究

商务专业学生和经理们在面对国际商务时不仅需要一定的跨文化沟通技巧和能力， 也需要清楚地意识到形成他们不同行为的各种复杂的认知过程以及偏见。计划行为 理论（TPB）为分析民族成见和民族距离对国际贸易意愿的影响提供了一个可行的 研究框架。TPB 理论背后的态度—行为关系对教育者很重要，因为他们会培养未来 的商务领袖。但是，成见（定势思维）非常微妙，它可以被激活，但却很难应用， 因为这需要多种多样的行为控制。在这种情况下，没有很多经验甚至没有任何实践 经验的商科学生却可以用来作为评估所谓的“纯粹的”民族成见和民族距离的标准， 以及民族成见与民族距离对他们开展国际贸易的意愿的影响力，同时也可作为态度 和行为之间的一个介质。本文的主要目的是测试商务专业学生对某个特定国家的民 族成见和民族距离，以及这样的民族成见和民族距离是否对进行国际贸易意愿有着 决定性影响。本文的研究结果显示了在国际商务环境中民族成见对意图行为起到的 交互性作用，特别强调了成见激活和成见应用的区别。更强的情感信念通过民族距 离与民族划分以及民族仇恨（民族主义）的联系更紧密。     

Missed cervical spine subluxation leading to bilateral facet dislocation with severe deformity requiring 360 fixation

A 41 year-old male that presented after a fall downstairs and the initial imaging was misinterpreted, missing a subtle abnormality, C5/6 subluxation. The patient presented later with neck pain and further imaging demonstrated bilateral facet dislocation with severe deformity requiring 360 spinal fixation.