bluuebunny/crossref_metadata_2025 huggingface dataset:
Severe Malaria among British Troops in the East African Campaign
Authors: Keyworth W. D.
Published: July 2019

(1) A study of the East African Campaign shows how helpless we are on field service as regards prevention of malaria in a malarious country. (2) Not only prophylaxis but also the symptoms, diagnosis and treatment of the disease are modified by the conditions of field service. (3) The accounts given of the disease in its different aspects do not represent any scientific advance but are included merely to illustrate the points considered under (1) and (2) and to show the responsible and difficult nature of the work that medical officers on field service may be called upon to do.
The Surgery of Muscle and Tendon in Relation to Infantile Paralysis
Authors: Dunn Naughton
Published: July 2019

(1) The most important periods in the treatment of muscles weakened as a result of infantile paralysis are the acute illness, and if necessary a prolonged convalescence. (2) Division of tendons or muscles is seldom necessary for correction of deformity. (3) Successful transference of muscle power to a new insertion, given a good surgical technique, is dependent mainly on recognition of the group action of muscles. (4) Tendon transplantation should always be helpful, but will seldom by itself produce spectacular success in the restoration of function in infantile paralysis.

AbréGé.—(1) Dans le traitement des muscles affaiblis par la paralysie infantile, les périodes les plus importantes sont celles de l'affection aiguë et, au besoin, de la convalescence prolongée. (2) La division des muscles ou des tendons est rarement nécessaire pour la correction des difformités. (3) Étant donnée une bonne technique chirurgicale, le transfèrement du pouvoir musculaire à une nouvelle insertion dépend principalement de la récognition de l'action du groupe des muscles. (4) La transplantation du tendon devrait toujours être considérée utile, mais il est bien rare qu'elle produise per se le succès spectaculeux d'une restoration de fonction dans la paralysie infantile.

Uebersicht.—(1) Die wichtigsten Perioden in der Behandlung von Muskeln, durch Kinder-Paralyse geschwächt, sind die der akuten Krankheit selbst und—wo notwendig—der verlängerten Genesungsdauer. (2) Für die Mässigung einer Misgestalt ist eine Trennung der Sehnen oder der Muskeln selten notwendig. (3) Bei einer guten chirurgischen Technik ist eine erfolgreiche Uebertragung der Muskelkraft auf eine neue Insertion meistenteils von der Anerkennung der Gruppenarbeit der Muskeln abhängig. (4) Eine Verpflanzung der Sehne dürfte stets nützlich sein, jedoch wird sie allein selten den frappanten Erfolg einer Wiederherstellung der Funktion bei der Kinder-Paralyse darstellen.
Discussion on the Painful Shoulder
Authors: Perkins George
Published: July 2019

Three or four definite types are separated from among the many examples of painful shoulder and their treatment is debated:—

Adhesions around the Joint.—Characterized by limitation of movement at the shoulder-joint, through the outer half of its range. Curable by manipulative surgery. Tendonitis.—Characterized by painful movements through a small arc in the middle of the normal range. Curable in the hyperacute patient by operation, in the acute by rest in partial abduction with the assistance of time. Osteo-arthritis of the Shoulder-joint.—Characterized by painful extremes of movement. Incurable but capable of alleviation by physiotherapy. Subacute Arthritis of the Shoulder-joint.—Characterized by muscle spasm at the commencement of movement. To be treated by rest on an abduction splint, and the eradication of septic foci.
Discussion on Meningitis
Authors: Jenkins G. J.
Published: July 2019

(1) Meningitis: two groups of cases. (2) A method of washing out the subarachnoid space in cases of septic meningitis secondary to infection of the ear. (3) Discussion on the value of maintaining a positive pressure of the cerebrospinal fluid when operating on a septic region communicating with the subarachnoid space. (4) Leaking cerebrospinal fluid from the region of the ear: operative treatment.
President's Address: Some Points in Connection with the Successful Issue of Simple Prostatectomy
Authors: Thompson A. Ralph
Published: July 2019

The patient before operation is trained by an experienced nurse in the art of thoracic respiration.—Deep anæsthesia during the actual enucleation of the growth of the prostate.—The scrotum and penis must be kept well up on the abdomen after the operation, and a suspensory bandage must be provided for the patient on discharge.—1 c.c. of pituitrin is injected immediately after the operation.—The first post-operative dressing is not done for twenty-four hours after the operation. No catheter is used after the operation, except very occasionally. The slightest sign of post-operative disease of the air-passages should be treated adequately, and immediately.
Chromophobe Cell Adenoma of the Pituitary Gland, Associated with Dystrophia Adiposo-Genitalis, in a Maiden Bitch
Authors: Hare Tom
Published: July 2019

What appears to be the first case of a chromophobe-cell adenoma of the pituitary gland in an animal is described. The tumour in a maiden bitch, aged 9 years, was associated with depression of the sexual functions for two years, atrophy of the ovaries and vulva, gross adiposity and progressive emaciation. No abnormality was found in the skin and skeleton.
The Occupational Neuroses (Including Miners' Nystagmus)
Authors: Culpin Millais
Published: July 2019

These disorders seem to conform to the conception of “functional nervous disorder” in the narrow sense of the phrase. Specific difficulties in writers' cramp, however, often found to have symbolic significance to the patient. Cramp frequently one symptom in a larger syndrome. Both writers' and telegraphists' cramp are excrescences upon an underlying psychoneurosis, though associated symptoms are often overlooked.

Miners' nystagmus supposed to be a physiological disorder that produces “neurasthenia”; ocular symptoms mostly psychoneurotic; the oscillation not a disability of itself.

Night-blindness as a hysterical symptom. History of night-blindness in armies; its epidemic prevalence in Continental armies in the Great War and its comparative rarity in ours. Its absence in war pensioners and possible replacement by fear of the dark. Night-blindness in nystagmus probably a conversion of this fear.

Accounts of nystagmus in crane-workers and train dispatchers. Cases of miners' nystagmus shown to be identical with psychoneuroses arising apart from nystagmus. The nervous symptoms increase as the nystagmus diminishes. Possibly the ocular disability behaves as a hysteria in guarding against further symptoms.

Appearance of an occupational disorder among deep-sea divers, and the psychological investigation of individual cases described. Spurious unconsciousness was due to a condition of Angst which could be experimentally reproduced. The existence of a psychoneurotic basis and the possibility of foretelling the development of the specific disorder were demonstrated.

Conclusion.—The occupational neuroses are to be regarded as minor psychoses (or psychoneuroses) and handled in accordance with modern principles of psychopathology.
The Influence of Industry on Public Health
Authors: Bridge J. C.
Published: July 2019

Recognized specific risks of industry considered.

Under Section 73, Factory and Workshop Act, certain diseases contracted in a factory or workshop are notifiable by medical practitioners to the Chief Inspector of Factories.

Lead poisoning, epitheliomatous and chrome ulceration and anthrax—considered in detail.

Effects of inhalation of dust in the causation of silicosis and asbestosis. Relation of these diseases to tuberculosis. Reason to believe that a large number of dusts of different characters will create pathological changes in the lung.

Other diseases included in the Schedule under the Workmen's Compensation Act, e.g., nystagmus and dermatitis.

Common risks, i.e., shared by the general non-industrial population, incurred by workers.

Direct supervision of workers in industry.

The sphere and work of a works medical officer. The effects of National Health Insurance on such service. Co-operation between panel and works doctors. Far-reaching effects of the services rendered by works medical officers.

Periodic medical inspection under regulations for dangerous trades. Advice given on all medical matters.

The charge that industry raises the cancer incidence considered. Means of controlling early recognition and treatment include some non-industrial cases of cancer.

Anthrax in industry led to the introduction into the country of Sclavo's serum. Disinfection of wool protects the consumer.

First-aid training in factories gives protection in the home.

It is suggested that well-organized industry is a centre radiating the principles of preventive medicine.
Recent Laboratory Contributions to the Control of Yellow Fever
Authors: Hindle Edward
Published: July 2019

The most important recent laboratory contributions to the control of yellow fever will be briefly summarized under three headings: (1) Methods of diagnosis, (2) Transmission, and (3) Protection.

(1) Methods of diagnosis.—The development of improved methods of identification, in particular by immunity tests, has made it possible to diagnose yellow fever with much greater certainty. Moreover, since the immunity following an attack of the disease is usually of life-long duration, it is possible to determine what proportion of any particular population has been infected and also how long any district has been free from infection. The application of immunity tests to the delimitation of endemic zones, especially in West Africa, has led to a great increase in our knowledge, and yellow fever has been found to have a much wider distribution than was previously suspected. Among other methods of recognizing the disease may be mentioned complement-fixation tests and also in post-mortem material the histopathology of the liver.

(2) Methods of transmission. Indirect.—The main factors in the transmision of the disease by mosquitoes have been elucidated, and the relations between the course of the infection in monkeys (and also presumably in man) and the infectivity of these animals to mosquitoes. It is found that the blood becomes infective at a very early stage, before febrile symptoms develop, and that infectivity usually disappears three to four days after the onset of fever, owing to the presence of immune bodies in the blood. It is evident that any yellow fever patient must be considered to have been capable of infecting mosquitoes before showing any signs of the disease. Many other species of mosquitoes in addition to the Aëdes ægypti have now been shown capable of transmitting yellow fever.

Direct.—It is now known that it is possible to acquire yellow fever in the absence of mosquitoes, through handling infected material. Many cases of laboratory infection have now been recorded in which other sources of infection can be definitely excluded.

(3) Protection.—The most important advance in this direction has been the development of practicable methods of vaccination. The use of attenuated virus was followed by the use of virus and immune serum. The development of the latter has depended mainly on the discovery that when yellow fever virus is inoculated intracerebrally into mice, after a few passages it acquires neurotropic affinities and loses to a great extent its capacity for producing a general infection. The use of such virus, combined with human or animal immune serum, has been found to result in the development of a high degree of immunity comparable in intensity with that following an attack of the disease.
Some Observations on Carcinoma of the Prostate, with Special Reference to Treatment
Authors: Feilden F. E.
Published: July 2019

It is thought that valuable data should be obtained from a correlation of the clinical and histological features, when dealing with a large number of cases of carcinoma of the prostate. As a result it should be possible to elaborate a system of grouping, each group being characterized by a definite clinical syndrome, pathological features and individual prognosis.

To be of value, a record of the end-results of treatment should be on this basis.

Malignant disease of the prostate is not infrequently associated with benign hypertrophy, and not infrequently arises in a lateral or median lobe.

Cystoscopy may be of definite value in the diagnosis of carcinoma of the prostate.

The perineal method of approach is the operation of choice in the small fibrous type of prostate, especially that which is suspected of being malignant.

The results so far recorded in this country, in the treatment of carcinoma of the prostate by radium, are not encouraging.

As a palliative method of treatment, trans-urethral diathermy should seldom be employed.

The most satisfactory palliative method of treatment is a suprapubic cystostomy. Under certain circumstances, a radical perineal excision is justifiable and satisfactory results may be anticipated.
Some Observations on the Adaptation of the Cathode Ray Oscillograph to the Recording of Bio-Electrical Phenomena, with Special Reference to the Electrocardiogram
Authors: Robertson Douglas
Published: July 2019

The mechanism of the Cathode Ray Oscillograph is described and illustrated. The character of the cathode ray image (“spot”), produced when the ray impinges on the fluorescent screen, is briefly considered. Simple associated circuits are explained (including a “Time base” circuit). The advantages and disadvantages of the Cathode ray tube as a bio-electrical recording device are briefly examined.

Some of the problems associated with the design of a suitable amplifier are dealt with, in conjunction with the amount of amplification to be performed and the time relations of the electrical transient to be examined, taking the electrocardiogram as an illustration. A very short account of the theory of amplifier distortions is given, and a practical method of examining these by means of an “artificial patient” is described and demonstrated.
The Significance of the Excretion of Sex Hormones in the Urine
Authors: Callow R. K.
Published: July 2019

Recent work on the extraction and assay of urinary sex hormones is reviewed. The “sex hormones” known to be excreted in the urine are not identical with the hormones which have been actually isolated from the organs of secretion. Experimentally it is found that when active substances are administered only a very small proportion is excreted in recognizable form, and the excreted form may even be inactive. This general statement applies to œstrogens, androgens, progestin, and gonadotropic hormone. Hormone activity in the urine is, therefore, an uncertain index of hormonal activities in the body. However, with increasing knowledge of the chemistry and metabolism of hormones, methods of urine assay have been devised which give results capable of correlation with known or assumed physiological processes, notably in pregnancy and the normal menstrual cycle, and obvious effects are produced by certain types of tumour.

In the case of male hormone activity the lack of relation between urinary androgens and sexual condition has led to the assumption that the androgens in urine are largely derived from sources other than the gonads, probably from the adrenal glands. Work on this question is described in detail.
Observations on an Epidemic of Cerebrospinal Meningitis in Cyprus and the Record of a Prophylactic Experiment
Authors: MacLean I. H. , Bevan C. E.
Published: July 2019

After a lapse of twenty-five years cerebrospinal meningitis appeared again in epidemic from during 1936–37.

A prophylactic inoculation experiment was undertaken during the autumn of 1937, a few months before the second epidemic season was due to begin.

Season 1936–37—836 cases—284 deaths.

Season 1937–38 (after inoculation)—298 cases—81 deaths.

Season 1938–39—122 cases—51 deaths (to end of May, 1939).

During the second season conditions were suitable for the continuance of the epidemic. We do not think that we obtained a false result by inoculating on a waning epidemic. Our results are inconclusive because owing to the sharp decline in the morbidity neither control nor inoculated groups were fully at risk. But our results are good enough to recommend a further trial of prophylaxis in future epidemics. The percentage of the population inoculated is an important factor. The aim should be 100%.

The experiment should aim at controlling not only the meningococcal carrier rate but also the general catarrh rate. We suggest that the rapid passage of the meningoccocus in association with an epidemic of nasopharyngeal catarrh raises the virulence of the meningococcus.

As the opportunity of a second experience in the prevention of cerebrospinal meningitis by prophylactic inoculation seldom occurs to an individual, we take this chance of making recommendations for guiding future experiments.
Some Practical Considerations in the Control of Louse-Borne Typhus Fever in Great Britain in the Light of Experience in Russia, Poland, Rumania and China
Authors: MacKenzie Melville D.
Published: July 2019

This paper deals with some aspects of the control of louse-borne typhus fever. The epidemic form is associated with famine and overcrowding. In producing an epidemic in a hitherto endemic area malnutrition is of greater importance than over-crowding; another factor which brings this about is widespread movement of civil or military population thus bringing non-immunes into a district where typhus is endemic.

Endemic typhus usually occurs in the early months of the year, whilst the epidemic form may appear at any time. Conditions under which epidemic typhus occurs favour the outbreak of other diseases so that an uncomplicated case is rarely seen.

Louse-borne typhus fever lasts from twelve to sixteen days. The incubation period is usually twelve to fourteen days, though it may be from five to twenty-one days. The onset is sudden, but is often preceded by malaise and a rise of temperature. Two common initial symptoms are acute frontal or occipital headache and bronchitis. The first sign may be mental confusion or delirium. Acute delirium is usually present after the first week.
Air Pollution
Authors: Clifton Marjorie
Published: July 2019

Dr Marjorie Clifton describes the classification of gaseous and nongaseous constituents of air pollution and then outlines the methods of measuring these. The National Survey embraced 150 towns of all sizes throughout England and Wales and provided data on smoke and sulphur dioxide in relation to climate, topography, industrialization, population density, fuel utilization and urban development.

Dr W C Turner discusses the relationship between air pollution and mortality from respiratory conditions, and particularly the incidence of chronic bronchitis. He postulates a theory that such respiratory conditions arise as an allergy to the spores of certain moulds, spore formation being encouraged by the air humidity in Greatv Britain and overcrowded and damp living conditions. He describes the results of a twenty-week study undertaken in 1962–3, showing associations between respiratory disease and levels of air pollution.

Dr Stuart Carne undertook a survey in general practice to plot the patterns of respiratory illness in London during the winter of 1962–3. There were two peaks of respiratory illnesses coinciding with the fog at the beginning of December and the freeze-up from the end of December until the beginning of March.
Deafness
Authors: Weston T E T
Published: July 2019

Dr T E T Weston describes his research into the effect of noise on hearing acuity and of deafness in the aged. He found that presbyacusis is associated with a multiplicity of factors, e.g. smoking, circulatory disturbance, urban domicile, heredity and occupational acoustic trauma.

Miss W Galbraith describes the social implications of various degrees of deafness and the ways in which they can be overcome by such measures as lipreading, hearing aids and rehabilitation.

Sir Terence Cawthorne discusses otosclerosis, nearly 1% of the population being affected by this type of deafness. He describes the modern operation of insertion of an artificial piston through the stapes and states that 90% of cases submitted to this operation will show immediate improvement, whilst 85% should still have retained this improvement at the end of two years.
Displacement of One Drug by Another from Carrier or Receptor Sites
Authors: Brodie Bernard B
Published: July 2019

The medium of drug transfer is the water of plasma and extracellular fluid. Without complicating factors, the level of drug at a receptor site would be equal to that in the tissues and in plasma, and in dynamic equilibrium. Actually, almost all drugs are reversibly bound to proteins in plasma or tissue. The bound drug, often a high proportion of the total, acts as a reservoir, preventing wild fluctuations between ineffective and toxic levels of the biologically active unbound fraction.

Displacement from a receptor site diminishes drug activity, but displacement from plasma or tissue proteins augments the effect by making more unbound drug available at the receptor site.

Atropine has no intrinsic activity, but displaces acetylcholine or pilocarpine from receptors at para-sympathetic nerve endings. Similarly guanethidine competes with noradrenaline at sympathetic nerve endings, but in turn is displaced by amphetamine-like drugs.

Many acidic drugs (phenylbutazone, sulfonamides, coumarin anticoagulants, salicylates, &c.) are highly bound to one or two sites on albumin molecules. When the limited carrying capacity of the plasma proteins is filled, any unbound surplus is usually soon metabolized or excreted, so the plasma level becomes restabilized. Meanwhile, however, there may be dramatic effects such as hypoglycemia, when sulfonamides are given to patients on tolbutamide, or bleeding when phenylbutazone is given to patients on warfarin.

Although hormones, like thyroxine, insulin and cortisol, are carried by specific proteins, they too can be displaced. All the antirheumatic drugs so far examined have displaced cortisol and presumably driven it into tissues. This may be one mechanism of action. Possibly the sulfonylurea drugs act by displacing insulin from proteins in the pancreas, plasma or elsewhere.
Drug Addiction [Abridged]
Authors: Bewley Thomas H
Published: July 2019

Dr T H Bewley discusses recent increases in the incidence of all types of drug dependence in Great Britain.

Dr P H Connell considers the problem of amphetamine dependence historically and in different age groups and draws attention to the sociocultural patterns of behaviour which have sprung up amongst the adolescent and young adult population. Treatment is discussed.

Dr R H V Ollendorff outlines a theory of drug addiction based upon seven ætiological factors, and stresses the importance of the general practitioner in treating the addict.
International reconciliation on the Internet? Ontological security, attribution and the construction of war memory narratives in Wikipedia
Authors: Gustafsson Karl
Published: July 2019

This article explores the Internet’s often touted potential for facilitating reconciliation. It conceptualises Wikipedia as a site for collective memory construction and analyses the Chinese- and Japanese-language entries on the bilaterally contentious Second Sino-Japanese War. It addresses the question of how to make sense of the construction of these online collective memory narratives theoretically. Both historical determinism and instrumentalism – two influential theoretical approaches to collective memory and reconciliation – have great difficulties in fully accounting for this case. Instead, it is argued that ontological security theory is better equipped for understanding collective memory construction in Wikipedia. It is suggested that ontological security seeking can impede efforts for reconciliation even when, as in Wikipedia, there exist norms seeking to promote more neutral narratives. It is argued that a subtle bias in favour of the in-group and against the out-group functions as a mechanism for ontological security management that protects a positive self-identity.
CASM: A Deep-Learning Approach for Identifying Collective Action Events with Text and Image Data from Social Media
Authors: Zhang Han , Pan Jennifer
Published: July 2019

Protest event analysis is an important method for the study of collective action and social movements and typically draws on traditional media reports as the data source. We introduce collective action from social media (CASM)—a system that uses convolutional neural networks on image data and recurrent neural networks with long short-term memory on text data in a two-stage classifier to identify social media posts about offline collective action. We implement CASM on Chinese social media data and identify more than 100,000 collective action events from 2010 to 2017 (CASM-China). We evaluate the performance of CASM through cross-validation, out-of-sample validation, and comparisons with other protest data sets. We assess the effect of online censorship and find it does not substantially limit our identification of events. Compared to other protest data sets, CASM-China identifies relatively more rural, land-related protests and relatively few collective action events related to ethnic and religious conflict.
Brazil Moves Toward the Replacement of Animal Experimentation
Authors: de Ávila Renato Ivan , Valadares Marize Campos
Published: July 2019

In Brazil, efforts towards the regulatory acceptance and implementation of innovative methods to replace experimental animal use in various fields began to gather force in 2008, with the approval of Law No. 11,794/2008 (the Arouca Law). This law represented a milestone, as it created the National Council for the Control of Animal Experimentation (CONCEA) to deal with the ethical and legal issues related to the use of laboratory animals. In 2014, CONCEA put together a framework for expanding the implementation of non-animal methodologies for use in research and education. It also promoted the regulatory acceptance in Brazil of 24 test guidelines, including 15 in vitro approaches. It should be emphasised that, in Brazilian legislation, replacement is generally based on the toxicological endpoint and not on the category of product, as tends to be the case in other countries (e.g. cosmetics in the European Union). The resolution-dependent deadlines for the obligatory replacement of in vivo methods with the CONCEA-approved tests are 2019 and 2021. Brazil has advanced considerably towards the replacement of animal experimentation, and in certain aspects, this has been in a highly progressive manner. However, there is still a lot of work to be done, especially considering the current political scenario with reduced investment in research, development and innovation. The chronology of significant events following the approval of the Arouca Law, which have contributed to the promotion of the Three Rs alternatives in Brazil, will be examined.
Probation supervision as a network of relationships: Aiming to be thick, not thin
Authors: Dominey Jane
Published: July 2019

This article is about the networks of relationships (between people and between organisations) that underpin probation supervision. Drawing on evidence from a study researching these interactions, it develops two models of supervision (‘thin’ and ‘thick’) by taking themes that shape supervision and charting the interplay between them. The article develops these models in the increasingly fragmented landscape that has followed the Transforming Rehabilitation (TR) reforms in England and Wales. The concepts of ‘thin’ and ‘thick’ are used here to describe the supervisory network. Thin supervision describes a minimal and administrative approach to supervision. By contrast, thick supervision requires a network with strong and purposeful links. The article acknowledges the impact of public sector spending cuts on probation services and concludes by reflecting on the challenge of building and sustaining thick supervision in the current context.
Stepwise analysis of potential accuracy-influencing factors of iodine quantification on a fast kVp-switching second-generation dual-energy CT: from 3D-printed phantom to a simple solution in clinical routine use
Authors: Böning Georg , Jahnke Paul , Feldhaus Felix , Fehrenbach Uli , Kahn Johannes , Hamm Bernd , Streitparth Florian
Published: July 2019

Background

Measurement of iodine concentration from dual-energy or spectral computed tomography (CT) provides useful diagnostic information especially in patients suffering from malignant tumors of various origins.

Purpose

The purpose of this study was to systematically investigate the accuracy of the measurement of iodine concentration, focusing on potential influencing factors and assessing its suitability for routine clinical use.

Material and Methods

First, a 3D-printed cylindrical phantom was used to assess reliability of dual-energy CT-based iodine concentration measurement. Second, a semi-anthropomorphic phantom was used to evaluate the potential impact of positional variation of the target volume as typically seen in clinical scans. Finally, a reference vial was placed on the body surface of 38 patients undergoing abdominal dual-energy CT to analyze correlations between applied doses and patient diameters.

Results

The position of the target volume within the cylindrical phantom and the applied dose level significantly influenced the magnitude of measured iodine concentrations ( P < 0.001). We also found a significant difference in accuracy depending on target volume position in the semi-anthropomorphic phantom ( P = 0.028). In patient scans, we observed an error of 19.6 ± 5.6% in iodine concentration measurements of a reference and significant, moderate to strong, negative correlations between measured iodine concentration, maximum patient diameter, and applied dose (maximum sagittal diameter: r = −0.455, P = 0.004; maximum coronal diameter: r=−0.517, P = 0.001; CTDIvol: r = −0.385, P = 0.017)

Conclusion

Dual-energy CT-based iodine concentration measurement should be interpreted with caution. In clinical examinations, placement of a reference vial could be a potential solution to relativize errors.
Differential Item Functioning of a Truancy Assessment
Authors: French Brian F. , Vo Thao T.
Published: July 2019

The Washington Assessment of Risk and Needs of Students (WARNS) is a brief self-report measure designed for schools, courts, and youth service providers to identify student behaviors and contexts related to school truancy. Empirical support for WARNS item invariance between ethnic groups is lacking. This study examined differential item functioning (DIF) to ensure that items on the WARNS function similarly across groups, especially for groups where truancy rates are highest. The item response theory graded response model was used to examine DIF between Caucasian, African American, and Latinx students. DIF was identified in six items across WARNS domains. The DIF amount and magnitude likely will not influence decisions based on total scores. Implications for practice and suggestions for an ecological framework to explain the DIF results are discussed.
Comparison of Thrombocyte Count Between Pediatric Patients With Migraine or Tension-Type Headache: A Retrospective Cohort Study
Authors: Benedick Aviv , Zeharia Avraham , Markus Tal Eidlitz
Published: July 2019

Hypercoagulability may explain the increased risk of thromboembolic cerebrovascular events in patients with migraine. Thrombocytes play a crucial part in the coagulation process, and some studies have demonstrated hyperaggregation of thrombocytes in adult migraineurs. We aimed to compare thrombocyte count between pediatric patients with migraine or tension-type headache and to evaluate the correlation of thrombocyte count with headache parameters. The electronic database of a tertiary pediatric headache clinic was retrospectively searched for all children and adolescents diagnosed with migraine or tension-type headache in 2016-2018. Data on thrombocyte counts were collected from the medical files and compared between the groups by parametric and nonparametric statistical tests. The cohort included 299 patients, 176 girls (59.0%) and 123 (412.0%) boys, of mean age 12.2 ± 3.4 years; 198 had migraine and 101 had tension-type headache. Among the laboratory parameters evaluated, a significantly lower mean thrombocyte number was found in the migraine group than in the tension-type headache group (282 ± 60 vs 304±71 ×103/μL, P = .004). Within the migraine group, there was a significant negative correlation between the thrombocyte count and the duration of headache attacks in hours ( P < .05). No significant between- or within-group differences were found in other laboratory parameters. The low relative thrombocyte count in pediatric headache clinic patients with migraine and its negative correlation with duration of migraine suggest that migraine may be associated with a different underlying pathogenesis from tension-type headache.
Preliminary study of a customised total knee implant with musculoskeletal and dynamic squatting simulation
Authors: Wang Linjie , Wang Chang Jiang
Published: July 2019

Customised total knee replacement could be the future therapy for knee joint osteoarthritis. A preliminary design of a customised total knee implant based on knee anatomy was studied in this article. To evaluate its biomechanical performance, a dynamic finite element model based on the Oxford knee rig was created to simulate a squatting motion. Unlike previous research, this dynamic model was simulated with patient-specific muscle and joint loads that were calculated from an OpenSim musculoskeletal model. The dynamic response of the customised total knee implant was simulated under three cruciate ligament scenarios: both cruciate ligaments retained, only anterior cruciate ligament removed and both cruciate ligaments removed. In addition, an off-the-shelf symmetric total knee implant with retained cruciate ligaments was simulated for comparison analysis. The customised total knee implant with both cruciate ligaments retained showed larger ranges of femoral external rotation and posterior translation than the symmetric total knee implant. The motion of the customised total knee implant was also in good agreement with a healthy knee. There were no big differences in the tibiofemoral compressive forces in the customised total knee implant model under the three scenarios. These forces were generally consistent with other experimental and simulation results. However, the customised total knee implant design resulted in larger tibiofemoral compressive force than the symmetric total knee implant after 50° knee flexion, which was caused by the larger tibiofemoral relative motion.
A fault diagnosis approach for autonomous underwater vehicle thrusters using time-frequency entropy enhancement and boundary constraint–assisted relative gray relational grade
Authors: Yin Baoji , Zhang Mingjun , Lin Xi , Fang Jiwen , Su Shijie
Published: July 2019

This article presents a novel thruster fault diagnosis approach for an autonomous underwater vehicle. In the novel approach, a time-frequency entropy enhancement is used to extract feature, and then a boundary constraint–assisted relative gray relational grade is applied to identify thruster fault. The time-frequency entropy enhancement is developed from the smoothed pseudo Wigner–Ville distribution combined with Shannon entropy. First, the energy distributions of autonomous underwater vehicle dynamic signals are given in the time-frequency plane. And then the energy concentration in the energy distribution is enhanced based on a serial signal processing, including wavelet decomposition, modified Bayes’ classification algorithm, and two dimensional convolution operation, successively. After that the Shannon entropy of the energy distribution is calculated. The boundary constraint–assisted relative gray relational grade comes from the gray relational analysis. A mapping function between the relative gray relational grade and the fault severity is established. And then the boundary constraints of relative gray relational grades at each standard fault level are determined. Moreover, the mapping function is modified based on the boundary constraints. Experiments are performed on an experimental prototype autonomous underwater vehicle in a pool. The experimental results demonstrate the effectiveness of the developed approaches in terms of improving the sensitivity of the fault feature to the fault severity, compared with the smoothed pseudo Wigner–Ville distribution combined with Shannon entropy, and increasing the identification accuracy, compared with the gray relational analysis.
Factors behind ethical dilemmas regarding physical restraint for critical care nurses
Authors: Salehi Zahra , Najafi Ghezeljeh Tahereh , Hajibabaee Fatemeh , Joolaee Soodabeh
Published: July 2019

Background:

Physical restraint is among the commonly used methods for ensuring patient safety in intensive care units. However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety.

Aim:

The aim of this study was to explore factors behind ethical dilemmas for critical care nurses over using physical restraint for patients.

Design:

This is a qualitative study using conventional content analysis approach, as suggested by Graneheim and Lundman, to analyze the data.

Methods:

Seventeen critical care nurses were purposefully recruited from the four intensive care units in Tehran, Iran. Data were collected through in-depth semi-structured interviews and were concurrently analyzed through conventional content analysis as suggested by Graneheim and Lundman.

Ethical consideration:

This study was approved by the Ethics Committee of Iran University of Medical Sciences, Tehran, Iran with the code: IR.IUMS.REC.1397.795. Before interviews, participants were provided with explanations about the aim of the study, the confidentiality of the data, their freedom to participate, and the right to withdraw the study, and their free access to the study findings. Finally, their consents were obtained, and interviews were started.

Results:

Factors behind ethical dilemmas for critical care nurses over using physical restraint were categorized into three main categories, namely the outcomes of using physical restraint, the outcomes of not using physical restraint, and emotional distress for nurses. The outcomes of using physical restraint were categorized into the three subcategories of ensuring patient safety, physical damage to patients, and mental damage to the patient. The outcomes of not using physical restraint fell into two subcategories, namely the risks associated with not using physical restraint and legal problems for nurses. Finally, the two subcategories of the emotional distress for nurses main category were nurses’ negative feelings about restraint use and uncertainty over the decision on physical restraint use.

Conclusion:

Decision-making for restraint use is often associated with ethical dilemmas, because nurses need to weight the outcomes of its use against the outcomes of not using it and also consider patient safety and autonomy. Health authorities are recommended to develop clear evidence-based guidelines for restraint use and develop and implement educational and counseling programs for nurses on the principles of ethical nursing practice, patient rights, physical restraint guidelines and protocols, and management of emotional, ethical, and legal problems associated with physical restraint use.
Safe reinforcement learning using risk mapping by similarity
Authors: Serrano-Cuevas Jonathan , Morales Eduardo F , Hernández-Leal Pablo
Published: July 2019

Reinforcement learning (RL) has been used to successfully solve sequential decision problem. However, considering risk at the same time as the learning process is an open research problem. In this work, we are interested in the type of risk that can lead to a catastrophic state. Related works that aim to deal with risk propose complex models. In contrast, we follow a simple, yet effective, idea: similar states might lead to similar risk. Using this idea, we propose risk mapping by similarity (RMS), an algorithm for discrete scenarios which infers the risk of newly discovered states by analyzing how similar they are to previously known risky states. In general terms, the RMS algorithm transfers the knowledge gathered by the agent regarding the risk to newly discovered states. We contribute with a new approach to consider risk based on similarity and with RMS, which is simple and generalizable as long as the premise similar states yield similar risk holds. RMS is not an RL algorithm, but a method to generate a risk-aware reward shaping signal that can be used with a RL algorithm to generate risk-aware policies.
What Are the Important Risk Factors That Predispose a Patient to Infection After Total Ankle Arthroplasty (TAA)?
Authors: Senneville Eric , Aiyer Amiethab , Smyth Niall
Published: July 2019

Recommendation:

There is evidence indicating that the following risk factors may predispose a patient to an infection after a total ankle arthroplasty (TAA): inflammatory arthritis, prior ankle surgery, body mass index (BMI) <19, and peripheral vascular disease. Meanwhile, there is conflicting evidence (which may be due to patient selection bias) indicating that the following risk factors may predispose a patient to infection after a TAA: obesity (BMI >30), tobacco use, diabetes, duration of surgery, age <65 years, hypothyroidism, low preoperative American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and chronic lung disease.

Level of Evidence:

Limited.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Preoperative Optimization Should Be Implemented to Reduce the Risk of Surgical Site Infection/Periprosthetic Joint Infection (SSI/PJI) in Patients Undergoing Total Ankle Arthroplasty (TAA)?
Authors: Emara Khaled , Hirose Christopher B. , Rogero Ryan
Published: July 2019

Recommendation:

We recommend that patients awaiting total ankle arthroplasty (TAA) be optimized prior to surgery by implementing skin cleansing, nutritional status enhancement, glycemic control, body mass index (BMI) optimization, smoking cessation, and management of immune-modulating comorbidities. At the time of surgery, there is strong evidence that optimal preparation of the surgical site with an alcohol-containing agent, weight-based and timely administration of antibiotic prophylaxis, and reducing operating room traffic should also be put in place.

Level of Evidence:

Moderate.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
During Draping for Total Ankle Arthroplasty (TAA), Should the Foot Be Prepped Into the Surgical Field or Be Covered?
Authors: Kaplan Jonathan , Embil John M.
Published: July 2019

Recommendation:

There is insufficient data demonstrating any advantage or disadvantage to covering the toes during total ankle arthroplasty (TAA).

Level of Evidence:

Moderate.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Are Prophylactic Perioperative Antibiotics Required for Isolated Forefoot Procedures, Such as Hammertoes?
Authors: Oh Irvin , Englund Kristin
Published: July 2019

Recommendation:

Though limited clinical data exists, the administration of perioperative antibiotics is not required for isolated forefoot procedures in the absence of any risk factors, such as immunodeficiency or diabetes mellitus.

Level of Evidence:

Moderate.

Delegate Vote:

Agree: 67%, Disagree: 25%, Abstain: 8% (Super Majority, Weak Consensus)
Is There a Role for Measuring Synovial Biomarkers for Diagnosis of Infected Total Ankle Arthroplasty (TAA)?
Authors: Emara Khaled , Embil John M.
Published: July 2019

Recommendation:

Based on the hip and knee arthroplasty literature, measuring synovial biomarkers may play a role in the diagnosis of infected total ankle arthroplasty (TAA). The diagnosis of periprosthetic joint infection (PJI) in the setting of a TAA can be confirmed with cultures, provided that a plausible pathogen is recovered in the context of a compatible clinical picture. In the absence of a positive culture, synovial biomarker analysis may help in establishing the diagnosis.

Level of Evidence:

Moderate.

Delegate Vote:

Agree: 92%, Disagree: 8%, Abstain: 0% (Super Majority, Strong Consensus)
What Are the Indications and Contraindications for Irrigation and Debridement and Retention of Prosthesis (DAIR) in Patients With Infected Total Ankle Arthroplasty (TAA)?
Authors: Chan Jimmy J. , Mohamadi Amin , Walsh Samantha , Vulcano Ettore
Published: July 2019

Recommendation:

Debridement, antibiotics, and implant retention (DAIR) with polyethylene exchange may be indicated in early postoperative infection (<4 weeks) or acute hematogenous infection (<4 weeks of symptoms) in patients with infected total ankle arthroplasty (TAA), although recurrent infection has been seen. Suffcient clinical evidence is lacking.

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Metrics Can Be Used to Determine the Optimal Timing of Reimplantation in Patients Who Have Undergone Resection Arthroplasty as Part of a Two-Stage Exchange for Infected Total Ankle Arthroplasty (TAA)?
Authors: Senneville Eric , Lopez Valeria , Slullitel Gaston
Published: July 2019

Recommendation:

There is no conclusive data regarding what metrics can be used in order to determine the optimal timing of reimplantation for an infected TAA. We recommend that reimplantation is performed when there are clinical signs of resolution of infection (well-healed wound, lack of erythema, etc), and the serologic markers have substantially declined (>40%) from baseline (measured at the time of diagnosis of infection).

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).
Cancers in Vietnam—Burden and Control Efforts: A Narrative Scoping Review
Authors: Pham Tung , Bui Linh , Kim Giang , Hoang Dong , Tran Thuan , Hoang Minh
Published: July 2019

Although the burden of cancer is rapidly growing in Vietnam, there was no up-to-date review that describes cancer burden and control in Vietnam throughout the literature. By identifying various risk factors, means of prevention, and methods for early detection, this review seeks to systematically summarize the evidence for the future planning and management of cancer occurrence in Vietnam. Additionally, this report aims to identify improvements which are necessary for the treatment and palliative care of patients with cancer in Vietnam. We employed a hybrid approach including both a scoping review and narrative synthesis for this study. Information was identified, extracted, and charted from various sources, which include international and domestically published studies, in addition to gray literature. Our results illustrate that the burden of cancer in Vietnam has tripled in the past 30 years, and this situation could be partly explained by the growing prevalence of both old and new risk factors. Besides hepatitis B virus, various other important risk factors such as human papilloma virus, tobacco usage, physical inactivity, and improper diets are still not under control in Vietnam. There is presently a lack of national cancer screening programs, and the capacity of cancer care services could not maintain pace with the demands of a rapidly increasing Vietnamese population. Overall, policy frameworks for cancer control in Vietnam are in place, but there is still a lack of proper financing and governing models necessary to support a sustainable program. In conclusion, Cancer and its associated consequences are both persistent and emerging problems in Vietnam, and the results of cancer control programs are limited. A comprehensive and evidence-based approach toward the prevention and treatment of cancer should be the future direction for Vietnam.