bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Epilithic Communities due to Individual and Combined Treatments of Zinc and Snail Grazing in Stream Mesocosms
Authors: Genter Robert B. , Colwell Frederick S. , Pratt James R. , Cherry Donald S. , Cairns John
Published: May 2017

Effects of 0.5 mg/liter zinc (Zn) and snail grazing (400 snails/m2) on density of dominant algal and protozoan taxa, epilithic glucose respiration, and ash-free dry weight (AFDW) were examined using established (12-day colonization) periphyton communities inflow-through stream mesocosms with four treatments (Zn, snails, Zn and snails, control) for 30 days. Grazing and Zn similarly reduced the abundance of 5 of 10 dominant algal taxa and AFDW during the first 10 days of treatment. Abundance of these taxa and AFDW in grazed (ambient Zn) treatments approached control levels after 10 days as the effect due to snails decreased. Decreasing temperatures may have reduced snail activity. Snails, Zn, and the combination of these treatments contributed to higher rates of glucose respiration per unit AFDW. Protozoan species abundance was reduced to less than half by Zn but was unaffected by snails. Although Zn and snails individually altered structural and functional aspects of this microbial community, the effects when both treatments were combined could not always be inferred from the individual effects. Testing individual and combined variables that affect periphyton with a corresponding assessment of population dynamics, biomass, and community functional attributes will enhance understanding of the overall effects of pollutants on periphyton communities.
Design of a Primary Screen for Developmental Neurotoxicity
Authors: Walker Richard F. , Guerriero Frederick J. , Wier Patrick J.
Published: May 2017

A battery of tests was devised for routine use as a primary screen for developmental neurotoxicity. The battery was divided into pre-weaning and postweaning tests using rats as subjects. Since the rat CNS is structurally incomplete at birth, preweaning tests were predominantly physical, using specific landmarks of somatic maturation and regional brain growth as indices of normal development. Pupillary responses to light and positional responses to gravity (negative geotaxis) were also included in the preweaning battery to monitor reflex behavior, a relatively simple CNS function.

The postweaning battery predominantly contained functional tests to evaluate higher order behaviors that develop after completion of neurogenesis. The postweaning tests were divided into 4 subsets designed to evaluate (I) neuromuscular function, (II) memory, (III) problem solving, and (IV) neuroendocrine function, respectively. Curiosity, rhythmicity, patency of monoamine neurons, and physical measures of brain growth were included within the subsets so as to evaluate a spectrum of CNS functions.

Preliminary findings suggest that tests and instrumentation selected for the proposed battery provide an informative, objective, comprehensive and cost-efficient means to screen for developmental neurotoxicity.
Effects of Non-Psychotropic Drugs on Conditioned Behavior of Cats
Authors: Yen-Koo Helen C.Y. , Balazs T.
Published: May 2017

Cats were trained to obtain food pellets under a cycle reward condition in 4-6 weeks. These conditioned-behavior cats were then used for testing a group of non-psychotropic drugs, and any modification of the feeding cycle (FC) was considered as a side effect of the drug on conditioned behavior. All drugs were given orally. Of the 16 non-psychotropic drugs studied, only indomethacin caused a loss and irregularity in the FC. Antihistamines, acetylsalicylic acid, phenoxybenzamine and amantadine reduced the number of FC by about 50%. Studies of conditioned behavior in the cat appear to be useful for both the investigation of drug interactions and the detection of side effects of drugs not ordinarily considered to have central nervous system effects.
A Study of Mortality in Workers Engaged in the Mining, Smelting, and Refining of Nickel: I: Methodology and Mortality by Major Cause Groups
Authors: Roberts Robin S. , Julian James A. , Sweezey Daniel , Muir David C.F. , Shannon Harry S. , Mastromatteo Ernest
Published: May 2017

Following the publication of the NIOSH nickel criteria document in 1977, the Joint Occupational Health Committee of the International Nickel Company (INCO) commissioned a mortality study of the company's Ontario workforce. This paper describes the detailed methodology and primary mortality results of the ensuing study; subsequent papers will describe more detailed findings of cause-specific mortality. An historical prospective mortality study of approximately 54,000 INCO workers has been conducted. Men with six months or more of service were followed for mortality during a 35-year period by computerized record linkage to the Canadian National Mortality Data Base. From a company-provided list of men known to have died and through independent follow-up of a random sample of 1,000 subjects of unknown status, we estimate a mortality ascertainment rate of 95%. Cause-specific standardized mortality ratios calculated with respect to Ontario provincial mortality rates indicate an excess of accidental deaths in men working in the Sudbury area and an excess of cancer deaths at the company's Port Colborne nickel refinery. A strong healthy worker effect was found for both all-disease mortality ad cancer mortality. The lower than expected mortality persisted for about 15 years beyond initial hiring.
Experimental Exposures of Young Asthmatic Volunteers to 0.3 Ppm Nitrogen Dioxide and to Ambient Air Pollution
Authors: Avol Edward L. , Linn William S. , Peng Ru-Chuan , Whynot Jill D. , Shamoo Deborah A. , Little David E. , Smith Myra N. , Hackney Jack D.
Published: May 2017

Asthmatic volunteers aged 8 to 16 (N = 34) were exposed on separate occasions to clean air (control), to 0.30 ppm nitrogen dioxide (NO2) in otherwise clean air, and to polluted Los Angeles area ambient air on summer mornings when NO2 pollution was expected. Exposures lasted 3 hr, with alternating 10-min periods of exercise and rest. In ambient pollution exposures, 3-hr average NO2 concentrations ranged from 0.01 to 0.26 ppm, with a mean of 0.09 ppm. Ambient exposures did not significantly affect lung function, symptoms, or bronchial reactivity to cold air, relative to the control condition. Responses to 0.3 ppm NO2 exposures were equivocal. Asthma symptoms were more severe during 1-week periods before 0.3 ppm exposures, and lung function was decreased immediately before 0.3 ppm exposures, compared to other conditions. Lung function declined slightly during the first hour at 0.3 ppm, but improved over the remaining 2 hr. Compared to other conditions, symptoms were not increased during 0.3 ppm exposures, but were increased during 1-week periods afterward. These observations may reflect untoward effects of 0.3 ppm NO2, or may reflect chance increases in asthma severity prior to 0.3 ppm exposures.
“Environmental Justice”: The Central Role of Research in Establishing a Credible Scientific Foundation for Informed Decision Making
Authors: Sexton Ken , Olden Kenneth , Johnson Barry L.
Published: May 2017

Although much of the evidence is anecdotal and circumstantial, there are mounting concerns that environmental health risks are borne disproportionately by members of the population who are poor and nonwhite. We examine the central role of environmental health research in defining the dimensions of the problem, understanding its causes, and identifying solutions. Environmental health sciences, including epidemiology, exposure analysis, pharmacokinetics, toxicology, and surveillance monitoring, must be employed to determine the extent to which society has achieved “equity” and “justice” in safeguarding the health and safety of its citizens. By improving our ability to identify, evaluate, prevent, and/or reduce risks for all members of society, environmental health research can contribute directly to fair and equitable protection for everyone, regardless of age, ethnicity, gender, race, or socioeconomic status.
Health Risks from Contaminated Water: Do Class and Race Matter?
Authors: Calderon Rebecca L. , Johnson Charles C., , Craun Gunther F. , Dufour Alfred P. , Karlin Richard J. , Sinks Thomas , Valentine Jane L.
Published: May 2017

The impact of contaminants in water on minorities and economically disadvantaged persons was reviewed. Environmental legislation governing water was summarized as background information against which relevant studies were evaluated. The majority of the available information was anecdotal or case study and did not lend itself to making quantitative comparisons or analyses. However, the data did present certain trends that led to the conclusion that inequities concerning exposure to contaminants in water may exist. The following recommendations were made: current data bases should be analyzed and new data bases created to facilitate assessments of exposure to waterborne contaminants to all populations; an analysis of populations not covered by the Safe Drinking Water Act should be undertaken; a survey should be conducted of the drinking water infrastructure and the results evaluated to identify any impacts to minorities and economically disadvantaged persons; the social, cultural and economic characteristics that influence human exposure to waterborne contaminants need to be identified; and better educational and community outreach programs need to be developed and implemented.
Environmental Equity and Pesticide Exposure
Authors: Moses Marion , Johnson Eric S. , Anger W. Kent , Burse Virlyn W. , Horstman Sanford W. , Jackson Richard J. , Lewis Robert G. , Maddy Keith T. , Mcconnell Rob , Meggs William J. , Zahm Shelia Hoar
Published: May 2017

Although people of color and low-income groups bear a disproportionate share of the health risks from exposure to pesticides, research attention has been meager, and data on acute and chronic health effects related to their toxic exposures are generally lacking. Increased resources are needed both to study this issue and to mitigate problems already identified. People of color should be a major research focus, with priority on long-term effects, particularly cancer, neurodevelopmental and neurobehavioral effects, long-term neurological dysfunction, and reproductive outcome. Suitable populations at high risk that have not been studied include noncertified pesticide applicators and seasonal and migrant farm workers, including children.
A Cooperative Approach to the Logic of Collective Action: Voluntary Organizations and the Prisoners' Dilemma
Authors: Rich Richard C.
Published: May 2017

A reexamination of certain tenets of Olson's logic of collective action suggests that it fails to explain some types of behavior found in voluntary organizations, especially mutual assistance groups. Specifically, Olson fails to account for non-coercive and non-individualistic factors and gives insufficient attention to the social context of voluntary organization life. A fresh applications of the prisoners' dilemma and the introduction of the concept of community expand our understanding of behaviors heretofore unexplained. Implications are discussed for the design and management of voluntary organizations under certain conditions.
Attitudes toward the Homeless in Two New York City Metropolitan Samples
Authors: Benedict Annette , Shaw Jeffrey S. , Rivlin Leanne G.
Published: May 2017

Attitude questionnaires were administered to a sample of New York City residents and a suburban sample who worked in New York City (n = 112 for each). While overall attitudes toward the homeless were sympathetic, feelings about a shelter for the homeless in one's neighborhood were not favorable. Feelings toward a shelter were unfavorable regardless of whether the shelter was to serve “over 20” or “up to 10” homeless persons. Despite demographic differences on income, age, time living in the New York City area and education, the two samples differed significantly on only two responses related to attitudes or to experiences with the homeless. New York City residents rated their attitudes toward the elderly as more sympathetic than did suburban residents (p <. 05), though both samples reported very favorable attitudes. Also, a greater proportion of the New York City residents, 76.7%, as opposed to 52.8% for suburban residents, stated that the situation of the homeless had gotten worse in the past few years (p <. 001). To examine the relationships between attitude responses and other variables, factor analyses were carried out for each sample on those variables that correlated significantly with the attitude measures. Composite variables based on these factors revealed that, for both New York City and suburban residents, significantly more favorable attitudes were obtained for those respondents who had given money to the homeless and who had used the media and their own reading in forming an opinion about the homeless.
Thermal and exergetic evaluation of parabolic trough collectors with finned absorbers operating with air
Authors: Bellos Evangelos , Tzivanidis Christos , Daniil Ilias
Published: May 2017

The objective of this work is to evaluate energetically and exergetically the use of internal longitudinal fins in parabolic trough collectors operating with air. Nine different finned absorbers are compared with the smooth absorber for various inlet temperatures up to 500℃. More specifically, the use of 4, 8, and 16 fins with lengths 5 mm, 10 mm, and 15 mm are examined. The simulation tool is Solidworks Flow Simulation and the examined parabolic trough collector is the Eurotrough module. According to the final results, the global maximum exergetic efficiency is 43.65% and it is achieved for 4 fins with 15 mm length, while the inlet temperature of the air is equal to 350℃ and the thermal efficiency is 67.98%. Moreover, in the cases of 8 and 16 fins, the optimum lengths exergetically are 10 mm and 5 mm respectively, a fact that proves the reverse relationship between the number of fins and the fin length. Finally, it is also important to be stated that greater number of fins and higher fin length not only lead to higher thermal performance but also to higher pressure losses; two factors are taken into consideration in the exergetic performance, which is the main evaluation index of this study.
Difference of purpose: The usage of railway accounts in Victoria and Queensland (1880–1900), a comparative study
Authors: Stevenson-Clarke Peta , Bowden Bradley
Published: May 2017

In both the New and Old Worlds, the railways were invariably the largest business enterprises of the nineteenth century in terms of both employment and capitalisation. This article explores whether Australia’s railroads were also seminal institutions for the employment of accountants and the advance of their discipline, through a consideration of the effects of commonalities and differences with the American experience. Commonalities exist in the similar roles played by American and Australian railways in the global economy, while differences principally relate to ownership structure – the former being privately owned and the latter state-owned. State ownership is found to have had a more significant influence than economic commonalities. Financial accounting was retarded due to (1) dealings with investment markets being the responsibility of Parliamentarians and (2) the abstinence of Australian railways from financial endeavours such as land speculation. The domination of cost accounting by professional engineers also left little room for qualified accountants.
Acute Dystonia from Etoposide
Authors: Ascher David P. , Delaney Robert A.
Published: May 2017

We present a case of acute dystonia caused by administration of etoposide in an 11-year-old boy being treated for acute lymphoblastic leukemia. We believe this is the first report of this side effect.
The Role of Calcium Channel Blocking Agents in the Prevention of Migraine
Authors: Schuler Mary E. , Goldman Morton P. , Munger Mark A.
Published: May 2017

Vascular headache pathophysiology and manifestations are reviewed along with the role that calcium channel blocking agents play in prevention of these vascular headaches. Of the calcium channel blockers presently marketed in the U.S., verapamil has been the most widely studied. Verapamil has been shown to produce a significant improvement in frequency and duration of migraine as compared with placebo. Calcium channel blocking agents that have been studied and used outside of the U.S. are flunarizine and nimodipine, both of which provide significant improvement in measures of migraine severity, duration, frequency, and other pain and severity indices. There have been no controlled trials comparing these agents with each other as with beta-blocking agents and other prophylactic agents presently marketed in the U.S. Calcium channel blocking agents may become the drugs of first choice in migraine prophylaxis due to their effectiveness and mild side effect profile.
Phenytoin Hepatotoxicity: A Review of the Literature
Authors: Smythe Maureen A. , Umstead Greg S.
Published: May 2017

Phenytoin hepatotoxicity is a serious idiosyncratic reaction that occurs in less than one percent of patients. The onset of symptoms occurs early in therapy, usually within the first six weeks. Presenting symptoms often include fever, rash, lymphadenopathy, hepatomegaly, anorexia, and myalgias or arthralgias. Other significant findings that may develop throughout hospitalization are jaundice, periorbital or facial edema, and splenomegaly. The following alterations in liver function tests are associated with phenytoin hepatotoxicity: elevations in serum aminotransferases, lactic dehydrogenase, alkaline phosphatase, bilirubin, and prothrombin time. Rechallenges, lymphocyte stimulation test, and liver biopsy have been used to aid in the diagnosis. Rechallenge is the most definitive diagnostic approach; however, its use is limited by the potential of a fatal reaction. Although the exact mechanism of phenytoin hepatotoxicity is unknown, the majority of literature supports a hypersensitivity mechanism. The severity of this adverse effect ranges from self-limiting to fatal. Since 1965 six fatal cases have been reported. To date, sufficient evidence is not available to establish treatment guidelines. Discontinuation of phenytoin therapy is warranted.
Disopyramide and N-Monodesalkyl Disopyramide in Serum and Breast Milk
Authors: Ellsworth Allan J. , Horn John R. , Raisys Vidmantas A. , Miyagawa Lea Ann , Bell Judy L.
Published: May 2017

Maternal serum and breast milk were obtained to determine the concentration of disopyramide (DP) and its metabolite N-monodesalkyl disopyramide (NMD) from a woman requiring antidysrhythmic drug therapy. Infant serum and urine were also obtained for drug concentrations. DP 450 mg tid resulted in peak maternal serum concentrations of 4.0 μg/mL and 2.2 μg/mL for DP and NMD, respectively. Breast milk concentrations averaged 1.06 and 6.24 times the serum levels for DP and NMD, respectively. No DP was measurable in the infant's serum except for cord blood, which contained 0.7 μg/mL DP, 26 percent of simultaneous maternal concentration, and 0.9 μg/mL NMD, which represented 43 percent of the maternal concentration. Infant urine collected over an eight-hour period contained 3.3 μg/mL of DP and 3.7 μg/mL of NMD.
Methazolamide-Associated Temporary Leukopenia and Thrombocytopenia
Authors: Cohen Amos M. , Prialnik Michael , Ben-Nissan David S. , Savir Hanna
Published: May 2017

A three-week course of methazolamide therapy for chronic open-angle glaucoma resulted in marked leukopenia and thrombocytopenia. Prompt discontinuation of therapy resulted in complete recovery of white blood cell and platelet counts within five days. The recommendations for patients receiving carbonic anhydrase inhibitors for blood count control at six-month intervals are discussed.
Reducing the Risk of Aspiration Pneumonitis
Authors: Gonzalez Edgar R. , Kallar Surinder K.
Published: May 2017

Regurgitation of gastric contents with subsequent aspiration into the lungs contributes significantly to morbidity and mortality in surgical and nonsurgical patients. The consequences of aspiration pneumonitis depend on the volume and the acidity of the aspirate, and the presence of particulate and bacteria in the aspirate. The occurrence of aspiration pneumonitis may be prevented by correction of risk factors, careful monitoring, and appropriate airway management. The goal of aspiration pneumonitis prophylaxis is to minimize pulmonary complications by controlling risk factors for gastric regurgitation, which include gastric pH ≤ 2.5, gastric volume >25 mL, lower esophageal sphincter incompetence, and delayed peristalsis. Prophylactic techniques include nasogastric decompression, acid neutralization, acid suppression, and increased gastric peristalsis. The ability of drugs to alter risk factors does not guarantee that aspiration will not occur, but it does reduce the likelihood of secondary respiratory complications. The ideal prophylactic agent should consistently reduce all risk factors, produce a prompt and sustained response, and possess few adverse effects and drug interactions.
Drug-Induced Esophageal Injury: A Case Report of Percogesic
Authors: Nwakama Patrick E. , Jenkins Harry J. , Bailey Robert T. , Pelligrino John , Demeester Tom R. , Jones James B.
Published: May 2017

This is the first case report of esophageal injury caused by Percogesic. A 31-year-old healthy white woman presented with dysphagia and retrosternal pain following the ingestion of a Percogesic tablet. The patient felt the tablet lodge in her mid-esophagus even though she ingested it with a cupful of water and in the upright position. Additional fluid was taken to dislodge the tablet with no success. Past medical history was unremarkable for heartburn, regurgitation, or dysphagia. Upper gastrointestinal endoscopy revealed a well-circumscribed deep ulceration in the mid-esophagus. Hospitalization was required due to persistent dysphagia. Treatment consisted of a three-day regimen of liquid antacid, intravenous ranitidine hydrochloride, and metoclopramide. This case emphasizes that pill entrapment can occur in the esophagus in healthy individuals, even when taken in the upright position with plenty of fluid; and mucosal injury can be produced by drugs not generally reported to cause gastrointestinal adverse effects or mucosal injury.
Effects of Pentoxifylline on Proteinuria in Normotensive Patients with Diabetes Mellitus
Authors: White John R. , Karam John H. , Koda-Kimble Mary Anne
Published: May 2017

In 1985, investigators reported that four months of pentoxifylline therapy resulted in a significant decrease in proteinuria (46 percent reduction) and plasma fibrinogen concentrations (18 percent reduction) in patients with diabetes. Our study evaluated four normotensive patients with diabetes and documented proteinuria who were treated with pentoxifylline 400 mg tid for four months. A consistent decrease in proteinuria (as measured by the urine protein/creatinine ratio) and plasma fibrinogen concentrations was not observed. Therapy with pentoxifylline was discontinued after four months.
Reports of Erythematous Macular Skin Eruptions Associated with Diltiazem Therapy
Authors: Wirebaugh Stewart R. , Geraets Douglas R.
Published: May 2017

Diltiazem is a commonly prescribed calcium-channel antagonist for hypertension and ischemic heart disease. The incidence of rash associated with diltiazem therapy is reported to be 1.3 percent. We describe two patients who developed erythematous, macular skin eruptions, approximately two weeks following institution of diltiazem. The skin eruptions resolved after symptomatic treatment and the patients received further therapy with another calcium-channel antagonist. Diltiazem-associated skin eruptions are a rare adverse effect; however, the incidence of rash may occur more frequently than reported in postmarketing surveillance studies.
Chemical Stability of Suramin in Commonly used Infusion Fluids
Authors: Beijnen Jos H. , van Gijn Roel , Horenblas Simon , Underberg Willy J. M.
Published: May 2017

The chemical stability of suramin in NaCl 0.9%, dextrose 5%, and lactated Ringer's injection was investigated. The admixtures were stored in glass infusion bottles at 4°C in the dark, and at room temperature (22°C) both protected from light and under normal room fluorescent light conditions in a day-night rhythm. The initial concentration of suramin was approximately 1 mg/mL. Samples withdrawn immediately after preparation and at four hours, one, two, three, five, and seven days were analyzed by HPLC with ultraviolet (UV) detection. Samples were also inspected for visual changes and tested for changes in pH. Accelerated stability studies in NaCl 0.9% injection were executed at 90°C. The drug appeared to be stable under the chosen storage conditions with no visual changes or changes in pH. The accelerated experiments revealed that suramin degrades in NaCl 0.9% at 90°C with a half-life of about 5.5 hours. It is concluded that suramin 1 mg/mL is stable in NaCl 0.9%, dextrose 5%, and lactated Ringer's injections when stored in glass infusion bottles at 4°C in the dark and at 22°C under normal room light conditions in a day-night rhythm or protected from light for at least seven days.
Computers in Critical Care: Opportunities and Challenges
Authors: Dasta Joseph F.
Published: May 2017

Treating acutely ill patients in intensive care units (ICUs) requires assimilating large amounts of patient data. The computer can help process these data and display information in easy to understand formats. Also, knowledge-based systems can provide advice in diagnosis and treatment of common disorders in the ICU. For effective use of computers, systems must be integrated into the total hospital information system and computer data must logically become the primary medical record. Standards are being developed to aid in this process. Although computers have been used in the ICU for 25 years, most hospitals still use the paper medical record. Prototype systems such as the HELP, CARE, and PDMS systems are described. They are integrated ICU systems for computerizing most of the traditional functions in the ICU. Several commercial information management products are also described along with recently developed computerized drug and fluid delivery systems. Finally, prototype knowledge-based programs are presented that provide advice to the clinician on such topics as acid-base balance, hemodynamic monitoring, and shock management.
Drug Interactions of Macrolides: Emphasis on Dirithromycin
Authors: Watkins Vish S , Polk Ron E , Stotka Jennifer L
Published: May 2017

Objective

To describe the drug interactions of dirithromycin, a new macrolide, and to compare them with those of other macrolides.

Data Sources

A literature search was performed using MEDLINE to identify articles published between January 1980 and July 1995 concerning the drug interactions of macrolides. Published abstracts were also examined. All studies using dirithromycin were performed under the sponsorship of Eli Lilly and Company.

Data Synthesis

Erythromycin, the first macrolide discovered, is metabolized by the cytochrome P450 enzyme system. By decreasing their metabolism, erythromycin can interact with other drugs metabolized by the cytochrome P450 enzymes. The lack of such interactions would be a desirable feature in a newer macrolide. We describe studies performed to detect any interactions of dirithromycin with cyclosporine, theophylline, terfenadine, warfarin, and ethinyl estradiol. The studies showed that dirithromycin, like azithromycin, is much less likely to cause the interactions detected with clarithromycin and erythromycin. A review of the literature showed differences among macrolides in their abilities to inhibit cytochrome P450 enzymes and, thus, to cause drug–drug interactions. Erythromycin and clarithromycin inhibit cytochrome P450 enzymes, and have been implicated in clinically significant interactions. Azithromycin and dirithromycin neither inhibit cytochrome P450 enzymes nor are implicated in clinically significant drug–drug interactions.

Conclusions

Dirithromycin, a new macrolide, does not inhibit the cytochrome P450 enzyme system. The concomitant use of dirithromycin with cyclosporine, theophylline, terfenadine, warfarin, or ethinyl estradiol was studied in pharmacokinetic and pharmacodynamic studies. In vitro, dirithromycin did not bind cytochrome P450. In healthy subjects, erythromycin increases the clearance of cyclosporine by 51%, whereas dirithromycin causes no significant changes in the pharmacokinetics of cyclosporine. In kidney transplant recipients, administration of dirithromycin was associated with a significant (p < 0.003) decrease of 17.4% in the clearance of cyclosporine. In patients taking low-dose estradiol, the administration of dirithromycin caused a significant (p < 0.03) increase of 9.9% in the clearance of ethinyl estradiol; escape ovulation did not occur. Unlike erythromycin and clarithromycin, dirithromycin had no significant effects on the pharmacokinetics of theophylline, terfenadine, or warfarin. The alterations typical of drug interactions that are based on inhibition of the cytochrome P450 system occurring with erythromycin and clarithromycin were not observed with dirithromycin.
Response to Initial Griseofulvin Therapy in Pediatric Patients with Tinea Capitis
Authors: Abdel-Rahman Susan M , Nahata Milap C , Powell Dwight A
Published: May 2017

Objective

To estimate the response rate to initial griseofulvin therapy in pediatric patients with tinea capitis and to determine whether clinical or epidemiologic variables differed between patients responding positively and negatively to therapy.

Methods

A review of patients' medical records with a confirmed diagnosis of tinea capitis was performed retrospectively over a 2-year period. Patients were included only if a positive dermatophyte culture was obtained and the initial prescription for griseofulvin was filled at our pharmacy. Responders were children not returning to the clinic or returning without signs or symptoms of infection. Nonresponders were those returning within 8 months with signs and symptoms of disease, requiring additional therapy.

Results

During July 1993-June 1995, 479 positive fungal cultures were confirmed in 474 patients, and 857 prescriptions for griseofulvin were filled for 765 patients at our institution. Of 122 evaluable patients meeting both criteria, 60.7% were classified as responders to initial prescribed therapy. The remaining 39.3% returned to the clinic within 8 months of initial therapy, requiring additional treatment. An additional 10.7% had a recurrence at a later date. There was no correlation between clinical response and dosage, age, race, or gender, although there was a trend toward longer treatment duration among responders.

Conclusions

It is evident that tinea capitis persists in the urban pediatric population. Our data suggest that griseofulvin, the current drug of choice, may be ineffective in at least one-third of pediatric patients with tinea capitis.
Oral Terbinafine: A New Antifungal Agent
Authors: Abdel-Rahman Susan M , Nahata Milap C
Published: May 2017

Objective

To review the pharmacology, pharmacokinetics, efficacy, adverse effects, drug interactions, and dosage guidelines of terbinafine. Available comparative data of terbinafine and other antimycotic agents are described for understanding the potential role of terbinafine in patient care.

Data Sources

A MEDLINE search restricted to English language during 1966–1996 and extensive review of journals was conducted to prepare this article. MeSH headings included allylamines, terbinafine, SF 86–327, dermatophytosis, dermatomycosis.

Data Extraction

The data on pharmacokinetics, adverse effects, and drug interactions were obtained from open-label and controlled studies and case reports. Controlled single- or double-blind studies were evaluated to describe the efficacy of terbinafine in the treatment of various fungal infections.

Data Synthesis

Terbinafine is the first oral antimycotic in the allylamines class: a fungicidal agent that inhibits ergosterol synthesis at the stage of squalene epoxidation. Terbinafine demonstrates excellent in vitro activity against the majority of dermatophyte species including Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum; less activity is seen against Dematiaceae and the filamentous fungi. It is least active against the pathogenic yeast and this correlates with the relatively poor efficacy against these organisms in vivo. High concentrations of terbinafine are achieved in keratinous tissues, the site of superficial infections, and these concentrations are maintained for up to 3 months. The clinical efficacy of terbinafine against a number of dermatophyte infections exceeds that of the current standard of therapy, griseofulvin. The efficacy of terbinafine may be as good or better than that of the azole antifungals. Additional studies are required to confirm these observations. Terbinafine demonstrates a good safety profile, and relatively few drug interactions have been identified.

Conclusions

Terbinafine is more effective than the gold standard, griseofulvin, in the treatment of tinea pedis and tinea unguinum, with considerably shorter treatment duration in the latter. It has been proven as effective as griseofulvin in the treatment of tinea capitis, tinea corporis, and tinea cruris. Terbinafine does not appear to offer any advantage in the treatment of nondermatophyte infections; its utility in the treatment of systemic infections has yet to be established. Depending on individual institutional costs, terbinafine may be a front-line drug for some superficial infections responding poorly to the current standard of therapy.
Clarithromycin-Induced Digoxin Intoxication
Authors: Laberge Patrice , Martineau Pierre
Published: May 2017

Objective

To report a case of clarithromycin-induced digoxin intoxication.

Case Summary

A 78-year-old white man with ischemic cardiomyopathy and chronic renal insufficiency was admitted 4 days after being prescribed clarithromycin for a suspected episode of bronchitis. He reported weakness, asthenia, and gastrointestinal symptoms; the digoxin serum concentration was measured at 3.89 ng/mL. The patient recovered uneventfully after digoxin and clarithromycin were discontinued.

Discussion

Erythromycin frequently interacts with other drugs that are also metabolized by the CYP3A4 isoenzyme. However, erythromycin is hypothesized to interact with digoxin by inhibiting Eubacterium lentum, which is a normal inhabitant of the human gut and is responsible for intestinal metabolism of digoxin in 10% of patients. Since clarithromycin shares a comparable antibacterial spectrum with erythromycin, the possibility of a drug interaction with digoxin remains. Only four cases of clarithromycin interacting with digoxin have been reported to date. Clinically, this interaction may have been more obvious because of our patient's moderate renal dysfunction and serum digoxin concentrations in the upper therapeutic range prior to clarithromycin initiation. Other causes for digoxin intoxication could not be identified.

Conclusions

Clarithromycin may inhibit the growth of E. lentum, which can lead to an increase in digoxin bioavailability and blood concentrations in patients in whom this intestinal metabolic pathway is present. Patients at risk include those with renal dysfunction, with serum concentrations in the upper therapeutic range, or with measured digoxin concentrations that are much lower than predicted by Pharmacokinetic calculations. For these patients, appropriate therapy includes the selection of an alternative, noninteracting antibiotic or, if this is not possible, a temporary reduction of digoxin dosage.
User-Centered Design of a Portable Fire Extinguisher
Authors: Amos Mary , Lawson Glyn
Published: May 2017

This case study documents the process followed to produce an alternative design of a fire extinguisher. The work focuses on how informative data can be gathered for an ethically challenging product scenario through the use of a range of user-centered research methods, including literature review, product evaluation, shadowing study, empathy study, expert interview, focus groups, and simulation equipment. Design improvements as a consequence of this process include reductions in size and weight, refillable cartridges, single-handed operation, intuitive form, minimal cleanup post-use, and better portability.
Plate theory as the variational limit of the complementary energy functionals of inhomogeneous anisotropic linearly elastic bodies
Authors: Murat François , Paroni Roberto
Published: May 2017

We consider a sequence of linear hyper-elastic, inhomogeneous and fully anisotropic bodies in a reference configuration occupying a cylindrical region of height [Formula: see text]. We study, by means of Γ-convergence, the asymptotic behavior as [Formula: see text] goes to zero of the sequence of complementary energies. The limit functional is identified as a dual problem for a two-dimensional plate. Our approach gives a direct characterization of the convergence of the equilibrating stress fields.
Mechanistic Modelling of Drug-Induced Liver Injury: Investigating the Role of Innate Immune Responses
Authors: Shoda Lisl KM , Battista Christina , Siler Scott Q , Pisetsky David S , Watkins Paul B , Howell Brett A
Published: May 2017

Drug-induced liver injury (DILI) remains an adverse event of significant concern for drug development and marketed drugs, and the field would benefit from better tools to identify liver liabilities early in development and/or to mitigate potential DILI risk in otherwise promising drugs. DILIsym software takes a quantitative systems toxicology approach to represent DILI in pre-clinical species and in humans for the mechanistic investigation of liver toxicity. In addition to multiple intrinsic mechanisms of hepatocyte toxicity (ie, oxidative stress, bile acid accumulation, mitochondrial dysfunction), DILIsym includes the interaction between hepatocytes and cells of the innate immune response in the amplification of liver injury and in liver regeneration. The representation of innate immune responses, detailed here, consolidates much of the available data on the innate immune response in DILI within a single framework and affords the opportunity to systematically investigate the contribution of the innate response to DILI.
Working memory demand of a task modulates bilingual advantage in executive functions
Authors: Jiao Lu , Liu Cong , Wang Ruiming , Chen Baoguo
Published: May 2017

Aims:

The present study aimed to investigate the effect of task demand in working memory on bilingual cognitive advantage (interference suppression and response inhibition) in young bilinguals.

Methodology:

Experiment 1 was performed with the flanker, Go/No-go, and modified flanker tasks, in which the first two tasks were involved in lower storage demand of working memory and the last task was involved in higher storage demand of working memory. Experiment 2 was performed with the Conditional-Go/No-go task, with a higher processing demand of working memory.

Data and analysis:

Reaction time and accuracy data were analyzed using a repeated measures analysis of variance.

Findings/Conclusions:

In Experiment 1, results showed that compared to monolinguals, the bilingual advantage in interference suppression occurred in the task with high storage demand (i.e., modified flanker task) and not in the low demand task (i.e., flanker task); however, this advantage effect was not observed in response inhibition. In Experiment 2, with the increasing working memory processing demand of tasks, the bilingual advantage in response inhibition was observed.

Originality:

The current study firstly examined the effect of task working memory demand on the bilingual advantage and provided some restrictive conditions for the advantage.

Significance/Implications:

Our results provide new evidence to support the effect of bilingual cognitive advantage.
‘Now He Sings’. The My Musical Memories Reminiscence Programme: Personalised Interactive Reminiscence Sessions for People Living with Dementia
Authors: Evans Simon C , Garabedian Claire , Bray Jennifer
Published: May 2017

This paper explores the impact of the My Musical Memories Reminiscence Programme (MMMRP), an innovative intervention that adopts a music-based reminiscence approach. MMMRP builds on the format of the popular Singing for the Brain sessions with the aim of increasing opportunities for interaction and reminiscence amongst people living with dementia. Data were collected pre- and post-intervention and three months later using structured observation, interviews and focus groups. Results suggest that the programme had a positive impact on participants by promoting engagement, reminiscence and social interaction. For some individuals the impacts continued beyond their participation in the programme. A range of key facilitators for successful implementation of this approach were identified including the Session Leader role, the involvement of informal carers and the input of volunteers.
Prevalence and incidence of noncystic fibrosis bronchiectasis among US adults in 2013
Authors: Weycker Derek , Hansen Gary L , Seifer Frederic D
Published: May 2017

Bronchiectasis is an incurable pulmonary disorder that is characterized pathologically by permanent bronchial dilatation and severe bronchial inflammation and clinically by chronic productive cough and recurrent infectious exacerbations; bronchiectasis often occurs in the presence of chronic obstructive pulmonary disease. It is widely believed that increasing use of high-resolution computed tomography has led to a marked rise in the number of persons with diagnosed bronchiectasis in current US clinical practice; up-to-date evidence, however, is lacking. Using a retrospective cohort design and health-care claims data (2009–2013), we estimated the prevalence of bronchiectasis (noncystic fibrosis)—based on narrow case-finding criteria—to be 139 cases per 100,000 persons, to be higher among women versus men (180 vs. 95 per 100 K), and to increase substantially with age (from 7 per 100 K to 812 per 100 K aged 18–34 years and ≥75 years, respectively); annual incidence was estimated to be 29 cases per 100,000 persons. Disease prevalence based on broad case-finding criteria was estimated to be 213 cases per 100,000 persons. The findings of this study suggest that between 340,000 and 522,000 adults were receiving treatment for bronchiectasis and that 70,000 adults were newly diagnosed with bronchiectasis, in 2013 US clinical practice. The findings of this study also suggest that bronchiectasis is much more common than previously reported (annual growth rate since 2001, 8%), presumably due—at least in part—to recent advances in, and increased use of, radiologic techniques. Additional research is needed to validate the findings of this study, to identify the reasons for increased prevalence, and to promote education about bronchiectasis nationally.
Oxidative Stress Markers and Metal Ions are Correlated With Cognitive Function in Alzheimer’s Disease
Authors: Pu Zhengping , Xu Wenjie , Lin Yong , He Jincai , Huang Manli
Published: May 2017

We investigated oxidative stress markers and metal ions in patients with Alzheimer’s disease (AD). The serum levels of ceruloplasmin (CER), C-reactive protein (CRP), uric acid (UA), homocysteine (Hcy), copper, iron, and zinc were determined in 125 patients with AD (mild, n = 2 8; moderate, n = 42; and severe, n = 55) and 40 healthy control (HC) participants. Compared to HC, CER and UA levels were significantly lower in moderate and severe AD groups, whereas CRP and Hcy levels were significantly higher in the severe AD group. Copper level was significantly higher in moderate and severe AD groups than the other groups. Compared to HC, iron level was significantly higher in patients with AD, whereas zinc level was significantly lower in patients with AD. In patients with AD, the severity of cognitive impairment was positively correlated with CER, UA, and zinc levels, whereas it was negatively correlated with copper level. Taken together, our findings provide a novel approach to assess AD progression.
Fines erosion: Turbophoresis can be harmful
Authors: Boulanger Joan AR , Wong Chong Y , Zamberi MS Amir , Shaffee SN Amira , Johar Zurita , Jadid Maharon
Published: May 2017

Enabling turbulence dispersion in a computational fluid dynamics simulation of a developing liquid–solid pipe flow leads to a focus of low-Stokes number particles around the pipe axis. This phenomenon is found to concentrate their impacts on a centrally located target surface such that a local erosion spot develops. This result is counter-intuitive as low-Stokes particles are deemed to follow the carrier average streamlines going around the body, which diminishes their probability of impact. This is nevertheless a fact reported experimentally too. Analysis of the simulations reveals that turbulence tends to drive preferentially tiny particles from areas of high to low agitation. This phenomenon is sometimes named as turbophoresis. Long straight piping systems are typical candidates for turbulent pipe flows hosting an annular zone of turbulence that tends to disperse and concentrate fines towards the axis. At the approach of a body, like a cross-flow cylinder, particles may be somewhat re-scattered away by the carrier dragging them around. As such, this turbulence dispersion effect on fines concerns various industrial solid transport systems. Fine impacts concentration is likely to create unexpected, local wear zone.
Between mediatisation and politicisation: The changing role and position of Whitehall press officers in the age of political spin
Authors: Garland Ruth
Published: May 2017

Despite widespread critiques of ‘political spin’, the way governments engage with the mass media has attracted relatively little empirical attention. There is a small but growing body of research into bureaucracies’ responses to mediatisation from within which have identified tensions between bureaucratic and party political values, but this has not included the United Kingdom. There are concerns that the traditional dividing line between government information and political propaganda has come under increasing pressure as a higher premium is placed on persuasion by both journalists and politicians battling for public attention in an increasingly competitive market. Within Whitehall, the arrival of Labour in 1997 after 18 years in opposition was a watershed for UK government communications, allowing the government to reconfigure its official information service in line with the party political imperative to deploy strategic communications as a defence against increasingly invasive media scrutiny. Public relations, in government as elsewhere, has grown in scale, scope and status, becoming institutionalised and normalised within state bureaucracies, but how has this affected the role, status and influence of the civil servants who conduct media management? Within the system of executive self-regulation of government publicity that is characteristic of Whitehall, government press officers must negotiate a difficult path between the need to inform citizens about the government’s programme, and demands by ministers to deploy privileged information to secure and maintain personal and party advantage in the struggle for power. Taking 1997 as a turning point, and through the voices of the actors who negotiate government news – mainly press officers, but also journalists and special advisers – this article examines the changing role and position of Whitehall press officers in what has become known as the age of political spin, finding that profound and lasting change in the rules of engagement has taken place and is continuing.