bluuebunny/crossref_metadata_2025 huggingface dataset:
Malaria from a Zoological Point of View
Authors: Christophers Rickard
Published: July 2019

Protozoal parasites occurring in the red cells of mammals are: Hepatozoon, Babesia, Theileria and Plasmodium. The frequency with which these forms occur differs considerably in the different mammalian orders. But whilst there is a relationship apparent between the mammalian stem and the form of parasite, there appears to be an even closer association with the type of blood-sucking arthropods which the mode of life of the animals in a particular stem favours. Ungulates in the days of their greatest development chiefly roamed in herds over rather arid country not favouring mosquitoes, but suitable for tick infestation. Monkeys and bats are more likely to live in a humid sheltered environment where they are more liable to attack by mosquitoes.

Knowledge of the plasmodial parasites of monkeys has up to recently been very meagre, but from the work of Sinton and Mulligan it appears certain that in the main distinct parasites occur respectively in the Oriental and Ethiopian regions, just as the genera of monkeys under present nomenclature are mainly confined to one or other of these zoo-geographical realms. P. brasilianum occurring in the Neotropical monkeys is a distinct parasite from any Old World form. None of the monkey parasites are probably really very close to those of man.

The apes evolved as part of a great Pliocene fauna, and their remains occur in Europe, Egypt and India. The progenitors even of the present-day African forms are found in the Indian deposits. In the gorilla and chimpanzee, forms of plasmodium, so far described, appear to be very similar to those of man, including the characteristic cresceni forms.

In the main the races of men are essentially Pleistocene and Palæarctic. They none of them form true Neotropical, Australasian or Oriental man in the zoological sense, but it is less certain there is not a relationship in the case of the Ethiopian region. The parasites of malaria in any case do not show any apparent relationship to the usual zoogeographical realms, and their distribution and prevalence appear to be determined on quite other grounds than those normal to zoological distributions. P. vivax occurs almost throughout the world within the July and January isotherms of 60°. P. falciparum is limited by the isotherms of 70°. Quartan is believed by Knowles and Senior White to have a peculiar geographical distribution. Frequency of occurrence is, however, entirely different from distribution, and this parasite probably also has its distribution determined by factors other than those usually concerned in the distribution of animal forms of life. Among other features it appears to be associated with areas of severe endemicity, and becomes conspicuous when transmission is abeyance. Mer has recently shown that it has a very slow development in the mosquito, and this may explain some of its peculiarities.
The Otosclerosis Problem: Including Reports of Two Cases Pathologically Examined (Dalby Memorial Lecture)
Authors: Gray Albert A.
Published: July 2019

The essential causative factor of otosclerosis is a gradually increasing defect in the vasomotor mechanism which governs the nutrition of the structures of the organ of hearing as a whole. The axon reflexes are, of course, included in this vasomotor mechanism, and the stimulus which excites the vasomotor mechanism is sound and sound alone. Consequently the vestibular apparatus and the semicircular canals are unaffected in otosclerosis.

There is no evidence whatever of any defect in any of the endocrine glands or their secretions in otosclerosis. Neither is there any evidence of any defect in the bone metabolism of the body. On the contrary the subjects of otosclerosis are, apart from their deafness, perfectly normal individuals with ordinary average health.

The deafness of otosclerosis bears very little relationship to the extent of the disease in the bone. The deafness may be very severe when the stapes is hardly fixed at all.

The severity of the tinnitus bears no relationship at all to the extent of the disease in the bone.

The extent of the change in the bone bears very little relationship to the duration of the disease.

The extent of the changes in the bone appears to depend upon the age of onset of the disease. The earlier in life that the otosclerosis begins, the more extensive will the bone lesion become.

The deafness of otosclerosis is to a large extent functional, and is the result of the insufficient supply of blood to all the nerve-structures concerned in the perception of sound.

The preponderance of women as subjects of otosclerosis is the result of the greater instability of their vasomotor system and the more frequent disturbances to which it is exposed.

The changes in the bone show a remarkable bilateral symmetry even to minute details. This symmetrical distribution is readily explained by the writer's view of the causative factor of otosclerosis. The vasomotor nerves governing the nutrition of the organ of hearing are anatomically symmetrical like other nerve-structures in the body. If, therefore, structural changes occur as a result of defective functioning of those nerves, such structural changes will naturally be bilaterally symmetrical in their distribution.
The Treatment of Otosclerotic and Similar Types of Deafness by the Local Application of Thyroxine
Authors: Gray Albert A.
Published: July 2019

The treatment described is the rational sequence, dependent on the writer's vasomotor explanation of otosclerosis. It consists in the local application of thyroxine to the ear. Many years ago it was observed by the writer that thyroid extract applied locally to the mucous membrane of the nose produced an active congestion without inflammatory reaction and lasting for a long time. If otosclerosis is the result of a defective vasomotor response in the small blood-vessels of the ear, then thyroxine locally applied might overcome this defect.

Fourteen cases were treated and very considerable improvement resulted in seven of these (50%). Of these seven, tinnitus was greatly relieved in those in which that symptom was present. Wax also began to be secreted again. The subjective symptom of paracusis, usually considered of very unfavourable significance, is no contra-indication to this method of treatment, as two of the most successful cases were the subjects of paracusis.

The method of application is very simple and is described in full in the paper.

Cases which are not suitable for this treatment are very advanced cases, and those in which there is any serious loss of bone conduction, or in which the loss of hearing for high notes is marked.
The Importance of Statistics in Psychiatry
Authors: Penrose L. S.
Published: July 2019

The paper gives an outline, with examples, of various statistical methods which may be of special use in psychiatry.

(1) Actuarial data.—The simple accumulation of accurate figures on the ages of patients, their diagnoses and length of stay in hospital or under treatment for mental illness is of great value in understanding the scope of psychiatric problems. The age and sex incidences which correspond to different disease groups are very characteristic. Such material has value in the estimation of the results of therapeutic experiments but special methods have to be devised, as there is no exact prototype in standard vital statistics or in work on therapeutic trials.

(2) Biometric techniques.—Knowledge of ordinary statistical practice guards against elementary errors and aids in establishing significance or otherwise of metrical deviations from the normal found in mentally ill subjects. Also the range of variations may be much more marked in abnormal than in normal groups. Furthermore, abnormal reactions in themselves may be characterized by either too much or too little variety, i.e. by scatter or by stereotypy.

Discrimination between normal and abnormal reaction can be based on a single quantitative measurement, on difference in variance or on a compound measurement, i.e. pattern or profile. The discriminative approach has advantages over other methods because in this approach the initial factors are concrete and based on known classes such as males and females, children and adults, special clinical types, &c.

(3) Genetical analysis.—Actuarial data can be useful in genetic studies by leading to estimation of population frequency of genes and consanguinity rates. Moreover, combined clinical and genetical observations can reveal the existence of new clinical entities.
Some Recent Advances in the Study of Carbohydrate Degradation in the Mouth
Authors: Hartles R. L.
Published: July 2019

The metabolism of carbohydrates in the oral environment is discussed.

Manometric methods are very suitable for the study of carbohydrate breakdown in the mouth, only small amounts of material being required. Results of the overall metabolic products can be obtained as also a knowledge of particular enzymic processes.

The use of enzyme inhibitors to reduce acid production in the mouth is discussed briefly.
Obesity [Abridged]
Authors: Hopkins Philip
Published: July 2019

Dr Philip Hopkins defines obesity and describes its incidence in his general practice. He stresses the importance of dealing with underlying psychological factors in the treatment of the condition.

Dr A A Lewis discusses hormonal influences and advocates a high protein diet as being an acceptable means of achieving weight reduction.

Professor John Yudkin shows that a low protein diet is impracticable, and stresses the importance of physical activity in the treatment of obesity. He advocates a low carbohydrate diet with unrestricted fat and protein.
Influence of Acid-Base Balance on Efficacy and Toxicity of Drugs
Authors: Milne M D
Published: July 2019

Changes in acid-base balance have a profound influence on many aspects of the action of drugs. This is illustrated by data on the absorption of drugs from the stomach and intestine, in changes in distribution of drugs between plasma and cells, and the effect of change in urinary pH.

As a general principle, these changes in the pharmacology of weak acids and bases are governed by physicochemical principles, which influence the proportion of the ionized and unionized components according to the pH of the medium and also to the peculiar property of biological membranes which allow the free passage of the lipoid-soluble unionized component and impede transfer of the water-soluble ionized fraction.

Lipoid-soluble weak acids are excreted at higher clearances in alkaline urine, and conversely weak bases in acid urine. This is shown to be of practical importance in the treatment of poisoning, in the diagnosis of addiction to drugs and in studies of drug metabolism. In general, the excretion of natural metabolites is less likely to be influenced by urinary pH, as these substances are usually less lipoid-soluble than many widely used drugs. pH-dependent excretion is, however, of practical importance in relation to the urinary content of many indolic metabolites and also in the excretion of pigments derived from the degradation of hæmoglobin. Urobilinogen excretion is certainly pH-dependent, a higher clearance rate occurring in alkaline urine. However, work is necessary to decide whether some of the porphyrins also show this important physiological property.
The Dawn of State Medicine in Britain
Authors: McConaghey R M S
Published: July 2019

Dr R M S McConaghey traces the development of State control in the provision of medical services and also describes the rise in status of the general practitioner, from the early apothecary-surgeons.

Mr Paul Vaughan describes the history of the British Medical Association and its development from the Provincial Medical and Surgical Association, founded by Sir Charles Hastings. He considers the relationship between the BMA and the Government, both in the past and present.
Developmental Pædiatrics
Authors: Holt K S
Published: July 2019

Dr K S Holt defines the variety of neurologicalresponses which can be elicited in the newbornbaby and considers their importance in diagnosingdelay in development or abnormalities of thenervous system.

Dr Mary D Sheridan describes her finely developedmethods and ingenious devices for testingchildren down to the age of 6 months.

Dr Margaret Pollak outlines the advantages ofa developmental pediatric clinic in general practiceand quotes examples of how this has helpedher own patients.
Can fixed versus growth mindset theories of intelligence and chess ability, together with deliberate practice, improve our understanding of expert performance?
Authors: Tenemaza Kramaley David , Wishart Jocelyn
Published: July 2019

The expert performance theory by Ericsson et al. which maintains that deliberate practice can account for most of the variance in expertise studies is often posed as a strong scientific framework for research on giftedness. The current study explored relationships between performance, deliberate practice and mindset beliefs about intelligence and ability in chess play. Data were gathered through questionnaire survey from a sample of 21 participants at a chess tournament. Results indicate that those with a growth mindset for chess ability had longer serious study sessions and those with an intelligence growth mindset participated in more serious competitions. In light of this, educators should consider that a student’s performance in their academic setting may be affected by a mindset category that they have not yet considered and in different ways. This could include, for example, ‘mathematics’ or ‘examination performance’ mindsets, among others.
Reduced gray matter volume in patients with retinal detachment: evidence from a voxel-based morphometry study
Authors: Li Biao , Liu Yu-Xin , Li Hai-Jun , Yuan Qing , Zhu Pei-Wen , Ye Lei , Su Ting , Shi Wen-Qing , Lin Qi , Min You-Lan , Xu Xiao-Wei , Shao Yi
Published: July 2019

Background

We know little about the pathogenesis and diagnosis of retinal detachment.

Purpose

To assess spontaneous changes in the cerebral cortex of patients with retinal detachment using voxel-based morphometry and to explore the relationship between retinal detachment and clinical behavioral performance.

Material and Methods

Patients (14 men, 6 women; average age = 49.15 ± 10.32 years) with rhegmatogenous retinal detachment (duration of 24.05 ± 19.61 days) and 20 matched healthy controls were recruited. All participants underwent repeated functional magnetic resonance imaging scans. The original three-dimensional T1 brain images were analyzed using voxel-based morphometry and whole brain white matter volume and whole brain gray matter volume were compared with those of the control group. A receiver operating characteristic (ROC) curve was used to classify the mean gray matter volume values of the patients with retinal detachment compared with the controls.

Results

Compared with the controls, whole brain gray matter volume was significantly reduced in patients with retinal detachment, as evidenced by changes in the right inferior frontal gyrus, right superior temporal gyrus, right anterior cingulate gyrus, and right cuneus. In addition, the posterior lobe of the cerebellum, left hippocampus, left cingulate gyrus, and left middle temporal gyrus were also obviously atrophied. Furthermore, whole brain white matter volume of the patients with retinal detachment showed a slight reduction. The ROC curve analysis of each brain region showed that the accuracy of the area under the curve was high.

Conclusion

We proved that patients with retinal detachment had unusual changes in the gray matter volume and white matter volume in vision-related brain regions, which could reveal potential pathological mechanisms of retinal detachment.
System-Level Optimization of Multi-Modal Transportation Networks for Energy Efficiency using Personalized Incentives: Formulation, Implementation, and Performance
Authors: Araldo Andrea , Gao Song , Seshadri Ravi , Azevedo Carlos Lima , Ghafourian Hossein , Sui Yihang , Ayaz Sayeeda , Sukhin David , Ben-Akiva Moshe
Published: July 2019

The paper presents the system optimization (SO) framework of Tripod, an integrated bi-level transportation management system aimed at maximizing energy savings of the multi-modal transportation system. From the user’s perspective, Tripod is a smartphone app, accessed before performing trips. The app proposes a series of alternatives, consisting of a combination of departure time, mode, and route. Each alternative is rewarded with an amount of tokens which the user can later redeem for goods or services. The role of SO is to compute the optimized set of tokens associated with the available alternatives to minimize the system-wide energy consumption under a limited token budget. To do so, the alternatives that guarantee the largest energy reduction must be rewarded with more tokens. SO is multi-modal, in that it considers private cars, public transit, walking, car pooling, and so forth. Moreover, it is dynamic, predictive, and personalized: the same alternative is rewarded differently, depending on the current and the predicted future condition of the network and on the individual profile. The paper presents a method to solve this complex optimization problem and describe the system architecture, the multi-modal simulation-based optimization model, and the heuristic method for the online computation of the optimized token allocation. Finally it showcases the framework with simulation results.
Search for accurate RSM metamodels for structural engineering
Authors: Kalita Kanak , Dey Partha , Haldar Salil
Published: July 2019

With rapid advancement in computing power and development of numerical tools and scientific theories in fields like structural engineering, simple experiments can now be carried out in-silico. However, simulating many real-life phenomena in analytical fields still remains largely intractable or requires huge computational resources. A number of researchers have developed suitable metamodels to reduce the computational time needed to solve complex structural problems. As such, response surface method has become quite popular due to its versatility and ability to reduce even the most hard-to-model engineering problems into a simple polynomial form. The number and type of sampling points needed for building the response surface approximation are selected by design of experimentation techniques like Box–Behnken design, central composite design, D-optimal design, etc. One design may be appropriate for some particular problems, while a different design would perform better on others. To assess the performance of such metamodels, statistical measures like [Formula: see text] and error-based metrics like root-mean-squared error have been commonly used by researchers. In this paper, extensive numerical experiments are performed to gauge the performance of Box–Behnken design, central composite design and D-optimal designs as a metamodeling tool in structural engineering. The insufficiency of classical statistical accuracy measures like [Formula: see text], [Formula: see text] and [Formula: see text] is demonstrated, and the need for measures based on external test data such as [Formula: see text], [Formula: see text] or [Formula: see text] is stressed. Subsequently, some recommendations are also made on building metamodels for structural engineering problems.
Implications of Interpersonal Violence on Population Mental Health Status in a Low-Income Urban Community-Based Sample of Adults
Authors: Roesch Pamela Therese , Velonis Alisa Joy , Sant Sayli M. , Habermann Lauren Elisabeth , Hirschtick Jana L.
Published: July 2019

Research links interpersonal violence (IPV) perpetrated by a close personal contact, such as a family member or partner, to poor mental health; however, few studies assess associations by gender and explore the community-wide impacts of IPV on rates of depression and posttraumatic stress disorder (PTSD). Using Sinai Community Health Survey (2015-2016), a face-to-face probability survey in 10 Chicago neighborhoods, we examined the association of a broad IPV measure, ever being emotionally or physically abused by a partner or someone important to you, with current depressive (DEPsym) or PTSD symptoms (PTSDsym), stratified by gender. After logistic regression model building, we used direct model-based standardization to calculate adjusted relative prevalence and population attributable prevalence fractions. Of 1,535 respondents, 8% of men and 15% of women had DEPsym; 15% and 20% had PTSDsym, respectively; and 12% and 26% ever experienced IPV, respectively. Controlling for confounders, men who experienced IPV had a 3.6 times (95% confidence interval [CI]: [1.5, 6.8]) higher prevalence of DEPsym and a 2.5 times (95% CI: [1.3, 4.9]) higher prevalence of PTSDsym. Women who experienced IPV had a 2.2 times (95% CI: [1.1, 3.9]) higher prevalence of DEPsym. If the association between IPV and mental health is causal, almost one in three cases of DEPsym (males: 31.7%; females: 27.3%) and one in five cases of PTSDsym (19.2%) among males may be attributed to IPV. Our findings underscore the need for a public health response to IPV and mental health, and additional research on evidence-driven practices that address this association among men and women.
Cold War Books: George Minden and His Field Workers, 1973–1990
Authors: Sowiński Paweł
Published: July 2019

The article deals with the history of the so-called Book Program—a joint effort of the US government, the East European diaspora, and readers of books prohibited behind the Iron Curtain. This was one of the most brilliant smuggling operations in the history of Eastern Europe. In 1956– 1989, the operational budget was used for the purchase and delivery to the population of Soviet-dominated Europe of about ten million publications in an effort to undermine communist rule there. This study adds new things to what is already known about the cultural Cold War. Concentrating mostly on Polish cases, the author examines relations between state and non-state actors inside the network of the book program. Using historical materials, he captures the complexity of the grassroots activists–US government interactions, which were finally successful, but this communication also proved difficult for both parties. Contributing to the discussion of hegemony and autonomy in state–private networks, the author points out cooperation and negotiation, not the co-optation of diaspora communities by the US government.
Fighting Gendered Battles: On Being a Woman in a Contemporary Gaming Community
Authors: McKinnon-Crowley Saralyn
Published: July 2019

This scholarly personal narrative (Nash 2004) draws on the author’s experiences as a woman in a male-dominated gaming community. In such a space, being a woman who plays the game problematizes notions of gender for both the author and for her most-often male opponents. When playing the game, she operates in a liminal space between expert and outsider because of her gender identity. At the same time, her gender troubles her men opponents. She discusses her struggles for acceptance in this community and how her notions and enactment of gender have changed as a result of her experiences. In the article, the author explains the social norms of the game and the demographic breakdown of the game’s players; to accomplish this, the author shares stories from her time as a player.
Momentary Reports of Fatigue Predict Physical Activity Level: Wrist, Waist, and Combined Accelerometry
Authors: Smith Dylan M. , DeCaro Jason A. , Murphy Susan L. , Parmelee Patricia A.
Published: July 2019

Objective: Fatigue is commonly reported by persons with osteoarthritis (OA) and predicts worse functioning and decreased activity. The current research used a combination of wrist and waist accelerometry along with experience sampling methodology to examine the relationship between reports of fatigue and subsequent physical activity among older adults with knee OA. Method: Two hundred one participants completed an interview followed by a 1-week period during which their activity was monitored and they reported symptoms of pain and fatigue. Multilevel models examined within-subjects versus between-subjects patterns of symptoms and their association with physical activity. Results: Fatigue was the most consistent predictor of lowered physical activity (β = −20.83, p < .001). Although wrist-worn actigraphs produced higher averaged activity counts than did waist actigraphs ( t = 34.68, p < .001), multilevel models showed consistent results regardless of placement. Discussion: Fatigue was a consistent predictor of lowered activity regardless of actigraph location.
Evaluation of screening for drug use using postmortem prolactin levels in serum and cerebrospinal fluid
Authors: Tani N , Ikeda T , Aoki Y , Shida A , Oritani S , Ishikawa T
Published: July 2019

Prolactin (PRL) levels can usually be controlled by PRL-inhibiting psychiatric drugs that include anti-dopamine agents. However, the use of dopamine (DA) antagonists may lead to hyperprolactinemia under certain clinical conditions. The aim of this study was to investigate postmortem PRL levels as potential markers of drug abuse, especially that of DA antagonists, in autopsy cases. We examined 121 autopsy cases, excluding cases involving acute hypoxia/ischemia, such as asphyxia, because PRL concentrations are reportedly increased under acute hypoxic conditions. Detected drugs were classified as either DA antagonists, stimulants, psychotropic drugs other than DA antagonists, or other non-psychotropic drugs, and many cases had no detected drugs. Samples comprised blood collected from the right heart chamber and cerebrospinal fluid (CSF). PRL protein level was measured by chemiluminescent immunoassay, and PRL gene expression in the anterior pituitary of autopsy cases was analyzed by reverse transcription-polymerase chain reaction. The PRL-positive cell ratio in the anterior pituitary gland was also measured by immunohistochemical analysis. The results indicated that PRL levels in the serum and CSF were higher in DA antagonist cases than in other cases. PRL levels in the serum and CSF also correlated with the PRL gene expression in cases with abuse of DA antagonists. However, no significant difference in the PRL-positive cell ratio in the anterior pituitary gland was evident between any of the classes of drug-detected and drug-undetected cases. These results suggest that postmortem measurements of PRL transcription levels may be useful for diagnosing cases of DA antagonist use.
Testicular toxicity of gentamicin in adult rats: Ameliorative effect of lycopene
Authors: Aly HAA
Published: July 2019

The current study was aimed to investigate the ameliorative effect of lycopene against gentamicin-induced testicular toxicity in adult rat testes. Pretreatment with lycopene (4 mg/kg/day) significantly prevented the decrease in the absolute testes weight and relative testes weight and the reduction in sperm count, motility, viability, and daily sperm production in gentamicin (100 mg/kg/day)-treated rats. Gentamicin significantly decreased the level of serum testosterone and testicular lactate dehydrogenase-X and G6PDH activities but a marked increase was observed upon pretreatment with lycopene. Testicular caspase-3 and -9 activities were significantly increased but lycopene showed significant protection from gentamicin-induced apoptosis. Oxidative stress was induced by gentamicin treatment as evidenced by increased hydrogen peroxide level and lipid peroxidation and decreased the antioxidant enzymes superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase activities and glutathione content. These alterations were effectively prevented by lycopene pretreatment. Histopathological examination showed loss of spermatogenesis and morphological abnormalities of the testis after treatment with gentamycin. These abnormalities were effectively normalized by pretreatment with lycopene. In conclusion, gentamicin decreases rat testes weight and inhibits spermatogenesis. It induces oxidative stress and apoptosis by possible mitochondrial dysfunction. These data provide insight into the mode of action of gentamicin-induced testicular toxicity and the beneficial role provided by lycopene to restore the suppressed spermatogenesis.
Ethical dilemmas experienced by spouses of a partner with brain tumour
Authors: Francis Sara R , Hall Elisabeth OC , Delmar Charlotte
Published: July 2019

Background:

Caring for a partner with primary malignant brain tumour can be a dramatic life-changing event. Primary malignant brain tumour is known to give poor life expectancy and severe neurological and cognitive symptoms, such as changed behaviour and personality, which demand greater caring responsibilities from spouses.

Aim:

The aim of the study is to explore ethical dilemmas spouses experience in the everyday care of a partner in treatment for primary malignant brain tumour.

Research design, participants and research context:

A phenomenological and hermeneutic qualitative descriptive design was adopted as a method for collecting and analysing data. Ten spouses were interviewed twice using an in-depth, semi-structured interview guide. The interviews took place at the spouses’ homes or at the hospital.

Ethical consideration:

Ethical matters were considered throughout the research process. Permission from The National Committee on Health Research Ethics and the Danish Data Protection Agency was obtained.

Findings:

The analysis showed that the spouses perceived daily ethical dilemmas in caring for a partner with primary malignant brain tumour. Their life as well as their partner’s life had changed considerably. The main theme that emerged therefore was ‘oscillating in a changing relationship’. This theme was further elaborated in three subthemes that in more detail demonstrated the dilemmas: ‘doing the right thing in unpredictable daily situations’; ‘torn between patience and guilt’; and ‘living in a time of uncertainty, hope and despair’.

Conclusion:

Caring for a partner with changed behaviour and personality due to primary malignant brain tumour may involve exhausting ethical caring dilemmas. Spouses’ married life may change to a semi-professional asymmetrical relationship, which is challenged by the oscillation between acting responsibly for their partners’ well-being and caring dilemmas with no answer for what the right thing to do is. Mixed feelings of right and wrong, patience and guilt, hope and despair seem to be spousal companions through their partners’ progressing illness.
What Is the Optimal Management of Patients With Prior Septic Arthritis of the Ankle Who Are Undergoing Total Ankle Arthroplasty (TAA)?
Authors: Winters Brian , Da Rin de Lorenzo Ferdinando , O’Neil Jake
Published: July 2019

Recommendation:

There is a paucity of data regarding total ankle arthroplasty (TAA) in patients with prior infection involving the ankle, whether it be septic arthritis, osteomyelitis, or infection of the surrounding soft tissues. We recommend that patients with prior infections in the affected ankle be worked up for infection, including a thorough history and physical examination, as well as ordering serologic tests and possible aspiration of the joint. During ankle arthroplasty in patients with prior infection, antibiotics should be added to the cement (if used), and the joint should be thoroughly cleansed. Intraoperative cultures of bone and soft tissue should also be obtained.

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Diagnostic “Algorithm” for Infected Total Ankle Arthroplasty (TAA)?
Authors: Heidari Nima , Oh Irvin , Malagelada Francesc
Published: July 2019

Recommendation:

Patients who present with clinical symptoms and signs of periprosthetic ankle infection (pain, erythema, warmth, sinus tract, abscess around the wound) and sinus tracts communicating with the ankle/subtalar joint are likely to have total ankle arthroplasty (TAA) infection. In the absence of a sinus tract, elevated inflammatory markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) should prompt ankle joint aspiration for cell count, differential, and culture. The joint aspiration is to be repeated. If the same organism is identified in at least 2 cultures of synovial fluid, the patient is diagnosed to have an infection. If the repeat aspiration is negative, further investigation is warranted. In patients not requiring operative intervention for other reasons, nuclear imaging should be considered for diagnosis. If an operation is indicated, histologic examination (>5 neutrophils/high-power field) or synovial fluid analysis is conducted to confirm infection.

Level of Evidence:

Limited.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Best Technique for Performing Aspiration of Patients With Total Ankle Arthroplasty (TAA)?
Authors: Shakked Rachel
Published: July 2019

Recommendation:

In the absence of evidence, we recommend that ankle joint aspiration to evaluate for periprosthetic joint infection (PJI) be performed under sterile conditions via the anteromedial approach. Ultrasound guidance may be used if available but is not necessary to obtain an acceptable synovial fluid sample.

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
What Is the Treatment “Algorithm” for an Infected Total Ankle Arthroplasty (TAA)?
Authors: Raikin Steven , Parekh Selene , McDonald Elizabeth
Published: July 2019

Recommendation:

The treatment of an infected total ankle arthroplasty (TAA) is largely dictated by the acuity of the infection. The following treatment algorithm modified for TAA is recommended.19

Level of Evidence:

Limited.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).
Gene expressions of de novo hepatic lipogenesis in feline hepatic lipidosis
Authors: Valtolina Chiara , Robben Joris H , van Wolferen Monique E , Kruitwagen Hedwig S , Corbee Ronald J , Favier Robert P , Penning Louis C
Published: July 2019

Objectives

The aim of this study was to evaluate if de novo hepatic lipid synthesis contributes to fatty acid overload in the liver of cats with feline hepatic lipidosis (FHL).

Methods

Lipogenic gene expression of peroxisome proliferator-activated receptor-alpha ( PPAR-α), peroxisome proliferator-activated receptor-gamma ( PPAR-γ), fatty acid synthase ( FASN) and sterol regulatory element-binding factor ( SREBF1) were evaluated using quantitative RT-PCR in liver tissue of six cats with FHL and compared with the liver tissue of eight healthy cats.

Results

In liver tissue, PPAR-α, PPAR-γ and FASN mRNA expression levels were not significantly different ( P >0.12, P >0.89 and P >0.5, respectively) in the FHL group compared with the control group. SREBF1 gene expression was downregulated around 10-fold in the FHL group vs the control group ( P = 0.039).

Conclusions and relevance

The downregulation of SREBF1 in the liver tissue of cats with FHL does not support the hypothesis that de novo lipogenesis in the liver is an important pathway of fatty acid accumulation in FHL.
Toward a just and inclusive environmental archaeology of southwest Madagascar
Authors: Douglass Kristina , Morales Eréndira Quintana , Manahira George , Fenomanana Felicia , Samba Roger , Lahiniriko Francois , Chrisostome Zafy Maharesy , Vavisoa Voahirana , Soafiavy Patricia , Justome Ricky , Leonce Harson , Hubertine Laurence , Pierre Briand Venance , Tahirisoa Carnah , Colomb Christoph Sakisy , Lovanirina Fleurita Soamampionona , Andriankaja Vanillah , Robison Rivo
Published: July 2019

In this paper, we advocate a collaborative approach to investigating past human–environment interactions in southwest Madagascar. We do so by critically reflecting as a team on the development of the Morombe Archaeological Project, initiated in 2011 as a collaboration between an American archaeologist and the Vezo communities of the Velondriake Marine Protected Area. Our objectives are to assess our trajectory in building collaborative partnerships with diverse local, indigenous, and descendent communities and to provide concrete suggestions for the development of new collaborative projects in environmental archaeology. Through our Madagascar case study, we argue that contemporary environmental and economic challenges create an urgency to articulate and practice an inclusive environmental archaeology, and we propose that environmental archaeologists must make particular efforts to include local, indigenous, and descendent communities. Finally, we assert that full collaboration involves equal power sharing and mutual knowledge exchange and suggest an approach for critical self-evaluation of collaborative projects.
Gender Equality in European Union Development Policy in Times of Crisis
Authors: Allwood Gill
Published: July 2019

Gender equality is firmly established on the European Union development policy agenda. However, a series of interrelated crises, including migration, security and climate change, are becoming more prominent in European Union development policy. This article asks whether development objectives have been subsumed under these crisis-driven European Union priorities, whether this is compatible with efforts to achieve gender equality and women’s empowerment through development cooperation and whether it will affect the ability to keep gender equality high on the European Union’s development policy agenda. The theoretical framework draws on horizontal policy coordination and nexuses. The analysis of European Union development policy documents shows how migration, security and climate change are constructed as crises, how they intersect in various nexuses and how gender intersects with each of these nexuses. This research finds that gender equality is absent from the migration–security–climate nexuses, which are increasingly driving development policy priorities. The article argues that it is quite straightforward to keep gender equality on the development policy agenda, but it is difficult to retain a focus on gender equality when multiple policy areas intersect. The research suggests that the discourse of crisis has blocked the way, and this will have an impact on the European Union’s internal and external activities.
Reconstruction of the Lower Leg With Percutaneous Aponeurotomy and Lipofilling: A Case Report
Authors: Ha Yooseok , Yang Hee Sang , Song Seung Han , Oh Sang-Ha
Published: July 2019

Soft tissue loss in the lower leg presents a challenge for reconstructive surgeons. When a defect is large, free flap transfer provides a well-established method, but local flaps are more convenient for small to moderately sized soft tissue defects. When a defect is very small, even local flaps are too invasive, leave additional scar, and cause bulky flaps. We present our case aiming to underline the usefulness of percutaneous aponeurotomy and lipofilling in a small lower leg defect with several advantages.
Dorsal Cortical Breaks in Volar Barton Distal Radius Fractures
Authors: Daly Michael C. , Horst Taylor A. , Mudgal Chaitanya S.
Published: July 2019

Background: Volar Barton fractures involve the volar articular margin of the distal radius with proximal and volar subluxation of the carpus. Although traditionally conceptualized as partial articular, some volar Barton fractures are complete articular injuries due to a dorsal cortical break in the distal radial metaphysis. While dorsal cortical breaks can affect surgical strategy, they may be difficult to identify on plain radiographs and their epidemiology remains poorly characterized. Some authors have hypothesized an association with osteoporosis; however, this hypothesis remains untested. To better characterize volar Barton fractures, we analyzed fracture geometry on pre-operative computed tomography (CT) scans to: (1) determine the frequency of a dorsal cortical break; and (2) test the null hypothesis that a dorsal cortical break is not associated with age or gender. Methods: We retrospectively reviewed adults with a volar Barton distal radius fracture and an available pre-operative CT who underwent surgical fixation. Using multivariable logistic regression, we assessed whether age or gender was an independent predictor of a dorsal cortical break. Results: Forty patients (mean age 52 years, 57% female) were identified. Including the shaft as a fragment, 32 (80%) had 3 or more discrete fracture fragments. Thirty patients (75%) had a dorsal cortical break. Dorsal cortical breaks were not associated with either age or gender ( P > 0.05). Conclusions: Most (75%) patients with volar Barton distal radius fractures had a dorsal cortical break. Dorsal cortical breaks were not statistically associated with age or gender, suggesting these fracture patterns may not be associated with osteoporosis as previously hypothesized.
Occupation-based hand therapy in a baker with monomelic amyotrophy (distal segmental spinal muscular atrophy or Hirayama disease)
Authors: Nijland Elien
Published: July 2019

The aim of this case report is twofold: the very rare Hirayama disease is discussed, including the impact on the patient’s functioning. The unique way to solve an orthesis problem is described, by observing patient’s performance meticulously. Various hand function assessments were used to cover every level of the International Classification of Functioning model. An occupation-based approach was followed by performing a working visit during which the essence of his treatment problem became apparent. The development of a new adjustable brace is described. Combining two sorts of wrist positions in one splint is a novel approach that could be helpful for patients with other conditions. A work visit was helpful to focus on the participation level. The occupation-based intervention resulted in the patient’s ability to resume work.
Bluetooth Wireless Technology Cybersecurity and Diabetes Technology Devices
Authors: Saltzstein William
Published: July 2019

Medical devices have transitioned from hospital into the home and consumer environments and have been shown to provide for mobility and quality-of-life improvements for chronic conditions such as diabetes. It is important to collect sensor and usage data while remotely connected in real time. The protection of these data is commonly called “cybersecurity.” Bluetooth® wireless technology (Bluetooth is a registered trademark of the Bluetooth Special Interest Group, Inc.) is commonly used for low-cost medical devices to provide connections to other medical devices as well as compute and display devices such as smartphones. This paper provides a review of its use with respect to diabetes devices with a particular focus on cybersecurity.
Management of cervical spine epidural abscess: a systematic review
Authors: Turner Anastasia , Zhao Linlu , Gauthier Paul , Chen Suzan , Roffey Darren M. , Wai Eugene K.
Published: July 2019

Background:

Cervical spinal epidural abscess (CSEA) is a localized infection between the thecal sac and cervical spinal column which may result in neurological deficit and death if inadequately treated. Two treatment options exist: medical management and surgical intervention. Our objective was to analyze CSEA patient outcomes in order to determine the optimal method of treatment.

Methods:

An electronic literature search for relevant case series and retrospective reviews was conducted through June 2016. Data abstraction and study quality assessment were performed by two independent reviewers. A lack of available data led to a post hoc decision not to perform meta-analysis of the results; study findings were synthesized qualitatively.

Results:

927 studies were identified, of which 11 were included. Four studies were ranked as good quality, and seven ranked as fair quality. In total, data from 173 patients were included. Mean age was 55 years; 61.3% were male. Intravenous drug use was the most common risk factor for CSEA development. Staphylococcus aureus was the most commonly cultured pathogen. 140 patients underwent initial surgery, an additional 18 patients were surgically treated upon failure of medical management, and 15 patients were treated with antibiotics alone.

Conclusion:

The rates of medical management failure described in our review were much higher than those reported in the literature for thoracolumbar spinal epidural abscess patients, suggesting that CSEA patients may be at a greater risk for poor outcomes following nonoperative treatment. Thus, early surgery appears most viable for optimizing CSEA patient outcomes. Further research is needed in order to corroborate these recommendations.
The Great Recession and Mental Health in the United States
Authors: Forbes Miriam K. , Krueger Robert F.
Published: July 2019

The full scope of the impact of the Great Recession on individuals’ mental health has not been quantified to date. In this study we aimed to determine whether financial, job-related, and housing impacts experienced by individuals during the recession predicted changes in the occurrence of symptoms of depression, generalized anxiety, panic attacks, and problematic alcohol use or other substance use. Longitudinal survey data ( n = 2,530 to n = 3,293) from the national Midlife in the United States study that were collected before (2003–2004) and after (2012–2013) the Great Recession were analyzed. The population-level trend was toward improvements in mental health over time. However, for individuals, each recession impact experienced was associated with long-lasting and transdiagnostic declines in mental health. These relationships were stronger for some sociodemographic groups, which suggests the need for additional support for people who suffer marked losses during recessions and for those without a strong safety net.
Evaluation of Remote Versus Face-to-Face Observation of Teacher Candidates in an Alternative Certification Program
Authors: Ault Melinda Jones , Spriggs Amy D. , Bausch Margaret E. , Courtade Ginevra R.
Published: July 2019

The University of Kentucky provides an alternative certification program to prepare teacher candidates in moderate and severe disabilities. Observations occur every semester that candidates are in the 2-year program and must be conducted all across Kentucky, often many miles away from campus. University researchers placed cameras in the classrooms of teacher candidates and measured reliability of teacher observations conducted face-to-face and remotely. The researchers also surveyed perceptions of the teacher candidates and university observers and analyzed the cost-effectiveness of the two observation methods. The results indicated that the observers achieved similar results on an observation form regardless of the observation method used. The remote observations were the most cost efficient of the two methods both monetarily and in the time commitment needed by the observers. The findings include the perceptions of the teacher candidates and university observers for benefits and challenges of each observation method.