bluuebunny/crossref_metadata_2025 huggingface dataset:
Receptor-mediated binding and internalization of colony-stimulating factor (csf-1) by mouse peritoneal exudate macrophages
Authors: Chen Ben D.-M. , Kuhn Charles , Lin Hsiu-San
Published: April 2021

Colony-stimulating factor (CSF-1) purified from L-cell-conditioned medium is a haemopoietic growth factor that specifically stimulates the proliferation and differentiation of mononuclear phagocytes. Using radioactively labelled CSF-1 ([125I]CSF-1), the presence of specific CSF-1 receptor has been identified in the cells of the mononuclear phagocytic series and their precursors only. To determine the fate of [125I]CSF-l bound to peritoneal exudate macrophages (PEM) at 37 °C, we have examined the distribution of radioactivity as a function of time by quantitative electron microscopic autoradiography. At 0°C, we have localized the initial step in the binding of [l25I]CSF-l to the plasma membrane and its invaginations of the mouse PEM. Approximately 16% of the macrophages were not labelled at this time point. When the temperature was raised to 37 °C, the labelled CSF-1 was internalized progressively by the cells in a time-dependent fashion. The proportion of grains associated with the phagolysosome compartment increased progressively, reaching a plateau by 40 min after warming up, while the relative areas of the surface membrane and its invaginations decreased in invaginated membrane. At 37 °C, incubation with unlabelled CSF-1 resulted in a ‘down-regulation’ of the subsequent [125I] CSF-1-binding activity by PEM in a time- and dose-dependent fashion. The restoration of CSF-l-binding activity after CSF-1 induced downregulation was inhibited by cycloheximide, a potent protein synthesis inhibitor. These data provide direct evidence that at 37 °C, saturable binding of CSF-1 to PEM is followed by internalization and cellular degradation of the ligand and possibly its receptor by phagolysosomes.
On the Structure of the Retina
Authors: Nunneley Thomas
Published: April 2021

The retina is the sentient part of the eye, for which all the other textures are formed, and to which they may be said to be subservient. It is coextensive with the choroid proper ; it covers the whole of the convex portion of the vitreous humour, and is covered by the choroid. It terminates in a serrated line, ora serrata, which is readily seen with an inch lens, just where the ciliary processes are continuous with the choroid. There is, according to some anatomists, a circular blood-vessel running near to this edge, if so, it is probably a vein, but it rather appears as a series of capillary loops of the central artery. Some of the older anatomists and opticians described the retina as being continuous over the anterior surface of the crystalline lens, an opinion which has been adopted to a great extent by Arnold, who describes and figures the retina as being continuous with the ciliary body and processes to the edge of the lens *,—pars ciliaris retinœ and processus ciliaris retinœ. This, however, is, without doubt, an error ; though the retina does not terminate wholly and absolutely at the ora serrata, as is commonly described. The nervous structure here ends, but there is, continuous with the suspensory ligament of the lens, a cellular layer, as far as the edge of the lens : this is best seen after the eye has been kept for some time in spirit or Goadby’s solution, by which the layer is rendered opaque and white. Its continuity with the retina may then be readily traced, and, indeed, in some eyes it looks so like a continuation of the whole retina as to render the microscope essential to prove that the nerve-structure is not so prolonged. † The retina has, until very recently, been described as the terminal expansion of the fibres of the optic nerve into a membrane. It is, however, much more than this ; it is one of the most complex, perhaps the most complex, structure to be found in the body, and instead of being thought of as simply a terminal nervous expansion, it should be regarded as in itself a nervous centre ; having the fibres of the nerve expanded it is true in it, and by which it is connected with the brain, but possessed itself of structures and properties peculiar to it, and altogether different from those of the optic fibres, which are expanded in and make part of it. These fibres are for the purpose of conveying to the sensorium the impressions excited in the retina, but are not for receiving the impression, while the other complex structures of the retina receive and appreciate the impressions of external objects.
Clinical Lectures on the Principles and Practice of Medicine
Authors: Bennett John Hughes
Published: April 2021

Although this is a second edition of a work well known, and its main purpose beyond the sphere of our criticism, we think it right to bring it before the notice of our readers, because it contains a large amount of matter bearing directly on microscopic research. Dr. Bennett is one of those teachers of medicine, who has, from an early period of his career, recognised the importance of conducting pathological researches by the aid of the microscope, and in this work abundant evidence is afforded of the value and necessity of this instrument to the practitioner of medicine. In an early number of this Journal (volume I, page 223), we reviewed Dr. Bennett’s ‘Introduction to Clinical Medicine’, and recommended it to the notice of our medical readers, as conveying a just estimate of the value of the microscope in pathological research. In the present work the practical application of this instrument to the various forms of disease in which it may be employed is fully brought out. In fact, with regard to a large number of the forms of disease no true theory of their nature can be formed independent of an investigation by the aid of the microscope. It is in the section devoted to the principles of medicine that Dr. Bennett handles the facts supplied by microscopic research in the most masterly manner. This section should be studied by all those who are anxious to understand the intimate causes engaged in the production of disease, and what are the changes which are necessary to the establishment of health. We should not pretend, even had we space here, to criticise Dr. Bennett’s theoretical or practical conclusions from the observations he records, but we draw attention to them, as showing the comparative valuelessness of any observations or deductions on the intimate nature of organic disease without microscopic investigation.
On some Madeiran Polyzoa
Authors: Johnson J. Yates
Published: April 2021

We here give figures and descriptions of some species of Madeiran Polyzoa, additional to those contained in a former part of the Journal .
Methods of preparing the Cochlea for Microscopical Investigation
Authors: Pritchard Urban
Published: April 2021

When I undertook the investigation of the cochlea, at the suggestion of Professor Rutherford, I was totally unacquainted with the method of preserving, softening, and cutting its structures, and were I to enumerate the experiments I made, the valuable cochleæ I spoilt, and the failures I experienced before obtaining any results, I should fill many pages, and only succeed in wearying the reader by the monotomy of my disappointments. I shall therefore confine myself to describing the methods which at last proved successful, merely alluding to the chief points of the fruitless attempts. ‘
On the Head Kidney of Bdellostoma, with a Suggestion as to the Origin of the Suprarenal Bodies
Authors: Weldon W. F. R.
Published: April 2021

The structure of the greater part of the kidney of Bdellostoma and the Myxinoids generally has been known since the time of Johannes Müller. It consists of a simple segmental duct on each side, which represents both the Wolffian and Müllerian ducts of the higher Vertebrates, giving off in its course a series of short tubules, each of which ends in a large glomerulus. These tubules are segmentally arranged, a single pair being present in every segment of the body in the anterior three fourths of the region lying between the anus and the hinder border of the pericardium. The relations of this system of simple segmental tubules, opening into a segmental duct, were described with perfect accuracy by Johannes Müller;1 and no important additions have since been made to the account which he gave.
Fair Utilitarianism
Authors: Fleurbaey Marc , Zuber Stéphane
Published: April 2021

Utilitarianism plays a central role in economics, but there is a gap between theory, where utilitarianism is dominant, and applications, where monetary criteria are often used. For applications, a key difficulty is to define how utilities should be measured and compared. Drawing on Harsanyi’s (1955) approach, we introduce a new normalization of utilities ensuring that: (i) a transfer from a rich population to a poor population is welfare enhancing, and (ii) populations with more risk-averse people have lower welfare. We study some implications of this “fair utilitarianism” for risk sharing, collective risk aversion, and the design of health policy. (JEL D63, D81)
Learning from Unrealized versus Realized Prices
Authors: Ngangoué M. Kathleen , Weizsäcker Georg
Published: April 2021

Our experiments investigate the extent to which traders learn from the price, differentiating between situations where orders are submitted before versus after the price has realized. In simultaneous markets with bids that are conditional on the price, traders neglect the information conveyed by the hypothetical value of the price. In sequential markets where the price is known prior to the bid submission, traders react to price to an extent that is roughly consistent with the benchmark theory. The difference’s robustness to a number of variations provides insights about the drivers of this effect. (JEL D44, D82, D84, G12, G14)
Retail Prices in a City
Authors: Eizenberg Alon , Lach Saul , Oren-Yiftach Merav
Published: April 2021

This study examines grocery price differentials across neighborhoods in a large metropolitan area (the city of Jerusalem, Israel). Important variation in access to affordable grocery shopping is documented using CPI data on prices and neighborhood-level credit card expenditure data. Residents of peripheral, nonaffluent neighborhoods are charged some of the highest prices in the city and yet display a low tendency to shop outside their neighborhood. In contrast, residents of affluent, centrally located neighborhoods often benefit from lower grocery prices charged in their own neighborhood while also displaying a high propensity to shop at the hard discount grocers located in the city’s commercial districts. The role of spatial frictions in shaping these patterns is studied within a structural model where households determine their shopping destination and retailers choose prices. The estimated model implies strong spatial segmentation in households’ demand. Counterfactual analyses reveal that alleviating spatial frictions results in considerable benefits to the average resident of the peripheral neighborhoods. At the same time, it barely affects the equilibrium prices charged across the city, and so it does little to benefit households with limited mobility (e.g., the elderly). (JEL L11, L81, R22, R23)
Racial Divisions and Criminal Justice: Evidence from Southern State Courts
Authors: Feigenberg Benjamin , Miller Conrad
Published: April 2021

The US criminal justice system is exceptionally punitive. We test whether racial heterogeneity is one cause, exploiting cross-jurisdiction variation in punishment severity in four Southern states. We estimate the causal effect of jurisdiction on arrest outcomes using a fixed effects model that incorporates extensive charge and defendant controls. We validate our estimates using defendants charged in multiple jurisdictions. Consistent with a model of ingroup bias in electorate preferences, the relationship between local severity and Black population share follows an inverted U-shape. Within states, defendants are 27–54 percent more likely to be incarcerated in “peak” heterogeneous jurisdictions than in homogeneous jurisdictions. We estimate that confinement rates and race-based confinement rate gaps would fall by 15 percent if all jurisdictions adopted the severity of homogeneous jurisdictions within their state. (JEL H76, J15, K42)
FERRAMENTAS GERENCIAIS PARA MICRO E PEQUENAS EMPRESAS: UM ESTUDO NA CIDADE DE PETROLINA-PE
Authors: Aquino José Vinícius Sento-Sé de Moura , Lima Filho Raimundo Nonato
Published: April 2021

A pesquisa buscou identificar quais as ferramentas gerenciais mais demandadas dos escritórios de contabilidade pelos micro e pequenos empresários na cidade de Petrolina-PE, sendo, então, desenvolvida como um estudo descritivo, com a abordagem quantitativa por survey. Utilizou-se da aplicação de questionários direcionados para 64 escritórios de contabilidade da cidade, obtendo resposta de 34 deles. Os resultados apontaram que as ferramentas gerenciais mais utilizadas foram o planejamento tributário, a análise das demonstrações contábeis e a formação do preço de venda, demonstrando a importância agregada a elas que são ferramentas que influenciam, diretamente, a operacionalidade da empresa. Conclui-se, então, que existe um baixo nível de procura por ferramentas gerenciais, as quais são de grande importância e uso para as empresas que, muitas vezes, não têm ciência da influência que a contabilidade voltada para fins gerenciais pode exercer sobre o desempenho das entidades no mercado que está cada mais competitivo. Portanto, este estudo torna-se relevante por contribuir para que os escritórios de contabilidade e empresários se atentem em quais as ferramentas gerenciais mais utilizadas e que elas podem ocasionar uma melhoria para a gestão na organização, que se torna, cada dia, mais necessária.
Portfolio Choices with Many Big Models
Authors: Anderson Evan , Cheng Ai-ru (Meg)
Published: April 2021

This paper proposes a Bayesian-averaging heterogeneous vector autoregressive portfolio choice strategy with many big models that outperforms existing methods out-of-sample on numerous daily, weekly, and monthly datasets. The strategy assumes that excess returns are approximately determined by a time-varying regression with a large number of explanatory variables that are the sample means of past returns. Investors consider the possibility that every period there is a regime change by keeping track of many models, but doubt that any specification is able to perfectly predict the distribution of future returns, and compute portfolio choices that are robust to model misspecification.

This paper was accepted by Tyler Shumway, finance.
Optimized Hybrid Upflow Anaerobic Sludge Blanket with Post Treatment Processes for Wastewater
Authors: Patel Bina Birenkumar , Gundaliya Pradipkumar Jayantilal , Amin Drashti Dineshkumar
Published: April 2021

This paper presents a review and findings of the Hybrid Upflow Anaerobic Sludge Blanket (HUASB) technologies, deploying lab scale reactors for treatment of domestic and industrialwastewater. The major controlling parameters for HUASB reactors such as inert media used, pH, temperature, upflow velocity, organic loading, hydraulic residence time along with startup and granulation are highlighted for its efficient performance and achieving optimum results. Wastewater arising from a plethora of industrial activities along with its characteristics has been included in conjunction with its treatability with different types of HUASB reactors. This review study found that inert media in different types of HUASB reactors are varied in the range of 10-40% of reactor volume, the COD removal efficiency of 41-99% along with methane generation 50-75% of biogas produced. Moreover, this review paper highlighted and studied the post treatment options for enhanced effluent water quality and energy recovery. Therefore, to achieve sustainability and circular economy different types of HUASB technology with suitable post treatment can be adopted for the purpose of domestic and industrial wastewater treatment and reuse.
The Effects of COVID-19 Pandemic on Preschool Education
Authors: Duran Munise
Published: April 2021

In this study in which case study – one of the qualitative research methods - was used, it was aimed to assess the effects of covid-19 pandemic on preschool education by teachers. Preschool teachers working in 14 provinces where the number of cases is high form the universe of the study. Sample group is 140 teachers in total. So as to get data for the study, survey questions prepared by the researcher and submitted to expert opinion and structured interview forms were used. The findings of the study are as follows: preschool children had feelings of anxiety, fear and longing all together during this process and they wanted to return to their schools as soon as possible. Similarly, most of the teachers were highly concerned and worried. The teachers attended online educations related to their professional development during the process of staying home. Before Covid-19 came to Turkey, the schools did not take any measures; then, when distance education started, all schools were disinfected, the materials and toys in the classrooms were put aside after disinfection. Distance education process was quite difficult in preschool education; all the teachers taught in line with their own initiatives. During this process, while the activities most preferred by the teachers were games and art activities, the activities having pandemic theme were experiments and dramas about hygiene. Distance education increased parent participation to preschool education and this had a positive effect on parent-child interaction. In the distance education process, by establishing platforms intended for preschools, suggestions to make more and professional activities, to have common actions in cooperation with schools and to train parents were made.
Comparison of rehabilitation interventions in nonoperatively treated distal radius fractures: a randomized controlled trial of effectiveness
Authors: Coughlin Tim , Norrish Alan R. , Scammell Brigitte E. , Matthews Paul A. , Nightingale Jessica , Ollivere Ben J.
Published: April 2021

Aims

Following cast removal for nonoperatively treated distal radius fractures, rehabilitation facilitated by advice leaflet and advice video were compared to a course of face-to-face therapy.

Methods

Adults with an isolated, nonoperatively treated distal radius fracture were included at six weeks post-cast removal. Participants were randomized to delivery of rehabilitation interventions in one of three ways: an advice leaflet; an advice video; or face-to-face therapy session(s). The primary outcome measure was the Disabilities of the Arm, Shoulder and Hand (DASH) score at six weeks post intervention and secondary outcome measures included DASH at one year, DASH work subscale, grip strength, and range of motion at six weeks and one year.

Results

A total of 116 (97%) of 120 enrolled participants commenced treatment. Of those, 21 were lost to follow-up, resulting in 30 participants in the advice leaflet, 32 in the advice video, and 33 face-to-face therapy arms, respectively at six weeks of follow-up. There was no significant difference between the treatment groups in the DASH at six weeks (advice leaflet vs face-to-face therapy, p = 0.69; advice video vs face-to-face therapy, p = 0.56; advice leaflet vs advice video, p = 0.37; advice leaflet vs advice video vs face-to-face therapy, p = 0.63). At six weeks, there were no differences in any secondary outcome measures except for the DASH work subscale, where face-to-face therapy conferred benefit over advice leaflet (p = 0.01).

Conclusion

Following cast removal for nonoperatively treated distal radius fractures, offering an advice leaflet or advice video for rehabilitation gives equivalent patient-reported outcomes to a course of face-to-face therapy. Cite this article: Bone Joint J 2021;103-B(6):1033–1039.
Rasgos melódicos de la emoción: estudio de un corpus conversacional
Authors: Hidalgo Navarro Antonio
Published: April 2021

El present estudi descriu algunes peculiaritats melòdiques de la parla emocional a partir d’un corpus conversacional en el qual s'expressen diferents valors emotius. Com a punt de referència, partim de l'estrella de Plutchik (1980), amb vuit emocions bàsiques (alegria, confiança, por, sorpresa, tristesa, disgust, enuig i anticipació-interès), de les quals, donat el caràcter limitat del nostre corpus, només n’estudiarem cinc (alegria, tristesa, enuig, por i sorpresa), que són les que hi han aparegut. Les marques prosòdiques seleccionades, d'acord amb investigacions prèvies, són el contorn del patró melòdic, associat al tonema o a la inflexió final; el registre del contorn, és a dir, la seva mitjana de F0; la intensitat global de l'enunciat (mitjana d’intensitat al llarg de l'enunciat); i la velocitat de parla en l’enunciat (acte). A partir d'aquí s'ha fet una anàlisi acústica i es proposen algunes conclusions provisionals.
Mitigating the effect of atmospheric turbulence on orbital angular momentum-based quantum key distribution using real-time adaptive optics with phase unwrapping
Authors: Tao Zhiwei , Ren Yichong , Abdukirim Azezigul , Liu Shiwei , Rao Ruizhong
Published: April 2021

Quantum key distribution (QKD) employed orbital angular momentum (OAM) for high-dimensional encoding enhances the system security and information capacity between two communication parties. However, such advantages are significantly degraded because of the fragility of OAM states in atmospheric turbulence. Unlike previous researches, we first investigate the performance degradation of OAM-based QKD by infinitely long phase screen (ILPS), which offers a feasible way to study how adaptive optics (AO) dynamically corrects the turbulence-induced aberrations in real time. Secondly, considering the failure of AO while encountering phase cuts, we evaluate the quality enhancement of OAM-based QKD under a moderate turbulence strength by AO after implementing the wrapped cuts elimination. Finally, we simulate that, with more realistic considerations; real-time AO can still mitigate the impact of atmospheric turbulence on OAM-based QKD even in the large wind velocity regime.
Effects of rumen-protected methionine supplementation on the performance of high production dairy cows in the tropics
Authors: Junior Valdir Chiogna , Lopes Fernanda , Schwab Charles George , Toledo Mateus Zucato , Collao-Saenz Edgar Alain
Published: April 2021

Increasing methionine availability in dairy cow diets during the first third of lactation may enhance their performance and health. The aim of this study was to determine the effect of supplementing rumen-protected methionine (Smartamine® M, SM) in a lactation diet with protein and energy levels calculated according to the literature. Seventy-six multiparous Holstein cows (39.1 ± 6.8 kg of milk/d and 65 ± 28 DIM) were assigned to 1 of 2 dietary treatments (38/treatment) according to a randomized complete block design with a 2-wk (covariate) and 10-wk experimental period. Treatments were a basal diet (CON; 3.77 Lys:1Met); and CON + 23 g SM (2.97 Lys:1 Met). Individual milk samples were taken every 2 weeks to determine milk composition. Blood was collected from 24 cows on d+30 d to measure plasma AA levels. Body weight and body condition score (BCS) were measured at the beginning and the end of the experiment. The SM diet promoted higher milk yield (41.7 vs. 40.1 kg/d; P = 0.03). Energy-corrected milk yield (41.0 vs. 38.0 kg/d), milk protein yield (1.30 vs. 1.18 kg/d), milk protein (3.14% vs. 2.97%) and casein (2.39% vs. 2.28%) were also different (P < 0.01) as well as milk fat yield (1.42 vs. 1.29 kg/d; P = 0.02). A trend (P = 0.06) for higher milk fat % (3.41% vs. 3.21%) was observed. Both diets resulted in similar body weight, but CON-fed cows tended (P = 0.08) to have higher BCS. Higher plasma methionine levels were determined with SM compared with CON (29.6 vs. 18.4 μM; P < 0.01), but lysine and histidine were not different. Dietary supplementation of RPM improved productive performance by increasing milk yield and milk components yields, suggesting better dietary AA utilization when Met levels are adjusted in Lys-adequate lactation diets.
Probabilistic, entropy-maximizing control of large-scale neural synchronization
Authors: Menceloglu Melisa , Grabowecky Marcia , Suzuki Satoru
Published: April 2021

Oscillatory neural activity is dynamically controlled to coordinate perceptual, attentional and cognitive processes. On the macroscopic scale, this control is reflected in the U-shaped deviations of EEG spectral-power dynamics from stochastic dynamics, characterized by disproportionately elevated occurrences of the lowest and highest ranges of power. To understand the mechanisms that generate these low- and high-power states, we fit a simple mathematical model of synchronization of oscillatory activity to human EEG data. The results consistently indicated that the majority (~95%) of synchronization dynamics is controlled by slowly adjusting the probability of synchronization while maintaining maximum entropy within the timescale of a few seconds. This strategy appears to be universal as the results generalized across oscillation frequencies, EEG current sources, and participants (N = 52) whether they rested with their eyes closed, rested with their eyes open in a darkened room, or viewed a silent nature video. Given that precisely coordinated behavior requires tightly controlled oscillatory dynamics, the current results suggest that the large-scale spatial synchronization of oscillatory activity is controlled by the relatively slow, entropy-maximizing adjustments of synchronization probability (demonstrated here) in combination with temporally precise phase adjustments (e.g., phase resetting generated by sensorimotor interactions). Interestingly, we observed a modest but consistent spatial pattern of deviations from the maximum-entropy rule, potentially suggesting that the mid-central-posterior region serves as an “entropy dump” to facilitate the temporally precise control of spectral-power dynamics in the surrounding regions.
Mothers’ neural response to valenced infant interactions predicts postpartum depression and anxiety
Authors: Finnegan Megan Kate , Kane Stephanie , Heller Wendy , Laurent Heidemarie
Published: April 2021

It is currently unknown whether differences in neural responsiveness to infant cues observed in postpartum affective disturbance are specific to depression/anxiety or are better attributed to a common component of internalizing distress. It is also unknown whether differences in mothers’ brain response can be accounted for by effects of past episodes, or if current neural processing of her child may serve as a risk factor for development of future symptoms. Twenty-four mothers from a community-based sample participated in an fMRI session viewing their 3-month- old infant during tasks evoking positive or negative emotion. They were tracked across the ensuing 15 months to monitor changes in affective symptoms. Past and current episodes of depression and anxiety, as well as future symptoms, were used to predict differences in mothers’ hemodynamic response to their infant in positive compared to negative emotion contexts. Lower relative activation in largely overlapping brain regions involving frontal lobe structures to own infant positive vs. negative emotion was associated with concurrent (3-month) depression diagnosis and prospective (3–18 month) depression and anxiety symptoms. There was little evidence for impacts of past psychopathology (more limited effect of past anxiety and nonsignificant effect of past depression). Results suggest biased maternal processing of infant emotions during postpartum depression and anxiety is largely accounted for by a shared source of variance (internalizing distress). Furthermore, differential maternal responsiveness to her infant’s emotional cues is specifically associated with the perpetuation of postpartum symptoms, as opposed to more general phenotypic or scarring effects of past psychopathology.
“Satanism is witchcraft’s younger sibling”: Changing perceptions of natural and supernatural anaemia causality in Malawian children
Authors: Svege Sarah , Nkosi-Gondwe Thandile , Lange Siri
Published: April 2021

In countries of sub-Saharan Africa, many children are admitted to hospital with severe forms of anaemia. The late hospital admissions of anaemic children contribute significantly to child morbidity and mortality in these countries. This qualitative study explores local health beliefs and traditional treatment practices that may hinder timely seeking of hospital care for anaemic children. In January of 2019, nine focus group discussions were conducted with 90 participants in rural communities of Malawi. The participants represented four groups of caregivers; mothers, fathers, grandmothers and grandfathers of children under the age of five. The Malawian medical landscape is comprised of formal and informal therapeutic alternatives–and this myriad of modalities is likely to complicate the healthcare choices of caregivers. When dealing with child illness, many participants reported how they would follow a step-by-step, ‘multi-try’ therapeutic pathway where a combination of biomedical and traditional treatment options were sought at varying time points depending on the perceived cause and severity of symptoms. The participants linked anaemia to naturalistic (malaria, poor nutrition and the local illnesseskakoziandkapamba), societal (the local illnessmsempho) and supernatural or personalistic (witchcraft and Satanism) causes. Most participants agreed that anaemia due to malaria and poor nutrition should be treated at hospital. As for local illnesses, many grandparents suggested herbal treatment offered by traditional healers, while the majority of parents would opt for hospital care. However, participants across all age groups claimed that anaemia caused by witchcraft and Satanism could only be dealt with by traditional healers or prayer, respectively. The multiple theories of anaemia causality combined with extensive use of and trust in traditional and complementary medicine may explain the frequent delay in admittance of anaemic children to hospital.
Budget impact analysis of using procalcitonin to optimize antimicrobial treatment for patients with suspected sepsis in the intensive care unit and hospitalized lower respiratory tract infections in Argentina
Authors: Garay Osvaldo Ulises , Guiñazú Gonzalo , Cornistein Wanda , Farina Javier , Valentini Ricardo , Levy Hara Gabriel
Published: April 2021

Background

Inappropriate antibiotic use represents a major global threat. Sepsis and bacterial lower respiratory tract infections (LRTIs) have been linked to antimicrobial resistance, carrying important consequences for patients and health systems. Procalcitonin-guided algorithms may represent helpful tools to reduce antibiotic overuse but the financial burden is unclear. The aim of this study was to estimate the healthcare and budget impact in Argentina of using procalcitonin-guided algorithms to guide antibiotic prescription.

Methods

A decision tree was used to model health and cost outcomes for the Argentinean health system, over a one-year duration. Patients with suspected sepsis in the intensive care unit and hospitalized patients with LRTI were included. Model parameters were obtained from a focused, non-systematic, local and international bibliographic search, and validated by a panel of local experts. Deterministic and probabilistic sensitivity analyses were performed to analyze the uncertainty of parameters.

Results

The model predicted that using procalcitonin-guided algorithms would result in 734.5 [95% confidence interval (CI): 1,105.2;438.8] thousand fewer antibiotic treatment days, 7.9 [95% CI: 18.5;8.5] thousand antibiotic-resistant cases avoided, and 5.1 [95% CI: 6.7;4.2] thousand fewerClostridioides difficilecases. In total, this would save $422.4 US dollars (USD) [95% CI: $935;$267] per patient per year, meaning cost savings of $83.0 [95% CI: $183.6;$57.7] million USD for the entire health system and $0.4 [95% CI: $0.9;$0.3] million USD for a healthcare provider with 1,000 cases per year of sepsis and LRTI patients. The sensitivity analysis showed that the probability of cost-saving for the sepsis patient group was lower than for the LRTI patient group (85% vs. 100%).

Conclusions

Healthcare and financial benefits can be obtained by implementing procalcitonin-guided algorithms in Argentina. Although we found results to be robust on an aggregate level, some caution must be used when focusing only on sepsis patients in the intensive care unit.
Frailty and length of stay in older adults with blunt injury in a national multicentre prospective cohort study
Authors: Tan Timothy Xin Zhong , Nadkarni Nivedita V. , Chua Wei Chong , Loo Lynette Ma , Iau Philip Tsau Choong , Ang Arron Seng Hock , Goo Jerry Tiong Thye , Chan Kim Chai , Malhotra Rahul , Ong Marcus Eng Hock , Matchar David Bruce , Seow Dennis Chuen Chai , Nguyen Hai V. , Ng Yee Sien , Chan Angelique , Wong Ting-Hway
Published: April 2021

Background

Patients suffering moderate or severe injury after low falls have higher readmission and long-term mortality rates compared to patients injured by high-velocity mechanisms such as motor vehicle accidents. We hypothesize that this is due to higher pre-injury frailty in low-fall patients, and present baseline patient and frailty demographics of a prospective cohort of moderate and severely injured older patients. Our second hypothesis was that frailty was associated with longer length of stay (LOS) at index admission.

Methods

This is a prospective, nation-wide, multi-center cohort study of Singaporean residents aged ≥55 years admitted for ≥48 hours after blunt injury with an injury severity score or new injury severity score ≥10, or an Organ Injury Scale ≥3, in public hospitals from 2016–2018. Demographics, mechanism of injury and frailty were recorded and analysed by Chi-square, or Kruskal-Wallis as appropriate.

Results

218 participants met criteria and survived the index admission. Low fall patients had the highest proportion of frailty (44, 27.3%), followed by higher level fallers (3, 21.4%) and motor vehicle accidents (1, 2.3%) (p < .01). Injury severity, extreme age, and surgery were independently associated with longer LOS. Frail patients were paradoxically noted to have shorter LOS (p < .05).

Conclusion

Patients sustaining moderate or severe injury after low falls are more likely to be frail compared to patients injured after higher-velocity mechanisms. However, this did not translate into longer adjusted LOS in hospital at index admission.
Time distribution for pharmacists conducting a randomized controlled trial—An observational time and motion study
Authors: Havnes Kjerstin , Lehnbom Elin C. , Walter Scott R. , Garcia Beate H. , Halvorsen Kjell H.
Published: April 2021

Introduction

An expected future increase in older adults will demand changes in health care delivery, making development, implementation and evaluation of new health care models essential. The rationale for political decision-making concerning the implementation and application of interventions in health care should include cost estimations, specifically those involving clinical interventions. To provide such data knowledge of time spent on the intervention is imperative. Time and motion methodology is suitable to quantify health care personnel’s time distribution.

Aim

To investigate the time distribution for pharmacists conducting a randomized controlled trial (RCT) implementing a clinical intervention.

Materials and methods

The setting was an RCT with a 5-step pharmacist-intervention in collaboration with the interdisciplinary team in a geriatric ward. Two pharmacists were involved in the trial during the observation period. Pharmacist activities, classified as RCT-tasks (intervention or administrative), non-RCT tasks and social/breaks, were recorded applying the Work Observation Method By Activity Timing methodology, enabling recording of predefined work tasks as well as interruptions and multitasking. One observer collected data over eight weeks.

Results

In total, 109.1 hours were observed resulting in 110.2 hours total task time, including multitasking. RCT tasks comprised 85.4% of the total observed time, and nearly 60% of the RCT time was spent on intervention tasks. Medication reviews was the most time consuming task, accounting for 32% of the observed time. The clinical pharmacists spent 14% of the intervention time communicating verbally, mainly with patients and healthcare professionals.

Conclusion

During the RCT, the clinical pharmacists spent about half their time performing the actual intervention. Consequently, costs for providing such a clinical pharmacist service should reflect actual time spent; otherwise, we may risk overestimating theoretical costs.
Multidimensional characteristics of young Brazilian volleyball players: A Bayesian multilevel analysis
Authors: Mendes Felipe G. , Lima Ahlan B. , Christofoletti Marina , Quinaud Ricardo T. , Collet Carine , Gonçalves Carlos E. , Carvalho Humberto M.
Published: April 2021

Brazil has been the benchmark for volleyball performance for at least two decades, providing a unique context to examine expertise development. This study examined the variation in body size, functional capacities, motivation for achievement, competitiveness, and deliberate practice of youth volleyball players associated with differences in biological maturity status, chronological age, and accumulated deliberate volleyball practice, adopting a Bayesian multilevel modeling approach. We considered 68 female and 94 male adolescent players (14.2 years, 90% confidence interval: 12.7 to 16.0). Players were grouped by the onset of deliberate volleyball practice as related to biologic maturation milestones [pre-puberty deliberate practice onset (12% of the sample), mid-puberty deliberate practice onset (51% of the sample), and late-puberty deliberate practice onset (37% of the sample). There was substantial variation in body dimensions and functional performance by gender. There was no variation by gender for motivation for deliberate practice and motivation for achievement and competitiveness. The young volleyball players appeared to be highly motivated and committed to deliberate practice, achievement, and competitiveness. Alignment of chronological age, biological maturation, and accumulated training experience allow more in-depth insights into young volleyball players’ development, providing sounder support for coaches´ decisions.
Mobile phone use intention while driving among public service vehicle drivers: Magnitude and its social and cognitive determinants
Authors: Eijigu Temesgen Demissie
Published: April 2021

Despite its risks for accident and illegality, little is known about the magnitude and associated social and cognitive factors that motivate drivers to use mobile phone while driving. The present study, guided by theory of planned behavior, aimed at describing the magnitude of mobile use while driving and examining the role of attitudes, subjective norms, perceived behavioral control, and risk perceptions in predicting drivers’ intentions to use mobile phone while driving. A total of 155 public service vehicle drivers, who were selected from Debre Markos Town and its vehicle terminal took part in the study. To select study participants, systematic random sampling technique was employed. The instrument used to collect data was self-report questionnaire. The results indicated that more than two-third (69%) of the participants used their mobile phone while driving over the past week. Hierarchical regression analysis displayed that perceived behavioral control, risk perception, and attitude were found to be the most significant social and cognitive predictors of public service vehicle drivers’ intention to use mobile phone while driving, but not age and subjective norm variables. So as to reduce drivers’ intention to use mobile phone while driving, intervention strategies should focus on enhancing their confidence to avoid this behavior; alerting drivers to the traffic control regulation and the dangers of using mobile phones while driving.
Failure of non-invasive respiratory support after 6 hours from initiation is associated with ICU mortality
Authors: Nishikimi Mitsuaki , Nishida Kazuki , Shindo Yuichiro , Shoaib Muhammad , Kasugai Daisuke , Yasuda Yuma , Higashi Michiko , Numaguchi Atsushi , Yamamoto Takanori , Matsui Shigeyuki , Matsuda Naoyuki
Published: April 2021

A previous study has shown that late failure (> 48 hours) of high-flow nasal cannula (HFNC) was associated with intensive care unit (ICU) mortality. The aim of this study was to investigate whether failure of non-invasive respiratory support, including HFNC and non-invasive positive pressure ventilation (NPPV), was also associated with the risk of mortality even if it occurs in the earlier phase. We retrospectively analyzed 59 intubated patients for acute respiratory failure due to lung diseases between April 2014 and June 2018. We divided the patients into 2 groups according to the time from starting non-invasive ventilatory support until their intubation: ≤ 6 hours failure and > 6 hours failure group. We evaluated the differences in the ICU mortality between these two groups. The multivariate logistic regression analysis showed the highest mortality in the > 6 hours failure group as compared to the ≤ 6 hours failure group, with a statistically significant difference (p < 0.01). It was also associated with a statistically significant increased 30-day mortality and decreased ventilator weaning rate. The ICU mortality in patients with acute respiratory failure caused by lung diseases was increased if the time until failure of HFNC and NPPV was more than 6 hours.
‘Filming the invisible’: Barrie Gavin in conversation with John Wyver
Authors: Wyver John
Published: April 2021

Barrie Gavin (b. 1935) is a celebrated producer, director and writer who is best known for numerous programmes about music and musicians made primarily for BBC Television from 1964 onwards. He worked on numerous occasions with the conductors Pierre Boulez and Simon Rattle, and with them and other collaborators he has directed more than 90 films. In this conversation recorded in Leeds in June 2018 Gavin discusses with the writer and producer John Wyver his ideas about making music television, his innovative approaches to filmmaking, his profiles of composers including Luigi Nono, Karlheinz Stockhausen and Toru Takemitsu, and his working relationships with Boulez and Rattle.
Television as the arena of shaping a music genre: The Hong Kong TV broadcasting culture and the rise of Cantopop, 1970–85
Authors: Wong Yat-wai Joseph
Published: April 2021

The term Cantopop is used by scholars to describe Cantonese popular songs developed in Hong Kong during the early 1970s. The rise and development of the genre was not cultivated by music programmes or variety shows but by Cantonese TV drama culture and the competition between different channels in the 1970s. Footage of early 1970s shows indicates that cover versions of English popular songs were initially more prominent than Cantopop in these programmes. Producers and music directors introduced the genre to television by tailor-making Cantonese theme songs based on the characters and stories of TV dramas. By doing so, Cantopop emerged as an effective tool for promoting TV dramas. In this way, and benefitting from the success of Cantonese TV dramas, Cantopop gradually became accepted as one of the mainstream genres in TV culture.
The South Bank Show, popular music and the reframing of arts television
Authors: Lee David
Published: April 2021

This article focuses on the framing of popular music on The South Bank Show (SBS) (1978–2010, 2012–present). Popular culture was central to SBS’s agenda from its very conception, framed by the title sequence by Pat Gavin and the choice of subject matter – the first ever episode was on Paul McCartney, signalling a mainstream cultural appeal and a cultural conservativism given the wider contemporary context of punk sensibility. Therefore, to understand SBS’s approach to popular music, we need to understand the context from which it emerges: the British broadcasting political economy of the late 1970s centred around the pre-choice duopoly and intense rivalry between the BBC and ITV, as well as a production environment centred around Melvyn Bragg. Yet, SBS was not a radical programme, and its focus on popular music over the years has largely been focused on mainstream artists and tastes – speaking to a mainstream audience rather than to avant-garde tastes. In assessing this history, this article considers two programmes from the SBS archive in some detail, as well as reflecting on how production cultures impact cultural outputs.
First evidence of Klebsiella pneumoniae infection in Aceh cattle: Pathomorphology and antigenic distribution in the lungs
Authors: Darniati Darniati , Setiyaningsih Surachmi , Agungpriyono Dewi Ratih , Handharyani Ekowati
Published: April 2021

Background and Aim: Klebsiella pneumoniae is an emerging zoonotic and foodborne pathogen worldwide. Hypervirulent K. pneumoniae (hvKp) was reported as the causative agent of bovine mastitis. This is the first study in Indonesia that has been conducted to determine the capsular serotype of K. pneumoniae, pulmonary gross pathology and histopathology, and distribution of hvKp in the lungs of Aceh cattle. Materials and Methods: The presence of K. pneumoniae in Aceh cattle was investigated in two slaughterhouses in Banda Aceh and Aceh Besar, Indonesia. Lung tissues with gross pathological lesions were collected from 15 cattle presenting with depression, dehydration, or cachexia. The confirmation and capsular serotyping of K. pneumoniae isolates were performed using polymerase chain reaction. The tissues were stained with hematoxylin-eosin and immunohistochemistry to observe the histopathological lesions and the distribution of the hvKp antigens. Results: The pneumonic lesions identified in the lungs of Aceh cattle included hyperemia, hemorrhage, consolidation, and atelectasis. K. pneumoniae was isolated in all 15 lung tissues with pathological pneumonic lesions. Two patterns of infection were observed histopathologically. Acute infection was characterized by hyperemia, inflammatory cell infiltration, hemorrhage, bronchiolar epithelium hyperplasia, bronchial and bronchiolar obstruction with purulent exudates, edema, and atelectasis. On the other hand, chronic infection was defined by macrophage infiltration, emphysema, bronchial dilatation, pleural fibrosis, and alveolar wall thickening by interstitial fibrosis. Immunohistochemical staining using monospecific antisera induced by the hvKp isolate confirmed the presence of K. pneumoniae-specific antigens in the acute infection, predominantly in the bronchiolar, vascular, and alveolar areas. In contrast, generally diffuse infiltrates were found in the pleura and interstitial alveolar areas in chronic infection. Conclusion: hvKp can be detected in the lungs of Aceh cattle, representing acute and chronic infections. The distribution of Klebsiella antigens in the lung tissue was consistent with the histopathological findings.