bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Practical and Theoretical Points in Labyrinthology
Authors: Dohlman Gösta
Published: July 2019

The work of Steinhausen in Greifswald on the function of the cupula ( Pflüger's Archiv, 1933, Band 232, Heft 4) is of extreme value in the conception of the physiological mechanism of the labyrinth. Extension of this work by measurement of the exact relationship between the movements of the endolymph in the canals and the bending of the cupula. Demonstration by means of pictures, etc.

Comparison of the three methods of examination of the peripheral labyrinth. The time of the post-rotational nystagmus, the duration of the nystagmus after applying a constant pressure to a fistula, the time during which the caloric nystagmus continues after changing position of the head from Brüning's optimum to minimum position—all are comparable quantities and are times of about the same length, and all seem to be due to the elasticity of the cupula.

The galvanic reaction: why it does not give practical results: the theory and technique of chronaxiemetrie: a new method of obtaining an exact estimation of the chronaxie of the vestibular nerve and the possibility of the practical use of this method.

Demonstration of apparatus for determining the vestibular chronaxie, and of instruments for the exact registration of the eye-movements during nystagmus.
Renal Sympathectomy: Its Scope and Limitations
Authors: Harris S. Harry
Published: July 2019

Indications for renal sympathectomy, which are deemed to be warrantable by our present state of knowledge. A disease syndrome is described in detail under the title of “renal sympatheticotonus.” This is an obstructive nephropathy in which the neuromuscular dysfunction causing the faulty drainage is typically unilateral and due presumably to overactivity of the sympathetic nerve supply to the kidney. The outstanding features are unilateral renal stasis, renal pain and costo-vertebral tenderness, their recurrence after temporary relief by eserine, and the absence of any demonstrable cause of organic obstruction. Three stages, which are readily demonstrable by pyelographic methods, are described, namely, ( a) the stage of irritability or systole, ( b) the stage of diastole or exhaustion, and ( c) the stage of paralysis or hydronephrosis. Immediate and permanent relief of symptoms is afforded by renal sympathectomy in stages ( a) and ( b). (7) In stage ( c) the aid of plastic surgery may be necessary to overcome secondary organic obstruction. (8) The best interests of surgery in general and of renal sympathectomy in particular will be conserved by rigidly confining the operation to the type of case described.
The Chemotherapy of Infectious Diseases Caused by Protozoa and Bacteria
Authors: Hörlein H.
Published: July 2019

The possibility of combating infectious diseases with chemotherapeutically active substances depends to a large extent on the structure of the pathogenic organism. Apart from the cure of contagious pleuro-pneumonia in horses with neosalvarsan, we have, as yet, no chemotherapeutic substance which is active in virus diseases.

The position is scarcely better when we turn to bacterial infections due to cocci and bacilli. These two types of infective organisms occupy the lowest level in the scale of micro-organisms. On the other hand, the spirochætes, which also belong to the bacteria group, and, still more so, those causal organisms belonging to the protozoa, represent relatively highly differentiated species, and the more highly developed a pathogenic organism is, the more points for attack it appears to offer to the action of chemotherapeutic substances.

It is, therefore, not to be wondered at that the best results with chemotherapeutically active substances have been obtained in spirochætal diseases (syphilis, relapsing fever, frambœsia, etc.), and above all, in protozoal diseases. There is scarcely a protozoal disease of man which cannot be cured nowadays by early treatment with the appropriate synthetic drug. (Sleeping sickness, malaria, amœbic dysentery, leishmaniasis.) Epizootics resembling human diseases, as for example, trypanoses, are also relatively easily dealt with by the same drugs as have been found of value in the treatment of disease in man. On the other hand, there has been a lack of success, up to the present, in the treatment of those diseases of animals which are not generally related to the tropical diseases of man. The most important of these epizootics are the piroplasmoses, which are caused by babesiæ and theileriæ and which are found, not only in tropical and subtropical regions, but also in temperate zones.

In this paper the discovery of a new remedy against piroplasmosis will be reported (acaprin).

Further, advice will be given of a new class of substances, which have an actual chemotherapeutic action in streptococcal infections (prontosil, prontosil S), so that one can hope to be able in the future also to attack bacterial infections due to cocci chemotherapeutically.
The Peripheral Circulation in Chronic Rheumatism
Authors: Kersley G. D.
Published: July 2019

A series of cases of rheumatoid arthritis, osteo-arthritis, gout and fibrositis have been investigated by means of the sedimentation rate, Arneth count, saline absorption test, glucose tolerance test, and direct observation of the capillaries, in order to correlate any abnormality of the peripheral circulation with the type and activity of the disease.

The sedimentation rate test, in which a wide bore tube was used, was of great value as an estimation of activity in the rheumatoid arthritic cases, but a small group showed a normal reading. In the gouty subjects it was usually low but was liable to vary greatly within a short time. In the osteo-arthritic and fibrositic groups it was normal.

The Arneth count did not parallel the sedimentation rate; it was usually normal in the gouty subjects but showed abnormalities in the rheumatoid arthritics and sometimes in the osteo-arthritics (a shift usually to the left, but sometimes to the right).

The saline absorption test was valueless except in cases of gross circulatory disturbance.

The glucose tolerance test, although producing some abnormal curves, in both the osteo-arthritic and the rheumatoid arthritic groups gave normal curves, taking an average of a large number of cases.

Observation of the capillaries—notes being taken of their number, shape, &c., with a drawing eyepiece and photographs—showed a wide variation in normal individuals. This was so remarkable that the only clear-cut findings were a slight increase in tortuosity in the osteo-arthritic group—probably due to the increase in the average age of this group—and an increase in the visibility of the full-length of the capillary loop and of the basal meshwork in the rheumatoid arthritics, probably due to trophic thinning of the epidermis.
Bacteriæmia and Oral Sepsis
Authors: Elliott S. D.
Published: July 2019

Transient streptococcal bacteriæmias are a frequent sequel to dental extractions especially when the mouth is the seat of severe chronic gum infection. Bacteria may also gain admission to the blood-stream in such cases irrespective of operative procedures and probably as the result, in many instances, of minor degrees of gum injury such as is produced by biting on a loose tooth. Acute apical infections do not appear to be especially associated with blood infection of this kind, the focus of infection here apparently being effectively “walled off” by the associated inflammatory reaction.

Of the two factors, infection and trauma, involved in the production of these post-operative bacteriæmias, infection appears to be the more important since, when it is marked, very slight degrees of gum injury are sufficient to produce blood-stream invasion. In the complete absence, however, of the type of trauma induced by the “rocking” of a tooth during its removal, extraction may be accomplished without producing a heavy bacterial shower in the blood.

Usually these transient bacteriæmias produce no permanent ill-effect, but there is some evidence that, occurring in subjects with abnormal heart valves, they may lead to subacute infective endocarditis. Thirteen cases are reported where the valvular infection appeared to result from a post-operative dental bacteriæmia.

Prevention of such bacteriæmias may be achieved by the reduction or elimination of infection and trauma. Complete elimination of the gum infection is difficult although preliminary treatment of the gum margin by some measure such as cauterization may lessen it and lead to a reduction of the post-operative bacterial shower. Similarly, by manipulating an infected tooth as little as possible during its extraction the incidence or degree of blood infection may be decreased.
Pelvic Osteo-Arthropathy of Pregnancy
Authors: Young James
Published: July 2019

Excessive relaxation of the pelvic joints during pregnancy has as its chief symptoms chronic backache and locomotor disturbances. Goldthwait and others have for long drawn attention to the frequent part played by softening of the sacro-iliac joint structures in the production of the common backache of pregnancy. The frequency of this symptom may be gauged by the fact that 114 women out of a successive series of 3,030 cases at the antenatal clinic, or 3.7%, suffered in such a degree as to lead them to call for treatment. In 69, or 60.5%, the pain commenced before the 28th week, whilst in the remaining 45 or 39.5%, it commenced later.
Aspects of Asthma [Abridged]
Authors: Blair Henry
Published: July 2019

Dr H Blair outlines the etiology of asthma inchildren and discusses investigation, treatmentand prevention with special reference to theelimination of external allergens.
Understanding Individual Voluntary Giving as a Practice: Implications for Regional Arts Organisations in the UK
Authors: Moraes Caroline , Daskalopoulou Athanasia , Szmigin Isabelle
Published: July 2019

This research examines individual voluntary giving as an integrative practice. Our research speaks to the new funding challenges traversing the British arts sector. Historically reliant on government funds, increasingly regional non-profit arts organisations must diversify their income sources and target a range of voluntary givers. By drawing on practice theories and interpretive qualitative data, we illuminate how giving understandings, procedures and engagements interconnect and interact, coming together in ways that lead to specific giving choices that prioritise cause-based charities over the arts. In doing so, we make two original contributions towards existing sociological research on voluntary giving. First, we transform and broaden the scope of empirical research by conceptualising voluntary giving as an integrative practice. Second, we offer a lens through which to investigate and explicate shared social processes, mechanisms and acts that traverse structures and individuals, co-construing and reproducing voluntary giving patterns.
Performance Appraisal Politics in the Public Sector: The Effects of Political Skill and Social Similarity on Performance Rating
Authors: Kwon Hyang Won
Published: July 2019

This study investigated the main effects of a subordinate’s (ratee) political skill dimensions (social astuteness, apparent sincerity, interpersonal influence, and networking ability) on supervisor (rater) performance rating and further analyzed the interactive effects of social similarity in the subordinate–supervisor dyad on the relationship between political skill dimension and performance rating. To test these relationships, hierarchical linear modeling (HLM) was used on a matched sample of 337 subordinate–supervisor dyads who worked in South Korea’s central government. Findings showed that subordinates with higher social astuteness, interpersonal influence, and networking abilities (but not apparent sincerity) will likely achieve more positive supervisor ratings. More importantly, the relationship between these political skill dimensions and performance ratings is stronger when there is greater social similarity between a subordinate (ratee) and his or her supervisor (rater). The findings’ practical and academic implications and future research directions are discussed.
Global sampled-data output feedback stabilization for a class of switched stochastic nonlinear systems with quantized input and unknown output gain
Authors: Jiang Yan , Zhai Junyong
Published: July 2019

This paper aims at addressing the sampled-data output feedback control problem for a class of uncertain switched stochastic nonlinear systems, whose control input is quantized by a logarithmic quantizer and the output gain cannot be precisely known. We design a compensator with the quantized information. With the help of the feedback domination approach and the backstepping design method, a sampled-data output feedback controller is constructed with appropriate design parameters and a maximum sampling period to guarantee the global exponential stability in mean square of the closed-loop system under arbitrary switching. Finally, a numerical example is given to illustrate the effectiveness of the proposed scheme.
Postschool Outcomes of Youths with Deafblindness in the United States: Building Further Understandings for Future Practice
Authors: Petroff Jerry G. , Pancsofar Nadya , Shaaban Engy
Published: July 2019

Introduction:

This study examines the postschool outcomes for youths with deafblindness, aged 18–30 years, in the areas of independent living, employment, and friendships.

Methods:

Survey data were collected on 80 youths with deafblindness across the United States. Data addressed postschool outcomes, in addition to youths’ demographics and high school experiences.

Results:

The findings of this study suggest that very few youths were living independently or engaged in paid employment. Conversely, it was reported that the vast majority of youths had friends, and most youths had five or more friendships. Associations between the youths’ demographics, high school experiences, and postschool outcomes show that youths with higher skills in reading and problem-solving were more apt to have been educated in inclusive secondary education settings, had access to the general education curriculum, and to have experienced positive postschool outcomes. Transition planning for these youths was not significantly associated with their postschool outcomes.

Discussion:

These findings are consistent with trends in previous studies regarding postschool outcomes for youths with deafblindness. Future research is needed in formal transition planning and what additional factors may need to be better understood in providing opportunities in postschool life for youths with deafblindness.

Implications for practice:

Findings from this study suggest better inclusion efforts are needed for students with deafblindness in terms of associated opportunities and experiences that would prepare them for paid employment and independent living, along with social engagement and friendships.
GPU-accelerated Double-stage Delay-multiply-and-sum Algorithm for Fast Photoacoustic Tomography Using LED Excitation and Linear Arrays
Authors: Miri Rostami Seyyed Reza , Mozaffarzadeh Moein , Ghaffari-Miab Mohsen , Hariri Ali , Jokerst Jesse
Published: July 2019

Double-stage delay-multiply-and-sum (DS-DMAS) is an algorithm proposed for photoacoustic image reconstruction. The DS-DMAS algorithm offers a higher contrast than conventional delay-and-sum and delay-multiply and-sum but at the expense of higher computational complexity. Here, we utilized a compute unified device architecture (CUDA) graphics processing unit (GPU) parallel computation approach to address the high complexity of the DS-DMAS for photoacoustic image reconstruction generated from a commercial light-emitting diode (LED)–based photoacoustic scanner. In comparison with a single-threaded central processing unit (CPU), the GPU approach increased speeds by nearly 140-fold for 1024 × 1024 pixel image; there was no decrease in accuracy. The proposed implementation makes it possible to reconstruct photoacoustic images with frame rates of 250, 125, and 83.3 when the images are 64 × 64, 128 × 128, and 256 × 256, respectively. Thus, DS-DMAS can be efficiently used in clinical devices when coupled with CUDA GPU parallel computation.
Safety and tolerability of iobitridol in cerebral angiography: a prospective, multicenter study
Authors: Heo Young Jin , Jeong Hae Woong , Kim Donghyun , Baek Jin Wook , Lee Tae Hong , Hwangbo Lee , Shin Shang Hun
Published: July 2019

Background

To date, only a few data have demonstrated the safety of iodinated contrast media for cerebral angiography.

Purpose

To assess contrast-related adverse events after cerebral angiography using iobitridol.

Material and Methods

A total of 790 patients who underwent cerebral angiography at three tertiary hospitals in the Republic of Korea between November 2017 and October 2018 were prospectively enrolled in this study. We interviewed all patients and recorded their symptoms before they left the interventional clinic after the angiography procedure and during the seven-day follow-up visit. The primary endpoints were acute (within 1 h) and delayed (1 h–7 days) adverse events associated with iobitridol injection. We also visually graded the radiographic density and image quality as secondary endpoints.

Results

Acute adverse events were more common than delayed adverse events. Most adverse events were either mild (96.5%) or moderate (3.45%). Among the contrast-related adverse events, feeling of warmth (59.1%) and altered taste (17.5%) were the most common acute events, whereas headache (41.9%) and allergic skin reactions (20.0%) were the most common delayed events. All cerebral angiography showed optimal density and good/excellent image quality.

Conclusion

The findings of this study suggest that iobitridol is a safe and effective iodinated contrast medium for use in cerebral angiography.
Evaluation of Remineralizing Efficacy of Calcium Sucrose Phosphate: A Systematic Review of In Vitro Studies
Authors: Karad Ashok , Dhole Prashant
Published: July 2019

Background: Despite improved oral hygiene regime and availability of preventive formulations, dental caries continues to be a global dental problem. Calcium sucrose phosphate (CaSP) is a remineralizing agent with cariostatic action, which is commonly available in the form of tooth cream. Considering the paucity of evidence, this systematic literature review aims to evaluate the remineralizing efficacy of CaSP.

Methodology: The review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Various databases, including PubMed, Cochrane Central, and Google Scholar, were searched until March 15, 2018 and were assessed for inclusion by two independent reviewers. The primary outcome was to assess the remineralizing efficacy of CaSP, and the secondary outcome was to assess the potential of CaSP in arresting white spot lesion(s) on enamel.

Results: Out of 2,876 articles, only 13 were qualified for inclusion. Included studies presented a low risk of bias for the following items: caries-free teeth or restoration, and adherence to manufacture’s instruction for the usage of remineralizing agent in the risk of bias scale. Ten studies reported an increase in the microhardness of enamel after CaSP application, and three studies reported the effect of CaSP on arresting white spot lesion(s). CaSP was found to be a better remineralizing agent in comparison to casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), casein phosphopeptide-amorphous calcium phosphate with fluoride (CPP-ACPF) and other remineralizing agents in terms of increasing microhardness of enamel. In addition, CaSP application was also found to have a beneficial effect in restoring the color of white spot lesion(s) to that of normal enamel.

Conclusion: CaSP tooth cream was found to be an effective remineralizing agent, compared to others, such as CPP-ACP and CPP-ACPF, in terms of increasing the mean microhardness of enamel and arresting white spot lesion(s).
Room for improvement: A study of overconfidence in numerical skills among British graduates
Authors: Hack-Polay Dieu , Igwe Paul Agu , Okolie Ugochukwu Chinonso
Published: July 2019

The experiment tested overconfidence in number skills among British graduates and non-graduates. The data were collected at a residential management training programme for part-time professional students. The aim of the research was to test whether graduate professionals, due to their higher qualifications, overstated their numeracy abilities compared to non-graduates. The experiment, conducted using E-prime, showed a significant interaction between the level of qualification and the overstatement of numerical abilities. The results support the hypotheses and showed that graduates rated themselves higher than their actual abilities: their test performance was not consistent with their confidence estimates. The findings are significant in relation to rethinking higher education curricula, which are currently under pressure to align with the needs of the economy. The authors advocate more inclusive and interpretive research for a greater understanding of the relevant issues to offer useful policy data and help higher education institutions prepare their graduates for task fulfilment and decision-making in a dynamic workplace. To date, few experiments have tested the numeracy level of graduates to corroborate the narrative communicated by employers. This study, despite the limited sample, is a first attempt and will serve as a reference for future, wider studies.
Suboptimal Engagement of High-Level Cortical Regions Predicts Random-Noise-Related Gains in Sustained Attention
Authors: Harty Siobhán , Cohen Kadosh Roi
Published: July 2019

Interindividual variability in outcomes across individuals poses great challenges for the application of noninvasive brain stimulation in psychological research. Here, we examined how the effects of high-frequency transcranial random-noise stimulation (tRNS) on sustained attention varied as a function of a well-studied electrocortical marker: spontaneous theta:beta ratio. Seventy-two participants received sham, 1-mA, and 2-mA tRNS in a double-blind, crossover manner while they performed a sustained-attention task. Receiving 1-mA tRNS was associated with improved sustained attention, whereas the effect of 2-mA tRNS was similar to the effect of sham tRNS. Furthermore, individuals’ baseline theta:beta ratio moderated the effects of 1-mA tRNS and provided explanatory power beyond baseline behavioral performance. The tRNS-related effects on sustained attention were also accompanied by reductions in theta:beta ratio. These findings impart novel insights into mechanisms underlying tRNS effects and emphasize how designing studies that link variability in cognitive outcomes to variability in neurophysiology can improve inferential power in neurocognitive research.
What Is the Optimal Method to Perform Bone Biopsy (Method, Location, Imaging Use) for Patients With Foot and Ankle Infections?
Authors: O’Neil Joseph T.
Published: July 2019

Recommendation:

A bone biopsy should generally be performed in a percutaneous fashion, particularly in cases where surgical debridement is not considered necessary. If surgical debridement is considered necessary, then an open biopsy can be performed as part of the debridement. Percutaneous biopsy should be performed under sterile conditions by an interventional radiologist or other physician trained in image-guided techniques. The location of the biopsy will depend upon the clinical and radiographic evaluations, with a goal of maximizing the yield of the biopsy while minimizing the risk of injury to surrounding and/or overlying soft tissue structures.

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Post Qualitative Inquiry, the Refusal of Method, and the Risk of the New
Authors: St. Pierre Elizabeth Adams
Published: July 2019

This article is a slight revision of a keynote lecture presented at the 15th International Congress of Qualitative Inquiry in Illinois in 2019. It argues that to experiment and create the “new” in post qualitative, post humanist, and other “new” forms of inquiry invented for the 21st century, social science researchers may well need to refuse conventional humanist social science research methodologies created for the problems of previous centuries.
Airway Stenosis Related to Foreign Body Aspiration: An Under-recognized Long term Complication
Authors: Mehta Ravindra M , Rashmi Nadakuditi , Bajaj Pooja , Krishnan Shyam , Srinivasan Lakshmipriya
Published: July 2019

Introduction:

Sequelae of chronic foreign body aspiration include occlusive granulation tissue formation, which can cause delayed fixed airway stenosis. The aim of this study is to highlight this complication, which should be diagnosed early and treated proactively.

Methods:

We present a case series of areca nut aspiration, an organic foreign body commonly chewed in Southeast Asia, complicated by delayed airway stenosis and examine the peculiar nature of areca nut that predisposes to this complication.

Results:

Long-term sequelae of areca nut aspiration are granulation tissue formation, potentially complicated by airway stenosis due to the mechanical and chemical irritant nature of areca nut.

Discussion:

Organic impacted foreign bodies such as areca nut can cause delayed complications of airway stenosis. Both the sharp edges of the areca nut and chemical irritation caused by alkaloids released by the nut in constant contact with the airway mucosa can predispose to this long-term complication. Early diagnosis and appropriate therapeutic interventions such as balloon bronchoplasty can help restore airway patency and prevent lung damage.
Digital first personality: Automation and influence within evolving media ecologies
Authors: Hutchinson Jonathon
Published: July 2019

This article is about the new roles within social media as a result of the software that automatically gathers and influences our usage: digital first personalities. I use cultural intermediation as a framework to locate the automated processes, such as algorithmic generated recommender systems, that influence content consumption practices driven by digital first personalities. First, the article applies cultural intermediation to celebrity, social media influencers and algorithms to highlight how media is produced and distributed by new forms of intermediation. This section outlines the new players in social media, how the value of media content is transferred from one stakeholder group to another and how algorithms increasingly place prominence on particular types of content. The article then presents fieldwork from several digital agencies that are responsible for creating the digital first personality role. These agencies are demonstrable of those that produce commercially oriented content alongside other more public affairs-oriented content. Finally, the article argues that digital first personalities are crucial actors within cultural intermediation to ensure public issues remain visible to those stakeholders who are most impacted by timely information on societal issues.
Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy
Authors: Albayrak Ilknur , Biber Ayten , Çalışkan Ahmet , Levendoglu Funda
Published: July 2019

The aim of this study were to evaluate pain, care burden, depression level, sleep quality, fatigue and quality of life (QoL) among a group of mothers of children with cerebral palsy (CP) and to compare their results with a group of healthy controls. The study involved 101 mothers who had children with CP and 67 mothers who had a healthy child as the control group. Pain, care burden, depression level, sleep quality, fatigue and QoL of all the participants were evaluated by the numerical rating scale, the Zarit care burden scale (ZCBS), the beck depression inventory (BDI), the Pittsburgh sleep quality index (PSQI), the checklist individual strength (CIS) and the short form-36 (SF-36), respectively. Numerical rating scale value was 3.57 ± 2.96 in the patient group. When the two groups were compared, the CP group showed higher scores for ZCBS, BDI, PSQI, total CIS and SF-36 subscales of general health and vitality whereas the scores for role physical, role emotional, mental health and mental component summary were found to be lower in the patients, compared to the control group. Reducing caregiving burden of the mothers’ by other family members and increasing psychosocial supports may help improve the mother’s health status.
Associations between genetic polymorphisms of TLRs and susceptibility to tuberculosis: A meta-analysis
Authors: Zhou Yong , Zhang Mengtao
Published: July 2019

Some genetic association studies have tried to investigate potential associations between TLR polymorphisms and tuberculosis. However, the results of these studies have not been consistent. Thus, we performed the present meta-analysis to explore associations between TLR polymorphisms and tuberculosis in a larger combined population. A systematic literature research of PubMed, Web of Science and Embase was performed to identify eligible studies for combined analyses. I2 statistics were employed to assess between-study heterogeneities. If I2 was >50%, random-effects models were used to combine the data. Otherwise, fixed-effects models were applied for synthetic analyses. A total of 39 genetic association studies were included in the analyses. The combined analyses showed that TLR1 rs4833095, TLR1 rs5743557, TLR1 rs5743596, TLR2 rs3804099, TLR2 rs5743704, TLR2 rs5743708, TLR6 rs5743810 and TLR8 rs3764879 polymorphisms were significantly associated with susceptibility to TB in the overall population. Further subgroup analyses revealed similar significant findings for TLR1 rs4833095, TLR1 rs5743557, TLR1 rs5743596, TLR1 rs5743618, TLR2 rs3804099, TLR2 rs5743704, TLR2 rs5743708, TLR4 rs4986790 and TLR4 rs4986791 polymorphisms in certain ethnicities. In conclusion, our findings support that these TLR polymorphisms may be used to identify individuals at high risk of developing tuberculosis.
Using debate to educate young people in schools about antibiotic use and resistance: A before and after evaluation using a questionnaire survey
Authors: Young Vicki L , Berry Mark , Verlander Neville Q , Ridgway Andy , McNulty Cliodna AM
Published: July 2019

Introduction:

The use of debating as an educational tool is increasing in popularity. Students who take part in debates can develop a range of skills such as confidence and communication as well as gaining a greater understanding of the topic discussed. Within this study we have evaluated an antibiotic-resistant debate kit, assessing the ability of the debate lesson to improve student knowledge and awareness around antibiotics.

Methods:

The debate lesson was delivered in seven schools across South West England to 235 students aged 13-16 years. Change in student knowledge was measured using before and after knowledge questionnaires. Student and teacher feedback and suggestions for improvements for the lesson were also collected through questionnaires and interviews.

Results:

Quantitative questionnaires found a significant improvement in knowledge for most areas covered in the debate, particularly around the use of antibiotics to treat colds and bacteria developing resistance. Teachers felt their students engaged well with the debate session and made suggestions for minor modifications that could improve the lesson.

Conclusions:

The results suggest that the e-Bug antibiotic resistant debate kit is able to improve knowledge in young people around antibiotics and antibiotic resistance. Furthermore, the lesson was enjoyed by students and therefore this resource should be promoted more widely to teachers and schools.
Gastroprotective Effect and Chemical Constituents of Flabellaria paniculata (Malpighiaceae)
Authors: Sofidiya Margaret O. , Taiwo Elizabeth , Awolola Victoria , Habila James , Koorbanally Neil A.
Published: July 2019

Leaves from Flabellaria paniculata Cav (Malpighiaceae) are used in traditional medicine for wound dressing, and to treat ulcers and inflammation in Nigeria. The present study evaluates the gastroprotective activity of the ethyl acetate fraction of the methanolic leaf extract and reports on the chemical constituents from the fraction. The methanolic crude extract and solvent fractions (100 mg/kg, PO) were screened using an ethanol-induced ulcer model. The activity of the most active EtOAc fraction (25, 50, and 100 mg/kg, PO) was further evaluated in indomethacin and pylorus ligation-induced ulcer models. The EtOAc fraction was chromatographed and chemical structures of the isolated compounds were elucidated by nuclear magnetic resonance spectroscopy. The MeOH extract of F. paniculata and EtOAc fraction from this extract displayed significant gastroprotective effects. Two triterpenoids (friedelin and friedelinol), two steroids (sitosterol and sitosterol-β-d-glucoside), and a flavonoid glycoside (kaempferol-3- O-α-l-rhamnopyranosyl-(1→6)-β-d-glucopyranoside) were identified from the EtOAc fraction. This is the first report on the isolation of these compounds from the plant. The identified compounds could be responsible in part for the observed gastroprotective effect of the EtOAc fraction.
HDAC inhibitors as antifibrotic drugs in cardiac and pulmonary fibrosis
Authors: Lyu Xing , Hu Min , Peng Jieting , Zhang Xiangyu , Sanders Yan Y
Published: July 2019

Fibrosis usually results from dysregulated wound repair and is characterized by excessive scar tissue. It is a complex process with unclear mechanisms. Accumulating evidence indicates that epigenetic alterations, including histone acetylation, play a pivotal role in this process. Histone acetylation is governed by histone acetyltransferases (HATs) and histone deacetylases (HDACs). HDACs are enzymes that remove the acetyl groups from both histone and nonhistone proteins. Aberrant HDAC activities are observed in fibrotic diseases, including cardiac and pulmonary fibrosis. HDAC inhibitors (HDACIs) are molecules that block HDAC functions. HDACIs have been studied extensively in a variety of tumors. Currently, there are four HDACIs approved by the US Food and Drug Administration for cancer treatment yet none for fibrotic diseases. Emerging evidence from in vitro and in vivo preclinical studies has presented beneficial effects of HDACIs in preventing or reversing fibrogenesis. In this review, we summarize the latest findings of the roles of HDACs in the pathogenesis of cardiac and pulmonary fibrosis and highlight the potential applications of HDACIs in these two fibrotic diseases.
Development of Young's modulus of natural illitic clay during the heating and cooling stages of firing
Authors: Húlan Tomáš , Štubňa Igor , Shishkin Andrei , Ozolins Jurijs , Csáki Štefan , Bačík Peter , Fridrichová Jana
Published: July 2019

Illitic clay from the locality of Liepa, Latvia, was investigated using dynamic thermomechanical analysis during the heating and cooling stages of firing. Differential thermal analysis, thermogravimetry, thermodilatometry, X-ray diffraction and porosimetry were also performed to shed light on the processes influencing the elastic properties of clay. The increase in the Young's modulus (YM) at low temperatures was linked to the release of physically bound water. Above 850°C, the bulk density and YM both increased as a consequence of sintering. The YM was more sensitive to the progress of sintering compared to dimension changes. The YM values continued to increase during cooling until the glass-transition temperature was reached. At this temperature, the first microcracks caused by the differences in thermal expansion coefficients of the present phases were expected to appear. The YM showed a sharp V-shaped minimum at the β → α transition of quartz, which was a result of alternation of the mechanical radial stresses around the quartz grains. When the transition of quartz was completed, the YM continued to decrease because microcracks were still being created at the boundaries between the different phases. The decrease of the YM during cooling from the glass-transition temperature down to room temperature was ~50% for all of the firing temperatures and isothermal periods applied.
Signal-to-noise ratio assessment of muscle diffusion tensor imaging using single image set and validation by the difference image method
Authors: Wang Zhiyue J. , Yamamura Jin , Keller Sarah
Published: July 2019

Objective:

Signal-to-noise ratio (SNR) assessment is essential for accurate quantification of diffusion tensor imaging (DTI) metrics and usually requires the use of a difference image method using duplicate images. We aimed to estimate the SNR of DTI of thigh muscles using a single image set without duplicate images.

Methods:

DTI of one thigh were acquired on a 3 T scanner from 15 healthy adults, and scans with number of signal averages (NSA) = 4 and 8 were repeatedly acquired. SNR were evaluated for six thigh muscles. For SNR calculation from a single image set, diffusion-weighted images with similar diffusion encoding directions were grouped into pairs. The difference image of each pair was high-pass filtered in k-space to yield noise images. Noise images were also calculated with a difference method using two image sets as a reference. Subjects were divided into two groups for filter optimization and validation, respectively. The coefficient of repeatability (CR) of the SNR obtained from the two methods was also evaluated separately.

Results:

Bland–Altman analysis comparing the single image set method and the reference showed 95% limits of agreement of −9.2 to 9.2% for the optimization group and −12.5 to 12.6% for the validation group. The SNR measurement had a CR of 21.1% using the reference method, and 13.8% using the single image set method.

Conclusion:

The single image method can be used for DTI SNR assessment and offers better repeatability.

Advances in knowledge:

SNR of skeletal muscle DTI can be assessed for any data set without duplicate images.
Improving the Transition of Intravenous to Enteral Antibiotics in Pediatric Patients with Pneumonia or Skin and Soft Tissue Infections
Authors: Girdwood Sonya C Tang , Sellas Maria N , Courter Joshua D , Liberio Brianna , Tchou Michael J , Herrmann Lisa E , Dewan Maya L , Statile Angela M , Unaka Ndidi I
Published: July 2019

BACKGROUND

Despite national recommendations for early transition to enteral antimicrobials, practice variability has existed at our hospital.

OBJECTIVE

The aim of this study was to increase the proportion of enterally administered antibiotic doses for Pediatric Hospital Medicine patients aged >60 days admitted for uncomplicated community‐acquired pneumonia or skin and soft tissue infections from 44% to 75% in eight months.

METHODS

This quality improvement study was conducted at a large, urban, academic children's hospital. The study population included Hospital Medicine patients aged >60 days with diagnoses of pneumonia or skin and soft tissue infections. Interventions included education on intravenous and enteral antibiotic charge differentials, documentation of transition plan, structured discussions of transition criteria, and real‐time identification of failures with feedback. Our process measure was the total number of enteral antibiotic doses divided by all antibiotic doses in patients receiving enteral medications on the same day. An annotated statistical process control chart tracked the impact of interventions on the administration route of antibiotic doses over time. Additional outcome measures included antimicrobial costs per patient encounter using average wholesale prices and length of stay.

RESULTS

The percentage of enterally administered antibiotic doses increased from 44% to 80% within eight months. Antimicrobial costs per patient encounter and the associated standard deviation of costs for our target diagnoses decreased by 70% and 84%, respectively. Average length of stay did not change.

CONCLUSIONS

Standardized communication about criteria for transition from intravenous to enteral antibiotics can lead to earlier transitions for patients with pneumonia or skin and soft tissue infections, subsequently reducing costs and prescribing variability.
Spectral Analysis of the MIXMAX Random Number Generators
Authors: L’Ecuyer Pierre , Wambergue Paul , Bourceret Erwan
Published: July 2019

We study the lattice structure of random number generators of the MIXMAX family, a class of matrix linear congruential generators that produces a vector of random numbers at each step. The design of these generators was inspired by Kolmogorov K-systems over the unit torus in the real space, for which the transition function is measure preserving and produces a chaotic behavior. In actual implementations, however, the state space is a finite set of rational vectors, and the MIXMAX has a lattice structure just like linear congruential and multiple recursive generators. Its matrix entries were also selected in a special way to allow a fast implementation, and this has an impact on the lattice structure. We study this lattice structure for vectors of successive and nonsuccessive output values in various dimensions. We show in particular that for coordinates at specific lags not too far apart, in three dimensions, or if we construct points of k+2 or more successive values from the beginning of an output vector of size k, all the nonzero points lie in only two hyperplanes. This is reminiscent of the behavior of lagged-Fibonacci and add-with-carry/subtract-with-borrow generators. And even if we skip the output coordinates involved in this bad structure, other highly structured projections often remain, depending on the choice of parameters. We show that empirical statistical tests can easily detect this structure.
Globally Solving Nonconvex Quadratic Programs via Linear Integer Programming Techniques
Authors: Xia Wei , Vera Juan C. , Zuluaga Luis F.
Published: July 2019

We reformulate a (indefinite) quadratic program (QP) as a mixed-integer linear programming (MILP) problem by first reformulating a QP as a linear complementary problem, and then using binary variables and big-M constraints to model its complementary constraints. To obtain such reformulation, we use fundamental results on the solution of perturbed linear systems to impose bounds on the QP’s dual variables without eliminating any of its (globally) optimal primal solutions. Reformulating a nonconvex QP as a MILP problem allows the use of current state-of-the-art MILP solvers to find its global optimal solution. To illustrate this, we compare the performance of this MILP-based solution approach, labeled quadprogIP, with quadprogBB, BARON, and CPLEX. In practice, quadprogIP is shown to typically outperform by orders of magnitude quadprogBB, BARON, and CPLEX on standard QPs. Also, unlike quadprogBB, quadprogIP is able to solve QP instances in which the dual feasible set is unbounded. The MATLAB code quadprogIP and the instances used to perform the reported numerical experiments are publicly available at https://github.com/xiawei918/quadprogIP .
How Do EHRs and a Meaningful Use Initiative Affect Breaches of Patient Information?
Authors: Kim Seung Hyun , Kwon Juhee
Published: July 2019

Effective use of electronic health records (EHRs) is considered an important step toward the goal of improving the quality of U.S. healthcare, while reducing its costs. However, did EHRs and a meaningful use (MU) initiative increase the risk of a breach of patient information as many people were worried about? This study shows that implementing EHRs led to a 3.081 times higher risk of a breach of patient information. This heightened risk was mostly driven by the occurrence of more accidental breaches. Undertaking MU initiatives increased the risk of accidental breaches by 1.771 times, but not the risk of malicious breaches. We also found that these risks increased more among relatively larger hospitals. We conclude that despite recent evidence that the usage of EHRS has improved the quality of healthcare, quality must go hand in hand with the protection of patient information. Thus, we argue that the government’s future revision of the criteria for MU should better reflect the risk of accidental breaches. Our study also suggests that policy makers should carefully address the possible increase in the risk of privacy breaches when considering whether to promote industry-wide adoption of digitized data and processes.
Understanding the Social Learning Effect in Contagious Switching Behavior
Authors: Hu Mandy Mantian , Yang Sha , Xu Daniel Yi
Published: July 2019

We study the contagious switching behavior related to a consumer’s choice of wireless carriers, that is, that a consumer is more likely to switch wireless carriers if more of their contacts from the same carrier have switched. Contagious switching (or a positive network effect) can be driven by information-based social learning, as well as other mechanisms related to network size. Although previous marketing literature has documented the social-learning effect, most of the applications studied involve products in which consumers usually do not enjoy any direct benefits from a large network other than from information-based social learning. We explore the importance of the social-learning effect relative to other mechanisms that may also lead to the network effect. We propose a dynamic structural model with interpersonal interactions. To model the social-learning effect, a consumer uses feedback from his or her contacts who have switched from a focal carrier to update his or her quality expectations of alternative carriers. Our model further accounts for two unique aspects of consumer strategic learning: (i) the individual’s perception on the signal of alternative carriers from contacts who switch is systematically different according to whether the signal comes from a loyal contact; and (ii) that the perceived noisiness of the signal on alternative carriers from a contact who has switched depends on the strength of the relationship between the individual and the contact. The remaining network effect not captured through social learning is modeled as a function of the size of the network. We solve the model with a two-step dynamic programming algorithm, with the assumption that a consumer is forward-looking and decides whether to stay with the same service carrier in each period by maximizing the total utility received from that day onward. We apply the proposed model to the data set of a mobile network operator in a European country. We find that churning/switching behavior is contagious in the network context and that one-third of general network effects can be attributed to social learning. We also detect strategic learning by consumers from their contacts in two ways: the experience signal on alternative carriers from a more loyal contact who has switched from the focal carrier is perceived to be more positive than that from a less loyal contact; and the social-learning effect is stronger from an individual’s closest contacts. The simulation analysis demonstrates the value of our model in helping a company prioritize its customer relationship management effort.

This paper was accepted by Matthew Shum, marketing.