bluuebunny/crossref_metadata_2025 huggingface dataset:
Some Observations on Temporary Drainage of the Kidney
Authors: Dix Victor W.
Published: July 2019

Temporary drainage may be necessary for the success of an operation, as, e.g., a plastic operation on a hydronephrosis. It may, however, also be used as an aid to recovery of function by a damaged kidney; its use in these cases is not a necessity but is an optional point in technique.

The method of drainage should be simple to adjust at the time of the operation, easy to control during the post-operative period, and one which causes no damage to the kidney when the drainage tube is removed. The technique of such a method is described. Some difficulties in operative technique, and in post-operative management, are considered, and the normal course of drainage in these cases is outlined.

An additional point in favour of the method is that it can be used both in those cases in which drainage is necessary and in the others where it is not; and the experience gained by overcoming difficulties and complications in those cases where drainage is not of vital importance is of the greatest possible use in establishing a good technique for those cases in which failure of the drainage system would imperil the success of the operation.
Therapeutic Action of Injectio Ferri B.P
Authors: Burger G. N. , Witts L. J.
Published: July 2019

The injection of iron, which was introduced into the British Pharmacopœia, 1932, has been carefully tested in ten cases of anæmia.

The parenteral administration of iron is rarely desirable, because the therapeutic dose of iron by injection is so near to the toxic dose. Injectio Ferri B.P. has a very low therapeutic efficiency owing to its small content of iron; it is also painful, though this may be corrected by the addition of a local anæsthetic such as 3% procaine hydrochloride.

Double the maximum official dose of Injectio Ferri B.P., i.e. 14 mgm. of metallic iron, can apparently be safely given at one injection, but it would be necessary to give this dose twice a day for about six weeks to equal the effects of large doses of iron by mouth. The treatment of anæmia by weekly or bi-weekly injections of small doses of iron is irrational and to be deplored.
The Bartonella and Related Parasites in Man and Animals (Oroya Fever and Verruga Peruviana)
Authors: Kikuth Walter
Published: July 2019

Through the investigations of Noguchi on the one hand, and Mayer and Kikuth on the other, the unity of the ætiology of Oroya fever and verruga peruviana has been demonstrated experimentally. The Bartonella bacilliformis, the causal organism of Oroya fever, belongs to a group of micro-organisms, the parasitic nature of which has been definitely proved during the last few years. Tests with a view to transmitting the disease to monkeys, and the ætiology, clinical data, pathology, therapy and immunobiology are further explained with reference to personal experiments.

Bartonella muris, which was first observed by Mayer in 1921, was confirmed by Mayer, Borchardt and Kikuth to be the causal organism of infectious rat anæmia following splenectomy. After splenectomy of the rat, the latent parasite becomes virulent and often causes a fatal anæmia. The clinical course of this infection is connected with an endothelial reaction which can be demonstrated histologically. The infection is transmitted by rat lice. Chemotherapeutic experiments led to the discovery of an effective arsenic-antimony compound with an index of 1: 3,500, which figure has never hitherto been reached in chemotherapy.

The causal organism of dog anæmia following splenectomty is the Bartonella canis.

Bartonella and bartonella-like structures as causal organisms and harmless blood parasites in various animals.

On account of their peculiar behaviour the Grahamella, which were first described by Graham-Smith, should be kept strictly apart from the Bartonella and looked upon as a species by itself.
Some Medical and other Aspects of Bacterial Chemistry
Authors: Fildes Paul
Published: July 2019

The evolution of bacterial chemistry as applied to medicine from bacterial chemistry as applied for economic purposes is traced. The outlook of the bacterial chemist is contrasted with that of the medical bacteriologist.

The possible results of the study of bacterial nutrition from the medical aspect are noted. Difficulties arise from the fact that the nutrition of a single species varies. A variation in bacterial enzymes results from alteration in the substrate.

The evolution of bacteria from primitive autotrophic types to the parasitic types of the present day may be explained on the basis of an evolution depending upon a gradual alteration in the substrate. The primitive bacteria in an evolutionary sense are endowed with great powers of synthesis, while the evolved bacteria are not. Thus, while the primitive bacteria can synthesize their protoplasm from simple nutrients, the parasitic bacteria cannot and must receive complex compounds pre-formed.

In the case of parasitic bacteria this taking of nutrients from the tissue cells may have a bearing upon disease. An infective disease may in part be a deficiency disease. An essential cell nutrient may be taken from the cells by the bacteria, with a result that they cannot function properly in the “anti” sense.
Some Points in the Diagnosis of Stone by X-Rays
Authors: Wells C. A.
Published: July 2019

The investigation of cases suspected of stone is concerned with (1) those in which a shadow is visible and (2) those in which X-rays throw no shadow.

In the former group the nature of the shadow must be determined. If a stone, it must be accurately placed in the urinary tract and the anatomy and function of the affected and unaffected parts of the tract must be determined.

A stone may be recognized by the characteristic shape to which it grows in the pelvis, in a calyx or in the ureter. In the earlier stages, or when the shape of the shadow is not characteristic, radiograms may be made on inspiration and expiration. In orthopædic and other cases immobilized for long periods interesting calculi may form and may subsequently be disintegrated and passed, or may require surgical treatment.

For stones in the kidney and upper ureter pyelography by the descending route is ideal. For infected stones the retrograde route is preferable. For small ureteric stones an opaque catheter is best.

Non-opaque stones are of real surgical significance. It is essential to make a positive diagnosis in a case of suspected stone, even if operation is not required. Furthermore, non-opaque stones are sometimes sufficiently large to demand operative removal. The presence of these stones can be inferred from descending pyelograms, and the stones themselves can be displayed by means of the opaque material they pick up in the course of a descending pyelography.
The Present and Future of Radium Teletherapy
Authors: Carling E. Rock , Allchin F. M.
Published: July 2019

The problems before the radium teletherapist are those ordinarily dealt with by the deep-X-ray therapist. There is, unfortunately, only one method available for the solution of many of these problems, that of trial and error. This paper records errors and attempts to rectify them.

The problems are:—

(1) To construct apparatus that can safely be used by the workers. (2) To ascertain with precision the site and extent of the tumour. (3) To obtain a depth-intensity and dose of cancericidal order without damage to the skin or intervening and surrounding tissues. (4) To measure and record the dose received by the tumour. (5) To ascertain the best total duration and spacing of component parts of the total dose. (6) To find means for increasing differentially the sensitivity of malignant cells. (7) To safeguard the patient's general health.

Unless there be any advantage in the use of short waves, there is no permanent field for teletherapy.

The combination of long and short waves appears to us to offer advantages: (1) Permitting continuance of irradiation when one type ceases to be effective; (2) safeguarding the skin; (3) perhaps offering a biological superiority.

The immediate future calls for:—

(1) Improvements in apparatus. (2) Agreement as to the best unit applicable alike to gamma and X-irradiation. (3) Further exploration of means for measuring dose received. (4) Accumulation of data as to effective dose in relation to tumours of different organs and different histological type. (5) Better grouping of clinical classes. (6) More universal co-operation with physicists. (7) Concentration of control of both forms of treatment in the same hands.
The Uses and Limitations of Sterilization in Social Psychiatry
Authors: Blacker C. P.
Published: July 2019

The uses and limitations of sterilization in psychiatry have become questions of considerable sociological importance since the publication of the Brock Report in January 1934.

Compulsory and voluntary sterilization have quite different social implications—Psychiatric implications of the German law and of laws which have been proposed or passed in the U.S.A.

Proposals of the Brock Committee; psychiatric aspects of the safeguards proposed; necessity for some general safeguards to prevent abuses.

Genetic results attainable by a vigorously applied compulsory measure as against those to be expected from a voluntary measure.
Carbon Dioxide Absorption from Anæsthetic Atmospheres
Authors: Waters Ralph M.
Published: July 2019

A safe and practical technique for the application of carbon dioxide absorption from anæsthetic atmospheres is described. It has been found satisfactory in over 20,000 administrations over a period of fifteen years. High-grade soda lime is utilized as the chemical absorbent. Granules are placed in a canister between face mask, and breathing bag. The canister is carefully checked for efficiency by both chemical analyses and physical experiments. Its size, shape and arrangement is shown to be important for safety and maximum efficiency. Detailed techniques are described for the use of various agents. Advantages of carbon dioxide absorption are set forth. The “Apnœa” suggested by Guedel is described under the term “Controlled Respiration” and attention is called to certain of its advantages.
Local and Remote Sequelæ of Infection in the Parodontal Sulcus
Authors: Fish E. Wilfred
Published: July 2019

It is shown in this paper that the infecting organisms in the parodontal sulcus are confined to the surface, but may be forced into the blood and lymph stream by traumatic interference. Local and general disturbances may therefore arise both as a result of the absorption of soluble toxic matter from the pocket into the tissues and also as a result of this traumatic introduction of organisms into the blood-stream. The effect of toxic absorption on the local tissues is destruction of the attachment of the tooth-pyorrhœa. The remote effects of toxic absorption may be a similar destruction of the connective tissue generally-arthritis and fibrositis. The liver and kidney may suffer since they excrete the toxic matter, and other susceptible tissues may also be involved. Traumatic bacteræmia may produce local bone necrosis or “dry” socket. Acute suppurative lymphangitis produces the “pyorrhœtic abscess”. The remote effect of bacteræmia may be to produce osteomyelitis (e.g. of the tibia) or to convert a simple endocarditis into the bacterial type. The mechanism of bone absorption and deposition in response to irritation is discussed. Methods of eliminating parodontal infection are referred to and the importance of complete elimination is stressed. It is shown to be not incompatible with the conservation of the teeth.
Familial Hepatitis and Chronic Jaundice
Authors: Debré Robert
Published: July 2019

The author reports the history of a family of six children, of whom two, the eldest and the fifth, are normal; three died, a boy when 6 months old and two girls when 9 and 10 years old, from the same familial disease that also attacked another boy now 7 years old. The essential features of this disease are hypertrophy of both liver and spleen, chronic icterus with evidence of salts and bile-pigments in the blood and urine, retardation of physical, mental, and sexual development, slight deafness in one case and clubbing of the fingers in another. This condition is a good example of biliary cirrhosis of the liver.

After reviewing recent French observations, the author recalls the large contribution of English authors on the subject.

He then distinguishes three types of familial cirrhosis: Laennec's type with enlarged liver, the type of splenomegalic anascitic and anicteric cirrhosis, resembling Banti's syndrome, and the commonest type or biliary cirrhosis.

The author describes particular histological lesions, and when dealing with differential diagnoses, excludes dyslipoidic, polycoric, and other acquired cirrhosis in children. He then summarizes the relationships between this disease and the obstructive cirrhosis to a congenital defect of the bile-ducts, the cirrhosis in young Indians, the syndrome of hepatic lenticular degeneration, and the syndrome of cirrhosis of the liver combined with hæmangiomatosis. Finally, after recalling the close analogy of the condition with renal dwarfism, the author shows how the interpretation of these relationships may throw light on the pathogenesis of various progressive congenital diseases.
Discussion on Active Immunization—Some Present-Day Problems
Authors: Parish H.J.
Published: July 2019

Diphtheria.—Immunization is safe and effective. Compulsory measures are indicated, especially for the younger age-groups. The Schick test may be reserved for selected groups and to control modified methods. Proper spacing of doses of prophylactics and periodic reinoculation will ensure a high level of immunity. It is important to beware of “one-shot” methods. Indiscriminate swabbing is to be discouraged; high carrier rates are an indication for widespread diphtheria prophylaxis.

Enteric fever.—Mass immunization is desirable in many areas, although there is no justification for compulsion except for people exposed to special risks. In deciding upon dosage of vaccine, more attention should be paid to physical state and body-weight. After the primary course, very small periodic doses (for example o.i.c.c) are worthy of trial. Vaccine can be given during an epidemic without increasing the chances of infection.

Tetanus.—Two doses of toxoid spaced by six weeks give useful immunity. Women give significantly higher titres than men. A third dose of i.o.c.c. after a long interval—seven to nine months—often produces a dramatic rise in circulating antitoxin, and counteracts any tendency to waning immunity.

Smallpox.—As vaccination has not been made compulsory in this country, infection by virulent strains from the continent may tax the resources of the public health services.

Whooping-cough.—The large number of injections of vaccine usually recommended is a deterrent to mass immunization. Research into the possibility of fewer doses and wider spacing is indicated.

Other diseases are considered briefly.

Combined immunization.—It may be useful to combine diphtheria T.A.F. and tetanus toxoid, also tetanus toxoid and T.A.B. vaccine. T.A.F. plus T.A.B. is probably contra-indicated for adults on account of severe reactions. Diphtheria A.P.T. should not be mixed with tetanus toxoid as it may go into solution and become ineffective.

Sterilization of syringes and needles.—An intensive inoculation campaign is no excuse for slip-shod methods.
Drug Interaction in the Field of Analgesic Drugs
Authors: Lasagna Louis
Published: July 2019

The evidence for believing that mixtures of aspirin, phenacetin, and caffeine provide advantages over the individual components of these mixtures is reviewed, and doubt expressed as to the rationale for the use of these mixtures in ordinary medical practice. The syndrome of ‘analgesic nephropathy’ is also reviewed, and on the basis of experiments in healthy volunteers it is suggested that individual ingredients of analgesic mixtures be scrutinized more carefully in an attempt to track down the agents responsible for toxic effects.

The use of phenothiazine compounds, alone or in mixture with narcotics, is reviewed, and the opinion expressed that methotrimeprazine has special analgesic attributes.

The narcotic antagonists represent an extremely interesting group of drugs which possess analgesic activity as well as the ability to antagonize certain effects of morphine and other narcotic agents. The patterns of respiratory effect, psychotomimesis, and abstinence phenomena seen with these antagonists illustrate the possibility of dissociating certain effects usually assumed to be linked inseparably in drugs possessing the analgesic power of morphine.
Physiological and Pharmacological Interactions of Antihypertensive Drugs
Authors: Dollery C T
Published: July 2019

The complex mechanisms that maintain the blood pressure can be interfered with at many points by drugs. A drug acting at one point may be potentiated by another which blocks a compensatory reflex minimizing the effect of the first. Many therapeutically useful drug combinations have a nonspecific mechanism of this kind although drugs that act upon different points in the sympathetic efferent vasomotor pathway have not been proved to have a useful additive effect.

It is not easy to prove a synergistic action of two drugs unless it is large. The best supported examples are combinations of either a diuretic or a vasodilator with a sympathetic blocking drug. These combinations are the ones most widely used in treatment of hypertension. They allow the dose of each active substance to be reduced so that unwanted side-effects are decreased without losing the desired action on the blood pressure.

Drug combinations have special risks besides their obvious advantages. Patients are more likely to become confused and take the wrong doses if their treatment regime is complicated. Two drugs which are individually nontoxic may have dangers when used together. Oliguria and a mounting blood urea may follow combined use of powerful modern diuretics. Toxic effects may be entirely unrelated to the main therapeutic action of the drug, as with the enhanced diabetogenic effect of diazoxide used with hydrochlorothiazide.

Several potent cardiovascular drugs modify the response to drugs which might be given to raise the blood pressure in an emergency. No drug in common therapeutic use seriously reduces the response to injected noradrenaline but some, such as sympathetic blockers and monoamine oxidase inhibitors, greatly increase sensitivity. Pressor amines that act indirectly by noradrenaline release may be ineffective in the presence of drugs which deplete or insulate the stores of the transmitter in adrenergic nerve endings.

The advantages and disadvantages of drug interactions deserve more thought and study than they usually receive.
Drug Combinations in Antibacterial Chemotherapy
Authors: Barber Mary
Published: July 2019

Double chemotherapy for the treatment of bacterial infections has been recommended for many reasons, of which the most important are the following: (1) To achieve a synergic effect. (2) To delay the emergence of resistant strains. (3) To prevent superinfection. (4) To treat relatively inaccessible bacteria. (5) To treat mixed infections. (6) To treat undiagnosed infections.

Combinations which have a truly synergic effect in vivo are those which show bacteri cidal synergy in vitro. Bacteri cidal therapy is of great practical importance in conditions which are inaccessible to the natural defences of the body, or where they are deficient. If in such cases the infecting bacterium is not readily killed by a single drug, then combinations should be tried. There are no absolute rules and double bactericidal sensitivity tests should always be carried out on the infecting strain, but the most likely combination to show this type of synergy is a penicillin and streptomycin.

If a bactericidal drug is combined with an agent which is only bacteristatic, the killing effect may be antagonized, since many bactericidal drugs only kill rapidly multiplying cells. Again there are no absolute rules, but antagonism is particularly liable to occur when the bactericidal agent is one of the penicillins and is very unlikely to occur when it is a polymyxin, since this kills resting bacteria.

Drug combinations to delay the emergence of drug-resistant strains should be considered for infections due to staphylococci and coliform bacilli, particularly in hospitals, and when it is desired to use drugs to which these bacteria readily develop resistance.

Drug combinations may also be the most efficient treatment for mixed infections and may be necessary for the treatment of fulminating infections pending bacteriological diagnosis. The combination of nystatin with a tetracycline may be necessary to prevent candidiasis if tetracycline therapy has to be prolonged.
The Status of Doctors
Authors: Snow Lord
Published: July 2019

Lord Snow compares the status of doctors with that of engineers, and considers the status of both professions in Great Britain, the USA and the Soviet Union. He makes a plea for a more liberal education, and feels that doctors should play a larger part in advising Government. He proceeds to consider the special role of the general practitioner, which should embrace a personal as well as a professional relationship.
Aspects of Asthma [Abridged]
Authors: Meyrick Roger
Published: July 2019

Dr R Meyrick considers parental relationshipsand their effect on children with asthma, illustratinghis remarks by representative case records.
Organization of Work Factors Associated with Work Ability among Aging Nurses
Authors: Stimpfel Amy Witkoski , Arabadjian Milla , Liang Eva , Sheikhzadeh Ali , Weiner Shira Schecter , Dickson Victoria Vaughan
Published: July 2019

The United States (U.S.) workforce is aging. There is a paucity of literature exploring aging nurses’ work ability. This study explored the work-related barriers and facilitators influencing work ability in older nurses. We conducted a qualitative descriptive study of aging nurses working in direct patient care (N = 17). Participants completed phone or in-person semi-structured interviews. We used a content analysis approach to analyzing the data. The overarching theme influencing the work ability of aging nurses was intrinsically motivated. This was tied to the desire to remain connected with patients at bedside. We identified factors at the individual, unit-based work level and the organizational level associated with work ability. Individual factors that were protective included teamwork, and feeling healthy and capable of doing their job. Unit-based level work factors included having a schedule that accommodated work-life balance, and one’s chronotype promoted work ability. Organizational factors included management that valued worker’s voice supported work ability.
A case of right ductus and left innominate artery from the pulmonary trunk
Authors: Tran Vinh Quang , Nguyen Truong Ly Thinh , Nguyen Mai Tuan , Luong Canh Minh , Dinh Duyen Mai , Vuong Anh Doan
Published: July 2019

Right-sided aortic arch is a rare anatomic variation of aortic arch anomaly, which may coexist with or without other cardiac defects. We report an extremely rare case of right-sided aortic arch with a right ductus arteriosus and isolation of the left brachiocephalic trunk, without other associated intracardiac lesions. We describe the successful surgical management of this anomaly in a neonate who had bilateral choanal atresia without DiGeorge syndrome or Down syndrome. However, our patient had clinical signs of hearing loss in the postoperative follow-up period.
Robocentric visual–inertial odometry
Authors: Huai Zheng , Huang Guoquan
Published: July 2019

In this paper, we propose a novel robocentric formulation of the visual–inertial navigation system (VINS) within a sliding-window filtering framework and design an efficient, lightweight, robocentric visual–inertial odometry (R-VIO) algorithm for consistent motion tracking even in challenging environments using only a monocular camera and a six-axis inertial measurement unit (IMU). The key idea is to deliberately reformulate the VINS with respect to a moving local frame, rather than a fixed global frame of reference as in the standard world-centric VINS, in order to obtain relative motion estimates of higher accuracy for updating global pose. As an immediate advantage of this robocentric formulation, the proposed R-VIO can start from an arbitrary pose, without the need to align the initial orientation with the global gravitational direction. More importantly, we analytically show that the linearized robocentric VINS does not undergo the observability mismatch issue as in the standard world-centric counterparts that has been identified in the literature as the main cause of estimation inconsistency. Furthermore, we investigate in depth the special motions that degrade the performance in the world-centric formulation and show that such degenerate cases can be easily compensated for by the proposed robocentric formulation, without resorting to additional sensors as in the world-centric formulation, thus leading to better robustness. The proposed R-VIO algorithm has been extensively validated through both Monte Carlo simulation and real-world experiments with different sensing platforms navigating in different environments, and shown to achieve better (or competitive at least) performance than the state-of-the-art VINS, in terms of consistency, accuracy, and efficiency.
Radiologists as co-authors in case reports: does their involvement make a difference?
Authors: Bosmans Jan ML , Luyckx Elisa , Broeckx Bart JG , Ceyssens Sarah , Parizel Paul M , Snoeckx Annemie
Published: July 2019

Background

Due to their crucial role in many diagnostic processes, a considerable number of papers in non-radiological medical journals contain images. We noticed that radiologists are seldom mentioned as co-authors.

Purpose

To investigate how often radiologists are involved as co-authors and to measure the influence of their involvement on the choice and quality of the illustrations and captions.

Material and Methods

We queried PubMed for papers in English with the search string “case report” in the title, examined them for the presence of radiological images, and excluded those published in radiological journals. We developed a scoring system, containing objective and subjective qualification criteria. In addition, we checked if a radiologist was involved as co-author, or mentioned in the Acknowledgments section. We performed a statistical analysis to check if the involvement of a radiologist had a significant effect on the overall quality of the case report.

Results

In 21% (45/218) of the papers, a radiologist was mentioned as co-author and in 3% (7/218) a radiologist was mentioned in the acknowledgments. In 76% (166/218), radiologists were neither involved as co-authors, nor mentioned in acknowledgments. We found statistically significant quality differences between these three groups ( P < 0.001).

Conclusion

This study indicated that the quality of case reports can be improved when radiologists are involved in the preparation and publication of papers containing imaging studies.
Probable Interaction Between Warfarin and Inhaled and Oral Administration of Cannabis
Authors: Hsu Amy , Painter Nathan A.
Published: July 2019

Objective:

To report a probable interaction between warfarin and edible cannabis that resulted in an elevated international normalized ratio (INR) without bleeding complications. Case Summary: A 35-year-old Middle Eastern male on warfarin long term with an INR goal of 2.5 (accepted range: 2.0-3.0). The patient has generally been stable on warfarin 10 mg daily from 2010 to 2018, until INR suddenly increased to 7.2 following 1 month of edible cannabis ingestion and cannabis smoking. Patient denied any signs and symptoms of bleeding. No other reasonable causes of the elevation in INR were apparent. The patient was advised to hold 2 doses of warfarin and discontinue cannabis use. The INR dropped below 4 upon discontinuation of cannabis with dose adjustments to warfarin.

Discussion:

The elevation in INR can be explained by the inhibition of CYP2C9 by cannabis use causing decreased metabolism of warfarin. The interaction between warfarin and cannabis was determined to be probable using the Horn Drug Interaction Probability Scale.

Conclusions:

There are no previous reports of interactions between edible cannabis and warfarin, with very few case reports describing the interaction with other forms of cannabis. Close monitoring of INR in patients with concomitant cannabis is recommended for proper warfarin management.
The strengths and limitations of using hospital records to assess environmental health in Karonga, Malawi
Authors: Brown Donald
Published: July 2019

This paper explains the methods that were used to study environmental health problems in Karonga, a rapidly growing secondary urban centre in Malawi. The study used existing information from hospital records and consulted local health officials and academics on how best to use it. The aim was to position the hospital as a disease surveillance site by using its records to generate disaggregated health data at the intra-urban scale. This paper identifies the strengths and limitations of using hospital data to inform joint urban planning and public health interventions. It also provides a summary of the key findings, including a discussion of the implications for enhancing urban health intelligence and urban policy formulation in Malawi and other rapidly urbanizing countries. This paper is intended to show researchers how existing information in low-resource settings can be used to generate needed health data for urban populations, with a particular interest in secondary centres.
How the urban poor define and measure food security in Cambodia and Nepal
Authors: Boonyabancha Somsook , Kerr Thomas , Joshi Lumanti , Tacoli Cecilia
Published: July 2019

Urban food security, or its lack, is attracting growing interest in global policy debates. Glaringly missing in these conversations, however, are the voices of the urban poor. To fill this gap, grassroots community organizations, with decades-long experience collecting data on their own communities and taking action to improve conditions, decided to ask the urban poor in Cambodia and Nepal how they define and measure food security, what key challenges they face in the daily struggle to put food on the table and what actions might help. Their findings show that access to adequate diets is a major challenge for low-income communities in Asia, and that hunger is widespread, although with great variations and fluctuations between and within households. They also highlight the extraordinary resilience of urban poor women and their multiple strategies to stretch meagre budgets and make sure there is something to eat, even though sometimes this is not enough.
Symptoms, Hope, Self-Management Behaviors, and Quality of Life Among Chinese Preoperative Patient With Symptomatic Valvular Heart Diseases
Authors: Chen Yongfeng , Fu Guifen , Liang Fang , Wei Jing , He Jing , Bai Jinbing
Published: July 2019

Introduction: More than 42 million people are estimated to suffer from valvular heart disease (VHD) worldwide with a prevalence of 5.3% to 7.7% in the Chinese adult population. The purpose of this study was to examine the associations between symptoms, hope, self-management behaviors, and quality of life (QOL) for preoperative patients with symptomatic VHD in a rural area of China. Method: This was a descriptive comparative study that took place in Nanning, China, between January 2015 and March 2016. The sample was 128 preoperative patients with symptomatic VHD. Data were collected using the Symptom Distress Questionnaire, Herth Hope Index, Self-Management Scale, and Minnesota Living with Heart Failure Questionnaire. Results: Data from 122 patients were included in the final analysis. Mean scores of hope, self-management, and QOL were 36.71, 55.27, and 55.56. Worse total scores of symptom severity ( r = 0.57 to 0.69, p < .001) and self-management behaviors ( r = −0.22 to −0.25, p < .05) were associated with poorer QOL. Fatigue, loss of appetite, and self-management behaviors explained 49.90% variance of QOL ( p < .001). Discussion: Fatigue, loss of appetite, and self-management influenced QOL of patients with symptomatic VHD. Interventions aimed at strengthening self-management and relieving symptoms should be tailored for patients with symptomatic VHD base on their traditional animist belief and food culture in rural areas of China such as the Zhuang Autonomous Region.
Amifampridine for the Management of Lambert-Eaton Myasthenic Syndrome: A New Take on an Old Drug
Authors: Yoon Connie H. , Owusu-Guha Jocelyn , Smith Adam , Buschur Pamela
Published: July 2019

Objective: The purpose of this article is to review the literature for both 3,4-diaminopyridine (3,4-DAP) and amifampridine for the treatment of Lambert-Eaton myasthenic syndrome (LEMS). Amifampridine (Firdapse) is the salt form of 3,4-DAP and was approved by the Food and Drug Administration for the treatment of LEMS. Data Sources: PubMed, TRIP database, and EMBASE searches were conducted without a back date (current to June 2019) utilizing the following search terms: amifampridine, 3,4-diaminopyridine, and Lambert-Eaton myasthenic syndrome. Completed trials were also reviewed at clinicaltrials.gov. Study Selection and Data Extraction: Criteria for article inclusion consisted of human subjects, age ≥18 years, phase II or III clinical trials, and English language for both drugs. Observational and pharmacokinetic studies for amifampridine were also included. Data Synthesis: Prior to the approval of amifampridine, 3,4-DAP was first-line for the management of LEMS symptoms. Two phase III trials have evaluated amifampridine to confirm efficacy, both showing superiority over placebo in the management of LEMS symptoms, with minimal adverse effects. A significant improvement in both quantitative myasthenia gravis scores and Subjective Global Impression scores was established at days 4 and 14. Relevance to Patient Care and Clinical Practice: With an improved stability profile and decreased dose variability, amifampridine will likely assume the role of first-line management of LEMS. Conclusions: Amifampridine has been shown to improve symptoms of LEMS and is generally well tolerated.
Evaluation of FDA Boxed Warning on Prescribing Patterns of Fluoroquinolones for Uncomplicated Urinary Tract Infections
Authors: Cowart Kevin , Worley Marylee , Rouby Nihal El , Sando Karen
Published: July 2019

Background: Little is known regarding the impact of the Food and Drug Administration (FDA) boxed warning on prescribing rates of fluoroquinolone (FQ) antibiotics in the outpatient setting. Objective: The primary objective of this study was to evaluate the 2016 FDA boxed warning update on FQ prescribing rates for uncomplicated urinary tract infection (uUTI). Methods: This was a single-center retrospective cohort study conducted at 6 family medicine practices, including women aged 18 to 65 years with an outpatient visit for uUTI from January 1, 2016, to December 31, 2016. Results: A total of 436 patients met inclusion. FQs were prescribed in 38% of patients before the FDA boxed warning and in 30% of patients after (8% reduction). Non-FQ prescribing had a corresponding 8% increase, comprising 62% of uUTI prescribing before the FDA boxed warning and 70% after ( P = 0.08). The likelihood of being prescribed a FQ was not significantly different following release of the FDA boxed warning (adjusted odds ratio = 0.67 [95% CI = 0.41-1.10]). Variables significantly associated with an increase in FQ prescribing based on logistic regression were age ≥58 years and chronic kidney disease. Concordance of antibiotic prescribing with the Infectious Diseases Society of America clinical practice guidelines for uUTI was low, and the incidence of treatment failure was low. Conclusion and Relevance: The 2016 FDA boxed warning was not significantly associated with decreased FQ prescribing for uUTI across a large academic family medicine practice. Methods to improve education and disseminate FDA warnings in practice are needed.
What Prophylactic Antibiotic (Type, Dose and Route of Administration) Should Be Administered Perioperatively for Patients Undergoing Total Ankle Arthroplasty (TAA)?
Authors: Sanchez Marisa , Losada Cecilia
Published: July 2019

Recommendation:

The administration of prophylactic antibiotics before total ankle arthroplasty (TAA) potentially reduces the incidence of surgical site infection (SSI) and/or periprosthetic joint infection (PJI). Weight-based (of at least 2 g) cefazolin administered intravenously within 60 minutes before the procedure can be an adequate choice for antibiotic prophylaxis. If the patient has a beta-lactam anaphylaxis, we recommend an appropriate alternative antibiotic effective against Staphylococcus. It is unclear whether prophylaxis should be given as a single dose or as multiple doses.

Level of Evidence:

Strong.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Is There a Role for the Use of Dilute Povidone-Iodine (Betadine) Irrigation or Other Antiseptic Irrigation Solutions During Total Ankle Arthroplasty (TAA) or Other Foot and Ankle Procedures?
Authors: Englund Kristin , Heidari Nima
Published: July 2019

Recommendation:

With regard to total ankle arthroplasty (TAA), there is a lack of evidence to recommend for or against the use of betadine solution.

Level of Evidence:

Consensus.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus)
Does Deep Chronic Infection After Total Ankle Arthroplasty (TAA) Require Implant Removal?
Authors: Kaplan Jonathan , Raikin Steven
Published: July 2019

Recommendation:

Yes. Deep chronic infection after total ankle arthroplasty (TAA) requires implant removal unless otherwise contraindicated.

Level of Evidence:

Strong.

Delegate Vote:

Agree: 100%, Disagree: 0%, Abstain: 0% (Unanimous, Strongest Consensus).
Literacy-Related Abilities’ Effects on Argumentative Text Quality Structure
Authors: Stavans Anat , Seroussi Batia , Zadunaisky Ehrlich Sara
Published: July 2019

Writing argumentative texts is a hallmark of literacy attainments with a long and laborious trajectory. The present study explored the incipient stages in argumentative texts written by 293 Hebrew-speaking Israeli children in second, third, fourth, and fifth grades. The literacy cognitive, transcriptional, linguistic, and reading abilities were analyzed, as well the different text structure quality of children’s argumentative texts. The results indicate that that both literacy ability and text structure quality increase with age. However, not all the increases in the different literacy abilities are significant. Text structure quality—a measure of text organization and ideation—becomes more sophisticated and complete with age, attaining high-quality text structure in fourth and fifth grades in the production of autonomous texts with genre-driven elaborate features. The predictive power of the different literacy abilities to sustain a better-structured text varies across ages.
Emotion Regulation and Children With Attention-Deficit/Hyperactivity Disorder: The Effect of Varying Phonological Working Memory Demands
Authors: Tarle Stephanie J. , Alderson R. Matt , Arrington Elaine F. , Roberts Delanie K.
Published: July 2019

Objective: Findings from extant studies of the relationship between ADHD-related emotion regulation and working memory deficits have been equivocal, and their correlational designs preclude inferences about the functional relationship between working memory demands and emotion regulation. This study aimed to experimentally examine the functional relationship between varying working memory demands and ADHD-related emotion regulation deficits. Method: Overt emotion regulation behaviors were coded while children with and without ADHD completed experimental tasks that manipulated low and high working memory demands. Results: Compared with typically developing children, children with ADHD exhibited large-magnitude overall emotion expression deficits, disproportionately greater self-criticism during high working memory conditions, and disproportionately greater positive emotion expression during low working memory demand conditions. Conclusion: These findings suggest that working memory demands are functionally related to emotion regulation deficits exhibited by children with ADHD and may explicate variability of emotion regulation difficulties related to environmental demands.
A systematic review of mobile health interventions in China: Identifying gaps in care
Authors: Yang Xiaoshi , Kovarik Carrie L
Published: July 2019

Introduction

Mobile health has a promising future in the healthcare system in most developed countries. China’s rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions.

Methods

A systematic review of the literature published from 18 December 2015 – 3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes.

Results

A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations.

Conclusions

Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.
Realizing the existence of blind spots in the ‘West’: A systems-theoretical perspective
Authors: Tani Kenichi , Sakai Kosuke
Published: July 2019

The aim of this paper is to define transcendental relativization, by using the binary in some anthropological works, and to give a description of it along with Niklas Luhmann’s sociology. We examine how the binary [the West/non-West] has been used in some anthropological works and how it has contributed not only to understanding ‘them’ as a research object but also to realizing ‘our’ conceptual limitations. This paper is an attempt to deal with political or power-relational asymmetry and scientific observational asymmetry in anthropological works. Luhmann’s sociology, which is based on the functional analysis and theory of social systems, shows that the binary approach in anthropology can be seen as a semantic form of science system, which realizes the existence of blind spots in anthropological observation, and is a possible strategy for anthropological investigations.
Negotiating access to research on triad society: the importance of Chinese and triad cultural capital
Authors: Kwok Sharon Ingrid
Published: July 2019

Negotiating access to participants presents challenges for researchers of organised crime. Issues in accessing the field of criminal organisations in Western settings have been well-documented. However, strategies for accessing Chinese criminal organisations remain embryonic. This article presents findings that represent the researcher’s first-hand fieldwork experiences in overcoming such challenges, especially the problem of access negotiation when conducting triad society research. As the first ethnographic study of triad society in China, this paper aims to identify the ways in which the effective use of Chinese culture and triad subculture, insider information and knowledge facilitates access negotiation to the field, and helps establish social networks with individuals at different levels of the triad hierarchy. Attention is paid to the ways in which the researcher utilised Chinese networking culture, including guanxi principles and the mechanism of renqing as well as face culture and face-work, in gaining access to and building trust with triad members. Techniques to acquire triad subculture will also be addressed.
Decreased Levels of Serum IGF-1 and Vitamin D Are Associated With Cognitive Impairment in Patients With Type 2 Diabetes
Authors: Rui-hua Chen , Yong-de Peng , Xiao-zhen Jiang , Chen Jason , Bin Zhou
Published: July 2019

Purpose:

To determine the association of serum insulin-like growth factor 1 (IGF-1) and vitamin D levels with cognition status in patients with type 2 diabetes mellitus (T2DM).

Methods:

A total of 173 patients with T2DM were recruited and divided into mild cognitive impairment (MCI) group (n = 94) and normal cognition (NC) group (n = 79). Levels of IGF-1 and 25(OH)D were measured and compared, and the correlations among IGF-1, 25(OH)D, and cognitive function were analyzed.

Results:

Insulin-like growth factor 1 and 25(OH)D levels significantly decreased in MCI group than those in the NC group (both P < .001). Multiple stepwise regression analysis revealed that IGF-1 (β = .146, P < .001) and 25(OH)D (β = .199, P < .001) independently predicted Montreal Cognitive Assessment (MoCA) scores. Partial least square regression showed that contributions of both 25(OH)D ( P < .001) and IGF-1 ( P < .001) to MoCA scores were significant, while no cross-effect was observed between them ( P = .714).

Conclusions:

Low serum IGF-1 and 25(OH)D levels may separately predict poor cognitive performance in patients with diabetes.