bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual differences in encoding strategies and free recall dynamics
Authors: Unsworth Nash , Miller Ashley L , Robison Matthew K
Published: April 2019

Individual differences in encoding strategies and their relation to free recall dynamics were examined. Participants performed a delayed free recall task and following each list reported which strategies they may have used on the prior list. Individual differences in effective encoding strategy use were positively correlated with overall recall performance. Examining recall dynamics suggested that variation in effective encoding strategy use was associated with greater recall, particularly on non-primacy items and slightly more organised recall in terms of recall transitions. However, no differences were found for recall of items at the first serial position, in recall initiation, or in how quickly participants recalled items. Collectively, the results are consistent with the notion that effective encoding strategies increase the strength of items, resulting in a higher likelihood of recovering the items during recall. Individual differences in control processes in the form of effective encoding strategies are critically important for understanding normal variation in memory abilities.
Current evidence for nonpharmacological interventions and criteria for surgical management of persistent acromioclavicular joint osteoarthritis: A systematic review
Authors: Farrell Gerard , Watson Lyn , Devan Hemakumar
Published: April 2019

Background

The primary aim of this systematic review was to investigate the individual/combined effectiveness of nonpharmacological interventions in individuals with persistent acromioclavicular joint osteoarthritis. The secondary aims were to investigate the comparative effectiveness of nonpharmacological versus surgical interventions, and to identify the criteria used for defining failure of conservative interventions in individuals who require surgery for persistent acromioclavicular joint osteoarthritis.

Method

Major electronic databases were searched from inception until October 2018. Studies involving adults aged 16 years and older, diagnosed clinically and radiologically with isolated acromioclavicular joint osteoarthritis for at least three months or more were included. Studies must explicitly state the type and duration of conservative interventions. Methodological risk of bias was assessed using the Modified Downs and Black checklist.

Results

Ten surgical intervention studies were included for final synthesis. No studies investigated the effectiveness of nonpharmacological interventions or compared them with surgical interventions. Common nonpharmacological interventions trialed from the 10 included studies were activity modification (n = 8) and physiotherapy (n = 4). Four to six months was the most often reported timeframe defining failure of conservative management (range 3–12 months).

Conclusions

Currently, there is no evidence to guide clinicians about the individual or combined effectiveness of nonpharmacological interventions for individuals with persistent acromioclavicular joint osteoarthritis.
Cutibacterium acnes is less commonly identified by next-generation sequencing than culture in primary shoulder surgery
Authors: Namdari Surena , Nicholson Thema , Abboud Joseph , Lazarus Mark , Ramsey Matthew L , Williams Gerald , Parvizi Javad
Published: April 2019

Introduction

High rates of positive Cutibacterium acnes cultures from primary shoulder surgery make positive cultures in the revision surgery setting difficult to interpret. Our goal was to determine concordance between culture and next-generation sequencing techniques for identification of C. acnes from primary shoulder surgery.

Methods

Patients undergoing shoulder arthroscopy for rotator cuff tear or primary anatomic shoulder arthroplasty for osteoarthritis were prospectively enrolled. Specimens were sent for culture (aerobic and anaerobic) and next-generation sequencing. For next-generation sequencing, the entire microbial DNA was sequenced in order to identify pathogens within the sample.

Results

Our cohort consisted of 90 patients (45 patients in the osteoarthritis group and 45 patients in the rotator cuff tear group). At least one sample was positive for C. acnes in 18 (20%) cases by culture and in 14 (15.6%) cases by next-generation sequencing (p = 0.559). Four (22.2%) of the 18 cases with positive C. acnes cultures also had C. acnes identified by next-generation sequencing (kappa = 0.238). There was no difference in C. acnes identification rates between osteoarthritis and rotator cuff tear groups.

Conclusions

There was limited concordance between culture and next-generation sequencing for C. acnes identification. Further studies are needed to determine the potential for next-generation sequencing as a diagnostic tool.
New-onset cutaneous sarcoidosis under tocilizumab treatment for giant cell arteritis: a quasi-paradoxical adverse drug reaction. Case report and literature review
Authors: Del Giorno Rosaria , Iodice Alfonso , Mangas Cristina , Gabutti Luca
Published: April 2019

Background:

New-onset sarcoidosis has been previously described in three case reports in patients affected by rheumatoid arthritis treated with tocilizumab (TCZ). The existence of a cause–effect mechanism between the biological treatment and the onset of the illness is still being debated.

Patient concerns:

A 74-year-old woman was diagnosed with giant cell arteritis (GCA). The first-line treatment with glucocorticoids; and the second-line with methotrexate and low-dose glucocorticoids were stopped due to multiple pathological vertebral fractures and insufficient biological and clinical response. The cytotoxic agent, cyclophosphamide, was then introduced and in turn stopped, because of gastrointestinal side effects. Thereafter a treatment with TCZ was begun. The patient experienced good clinical response; however, 8 months later she developed painful hyper-pigmented reddish cutaneous micronodular lesions localized to the abdomen and thorax. A cutaneous biopsy was performed, and histological analysis showed noncaseating epithelioid granulomas in the hypodermis. The diagnosis of cutaneous sarcoidosis was made.

Interventions:

Topical corticosteroids were administered and, as requested by the patient, TCZ was discontinued with slow but complete resolution of the skin lesions. After TCZ discontinuation however, the GCA flared and the patient’s symptoms and biological abnormalities reappeared. Thus, after a 6-month suspension, TCZ was re-administered. At 2 months later the skin lesions compatible with cutaneous sarcoidosis reappeared. Topical corticosteroids were once again prescribed and as suggested by the patient the TCZ posology was reduced. The patient’s symptoms disappeared, and the cutaneous lesions resolved.

Lessons:

The time elapsed from TCZ treatment start and the onset of cutaneous sarcoidosis, as well as its recurrence after TCZ suspension and rechallenge supported the diagnosis of a drug-induced reaction. To the best of our knowledge, this case report represents the first instance of cutaneous sarcoidosis most likely induced by TCZ in patients affected by GCA. In addition, our case emphasizes that although TCZ in monotherapy confirms to be an effective treatment for GCA, further immunological disorders could be unmasked, and the discussed side effect of the drug could be dose-dependent.
System Accuracy Assessment of a Blood Glucose Meter With Wireless Internet Access Associated With Unusual Hypoglycemia Patterns in Clinical Trials
Authors: Pfützner Andreas , Demircik Filiz , Kirsch Valeria , Pfützner Johannes , Strobl Stephanie , Hanna Mina , Spatz Jan , Pfützner Anke H.
Published: April 2019

Background:

In recent randomized clinical trials, an unusual reporting pattern of glycemic data and hypoglycemic events potentially related to an internet enabled blood glucose meter (MyGlucoHealth, BGM) was observed. Therefore, this clinical study was conducted to evaluate the system accuracy of the BGM in accordance with the ISO15197:2015 guidelines with additional data collection.

Methods:

To investigate system accuracy, 10 of 3088 devices and 6 of 23 strip lots, used in the trials, were selected by a randomization procedure and a standard repeatability assessment. YSI 2300 STAT Plus was used as the standard reference method. The samples were distributed as per the ISO15197:2015 recommendations with 20 additional samples in the hypoglycemic range. Each sample was tested with 6 devices and 6 strip lots with double determinations.

Results:

Overall, 121 subjects with blood glucose values 26-423 mg/dL were analyzed, resulting in 1452 data points. In all, 186/1452 readings (12.8%) did not meet the ISO acceptance criteria. Data evaluated according to the FDA guidelines showed that 336/1452 (23.1%) readings did not meet the acceptance criteria. A clear bias toward elevated values was observed for BG <100 mg/dL (MARD: 11.0%).

Conclusions:

The results show that the BGM, although approved according to standard regulatory guidelines, did not meet the level of analytical accuracy required for clinical treatment decisions according to ISO 15197:2015 and FDA requirements. In general, caution should be exercised before selection of BGMs for patients and in clinical trials.
Beyond solutionist science for the Anthropocene: To navigate the contentious atmosphere of solar geoengineering
Authors: Asayama Shinichiro , Sugiyama Masahiro , Ishii Atsushi , Kosugi Takanobu
Published: April 2019

The emerging narrative of the Anthropocene has created a new space for changes in global environmental change (GEC) science. On the one hand, there is a mounting call for changing scientific practices towards a solution-oriented transdisciplinary mode that can help achieve global sustainability. On the other hand, the scientists’ desire to avoid exceeding planetary boundaries has broken a taboo on researching solar geoengineering, a dangerous idea of deliberately cooling the Earth’s climate. Whilst to date the two features have been discussed separately, there is a possible confluence in the future. This paper explores this close yet precarious relationship between transdisciplinary GEC science and solar geoengineering in the context of Future Earth, a new international platform of Earth system science. Our aim is to understand how a transdisciplinary mode of science can navigate the contention over solar geoengineering and its course of research without breeding polarization. By seeking the immediacy of ‘problem-solving’, Future Earth is drawn into the solutionist thinking that orders the mode of engagement in pursuing consensus. However, because conflict is inescapable on the solar geoengineering debate, transdisciplinary engagement might as well aim at mapping out plural viewpoints and allowing people to disagree. In transdisciplinary engagement, as co-design signifies the engagement of stakeholders with decision-making in science, a fair and transparent procedure of making decisions is also needed. From our own experience of co-designing research priorities, we suggest that, if carefully designed, voting can be a useful tool to mediate the contentious process of transdisciplinary decision-making with three different benefits for collective decision-making, namely, efficiency, inclusivity and learning. For the future directions of transdisciplinary GEC science, since the Anthropocene challenges are truly uncertain and contentious, it is argued that the science for the Anthropocene should move away from a solutionist paradigm towards an experimentalist turn.
For Whom the Bot Tolls: A Neural Networks Approach to Measuring Political Orientation of Twitter Bots in Russia
Authors: Stukal Denis , Sanovich Sergey , Tucker Joshua A. , Bonneau Richard
Published: April 2019

Computational propaganda and the use of automated accounts in social media have recently become the focus of public attention, with alleged Russian government activities abroad provoking particularly widespread interest. However, even in the Russian domestic context, where anecdotal evidence of state activity online goes back almost a decade, no public systematic attempt has been made to dissect the population of Russian social media bots by their political orientation. We address this gap by developing a deep neural network classifier that separates pro-regime, anti-regime, and neutral Russian Twitter bots. Our method relies on supervised machine learning and a new large set of labeled accounts, rather than externally obtained account affiliations or orientation of elites. We also illustrate the use of our method by applying it to bots operating in Russian political Twitter from 2015 to 2017 and show that both pro- and anti-Kremlin bots had a substantial presence on Twitter.
Keep the Ball Rolling: Information Diffusion within Large Sports-Related Networks through Social Mediators
Authors: Vermeer S. A. M. (Susan) , Araujo T. B. (Theo)
Published: April 2019

Social media have enabled sports fans to interact with their favourite clubs, players, and fellow fans. By using a sample of over 4.5 million tweets, we applied a social networks approach to examine whether and, if so, how different types of users influence online engagement and patterns of information flow of professional football clubs on Twitter. We focus on five types of social mediators (i.e., key users who connect organizations with their publics): (1) organizational (e.g., teams or players), (2) industry (e.g., competitors or associations), (3) media (e.g., journalists), (4) individual (e.g., fans), and (5) celebrities. Our results indicate that the power of media social mediators—the most traditional mediators—has declined over recent years, and they were negatively associated with engagement on Twitter. Instead, relationships between football clubs and publics were primarily mediated by individual social mediators, for top division clubs in particular. Taken together, scholars and practitioners should recognize the potential impact of social mediators, given that even individuals can function as powerful users in the information diffusion process.
Concomitant Medial Patellofemoral Ligament Reconstruction and Tibial Tubercle Osteotomy Do Not Increase the Incidence of 30-Day Complications: An Analysis of the NSQIP Database
Authors: Agarwalla Avinesh , Gowd Anirudh K. , Liu Joseph N. , Puzzitiello Richard N. , Yanke Adam B. , Verma Nikhil N. , Forsythe Brian
Published: April 2019

Background:

Lateral patellar dislocations account for 2% to 3% of total knee injuries, especially in adolescents. Depending on the anatomic abnormality contributing to lateral patellar instability, medial patellofemoral ligament reconstruction (MPFLR) and/or tibial tubercle osteotomy (TTO) may be indicated.

Purpose:

To assess the risk of adverse events (AEs) after TTO, MPFLR, and concomitant MPFLR and TTO.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent MPFLR, TTO, and concomitant MPFLR and TTO between 2005 and 2016 were identified through the American College of Surgeons–National Surgical Quality Improvement Program (ACS-NSQIP) database. Medical complications (eg, surgical site infection and deep vein thrombosis), readmission rates, and extended hospital stay within 30 days of the procedure were recorded. Outcomes were compared with bivariate and multivariate Poisson regression.

Results:

Out of 882 patients, 617 (70.0%) underwent isolated MPFLR, 170 (19.3%) underwent TTO, and 95 (10.8%) underwent concomitant MPFLR and TTO. The operative time for concomitant MPFLR and TTO was significantly longer (122 ± 45 minutes) compared with isolated MPFLR (97 ± 55 minutes; P < .001) and isolated TTO (89 ± 51 minutes; P < .001). There were 32 AEs (3.6%), with 10 AEs in the isolated TTO group (5.9%), 18 AEs in the isolated MPFLR group (2.9%), and 4 AEs in the MPFLR + TTO group (4.2%). There was no significant difference in the rate of AEs between the isolated MPFLR and isolated TTO groups ( P = .1), isolated MPFLR and MPFLR + TTO groups ( P = .5), and isolated TTO and MPFLR + TTO groups ( P = .8). Diabetes mellitus was associated with an increased risk of developing an AE (odds ratio, 4.0; P = .003), and hypertension resulted in an increased risk of an extended hospital stay (odds ratio, 4.0; P = .010).

Conclusion:

While concomitant MPFLR and TTO significantly increased operative time, there was no difference in the rate of AEs, extended hospital stay, and readmissions within 30 days after isolated MPFLR, isolated TTO, and concomitant MPFLR and TTO.
Age-Related Changes in the Auditory Brainstem Response and Suprathreshold Processing of Temporal and Spectral Modulation
Authors: Grose John H. , Buss Emily , Elmore Hollis
Published: April 2019

The purpose of this study was to determine whether cochlear synaptopathy can be shown to be a viable basis for age-related hearing difficulties in humans and whether it manifests as deficient suprathreshold processing of temporal and spectral modulation. Three experiments were undertaken evaluating the effects of age on (a) the auditory brainstem response as a function of level, (b) temporal modulation detection as a function of level and background noise, and (c) spectral modulation as a function of level. Across the three experiments, a total of 21 older listeners with near-normal audiograms and 29 young listeners with audiometrically normal hearing participated. The auditory brainstem response experiment demonstrated reduced Wave I amplitudes and concomitant reductions in the amplitude ratios of Wave I to Wave V in the older listener group. These findings were interpreted as consistent with an electrophysiological profile of cochlear synaptopathy. The temporal and spectral modulation detection experiments, however, provided no support for the hypothesis of compromised suprathreshold processing in these domains. This pattern of results suggests that even if cochlear synaptopathy can be shown to be a viable basis for age-related hearing difficulties, then temporal and spectral modulation detection paradigms are not sensitive to its presence.
Research in Social Psychology Changed Between 2011 and 2016: Larger Sample Sizes, More Self-Report Measures, and More Online Studies
Authors: Sassenberg Kai , Ditrich Lara
Published: April 2019

The debate about false positives in psychological research has led to a demand for higher statistical power. To meet this demand, researchers need to collect data from larger samples—which is important to increase replicability, but can be costly in both time and money (i.e., remuneration of participants). Given that researchers might need to compensate for these higher costs, we hypothesized that larger sample sizes might have been accompanied by more frequent use of less costly research methods (i.e., online data collection and self-report measures). To test this idea, we analyzed social psychology studies published in 2009, 2011, 2016, and 2018. Indeed, research reported in 2016 and 2018 (vs. 2009 and 2011) had larger sample sizes and relied more on online data collection and self-report measures. Thus, over these years, research improved in its statistical power, but also changed with regard to the methods applied. Implications for social psychology as a discipline are discussed.
Case Study of a Thymus Gland Squamous Cell Carcinoma With Impingement on Cardiac Structures
Authors: Perkins Maggie , Clem Douglas
Published: April 2019

Thymus tumors are rare primary neuroendocrine tumors that develop near the mediastinum. These tumors often have no known etiology but can arise from ectopic tissues in the mediastinum or occur within the thymus. This case study presents a rare finding of a 9-cm × 8-cm squamous cell carcinoma tumor arising from the thymus within the anterior mediastinum. The patient’s symptoms included congestion, coughing, and chest pain. The mass was initially found on a chest radiograph. Results of the echocardiogram showed that the tumor was impinging on the right ventricular outflow tract and the pulmonary artery of the heart.
Intermittent Versus Continuous PEG-Asparaginase to Reduce Asparaginase-Associated Toxicities: A NOPHO ALL2008 Randomized Study
Authors: Albertsen Birgitte Klug , Grell Kathrine , Abrahamsson Jonas , Lund Bendik , Vettenranta Kim , Jónsson Ólafur G. , Frandsen Thomas L. , Wolthers Benjamin O. , Heyman Mats , Schmiegelow Kjeld
Published: April 2019

PURPOSE

Asparaginase is an essential drug in childhood acute lymphoblastic leukemia (ALL) therapy and is frequently given for months to obtain continuous asparagine depletion. We randomly assigned patients to continuous versus intermittent pegylated-asparaginase (PEG-asp) treatment, hypothesizing there would be decreased toxicity with unchanged efficacy.

METHODS

Children (median age, 4.2 years) treated for non–high-risk ALL according to the Nordic Society for Pediatric Hematology and Oncology ALL2008 protocol received five intramuscular PEG-asp injections (1,000 IU/m2) every two weeks and were then randomly assigned to additional three doses (6-week intervals [experimental arm], n = 309) versus 10 doses (2-week intervals [standard arm], n = 316). The primary end point was noninferior (6% margin) disease-free survival. Toxicity reduction was a secondary end point. Occurrence of asparaginase-associated hypersensitivity, pancreatitis, osteonecrosis, and thromboembolism were prospectively registered.

RESULTS

After a median follow-up of 4.1 years, the 5-year disease-free survival was 92.2% (95% CI, 88.6 to 95.8) and 90.8% (95% CI, 87.0 to 94.6) in the experimental and standard arms, respectively. The 3-year cumulative incidence of any first asparaginase-associated toxicity (hypersensitivity [n = 13]; osteonecrosis [n = 29]; pancreatitis [n = 24]; thromboembolism [n = 17]) was 9.3% in the experimental arm and 18.1% in the standard arm ( P = .001). Asparaginase-associated toxicity reduction was confirmed in sex- and risk-group–adjusted Cox regression analysis stratified by age (≥ 10 and < 10 years; hazard ratio, 0.48; P = .001). The experimental arm had the lowest incidences of all four toxicities, reaching significance for pancreatitis (6-month risk, 5.8% v 1.3%; P = .002).

CONCLUSION

The excellent cure rates and reduced toxicity risk support the use of intermittent PEG-asp therapy after the first 10 weeks in future childhood ALL trials that apply prolonged PEG-asp therapy.
Diet-Dependent Acid Load—The Missing Link Between an Animal Protein–Rich Diet and Nonalcoholic Fatty Liver Disease?
Authors: Alferink Louise J M , Kiefte-de Jong Jessica C , Erler Nicole S , de Knegt Robert J , Hoorn Ewout J , Ikram M Arfan , Janssen Harry L A , Metselaar Herold J , Franco Oscar H , Darwish Murad Sarwa
Published: April 2019

Objective

Our group recently showed that animal protein was independently associated with nonalcoholic fatty liver disease (NAFLD). We hypothesize that this may be explained by a high diet-dependent acid load [dietary acid load (DAL)].

Methods

This cross-sectional study is embedded in a prospective population-based cohort. We estimated DAL proxies via food-frequency questionnaires using potential renal acid load (PRAL; using dietary protein, phosphorus, potassium, calcium, and magnesium intake), net endogenous acid production (NEAP; using protein and potassium intake), and the animal protein–to–potassium ratio (A:P). We defined NAFLD using ultrasound after excluding secondary steatogenic causes. We used logistic regression models—adjusted for sociodemographic, lifestyle, and metabolic traits—on categorized [quartile (Q)1 to 4] and continuous DAL proxies (allowing for nonlinearity) and NAFLD.

Results

We included 3882 participants, of which 1337 had NAFLD. All DAL proxies were higher, meaning more acidic, in individuals with NAFLD (PRAL, −2.9 vs −5.5 mEq/d; NEAP, 37.0 vs 35.1 mEq/d; and A:P, 13.3 vs 12.4; all P < 0.001). The highest Q of DAL proxies was associated with NAFLD independent of sociodemographic and lifestyle confounders, but significance dissipated after correction for metabolic confounders and multiple testing. However, the P value for nonlinearity was significant in all DAL proxies (P < 0.001). Natural cubic splines performed better with than without DAL proxies in the fully adjusted model (all P ≤ 0.038). The highest probability of NAFLD was found for an acidic diet.

Conclusions

This study showed an independent nonlinear association between an acidic diet and NAFLD. Further studies with acid-base biomarkers are needed, but our findings might provide a mechanistic explanation for the harmful association between an animal protein–rich diet and NAFLD.
Protein-mediated gelation and nano-scale assembly of unfunctionalized hyaluronic acid and chondroitin sulfate
Authors: Tabet Anthony , Park June Y. , Shilts Jarrod , Sokolowski Kamil , Rana Vijay K. , Kamp Marlous , Warner Nina , Hoogland Dominique , Scherman Oren A.
Published: April 2019

Background: Hyaluronic acid (HA) is a major component of the extracellular matrix (ECM) in the central nervous system and the only purely supramolecular glycosaminoglycan. Much focus has been given to using this high molecular weight polysaccharide for tissue engineering applications. In most studies, HA is covalently functionalized with moieties that can facilitate network formation through physical self-assembly, or covalent crosslinking (e.g. photo-catalyzed) as the polysaccharide does not gel on its own. However, these crosslinks are not the driving force of HA self-assembly in biological tissues.

Methods: Oscillatory rheology, dynamic light scattering, and scanning electron microscopy were used to study albumin/HA structures. Dynamic light scattering and transmission electron microscopy were used to study albumin/chondroitin sulfate (CS) structures. UV-vis spectroscopy was used to demonstrate the potential for using protein-crosslinked polymers as an ECM-mimetic model to study transport of hydrophilic small molecules.

Results: We examine the intermolecular interactions of two major glycosaminoglycans found in the human brain, HA and the lower molecular weight CS, with the model protein albumin. We report the properties of the resulting micro- and nano-materials. Albumin/HA mixtures formed supramolecular gels, and albumin/CS mixtures formed micro- and nanoparticles. These systems are formed from unfunctionalized polysaccharides, which is an attractive and simpler method of forming HA hydrogels and CS nanoparticles than functional chemistry-based approaches such as chemically modifying the polymer backbones. We also summarize the concentrations of HA and CS found in various mammalian brains, which could potentially be useful for biomimetic scaffold development in tissue engineering.

Conclusions: Simple preparation and combination of commercially available charged biomacromolecules rapidly result in interesting self-assembled materials with structures at the micron and nanometer length-scales. Such materials may have utility in serving as cost-effective and simple models of nervous system electrostatic interactions and as in vitro drug release and model system for ECM transport studies.
Searching basic units in memory traces: associative memory cells
Authors: Wang Jin-Hui
Published: April 2019

The acquisition of associated signals is commonly seen in life. The integrative storage of these exogenous and endogenous signals is essential for cognition, emotion and behaviors. In terms of basic units of memory traces or engrams, associative memory cells are recruited in the brain during learning, cognition and emotional reactions. The recruitment and refinement of associative memory cells facilitate the retrieval of memory-relevant events and the learning of reorganized unitary signals that have been acquired. The recruitment of associative memory cells is fulfilled by generating mutual synapse innervations among them in coactivated brain regions. Their axons innervate downstream neurons convergently and divergently to recruit secondary associative memory cells. Mutual synapse innervations among associative memory cells confer the integrative storage and reciprocal retrieval of associated signals. Their convergent synapse innervations to secondary associative memory cells endorse integrative cognition. Their divergent innervations to secondary associative memory cells grant multiple applications of associated signals. Associative memory cells in memory traces are defined to be nerve cells that are able to encode multiple learned signals and receive synapse innervations carrying these signals. An impairment in the recruitment and refinement of associative memory cells will lead to the memory deficit associated with neurological diseases and psychological disorders. This review presents a comprehensive diagram for the recruitment and refinement of associative memory cells for memory-relevant events in a lifetime.
Economy of cooperative-network interactions as a resource of self-organization and achievement of qualitative results
Authors: Куимов Василий , Kuimov Vasiliy , Суслова Юлия , Suslova Julia , Щербенко Ева , Scherbenko Eva , Лукиных Валерий , Lukinyh Valeriy , Подопригора Владимир , Podoprigora Vladimir , Волошин Андрей , Voloshin Andrey , Дягель Оксана , Dyagel' Oksana , Конева Ольга , Koneva Ol'ga , Юшкова Людмила , Yushkova Lyudmila , Ананина Римма , Ananina Rimma , Богданов Никита , Bogdanov Nikita , Корчебный Петр , Korchebnyy Petr , Новикова Светлана , Novikova Svetlana , Панкова Любовь , Pankova Lyubov' , Тод Наталья , Tod Natal'ya , Цацорин Александр , Cacorin Aleksandr
Published: April 2019

The monograph discusses some problems of the modern economy and substantiates the need for qualitatively new approaches to the analysis and design of the economy of cooperative and network interactions based on the digitalization of business processes and the use of key technologies - mobility, cloud, Internet of things, big data, artificial intelligence, blockchain, inter-corporate legally significant exchange.
The monograph highlights the resources manifested in cooperative-network interactions, which are characterized by a systemic increase in the process of their use. Specific studies of modern legislation, tax practice, forms of marketing and practices of individual organizations and enterprises show that the achievement of quality results is achieved on the basis of cooperation and network interactions, including both hierarchical, quasi-market and network relations, common goal setting, active cooperation of resources or their parts, active interaction of partners on the basis of platform methods. Modern information and communication environment creates high-quality opportunities for participants to use new laws for the effective development of the economy, to achieve a network effect of interaction.
It is intended for scientific and practical business workers, management specialists.
The monograph summarizes the results of long-term research of the authors, including the materials obtained under The RFBR grant 18-010-00192 "Cooperative network interaction as a resource of self-organization and achievement of quality results in the economy»
Management of purpura fulminans skin lesions in a premature neonate with sepsis: a case study
Authors: Pérez-Acevedo Gemma , Torra-Bou Joan Enric , Manzano-Canillas Maria Luisa , Bosch-Alcaraz Alejandro
Published: April 2019

Purpura fulminans is a severe and rapidly progressive septic process characterised by the development of haemorrhagic and ecchymotic lesions and skin necrosis. It can appear on any part of the body but predominantly affects the limbs. Purpura fulminans is a rare but possible complication in paediatric patients, especially neonates. It can increase their risk of morbidity and mortality if not treated early and cause a severe long-term condition in survivors of the infectious episode, including amputation. For professionals involved in wound healing, purpura fulminans poses a major challenge. This report describes the case of a premature neonate with extensive purpura fulminans of the legs and arms. Topical treatment of the limbs and purpuric areas with hyperoxygenated fatty acids (HOFAs) every two hours produced an improvement in the lesions. Complete healing was achieved using moist wound healing products. Early topical application of HOFAs appears to be a safe treatment that improves tissue microcirculation in paediatric patients with Purpura fulminans, minimising sepsis-related skin damage.
Negative pressure wound therapy versus microcurrent electrical stimulation in wound healing in burns
Authors: Ibrahim Zizi M. , Waked Instar S. , Ibrahim Olfat
Published: April 2019

Objective:

To compare the efficacy of negative pressure wound therapy (NPWT) with that of microcurrent electrical stimulation (MES) on wound surface area, length of stay (LoS) and colony count of wounds in patients with burns.

Method:

Patients with thermal dermal burn injuries covering 25–40% of total body surface area were enrolled in this clinical trial. Participants were randomly allocated into three, equal-sized groups: patients receiving NPWT, patients receiving MES and a control group which received standard wound care. All groups received the same traditional physical therapy programme in addition to the same nursing and medical care. In all groups, wound surface area, colony count and LoS were measured 72 hours after thermal burn injury (pre), after 10 days and again at 21 days from the beginning of the study.

Results:

A total of 45 patients took part in the study. There were statistically significant decreases in wound surface area observed in all groups (p<0.05) while MES showed the highest mean percentage of reduction in wound surface. MES and NPWT both showed the lowest values for bacterial growth but NPWT was superior in colony count reduction. For LoS, both MES and NPWT showed the lowest mean value.

Conclusion:

From the findings of this study, MES was more effective in decreasing wound surface area in burn wounds while NPWT was more effective in reducing bacterial growth.
Re-evaluation of polihexanide use in wound antisepsis in order to clarify ambiguities of two animal studies
Authors: Kramer Axel , Eberlein Thomas , Müller Gerald , Dissemond Joachim , Assadian Ojan
Published: April 2019

Objective:

Due to classification of the agent polihexanide (PHMB) in category 2 ‘may cause cancer’ by the Committee for Risk Assessment of the European Chemicals Agency in 2011, the users of wound antiseptics may be highly confused. In 2017, this statement was updated, defining PHMB up to 0.1% as a preservative safe in all cosmetic products. In the interest of patient safety, a scientific clarification of the potential carcinogenicity of PHMB is necessary.

Methods:

A multidisciplinary team (MDT) of microbiologists, surgeons, dermatologists and biochemists conducted a benefit-risk assessment to clarify the hazard of antiseptic use of PHMB.

Results:

In two animal studies, from which the assessment of a carcinogenic risk was derived, PHMB was administered orally over two years in extremely high concentrations far above the NO(A)EL (no-observed-(adverse-) effect level) in rats and mice. Feeding in the NO(A)EL range resulted in no abnormal effects. In one male in the highest dose group of 4000ppm PHMB, an adenocarcinoma was found, which the author attributed to chronic inflammation of the colon with systemic atypical exposure. The increasing incidence of hemangiosarcomas highly probably resulted from increased endothelial proliferation, triggered by the exceedingly high dosage fed, because PHMB is not genotoxic and there is no evidence for epigenetic effects.

Discussion:

It is well known that PHMB is not absorbed when applied topically. Considering the absence of genotoxicity and epigenetic effects together with the interpretation of the animal studies, it is the consensus of the multidisciplinary experts that a carcinogenic risk from PHMB-use for wound antisepsis can be ruled out.

Conclusion:

On this basis and considering their effectiveness, tolerability and clinical evidence, the indications for PHMB based wound antiseptics are justified.
Pressure ulcer prevalence and prevention rates in Abu Dhabi: an update
Authors: Tariq Gulnaz , Hamed Jassin , George Beji , Cruz Salvacion , Jose Jasmine
Published: April 2019

Objective:

This article compares the results from a recent pressure ulcer (PU) prevalence audit at the Sheikh Khalifa Medical City (SKMC) hospital in Abu Dhabi to identify the impact of new prevention initiatives introduced around 2013 and establish the effectiveness of PU prevention strategies, judged quality of nursing care, and costs associated with patients developing a hospital-acquired pressure ulcer (HAPU).

Method:

The methods used were based on a previous point prevalence study involving 441 acute care patients, who were assessed using the International Pressure Ulcer Prevalence (IPUP) Survey. Following pre-selection of a 24-hour period for data capture, hospital staff collected PU data. Hill-Rom provided SKMC with an electronic report comprising various epidemiological and financial outputs.

Results:

PU prevalence was 10.4% in 2018 versus 6.4% in 2013. The 2018 HAPU prevalence was 1.8% versus 2% in 2013. The 2018 findings were in line with IPUP's international benchmarks. In 2018, 99% of patients had their skin assessed and PU risk documented within 24 hours of admission, leading to rapid implementation of a prevention care plan. Most patients who developed a HAPU (n=8) were female (62%) and aged 20–29 years old (25%) or 70–79 years old (25%). All HAPU patients lay on three layers of linen, most on their side (88%) and 75% were hospitalised for >30 days. Costs were estimated for the eight HAPU patients; weighted average cost (per case) was around US$8035.32, giving a total estimated cost of US$64,282.54. Total annual cost (average length of stay basis) for the eight patients was estimated at US$1,830,082.32.

Conclusion:

The PU prevention plan at SKMC proved to be effective, reflected by a low HAPU prevalence rate, suggesting an excellent quality of patient care.
Pregnancy and diabetes
Authors: Todd Diane
Published: April 2019

Diabetes is an increasingly common condition observed in antenatal clinics. It describes not only those women with pre-existing diabetes, but also a significant number of women who develop diabetes during their pregnancy (gestational diabetes), which may resolves postnatally. These high-risk pregnancies are known to be associated with maternal, fetal and neonatal complications and require specialist care.

This happy time in a woman's life can also be one of anxiety and concern over their baby's health. Having diabetes in pregnancy requires daily monitoring of blood glucose levels, adaptions to dietary intake, frequent hospital visits, additional ultrasound scans and the fear of the baby growing ‘too big’.

This article describes the woman's journey from pre-conception to postnatal care and the management, guidance and support offered by the multidisciplinary team to keep her and her baby safe and achieve a successful pregnancy outcome.
Sacubitril/valsartan in patients with symptomatic chronic heart failure with reduced ejection fraction
Authors: Jalal Zahraa , Cabdi Summaya , Khan Nazish , Dorsch Marina , Gill Navneet , Stalker Fionnuala , Jones Alan M
Published: April 2019

Background:

Sacubitril/valsartan is a combination drug therapy for heart failure (HF) patients that has been shown to reduce mortality and hospitalisation.

Aims:

To explore clinically relevant real-life patient data regarding prescribing of sacubitril/valsartan for HF patients in three hospitals, in accordance with national guidelines.

Methods:

A retrospective multicentre study in three large UK hospital Trusts based in the West Midlands.

Findings:

A total of 118 symptomatic chronic HF patients with reduced ejection fraction were included in the study. A high proportion of prescribers adhered to NICE guidelines for treatment with sacubitril/valsartan; 99% of patients had a New York Heart Association functional class of at least II; 82% had a left ventricle ejection fraction of under 35%; 100% received an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker before commencing sacubitril/valsartan. The mean age of men and women at the three hospitals was 65 and 59 years, respectively. The proportion of men prescribed sacubitril/valsartan was greater than women: 80% compared to 20%, respectively. The majority of patients on the therapy were white British (65%). Total prescribing of sacubitril/valsartan at the three hospitals was 295 patients, lower than expected.

Conclusion:

The prescribing of sacubitril/valsartan at the Trusts generally adhered to NICE guidance; however, the prescribing rate was lower than expected compared with the NICE resource tool. Further investigations into the safety and scope of application of sacubitril/valsartan are required to match the prescribing of sacubitril/valsartan with eligible patients who could benefit from the medication.
How prescribers can use technology to improve patient care
Authors: Shah Sam , Coughlan James
Published: April 2019

Health information technologies (HITs) have become increasingly used in the NHS and offer prescribers the opportunity to prescribe in a more consistent and reliable way. There is a growing use of electronic prescribing systems, especially in primary care. This will likely reduce prescription errors, but evidence is unclear if it will improve patient outcomes. Clinical decision support systems can reduce variability and alert clinicians when prescriptions could cause patients harm; however, automation bias can create new errors to prescribers who over-rely on the system. HITs can better communication by improving discharge letters, facilitating telehealth appointments and supporting those working in remote settings. Mobile apps offer a way to engage patients in their own care and allow remote monitoring of chronic conditions in primary care, and acute conditions in emergency care settings. There are challenges in realising these benefits, with inconsistent infrastructure and a 10-year delay in realising predicted efficiency savings.
The best of both worlds? combining specialist practice with hospital consultancy
Authors: Scott Paul , Shelton Andrew T
Published: April 2019

This article describes the experience of undertaking post specialty consultant training, on a part-time basis, with its advantages and disadvantages, and how this experience is transferred into a current practice combining a hospital consultant and specialist practice position, with its challenges and benefits.

CPD/Clinical Relevance: The workforce providing primary and secondary care orthodontics is evolving and it is important that alternative training modalities and working practices are available to allow flexibility in provision of care.
Prescribing: A dilemma in general practice
Authors: White Ben
Published: April 2019

Ben White presents a prescribing dilemma that could face you as a practice manager in charge of a travel health clinic. How would you and your staff respond to this patient?
L’ensenyament musical de mossén Vicent Garcia Julbe
Authors: Rocamora Riquelme Francesc
Published: April 2019

El Seminari Diocesà de Tortosa fou, a mitjan segle passat, el principal centre d’ensenyament d’un territori que abastava les comarques del nord de Castelló i sud de Tarragona. En aquest centre una disciplina va destacar per damunt de la resta: la música, amb mossén Vicent Garcia Julbe (Vinaròs, 1903-1997) com a gran referent. Aquest capellà hi implantà una formació musical fonamentada en l’Schola Cantorum, instrucció simuntaniejada amb la preparació pianística i compositiva d’aquells alumnes més avantatjats. En aquest context, Garcia Julbe va anar bastint una metodología pròpia, personal, genuïna, la qual va permetre al centre viure una etapa esplendorosa, corroborada amb el temps pel fet que molts d’aquells seminaristes esdevingueren grans referents musicals i culturals als seus respectius territoris.
The Sylvia Townsend Warner Conference, April 2018
Authors: Booth Howard J. , Moss Gemma
Published: April 2019

This introduction explains the rationale for the Sylvia Townsend Warner and Modernism conference, at which the essays that follow were presented. The conference sought to place Warner’s work in relation to current debates about modernism and to build on existing work – notably by David James – that began to think about Warner’s texts with attention to issues of form and style. An overview of the range of papers and topics is also provided.
Sigmund Freud dan Homoseksual (Sebuah Tinjauan Wacana Keislaman)
Authors: Dawam Ainurrafiq
Published: April 2019

It is very interesting to bring discourse on homosexuality and lesbianism, particularly from a psychological perspective into the arena of Islamic discourse. Study of homosexuality and lesbianism becomes even more interesting when we try to elaborate on the psychological theories of sexuality from the expert and pioneer of psychoanalysis, Sigmund Freud. Freud was considered by some as anti-God, anti-establishment, anti-argument, anti-consciousness and anti-rationality. This was because Freud created inner psychology, which not only examined the visible indications of the soul, but also those things connected to dreams, hysteria and imaginings. This article discusses the phenomena of homosexuality and lesbianism from a psychological perspective, mainly focusing on the theories of Freud. This is because Sigmund Freud is the psychologist who proposed psychoanalysis, which introduced and spread.
Waria Dalam Pandangan Islam
Authors: Nadia Zunly
Published: April 2019

The existence of transvestism is something that cannot be denied, even though these tendencies represent symptoms of sexual abnormality. From this point, many views have emerged regarding transvestites. This article endeavours to explain the various forms of this phenomenon including homosexuality, transvestism and transsexuality, and the differences between them. It then goes on to review the Islamic laws concerning these by putting forward argumentation and quoting the hadith of the Prophet.
Kepemimpinan Dalam Keluarga: Perspektif Fiqh dan Analisis Gender
Authors: Maulana Bani Syarif
Published: April 2019

Islam is a religion which has attempted to elevate the status of women so that there should be no discrimination between women and men from the Islamic perspective. However, in some fiqh texts, which are based on selected Qur'an and hadith, there is discrimination against women. On the other side, gender discourse now becomes an important issue and is used to improve the status of women. This article attempts to explore both the jiqh texts and gender discourse on the models of leadership in a family, especially on the role of women and men in the family and on the sexual relations, from the Islamic perspective.
Pornografl-Pornoaksi Dalam Perundang-Undangan dan Perjuangan Membebaskan Perempuan
Authors: Zulfa Kholid
Published: April 2019

Women still have to make hard effort to strive for liberating themselves. As most of them persistently fight for gender equality to gain their equal rights before men, and when men's sympathy hugely grows to take women as their equal contenders, many other women at the same time enjay being involved in pornography and porno-action. They harm people by committing sex exploitation in various actions. The question then comes up, how the acts govern the pornography and porno action and what impact it will make for women's struggle. This article describes the constitutions regulating porno. graphy and porno-action and elaborates the impact of pornography-porno action towards the entire women's liberation struggle. The term of porno. graphy-porno action, scope, and the object used in criminal laws vary in many countries. They use it both explicitly or implicitly in which the judge's reasoning plays a large role within it. Terminologically, the word of porno. graphy-pomo-action is not found in Indonesian Criminal Law. Nevertheless, it is substantially stated by: Crime against Norms. we can read that in chapters 281, 282, 283, 532 and533  of Criminal Law.