bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanical antithrombogenic properties by vibrational excitation of the impeller in a magnetically levitated centrifugal blood pump
Authors: Murashige Tomotaka , Hijikata Wataru 
Published: July 2019

AbstractMechanical circulatory support devices have been used clinically for patients with heart failure for over 10 years. However, thrombus formation inside blood pumps remains a risk to patient life, causing pump failure and contributing to neurological damage through embolization. In this article, we propose a method for preventing thrombus formation by applying vibrational excitation to the impeller. We evaluate the ability of this method to enhance the antithrombogenic properties of a magnetically levitated centrifugal blood pump and ensure that the impeller vibration does not cause undue hemolysis. First, 3 vibrational conditions were compared using an isolated pump without a mock circulation loop; the vibrational excitation frequencies and amplitudes for the impeller were set to (a) 0 Hz‐0 μm, (b) 70 Hz‐10 μm, and (c) 300 Hz‐2.5 μm. The motor torque was measured to detect thrombus formation and obtain blood coagulation time by calculating the derivative of the torque. Upon thrombus detection, the pump was stopped and thrombi size were evaluated. The results showed an increase in the blood coagulation time and a decrease in the rate of thrombus formation in pumps with the impeller vibration. Second, an in vitro hemolysis test was performed for each vibrational condition to determine the effect of impeller vibration on hemolysis. The results revealed that there was no significant difference in hemolysis levels between each condition. Finally, the selected vibration based on the above test results and the non‐vibration as control were compared to investigate antithrombogenic properties under the continuous flow condition. The blood coagulation time and thrombi size were investigated. As a result, vibrational excitation of the impeller at a frequency of 300 Hz and amplitude of 2.5 μm was found to significantly lengthen clotting time, decreasing the rate of pump thrombus compared to the non‐vibration condition. We indicate the potential of impeller vibration as a novel mechanical antithrombogenic mechanism for rotary blood pumps.
Addition of Wakame seaweed (Undaria pinnatifida) stalk to animal feed enhances immune response and improves intestinal microflora in pigs
Authors: Shimazu Tomoyuki , Borjigin Liushiqi , Katoh Kazuo , Roh Sang‐gun , Kitazawa Haruki , Abe Keietsu , Suda Yoshihito , Saito Hayato , Kunii Hiroshi , Nihei Ken , Uemoto Yoshinobu , Aso Hisashi , Suzuki Keiichi 
Published: July 2019

AbstractThis study was conducted to evaluate the effects of supplementation of Wakame seaweed stalks on the immunity and intestinal microflora of pigs. Three separate experiments were performed: Relatively young (start at 20–30 kg; Experiments 1 and 2) and fattening period (70 kg; Experiment 3). All pigs (including the control group) were fed the same commercial feed, free from antibiotic additives, but in the feed for the treatment groups, 1% seaweed powder was added. There were no group differences observed in daily weight gain and feed intake in Experiments 1 and 2 between groups; however, daily weight gain was significantly higher in the treatment group compared to the control group in Experiment 3. The percentage of peripheral blood natural killer cells of the treatment group was significantly higher than that of the control group in all experiments. Although addition of seaweed changed the gene expression of cytokine and toll‐like receptors of the small intestinal Peyer's patches slightly, seaweed seems to alter intestinal microflora preferentially, for instance, there was an increase in Lactobacillus and a decrease of Escherichia coli observed. These results suggest that Wakame seaweed can be used as supplement for pig feed to improve the gut health and immunity of pigs.
Doctors and diversity: Using interfaith literacy and interfaith dialogue to improve patient care
Authors: Bellwood Leslie 
Published: July 2019

AbstractIn an increasingly diversifying world, how can doctors and other healthcare professionals improve patient care? Currently, many doctors do not understand how to approach religious differences or recognize their effect on patient health. Doctors must acquire interfaith literacy in medical school through required courses and learn the skills necessary to engage in interfaith dialogue with patients in their practice in order to provide the best patient care in areas with growing diverse patient populations.
Helvétius's challenge: Moral luck, political constitutions, and the economy of esteem
Authors: Blank Andreas 
Published: July 2019

AbstractThis article explores a historical challenge for contemporary accounts of the role that the desire of being esteemed can play in exercising social control. According to Geoffrey Brennan and Philip Pettit, the economy of esteem normally has two aspects: it is supportive of virtuous action and it occurs spontaneously. The analysis of esteem presented by the 18th‐century materialist Claude‐Adrien Helvétius challenges the intuition that these two aspects go together unproblematically. This is so because, in Helvétius's view, the desire for esteem is always triggered by sensible interest. In the frequent situations where sensible interest diverges from the demands of virtue, the economy of esteem thus can be spontaneous but will not be supportive of virtue. Helvétius allows for cases of moral luck where sensible interest coincides with the demands of virtue but regards these cases as rare occurrences. This is why he believes that a functioning economy of esteem crucially depends on political constitutions—in which case the economy of esteem can be supportive of virtue but will not be spontaneous.
The Autoimmune Regulator (Aire) transactivates HLA‐G gene expression in thymic epithelial cells
Authors: Melo‐Lima Breno Luiz , Poras Isabelle , Passos Geraldo Aleixo , Carosella Edgardo D. , Donadi Eduardo Antonio , Moreau Philippe 
Published: July 2019

SummaryThe Autoimmune Regulator (Aire) protein coordinates the negative selection of developing thymocytes by inducing the expression of hundreds of tissue‐specific antigens within the thymic medulla, which is also a primary site of the expression of the immune checkpoint HLA‐G molecule. Considering the immunomodulatory properties of Aire and HLA‐G, and considering that the role of the constitutive thymus expression of HLA‐G has not been elucidated, we studied the effect of AIRE cDNA transfection on HLA‐G expression in 4D6 thymic cells and in the HLA‐G‐positive JEG‐3 choriocarcinoma cells. Aire promoted the transactivation of HLA‐G gene by increasing the overall transcription, inducing the transcription of at least G1 and G2/G4 isoforms, and incrementing the occurrence and distribution of intracellular HLA‐G protein solely in 4D6 thymic cells. Luciferase‐based assays and chromatin immunoprecipitation experiments performed in 4D6 cells revealed that Aire targeted at least two regions within the 5′‐untranslated regulatory region (5′‐URR) extending 1·4 kb from the first ATG initiation codon. The interaction occurs independently of three putative Aire‐binding sites. These results indicate that the Aire‐induced upregulation of HLA‐G in thymic cells is likely to act through the interaction of Aire with specific HLA‐G 5′‐URR DNA‐binding factors. Such a multimeric transcriptional complex might operate in the thymus during the process of promiscuous gene expression.
Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis
Authors: Mauro Maria Francisca F.P. , Papelbaum Marcelo , Brasil Marco Antônio Alves , Carneiro João Regis Ivar , Coutinho Evandro Silva Freire , Coutinho Walmir , Appolinario José Carlos 
Published: July 2019

SummaryBariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity. The objective of the study is to conduct a systematic review and meta‐analysis of studies investigating the relationship between psychiatric comorbidity and weight regain. A systematic review through PubMed, Web of Science, Cochrane Library, Scopus, and PsycINFO was performed, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). After a stepwise selection, 13 articles were included in the qualitative analysis and 5 were included for a meta‐analysis. Women was majority in most of the studies (87.6%), and a bypass procedure was the bariatric intervention most evaluated (66.8%), followed by gastric banding (32.1%) and sleeve (1.1%). Higher rates of postbariatric surgery eating psychopathology were reported in patients with weight regain. However, the association between general psychopathology and weight regain was not consistent across the studies. In the meta‐analysis, the odds of eating psychopathology in the weight regain group was higher compared with the nonweight regain group (OR = 2.2, 95% CI 1.54‐3.15). Postbariatric surgery eating psychopathology seems to play an important role in weight regain.
Are community health workers effective in retaining women in the maternity care continuum? Evidence from India
Authors: Agarwal Smisha , Curtis Sian , Angeles Gusavo , Speizer Ilene , Singh Kavita , Thomas James 
Published: July 2019

ObjectivesDespite the recognised importance of adopting a continuum of care perspective in addressing the care of mothers and newborns, evidence on specific interventions to enhance engagement of women along the maternity care continuum has been limited. We use the example of the Accredited Social Health Activist (ASHA) programme in India, to understand the role of community health workers in retaining women in the maternity care continuum.MethodsUsing the Indian Human Development Survey data from 2011 to 2012, we assess the association between individual and cluster-level exposure to ASHA and four key components along the continuum of care—at least one antenatal care (ANC) visit, four or more ANC visits, presence of a skilled birth attendance (SBA) at the time of birth and postnatal care for the mother or child within 48 hours of birth, for 13 705 women with a live birth since 2005. To understand which of these services experience maximum dropout along the continuum, we use a linear probability model to calculate the weighted percentages of using each service. We assess the association between exposure to ASHA and number of services utilised using a multinomial logistic regression model adjusted for a range of confounding variables and survey weights.ResultsOur study indicates that exposure to the ASHA is associated with an increased probability of women receiving at least one ANC and SBA. In terms of numbers of services, exposure to ASHA accounts for a 12% (95% CI: 9.1 to 15.1) increase in women receiving at least some of the services, and an 8.8% (95% CI: −10.2 to −7.4) decrease in women receiving no services. However, exposure to ASHA does not increase the likelihood of women utilising all the services along the continuum.ConclusionsWhile ASHA is effective in supporting women to initiate and continue care along the continuum, it does not significantly affect the completion of all services along the continuum.
Performance of primary care in different healthcare facilities: a cross-sectional study of patients’ experiences in Southern Malawi
Authors: Dullie Luckson , Meland Eivind , Hetlevik Øystein , Mildestvedt Thomas , Kasenda Stephen , Kantema Constance , Gjesdal Sturla 
Published: July 2019

ObjectiveIn most African countries, primary care is delivered through a district health system. Many factors, including staffing levels, staff experience, availability of equipment and facility management, affect the quality of primary care between and within countries. The purpose of this study was to assess the quality of primary care in different types of public health facilities in Southern Malawi.Study designThis was a cross-sectional quantitative study.SettingThe study was conducted in 12 public primary care facilities in Neno, Blantyre and Thyolo districts in July 2018.ParticipantsPatients aged ≥18 years, excluding the severely ill, were selected to participate in the study.Primary outcomesWe used the Malawian primary care assessment tool to conduct face-to-face interviews. Analysis of variance at 0.05 significance level was performed to compare primary care dimension means and total primary care scores. Linear regression models at 95% CI were used to assess associations between primary care dimension scores, patients’ characteristics and healthcare setting.ResultsThe final number of respondents was 962 representing 96.1% response rate. Patients in Neno hospitals scored 3.77 points higher than those in Thyolo health centres, and 2.87 higher than those in Blantyre health centres in total primary care performance. Primary care performance in health centres and in hospital clinics was similar in Neno (20.9 vs 19.0, p=0.608) while in Thyolo, it was higher at the hospital than at the health centres (19.9 vs 15.2, p<0.001). Urban and rural facilities showed a similar pattern of performance.ConclusionThese results showed considerable variation in experiences among primary care users in the public health facilities in Malawi. Factors such as funding, policy and clinic-level interventions influence patients’ reports of primary care performance. These factors should be further examined in longitudinal and experimental settings.
President's Address
Authors: Langdon-Down R. 
Published: July 2019

The principal reference of the Royal Commission was certification and detention, and treatment without certification of persons suffering from mental disorder. The general principles laid down as the result of the inquiry are set forth and shown to accord with the views of the medical profession. The Commission supports the medical view that greater facilities should be granted for treating mental disorders in their early stages without certification and repudiates the contention that grave abuses exist. It makes proposals for avoiding the stigma of certification by admitting patients to treatment under a provisional order without full certification. The real objection of the public to certification appears to lie in the judicial intervention and the legal formalities. Since these are accentuated in the proposed method, it is very little different from the present procedure. The reason for this anomaly appears to be adherence to what is said to be “an inviolable principle of law.” This principle is violated in the present law, in the proposals of the Royal Commission and was disregarded prior to 1890. A scheme is put forward to avoid these objections by extending the present facilities on the lines of the Report and simplifying the procedure, thus eliminating the magistrate from the proceedings prior to admission unless the patient desires his intervention, and placing the authorization for treatment on the relatives and friends in all cases where the patient does not apply voluntarily for treatment. The Board of Control is the safeguard in these matters. These two procedures would be applicable to all cases in the first instance; but should the friends prefer full certification, that should be possible at any stage. The proposals for voluntary boarders are approved with the proviso that it should not be necessary to apply these proposals where restraint is neither necessary nor, in fact, applied. The protection that doctors signing certificates need is considered and it is proposed that a medical assessor should advise the judge to whom application to stay an action is made. It is held that if the law is at present wrongly interpreted and unjust, this should be cleared up by public action rather than that a doctor should have to go through the anxiety and expense of appeal to the House of Lords. In the main the Report commands professional approval, but in points of the greatest importance to doctors practising psychiatry and to their patients it is unsatisfactory.
Some Public Health Aspects of Juvenile Rheumatism
Authors: Miller Reginald 
Published: July 2019

(1) The prevalence of juvenile rheumatism is shown by the incidence of heart disease in 1·5 to 2 per cent. of urban elementary school children. The annual mortality from rheumatic heart disease is probably about 20,000 deaths a year. (2) The age-incidence is due to the three factors of tonsillitis, exposure, and the diminished resistance to infection of childhood. Where these three factors overlap we get the heavy incidence of the infection. The class-incidence shows a rheumatic stratum of society in the upper poorer classes. The disease is therefore not a “poverty disease” strictly so-called; some added factor is also at work. (3) Juvenile rheumatism is clearly an environmental disease, for if the children of the poor are transported from their homes to residential schools they remain free from rheumatic infection. What is the factor at work amongst the poor which produces the disease in their own homes? The evidence that cold damp houses have an important influence in producing juvenile rheumatism is considerable. Overcrowding seems to protect to some extent, owing to the prevention of cold. The environmental causes of the disease must centre largely round the production of tonsillar infection. (4) The organized effort needed to prevent and control juvenile rheumatism consists in increased attention to housing conditions; increased endeavour in early detection by the School Medical Service; increased supervision by hospitals and practitioners of their rheumatic patients; and increased accommodation for prolonged treatment of heart disease.
The Pathogenesis of Rheumatic Fever in its Climatological Relationship to a Possible Insect Carrier
Authors: Clarke J. Tertius 
Published: July 2019

A short while ago a special sub-committee of the British Medical Association [1] sat to inquire into the problem of rheumatic heart disease in children, and suggested, among other conclusions, that the material for any accurate world map of the incidence of rheumatism was probably not available. My objects in presenting this paper are:— To provide data for this map. To show that the geographical distribution of rheumatic fever coincides with that of the common rat flea, Ceratophyllus fasciatus, and To suggest that this disease is caused by a protozoön, spirochæte or allied organism, which is carried by that flea.
Some Observations on Naso-Pharyngeal Epidemics in Public Schools
Authors: Glover J. A. 
Published: July 2019

Over 80 per cent. of school sickness, whether judged by the number of cases or by the time lost, is transmitted by “droplet” infection. The alleged increase in sickness in public schools is partly apparent, due to increased attention to minor febricula and partly real, due (1) to increased influenza prevalence, the aftermath of the great epidemic of 1918, and (2) to the increased demand for public school education leading to pressure upon accommodation, and especially to overcrowding in dormitories. The bulk of the droplet infections are accounted for by (1) influenza; (2) feverish cold, chill, or P.U.O.; (3) tonsillitis; regular infectious diseases make a comparatively small showing. The incidence and bacteriological findings and the variations in the incidence of pneumonia and otitis media are discussed. Are these complications really secondary epidemics? Tonsillitis, bacteriological findings, milk. Prophylaxis.—Efficacy of vaccines uncertain. Some evidence that they may diminish the onset of complications. If given vaccines should be administered before the danger period, i.e., not later than November. Intensive prophylaxia other than vaccines during the first half of the Lent term would probably amply repay any trouble. It should include:— Special efforts to prevent boys returning to school after the Christmas holidays infected with influenza or febricula. Temperature taking for three weeks. Immediate isolation of all pyrexias and catarrhs. No work before breakfast for at least the first six weeks of the term. All hot baths and showers taken during the day or after games to be followed by cold showers. Prevention of chill in watching games, etc. Increased provision for drying clothes, uniforms and boots. Infection mainly takes place in sleeping quarters, and proper spacing out of beds and thorough “cross” ventilation in dormitories is of paramount importance; instances of cross infection due to proximity of beds; illustrated by bed charts and bacteriological findings; standards of wall space, floor space and cubic space, laid down by the Royal Commission, Board of Education. No school authority has done its duty to its pupils unless it has provided dormitory accommodation allowing at least 3 ft. of clear space between the edges of beds, and thorough and through ventilation. Until these essential wants are met, the provision of properly sited, amply spaced and “cross” ventilated dormitories should take precedence of all other building requirements. Milk should be pasteurized.
Calcaneo-Scaphoid Coalition
Authors: Seddon H. J. 
Published: July 2019

Calcaneo-scaphoid coalition occurs in a number of forms, having one feature in common, namely, a skeletal abnormality of the calcaneo-scaphoid gap. The condition is congenital, but nothing is known of its causation. Ranking at first as merely an anatomical curiosity, it was later recognized to be frequently associated with spasmodic flat-foot. Probably 25% of all cases of spasmodic flat-foot show this skeletal anomaly in some form or other. Clinically, this variety of spasmodic flat-foot is indistinguishable from the better-known condition in which the bones are apparently normal. Diagnosis made radiographically; essential that an oblique lateral view of the foot should be taken. Causal relation of the condition to peroneal spasm. All the usual forms of treatment employed for the relief of spasmodic flat-foot fail when a calcaneo-scaphoid coalition is present. Resection of the offending bar is of no proven value, but may be worth further trial. If symptoms persist, subastragaloid arthrodesis is necessary.
An Examination of Tropical Neurasthenia
Authors: Culpin Millais 
Published: July 2019

The nineteenth century conception of neurasthenia is giving way to a psychological ætiology and classification. Quotations show that the older conception dies hard, and varied physical factors are invoked as causes of tropical neurasthenia. Australian experience shows the physical factors present without “neurasthenia.” It is suggested that mal-adjustment is not physiological but sociological. The possibility of psychoneuroses appearing in the guise of tropical diseases. Effect of selection of personnel in reducing breakdown. The writer doubts the existence of a neurasthenia special to the tropics, and urges that the use of the phrase “tropical neurasthenia” should be discontinued.