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Buttera, M., A. Clavenna, E. Maselli, L. Tansini, MP Canevini, and M. Bonati. "P19 Drug use in adolescents attending the emergency department for mental health problems." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e25.1-e25. http://dx.doi.org/10.1136/archdischild-2019-esdppp.58.
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BackgroundScant evidence is available regarding the pharmacological management of acute episodes of mental disorders in children and adolescents attending emergency departments (ED). In this regard, we performed a retrospective study with the aim to evaluate the pattern of psychotropic drug use in an ED of a large hospital.MethodsA retrospective chart review of adolescents (13–17 years) visited in the ED of San Paolo University Hospital in Milan for a mental disorder between January and June 2018 was conducted. In particular, information concerning age, gender, type of mental disorder, psychotropic drugs administered in the ED and outcome of the visit were extracted and analysed, using an anonymous patient code.ResultsA total of 1,298 adolescents 13–17 years old were visited during the observation period, 56 (4%) of whom had a diagnosis of mental disorder (35 females and 21 males).The most common disorder was predominant psychomotor disturbance (International Classification of Diseases 9 (ICD9) revision code 308.2; 12 patients), followed by anxiety disorder in conditions classified elsewhere (293.84, 8 patients) and anxiety states (300.0, 7 patients).Ten adolescents were hospitalised, while 16 (29%) received a psychotropic drug in the ED: 14 patients received a benzodiapine (8 delorazepam, 3 lorazepam), and 2 an antipsychotic drug (risperidone+olanzapine; promazine). Five out of 12 adolescents with psychomotor disturbance received a psychotropic drug (3 delorazepam, 1 lorazepam, 1 risperidone+olanzapine).Although no randomized controlled trial has evaluated the safety and effectiveness of benzodiazepines in the paediatric population, delorazepam was identified as the first choice pharmacological treatment for agitation in children and adolescents in a local protocol.ConclusionNearly all children received drugs for which no controlled trials have been performed in the paediatric population and for which the appropriateness is debatable. More evidence is needed to guide the pharmacological management of acute episodes of mental disorders.Disclosure(s)Nothing to disclose
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Brown, Tiffany A., Pamela K. Keel, and Ruth H. Striegel. "Feeding and Eating Conditions Not Elsewhere Classified (NEC) inDSM-5." Psychiatric Annals 42, no. 11 (November 1, 2012): 421–25. http://dx.doi.org/10.3928/00485713-20121105-08.
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Pyarejan, Karamath S., and Ravisankar Muthiah. "Clinical profile and risk factors of enuresis in children." International Journal of Contemporary Pediatrics 7, no. 3 (February 25, 2020): 546. http://dx.doi.org/10.18203/2349-3291.ijcp20200568.
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Background: Enuresis is a common problem in children and its incidence is multifactorial in nature. The aim of this study is to assess the etiological risk-factors in enuresis in the study population and also to compare the risk factors in enuresis subgroups.Methods: A total of 51 patients with enuresis presenting to the department of paediatrics, Institute of Social Paediatrics, Govt. Stanley Hospital, Chennai were included in the study. All children were sub classified as primary/secondary and the primary enuretics were sub classified into monosymptomatic/non monosymptomatic depending on the symptoms. The data was analyzed and the results presented.Results: Enuresis was common in boys. Statistically significant difference in the incidence of disorder between primary and secondary enuretic children was seen in relation to presence of storage symptoms (p=0.04), cystitis (p=0.013) sleep disordered breathing (p=0.0001) and low-income status (p=0.04). No statistically significant difference between into monosymptomatic nocturnal enuresis (MNE) and non-monosymptomatic nocturnal enuresis (NMNE) children was observed in terms of gender, difficulty in arousal, specific gravity, spina bifida, low bladder capacity and family history (p>0.05).Conclusions: The findings of the study reported that risk factors related to the incidence is similar in both primary and secondary enuresis. MNE and NMNE have no differences in the presentation and probably represent the spectrum of a same disorder.
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Tibout, Pauline, Natasha Ferguson, Guillaume St-Laurent, Judith Rondeau-Legault, David Simonyan, and Valérie Larouche. "RETROSPECTIVE STUDY OF THE RADIOLOGICAL FINDINGS OF THE MEDIASTINUM AFTER END-OF-TREATMENT FOR A MEDIASTINAL LYMPHOMATOUS MASS IN PEDIATRIC ONCOLOGY." Paediatrics & Child Health 23, suppl_1 (May 18, 2018): e43-e43. http://dx.doi.org/10.1093/pch/pxy054.111.
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Abstract BACKGROUND Reactive thymic hyperplasia, or rebound thymus, is a well-known phenomenon following chemotherapy. While rebound thymus has been described after treatment for many different malignancy, it has been more often noted after treatment for lymphomas. In children and adolescents in which the primary lymphoma was located in the mediastinum, a mediastinal mass, such as a reactive thymic hyperplasia, can be misdiagnosed as a tumor relapse. It can be difficult for the clinician to differentiate between a tumor relapse and a reactive thymic hyperplasia, which may cause unnecessary additional imaging and invasive diagnostic procedures as well as anxiety for the patient and his family. OBJECTIVES The main objective was to measure the incidence of reactive thymic hyperplasia following treatment for a paediatric mediastinal lymphoma. The secondary objectives were to describe the radiologic findings which may help differentiate thymic hyperplasia and tumor relapse and to analyse if the finding of a mediastinal mass changed the clinical management. DESIGN/METHODS We conducted a retrospective cohort study. The consent for reviewing medical files was obtained from the institutional ethics board. We obtained data from the archives at the Centre mère-enfant Soleil, CHU de Québec. The medical and radiologic files of 72 paediatric patients which completed two years of follow-up after the treatment for mediastinal lymphoma were reviewed. The radiologic imaging reports were analysed and the patients were classified depending if they developed a mediastinal mass during follow-up or not. If a mass was developed, its characteristics were described to differentiate between a tumor relapse and a thymic hyperplasia. Statistical analyses were performed using SAS 9.4 Statistical Software (Institute SAS, Cary, NC, USA). Descriptive analysis includes mean ± standard deviation, range and median, interquartile range for continuous variables, and frequency and percentage for categorical. Bivariate tests were used to compare the rebound thymic hyperplasia group with the group without this problem. RESULTS The patients were followed for a mean of 27.7 ± 28.0 months (95% CI 21.1–34.2) and a median of 12.6 months. Of seventy-two patients reviewed, thirty-nine (54.2%) developed a mediastinal mass at follow-up. Of them, three had a mediastinal relapse of their tumor. One patient had a lymphoma relapse located elsewhere than the mediastinum and a benign rebound mediastinal mass. Thirty-five out of the 72 patients (48.6%, 95% CI 37.3%-60%) developed a benign mediastinal mass and were diagnosed with having rebound thymic hyperplasia. Of those thirty-five patients, twelve were investigated with additional imaging, and one had a mediastinal biopsy showing true thymic hyperplasia. The other twenty-three were followed-up according to the clinician, with no modification to their follow-up because of the mediastinal mass. These results are shown in Table 2. The majority of the rebound thymic hyperplasia were a mass of triangular shape, with well-defined margins and homogenous density. It remained unchanged or minimized at follow-up, but it was noted that three patients had an augmentation of the hyperplasia at follow-up, while remaining disease-free. The age <14 years old was a risk factor in our population (Hazard Ratio (HR) 1.95, p=.0491). CONCLUSION Reactive thymic hyperplasia is a common phenomenon showed in half of our cohort of patients. Some radiological findings, including triangular shape, well defined margins and mild homogenous enhancement, oriented towards a rebound thymic hyperplasia. Additional imaging study should be limited to patients whose rebound mass or symptoms make the clinician suspect a tumor relapse. A prospective cohort study with standardized care should be conducted to better characterize the rebound thymic hyperplasia and help the clinician approach a mediastinal mass at follow-up.
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Burdman, Ilja, and Bjoern B. Burckhardt. "Prorenin and active renin levels in paediatrics: a bioanalytical review." Clinical Chemistry and Laboratory Medicine (CCLM) 59, no. 2 (August 19, 2020): 275–85. http://dx.doi.org/10.1515/cclm-2020-0857.
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Abstract As part of the extended renin-angiotensin-aldosterone system, active renin and its precursor prorenin have been an area of research interest for decades. Although several studies showed a correlation with disease, other studies found no significant association, e.g. attributed to limited sample size or pharmacological effects of antihypertensive drugs. Since the measurement of both proteins has typically been carried out in adult populations, the data in paediatrics is limited. This review aimed to collate the current data on plasma renin and prorenin levels in children and compare the levels of healthy vs. the diseased state. A literature search using Medline resulted in 213 publications of which 15 studies were classified as relevant. In the extant studies in the literature, an age-dependent decline of renin plasma concentration was observed in newborns compared to adolescents. For children with cardiovascular disease, five studies were identified that provide limited insight into the pathophysiological regulation of renin. In general, sample handling is still a crucial step, which might particularly affect measured active renin concentrations due to conformational changes of its precursor prorenin. A reliable assessment for prorenin levels in the maturating population is yet not possible due to the low number of available publications. Three different approaches to quantify prorenin were found and raise the question on the comparability of these methods. The review emphazised several weaknesses and highlights the need for an accurate procedure to determine levels of active renin as well as prorenin in its closed and open form.
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Louis, David N., Pieter Wesseling, Werner Paulus, Caterina Giannini, Tracy T. Batchelor, J. Gregory Cairncross, David Capper, et al. "cIMPACT-NOW update 1: Not Otherwise Specified (NOS) and Not Elsewhere Classified (NEC)." Acta Neuropathologica 135, no. 3 (January 25, 2018): 481–84. http://dx.doi.org/10.1007/s00401-018-1808-0.
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2015 Program Committee, BRASS. "From Committees of RUSA: BRASS Program: Not Elsewhere Classified: Researching New and Niche Industries." Reference & User Services Quarterly 55, no. 2 (December 16, 2015): 156. http://dx.doi.org/10.5860/rusq.55n2.156.
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The Business Research and Services Section (BRASS) 2015 program was directed to business research professionals who may be stymied by researcher requests related to newer or niche industries. In a stimulating ninety-minute session, two top research professionals informed, confronted and engaged their American Library Association (ALA) audience with their well-paced array of smart search strategies and sources designed to meet industry challenges. The presentation was effective in identifying research workaround strategies and tying real industry problems with practical, on-the-job solutions.The material provided here and the bibliography of sources may serve as additional resources for emerging industry queries of library users. The BRASS program presentation is available via this ALA conference website (http://alaac15.ala.org/node/28603).
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Burford, C., R. Laxton, Z. Sidhu, M. Aizpurua, A. King, I. Bodi, K. Ashkan, and S. Al-Sarraj. "ATRX immunohistochemistry can help refine ‘not elsewhere classified’ categorisation for grade II/III gliomas." British Journal of Neurosurgery 33, no. 5 (April 24, 2019): 536–40. http://dx.doi.org/10.1080/02688697.2019.1600657.
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Dakskobler, Igor, Andrej Martinčič, and Daniel Rojšek. "Phytosociological Analysis Of Communities With Adiantum Capillusveneris In The Foothills Of The Julian Alps (Western Slovenia)." Hacquetia 13, no. 2 (December 1, 2014): 235–58. http://dx.doi.org/10.2478/hacq-2014-0016.
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Abstract We conducted a phytosociological study of the communities hosting the rare and endangered fern Adiantum capillus-veneris in the foothills of the Julian Alps, in Karst and in Istria. Based on a comparison with similar communities elsewhere in the southern Alps (northern Italy) we classified most of the recorded stands into the syntaxa Eucladio-Adiantetum eucladietosum and -cratoneuretosum commutati. Releves from the southern Julian Alps, located in comparatively slightly colder and moister local climate and the dolomite bedrock are classified into the new subassociation -hymenostylietosum recurvirostri subass. nova. Stands with the abundant occurrence of the liverwort Conocephalum conicum, are classified in to the new subassociation -conocephaletosum conici subass. nova. Stands in conglomerate rock shelters along the Soča at Solkan are classified into the new association Phyteumato columnae-Adiantetum ass. nova, a community of transitional character between the classes Adiantetea capilli-veneris and Asplenietea trichomanis.
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Garanča, Biruta. "THE STRUCTURE OF MACHINERY BUILDING IN LATGALE AND PERSPECTIVES OF ITS DEVELOPMENT." Latgale National Economy Research 1, no. 1 (June 30, 2009): 53. http://dx.doi.org/10.17770/lner2009vol1.1.1761.
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The financial facility of development of machinery building in Latgale is expected in manufacturing of electrical and optical equipment and in production of metal and metal ware. At present the proportion of production of leading machinery and equipment non-classified elsewhere, as well as of production of transport means has a tendency to reduce and also they have lesser probability to manage the financial crisis.
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Brugman, Jaanri, Regan Shane Solomons, Carl Lombard, Andrew Redfern, and Anne-Marie Du Plessis. "Risk-Stratification of Children Presenting to Ambulatory Paediatrics with First-Onset Seizures: Should We Order an Urgent CT Brain?" Journal of Tropical Pediatrics 66, no. 3 (October 18, 2019): 299–314. http://dx.doi.org/10.1093/tropej/fmz071.
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Abstract Introduction A computed tomography (CT) brain scan is an often-utilised emergency department imaging modality to detect emergent intra-cranial pathology in a child with a first seizure. Identifying children at low risk of having a clinically significant intra-cranial abnormality could prevent unnecessary radiation exposure and contrast/sedation-related risks. Objectives To identify clinical variables which could predict clinically significant CT brain abnormalities and use recursive partitioning analysis to define a low-risk group of children in whom emergent CT brain can be deferred. Methods Retrospective cross-sectional review of 468 children who underwent emergent CT brain after presenting to a low- and middle-income paediatric emergency department following first seizure. Results In total 133/468 (28.4%) of CT brain scans had clinically significant abnormalities. Failure to return to neurological baseline and focal neurological deficit persisting >36 h had statistical significance in a multiple regression analysis. Recursive partitioning analysis, applied to a subgroup without suspected tuberculous meningitis (n = 414), classified 153 children aged between 6 months and 5 years, who had a normal neurological baseline, had returned to baseline post-seizure, and were not in status epilepticus, as non-clinically significant scans and 98% were correctly classified. Conclusion Our study re-inforces the American Academy of Neurology recommendation that children with persistent post-ictal abnormal neurological status and/or post-ictal focal deficit be prioritised for emergent CT brain. Having excluded children with suspected tuberculous meningitis, the remaining subgroup aged 6 months to 5 years presenting with a non-status first seizure, normal neurological baseline and return to baseline post-seizure, are at very low risk of having a clinically significant CT brain abnormality.
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Goldberg, David. "Should our major classifications of mental disorders be revised?" British Journal of Psychiatry 196, no. 4 (April 2010): 255–56. http://dx.doi.org/10.1192/bjp.bp.109.072405.
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SummaryOur major classification systems (DSM and ICD) face three main problems: the high rates of ‘comorbidity’ that are produced by our present diagnostic rules, the increasing use of ‘not elsewhere classified’ (NEC) by practising clinicians, and the fact that each new edition is longer and more complex than the one preceding it. A major simplification of the chapter structure used by each classification might pave the way to address these problems.
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Gangadhar, K., and D. Santhosh. "Primary Skull Osteosarcoma: MDCT Evaluation and Histopathological Correlation in Two Cases." Neuroradiology Journal 25, no. 2 (April 2012): 188–92. http://dx.doi.org/10.1177/197140091202500206.
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Osteosarcomas are typically long bone tumors and rarely affect the skull, with most articles reporting single cases. As elsewhere in the body, these lesions may be classified as primary or secondary, chiefly post-Paget and post-radiation therapy. We describe two cases of primary osteosarcoma of skull one presenting with cerebellar symptoms and another with giant skull swelling. Complete evaluation with 64 slice CT and histopathological correlation was carried out.
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Paul, McCague, Brennan Hilary, and Wallace Scott. "P13 Medication use and excipient exposure in paediatrics in a secondary care setting." Archives of Disease in Childhood 103, no. 2 (January 19, 2018): e1.17-e1. http://dx.doi.org/10.1136/archdischild-2017-314584.24.
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Background and aimPaediatric patients are widely exposed to a range of excipients which may cause harm to this vulnerable patient group. Legal requirement to disclose quantitative information on excipients changed in 2010,2 however, since most formulations were licensed prior to this date, there is a lack of potentially critical information available to currently practising pharmacists and clinicians. The aim of this study was to quantify excipient exposure to children in a secondary care setting.MethodA cohort study was conducted within Altnagelvin Area Hospital Paediatric Ward (Northern Ireland, Western Health and Social Care Trust) in January 2017. Medicines prescribed to patients throughout the study were recorded and exposure to ethanol, sodium benzoate and propylparaben was quantified.Exposure was then compared to proposed safe limits. Off-label and unlicensed use of medicines was assessed as a secondary aim. This study was classified as a service evaluation and ethical approval was not required.ResultsA total of 91 patients were enrolled in the study. Patient age ranged from 5 days to 15 years. The mean number of items prescribed per patient was 3.0. Analysis revealed that 75.8% of patients were exposed to ≥1 excipient of interest including ethanol, sodium benzoate and propylparabens. Excipient safety levels as proposed by the European Medicines Agency or World Health Organisation (where available) were not exceeded.Quantitative excipient information were not available for two products. There was both off-label and unlicensed use ofmedicines, with off-label prescribing (9.6%) being more common than the use of unlicensed medicines (0.4%).ConclusionThe paediatric population is exposed to potentially harmful excipients contained in commonly prescribed medicines. Although exposure within this study falls within existing safety limits, further research into paediatric specific safe exposure limits are required. It is notable that despite contacting themanufacturer, quantitative excipient information were not available for two products. Safety limits when considered together with quantitative excipient information will allow clinicians to complete an informed risk-benefit analysis for paediatric patients.ReferencesTulec C. Paediatric formulations in practice. In Costello I, Long PF, Wong IK, Tulec C, Yeung V (Ed.), Paediatric drug handling 2007:pp. 43–74. London: Pharmaceutical Press.European Commission. A guideline on summary of product characteristics [Online]2009;2:1–29. http://ec.europa.eu/health//sites/health/files/files/eudralex/vol-2/c/smpc_guideline_rev2_en.pdf [Accessed: 14th April 2017].
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MONNIOT, FRANÇOISE, and SUSANNA LÓPEZ-LEGENTIL. "Deep-sea ascidians from Papua New Guinea." Zootaxa 4276, no. 4 (June 14, 2017): 529. http://dx.doi.org/10.11646/zootaxa.4276.4.5.
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Four deep-sea ascidian species collected during the KAVIENG 2014 expedition in Papua New Guinea are described, including additional characteristics not reported previously. Fimbrora calsubia is classified within the family Ascidiidae, Dicopia fimbriata and Octacnemus bythius within Octacnemidae, and Culeolus recumbens within Pyuridae. Anatomical observations confirmed previous descriptions for these four species collected elsewhere. Here, we describe additional morphological features for these species and provide the first barcode DNA sequences (based on a fragment of the mitochondrial gene Cytochrome Oxidase I) for D. fimbriata and C. recumbens.
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Wang, Chih-Hung, Chi-Chun Yang, Wan-Ting Hsu, Frank Qian, Julia Ding, Han-Ping Wu, Jih-Jin Tsai, et al. "Optimal initial antibiotic regimen for the treatment of acute appendicitis: a systematic review and network meta-analysis with surgical intervention as the common comparator." Journal of Antimicrobial Chemotherapy 76, no. 7 (April 1, 2021): 1666–75. http://dx.doi.org/10.1093/jac/dkab074.
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Abstract Background The optimal antibiotic regimen for the medical management of acute appendicitis remains unknown due to a lack of head-to-head comparisons between different antibiotic regimens. Methods We systematically searched the PubMed, EMBASE, Scopus and Cochrane Central Register of Controlled Trials databases from their inception through to August 2020. We selected randomized controlled trials (RCTs) or observational studies comparing antibiotic therapy and appendectomy as the initial treatment for adult or paediatric patients with acute appendicitis. We performed a Bayesian network meta-analysis (NMA) to obtain the indirect comparison results between different antibiotic regimens by employing the group managed by surgery as a common comparator. Antibiotic regimens were classified into three categories: those including a carbapenem; those including a cephalosporin; and those including a β-lactam/β-lactamase inhibitor combination. Results A total of 9 RCTs (adults, n = 8; paediatrics, n = 1) and 12 observational studies (adults, n = 3; paediatrics, n = 9) were included in the NMA, with a total of 4551 patients. The most commonly administered regimen was a β-lactam/β-lactamase inhibitor combination (9/21; 43%), followed by a cephalosporin (7/21; 33%) or a carbapenem (5/21; 24%). The NMA indicated that surgery significantly increased 1 year treatment success, compared with cephalosporins [OR: 16.79; 95% credible interval: 3.8–127.64] or β-lactam/β-lactamase inhibitor combinations (OR: 19.99; 95% credible interval: 4.87–187.57), but not carbapenems (OR: 3.50, 95% credible interval: 0.55–38.63). In contrast, carbapenems were associated with fewer treatment-related complications compared with surgery (OR: 0.12; 95% credible interval: 0.01–0.85). Conclusions Carbapenems might be recommended as the initial antibiotic regimen for the non-operative management of adult patients with acute appendicitis. Nevertheless, due to the imprecise estimates in our NMA, additional RCTs are needed to corroborate these findings, especially for paediatric patients.
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Birring, Caprice, Trinh Huynh, Patricia Hayes, Agnieszka Sadowska-Koszela, Nanna Christiansen, and Asia N. Rashed. "P29 Medicine prescribing across primary, secondary and tertiary care interfaces in paediatrics: a retrospective cohort study." Archives of Disease in Childhood 107, no. 5 (April 20, 2022): e25.30-e25. http://dx.doi.org/10.1136/archdischild-2022-nppg.36.
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AimShared care agreements, commissioned by local clinical commissioning groups, are formal agreements that set out prescribing arrangements to provide a safe and cost-effective service that covers the prescribing requirements and to allow for the continued involvement of a hospital consultant alongside the provision of care in primary care settings.1–3 However, primary care prescribers have often expressed hesitancy to accept responsibility for prescribing in paediatrics, leaving secondary and tertiary care providers to prescribe these medications instead,1 resulting in inappropriate pressures on hospital pharmacies and often leaves families with difficulties in securing ongoing supply. This study aimed to investigate the volume, cost and type of hospital outpatient paediatric prescribing associated with items for which prescribing responsibility could be transferred to primary care. As well as to identify whether the current shared care agreements; traffic light rating (TLR) system and associated guidelines, encompass these medications.MethodA retrospective cohort study, involving descriptive and inferential statistical analysis, was conducted on prescription items prescribed and dispensed for paediatric patients. Prescriptions were identified by dispensary staff over a six-month period (October 2019-March 2020), at one tertiary care level hospital in southeast London. The prescription items were classified according to the TLR system defined in the South East London Joint Medicines formulary4 as red (specialist/hospital prescribing only); amber-1 (primary care initiation after a recommendation from a specialist); amber-2 (specialist initiation followed by maintenance prescribing in primary care); amber-3 (specialist initiation with ongoing monitoring using shared care agreement documentation); green (specialist or non-specialist prescribing).Data were analysed using Statistical Package for the Social Sciences (IBM SPSS) Software (V27).ResultsIn total 217 prescribed items prescribed and dispensed for 35 children were included in the study, and all of them had the potential to be prescribed in primary care. Of these, 93.1% (202/217) were rated ‘green’ with most of them prescribed for children aged 6-11 years (32.2%, 65/202).Only 3.2% (7/217) items had an ‘amber-3’ rating and required shared care agreements to initiate prescribing in primary care, many of them (85.7%, 6/7) had shared care agreements in place, assigned for their use in primary care. Only one item from the ‘amber-3’ category (melatonin 2 mg modified-relates tablets) had no shared agreement in place. None of the included items was classified as ‘red’.The highest volume of prescribing was for paediatric renal (62.2%, 135/217). The total cost incurred to the hospital for all items included in the study was £35,331.ConclusionThere is still hesitancy among general practitioners to prescribe medications for paediatrics in primary care that they can be clinically responsible for despite the emergence of new guidelines and resources to support primary care in taking on prescribing. This has a significant impact on hospital pharmacies both in terms of activity and finance and it is also making it more complex for arranging medication supplies. If those medicines were prescribed appropriately, considerable cost savings could occur in secondary/tertiary care which could be used to provide other important specialist paediatric services.ReferencesNHS England. Responsibility for prescribing between primary & secondary/tertiary care. 2018. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/03/responsibility-prescribing-between-primary-secondary-care-v2.pdf (accessed 29 Jul 2021).Terry D, Sinclair A. Prescribing for children at the interfaces of care. Archives of Disease in Childhood - Education and Practice 2012;97:152–156.British Medical Association. Prescribing in General Practice. Available at: https://www.bma.org.uk/advice-and-support/gp-practices/prescribing/prescribing-in-general-practice (accessed 29 Jul 2021).South East London Area Prescribing Committee. South East London Joint Medicines Formulary. Available at: http://www.selondonjointmedicinesformulary.nhs.uk/default.asp (accessed 29 Jul 2021).
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Leach, Stephen. "History, Ethics and Philosophy: Bernard Williams’ Appraisal of R. G. Collingwood." Journal of the Philosophy of History 5, no. 1 (2011): 36–53. http://dx.doi.org/10.1163/187226311x555446.
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AbstractThe author examines Williams’ appraisal of Collingwood both in his eponymous essay on Collingwood, in the posthumously published Sense of the Past (2006), and elsewhere in his work. The similarities and differences between their philosophies are explored: in particular, with regard to the relationship between philosophy and history and the relationship between the study of history and our present-day moral attitudes. It is argued that, despite Williams usually being classified as an analytic philosopher and Collingwood being classified as an idealist, there is substantial common ground between them. Williams was aware of this and made clear his sympathy for Collingwood; but, nonetheless, the relationship between Williams and Collingwood has not previously been explored in any detail. After establishing the common ground between these philosophers, and the areas of disagreement, the author suggests that both may have something to gain from the other.
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WALTON, JOHN K., and DAVID TIDSWELL. "‘Classified at random by veritable illiterates’: the taking of the Spanish census of 1920 in Guipúzcoa province." Continuity and Change 20, no. 2 (August 2005): 287–313. http://dx.doi.org/10.1017/s0268416005005503.
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This article offers an approach through administrative and cultural history to the problems associated with gathering and processing data for the Spanish national census of 1920, and by implication for earlier Spanish censuses. It focuses on the Basque province of Guipúzcoa, making use of correspondence between the central statistical office in Madrid, the provincial jefe de estadística and the localities, and of reports on three problematic towns within the province. The issues that emerge regarding ‘undercounting’, the definition of administrative boundaries and the classification of demographic characteristics are set in the wider context of census-taking practices and problems elsewhere in Spain and in other cultures.
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Pridmore, Saxby, Helen Hornsby, David Hay, and Ivor Jones. "Survival Analysis and Readmission in Mood Disorder." British Journal of Psychiatry 165, no. 6 (December 1994): 824–27. http://dx.doi.org/10.1192/bjp.165.6.824.
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BackgroundThis is an exploratory study of readmission in mood disorder.MethodThe study is naturalistic and employs survival analysis. We identified 821 individuals with ICD–9 diagnoses, drawn from the Tasmanian Mental Health Register.ResultsNo demographic variables influence the time to readmission. Two groups emerge: those with affective psychoses, and those with neurotic depression, brief depressive reaction and depressive disorders not elsewhere classified. The former group demonstrated shorter times to readmission than the latter. There was no support for a unipolar–bipolar distinction.ConclusionsAffective psychoses have a less favourable outcome than expected. There was support for an endogenous-neurotic distinction.
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Raja, P., and R. Rajaselvan. "Prevalence of anemia in school children in the age group of 8 to 14 years in Thiruvarur, Tamilnadu, India." International Journal of Contemporary Pediatrics 6, no. 4 (June 27, 2019): 1428. http://dx.doi.org/10.18203/2349-3291.ijcp20192168.
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Background: Iron deficiency is responsible for most of the nutritional anemia. Hemoglobin concentration is a reliable indicator of anemia at the population level, as opposed to clinical measures which are subjective and therefore have more room for error. Measuring Hemoglobin concentration is relatively easy and inexpensive, and this measurement is frequently used as a proxy indicator of iron deficiency. To study the association of certain risk factors with the prevalence of anemia in school children in the age group of 8-14 years.Methods: The study was conducted from April 2017 to March 2018 in Department of Paediatrics, Government Thiruvarur Medical College, Thiruvarur. The study population consisted of school children in the age group of 8 to 14 years fulfilling the inclusion and exclusion criteria. The sample size was 250. Complete hematological investigations was done to each child for differential diagnosis of anemia.Results: Majority of the children studied had a normal BMI 38.4% (n=96), 16.8% (n=42) were classified as overweight, 9.2% (n=23) were classified as obese. 22.8% (n=57) were classified as having thinness. 12.8% (n=32) were classified as having severe thinness. Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10). Of the 132 children with anemia, majority had mild anemia 64.39% (n=85) followed by moderate 28.03% (n=37) and severe anemia 7.58% (n=10).Conclusions: The prevalence of anemia was significantly higher in female children (64.91%) compared to male children (42.65%). The prevalence of anemia is highest in children with severe thinness (78.13%) followed by children with obesity (73.91%). The most common type of anemia in our study was iron deficiency anemia. Majority of the children were suffering from anemia of mild severity. There was no statistically significant correlation between the prevalence of anemia in children and age and socioeconomic status.
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Kopacz, Marek S., Cathleen P. Kane, Brady Stephens, and Wilfred R. Pigeon. "Use ofICD-9-CMDiagnosis Code V62.89 (Other Psychological or Physical Stress, Not Elsewhere Classified) Following a Suicide Attempt." Psychiatric Services 67, no. 7 (July 2016): 807–10. http://dx.doi.org/10.1176/appi.ps.201500302.
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Koretzky, Martin B., and Alexis S. V. Rosenoer. "MMPI Assessment of Posttraumatic Stress Disorder among Alcoholic Vietnam Veterans." Psychological Reports 60, no. 2 (April 1987): 359–65. http://dx.doi.org/10.2466/pr0.1987.60.2.359.
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One hundred Vietnam-era male veterans in a Veterans Administration. 28-day inpatient alcohol treatment program were classified into combat and noncombat groups according to whether they served in Vietnam or elsewhere during the Vietnam conflict. The MMPI scores of the two groups were compared according to a diagnostic decision-rule developed by Keane, Malloy, and Fairbank in 1984 for posttraumatic stress disorder. Chi-squared analysis showed that the combat group passed the decision-rule in significantly higher numbers than the noncombat group. The results provide evidence that the F-2-8 decision-rule to determine this diagnosis applies to alcoholic as well as nonalcoholic populations.
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Fountoulakis, Konstantinos N. "The Contemporary Face of Bipolar Illness: Complex Diagnostic and Therapeutic Challenges." CNS Spectrums 13, no. 9 (September 2008): 763–79. http://dx.doi.org/10.1017/s1092852900013894.
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AbstractManic depression, or bipolar disorder, is a multifaceted illness with an inevitably complex treatment. The current article summarizes the current status of our knowledge and practice concerning its diagnosis and treatment. While the prototypic clinical picture concerns the “classic” bipolar disorder, today mixed episodes with incomplete recovery and significant psychosocial impairment are more frequent. The clinical picture of these mixed episodes is variable, eludes contemporary classification systems, and possibly includes a constellation of mental syndromes currently classified elsewhere. Treatment includes the careful combination of lithium, antiepileptics, atypical antipsychotics, and antidepressants, but not all of the agents in these broad categories are effective for the treatment of bipolar disorder.
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Makino, Yasuhide, Takeshi Kawauchi, Yoshiki Arakawa, Tomoko Shofuda, Ema Yoshioka, Masahiro Tanji, Yohei Mineharu, Yonehiro Kanemura, and Susumu Miyamoto. "LGG-38. GENETIC ANALYSIS OF NEUROEPITHELIAL TUMORS IN THE PEDIATRIC AND ADOLESCENT AND YOUNG ADULT AGE IN A SINGLE INSTITUTE." Neuro-Oncology 22, Supplement_3 (December 1, 2020): iii373—iii374. http://dx.doi.org/10.1093/neuonc/noaa222.419.
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Abstract Molecular diagnosis in brain tumors has been widely spread after the publication of WHO 2016 classification. But it become a major problem that there are some tumors not to be classified on its criteria, especially in pediatric neuroepithelial tumors. To clarify the characteristics of gliomas in pediatric and adolescent and young adult age (AYA), we picked up 131 neuroepithelial tumors under 30-year-old at Kyoto University and analyze their molecular profiles. Hot spot mutations in IDH1/2, H3F3A, HIST1H3B, TERT promoter, and BRAF were analyzed by Sanger sequencing, and 1p/19q codeletion was examined by FISH or MLPA. With the pathohistological diagnosis and genetic information, all tumors were classified based on WHO 2016 classification. The terms “not otherwise specified” (NOS) and “not elsewhere classified” (NEC) were used based on cIMPACT-NOW. There were 25 glioblastomas and 34 pilocytic astrocytomas, which accounted for a larger percentage than in adult tumors. IDH-wild type gliomas accounted for 55% in diffuse astrocytomas and 69% in anaplastic astrocytomas. The percentages of gliomas with NEC were 50% of oligodendrogliomas and 20% in anaplastic oligodendrogliomas, respectively. Most pilocytic astrocytomas were under 20-year-old (27 patients) and located in infratentorial area (21 patients). Based on WHO 2016 classification, not a few neuroepithelial tumors in pediatric and AYA ages could be classified clearly. These tumors had more different genetic abnormalities than those in adult. Therefore, it may be important to evaluate these tumors with comprehensive genetic analysis.
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Dwivedi, Rajeev, Ruban Joshi, Sagar Panthi, Subin Byanjankar, and Rahul Shrestha. "Outcome of Both Bone Forearm Fracture Fixation in Children by Rush Nails." Journal of Nepal Medical Association 53, no. 200 (December 31, 2015): 244–49. http://dx.doi.org/10.31729/jnma.2739.
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Introduction: Forearm fractures are common upper limb injuries among children and usuallytreated non-operatively. Failure of non-operative treatment, open injuries and multiple fracturesare the indications for surgery in paediatric both bone forearm fractures. Intramedullary nailingis considered as minimally invasive procedure with excellent to fair outcomes but it is not freeof complications. We reviewed the results and evaluated the outcomes of IM fixation of forearmfractures in children by Rush nails to understand the risks and complications associated with theseprocedures.Methods: A retrospective crossectional study of all paediatric patients treated for diaphyseal forearmfractures for period of five years in a tertiary care setup. Complications were classified accordingto modified Clavien-Dindo complication classification system. Outcomes were graded dependingupon complication grade along with range of motion of forearm.Results: A total of 25 patients were included in the study. Mean time for fracture union was 10.56weeks. Outcomes were excellent in 16 (64%), good in 7 (28%), fair in 2 (8%) patients and no pooroutcome was noted. Ten minor complications were seen.Conclusion: Fixation of paediatric forearm fractures by intramedullary Rush nail is minimallyinvasive procedure and outcomes are excellent to fair with acceptable complication rates.Keywords: complication; forearm fractures; intramedullary nailing; outcome; paediatrics; Rush nail.
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Lingzhi, Zhang. "Analysis on Trade Competitiveness and Trade Complementarity between Uzbekistan and the Member States of Eurasian Economic Union." International Journal of Innovation and Economic Development 7, no. 2 (2021): 7–19. http://dx.doi.org/10.18775/ijied.1849-7551-7020.2015.72.2001.
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Based on the 2010-2019 United Nations commodity trade data, this paper has calculated the regional revealed comparative advantage index, export similarity index, trade complementarity index and intra-industry trade index of trade between Uzbekistan and the member states of the Eurasian Economic Union. This paper analyses the competitiveness and complementarity of trade between Uzbekistan and the member states of the Eurasian Economic Union. Uzbekistan and the Eurasian Economic Union member countries have a high degree of similarity in the export of commodities. There is a certain degree of competitiveness in commodities exported to the same market. However, there are differences in the structure of commodity trade among member states. Uzbekistan’s trade complementarity with the member states of the Eurasian Economic Union is distributed in food and live animals (SITC0), mineral fuels, lubricants and related materials (SITC3), manufactured goods classified chiefly by material (SITC6), commodities and transactions not classified elsewhere in the SITC (SITC9). Uzbekistan has strong trade complementarity with Armenia, Belarus and Kyrgyzstan, but weak trade complementarity with Russia and Kazakhstan.
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Sweeney, Vincent P., Adele D. Sadovnick, and Vilma Brandejs. "Prevalence of Multiple Sclerosis in British Columbia." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 13, no. 1 (February 1986): 47–51. http://dx.doi.org/10.1017/s0317167100035782.
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ABSTRACT:A province wide prevalence study on multiple sclerosis (MS) was conducted in British Columbia (B.C.). The prevalence date was July 1, 1982. The major portion of this study was a review of all the files of neurologists practicing in B.C. as this was judged to be the most accurate source for identifying MS patients. 239,412 neurologists' files were hand searched by one researcher using modified Schumacher criteria for classification. Other sources used during the study for identifying MS patients were the MS Clinic, general practitioners, ophthalmologists, urologists, specialized facilities such as long term care facilities and rehabilitation centres, and patient self-referrals.A total of 4,620 non-duplicated cases were identified and classified. 4,112 of these (89%) were classified according to information contained in neurologists' records.The prevalence estimate for definite/probable MS in B.C. was 93.3/100,000 population. This increased to 130.5/100,000 population if possible MS and optic neuritis were also included. These rates are among the highest reported in Canada or elsewhere. The cooperation of B.C. neurologists made this study unique in its scope and accuracy of diagnosis.
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Cimino, J. J. "Desiderata for Controlled Medical Vocabularies in the Twenty-First Century." Methods of Information in Medicine 37, no. 04/05 (October 1998): 394–403. http://dx.doi.org/10.1055/s-0038-1634558.
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AbstractBuilders of medical informatics applications need controlled medical vocabularies to support their applications and it is to their advantage to use available standards. In order to do so, however, these standards need to address the requirements of their intended users. Overthe past decade, medical informatics researchers have begun to articulate some of these requirements. This paper brings together some of the common themes which have been described, including: vocabulary content, concept orientation, concept permanence, nonsemantic concept identifiers, polyhierarchy, formal definitions, rejection of “not elsewhere classified” terms, multiple granularities, mUltiple consistent views, context representation, graceful evolution, and recognized redundancy. Standards developers are beginning to recognize and address these desiderata and adapt their offerings to meet them.
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Utami, Surti Nur, and Rina Wahyuni. "HOW DOES GROUP DISCUSSION MINIMIZE ON TASK BEHAVIOR." UAD TEFL International Conference 1 (November 20, 2017): 485. http://dx.doi.org/10.12928/utic.v1.204.2017.
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This research investigated the students learning behavior during the Reading class. The aimed of this study was improving students’ on-task behavior using group discussion. Furthermore, this study reveals the students’ attitudes who mostly were not directing their eyes gaze at the teacher and the instructional activity. For instance, the students did not pay attention toward appropriate instructional material and they were looking elsewhere. Thus, that behave was classified as off-task. While On-task behavior was defined as activity that complied with instructions given by the teacher for that lesson. Based on the previous matter, the use of group discussion during the classroom activities is definitely a fascinating phenomenon that can improve their on-task behavior during the learning activities in the class, especially reading.
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Andon, N'guessan Simon, Kouadio Augustin Alla, and Kouacou Jean-Marie Atta. "Participation in the Management of a Peri-Urban Protected Forest in Northern Côte d'Ivoire: Case of the Mount Korhogo Classified Forest." European Journal of Social Sciences 1, no. 3 (November 29, 2018): 21. http://dx.doi.org/10.26417/ejss.v1i3.p21-33.
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The evolution of tropical forest deforestation in Côte d'Ivoire is very alarming. From 16 million hectares in 1900, the area increased to 9 million hectares in 1965 to less than 2.5 million hectares in 2016. Even forests protected by the State of Côte d'Ivoire are not spared while peri-urban protected forests are the most exposed. The finding reveals many shortcomings in the state monopoly of protected area management. Yet, elsewhere in Africa, many experiences of participatory management have shown significant advances in protection and their introduction in Côte d'Ivoire from 1990. To understand the effectiveness of this new consultation framework adopted as a management tool, national policies and locally adopted strategies on the Mount Korhogo classified forest in northern Côte d'Ivoire have been analyzed. Results show a failure of participation at the national level since 1996 and a lack of participation at the local level. Despite the establishment of a local committee for forest defense and fight against bush fires, the lack of consultation undermines the proper functioning of this organization, thus leading to the exacerbation of deforestation. Mount Korhogo Classified Forest.Keywords: participatory management, consultation framework, protected forest, urbanization, deforestation
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Clemmensen, L. B., and H. F. Jepsen. "Lithostratigraphy and geological setting of Upper Proterozoic shoreline-shelf deposits, Hagen Fjord Group, eastern North Greenland." Rapport Grønlands Geologiske Undersøgelse 157 (January 1, 1992): 1–27. http://dx.doi.org/10.34194/rapggu.v157.8195.
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During the Late Proterozoic a more than 1000 m thick succession of sediments was deposited on the shelf fringing the north-eastern corner of the Greenland craton. These sediments were classified together with an underlying turbidite sequence in the Hagen Fjord Group (Haller, 1961), which is here redefined to contain only Upper Proterozoic, mainly shallow marine shelf deposits outcropping between Independence Fjord and Kronprins Christian Land in eastern North Greenland. Both siliciclastic and carbonate sedimentation occurred during the Late Proterozoic, and the changing tectonic environment along the northern and eastern shelf-margin of Greenland at that time is well recorded within the sediment sequence. Correlation of the Hagen Fjord Group with similar shelf deposits elsewhere along the eastern and northern margin of the Canadian-Greenlandian Shield is discussed.
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Matthews, Peter C. "Pathological Habit Disorder?" Canadian Journal of Psychiatry 33, no. 9 (December 1988): 826–29. http://dx.doi.org/10.1177/070674378803300908.
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This paper outlines a diagnostic entity called ‘Pathological Habit Disorder’ which is suggested for inclusion in the DSM as an Axis II option. Specific areas of concern, either mental (Axis I) or physical (Axis III), would delineate the syndrome. Pathological Habit Disorder (PHD) points to treatment options where the syndrome is wholly or partly habit-driven. Whether the syndrome is habit-driven or not will remain a clinical judgement even though many conditions, previously thought immutable except by medication, are proving accessible to behavioural engineering. In the ICD system, PHD seems to fit in “Special Symptoms or Syndromes not elsewhere Classified”. It is demonstrably useful to have a diagnosis such as PHD and to incorporate it into the body of medical classification, recognizing current practices for dealing with unwelcome or damaging habits.
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Kulkarni, Sudhir A., and Shridhar R. Gadre. "On the Topography of Electron Momentum Densities of Linear Molecules." Zeitschrift für Naturforschung A 48, no. 1-2 (February 1, 1993): 145–50. http://dx.doi.org/10.1515/zna-1993-1-233.
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Abstract A topographical study of the electron momentum density (EMD) of some linear molecules is presented with special emphasis on the bond-directionality principle. A new approach to the bond-directionality (BD) principle has been proposed. This is based on the analysis of curvatures of critical points at p = 0 and elsewhere on the bonding axis. The linear molecules are classified into three broad categories: those which fully obey or disobey the BD principle as well as those which satisfy it only partly. The Laplacian of the EMD at p = 0 has been associated with the quality of the wavefunction via the electron density in the tail region. Also, the similarity in the critical structure of both the EMD and the spherically averaged EMD at the origin is brought out.
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el-Yazigi, A., K. Chaleby, and C. R. Martin. "A simplified and rapid test for acetylator phenotyping by use of the peak height ratio of two urinary caffeine metabolites." Clinical Chemistry 35, no. 5 (May 1, 1989): 848–51. http://dx.doi.org/10.1093/clinchem/35.5.848.
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Abstract We describe a simplified liquid-chromatographic test in which acetylator phenotype is determined by measuring the peak height ratio of two urinary caffeine metabolites, 5-acetylamino-6-formylamino-3-methyluracil and 1-methylxanthine. We applied this test to determine the acetylator phenotypes of 52 subjects who regularly drink coffee, tea, or caffeinated beverages. Also, we determined the acetylator phenotypes of these subjects according to a well-established sulfasalazine test, which yielded identical results. We established the reproducibility of the described test by determining the acetylator phenotypes of 10 additional subjects on two different days separated by a period of two to five weeks. Of the 52 subjects examined by both tests, 40 (76.9%) were classified as slow acetylators, which agrees well with the percentage reported elsewhere for 297 similar subjects from the Saudi population.
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Masaki, Motofumi, and Akira Koizumi. "Demographic characteristics and their genetic implications in a small island." Journal of Biosocial Science 20, no. 2 (April 1988): 225–34. http://dx.doi.org/10.1017/s0021932000017454.
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SummaryThe family registration records from a village population in a small island of Japan are used to assess the effect of demographic differentiation within a population on genetic measures. When the couples studied are classified by birth cohorts and origins, wives of the couples where one spouse came from elsewhere were older at marriage and had a shorter duration of marriage or registration than wives where both spouses were natives of the village. The mean number of offspring is statistically smaller in the former except for the latest cohort, due mainly to out-migration during the reproductive ages which also resulted in low rates of marriage among the offspring within the village. This leads to a small effective population size and an increased likelihood of genetic drift in the overall population.
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Rivera, Paola A., Akash Gupta, and Ninani Kombo. "Treatment of non-infectious retinal vasculitis." Therapeutic Advances in Ophthalmology 15 (January 2023): 251584142311527. http://dx.doi.org/10.1177/25158414231152761.
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Retinal vasculitis (RV) refers to an entity in which the retinal vasculature is inflamed, frequently with indications of inflammation elsewhere in the eye. Non-infectious RV can be idiopathic or associated with systemic disease, ocular conditions, and malignancy. It can also be classified based on the vessel affected: artery, vein, or both. Due to the lack of strong evidence-based treatment trials and algorithms for RV, physicians must often rely on their experience, which creates great variability in treating this entity. This article provides an overview of various treatment modalities used in the management of non-infectious RV, with a focus on immunomodulatory therapies. We outline a potential stepwise approach of starting with steroids to control the acute inflammation and subsequently changing to immunomodulatory therapy (IMT) for long-term treatment.
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Nagy, Barnabás. "A Mecsek Orthoptera faunájának jellegzetes vonásai." Natura Somogyiensis, no. 9 (2006): 153–66. http://dx.doi.org/10.24394/natsom.2006.9.153.
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The Mecsek Mts and the Villány Hills represent the most southern (low)mountain region of Hungary. Here 63 grasshopper species were detected (=51,6% of the total Hungarian Orthoptera fauna), however, several in Hungary elsewhere common species were not found. High percentage of some Mediterranean, Balkan and other, elsewhere in Hungary rare or missing Orthoptera species (as e.g. Poecilimon fussi, Poecilimon intermedius, Isophya costata, I. modestior, I. modesta, I. camptoxypha, Sagapedo, Odontopodisma decipiens, O. schmidtii, Aiolopus strepens, Acrotylus insubricus, etc.), are characteristic to this fauna and to these grasshopper assemblages. The joint and frequent occurrence of bigger, mostly predaceous decticines (3 Pholidoptera spp., Pachytrachis gracilis, Pterolepis germanica) is also remarkable. Species being under legislative nature protection in Hungary amounted to 10 taxons (=15,9 %) in the Mecsek, - among them with two sub-endemics for the Carpathian Basin: Isophya costata and /. camptoxypha. However, during the last decades some flightless phaneropterids (/. modesta, I. camptoxypha, I. modestior) seem to have suffered local extiction around settlements due to the urbanization pressure. Species occurring in the Mecsek Mts were classified according to their phenology. The northernmost sites of the area of Aiolopus strepens - the adults overwinter - were detected in the Mecsek. Places of occurrence of rare and protected species {Isophya spp., Poecilimon intermedius, Aiolopus strepens) are endangered by habitat destruction, especially around the city Pécs, that is extending to parts of the southern slopes of the Misina Mt (535 m).
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Paltridge, Rachel. "The diets of cats, foxes and dingoes in relation to prey availability in the Tanami Desert, Northern Territory." Wildlife Research 29, no. 4 (2002): 389. http://dx.doi.org/10.1071/wr00010.
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In most areas of Australia, mammals constitute the staple diets of cats, foxes and dingoes. In central Australia the abundance of mammals is often too low to meet the dietary requirements of these carnivores and yet populations of cats, foxes and dingoes persist. To investigate alternative feeding strategies of cats, foxes and dingoes in arid environments, their diets were monitored in relation to prey availability in two areas of the Tanami Desert where rabbits do not occur. Dietary information was obtained by analysing predator scats collected between 1995 and 1997. Prey availability was monitored by track counts, pitfall trapping, Elliott trapping, and bird counts along walked transects. In contrast to dietary studies elsewhere in Australia, it was found that reptiles were an important component of the diets of predators in the Tanami Desert, and should be classified as seasonal staples. Birds increased in importance in the diets of cats and foxes during the winter, when reptiles were less active. There was considerable overlap between the diets of all three predators, although dingoes ate more large prey items (e.g.�macropods) than the other two predators. Results highlight the opportunistic feeding habits of cats, foxes and dingoes and show that, although mammalian prey are less important in central Australia than has been found elsewhere, species that are vulnerable to extinction, such as the bilby (Macrotis lagotis), mulgara (Dasycercus cristicauda) and marsupial mole (Notoryctes typhlops), are also consumed by these predators.
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Bisio, G. "Exergy Analysis of Thermal Energy Storage With Specific Remarks on the Variation of the Environmental Temperature." Journal of Solar Energy Engineering 118, no. 2 (May 1, 1996): 81–88. http://dx.doi.org/10.1115/1.2848020.
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Energy storage is a key technology for many purposes and in particular for air conditioning plants and a successful exploitation of solar energy. Thermal storage devices are usually classified as either variable temperature (“sensible heat”) or constant temperature (“latent heat”) devices. For both models a basic question is to determine the efficiency suitably: Only exergy efficiency appears a proper way. The aim of this paper is to examine exergy efficiency in both variable and constant temperature systems. From a general statement of exergy efficiency by the present author, two types of actual definitions are proposed, depending on the fact that the exergy of the fluid leaving the thermal storage during the charge phase can be either totally lost or utilized elsewhere. In addition, specific remarks are made about the exergy of a system in a periodically varying temperature environment.
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Wang, Hongren, Zhiguo Yuan, Eleanor Barnes, Manqiong Yuan, Chunhua Li, Yongshui Fu, Xueshan Xia, et al. "Eight novel hepatitis C virus genomes reveal the changing taxonomic structure of genotype 6." Journal of General Virology 94, no. 1 (January 1, 2013): 76–80. http://dx.doi.org/10.1099/vir.0.047506-0.
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Analysis of partial hepatitis C virus sequences has revealed many novel genotype 6 variants that cannot be unambiguously classified, which obscure the distinctiveness of pre-existing subtypes. To explore this uncertainty, we obtained genomes of 98.0–98.8 % full-length for eight such variants (KM35, QC273, TV257, TV476, TV533, L349, QC271 and DH027) and characterized them using phylogenetic analyses and per cent nucleotide similarities. The former four are closely related phylogenetically to subtype 6k, TV533 and L349 to subtype 6l, QC271 to subtypes 6i and 6j, and DH027 to subtypes 6m and 6n. The former six defined a high-level grouping that comprised subtypes 6k and 6l, plus related strains. The threshold between intra- and inter-subtype diversity in this group was indistinct. We propose that similar results would be seen elsewhere if more intermediate variants like QC271 and DH027 were sampled.
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Pérez Tadeo, María, Martin Gammell, and Joanne O'Brien. "First Steps towards the Automated Detection of Underwater Vocalisations of Grey Seals (Halichoerus grypus) in the Blasket Islands, Southwest Ireland." Journal of Marine Science and Engineering 11, no. 2 (February 4, 2023): 351. http://dx.doi.org/10.3390/jmse11020351.
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Underwater vocalisations of grey seals (Halichoerus grypus) were recorded by static acoustic monitoring (SM2M, Wildlife Acoustics) in the vicinity of a colony located at White Strand beach on Great Blasket Island, southwest Ireland during the pre-breeding and breeding seasons. Grey seal vocalisations were first classified across nine different categories based on aural and visual characteristics of the spectrograms, providing an acoustic repertoire for grey seals. This classification was further investigated by applying a classification tree analysis, resulting in five of the initial nine groups being selected. Furthermore, a comparison of two common approaches for the detection and extraction of vocalisations from acoustic files was done using the software Raven Pro and PAMGuard. The outputs of this study will present an essential first step towards the development of a protocol for underwater acoustic monitoring of grey seals in Irish waters and elsewhere.
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Desouza, Jinela, Mohan Patil, Yamini S., and A. B. Kurane. "Cerebral palsy: comorbidities, the second hidden side." International Journal of Contemporary Pediatrics 7, no. 11 (October 21, 2020): 2180. http://dx.doi.org/10.18203/2349-3291.ijcp20204541.
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Background: Cerebral palsy (CP) is the most common group of permanent disorders of motor impairment resulting from injury in the developing brain which are accompanied by comorbidities. Moreover, it has been observed that because of physical disabilities, the underlying comorbidities are neglected. The study aimed to assess the co-morbidities in children suffering from cerebral palsy in Kolhapur district.Methods: The cross-sectional study was conducted among children suffering from cerebral palsy and presenting to Department of Paediatrics (n=250), D. Y. Patil Medical College, between October 2018 to October 2019. Detailed history with clinical examination were recorded in a pre-designed performa. The patients were classified according to the physiological and topographical classification. Data was analyzed using R software version 3.6.1. Variables were represented using frequency distribution, (p<0.05).Results: Of the total participants (n=250), male predominance was observed (n=140); with age range of 1-18 years. Common form of cerebral palsy was spastic type (n=140; 56%). Most common type among spastic CP was diplegia (n=96; 38%). Children were suffering from speech abnormality in spastic CP cases (n=65). Among spastic hemiplegic cases all the children were suffering from intellectual disability (n=3).Conclusion: Thus, it can be concluded that the motor impairment in just the top notch, the actual disability is the underlying co morbidities.
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E.O., Ewunonu. "Incidence of brachycephalization among Nigerians." Journal of Scientific and Innovative Research 5, no. 2 (April 25, 2016): 43–45. http://dx.doi.org/10.31254/jsir.2016.5203.
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Background- The study of head dimension is of considerable anthropological interest especially in the study of the growth in shape of the head. The incidence of brachycephalization in Nigeria was established by carrying out an analysis of the craniometric study of the three major tribes in Nigeria. Similar reports have been made elsewhere within and outside Africa. Materials and Method- A cross sectional measurement of the head length and head breadth was carried out on regional basis on 500 subjects each from Hausa, Ibo and Yoruba tribes of Nigeria. The Cephalic Index was calculated accordingly and classified. Result- The Mean Cephalic Index of the Hausa subjects was 80.20 ± 2.66 while the mean values for Ibo and Yoruba subjects were 82.40 ± 2.91 and 82.20 ± 3.09 respectively. Conclusion- The present report shows that Cephalic Index of Nigerians appreciated from the mesocephalic values reported by earlier researchers to brachycephalization.
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Ross, PM. "Differences in morphology and reproduction of the barnacles Elminius covertus and Hexaminius spp. from mangrove forests in the Sydney region of New South Wales." Marine and Freshwater Research 47, no. 5 (1996): 715. http://dx.doi.org/10.1071/mf9960715.
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E. covertus is found on bark and leaves of the grey mangrove Avicennia marina, H. foliorum is found on leaves and H. popeiana is found on bark. 7655 barnacles were collected from two sites at Woolooware Bay from winter 1987 to summer 1989. Reproductive and external features in E. covertus differed depending on the substratum on which it lived; reproductive output was greater on leaves than on bark. The genus Hexaminius has been classified elsewhere as two species on the basis of external features and reproductive differences of adults, larval development and larval setation; however, the adults were living on different substrata. A detailed study of larval and juvenile stages of Hexaminius in the field showed no differences in external features until juveniles were one month old and no differences in the time taken to rear cyprid larvae. This suggests that Hexaminius should not continue to be divided into two species.
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Feng, Shuxian, and Toshiya Yamamoto. "Preliminary research on sponge city concept for urban flood reduction: a case study on ten sponge city pilot projects in Shanghai, China." Disaster Prevention and Management: An International Journal 29, no. 6 (November 9, 2020): 961–85. http://dx.doi.org/10.1108/dpm-01-2020-0019.
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PurposeThis research aimed to determine the differences and similarities in each pilot project to understand the primary design forms and concepts of sponge city concept (SCC) projects in China. It also aimed to examine ten pilot projects in Shanghai to extrapolate their main characteristics and the processes necessary for implementing SCC projects effectively.Design/methodology/approachA literature review and field survey case study were employed. Data were mostly collected through a field survey in Shanghai, focusing on both the projects and the surrounding environment. Based on these projects' examination, a comparative method was used to determine the characteristics of the ten pilot SCC projects and programs in Shanghai.FindingsSix main types of SCC projects among 30 pilot cities were classified in this research to find differences and similarities among the pilot cities. Four sponge design methods were classified into ten pilot projects. After comparing each project size using the same geographical size, three geometrical types were categorized into both existing and new city areas. SCC project characteristics could be identified by combining four methods and three geometrical types and those of the SCC programs by comparing the change in land-use and the surrounding environment in ten pilot projects.Originality/valueThe results are valuable for implementing SCC projects in China and elsewhere and future research on the impact of SCC projects.
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Purkait, Radheshyam, and Rajarshi Basu. "The changing clinico-demographic profile of dengue infection in children: a hospital-based study from eastern India." International Journal Of Community Medicine And Public Health 7, no. 5 (April 24, 2020): 1901. http://dx.doi.org/10.18203/2394-6040.ijcmph20202003.
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Background: Many parts of India, including the eastern regions, are now endemic for the dengue infection with increased recognition of atypical neurological manifestations apart from the classical clinical features.Methods: This prospective study was conducted in the department of paediatrics in a tertiary care teaching hospital in eastern India from July 2019 to November 2019 to determine the changing trends of the clinical features in the dengue patients of this region in the recent years among paediatric populations. All the serologically confirmed dengue patients admitted during this period satisfying the inclusion criteria were enrolled in the study population and classified as per new WHO-2009 classification into: dengue fever without warning signs (DF), dengue fever with warning signs (DFWS) and severe dengue (SD). Detailed history, clinical and laboratory parameters were recorded and analysed for all children.Results: Out of the total of 110 cases, 16 cases (14.55%) were DF, 80 cases (72.73%) were DFWS and 14 cases (12.73%) were SD. The commonest age group affected (63.64 %) was between 4-<10 years. The male: female ratio of cases was 1.68:1. Besides classical clinical manifestations, we observed CNS involvement in nine cases (8.18%). Among them, five patients had dengue encephalitis, two patients had dengue encephalopathy, one patient had hypokalemic paralysis and one patient had Guillain-Barré syndrome. All the patients were treated as per standard guidelines.Conclusions: Clinician must be aware of such association during dengue outbreak because early diagnosis and appropriate supportive care can reverse this potentially fatal disease.
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Tehreem Afzal, Naveed Butt, and Shahzad Munir. "Effect of Addition of Nebulized Magnesium Sulphate to Standard Therapy in Children with Severe Asthma." Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University 17, no. 4 (February 4, 2022): 295–99. http://dx.doi.org/10.48036/apims.v17i4.419.
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Objective: To compare the outcome of addition of nebulized magnesium sulphate to the standard treatment in children with acute severe asthma. Methodology: The trial was undertaken at the emergency of Paediatrics Department, Federal Government Polyclinic (Post Graduate Medical Institute), Islamabad from 1st April to 30th September 2019.Children between 1 to 12 years of age with acute severe asthma were initially nebulized with salbutamol thrice and ipratropium once.All the patients were also given intravenous steroid.Those not responding to this treatment and still classified as acute severe asthma were randomly divided into two groups each having 38 patients.Each patient in Group A received 2.5 ml (150 mg) of isotonic magnesium sulphate via nebulizer, thrice20 minutes apart, while group B received 2.5 ml of isotonic saline via nebulizer, thrice20 minutes apart.Each nebulization also contained salbutamol. Yung Asthma Severity Score (ASS) was determined at the start of treatment, at30 minutes and at 60 minutes of treatment. Results: After 60 minutes, the mean Asthma Severity Score of children in group A was 6.95 ± 1.29 and 7.63 ± 1.03 in group B (p < 0.05). In group A, 18 (47.4%) children were discharged and 20 (52.6%) were admitted in the hospital. In group B, 7 (18.4%) children were discharged while 31 (81.6%) were admitted in the hospital (p < 0.05). Conclusion: It is concluded that nebulized magnesium sulphate along with salbutamol can give a better outcome than salbutamol alone in children with acute severe asthma.
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Jayanath, Subhashini, and Sally Ozonoff. "First Parental Concerns and Age at Diagnosis of Autism Spectrum Disorder: A Retrospective Review from Malaysia." Malaysian Journal of Medical Sciences 27, no. 5 (October 27, 2020): 78–89. http://dx.doi.org/10.21315/mjms2020.27.5.8.
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Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder. This is the first study to examine first parental concerns in ASD in Malaysia. We examined: i) age and type of first parental concerns (AOC); ii) association between AOC and severity; iii) time lag between AOC and diagnosis; and iv) factors associated with diagnostic delay. Methods: Medical records of 366 patients (aged 1–18 years) with ASD, at the Developmental Paediatrics Clinic of University of Malaya Medical Centre (UMMC), Kuala Lumpur, were reviewed for this 16-month retrospective cohort study. A validated coding system was used for initial parent concerns. Severity was classified via the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) criteria. Time lag between AOC and age at diagnosis (AOD) was calculated. Potential predictors of delayed diagnosis were extracted. Results: Three-quarters (75.1%) of parents had concerns by 36 months. Speech/language/ communication concerns were most frequent (60.1%). Number of first concerns was significantly correlated with severity (social communication/interaction, SCI [P = 0.019] and restricted, repetitive patterns of behaviours and/or interests/activities, RRB [P < 0.001]). AOC and AOD were significantly negatively correlated with SCI and RRB (P < 0.001). Medians; AOC: 24 months, AOD: 46 months and time lag: 17 months. Higher initial screen time was associated with diagnostic delay (P = 0.031). Conclusion: First parental concerns and AOD were comparable to studies across countries. Speech/communication delays may represent universal first parental recognition of ASD.
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O'Regan, Patrick W., Jennifer M. Ní Mhuircheartaigh, Timothy G. Scanlon, and Martin J. Shelly. "Radiology of the Mesentery." Clinics in Colon and Rectal Surgery 35, no. 04 (July 2022): 328–37. http://dx.doi.org/10.1055/s-0042-1744481.
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AbstractThe recent description and re-classification of the mesentery as an organ prompted renewed interest in its role in physiological and pathological processes. With an improved understanding of its anatomy, accurately and reliably assessing the mesentery with non-invasive radiological investigation becomes more feasible.Multi-detector computed tomography is the main radiological modality employed to assess the mesentery due to its speed, widespread availability, and diagnostic accuracy.Pathologies affecting the mesentery can be classified as primary or secondary mesenteropathies. Primary mesenteropathies originate in the mesentery and subsequently progress to involve other organ systems (e.g., mesenteric ischemia or mesenteric volvulus). Secondary mesenteropathies describe disease processes that originate elsewhere and progress to involve the mesentery with varying degrees of severity (e.g., lymphoma).The implementation of standardized radiological imaging protocols, nomenclature, and reporting format with regard to the mesentery will be essential in improving the assessment of mesenteric anatomy and various mesenteropathies.In this article, we describe and illustrate the current state of art in respect of the radiological assessment of the mesentery.