Current Usefulness Research Articles

Decreased susceptibility to cephalosporins among gonococci: data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) in England and Wales, 2007–2011

Effective treatment of gonorrhoea is fundamental to public health control; however, the ability of Neisseria gonorrhoeae to successively develop resistance to different treatments has hampered control efforts. The extended-spectrum cephalosporins--cefixime and ceftriaxone--have been recommended in the UK for treatment of gonorrhoea since 2005. We looked at surveillance data from England and Wales to ascertain the current usefulness of these drugs and to inform changes to national treatment guidelines. We obtained data from the Gonococcal Resistance to Antimicrobials Surveillance Programme (GRASP) for patients attending 26 genitourinary medicine clinics in England and Wales between 2007 and 2011. We did analyses with univariate and multivariable logistic regression methods to identify trends in susceptibility to cephalosporins and risk factors associated with infection with isolates with decreased susceptibility to cefixime, and we assessed changes in prescribing practices. We did molecular typing to investigate genetic relatedness of non-susceptible isolates. The prevalence of decreased susceptibility to both cefixime and ceftriaxone rose between 2007 and 2010 but was more noticeable for cefixime (an increase from 1·5% in 2007 to 17·1% in 2010), with a bimodal distribution of minimum inhibitory concentration recorded between 2009 and 2010. By multivariable analysis, isolates with decreased susceptibility to cefixime were associated with infection in men who have sex with men (odds ratio 5·47, 95% CI 3·99-7·48; p<0·0001) and year of isolation (in 2010, 13·08, 7·49-22·8; p<0·0001). Such isolates had a largely clonal population, with most belonging to genogroup G1407 and harbouring the penA mosaic gene. Data from 2011 showed a significant decline in prevalence of isolates with decreased cefixime susceptibility, falling from 17·1% in 2010 to 10·8% in 2011 (p<0·0001), concomitant with the change in prescribing practice in 2010 from cefixime to ceftriaxone plus azithromycin. Guidance for treatment of gonorrhoea in England and Wales was changed in 2010 to prolong the use of cephalosporins. The decline in prevalence of isolates with decreased cefixime susceptibility cannot be attributed unequivocally to this change in prescribing practice; however, the association is striking. Department of Health (England), Public Health England.

A method of feature selection and sentiment similarity for Chinese micro-blogs

Sentiment analysis of messages posted on micro-blogs is helpful in determining the current usefulness and acceptability of target products or services. It is the basis for finding users with similar attitudes. In this paper, we propose a new sentiment similarity technique to analyse Chinese micro-blog accounts. However, the Chinese text features have not been well studied. Therefore, we first chose four types of feature sets and selected principle features by combining information gain and support vector machine techniques. Next, we compared the four types of features to determine which type of feature contributed more than others. Here we used three classification techniques: decision tree, support vector machines and naive Bayes. Finally, we used Karhunen–Loéve transform technique and average precision between positive and negative features to measure sentiment similarity. Experiment evaluations demonstrated that this new method is efficient and performs better than original average distance for Chinese micro-blogs.

Abstract TP408: Availability and Efficacy of Mobile Health Technology Targeting Patients: A Systematic Evidence-based Review

BACKGROUND: There are approximately 14,000 health/medical iPhone apps with a relative lack of both stroke-specific content and studies on effectiveness, usability, and usefulness. OBJECTIVE: Systematic, evidence-based literature search to determine the current availability, usefulness, and efficacy of mobile apps targeting stroke survivors or management of vascular risk factors. METHODOLOGY: Repetitive search study in PubMed and EMBASE using pre-specified medical subject headings (MeSH) terms, Boolean logic, and Preferred Reporting items for Systematic Reviews and Meta-analysis (PRISMA) guidelines (last updated 8/12/12). Publications were screened for inclusion using the following criteria: (1) potential usefulness of smartphones in daily patient care, (2) meta-analyses of stroke/vascular risk factor smartphone applications, (3) trials of smartphone-based patient care tools. RESULTS: We retrieved 73 articles from 2005-12 from 77 identified; 40/73 were duplicates. The remaining 33 abstracts were reviewed independently by 3 reviewers for relevance. Upon final evaluation/adjudication: 13 articles addressed potential usefulness of smartphones, 3 were on traditional specific stroke risk factors (none for stroke itself), and 8 on the results of trials of smartphone-based patient care tools. Sample sizes ranged from 3 to 3,001. Four articles addressed diabetes, two hypercholesterolemia, three weight loss, three diet/activity, one heart disease, and none addressed hypertension specifically. Of these, 8 were clinical trials on effectiveness or usefulness (3 for patient evaluation/monitoring, 2 for rehabilitation, 1 each for diet/activity, imaging, and drug infusion). Only one study evaluated risk analysis of information security with no studies evaluating strict regulation and critical appraisal. CONCLUSION: Despite rapid growth of mobile health applications, there is a paucity of linguistically relevant and culturally sensitive and sustainable stroke-specific apps. There is also a significant lack of studies in general that rigorously test mobile apps for their efficacy, usefulness, and sustainability with specific attention to patient privacy and regulatory compliance.

Positron Emission Tomography Applications in Clinical Neurology

Positron emission tomography (PET) is a molecular imaging technique for developing maps of functional and biochemical activity in target tissues in vivo. PET has led to significant insights into nervous system biology, physiology, and pathophysiology in health and disease. Several of these insights and applications have a direct usefulness for the clinical neurologist. Although [F-18]fluorodeoxyglucose (FDG-) PET has remained a workhorse of PET imaging, many other radiolabeled biomolecules have been studied using PET. This article aims to provide an overview of current clinical usefulness of PET across the neurologic subspecialties including dementias, movement disorders, epilepsy, brain tumors, and neurologic infectious and inflammatory diseases.

Herbal medicine and acupuncture for breast cancer palliative care and adjuvant therapy.

Breast cancer is a life-threatening disease among women worldwide with annual rates of reported incidence and death increasing alarmingly. Chemotherapy is a recommended and effective treatment option for breast cancer; however, the narrow therapeutic indices and varied side effects of currently approved drugs present major hurdles in increasing its effectiveness. An increasing number of literature evidence indicate that complementary and alternative medicine (CAM) used in treatment-related symptom control and alleviation of side effects plays an important role in increasing survival rate and quality of life in breast cancer patients. This review focuses on the use of herbal medicines and acupuncture in palliative care and as adjuvants in the treatment of breast cancer. Herbal medicinal treatments, the correlation of clinical use with demonstrated in vitro and in vivo mechanisms of action, and the use of certain acupoints in acupuncture are summarized. The aim of this review is to facilitate an understanding of the current practice and usefulness of herbal medicine and acupuncture as adjuvants in breast cancer therapy.

Civilization and Its Discontents in Anthropological Perspective, Eight Decades On

Freud's Civilization and Its Discontents (1930; henceforth CD), as its author readily admits, is a sprawling work with numerous side paths and detours that can easily tempt a commentator into exploring them further. In this article, I resist an such temptation and attempt instead to discern the central argument sometimes hidden in the thicket of rhetorical false starts and extended digressions. Once having laid out relatively briefly what I take to be the main argument, I examine it from the perspective of contemporary anthropology, including both evolutionary and cultural points of view, to determine its current validity and usefulness as a way to think about the relationship between nature and culture in human life. Having done that, I then present an alternative view that conserves many of Freud's insights but is not subject to some of the problems in his original analysis.

A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities

A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities

Estado actual y utilidad de la autopsia clínica en una unidad de cuidados intensivos pediátricos

BackgroundsThe autopsy is a diagnostic tool in decline over the last few decades. Our purpose is to describe the autopsy rates, the relationship between clinical and post-mortem diagnosis to evaluate the current overall usefulness of the autopsy. Patients and methodsRetrospective review of all cases in which clinical autopsy was performed between January 2004 and December 2009 in a paediatric intensive care unit (PICU) of a tertiary care hospital. ResultsOf 154 deaths in the PICU during the study period, 23 autopsies were performed (rate 14.9%). Autopsy rates decreased over the study period; from 26% in 2004 to 11% in 2009. There was a complete correlation (class V) in seven patients (29.1%). Some missed minor diagnosis (class IV) were found in four patients. Five patients had class III discrepancies, and four had class II discrepancies. Major diagnoses were missed in three (17.4%) patients, with a potencial adverse impact on survival and that could have changed management in life (Class IA). In three cases (13%) the autopsy results led to parents having genetic counselling. ConclusionsThe autopsy rate in our country is low when compared to other developed countries. The fact that in 69.6% of cases the autopsy revealed new findings related with the illness that caused or contributed to death shows that the reasons for performing the autopsy are still valid.

Comprehensive evaluation of DNA barcoding for the molecular species identification of forensically important Australian Sarcophagidae (Diptera)

Carrion-breeding Sarcophagidae (Diptera) can be used to estimate the post-mortem interval in forensic cases. Difficulties with accurate morphological identifications at any life stage and a lack of documented thermobiological profiles have limited their current usefulness. The molecular-based approach of DNA barcoding, which utilises a 648-bp fragment of the mitochondrial cytochrome oxidase subunitI gene, was evaluated in a pilot study for discrimination between 16 Australian sarcophagids. The current study comprehensively evaluated barcoding for a larger taxon set of 588 Australian sarcophagids. In total, 39 of the 84 known Australian species were represented by 580 specimens, which includes 92% of potentially forensically important species. A further eight specimens could not be identified, but were included nonetheless as six unidentifiable taxa. A neighbour-joining tree was generated and nucleotide sequence divergences were calculated. All species except Sarcophaga (Fergusonimyia) bancroftorum, known for high morphological variability, were resolved as monophyletic (99.2% of cases), with bootstrap support of 100. Excluding S. bancroftorum, the mean intraspecific and interspecific variation ranged from 1.12% and 2.81–11.23%, respectively, allowing for species discrimination. DNA barcoding was therefore validated as a suitable method for molecular identification of Australian Sarcophagidae, which will aid in the implementation of this fauna in forensic entomology.

Relaxation Behavior Study of Ultrasmall Superparamagnetic Iron Oxide Nanoparticles at Ultralow and Ultrahigh Magnetic Fields

Ultrasmall superparamagnetic iron oxide nanoparticles (USPIOs) have attracted attention because of their current and potential usefulness as contrast agents for magnetic resonance imaging (MRI) and nuclear magnetic resonance (NMR). USPIOs are usually used for their significant capacity to produce predominant proton relaxation effects, which result in signal reduction. However, most previous studies that utilized USPIOs have been focused on the relaxation behavior at commonly used magnetic fields of clinical MRI systems (typically 1-3 T). In this paper, magnetic relaxation processes of protons in water surrounding the USPIOs are studied at ultralow (≤10 mT) and ultrahigh magnetic fields (14.1 T). USPIOs used in our experiments were synthesized with a core size of 6 nm, and transferred from organic to water by ligand exchange. The proton spin-lattice relaxation time (T(1)) and spin-spin relaxation time (T(2)) were investigated at ultralow (212 μT for T(2) and 10 mT for T(1)) and at 14.1 T with different iron concentrations. At all of the fields, there is a linear relationship between the inverse of relaxation times and the iron concentration. The spin-spin relaxivity (r(2)) at 14.1 T is much larger than that value of the ultralow field. At ultralow field, however, the spin-lattice relaxivity (r(1)) is larger than the r(1) at ultrahigh field. The results provide a perspective on potential in vivo and in vitro applications of USPIOs in ultralow and ultrahigh field NMR and MRI.

Coronary artery calcium scoring and its impact on the clinical practice in the era of multidetector CT

With the suggestion of coronary artery calcium as an indicator of coronary artery disease 30 years ago, intense and controversial discussion regarding coronary artery calcium has been ongoing. Diverse techniques for evaluation of coronary artery calcium were suggested and validation of its feasibility has been followed up. Following establishment of reference standards, coronary artery calcium became widely utilized in clinical practice and scientific research. Originally coronary artery calcium scoring techniques were developed for prediction of cardiovascular risk. Additionally, coronary artery calcium scoring has been utilized as an indicator for other medical events. Recently, coronary artery calcium scoring used to be applied as a reference standard during scientific research. In this article, the topic of coronary artery calcium, from its introduction to its current usefulness, was discussed from the viewpoints of coronary artery calcium scoring techniques, imaging modalities, validation of the techniques, clinical feasibility of coronary artery calcium scoring beyond traditional cardiovascular risk prediction, and utilization of coronary artery calcium scoring as a reference standard. Popular coronary calcium scoring techniques comprises of Agatston, volume, and mass scores. Through validation of these techniques, pros and cons of each technique were analyzed and proper utility could be suggested. In parallel, the reference standards for Agatston and volume scores were established by age, sex, and race. Through the vigorous controversies, nowadays, the clinical feasibility of coronary artery calcium score as a surrogate marker of cardiovascular risk was acknowledged in the literature.

El radiólogo de urgencias ante el dolor torácico agudo: ¿cómo y para qué debo utilizar los equipos TC multicorte?

Chest pain is a challenging clinical problem in the emergency department. Despite advances in clinical diagnosis, many patients with atypical chest pain are needlessly hospitalized and others are mistakenly discharged. Faced with the specific clinical situation in which a patient has chest pain, an initially normal or inconclusive electrocardiogram, and normal cardiac biomarkers, multislice CT has proven useful for ruling out the conditions that involve the greatest morbidity and mortality and for establishing the cause of pain. This article reviews the current usefulness of multislice CT in the diagnostic workup of patients presenting at the emergency department with chest pain. We review the technique, define the most appropriate population, describe the acquisition protocols, and discuss the advantages and disadvantages of each study protocol.

Usefulness of simulating social phenomena: evidence

This paper discusses partial results of an ongoing project focused on analysing the current usefulness and implications of developing research on agent-based social simulation models beyond academic, hobbyist or educational purposes. Design, development and testing phases of such modelling are discussed along with common issues evidence-driven modellers often face whilst collecting, analysing and modelling quantitative and qualitative data into social simulations. It also includes a discussion on the evidence gathered in published literature and structured interviews with researchers that have lead mid- to long-term (3–5 years) projects on social simulation in Europe and the United States. Finally, good-practice recommendations are put forward by presenting a development methodology fully guided by evidence.

The RAMP Programme: a retrospect

This article reviews the history and progress of the Records and Archives Management Programme (RAMP), under which the General Information Programme (PGI) of UNESCO, in association with the ICA, ran a series of operations between 1979 and the late 1990s. The programme included a number of projects assisting archives services in developing countries, but is best known for its series of published studies and guidelines. There were about 100 of these, written by experts from many countries, providing specialist advice on most aspects of archives and records work. There were four consultative conferences in the period 1979-1989, and a final impact evaluation in 1993, and three review articles in international journals. RAMP publications remain available online, and many of them retain their current usefulness.

Acquisitions As Exaptation: The Legacy of Founding Institutions in the U.S. Commercial Banking Industry

This study focuses on how founding institutions impact intraorganizational capabilities and how such imprints may have different external manifestations in subsequent historical eras. We introduce the concept of exaptation to organizational theory, identifying an important process whereby the historical origin of a capability differs from its current usefulness. Three founding conditions—branching policy, modernization, and political culture—influenced banks’ development of capabilities for managing dispersed branches, and these capabilities subsequently led to variation in banks’ propensity to engage in acquisitions.

Life‐cycle greenhouse gas effects of introducing nano‐crystalline materials in thin‐film silicon solar cells

AbstractSolar PV is widely considered as a “green” technology. This paper, however, investigates the environmental impact of the production of solar modules made from thin‐film silicon. We focus on novel applications of nano‐crystalline Silicon materials (nc‐Si) into current amorphous Silicon (a‐Si) devices. Two nc‐Si specific details concerning the environmental performance can be identified, when we want to compare to a‐Si modules. First, in how far the extra (and thicker) silicon layer (s) affects upstream material requirements and energy use. Second, in how far depositing an extra silicon layer may increase emissions of greenhouse gases as additional emissions of Fluor gases (F‐gases) are associated to this step. The much larger global warming potential of F‐gases (17 200–22 800 times that of CO2) may lead to higher environmental burdens. To date, no study has yet analyzed the effect of F‐gas usage on the environmental profile of thin‐film silicon solar modules. We performed a life‐cycle assessment (LCA) to investigate the current environmental usefulness of pursuing this novel micromorph concept. The switch to the new micromorph technology will result in a 60–85% increase in greenhouse gas emissions (per generated kWh solar electricity) in case of NF3 based clean processing, and 15–100% when SF6 is used. We conclude that F‐gas usage has a substantial environmental impact on both module types, in particular the micromorph one. Also, micromorph module efficiencies need to be improved from the current 8–9% (stabilized efficiency) toward 12–16% (stab. eff.) in order to compensate for the increased environmental impacts. Copyright © 2010 John Wiley &amp; Sons, Ltd.

Current and Potential Usefulness of Pneumococcal Urinary Antigen Detection in Hospitalized Patients With Community-Acquired Pneumonia to Guide Antimicrobial Therapy

The role of pneumococcal urinary antigen detection in the treatment of adults with community-acquired pneumonia (CAP) is not well defined. We assessed the usefulness of pneumococcal urinary antigen detection in the diagnosis and antimicrobial guidance in patients hospitalized with CAP. A prospective study of all adults hospitalized with CAP was performed from February 2007 through January 2008. To evaluate the accuracy of the test, we calculated its sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios. The gold standard used for diagnosis of pneumococcal pneumonia was isolation in blood or pleural fluid (definite diagnosis) and isolation in sputum (probable diagnosis). Antibiotic modifications, complications, and mortality were analyzed. A total of 474 episodes of CAP were included. Streptococcus pneumoniae was the causative pathogen in 171 cases (36.1%). It was detected exclusively by urinary antigen test in 75 cases (43.8%). Sixty-nine patients had CAP caused by a pathogen other than S pneumoniae. Specificity was 96%, positive predictive value ranged from 88.8% to 96.5%, and the positive likelihood ratio ranged from 14.6 to 19.9. The results of the test led the clinicians to reduce the spectrum of antibiotics in 41 patients. Pneumonia was cured in all of them. Potentially, this optimization would be possible in the 75 patients diagnosed exclusively by the test. When its findings are positive, the pneumococcal urinary antigen test is a useful tool in the treatment of hospitalized adult patients with CAP because it may allow the clinician to optimize antimicrobial therapy with good clinical outcomes.

Perspectives of potential donors on cord blood and cord blood cryopreservation: a survey of highly educated, pregnant Korean women receiving active prenatal care

The aim of the study was to investigate the knowledge of cord blood (CB) and attitudes toward CB banking among high-potential donors (i.e., well-educated pregnant Koreans) because their voluntary donation is indispensable to the success of unrelated CB transplantation. Questionnaires examining perspectives on CB were distributed to and completed by 1001 women attending a maternity education program from April to October 2008; 863 women answered that they had heard of CB. We analyzed the 863 questionnaires to identify the sources of information, the plan for CB, the reasons for decisions, beliefs about the potential uses of CB, and knowledge about current therapeutic uses. Most subjects received information from promotional materials distributed by CB banks and the media; however, minimal information was obtained from obstetricians. More than 90% of women who planned to donate cited "altruism," and 75.0% of the "private preservation" group indicated that a desire to "safeguard for the future" was the reason for their decision. The probability of autologous CB transplantation (p = 0.001) and current usefulness were significantly overestimated in the private preservation group (p = 0.02). In addition, 56% of subjects underestimated the probability of identifying a matched CB in the public bank, and the overall rate of correct answers about current usefulness was 57.4%. A considerable portion of educated pregnant Korean women has more than minimal knowledge of CB, but the levels of knowledge regarding the potency of the public bank and the current usefulness and limitations of CB are generally low; in addition, obstetricians play insignificant roles in disseminating knowledge. Providing accurate and detailed information to pregnant women not only via brochures and the media and/or Internet but also by obstetricians would encourage CB donation.

Kinetic performance appraisal of poly(styrene- co-divinylbenzene) monolithic high-performance liquid chromatography columns for biomolecule analysis

A broad appraisal of the kinetic performance of organic polymeric monolithic columns is reported using commercially available poly(styrene- co-divinylbenzene) monolithic columns (Dionex ProSwift™ RP-1S). Analysis of a protein digest sample at elevated temperatures (≥80 °C) indicated no apparent analyte degradation using an inert polymeric stationary phase. Comparison between low molecular weight solute and peptide separations highlighted the markedly different mass transport processes observed on macroporous monolithic beds and an improved C term at elevated temperature in both instances. The current usefulness of this column format for biomolecule analysis was further studied via employment of a kinetic performance characterisation for the first time to provide direction for column development servicing this application.

Rethinking gender, heterosexual men, and women's vulnerability to HIV/AIDS.

Most HIV prevention literature portrays women as especially vulnerable to HIV infection because of biological susceptibility and men's sexual power and privilege. Conversely, heterosexual men are perceived as active transmitters of HIV but not active agents in prevention. Although the women's vulnerability paradigm was a radical revision of earlier views of women in the epidemic, mounting challenges undermine its current usefulness. We review the etiology and successes of the paradigm as well as its accruing limitations. We also call for an expanded model that acknowledges biology, gender inequality, and gendered power relations but also directly examines social structure, gender, and HIV risk for heterosexual women and men.