scholarly journals Defining Hormesis: Evaluation of a Complex Concentration Response Phenomenon

2010 ◽  
Vol 29 (3) ◽  
pp. 235-246 ◽  
Author(s):  
Eric L. Kendig ◽  
Hoa H. Le ◽  
Scott M. Belcher
Keyword(s):  
Dose Response ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Biological Molecules ◽  
Response Theory ◽  
Inappropriate Use ◽  
Toxicological Studies ◽  
History Of ◽  
High Doses ◽  
Dose Responses

Hormesis describes dose-response relationships characterized by a reversal of response between low and high doses of chemicals, biological molecules, physical stressors, or other initiators of a response. Acceptance of hormesis as a viable dose-response theory has been limited until recently, in part, because of poor conceptual understanding, ad hoc and inappropriate use, and lack of a defined mechanism. By examining the history of this dose-response theory, it is clear that both pharmacological and toxicological studies provide evidence for hormetic dose responses, but retrospective examination of studies can be problematic at best. Limited scientific evidence and lack of a common lexicon with which to describe these responses have left hormesis open to inappropriate application to unrelated dose-response relationships. Future studies should examine low-dose effects using unbiased, descriptive criteria to further the scientific understanding of this dose response. A clear, concise definition is required to further the limited scientific evidence for hormetic dose responses.

Clozapine and Seizures: A Review

1994 ◽  
Vol 39 (4) ◽  
pp. 236-238 ◽  
Author(s):  
Peter Toth ◽  
Frances R. Frankenburg
Keyword(s):  
Psychotic Disorders ◽  
Scientific Evidence ◽  
Previous History ◽  
Antipsychotic Agent ◽  
Dose Titration ◽  
Clozapine Treatment ◽  
Concurrent Use ◽  
History Of ◽  
High Doses ◽  
Novel Antipsychotic

Clozapine, a novel antipsychotic agent, is an alternative to standard neuroleptic therapy for psychotic disorders. Some advantages of clozapine over neuroleptics are that it may be a more effective antipsychotic in treatment resistant patients and has a lower incidence of extrapyramidal side effects. However, seizures associated with clozapine treatment occur at a rate of about three percent. Factors which seem to increase the likelihood of seizures include high doses of clozapine, rapid dose titration, the concurrent use of other epileptogenic agents and a previous history of neurological abnormalities. A strategy that has been proposed to reduce the occurrence of seizures is the addition of an anticonvulsant agent. At present, little rigorous scientific evidence exists to establish the effectiveness of this strategy or the choice of an anticonvulsant. However, based on what evidence there is and the side effect profiles of the various anticonvulsants, the authors propose the use of valproic acid for the prophylaxis and management of clozapine related seizures.

Resveratrol commonly displays hormesis: Occurrence and biomedical significance

2010 ◽  
Vol 29 (12) ◽  
pp. 980-1015 ◽  
Author(s):  
Edward J Calabrese ◽  
Mark P Mattson ◽  
Vittorio Calabrese
Keyword(s):  
Tumor Cell ◽  
Dose Response ◽  
Disease Process ◽  
Human Tumor ◽  
Human Tumor Cell Lines ◽  
Low Concentrations ◽  
Wide Range ◽  
High Doses ◽  
Dose Responses ◽  
Higher Doses

Resveratrol induces hormetic dose responses in a wide range of biological models, affecting numerous endpoints of biomedical and therapeutic significance. These responses were reported for numerous human tumor cell lines affecting breast, prostate, colon, lung, uterine and leukemia. In such cases, low concentrations of resveratrol enhanced tumor cell proliferation whereas higher concentrations were inhibitory. Similar resveratrol-induced biphasic dose responses were seen with several parasitic diseases, including Leishmaniasis and trichinella. Hormetic effects were also reported in animal models for cardiovascular induced injury, gastric lesions, ischemic stroke, Alzheimer’s disease and osteoporosis. In these cases, there was often a protective effect at low doses but an adverse effect at higher doses, exacerbating the disease process/incidence. This analysis indicates that many effects induced by resveratrol are dependent on dose and that opposite effects occur at low and high doses, being indicative of a hormetic dose response. Despite consistent occurrence of hormetic dose responses of resveratrol in a wide range of biomedical models, epidemiologic and clinical trials are needed to assess the nature of its dose-response in humans.

Comparative Analysis: The State of Colorado Study, Part II

2004 ◽  
Vol 9 (2) ◽  
pp. 1-16
Author(s):  
Christopher R. Brigham ◽  
Kathryn Mueller ◽  
Douglas Van Zet ◽  
Debra J. Northrup ◽  
Edward B. Whitney ◽  
...  
Keyword(s):  
Daily Living ◽  
Scientific Evidence ◽  
Pain Syndrome ◽  
Evidence Based ◽  
Clinical Assessments ◽  
Physician Judgment ◽  
History Of ◽  
Key Terms ◽  
Causation Analysis ◽  
Work Interference

Abstract [Continued from the January/February 2004 issue of The Guides Newsletter.] To understand discrepancies in reviewers’ ratings of impairments based on different editions of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), users can usefully study the history of the revisions as successive editions attempted to provide a comprehensive, valid, reliable, unbiased, and evidence-based system. Some shortcomings of earlier editions have been addressed in the AMA Guides, Fifth Edition, but problems remain with each edition, largely because of the limited scientific evidence available. In the context of the history of the different editions of the AMA Guides and their development, the authors discuss and contextualize a number of key terms and principles including the following: definitions of impairment and normal; activities of daily living; maximum medical improvement; impairment percentages; conversion of regional impairments; combining impairments; pain and other subjective complaints; physician judgment; and causation analysis; finally, the authors note that impairment is not synonymous with disability or work interference. The AMA Guides, Fifth Edition, contrasts impairment evaluations and independent medical evaluations (this was not done in previous editions) and discusses impairment evaluations, rules for evaluations, and report standards. Upper extremity and lower extremity impairment evaluations are discussed in terms of clinical assessments and rating processes, analyzing important changes between editions and problematic areas (eg, complex regional pain syndrome).

Treatment of varicose tributaries with sclerotherapy with polidocanol 0.5 % foam

VASA ◽  
2010 ◽  
Vol 39 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Reich-Schupke ◽  
Weyer ◽  
Altmeyer ◽  
Stücker
Keyword(s):  
Scientific Evidence ◽  
Daily Practice ◽  
Severe Adverse Effect ◽  
Safe Procedure ◽  
Efficacy And Safety ◽  
Foam Sclerotherapy ◽  
History Of ◽  
One Year ◽  
Additional Therapy

Background: Although foam sclerotherapy of varicose tributaries is common in daily practice, scientific evidence for the optimal sclerosant-concentration and session-frequency is still low. This study aimed to increase the knowledge on foam sclerotherapy of varicose tributaries and to evaluate the efficacy and safety of foam sclerotherapy with 0.5 % polidocanol in tributaries with 3-6 mm in diameter. Patients and methods: Analysis of 110 legs in 76 patients. Injections were given every second or third day. A maximum of 1 injection / leg and a volume of 2ml / injection were administered per session. Controls were performed approximately 6 months and 12 months after the start of therapy. Results: 110 legs (CEAP C2-C4) were followed up for a period of 14.2 ± 4.2 months. Reflux was eliminated after 3.4 ± 2.7 injections per leg. Insufficient tributaries were detected in 23.2 % after 6.2 ± 0.9 months and in 48.2 % after 14.2 ± 4.2 months, respectively. Only 30.9 % (34 / 110) of the legs required additional therapy. In 6.4 % vein surgery was performed, in 24.5 % similar sclerotherapy was repeated. Significantly fewer sclerotherapy-sessions were required compared to the initial treatment (mean: 2.3 ± 1.4, p = 0.0054). During the whole study period thrombophlebitis (8.2 %), hyperpigmentation (14.5 %), induration in the treated region (9.1 %), pain in the treated leg (7.3 %) and migraine (0.9 %) occurred. One patient with a history of thrombosis developed thrombosis of a muscle vein (0.9 %). After one year there were just hyperpigmentation (8.2 %) and induration (1.8 %) left. No severe adverse effect occurred. Conclusions: Foam sclerotherapy with injections of 0.5 % polidocanol every 2nd or 3rd day, is a safe procedure for varicose tributaries. The evaluation of efficacy is difficult, as it can hardly be said whether the detected tributaries in the controls are recurrent veins or have recently developed in the follow-up period. The low number of retreated legs indicates a high efficacy and satisfaction of the patients.

Writing and Ritual in Deuteronomy 28

2017 ◽  
Author(s):  
Laura Quick
Keyword(s):  
Ad Hoc ◽  
Comparative Method ◽  
Literary Texts ◽  
History Of ◽  
Important Means ◽  
Written Word ◽  
Ritual Process ◽  
Different Cultures ◽  
Ritual Context

This chapter argue that ritual behaviours might be just as good a source as literary texts for the diffusion of traditional cursing and treaty material across different cultures in the ancient Near East. In particular, the role of ad hoc oral Targum in the ritual process could have been an important means by which traditions were shared between different language communities. Recognition of the ritual context of this material also provides insights for the comparative method, the dating and authorship of Deuteronomy 28, and the subversive impetus thought to have stood behind its composition. Ultimately, the function of the written word in a largely oral world is shown to be fundamental to understanding the composition, function and the early history of the curses in the book of Deuteronomy.

scholarly journals “A debriefer must be neutral” and other debriefing myths: a systemic inquiry-based qualitative study of taken-for-granted beliefs about clinical post-event debriefing

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Julia Carolin Seelandt ◽  
Katie Walker ◽  
Michaela Kolbe
Keyword(s):  
Interpersonal Relationships ◽  
Western Europe ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Clinical Event ◽  
Clinical Settings ◽  
Healthcare Organizations ◽  
The Usa ◽  
Open Coding ◽  
Healthcare Administrators

Abstract Background The goal of this study was to identify taken-for-granted beliefs and assumptions about use, costs, and facilitation of post-event debriefing. These myths prevent the ubiquitous uptake of post-event debriefing in clinical units, and therefore the identification of process, teamwork, and latent safety threats that lead to medical error. By naming these false barriers and assumptions, the authors believe that clinical event debriefing can be implemented more broadly. Methods We interviewed an international sample of 37 clinicians, educators, scholars, researchers, and healthcare administrators from hospitals, universities, and healthcare organizations in Western Europe and the USA, who had a broad range of debriefing experience. We adopted a systemic-constructivist approach that aimed at exploring in-depth assumptions about debriefing beyond obvious constraints such as time and logistics and focused on interpersonal relationships within organizations. Using circular questions, we intended to uncover new and tacit knowledge about barriers and facilitators of regular clinical debriefings. All interviews were transcribed and analyzed following a comprehensive process of inductive open coding. Results In total, 1508.62 min of interviews (25 h, 9 min, and 2 s) were analyzed, and 1591 answers were categorized. Many implicit debriefing theories reflected current scientific evidence, particularly with respect to debriefing value and topics, the complexity and difficulty of facilitation, the importance of structuring the debriefing and engaging in reflective practice to advance debriefing skills. We also identified four debriefing myths which may prevent post-event debriefing from being implemented in clinical units. Conclusion The debriefing myths include (1) debriefing only when disaster strikes, (2) debriefing is a luxury, (3) senior clinicians should determine debriefing content, and (4) debriefers must be neutral and nonjudgmental. These myths offer valuable insights into why current debriefing practices are ad hoc and not embedded into daily unit practices. They may help ignite a renewed momentum into the implementation of post-event debriefing in clinical settings.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Modelling the COVID-19 pandemic in context: an international participatory approach

2020 ◽  
Vol 5 (12) ◽  
pp. e003126
Author(s):  
Ricardo Aguas ◽  
Lisa White ◽  
Nathaniel Hupert ◽  
Rima Shretta ◽  
Wirichada Pan-Ngum ◽  
...  
Keyword(s):  
Mathematical Models ◽  
Low Income ◽  
Scientific Evidence ◽  
Participatory Approach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Containment Measures ◽  
History Of ◽  
High Degree ◽  
The Mathematical Model

The SARS-CoV-2 pandemic has had an unprecedented impact on multiple levels of society. Not only has the pandemic completely overwhelmed some health systems but it has also changed how scientific evidence is shared and increased the pace at which such evidence is published and consumed, by scientists, policymakers and the wider public. More significantly, the pandemic has created tremendous challenges for decision-makers, who have had to implement highly disruptive containment measures with very little empirical scientific evidence to support their decision-making process. Given this lack of data, predictive mathematical models have played an increasingly prominent role. In high-income countries, there is a long-standing history of established research groups advising policymakers, whereas a general lack of translational capacity has meant that mathematical models frequently remain inaccessible to policymakers in low-income and middle-income countries. Here, we describe a participatory approach to modelling that aims to circumvent this gap. Our approach involved the creation of an international group of infectious disease modellers and other public health experts, which culminated in the establishment of the COVID-19 Modelling (CoMo) Consortium. Here, we describe how the consortium was formed, the way it functions, the mathematical model used and, crucially, the high degree of engagement fostered between CoMo Consortium members and their respective local policymakers and ministries of health.

scholarly journals Promoting Interpersonal Relationships through Elbow Tag, a Traditional Sporting Game. A Multidimensional Approach

2021 ◽  
Vol 13 (14) ◽  
pp. 7887
Author(s):  
Verónica Muñoz-Arroyave ◽  
Miguel Pic ◽  
Rafael Luchoro-Parrilla ◽  
Jorge Serna ◽  
Cristòfol Salas-Santandreu ◽  
...  
Keyword(s):  
Decision Making ◽  
Social Interactions ◽  
Interpersonal Relationships ◽  
Predictive Power ◽  
Ad Hoc ◽  
Scientific Evidence ◽  
Point Of View ◽  
Registration System ◽  
Motor Behaviors ◽  
Quasi Experimental

The aim of this research was to study from a multidimensional point of view (decisional, relational and energetic) the interpersonal relationships established by girls and boys in the traditional sport game of Elbow Tag. Scientific evidence has shown that Traditional Sport Games (TSG) trigger different effects on male and female genders in relation to emotional experiences, decision-making, conflicts and motor relationships. Despite the fact that these dimensions are intertwined, there are hardly any studies that interpret motor behaviors holistically, i.e., taking a multidimensional (360°) view of these dimensions. For this study, a quasi-experimental design was used and a type III design was applied, inspired by the observational methodology N/P/M. A total of 147 university students participated (M = 19.6, SD = 2.3): 47 girls (31.97%) and 100 boys (68.02%). A mixed ‘ad hoc’ registration system was designed with acceptable margins of data quality. Cross-tabulations, classification trees and T-patterns analysis were applied. The results indicated that social interactions between girls and boys in a mixed group were unequal. This difference was mainly due to decision-making (sub-role variable), which has much greater predictive power than the energetic variables (MV and steps).

Sinan’s Ambivalence

2014 ◽  
Vol 73 (3) ◽  
pp. 398-416
Author(s):  
Yasir Mohammad Sakr
Keyword(s):  
Ad Hoc ◽  
Educational Institution ◽  
Negative Association ◽  
Master Plan ◽  
Design Practice ◽  
Alternative Approach ◽  
Ottoman Architecture ◽  
History Of ◽  
Master Builder ◽  
Triangular Design

Sinan’s Ambivalence: The Triangular Design of the Süleymanıye Schools Complex in Istanbul interrogates the anomalous configuration of the Süleymanıye schools, including the unorthodox angular Dar-ul-Hadith, the largest and most important Ottoman educational institution, designed by the great Ottoman master-builder Sinan in 1548–59. The Süleymanıye, as Yasir Mohammad Sakr demonstrates, is not a mere adaptation of preexisting symmetrical school models to contextual contingencies, as historians have contended. Rather, the Süleymanıye and its seeming anomalies are a function of the architect’s own relentless retrospection, repeatedly reinterpreting and opposing the very types that he initially created during the same design process. Sinan synthesized the idealized Ottoman planning patterns with a vigorous fragmentation and dispersal of its functional and symbolic elements to create an innovative hybrid typology for the Süleymanıye schools, especially the Dar-ul-Hadith. The study concludes that the triangular Dar-ul-Hadith is not a residual, ad hoc space as commonly perceived. It is the key to formulating the Süleymanıye master plan, which the author defines as a powerful symbolic scheme monumentalizing the new social arrangement by Sinan’s patron, Süleyman the Magnificent. Thus, far from the negative association usually attached to the notion of “ambivalence,” Sinan’s design practice presents it as a viable alternative approach for the history of Ottoman architecture.

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