Management of respiratory tract infections in young children - A qualitative study of primary care providers' perspectives

Respiratory tract infections in young children are the most common cause of general practice visits in Australia. Despite the availability of clinical practice guidelines, the treatment and management of respiratory tract infections in young children is inconsistent. The aim of the study was to explore the management of respiratory tract infections in young children from a multi-disciplinary perspective using across-sectional qualitative research design based on the theoretical domains framework and the Capability, Opportunity and Motivation-B model. In-depth interviews were conducted with 30 primary care providers to explore their knowledge, views and management of respiratory tract infections in young children. Interviews focused on symptomatic management, over-the-counter medications and antibiotic use, and data were thematically analysed. Our findings showed that factors such as primary care providers' time constraints, parental anxiety, general practitioners' perception of what parents want, perceived parental pressure, and fear of losing patients were some of the reasons why primary care providers did not always adhere to guideline recommendations. Primary care providers also provided conflicting advice to parents concerning over-the-counter medications and when children should resume normal activities. Overall, this study showed that complex interactions involving emotional and psychological factors influenced the decision making process of primary care providers' management of respiratory tract infections in young children. A team care approach with consistent advice, and improved communication between primary care providers and parents is vital to overcome some of these barriers and improve guideline adherence. The findings of this research will inform the development of interventions to better manage respiratory tract infections in young children

Designing high efficiency glow discharge cleaning systems

In this paper we present our studies about the choices of anode design and operational regime in order to get high efficiency glow discharge cleaning of the first wall of a fusion device. We analyzed a database of toroidal and poloidal profiles of the ion current density at the wall, measured by electrostatic probes embedded in RFX-mod first wall tiles, taken in different configurations. The ion current at the wall, both global and local, is in fact strictly connected to the cleaning efficiency, since during glow discharge the wall is physically sputtered by the ions. We found that small size anodes and high in-vessel pressure lead to the peaking of the current profile around the anodes locations, and we experimentally characterized this effect. Instead, we found that anode radial position in the poloidal section has negligible effect on current density profile, even when the anodes are placed at the first wall. Finally, the most convenient operational regime, in terms of pressure and current, has been proposed. Keywords: RFX-mod, Glow discharge, Wall cleaning, Ion current profile, Anode desig

Modelling Plant Capacity and Productivity: The Multi-Machine Case

This study deals with systems (lines, departments or production units) made up of multiple machines, and it analyzes the meaning and assessment of productivity, utilization, efficiency and so forth at system level. Special emphasis is placed on calculating indices for the whole system starting from parameters referred to a single machine. Two basic system types are discussed, i.e. pure parallel systems and pure serial systems. The latter ones are further split into serial systems with tightly interconnected machines (i.e. without buffers), serial systems with loosely interconnected machines (i.e. provided with some decoupling buffers among stages), and independent departments systems

Reduced caveolae density in arteries of SHR contributes to endothelial dysfunction and ROS production

Caveolae are plasma membrane invaginations enriched with high cholesterol and sphingolipid content; they also contain caveolin proteins in their structure. Endothelial nitric oxide synthase (eNOS), an enzyme that synthesizes nitric oxide (NO) by converting L-arginine to L-citrulline, is highly concentrated in plasma membrane caveolae. Hypertension is associated with decreased NO production and impaired endothelium-dependent relaxation. Understanding the molecular mechanisms that follow hypertension is important. For this study, we hypothesized that spontaneously hypertensive rat (SHR) vessels should have a smaller number of caveolae, and that the caveolae structure should be disrupted in these vessels. This should impair the eNOS function and diminish NO bioavailability. Therefore, we aimed to investigate caveolae integrity and density in SHR aortas and mesenteric arteries and the role played by caveolae in endothelium-dependent relaxation. We have been able to show the presence of caveolae-like structures in SHR aortas and mesenteric arteries. Increased phenylephrine-induced contractile response after treatment with dextrin was related to lower NO release. In addition, impaired acetylcholine-induced endothelium-dependent relaxation could be related to decreased caveolae density in SHR vessels. The most important finding of this study was that cholesterol depletion with dextrin induced eNOS phosphorylation at Serine1177 (Ser1177) and boosted reactive oxygen species (ROS) production in normotensive rat and SHR vessels, which suggested eNOS uncoupling. Dextrin plus L-NAME or BH4 decreased ROS production in aorta and mesenteric arteries supernatant's of both SHR and normotensive groups. Human umbilical vein endothelial cells (HUVECs) treated with dextrin confirmed eNOS uncoupling, as verified by the reduced eNOS dimer/monomer ratio. BH4, L-arginine, or BH4 plus L-arginine inhibited eNOS monomerization. All these results showed that caveolae structure and integrity are essential for endothelium-dependent relaxation. Additionally, a smaller number of caveolae is associated with hypertension. Finally, caveolae disruption promotes eNOS uncoupling in normotensive and hypertensive rat vessels and in HUVECs.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2016/22180-9, 2016/21239-0, 2017/14797-9]; Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [400.164/2014-0, 304.137/2014-6]Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

Respiratory tract infections among children younger than 5 years: Current management in Australian general practice

Objective: To explore the current management in Australian general practice of common respiratory tract infections (RTIs) in children younger than 5 years. Design, setting and participants: Analysis of data from a sample of 4522 general practitioners who participated in the Bettering the Evaluation and Care of Health (BEACH) cross-sectional survey, April 2007 to March 2012. Consultations with children younger than 5 years were analysed. Main outcome measures: GPs’ management of four common RTIs (acute upper RTI [URTI], acute bronchitis/bronchiolitis, acute tonsillitis, and pneumonia) in association with six management options: antibiotic medications; prescribed or supplied non-antibiotic medications; medications advised for over-the-counter purchase; referrals; pathology testing; and counselling. Results: Of 31 295 encounters recorded, at least one of the four selected paediatric RTIs was managed at 8157 encounters. URTI was managed 18.6 times per 100 GP patient encounters, bronchitis/bronchiolitis 4.2 times, acute tonsillitis 2.7 times, and pneumonia 0.6 times per 100 encounters. Antibiotics were prescribed most frequently for tonsillitis and least frequently for URTI. Male GPs prescribed antibiotics for URTI significantly more often than female GPs, while older GPs prescribed antibiotics for URTI more often than younger GPs. Conclusion: GP management of paediatric RTIs in Australia varied according to the clinical problem and with age and sex of the GP. Further research into parents’ and health professionals’ attitudes and practices regarding the role of antibiotics, over-the-counter medications, and hygiene will help maintain favourable management practices

Multitask Learning on Graph Neural Networks: Learning Multiple Graph Centrality Measures with a Unified Network

The application of deep learning to symbolic domains remains an active research endeavour. Graph neural networks (GNN), consisting of trained neural modules which can be arranged in different topologies at run time, are sound alternatives to tackle relational problems which lend themselves to graph representations. In this paper, we show that GNNs are capable of multitask learning, which can be naturally enforced by training the model to refine a single set of multidimensional embeddings $\in \mathbb{R}^d$ and decode them into multiple outputs by connecting MLPs at the end of the pipeline. We demonstrate the multitask learning capability of the model in the relevant relational problem of estimating network centrality measures, focusing primarily on producing rankings based on these measures, i.e. is vertex $v_1$ more central than vertex $v_2$ given centrality $c$?. We then show that a GNN can be trained to develop a \emph{lingua franca} of vertex embeddings from which all relevant information about any of the trained centrality measures can be decoded. The proposed model achieves $89\%$ accuracy on a test dataset of random instances with up to 128 vertices and is shown to generalise to larger problem sizes. The model is also shown to obtain reasonable accuracy on a dataset of real world instances with up to 4k vertices, vastly surpassing the sizes of the largest instances with which the model was trained ($n=128$). Finally, we believe that our contributions attest to the potential of GNNs in symbolic domains in general and in relational learning in particular.Comment: Published at ICANN2019. 10 pages, 3 Figure

Design of the new electromagnetic measurement system for RFX-mod upgrade

A major modification of the RFX-mod toroidal load assembly has been decided in order to improve passive MHD control and to minimize the braking torque on the plasma, thus extending the operational space in both RFP and Tokamak configurations. With the removal of the vacuum vessel, the support structure will be modified in order to obtain a new vacuum-tight chamber and the first wall tiles will be directly in front of the passive stabilizing shell inside of it, so increasing both the poloidal cross section and the plasma-shell proximity. This implies the design of a new vacuum fit electromagnetic measurement system. The new local probes will be installed in vacuum onto the copper shell, behind the graphite tiles, and shall operate up to a maximum temperature of 180\ub0C to allow for baking cycles for first wall conditioning. Because of the reduced room available, tri-axial pickup probes have been designed, with the additional advantage of allowing the minimization of alignment errors. The paper describes the detailed design of the new probe set, in particular highlighting advantages and effectiveness of different probe solutions. Preliminary tests carried out on local probe prototypes to characterize their electromagnetic behaviour are also reported

Mapping adaptation of barley to droughted environments

Identifying barley genomic regions influencing the response of yield and its components to water deficits will aid in our understanding of the genetics of drought tolerance and the development of more drought tolerant cultivars. We assembled a population of 192 genotypes that represented landraces, old, and contemporary cultivars sampling key regions around the Mediterranean basin and the rest of Europe. The population was genotyped with a stratified set of 50 genomic and EST derived molecular markers, 49 of which were Simple Sequence Repeats (SSRs), which revealed an underlying population sub-structure that corresponded closely to the geographic regions in which the genotypes were grown. A more dense whole genome scan was generated by using Diversity Array Technology (DArT®) to generate 1130 biallelic markers for the population. The population was grown at two contrasting sites in each of seven Mediterranean countries for harvest 2004 and 2005 and grain yield data collected. Mean yield levels ranged from 0.3 to 6.2 t/ha, with highly significant genetic variation in low-yielding environments. Associations of yield with barley genomic regions were then detected by combining the DArT marker data with the yield data in mixed model analyses for the individual trials, followed by multiple regression of yield on markers to identify a multi-locus subset of significant markers/QTLs. QTLs exhibiting a pre-defined consistency across environments were detected in bins 4, 6, 6 and 7 on barley chromosomes 3H, 4H, 5H and 7H respectivel