Antimicrobial therapy for otitis media with effusion ( secretory otitis media)

Objective. —To determine the effectiveness of antimicrobial treatment for otitis media with effusion ( secretory otitis media) in children. Data Source. —We report the reexamination of a previously published study by Mandel et al that evaluated the efficacy of a 2-week course of antimicrobials (amoxicillin trihydrate) with and without a 4-week course of an oral decongestant-antihistamine combination in a double-blind, placebo-controlled, randomized trial involving 518 infants and children with otitis media with effusion. Data Synthesis. —At 4 weeks, amoxicillin efficacy as determined by a tympanometric criterion (P=.121) or by a measure of improvement in hearing (P=.311) was insignificant. Only by otoscopic judgment, which is shown to contain a systematic bias as used in this clinical trial, could an argument be made for a marginal efficacy of amoxicillin at the 4-week end point. Logistic regression analyses of the combined effects of treatment and prognostic factors showed no significant differences between placebo- and antibiotic-treated groups for unilateral effusions and for bilateral effusions. When subjects with unilateral and bilateral effusions were combined, the estimated efficacy of antibiotic treatment was 12.3% by otoscopy (P =.014) and 4.8% by tympanometry (P =.171). We also demonstrate the sensitivity of outcome to diagnostic measures used and provide statistical evidence questioning the validity of otoscopic observations in this study. Six weeks after the termination of amoxicillin therapy, the recurrence of effusion was two to six times higher in the amoxicillin-treated children than in those treated with placebo (P=.001), and resolution of effusion was not significantly different among antibiotic and placebo groups (13.6% and 11.3%, respectively; P=.477). Conclusions. —Amoxicillin with and without decongestant-antihistamine combination is not effective for the treatment of persistent asymptomatic middle-ear effusions in infants and children

Mothering for Schooling

In this paper I explore the relationship between mothering work in the family and the social organization of schooling. In particular, I address the ways in which mothers coordinate and contest the textually-organized discourse of schooling In contrast to other studies of the family/school relationship, this research began in the experience of mothers whose children attend primary school. The data were collected through interviews with mothers in two cities in Ontario. Mothering work constructs families that are differently connected to schools -- a connection strongly shaped by and constitutive of social class

Creep-rupture of polymer-matrix composites

An accelerated characterization method for resin matrix composites is reviewed. Methods for determining modulus and strength master curves are given. Creep rupture analytical models are discussed as applied to polymers and polymer matrix composites. Comparisons between creep rupture experiments and analytical models are presented. The time dependent creep rupture process in graphite epoxy laminates is examined as a function of temperature and stress level

The accelerated characterization of viscoelastic composite materials

Necessary fundamentals relative to composite materials and viscoelasticity are reviewed. The accelerated characterization techniques of time temperature superposition and time temperature stress superposition are described. An experimental procedure for applying the latter to composites is given along with results obtained on a particular T300/934 graphite/epoxy. The accelerated characterization predictions are found in good agreement with actual long term tests. A postcuring phenomenon is discussed that necessitates thermal conditioning of the specimen prior to testing. A closely related phenomenon of physical aging is described as well as the effect of each on the glass transition temperature and strength. Creep rupture results are provided for a variety of geometries and temperatures for T300/934 graphite/epoxy. The results are found to compare reasonably with a modified kinetic rate theory

Impact of noise on domain growth in electroconvection

The growth and ordering of striped domains has recently received renewed attention due in part to experimental studies in diblock copolymers and electroconvection. One surprising result has been the relative slow dynamics associated with the growth of striped domains. One potential source of the slow dynamics is the pinning of defects in the periodic potential of the stripes. Of interest is whether or not external noise will have a significant impact on the domain ordering, perhaps by reducing the pinning and increasing the rate of ordering. In contrast, we present experiments using electroconvection in which we show that a particular type of external noise decreases the rate of domain ordering

Fundamental analysis of the failure of polymer-based fiber reinforced composites

A mathematical model is described which will permit predictions of the strength of fiber reinforced composites containing known flaws to be made from the basic properties of their constituents. The approach was to embed a local heterogeneous region (LHR) surrounding the crack tip into an anisotropic elastic continuum. The model should (1) permit an explicit analysis of the micromechanical processes involved in the fracture process, and (2) remain simple enough to be useful in practical computations. Computations for arbitrary flaw size and orientation under arbitrary applied load combinations were performed from unidirectional composites with linear elastic-brittle constituent behavior. The mechanical properties were nominally those of graphite epoxy. With the rupture properties arbitrarily varied to test the capability of the model to reflect real fracture modes in fiber composites, it was shown that fiber breakage, matrix crazing, crack bridging, matrix-fiber debonding, and axial splitting can all occur during a period of (gradually) increasing load prior to catastrophic fracture. The computations reveal qualitatively the sequential nature of the stable crack process that precedes fracture

The Cure: Making a game of gene selection for breast cancer survival prediction

Motivation: Molecular signatures for predicting breast cancer prognosis could greatly improve care through personalization of treatment. Computational analyses of genome-wide expression datasets have identified such signatures, but these signatures leave much to be desired in terms of accuracy, reproducibility and biological interpretability. Methods that take advantage of structured prior knowledge (e.g. protein interaction networks) show promise in helping to define better signatures but most knowledge remains unstructured. Crowdsourcing via scientific discovery games is an emerging methodology that has the potential to tap into human intelligence at scales and in modes previously unheard of. Here, we developed and evaluated a game called The Cure on the task of gene selection for breast cancer survival prediction. Our central hypothesis was that knowledge linking expression patterns of specific genes to breast cancer outcomes could be captured from game players. We envisioned capturing knowledge both from the players prior experience and from their ability to interpret text related to candidate genes presented to them in the context of the game. Results: Between its launch in Sept. 2012 and Sept. 2013, The Cure attracted more than 1,000 registered players who collectively played nearly 10,000 games. Gene sets assembled through aggregation of the collected data clearly demonstrated the accumulation of relevant expert knowledge. In terms of predictive accuracy, these gene sets provided comparable performance to gene sets generated using other methods including those used in commercial tests. The Cure is available at http://genegames.org/cure

The viscoelastic behavior of a composite in a thermal environment

A proposed method for the accelerated predictions of modulus and life times for time dependent polymer matrix composite laminates is presented. The method, based on the time temperature superposition principle and lamination theory, is described in detail. Unidirectional reciprocal of compliance master curves and the shift functions needed are presented and discussed. Master curves for arbitrarily oriented unidirectional laminates are predicted and compared with experimantal results obtained from master curves generated from 15 minute tests and with 25 hour tests. Good agreement is shown. Predicted 30 deg and 60 deg unidirectional strength master curves are presented and compared to results of creep rupture tests. Reasonable agreement is demonstrated. In addition, creep rupture results for a (90 deg + or - 60 deg/90 deg) sub 2s laminate are presented

Distribution of Gains from Cattle Development in a Multi-Stage Production System: The Case of the Bali Beef Industry

Beef production in Bali is dominated by smallholders, just like the majority of Indonesian agriculture. A wide range of policies has been implemented to enhance development of the Bali beef industry. Knowledge about the distribution of the returns from the development of the cattle industry, including marketing, informs decision making. This paper examines the benefits from cattle development in a multi-stage production representation of the Bali beef industry using equilibrium displacement modelling (EDM). Benefits are measured as changes in economic surplus. The distribution of benefits among farmers, processors and retailers is also examined.beef production, government policy, EDM, economic surplus., Agricultural and Food Policy,