Treatment of Streptococcal Endocarditis with a Single Daily Dose of Ceftriaxone and Netilmicin for 14 Days: A Prospective Multicenter Study

A 2-week course of ceftriaxone (2 g) plus netilmicin (4 mglkg), administered as one short daily iv infusion, was evaluated for the treatment of streptococcal endocarditis in an open multicenter study. Of the 52 patients, 31 were infected with viridans streptococci, 18 with Streptococcus bovis, two with Gemella morbillorum, and one with group C Streptococcus; 48 patients were assessable. Infection was cured in 42 cases, 35 treated medically and seven treated both medically and surgically. Five patients died without evidence of active infection, and one relapsed. The bacteriologic failure was due to a strain of G. morbillorum against which no synergy of ceftriaxone and netilmicin was evident in vitro. The serum creatinine level increased during treatment in four cases, all involving patients >65 years old who had renal risk factors; in two of these cases, values did not return to baseline during follow-up. Of 40 patients assessed for auditory function, only one developed decreased perception of borderline significance. Other adverse reactions were mild. This regimen was efficacious, safe, and cost-effective for the treatment of streptococcal endocarditis. However, it must be used with caution for patients with preexisting renal impairment or concomitant exposure to other potentially nephrotoxic agent

The influence of a virtual companion on amusement when watching funny films

We investigated the role of a virtual companion and trait cheerfulness on the elicitation of amusement. Ninety participants watched funny films in four conditions: either alone, with a virtual companion laughing or verbally expressing amusement at fixed time points (pre-scripted), or additionally joining the participant’s laughter (responsive companion). Amusement was assessed facially and vocally by coding Duchenne Displays and laughter vocalizations. Participants’ cheerful mood pre and post the film watching and positive experience were assessed. Results showed that high trait cheerful individuals generally experienced and expressed more amusement than low trait cheerful individuals. The presence of a virtual companion (compared to being alone) led to more laughter for individuals low in trait cheerfulness. Unexpectedly, the responsive companion did not elicit more amusement than the pre-scripted companion. The general disliking of virtual companions and gelotophobia related negatively to amusement. Amusement expressing virtual companions may be used in interventions aiming at eliciting positive responses, especially for individuals with higher thresholds for amusement.European Union Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. 27078

Automatic medical encoding with SNOMED categories

BACKGROUND: In this paper, we describe the design and preliminary evaluation of a new type of tools to speed up the encoding of episodes of care using the SNOMED CT terminology. METHODS: The proposed system can be used either as a search tool to browse the terminology or as a categorization tool to support automatic annotation of textual contents with SNOMED concepts. The general strategy is similar for both tools and is based on the fusion of two complementary retrieval strategies with thesaural resources. The first classification module uses a traditional vector-space retrieval engine which has been fine-tuned for the task, while the second classifier is based on regular variations of the term list. For evaluating the system, we use a sample of MEDLINE. SNOMED CT categories have been restricted to Medical Subject Headings (MeSH) using the SNOMED-MeSH mapping provided by the UMLS (version 2006). RESULTS: Consistent with previous investigations applied on biomedical terminologies, our results show that performances of the hybrid system are significantly improved as compared to each single module. For top returned concepts, a precision at high ranks (P0) of more than 80% is observed. In addition, a manual and qualitative evaluation on a dozen of MEDLINE abstracts suggests that SNOMED CT could represent an improvement compared to existing medical terminologies such as MeSH. CONCLUSION: Although the precision of the SNOMED categorizer seems sufficient to help professional encoders, it is concluded that clinical benchmarks as well as usability studies are needed to assess the impact of our SNOMED encoding method in real settings. AVAILABILITIES : The system is available for research purposes on: http://eagl.unige.ch/SNOCat

Treatment of streptococcal endocarditis with a single daily dose of ceftriaxone and netilmicin for 14 days: a prospective multicenter study

A 2-week course of ceftriaxone (2 g) plus netilmicin (4 mg/kg), administered as one short daily iv infusion, was evaluated for the treatment of streptococcal endocarditis in an open multicenter study. Of the 52 patients, 31 were infected with viridans streptococci, 18 with Streptococcus bovis, two with Gemella morbillorum, and one with group C Streptococcus; 48 patients were assessable. Infection was cured in 42 cases, 35 treated medically and seven treated both medically and surgically. Five patients died without evidence of active infection, and one relapsed. The bacteriologic failure was due to a strain of G. morbillorum against which no synergy of ceftriaxone and netilmicin was evident in vitro. The serum creatinine level increased during treatment in four cases, all involving patients > 65 years old who had renal risk factors; in two of these cases, values did not return to baseline during follow-up. Of 40 patients assessed for auditory function, only one developed decreased perception of borderline significance. Other adverse reactions were mild. This regimen was efficacious, safe, and cost-effective for the treatment of streptococcal endocarditis. However, it must be used with caution for patients with preexisting renal impairment or concomitant exposure to other potentially nephrotoxic agents

Moving Forward in Fostering Humour: Towards Training Lighter Forms of Humour in Multicultural Contexts

The following theoretical position paper has the aim to outline two important future directions of humour intervention research. Firstly, existing humour trainings have not differentiated explicitly between different uses of humour or humour that may be virtuous or not. Within the realm of Positive Psychology, all virtuous forms of humour need to be identified and interventions developed that aim at fostering these benevolent/lighter forms. Secondly, most humour trainings have been adapted and conducted in one cultural context. Future trainings should consider cross-cultural perspectives to allow for comparative research and practice. Thus, the current paper first gives an overview on the extant literature on the distinction between lighter and darker forms of humour, as well as showing how humour can serve the virtues proposed by Peterson and Seligman (2004). Then, we elaborate on the findings on humour and well-being, as well as findings on existing humour interventions. The second section starts with open questions and hypotheses on how a new generation of trainings targeting lighter forms of humour could look like. Then, we discuss (potential) cultural differences in humour and how this may affect the design of interventions. When aiming for cross-cultural adaptations of the same humour program, several challenges have to be overcome, such as the term “humour” not having the same meaning in every culture, and cultural rules on what can be laughed at

Development and Validation of the Short Version of the Sense of Humor Scale (SHS-S)

Abstract. Humor training has become increasingly popular to enhance the “sense of humor” and well-being and to decrease depressive symptoms. Despite the wide applications of these training programs, the assessment of training efficacy has attracted less attention. The Sense of Humor Scale (SHS; McGhee, 1996 , 1999 ) recently was expanded to a long version (SHS-L) to enhance its internal consistency ( Ruch &amp; Heintz, 2018 ). At the same time, there is also the need for a brief version of this scale. The purpose of the present study is to develop a short version (SHS-S) in both German- and English-speaking countries, test its psychometric properties (internal consistency, factorial, construct, and criterion validity), and assess measurement invariance across gender and the two languages. Using three samples (Sample 1: 570 English-speakers, Sample 2: 353 German-speakers, Sample 3: 94 other-reports), the 29-item SHS-S was developed and yielded promising internal consistency and validity scores for the six humor skill factors of enjoyment of humor, laughter, verbal humor, finding humor in everyday life, laughing at yourself, and humor under stress. Overall, the SHS-S is an internally consistent, valid, and economic tool for future research and group-based applications, while the SHS-L seems especially useful in individual applications. </jats:p

What makes it so hard to look and to listen? Exploring the use of the Cognitive and Affective Supervisory Approach with children’s social work managers

This paper reports on the findings of an ESRC-funded Knowledge Exchange project designed to explore the contribution of an innovative approach to supervision to social work practitioners’ assessment and decision-making practices. The Cognitive and Affective Supervisory Approach (CASA) is informed by cognitive interviewing techniques originally designed to elicit best evidence from witnesses and victims of crime. Adapted here for use in childcare social work supervision contexts, this model is designed to enhance the quantity and quality of information available for decision-making. Facilitating the reporting of both ‘event information’ and ‘emotion information’, it allows a more detailed picture to emerge of events, as recalled by the individual involved, and the meaning they give to them. Practice supervisors from Children’s Services in two local authorities undertook to introduce the CASA into supervision sessions and were supported in this through the provision of regular reflective group discussions. The project findings highlight the challenges for practitioners of ‘detailed looking’ and for supervisors of ‘active listening’. The paper concludes by acknowledging that the CASA’s successful contribution to decision-making is contingent on both the motivation and confidence of supervisors to develop their skills and an organisational commitment to, and resourcing of, reflective supervisory practices and spaces

The 3D Morphology of VY Canis Majoris. I The Kinematics of the Ejecta

Images of the complex circumstellar nebula associated with the famous red supergiant VY CMa show evidence for multiple and asymmetric mass loss events over the past 1000 yrs. Doppler velocities of the arcs and knots in the ejecta showed that they are not only spatially distinct but also kinematically separate from the surrounding diffuse material. In this paper we describe second epoch HST/WFPC2 images to measure the transverse motions which when combined with the radial motions provide a complete picture of the kinematics of the ejecta including the total space motions and directions of the outflows. Our results show that the arcs and clumps of knots are moving at different velocities, in different directions, and at different angles relative to the plane of the sky and to the star, confirming their origin from eruptions at different times and from physically separate regions on the star. We conclude that the morphology and kinematics of the arcs and knots are consistent with a history of mass ejections not aligned with any presumed axis of symmetry. The arcs and clumps represent relatively massive outflows and ejections of gas very likely associated with large -- scale convective activity and magnetic fields.Comment: 20 pages, 10 figures, 5 table

Mood Induction in Depressive Patients: A Comparative Multidimensional Approach

Anhedonia, reduced positive affect and enhanced negative affect are integral characteristics of major depressive disorder (MDD). Emotion dysregulation, e.g. in terms of different emotion processing deficits, has consistently been reported. The aim of the present study was to investigate mood changes in depressive patients using a multidimensional approach for the measurement of emotional reactivity to mood induction procedures. Experimentally, mood states can be altered using various mood induction procedures. The present study aimed at validating two different positive mood induction procedures in patients with MDD and investigating which procedure is more effective and applicable in detecting dysfunctions in MDD. The first procedure relied on the presentation of happy vs. neutral faces, while the second used funny vs. neutral cartoons. Emotional reactivity was assessed in 16 depressed and 16 healthy subjects using self-report measures, measurements of electrodermal activity and standardized analyses of facial responses. Positive mood induction was successful in both procedures according to subjective ratings in patients and controls. In the cartoon condition, however, a discrepancy between reduced facial activity and concurrently enhanced autonomous reactivity was found in patients. Relying on a multidimensional assessment technique, a more comprehensive estimate of dysfunctions in emotional reactivity in MDD was available than by self-report measures alone and this was unsheathed especially by the mood induction procedure relying on cartoons. The divergent facial and autonomic responses in the presence of unaffected subjective reactivity suggest an underlying deficit in the patients' ability to express the felt arousal to funny cartoons. Our results encourage the application of both procedures in functional imaging studies for investigating the neural substrates of emotion dysregulation in MDD patients. Mood induction via cartoons appears to be superior to mood induction via faces and autobiographical material in uncovering specific emotional dysfunctions in MDD