bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilising a MacIntyrean approach to understand how social enterprise may contribute to wellbeing
Authors: Blake Joanne
Published: May 2019

Purpose

The purpose of this paper is to demonstrate the potential fruitfulness of the theory of Alasdair MacIntyre for understanding how social enterprises may facilitate well-being, using empirical evidence from doctoral research to illustrate this.

Design/methodology/approach

This paper is based on findings from research conducted at a mental health training and employment organisation which used gardening as rehabilitative tool. Participant observation and semi-structured interviews with staff, volunteers and service users were used to generate the data, a MacIntyrean lens used to analyse the data, and some suggestions are made as to why social enterprises may be particularly suited to such an approach.

Findings

Practitioners encouraged the seeking of “internal goods” or “goods of excellence” within practices, as it was this which was understood to facilitate well-being. Service users shared in this view, perceiving their time on the case site primarily as “work” and choosing to engage with the service out of a desire to meaningfully contribute to the community project.

Research limitations/implications

This research is conducted on a small scale and therefore lacks generalisability. The lack of comparison with other organisational forms using the same practice is also a limitation.

Originality/value

This theory offers an alternative lens for considering how social enterprises might contribute to well-being. The data presented here also complement the growing body of research literature on Work Integration Social Enterprises, considering some of the wider well-being benefits beyond work integration, which thus far has received limited empirical attention.
FGF19 sustains the high proliferative ability of keratinocytes in psoriasis through the regulation of Wnt/GSK‐3β/β‐catenin signalling via FGFR4
Authors: Yu Xiaoyun , Yan Ning , Li Zihai , Hua Yunhui , Chen Wei
Published: May 2019

Accumulating evidence has shown that fibroblast growth factor 19 (FGF19) plays an important role in regulating cell proliferation. Psoriasis is characterized by the hyperproliferation of keratinocytes in skin lesions. However, whether FGF19 regulates the proliferation of keratinocytes in psoriasis remains unknown. In this study, we aimed to explore the potential relevance of FGF19 in psoriasis. We found that FGF19 was highly expressed in psoriatic skin from psoriasis patients, as well as keratinocytes that were stimulated with a cocktail of cytokines (M5), which is an in vitro model of psoriasis. Functional experiments demonstrated that FGF19 overexpression promoted the growth and proliferation of keratinocytes, while FGF19 knockdown showed opposite effect. Moreover, we found that FGF19 increased the phosphorylation of glycogen synthase kinase (GSK)‐3β and promoted the expression of β‐catenin and the activation of T cell factor 4 (TCF4) transcriptional activity. Notably, blocking Wnt/β‐catenin signalling by silencing β‐catenin partially reversed FGF19‐mediated promotional effects on keratinocyte proliferation. In addition, FGFR4 inhibition significantly blocked the promotional effect of FGF19 on keratinocyte proliferation and GSK‐3β/β‐catenin/TCF4 signalling. Taken together, our results demonstrated that FGF19 contributes to sustaining the high proliferative ability of keratinocytes through promoting Wnt/GSK‐3β/β‐catenin signalling via FGFR4, highlighting the importance of FGF19 in the pathogenesis of psoriasis. Our study suggests that FGF19 may serve as a novel and potential therapeutic target for psoriasis.
Reconceptualizing Informal Work Practices: Some Observations from an Ethnic Minority Community in Urban UK
Authors: Rodgers Peter , Shahid Muhammad Shehryar , Williams Colin C.
Published: May 2019

Whilst paid informal work has been conceptualized as a form of paid employment imbued with solely economic motivations, this article critically argues that such a market‐­oriented reading fails to take into account alternative explanations for the existence of informal work practices. Using evidence from 50 interviews conducted within a Pakistani urban community in a northern UK city, this article, uses a mixed‐embeddedness perspective to highlight the importance of predominantly socially and culturally driven motives in the decision to engage in informal work. The findings highlight that participation in informal work, whilst a product of marginalization due to certain institutional and structural factors, is also driven by a range of non‐monetary motives—a result of certain socially embedded work relations between ethnic minority workers and their employers. It is this social embeddedness of the employer–employee relationship in the Pakistani ethnic minority community that explains the continuation of informal work practices in the face of prevailing laws and regulations. The findings add weight to the understanding of informal work as being about more than just economics and constraints, offering these ethnic minority workers opportunities, even status, and giving them agency in an otherwise disempowered situation.
Postmodernity – progress, imperfections and unintended consequences
Authors: Thorp John M. , Steer Philip
Published: May 2019

Deputy Editor‐in‐Chief, Dr John M. Thorp, discusses the latest thinking in women's health and highlights articles from this issue in an audio podcast available at: https://soundcloud.com/bjog/June-editorial-2019
Adverse childhood experiences and their relationship to complex health profiles among child welfare–involved children: A classification and regression tree analysis
Authors: Brown Samantha M. , Bender Kimberly , Orsi Rebecca , McCrae Julie S. , Phillips Jon D. , Rienks Shauna
Published: May 2019

Objective

To identify the clustering of adverse childhood experiences (ACEs) that best characterize child welfare–involved children with known complex health concerns.

Data Source

Multi‐informant data were obtained from Wave I of the National Survey of Child and Adolescent Well‐Being (NSCAW II).

Study Design

This study used a cross‐sectional design and classification and regression tree (CART) analyses.

Data Collection

Data were collected from families with children, aged birth to 17, investigated for child maltreatment and their child protective services caseworkers, including demographic characteristics of the children, their histories of adversity, and a wide range of health concerns.

Principal Findings

Results indicate that for children between the ages of six and 17, experiences of physical abuse alone, as well as experiences of physical abuse combined with having a caregiver with mental illness, are most strongly associated with complex health concerns. For children aged 2‐5 years, results suggest that caregiver mental illness is a key adverse experience associated with complex health concerns.

Conclusions

Identifying specific combinations of ACEs may be a critical next step for child‐ and youth‐serving agencies to allow providers to better calculate risk of health problems among children exposed to adversity.
The Extracellular Protease AprX from Pseudomonas and its Spoilage Potential for UHT Milk: A Review
Authors: Zhang Chunyue , Bijl Etske , Svensson Birgitta , Hettinga Kasper
Published: May 2019

The negative effects of proteases produced by psychrotrophic bacteria on dairy products, especially ultra‐high‐temperature (UHT) milk, are drawing increasing attention worldwide. These proteases are especially problematic, because it is difficult to control psychrotrophic bacteria during cold storage and to inactivate their heat‐resistant proteases during dairy processing. The predominant psychrotrophic species with spoilage potential in raw milk, Pseudomonas, can produce a thermostable extracellular protease, AprX. A comprehensive understanding of AprX on the aspects of its biological properties, regulation, proteolytic potential, and its impact on UHT milk can contribute to finding effective approaches to minimize, detect, and inactivate AprX. AprX also deserves attention as a representative of all extracellular metalloproteases produced by psychrotrophic bacteria in milk. The progress of current research on AprX is summarized in this review, including a view on the gap in current understanding of this enzyme. Reducing the production and activity of AprX has considerable potential for alleviating the problems that arise from the instability of UHT milk during shelf‐life.
Establishment of a loop‐mediated isothermal amplification system for on‐site diagnosis of Oryctes rhinoceros nudivirus in Allomyrina dichotoma (Coleoptera: Scarabaeidae)
Authors: Lee Seokhyun , Lee Heesam , Park Kwanho
Published: May 2019

The Korean insect industry is rapidly developing, with the Korean horn beetle Allomyrina dichotoma as one of the most popular insects kept as pets. Korean horn beetles reared in local farms are suffering from Oryctes rhinoceros nudivirus (OrNV). In a nationwide investigation on the early death of young larvae due to this virus, 70 to 77% mortality was found. It was also confirmed that several larvae collected from some wild horn beetle habitats were infected with the virus. Thus, it was concluded that the virus could be transmitted vertically from an infected adult to the offspring and that the OrNV disease is a very serious threat to the wild horn beetle in Korea. With local farmers expecting that an early detection technique would be helpful for the quick removal of infected larvae, an on‐site diagnosis method for the viral disease using loop‐mediated isothermal amplification (LAMP) assay was thus tested. To avoid the DNA extraction process, the LAMP assay used a 50‐fold diluted hemolymph was set for diagnosis standardization and convenient on‐site application to infected larvae from local farms. A. dichotoma larvae were assayed for the OrNV infectivity with LAMP primers targeting the OrNV_gp102 gene. To evaluate the LAMP specificity, two bacterial pathogens, Bacillus thuringiensis and Serratia marcescens, causing disease in A. dichotoma were tested along with OrNV. The positive results were detected only from the OrNV‐infected larvae.
Hop‐portunity Lost? Spetz Brewery Considers a Pale Future
Authors: Steeves Heather , Laplante Joanne , MacDonald Robert A.
Published: May 2019

This case seeks to have students operationalize the managerial accounting concepts of relevance and cost allocation within a retail context. Spetz Brewery is a division of an on‐premises wine and beer‐making business in Moncton, NB. Manager Nancy Wheeler is examining company financial performance to determine the veracity of her belief that the on‐premises brewing segment of the business is unprofitable. Product information is provided to allow contribution margin calculations. In addition, students must determine whether the deteriorating results detailed in the company's financial statements are the result of the problem identified by the manager or whether there are in fact additional issues that need to be addressed.
MVSE: An R‐package that estimates a climate‐driven mosquito‐borne viral suitability index
Authors: Obolski Uri , Perez Pablo N. , Villabona‐Arenas Christian J. , Thézé Julien , Faria Nuno R. , Lourenço José
Published: May 2019

Viruses, such as dengue, Zika, yellow fever and chikungunya, depend on mosquitoes for transmission. Their epidemics typically present periodic patterns, linked to the underlying mosquito population dynamics, which are known to be driven by natural climate fluctuations. Understanding how climate dictates the timing and potential of viral transmission is essential for preparedness of public health systems and design of control strategies. While various alternative approaches have been proposed to estimate local transmission potential of such viruses, few open‐source, ready to use and freely available software tools exist.

We developed the Mosquito‐borne Viral Suitability Estimator (MVSE) software package for the R programming environment. MVSE estimates the index P, a novel suitability index based on a climate‐driven mathematical expression for the basic reproductive number of mosquito‐borne viruses. By accounting for local humidity and temperature, as well as viral, vector and human priors, the index P can be estimated for specific host and viral species in different regions of the globe.

We describe the background theory, empirical support and biological interpretation of the index P. Using real‐world examples spanning multiple epidemiological contexts, we further demonstrate MVSE's basic functionality, research and educational potentials.
Gender differences in the effects of cannabidiol on ethanol binge drinking in mice
Authors: Viudez‐Martínez Adrián , García‐Gutiérrez María S. , Manzanares Jorge
Published: May 2019

The purpose of this study was to explore the effects of cannabidiol (CBD) on binge drinking and evaluate potential gender‐related differences. To this aim, male and female C57BL/6J mice (n = 60 per sex) were exposed to the drinking in the dark (DID) model for 4 weeks (DID‐1 to DID‐4). Dose‐response effects of CBD on the ethanol intake were tested by acute (day‐4 of DID‐3) or repeated administration (day‐1 to 4 of DID‐4) (experiment 1: CBD 15, 30, and 60 mg/kg, i.p.; experiment 2: CBD 90 mg/kg, i.p.). Finally, we analyzed the relative gene expression of tyrosine hydroxylase (TH) and μ‐opioid receptor (OPRM1) and cannabinoid CB1 receptor (CB1r) in the ventral tegmental area (VTA) and in the nucleus accumbens (NAc), respectively, by real‐time quantitative PCR. Females exhibited higher ethanol intake during each DID session. Interestingly, females also showed higher expression of TH and OPRM1, without any difference in CB1r. Only the acute administration of CBD at the highest dose (90 mg/kg) reduced significantly ethanol consumption in both sexes. Chronic CBD administration (30, 60 and 90 mg/kg) reduced ethanol intake in males, whereas in females a significant reduction was only achieved with the highest dose (90 mg/kg). Repeated administration with CBD (60 mg/kg) significantly reduced TH and OPRM1 in males. In addition, CBD (30 and 60 mg/kg) significantly reduced CB1r in males. No effect was observed in females. Taken together, these findings suggest that CBD may be of interest for treating binge‐drinking patterns and that gender‐related difference may affect the treatment outcome.
Large local reactions to Hymenoptera stings: Outcome of re‐stings in real life
Authors: Bilò Maria Beatrice , Martini Matteo , Pravettoni Valerio , Bignardi Donatella , Bonadonna Patrizia , Cortellini Gabriele , Kosinska Magdalena , Macchia Donatella , Mauro Marina , Meucci Elisa , Nittner‐Marszalska Marita , Patella Vincenzo , Pio Roberta , Quercia Oliviero , Reccardini Federico , Ridolo Erminia , Rudenko Michael , Severino Maurizio
Published: May 2019

Background

Large local reaction to Hymenoptera stings is usually defined as a swelling >10 cm which lasts longer than 24 hours, sometimes associated with erythema, pruritus and blisters. Currently, the risk of subsequent systemic reactions after re‐stings is considered low (2%‐15%). Therefore, a diagnostic workup in case of large local reaction is often judged unnecessary, as well as adrenaline auto‐injector and venom immunotherapy prescription. The aim of this study was to prospectively evaluate the outcome of re‐stings in a real‐world setting, in patients with a history of one previous large local reaction.

Methods

We consecutively enrolled patients who experienced their first large local reaction (as per EAACI definition), treated with antihistamine and steroids. They were followed for field re‐stings and assessed for risk of subsequent systemic reactions.

Results

We enrolled 662 patients. Out of the 225 re‐stung subjects, 24% did not experience reactions, 52% reported a second large local reaction and 24% had systemic reactions. The risk of subsequent systemic reactions was higher in case of skin test reactivity to Apis mellifera or Vespula species (OR 2.1 and 3.8, respectively), in particular if positive at 0.001 µg/mL concentration (OR 13.4 and 16.5, respectively).

Conclusions

Systemic reactions, after a previous large local reaction, occur more frequently than that reported by literature. After analysing the predictive role of large local reactions for systemic reactions, we demonstrated that an accurate diagnostic workup may be considered, particularly skin tests. Further studies in different countries are needed to confirm these results and large local reaction management.
Editorial: collagen proportionate area as a prognostic indicator in NAFLD
Authors: Ravaioli Federico , Anstee Quentin M.
Published: May 2019

Linked Content

This article is linked to Buzzetti et al and Buzzetti and Tsochatzis papers. To view these articles, visit https://doi.org/10.1111/apt.15219 and https://doi.org/10.1111/apt.15279.
Editorial: giving high‐grade help to low‐grade dysplasia
Authors: Sawas Tarek , Katzka David A.
Published: May 2019

Linked Content

This article is linked to Kunzmann et al paper. To view this article,
visit https://doi.org/10.1111/apt.15235.
Changes in the relationship between short‐term interest rate, inflation and growth: evidence from the UK, 1820–2014
Authors: Bataa Erdenebat , Vivian Andrew , Wohar Mark
Published: May 2019

This paper examines the dynamic relationship between interest rates, inflation and economic growth using a long dataset for the UK. The approach adopted enables us to identify structural breaks in the dynamic system (vector autoregression (VAR)). We find interest rates respond much more strongly to growth and inflation over recent decades, and forecast error variance decomposition analysis indicates there is increasing interconnectedness between the variables in recent years. Economic policymakers need to carefully monitor the linkages between these variables and be prepared to adjust their monetary policy tools when faced with structural changes.
A systematic review of reported cases of pachyonychia congenita tarda
Authors: Tatian A. , Slape D. , Lawless R. , Frew J. W.
Published: May 2019

Pachyonychia congenita (PC) describes a group of genodermatoses manifesting as thickened nails, palmoplantar keratoderma (PPK) and increased risk of cutaneous infections. PC tarda (PCT) describes late-onset PC, and associated genetic polymorphisms have been identified. There has been discussion that PCT may not be a distinct entity but rather misdiagnosed ectodermal dysplasia (ED) or PPK. Clarification of this is important for appropriate diagnosis, management and patient and genetic counselling. We aimed to conduct a systematic review of all reported cases of PCT in the published literature and collate evidence of genetic polymorphisms and clinical features to compare with known features of PC, ED and PPK. PubMed (1946 to 1 July 2018), Scopus (1955 to 1 July 2018) and Web of Science (1990 to 1 July 2018) databases were searched for case reports of PCT with no search restrictions on date or language. The search strategy included the terms pachyonychia congenita tarda OR pachyonychia congenita AND (late onset OR delayed OR PCT). In total, 13 reports describing 19 individual cases of PCT were identified. Of the three identified genetic polymorphisms, the earliest identified has been shown to be highly probably pathogenic, with the second likely to result in a benign amino acid change, while the third has since been shown to be nonpathogenic,. No epigenetic studies have been performed on any reported cases. Previous authors have suggested that a number of cases of PCT may be misdiagnosed ED or PPK. The findings of our review cannot refute this suggestion, and highlight the need for thorough clinical documentation of suspected cases of PCT and thorough genetic screening of kindred to identify causative genetic polymorphisms. Further high-quality datasets and reporting are needed to give further insight into the nature of PCT as a unique entity.
Myasthenia gravis in children; Issues and challenges
Authors: Nomura Yoshiko
Published: May 2019

Autoimmune myasthenia gravis (MG) occurs in children, as well as in adults. Childhood myasthenia gravis is characterized by its distinct clinical features. Epidemiological studies have shown the high frequency of onset before the age of 5 years in Japan. Similar results have been reported from China. Clinical types are divided into pure ocular, latent generalized and generalized. In general, childhood myasthenia gravis is milder, mainly with ocular symptoms. Anti‐acetylcholine receptor antibody is often negative (seronegative). The responsiveness to treatment is generally good, and almost 90% of patients can achieve complete remission. Early diagnosis and adequate treatments are important.
Use of trypan blue to assess lymphatic function following trabeculectomy
Authors: Khoo Ying J. , Abdullah Aulia A. H. , Yu Dao‐Yi , Morgan William H.
Published: May 2019

Importance

To illustrate the importance of lymphatic drainage in assessing trabeculectomy bleb function using intracameral trypan blue.

Background

To study the lymphatic drainage of trabeculectomy blebs using trypan blue, correlate with bleb function and classify them accordingly.

Design

Prospective cross‐sectional study in a tertiary care centre.

Participants

Thirteen glaucoma patients post‐trabeculectomy were studied.

Methods

Trypan blue was injected into the anterior chamber.

Main Outcome Measures

The duration taken for dye to stain a drainage bleb or lymphatics is recorded. The extent of the lymphatic structures were measured in clock hours. Intraocular pressure (IOP) prior to surgery was recorded.

Results

Eight post‐trabeculectomy subjects with dye stained lymphatic vessels had lower IOP (12.6 mmHg, P = .013) compared to the five with no lymphatic vessel staining (mean IOP 23.6 mmHg). Lymphatic extent was inversely related to IOP (P = .021).

Conclusions and Relevance

Eyes with lymphatic connections to drainage blebs had lower IOP and reduced requirement for topical medications. The extent of lymphatic connection to drainage blebs is related to lower IOP.
Minimally invasive transanal surgery is safe after incomplete polypectomy of low risk T1 rectal cancer: a systematic review
Authors: de Jong G. M. , Hugen N.
Published: May 2019

Aim

In patients who have undergone a polypectomy of a malignant rectal polyp without histopathological risk factors other than an involved or unclear resection margin, additional local excision is often performed. Evidence to support this approach is lacking. The aim of this systematic review and meta‐analysis was to determine the outcome in terms of local recurrence, disease‐free survival (DFS) and overall survival (OS) of additional local excision following incomplete polypectomy for low risk T1 rectal cancer.

Methods

A comprehensive search for published studies was performed. Only studies in which there was incomplete (or ≤ 1 mm) removal of pT1 rectal polyps or in which the resection plane could not be assessed were included. For each included study data on tumour stage, histological factors, surgical technique, local recurrence rate, 5‐year DFS and 5‐year OS were extracted. The PROSPERO registration number is CRD42017062702.

Results

A total of 580 studies were retrieved by the search in the MEDLINE database, Embase and the Cochrane Library. After careful appreciation, four studies were included in the analysis, comprising 102 patients of whom the majority had undeterminable (Rx) resection margins. Local excision via transanal endoscopic microsurgery was reported most frequently. Only 1% of patients developed a local recurrence. One study reported 5‐year DFS and 5‐year OS of 96% and 87% respectively.

Conclusion

This study supports the use of additional local excision techniques for rectal cancer patients who underwent an incomplete polypectomy for a malignant rectal polyp in the absence of risk factors other than an uncertain resection margin.
Addition of canagliflozin to insulin improves glycaemic control and reduces insulin dose in patients with type 2 diabetes mellitus: A randomized controlled trial
Authors: Torimoto Keiichi , Okada Yosuke , Goshima Yukiko , Tokutsu Akemi , Sato Yasunori , Tanaka Yoshiya
Published: May 2019

The aim of this study was to evaluate the efficacy of canagliflozin in reducing the required insulin dose and the risk of hypoglycaemia in type 2 diabetes (T2D). This study was conducted in patients with T2D treated with insulin. They were randomly assigned to the control (n = 17) and canagliflozin (n = 17, plus 100 mg/day canagliflozin) groups. In both groups, a defined insulin dose adjustment protocol was applied to achieve the same level of glycaemic control. The change from baseline in daily insulin dose was significantly smaller in the canagliflozin group (3.9 units/day) than in the control group (13.4 units/day; P = 0.040). Low blood glucose index and predicted % of blood glucose (BG) <70 mg/dL, which are hypoglycaemia‐related variables, worsened significantly in the control group but both remained unchanged in the canagliflozin group. The standard deviation for night‐time BG levels improved significantly only in the canagliflozin group. Supplementation of insulin therapy with 100 mg canagliflozin in patients with T2D reduced the required insulin dose and hypoglycaemic risk and flattened night‐time glycaemic fluctuations while maintaining the same level of glycaemic control.
Human Memory and the Limits of Technology in Education
Authors: Puddifoot Katherine , O'Donnell Cian
Published: May 2019

Human memory systems perform various functions beyond simple storage and retrieval of information. They link together information about events, build abstractions, and perform memory updating. In contrast, typical information storage and access technologies, such as note‐taking applications and Wikipedia, tend to store information verbatim. In this article, Katherine Puddifoot and Cian O'Donnell use results from cognitive psychology, neuroscience, and machine learning to argue that the increased dependence on such technologies in education may come at a price: the missed opportunity for memory systems of student learners to form abstractions and insights from newly learned information. This conclusion has important implications for how technologies should be adopted in education.
More salt, please: global patterns, responses and impacts of foliar sodium in grasslands
Authors: Borer E. T. , Lind E. M. , Firn J. , Seabloom E. W. , Anderson T. M. , Bakker E. S. , Biederman L. , La Pierre K. J. , MacDougall A. S. , Moore J. L. , Risch A. C. , Schutz M. , Stevens C. J.
Published: May 2019

Sodium is unique among abundant elemental nutrients, because most plant species do not require it for growth or development, whereas animals physiologically require sodium. Foliar sodium influences consumption rates by animals and can structure herbivores across landscapes. We quantified foliar sodium in 201 locally abundant, herbaceous species representing 32 families and, at 26 sites on four continents, experimentally manipulated vertebrate herbivores and elemental nutrients to determine their effect on foliar sodium. Foliar sodium varied taxonomically and geographically, spanning five orders of magnitude. Site‐level foliar sodium increased most strongly with site aridity and soil sodium; nutrient addition weakened the relationship between aridity and mean foliar sodium. Within sites, high sodium plants declined in abundance with fertilisation, whereas low sodium plants increased. Herbivory provided an explanation: herbivores selectively reduced high nutrient, high sodium plants. Thus, interactions among climate, nutrients and the resulting nutritional value for herbivores determine foliar sodium biogeography in herbaceous‐dominated systems.
Documenting Teaching Excellence for Tenure‐ and Non‐Tenure‐Track Positions in Family and Consumer Sciences
Authors: Delgadillo Lucy M.
Published: May 2019

Traditionally, faculty members are evaluated on the three academic areas of teaching, research, and service. The emphasis placed on an area depends on several factors including institutional mission, teaching load requirements, and faculty area of expertise. The explosion of teaching innovations over the last few years makes it increasingly important for faculty members to document their teaching excellence and the impact of their teaching. This article presents 10 domains to document teaching performance for tenure and promotion, or for annual evaluations.
On Quantile‐based Asymmetric Family of Distributions: Properties and Inference
Authors: Gijbels Irène , Karim Rezaul , Verhasselt Anneleen
Published: May 2019

In this paper, we provide a detailed study of a general family of asymmetric densities. In the general framework, we establish expressions for important characteristics of the distributions and discuss estimation of the parameters via method‐of‐moments as well as maximum likelihood estimation. Asymptotic normality results for the estimators are provided. The results under the general framework are then applied to some specific examples of asymmetric densities. The use of the asymmetric densities is illustrated in a real‐data analysis.
Channel coordination with price discount mechanism under price‐sensitive market demand
Authors: Sarkar Sumon , Tiwari Sunil , Wee Hui‐Ming , Giri B.C.
Published: May 2019

This paper considers a two‐echelon supply chain with single vendor single buyer for trading a single product. The buyer's demand has been assumed to be price‐sensitive. We have assumed three‐level inspection at the vendor's end in order to maintain good quality of the items delivered to the buyer. We have developed models for both decentralized and centralized scenarios and have determined the optimal solution using the basic concepts of analytic geometry and algebra. In addition, we have proposed a price discount mechanism, where the vendor has provided discounts on the purchase cost to the buyer against the buyer's (increased) order quantity. Finally, in order to illustrate and validate the proposed model, a numerical example and sensitivity analysis is carried out, which has provided some important managerial implications. It has been observed from the numerical study that the proposed price discount policy coordinates the supply chain and has improved the profitability of the supply chain and its members.
New Tensions over Social Europe? The European Pillar of Social Rights and the Debate within the European Parliament
Authors: Vesan Patrik , Corti Francesco
Published: May 2019

In September 2015, the European Commission launched a new political initiative ‐‐ the European Pillar of Social Rights (EPSR) ‐‐ with the stated aim of strengthening the social acquis of the European Union and promoting upward social convergence across eurozone countries. In January 2017, the European Parliament voted in a resolution supporting the EPSR. This article examines the positioning of the parliamentary political groups to grasp the tensions that emerged during the debate. In so doing, it provides empirical evidence of the existence of a complex ‘clash syndrome’ in European social policies which results from the combination of vertical and horizontal forms of euroscepticism. The main argument is that the coexistence of multiple political tensions may hamper the development of a stronger Social Europe, but may also lead to the emergence of new political coalitions through the ‘criss‐crossing’ of different lines of conflict.
Hyperglycemia in non‐obese patients with type 2 diabetes is associated with low muscle mass: The Multicenter Study for Clarifying Evidence for Sarcopenia in Patients with Diabetes Mellitus
Authors: Sugimoto Ken , Tabara Yasuharu , Ikegami Hiroshi , Takata Yasunori , Kamide Kei , Ikezoe Tome , Kiyoshige Eri , Makutani Yukako , Onuma Hiroshi , Gondo Yasuyuki , Ikebe Kazunori , Ichihashi Noriaki , Tsuboyama Tadao , Matsuda Fumihiko , Kohara Katsuhiko , Kabayama Mai , Fukuda Masahiro , Katsuya Tomohiro , Osawa Haruhiko , Hiromine Yoshihisa , Rakugi Hiromi
Published: May 2019

Aims/Introduction

Hyperglycemia is a risk factor for sarcopenia when comparing individuals with and without diabetes. However, no studies have investigated whether the findings could be extrapolated to patients with diabetes with relatively higher glycemic levels. Here, we aimed to clarify whether glycemic control was associated with sarcopenia in patients with type 2 diabetes.

Materials and Methods

Study participants consisted of patients with type 2 diabetes (n = 746, the average age was 69.9 years) and an older general population (n = 2,067, the average age was 68.2 years). Sarcopenia was defined as weak grip strength or slow usual gait speed and low skeletal mass index.

Results

Among patients with type 2 diabetes, 52 were diagnosed as having sarcopenia. The frequency of sarcopenia increased linearly with glycated hemoglobin (HbA1c) level, particularly in lean individuals (HbA1c <6.5%, 7.0%, ≥6.5% and <7.0%: 18.5%; HbA1c ≥7.0% and <8.0%: 20.3%; HbA1c ≥8.0%: 26.7%). The linear association was independent of major covariates, including anthropometric factors and duration of diabetes (HbA1c <6.5%: reference; ≥6.5% and <7.0%: odds ratio [OR] 4.38, P = 0.030; HbA1c ≥7.0% and <8.0%: 4.29, P = 0.024; HbA1c ≥8.0%: 7.82, P = 0.003). HbA1c level was specifically associated with low skeletal mass index (HbA1c ≥8.0%: OR 5.42, P < 0.001) rather than weak grip strength (OR 1.89, P = 0.058) or slow gait speed (OR 1.13, P = 0.672). No significant association was observed in the general population with a better glycemic profile.

Conclusions

Poor glycemic control in patients with diabetes was associated with low muscle mass.
Co‐infection of rainbow trout (Oncorhynchus mykiss) with infectious hematopoietic necrosis virus and Flavobacterium psychrophilum
Authors: Ma Jie , Bruce Timothy J. , Oliver Luke P. , Cain Kenneth D.
Published: May 2019

Co‐infection of rainbow trout with infections haematopoietic necrosis virus (IHNV) and Flavobacterium psychrophilum is known to occur, and it has been speculated that a combined infection can result in dramatic losses. Both pathogens can persist in fish in an asymptomatic carrier state, but the impact of co‐infection has not been well characterized or documented. In this study, it was hypothesized that fish co‐infected with F. psychrophilum and IHNV would exhibit greater mortality than fish infected with either pathogen alone. To test this, juvenile rainbow trout were co‐infected with low doses of either IHNV or F. psychrophilum, and at 2 days post‐initial challenge, they were given a low dose of the reciprocal pathogen. This combined infection caused high mortality (76.2%–100%), while mortality from a single pathogen infection with the same respective dose was low (5%–20%). The onset of mortality was earlier in the co‐infected group (3–4 days) when compared with fish infected with F. psychrophilum alone (6 days) or IHNV (5 days), confirming the synergistic interaction between both pathogens. Co‐infection led to a significant increase in the number of F. psychrophilum colony‐forming units and IHNV plaque‐forming units within tissues. This finding confirms that when present together in co‐infected fish, both pathogens are more efficiently recovered from tissues. Furthermore, pathogen genes were significantly increased in co‐infected groups, which parallel the findings of increased systemic pathogen load. Extensive tissue necrosis and abundant pathogen present intracellularly and extracellularly in haematopoietic tissue. This was pronounced in co‐infected fish and likely contributed to the exacerbated clinical signs and higher mortality. This study provides novel insight into host–pathogen interactions related to co‐infection by aquatic bacterial and viral pathogens and supports our hypothesis. Such findings confirm that mortality in fish exposed to both pathogens is greatly elevated compared to a single pathogen infection.
Mixed species biofilms of Lactobacillus plantarum and Listeria innocua show facilitated entrance to the VBNC state during chlorine‐induced stress
Authors: Olszewska Magdalena A. , Białobrzewski Ireneusz
Published: May 2019

Biofilms of Lactobacillus plantarum and Listeria innocua were grown under single‐ and mixed‐culture conditions in a bioreactor with either half‐strength brain heart infusion (BHI) medium or BHI medium with sodium dichloroisocyanurate (150 ppm) for 24 hr. A quantitative approach using plate counts and fluorescence in situ hybridization (FISH) was applied, representing the culturable and viable cells, respectively. Species contribution to the single and mixed species biofilms was similar, reaching ca. 6.5 and 7.0 log cfu (cells)/mL for L. plantarum and L. innocua, respectively. In the presence of chlorine, species contribution to the single or mixed species biofilms was 10‐ to 100‐times lower than in the absence of this chemical for L. plantarum and L. innocua, respectively. Notably, a large difference was observed between the culturable and the viable cells in the mixed species biofilms, reaching 1.5 and 2.5 log units for L. plantarum and L. innocua, respectively. L. innocua achieved almost complete nonculturability during an early stage of biofilm growth in the coculture, indicating that the physiological state of cells was significantly affected not only by chlorine challenge but also by interspecies interactions. Importantly, all biofilms consisted of culturable cells during the late stage of growth, which represented a potential source of contamination.

Practical Applications

Fluorescence‐based methods for bacterial viability measurement have remained useful for a wide diversity of applications. In our study, the approach employing FISH in a parallel with plate counting allowed us to enumerate viable and culturable cells of L. plantarum and L. innocua under either single‐ or mixed‐culture conditions. Thus, we recommend it for accurate estimation of viable but nonculturable cells in the experimental set‐up comprising single‐/mixed‐culture sessile community.
Family Caregiving in Serious Illness in the United States: Recommendations to Support an Invisible Workforce
Authors: Bell Janice F. , Whitney Robin L. , Young Heather M.
Published: May 2019

Family caregivers provide the vast majority of care for individuals with serious illness living in the community but are not often viewed as full members of the healthcare team. Family caregivers are increasingly expected to acquire a sophisticated understanding of the care recipient's condition and new skills to execute complex medical or nursing tasks, often without adequate preparation and support, and with little choice in taking on the role. This review draws on peer‐reviewed literature, government reports, and other publications to summarize the challenges faced by family caregivers of older adults in the context of serious illness and to identify opportunities to better integrate them into the healthcare workforce. We discuss promising approaches such as inclusion of family caregivers in consensus‐based practice guidelines; the “no wrong door” function, directing consumers to needed resources, regardless of where initial contact is made; and caregiver‐friendly workplace policies allowing flexible arrangements. We present specific recommendations focusing on research, clinical practice, and policy changes that promote family‐centered care and improve outcomes for caregivers as well as persons with serious illness. J Am Geriatr Soc 67:S451–S456, 2019.
Why Does Culture and Context Matter for Care That Aims for Quality and Impact?
Authors: Hansen Jennie Chin
Published: May 2019

This commentary comments on the article by Vyjeyanthi Periyakoil.
Integrated Home‐ and Community‐Based Services Improve Community Survival Among Independence at Home Medicare Beneficiaries Without Increasing Medicaid Costs
Authors: Valluru Girish , Yudin Jean , Patterson Christine L. , Kubisiak Joanna , Boling Peter , Taler George , De Jonge Karl Eric , Touzell Steve , Danish Ann , Ornstein Katherine , Kinosian Bruce
Published: May 2019

OBJECTIVES

To determine the effect of home‐based primary care (HBPC) for frail older adults, operating under Independence at Home (IAH) incentive alignment on long‐term institutionalization (LTI).

DESIGN

Case‐cohort study using HBPC site, Medicare administrative data, and National Health and Aging Trends Study (NHATS) benchmarks.

SETTING

Three IAH‐participating HBPC sites in Philadelphia, PA, Richmond, VA, and Washington, DC.

PARTICIPANTS

HBPC integrated with long‐term services and supports (LTSS) cases (n = 721) and concurrent comparison groups (HBPC not integrated with LTSS: n = 82; no HBPC: n = 573). Cases were eligible if enrolled at one of the three HBPC sites from 2012 to 2015. Independence at Home‐qualified (IAH‐Q) concurrent comparison groups were selected from Philadelphia, PA; Richmond, VA; and Washington, DC.

INTERVENTION

HBPC integrated with LTSS under IAH demonstration incentives.

MEASUREMENTS

Measurements include LTI rate and mortality rates, community survival, and LTSS costs.

RESULTS

The LTI rate in the three HBPC programs (8%) was less than that of both concurrent comparison groups (IAH‐Q beneficiaries not receiving HBPC, 16%; patients receiving HBPC but not in the IAH demonstration practices, 18%). LTI for patients at each HBPC site declined over the three study years (9.9%, 9.4%, and 4.9%, respectively). Costs of home‐ and community‐based services (HCBS) were nonsignificantly lower among integrated care patients ($2151/mo; observed‐to‐expected ratio = .88 [.68‐1.09]). LTI‐free survival in the IAH HBPC group was 85% at 36 months, extending average community residence by 12.8 months compared with IAH‐q participants in NHATS.

CONCLUSION

HBPC integrated with long‐term support services delays LTI in frail, medically complex Medicare beneficiaries without increasing HCBS costs.
A multi‐center comparative efficacy and safety study of two different hyaluronic acid fillers for treatment of nasolabial folds in a Chinese population
Authors: Li Dong , Sun Jiaming , Wu Sufan
Published: May 2019

Background

Nonsurgical injectable treatments, including hyaluronic acid (HA) fillers, are increasingly used in Asian patients.

Aims

To demonstrate the efficacy and safety of Restylane Lyft compared to Restylane for the correction of nasolabial folds (NLFs).

Patients/Methods

This was a randomized, evaluator‐blinded, split‐face, 12‐month study conducted in China using Restylane Lyft in the aesthetic correction of moderate to severe NLFs among adult subjects. One NLF was treated with Restylane Lyft, and the opposite NLF with the comparator Restylane. Efficacy outcomes included improvement in the Wrinkle Severity Rating Scale (WSRS) and aesthetic improvement (using the Global Aesthetic Improvement Scale [GAIS] assessed by the subject and blinded evaluator) for each treatment at Months 3, 6 (primary objective based on WSRS), 9, and 12. Safety was evaluated by the incidence of injection site reactions and adverse events (AEs).

Results

A total of 100 subjects were randomized to the treatments. Noninferiority for Restylane Lyft was established according to blinded evaluation of WSRS at 6 months after last treatment. Similarly, the WSRS improved throughout the study, and the responder rate (improvement in WSRS of ≥1 grade from Baseline) was sustained after 6 months (64% and 65% for NLFs treated with Restylane and Restylane Lyft, respectively). For GAIS after 6 months, improvement was approximately 80% in both groups. No treatment‐related serious AEs were reported. The safety profiles were similar between the two treatments.

Conclusions

Similar to Restylane, Restylane Lyft was effective and well tolerated for treatment of moderate to severe NLFs in this Chinese population.
Whitening effects of cosmetic formulation in the vascular component of skin pigmentation
Authors: Pereira Andréia Feital Costa , Igarashi Mamy Honda , Mercuri Maurizio , Pereira Amanda Francielli , Pinheiro Ana Lucia Tabarini Alves , da Silva Michelle Sabrina , Facchini Gustavo , Eberlin Samara
Published: May 2019

Background

Melanin plays an important role in protecting the skin against the harmful effects of solar radiation, but its abnormal accumulation may become an aesthetic problem, such as melasma and age spots.

Aims

The aim of this study was to evaluate the antiangiogenic and whitening effects of a depigmentation formulation (BLTX) using an in vitro model of human cell and skin culture.

Methods

Human fibroblasts, keratinocytes or melanocytes were treated with BLTX and subjected to oxidative stress by UV radiation or inflammatory stress with IL‐1α for quantification of melanin, tyrosinase, endothelin‐1, PAR‐2, VEGF and iNOS. Fragments of human skin, from elective plastic surgery, were treated with BLTX and subjected to histological evaluation with hematoxylin/eosin associated with Fontana‐Masson technique for melanin view. A parametric method, the one‐way analysis of variance (ANOVA) followed by the Bonferroni test, was used to compare data among all groups.

Results

The results demonstrated that BLTX promotes a reduction in VEGF and iNOS protein synthesis in cultured dermal fibroblasts, indicating an antiangiogenic property. In relation to whitening effect, BLTX was able to reduce the production of melanin in both systems, melanocytes and human skin cultures. The depigmenting action was also revealed by decreasing the levels of endothelin‐1, PAR‐2 and activity of tyrosinase, when compared to cultures exposed to UV radiation.

Conclusion

The results allow us to infer that BLTX presents an antiangiogenic effect indicating a role in the vascular component of melasma. Furthermore, the whitening property observed reinforces its use in the prevention and treatment of melasma.
Dual‐plane hyaluronic acid treatment for atrophic acne scars
Authors: Artzi Ofir , Cohen Sarit , Koren Amir , Niv Roni , Friedman Or
Published: May 2019

Background

Acne is a common condition that affects up to 80% of all adolescents. Scarring may affect some 95% as a function of severity and delay before treatment. The pathogenesis includes enzymatic degradation of collagen fibers and subcutaneous fat.

Objective

This study aimed to treat atrophic acne scars using the Dual‐Plane injection of Hyaluronic Acid.

Methods

A total of 12 patients with moderate‐to‐severe atrophic acne scars were treated with a novel NAHYCO™ based Hyaluronic Acid filler, using a dual‐plane technique for two treatment sessions at a 4‐week interval. Results were objectively assessed by two blinded Dermatologists and subjectively evaluated by the patients themselves.

Results

A total of 8 out of the 12 patients reported moderate improvement, two indicated marked improvement and two rated minimal improvement. Dermatologists' mean global evaluation score was 2.5 ± 0.43.

Limitations

The small sample size and regional nature of a single‐center study. Nevertheless, both the expert dermatologists' and the patients' evaluations of standardized high‐resolution medical photographs were consistent, suggesting that this inherent bias was negligible.

Conclusion

The treatment led to impressive improvement in the depth of the scars, suggesting that this technique can result in safe and rapid amelioration of atrophic acne scars in only two sessions.