bluuebunny/crossref_metadata_2025 huggingface dataset:
Memento: Localized Time‐Warping for Spatio‐Temporal Selection
Authors: Solteszova V. , Smit N. N. , Stoppel S. , Grüner R. , Bruckner S.
Published: July 2019

Interaction techniques for temporal data are often focused on affecting the spatial aspects of the data, for instance through the use of transfer functions, camera navigation or clipping planes. However, the temporal aspect of the data interaction is often neglected. The temporal component is either visualized as individual time steps, an animation or a static summary over the temporal domain. When dealing with streaming data, these techniques are unable to cope with the task of re‐viewing an interesting local spatio‐temporal event, while continuing to observe the rest of the feed. We propose a novel technique that allows users to interactively specify areas of interest in the spatio‐temporal domain. By employing a time‐warp function, we are able to slow down time, freeze time or even travel back in time, around spatio‐temporal events of interest. The combination of such a (pre‐defined) time‐warp function and brushing directly in the data to select regions of interest allows for a detailed review of temporally and spatially localized events, while maintaining an overview of the global spatio‐temporal data. We demonstrate the utility of our technique with several usage scenarios.
“If you don't speak from the heart, the young mob aren't going to listen at all”: An invitation for youth mental health services to engage in new ways of working
Authors: Wright Michael , Culbong Tiana , Crisp Nikayla , Biedermann Britta , Lin Ashleigh
Published: July 2019

Aim

Aboriginal and Torres Strait Islander young people are more likely to experience mental health issues or end their life by suicide than non‐Aboriginal youth, but are less likely to access mental health services for support. Systemic change is required if mainstream youth mental health services are to be relevant and culturally secure for Aboriginal and Torres Strait Islander young people.

Methods

Building Bridges (2017‐2019) is a three‐year participatory action research project being conducted in partnership with the Nyoongar community and three mainstream youth mental health services in Perth, Western Australia. The project involves Nyoongar Elders and Aboriginal and Torres Strait Islander young people working directly with senior management and key staff of youth mental health services to co‐design, implement and evaluate a framework for systems change. The aim of the project is to increase Aboriginal and Torres Strait Islander young people's engagement with services and improve mental health outcomes for young people and their families.

Results

This paper outlines the engagement process that underpinned the first phase of the project. Our research methods are premised by an investment in establishing safe spaces for the Elders, young people and service staff to engage in open, honest dialogue. We present two key activities that illustrate this process of building trust and deepening understanding, namely: spending time “On Country” and engaging in a “storying” process.

Conclusions

Building Bridges demonstrates the centrality of trusting relationships for systemic change and the way in which meaningful engagement is at the core of both the process and the outcome.
In vitro interactions of abiraterone, erythromycin, and CYP3A4: implications for drug–drug interactions
Authors: Masamrekh Rami A. , Kuzikov Alexey V. , Haurychenka Yaraslau I. , Shcherbakov Kirill A. , Veselovsky Alexander V. , Filimonov Dmitrii A. , Dmitriev Alexander V. , Zavialova Maria G. , Gilep Andrei A. , Shkel Tatsiana V. , Strushkevich Natallia V. , Usanov Sergey A. , Archakov Alexander I. , Shumyantseva Victoria V.
Published: July 2019

Potential drug–drug interactions of the antitumor drug abiraterone and the macrolide antibiotic erythromycin were studied at the stage of cytochrome P450 3A4 (CYP3A4) biotransformation. Using differential spectroscopy, we have shown that abiraterone is a type II ligand of CYP3A4. The dependence of CYP3A4 spectral changes on the concentration of abiraterone is sigmoidal, which indicates cooperative interactions of CYP3A4 with abiraterone; these interactions were confirmed by molecular docking. The dissociation constant (Kd) and Hill coefficient (h) values for the CYP3A4–abiraterone complex were calculated as 3.8 ± 0.1 μM and 2.3 ± 0.2, respectively. An electrochemical enzymatic system based on CYP3A4 immobilized on a screen‐printed electrode was used to show that abiraterone acts as a competitive inhibitor toward erythromycin N‐demethylase activity of CYP3A4 (apparent Ki = 8.1 ± 1.2 μM), while erythromycin and its products of enzymatic metabolism do not affect abiraterone N‐oxidation by CYP3A4. In conclusion, the inhibition properties of abiraterone toward CYP3A4‐dependent N‐demethylation of erythromycin and the biologically inert behavior of erythromycin toward abiraterone hydroxylation were demonstrated.
Real‐world experience of dupilumab treatment for atopic dermatitis in adults: a retrospective analysis of patients' records
Authors: Wang Candice , Kraus Christina N. , Patel Krupa G. , Ganesan Anand K. , Grando Sergei A.
Published: July 2019

Background

Clinical trial data for dupilumab, a monoclonal antibody against the interleukin‐4 receptor (IL‐4Rα), have shown that it is safe and effective for the treatment of moderate to severe atopic dermatitis in patients whose disease is resistant to other therapies. However, little real‐world experience with dupilumab use has been reported thus far. The aim of this retrospective study was to assess overall outcomes in adult patients with atopic dermatitis (AD) treated with dupilumab.

Methods

A retrospective review of electronic medical records was conducted for patients treated with dupilumab in the Department of Dermatology at the University of California, Irvine.

Results

We analyzed the medical records of 77 AD patients who received dupilumab according to standard dosing and had at least one documented follow‐up visit. In 66 patients (86%), dupilumab improved clinical disease severity, with 23 patients (30%) experiencing complete clearance on dupilumab. Dupilumab was generally well‐tolerated and caused no serious adverse events. The most common side effects included dry eyes, conjunctivitis, and keratitis. The most common reason for discontinuation of treatment was lack of substantial clinical improvement or progression of disease severity, followed by ophthalmologic side effects.

Conclusions

Overall, dupilumab was well‐tolerated and resulted in clinical improvement in our patient population. These results provide additional important information on the safety and utility of dupilumab treatment for moderate to severe atopic dermatitis in the real‐world clinical setting.
Evaluation of pharmacy-based telephone interventions on medication pick-up rates: a retrospective, quality improvement study at charity outpatient clinics
Authors: Tatachar Amulya , Cole Lyndsay C , Nguyen Hoa L , Heinrich Krista
Published: July 2019

Objectives

To evaluate a live telephonic outreach intervention made by clinical pharmacists and clinical pharmacy technicians on medication pick-up rates.

Methods

A retrospective, quality improvement study conducted at six outpatient charity clinics in Dallas-Fort Worth area between 1 January 2017 and 31 July 2017. A live telephonic call was made by a pharmacy team member if the patient did not pick-up at least one prescription item. Patients may receive more than one call if they did not pick-up medication(s) more than once during the study period. A live telephonic call resulted in three categories: contacted, left a voice message and unable to contact. Medication pick-up rates were obtained from a pharmacy claims database.

Key findings

The study population included 1726 individual patients who failed to pick-up at least one medication from Baylor Scott & White Health pharmacy. A total of 2551 live telephonic calls were made for the study population. A total of 1175 live telephonic calls (46.1%, n = 2551) resulted in a patient picking up medication(s). Results from the generalized estimating equation logistic regression models showed that patients who received a voice message (OR: 1.37; 95% CI: 1.05 to 1.80; P < 0.021) or was contacted (OR: 1.99; 95% CI: 1.54 to 2.60; P < 0.001) were more likely to pick-up their medications as compared to the ‘unable to contact’ group.

Conclusions

Telephonic interventions from the pharmacy team can serve as a successful means to increase medication pick-up rates among charity clinic patients.
Effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling among community‐dwelling older adults: A systematic review and meta‐analysis
Authors: Chua Claris Hui Min , Jiang Ying , Lim Der Shin , Wu Vivien Xi , Wang Wenru
Published: July 2019

Aims

To systematically review the evidence and determine the effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling and falls among community‐dwelling older adults who are at risk of falling.

Design

A systematic review and meta‐analysis.

Data Sources

Six electronic databases, including CENTRAL, CINAHL, EMBASE, PubMed, PsycInfo and Scopus, were searched. Studies published in English from January 1998–July 2018 were included in this review.

Review Methods

Only randomized controlled trials addressing fear of falling and/or the occurrence of falls using cognitive behaviour therapy‐based multicomponent interventions were included. A standard procedure based on the Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias of the selected studies. A meta‐analysis was performed to determine the effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling immediately after the interventions, at ≤6 months and >6 months postinterventions.

Results

This review included 15 randomized controlled trials involving 3,165 community‐dwelling adults aged 60 years and older. The pooled results showed that the intervention effects, including immediate, short‐term (i.e., ≤6 months postintervention) and long‐term (i.e., >6 months postintervention) effects, favoured the intervention group.

Conclusion

Cognitive behaviour therapy‐based multicomponent interventions are effective at reducing fear of falling among community‐dwelling older adults who are at risk of falling.

Impact

Fear of falling has been implicated in activity restriction among older adults and fall prevention interventions need to be multifaceted. Understanding and attending to individual psychological needs are as important as exercise training.
The experience of adults with sickle cell disease and their HLA‐matched adult sibling donors after allogeneic hematopoietic stem cell transplantation
Authors: Gallo Agatha M. , Patil Crystal L. , Knafl Kathleen A. , Angst Denise A. , Rondelli Damiano , Saraf Santosh L.
Published: July 2019

Aim

To provide a rich description and in‐depth understanding of the recipient–donor allogeneic hematopoietic stem cell transplantation experience.

Background

A stem cell transplant has a high likelihood of improving symptoms of sickle cell disease in adults. While studies have reported the transplant experiences of recipients and donors with haematological malignancies, no published reports have examined the experience of both adult recipients with sickle cell disease and their donors.

Design

Exploratory qualitative descriptive analysis.

Methods

We conducted individual interviews with 13 recipients and donors (eight males, five females) representing five recipient–donor dyads and one recipient–donor triad from one Midwest transplant centre between August 2017–February 2018. Interviews were digitally audio‐recorded, transcribed verbatim and analysed using conventional content analysis.

Findings

Five themes were identified: the downward spiral and a second chance; getting the monster off my back; difficult and manageable; it was worth it; and relating to the healthcare team.

Conclusions

The results provide a description and insights into the complex nature of the stem cell transplant experience in sickle cell disease from the perspectives of both recipients and donors.

Impact

Health provider awareness of recipient–donor experiences can contribute to family‐centred care that supports the health and quality of life for both recipients and donors. This understanding promotes high quality clinical care and improved communications by taking into account the knowledge, values and informed preferences of recipients and donors and contributes to improved decision‐making and clinical care. Future research can assess family experiences that support informed choice for potential transplant candidates.
The association between alexithymia, emotional intelligence and burnout among nursing assistants working in nursing home settings: A cross‐sectional study
Authors: Aldaz Erkuden , Aritzeta Aitor , Galdona Nerea
Published: July 2019

Aims

To determine the explanatory power of alexithymia and emotional intelligence over burnout and to examine their combined explanatory capacity over burnout in the context of older adult care.

Design

Cross‐sectional. All participants voluntarily and anonymously completed a questionnaire survey. They were all blind to the aim of the study.

Methods

One hundred and fifty‐nine nursing assistants recruited during 2014 took part in the study. They belong to 10 nursing homes in the north of Spain. Sociodemographic and work‐related information was collected, and measures of burnout, alexithymia and emotional intelligence were administered. Data were examined by means of regression analyses.

Results

The analysis showed that alexithymia made a moderate contribution to the depersonalization and personal accomplishment dimensions of burnout, controlling for the influence of work characteristics. Emotional intelligence did not have incremental validity over alexithymia in explaining burnout.

Conclusion

Alexithymia, rather than emotional intelligence, is a stronger explanatory variable for burnout among nursing assistants working in nursing homes.

Impact

Alexithymia and emotional intelligence are related to burnout and help to explain why, in the same context, each worker is affected differently by chronic stress at work. However, their combined explanatory capacity in nursing assistants working with older people remains underexplored. In our sample, alexithymia explains burnout better than emotional intelligence, a finding that was both unexpected and theoretically relevant. Researchers should take this into account when studying personal resources to prevent and manage burnout among nursing assistants, as alexithymia, rather that emotional intelligence, could play an important role once workers are burned out. Training nursing assistants to identify and describe emotions should be considered as part of their training programmes and/or in nursing homes as an institutional strategy to prevent burnout and to improve the quality of older adult care.
Cutaneous candidiasis – an evidence‐based review of topical and systemic treatments to inform clinical practice
Authors: Taudorf E.H. , Jemec G.B.E. , Hay R.J. , Saunte D.M.L.
Published: July 2019

Cutaneous candidiasis is a common skin disease, and several treatments have been investigated within the last fifty years. Yet, systematic reviews are lacking, and evidence‐based topical and systemic treatment strategies remain unclear. Thus, the aim of this review was to summarize efficacy and adverse effects of topical and oral therapies for cutaneous candidiasis in all age groups. Two individual researchers searched PubMed and EMBASE for ‘cutaneous candidiasis’ and ‘cutaneous candidiasis treatment’, ‘intertrigo’, ‘diaper dermatitis’ and ‘cheilitis’. Searches were limited to ‘English language’, ‘clinical trials’ and ‘human subjects’, and prospective clinical trials published in abstracts or articles were included. In total, 149 studies were identified, of which 44 were eligible, comprising 41 studies of 19 topical therapies and four studies of three systemic therapies for cutaneous candidiasis. Topical therapies were investigated in infants, children, adolescents, adults and elderly, while studies of systemic therapies were limited to adolescents and adults. Clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated similar efficacy with complete cure rates of 73%–100%. Single‐drug therapy was as effective as combinations of antifungal, antibacterial and topical corticosteroid. Four studies investigated systemic therapy, and oral fluconazole demonstrated similar efficacy to oral ketoconazole and topical clotrimazole. Limitations to this review were mainly that heterogeneity of studies hindered meta‐analyses. In conclusions, clotrimazole, nystatin and miconazole were the most studied topical drugs and demonstrated equal good efficacy and mild adverse effects similar to combinations of antifungal, antibacterial and topical corticosteroids. Oral fluconazole was as effective as topical clotrimazole and is the only commercially available evidence‐based option for systemic treatment of cutaneous candidiasis.
Stepwise approach of development of dermo‐cosmetic products in healthy and atopic dermatitis paediatric population: safety evaluation, clinical development and postmarket surveillance
Authors: Ribet V. , Gurdak M. , Ferret P.‐J. , Brinio E. , Giordano Labadie F. , Rossi A.B.
Published: July 2019

Background/objectives

Paediatric skin, considered sensitive, and infant skin, more susceptible to percutaneous toxicity, require specially formulated cosmetic products. As recently shown, early use of emollients in infants “at risk” of developing atopic dermatitis has shown controversial results in reducing the incidence of atopic dermatitis. Development of dermo‐cosmetic products for this specific population should especially ensure tolerance and safety. In absence of good clinical practice guideline, we propose here a stepwise approach for the development of paediatric cosmetic skincare products.

Methods

Our stepwise methodology for cosmetics aimed at paediatrics, starts with in vitro assessment of product's ingredients safety, followed by preclinical and clinical evaluations of the final product, including sequentially: (1) Repeated Open Application Test (ROAT), (2) Human Repeated Insult Patch Test (HRIPT), (3) In‐use dermatological and ophthalmological tolerance studies (sequentially in 3a: healthy adults, 3b: healthy paediatric subjects and finally 3c: paediatric patients). We also describe the integrated cosmetovigilance–toxicological surveillance during the clinical development phase and postmarketing.

Results

As illustrated with one dermo‐cosmetic product intended to be used as a preventative/maintenance treatment for atopic dermatitis in paediatric population, we show that using this stepwise methodology to test a product reduces potential risks of irritation and contact dermatitis in this sensitive population.

Conclusion

Standardized ethical stepwise development approach is needed to ensure the commercialization of safe and well‐tolerated dermo‐cosmetics for paediatrics. The approach described here could potentially serve as guidance for evaluation of new paediatric cosmetic products.
Health care professionals talking: Are services for young adults with type 1 diabetes fit for purpose?
Authors: Harris Margaret , James Steven , Perry Lin , Lowe Julia , Dunbabin Janet , Steinbeck Katharine
Published: July 2019

Introduction

The challenges of becoming a mature adult may distract young adults with type 1 diabetes from disease self‐management, increasing risks for premature morbidity and mortality. Despite the importance of young adults with type 1 diabetes engaging with preventative diabetes‐related health care services, few studies report health care professionals' experiences and perceptions of the support that is available, including during the period of transition. This study sought to determine these factors across diverse contexts in one health jurisdiction.

Methods

This qualitative study was undertaken in New South Wales, Australia. Recruitment was based on a snowball sampling technique, which began with members of an established diabetes service group. Data were collected by individual semistructured interviews with 16 health care professionals, most of whom were registered nurses (75%), working at differing levels of expertise and responsibility across metropolitan and regional/rural areas. Data were analysed using thematic analyses.

Results

Participants overwhelmingly recognized the time and care needed to support young adults with type 1 diabetes to prepare them for adult self‐management and to work with adult diabetes services, and the importance of youth‐friendly services. They reported shortfalls and inequitous distribution in services for these young adults. Two themes, addressing the present and future possibilities, expressed their perceptions of services for this population: working with what is available and mapping a route to better services.

Conclusion

Findings identify opportunities for development in the planning and provision of specialist multidisciplinary health care support for this population. New ideas are needed for policy and practice innovation and for the infrastructure to facilitate this, to ensure that young adults with type 1 diabetes have access to consistent and coordinated diabetes health care services, particularly in nonmetropolitan settings.
Sensing fermentation degree of cocoa (Theobroma cacao L.) beans by machine learning classification models based electronic nose system
Authors: Tan Juzhong , Balasubramanian Balu , Sukha Darin , Ramkissoon Saila , Umaharan Pathmanathan
Published: July 2019

Cocoa bean fermentation is an important postharvest process that develops aroma and processing properties. Although the cocoa fermentation is of high complexly, farmers are employing empirical methods to determine the fermentation degree of cocoa. Researchers, on the other hand, are using expensive equipment such as high‐performance liquid chromatography and gas chromatography‐mass spectrometry to study cocoa fermentation. In this study, machine learning based electronic nose system, a fast measuring and affordable method, was developed to determine the fermentation degree of cocoa beans. Six machine‐learning methods (bootstrap forest, boosted tree, decision tree, artificial neural network (ANN), naïve Bayes, and k‐nearest neighbors) were conducted to classify the fermentation time of cocoa beans. Bootstrap forest algorithm achieved a misclassification rate as low as 9.4%. ANN and boosted tree achieved 12.8 and 13.6% misclassification rate respectively. However, other methods failed to do classification for cocoa beans.

Practical applications

The electronic nose system can be used by cocoa farmers to monitor cocoa fermentation and ensure the quality of cocoa beans. The method is relatively inexpensive and easy to operate.
Role of the endolysosomal system in Parkinson’s disease
Authors: Vidyadhara D. J. , Lee John E. , Chandra Sreeganga S.
Published: July 2019

Parkinson’s disease (PD) is one of the most common neurodegenerative disorders, affecting 1–1.5% of the total population. While progress has been made in understanding the neurodegenerative mechanisms that lead to cell death in late stages of PD, mechanisms for early, causal pathogenic events are still elusive. Recent developments in PD genetics increasingly point at endolysosomal (E‐L) system dysfunction as the early pathomechanism and key pathway affected in PD. Clathrin‐mediated synaptic endocytosis, an integral part of the neuronal E‐L system, is probably the main early target as evident in auxilin, RME‐8, and synaptojanin‐1 mutations that cause PD. Autophagy, another important pathway in the E‐L system, is crucial in maintaining proteostasis and a healthy mitochondrial pool, especially in neurons considering their inability to divide and requirement to function an entire life‐time. PINK1 and Parkin mutations severely perturb autophagy of dysfunctional mitochondria (mitophagy), both in the cell body and synaptic terminals of dopaminergic neurons, leading to PD. Endolysosomal sorting and trafficking is also crucial, which is complex in multi‐compartmentalized neurons. VPS35 and VPS13C mutations noted in PD target these mechanisms. Mutations in GBA comprise the most common risk factor for PD and initiate pathology by compromising lysosomal function. This is also the case for ATP13A2 mutations. Interestingly, α‐synuclein and LRRK2, key proteins involved in PD, function in different steps of the E‐L pathway and target their components to induce disease pathogenesis. In this review, we discuss these E‐L system genes that are linked to PD and how their dysfunction results in PD pathogenesis.

image

This article is part of the Special Issue “Synuclein”.
Cost‐effectiveness of staffing levels on conflict and containment on psychiatric wards in England
Authors: Kartha Muralikrishnan R. , McCrone Paul
Published: July 2019

Accessible Summary

What is known on the subject?

Literature on staffing levels and outcomes in psychiatric wards is limited and shows mixed associations

Lack of economic evidence on conflicts and containment in psychiatric care

Data from the City‐128 study showed that regular qualified nurse staffing levels in the preceding shifts were associated with raised conflict and containment levels

What this paper adds to existing knowledge?

This is the first economic analysis using the City‐128 data, with costs and outcomes data have been combined.

Cost‐effectiveness of different staffing levels in relation to conflicts and containments in England, using data from the City‐128 study

Both day and night shifts appeared to show that the low staff scenario was cost‐effective in terms of conflicts and containment averted, even after attempts were made to adjust for patient severity

What are the implications for practice?

This paper could be an indication towards further investigation into how mental health inpatient care, specially nursing is organized in England.

Introduction

Evidence from City‐128 study shows a positive association between staffing levels and conflicts/containment. Economic evidence on this topic is scarce, with no economic analyses combining costs and outcomes.

Aim/Question

To assess the cost‐effectiveness of different staffing levels in relation to conflicts and containments in England, using City‐128 study data.

Methods

Shifts were grouped into three groups based on staff‐to‐bed ratio. Cost information was combined with total conflicts and containment measures to assess cost‐effectiveness.

Results

The cost‐effectiveness analysis of the three staffing scenarios for both day and night shifts appeared to show that the low staff scenario was cost‐effective in terms of conflicts and containment averted, even adjusting for patient severity. A production function analysis also revealed that increased staff numbers were associated with higher numbers of events.

Discussion

Causation cannot be attributed and neither can recommendations be made on optimal staffing levels. The impact on other outcomes such as symptoms, functioning and length of stay, and other factors should be explored, and these may all benefit from increased staff numbers.

Implications for practice

These results indicate that increasing staff numbers may not necessarily improve conflict and containment outcomes. They may produce positive outcomes in other domains.
Complementary and integrative health methods used for the treatment of oral mucositis in children with cancer in Turkey
Authors: Osmanoglu Yurdakul Zeynep , Esenay Figen Işık
Published: July 2019

Purpose

We aimed to determine the complementary and integrative health (CIH) methods used by parents to treat oral mucositis in their children who have cancer.

Design and Methods

In this multicenter, cross‐sectional study, data for the study were collected via the demographic form and CIH form for oral mucositis. The data collection tools were filled out by the researchers during the face‐to‐face interviews. The parents (N = 302) of children with cancer who had undergone at least one round of chemotherapy were included in this study.

Results

According to the parents' statements, oral mucositis developed in 91.1% of the children with cancer, and CIH was used in 50.9% of them to treat its side effects. Parents stated that to deal with the oral mucositis, they mainly used black mulberry (41.5%), carbonate (15.2%), and honey (11.6%). Some of the parents (51.8%) used CIH for their children without informing their healthcare providers.

Practice Implications

The majority of healthcare providers were unaware of the parents' use of CIH for their children's oral mucositis treatment. Parents' opinions of these methods, of which the side effects and potential interactions with chemotherapeutic agents are not precisely known, and their use by parents for their children's oral mucositis should be evaluated by healthcare providers.
Impact of behaviour change communication interventions on sales of fortified sunflower oil in Tanzania: A spatial–temporal analysis and association study
Authors: Wu Daphne Chen Nee , Horton Sue , Saleh Nadira , Mosha Theobald C.E. , Yusuph Nazir
Published: July 2019

The Masava project was implemented in Manyara and Shinyanga regions in Tanzania to improve vitamin A intake by making available vitamin A‐fortified sunflower oil with a subsidy through a mobile phone‐based e‐Voucher system. This study was conducted to assess the impact of the behaviour change communication (BCC) campaign of the project on volume of sales of vitamin A‐fortified sunflower oil. The e‐Voucher system provides real‐time data on the number of e‐Vouchers redeemed. The number, type, and locations of BCC events were obtained from the implementation agency. Multivariate linear regression was used to examine the associations between (a) the number and type of BCC events conducted in a ward and the volume of subsequent fortified oil redeemed in the ward and (b) distance of clinic shows, a component of the BCC campaign, from participating retailers and the volume of fortified oil redeemed in the store. After 1 year of the campaign, the volume of fortified oil redeemed monthly increased by more than 5 times in Manyara and by more than three times in Shinyanga. Among the different types of BCC events conducted, only clinic shows and cooking shows were significantly associated with the volume of redemptions (p < .05). Compared with retailers where at least one clinic show was conducted within 0.5 km from its location, the volume of redemptions was significantly lower at retailers where no clinic show conducted within 3.0 km from its location (p < .05). These findings suggest that future health promotion interventions in rural Africa should involve health clinics.
EzrA, a cell shape regulator contributing to biofilm formation and competitiveness in Streptococcus mutans
Authors: Xiang Zhenting , Li Zongbo , Ren Zhi , Zeng Jumei , Peng Xian , Li Yuqing , Li Jiyao
Published: July 2019

Bacterial cell division is initiated by tubulin homologue FtsZ that assembles into a ring structure at mid‐cell to facilitate cytokinesis. EzrA has been identified to be implicated in FtsZ‐ring dynamics and cell wall biosynthesis during cell division of Bacillus subtilis and Staphylococcus aureus, the model rod and cocci. However, its role in pathogenic streptococci remains largely unknown. Here, the role of EzrA was investigated in Streptococcus mutans, the primary etiological agent of human dental caries, by constructing an ezrA in‐frame deletion mutant. Our data showed that the ezrA mutant was slow‐growing with a shortened length and extended width round cell shape compared to the wild type, indicating a delay in cell division with abnormalities of peptidoglycan biosynthesis. Additionally, FtsZ irregularly localized in dividing ezrA mutant cells forming angled division planes, potentially contributing to an aberrant cell shape. Furthermore, investigation using single‐species cariogenic biofilm model revealed that deletion of ezrA resulted in defective biofilm formation with less extracellular polysaccharides and altered three‐dimensional biofilm architecture. Unexpectedly, in a dual‐species ecological model, the ezrA mutant exhibited substantially lower tolerance for H2O2 and reduced competitiveness against one commensal species, Streptococcus sanguinis. Taken together, these results demonstrate that EzrA plays a key role in regulating cell division and maintaining a normal morphology in S. mutans and is required for its robust biofilm formation/interspecies competition. Therefore, EzrA protein represents a potential therapeutic target in the development of drugs controlling dental caries and other biofilm‐related diseases.
Sex and age differences in hospitalized pediatric traumatic brain injury
Authors: Zhang Fang , Huang Lihong , Singichetti Bhavna , Li Huiling , Sullivan Lindsay , Yang Jingzhen Ginger
Published: July 2019

Background

The aim of this study was to investigate the epidemiological characteristics of pediatric traumatic brain injury (TBI) requiring hospitalization in Chinese children ≤17 years of age according to sex and age group.

Methods

This study retrospectively analyzed pediatric TBI inpatient data obtained via electronic health records from one children's hospital in China. Patients aged ≤17 years admitted to the hospital due to TBI between 1 January 2013 and 31 December 2015 were identified using International Classification of Diseases (ICD) ‐9 and ICD‐10 codes. The demographic, injury, and hospitalization characteristics were analyzed by sex and age groups.

Results

The subject consisted of 1,087 pediatric TBI patients admitted to the hospital (61.5% boys). The highest proportion of hospitalization was observed in the 1–3 years age group. For both boys and girls, the most common diagnosis was “traumatic epidural hematoma” and the leading mechanism of TBI was “fall”. The median length of hospital stay was 8.5 days and the median hospitalization cost was 7,977.4 Chinese yuan (approximately $US 1,140).

Conclusions

Boys and children aged 1–3 years incurred more pediatric TBI requiring hospitalization than their counterparts. Prevention of falls, the most common injury mechanism in both boys and girls, is an important strategy to reduce pediatric TBI and related hospitalizations.
Reliability of real‐time continuous glucose monitoring in infants
Authors: Tomotaki Seiichi , Toyoshima Katsuaki , Shimokaze Tomoyuki , Kawai Masahiko
Published: July 2019

Background

Neonatal hypoglycemia is a common and treatable risk factor for neurological impairment. Real‐time continuous glucose monitoring (RT‐CGM) can show glucose concentration in real time. Using an RT‐CGM alarm, physicians can be alerted and intervene in hypoglycemia. No reports, however, have evaluated the reliability of RT‐CGM at low glucose levels in infants. This study therefore investigated the difference between blood glucose (BG) and RT‐CGM sensor data at low glucose levels and assessed the optimum method of using a hypoglycemic alarm in infants.

Methods

We enrolled infants whose glycemic management was difficult. We calculated the mean absolute difference (MAD) and mean absolute relative difference (MARD) between BG and RT‐CGM sensor data. We compared the MAD and MARD between the low BG fluctuation and high BG fluctuation groups.

Results

We used RT‐CGM for 12 patients (29 times) and investigated 448 pairs of BG and RT‐CGM sensor data. The MAD between these pairs was 9.3 ± 8.9 mg/dL, and the MARD was 11.5%. The MAD at low glucose was 7.7 ± 6.0 mg/dL, and the MARD was 16.2%. The MAD and MARD were 6.8 ± 5.4 mg/dL and 7.8% in the low fluctuation group and 10.1 ± 9.5 mg/dL and 12.7% in the high fluctuation group, respectively.

Conclusions

The difference between BG and RT‐CGM sensor data changes with the degree of fluctuation in BG. When physicians set the hypoglycemic alarm, consideration of this difference and a change in the alarm setting according to the degree of fluctuation in BG may be useful.
Optical Spectroscopy as a Method for Skin Cancer Risk Assessment
Authors: Rodriguez‐Diaz Eladio , Manolakos Danielle , Christman Holly , Bonning Michael A. , Geisse John K. , A'Amar Ousama M. , Leffell David J. , Bigio Irving J.
Published: July 2019

Skin cancer is the most prevalent cancer, and its assessment remains a challenge for physicians. This study reports the application of an optical sensing method, elastic scattering spectroscopy (ESS), coupled with a classifier that was developed with machine learning, to assist in the discrimination of skin lesions that are concerning for malignancy. The method requires no special skin preparation, is non‐invasive, easy to administer with minimal training, and allows rapid lesion classification. This novel approach was tested for all common forms of skin cancer. ESS spectra from a total of 1307 lesions were analyzed in a multi‐center, non‐randomized clinical trial. The classification algorithm was developed on a 950‐lesion training dataset, and its diagnostic performance was evaluated against a 357‐lesion testing dataset that was independent of the training dataset. The observed sensitivity was 100% (14/14) for melanoma and 94% (105/112) for non‐melanoma skin cancer. The overall observed specificity was 36% (84/231). ESS has potential, as an adjunctive assessment tool, to assist physicians to differentiate between common benign and malignant skin lesions.
Habitat Traps in Mobile Platform Ecosystems
Authors: Pervin Nargis , Ramasubbu Narayan , Dutta Kaushik
Published: July 2019

Even with the rapid proliferation of applications (“apps”) running on smart handheld devices, achieving success in mobile platform ecosystems is challenging for developers because of the heavily crowded marketplaces and easy substitutability of apps. In this study, we draw inspiration from biological ecosystems research and from the operations management literatures on software production, product management, and digital platforms to empirically examine the sustainability of newly launched apps in the Apple and Google mobile platform ecosystems. In the ecology literature, a “habitat trap” refers to the instinctive but detrimental behavioral response which can potentially lead to the extinction of organisms facing dynamic changes in their habitats. Applying the habitat traps concept to mobile platform ecosystems, we investigate whether seemingly beneficial actions of app developers can indeed become detrimental to the sustainability of their apps. Using lifecycle data of 57,117 newly launched paid apps, we examine the impact of five developer actions (updating the apps, offering price promotions, and diversifying into functional variants, similar apps, and other platforms) on the sustainability of the apps. The results of our analysis show that while frequent app updates are beneficial, engaging in price promotions and diversification‐oriented activities indeed have the risks of turning into traps for developers. We utilize the empirical results to draw attention to the heterogeneity of traps in mobile platform ecosystems, shed light on the need to develop strategies for overcoming the traps, and discuss the implications of the presence of platform traps for emerging theories on digital ecosystems.
Evaluating antimicrobial resistance in the global shrimp industry
Authors: Thornber Kelly , Verner‐Jeffreys David , Hinchliffe Steve , Rahman Muhammad Meezanur , Bass David , Tyler Charles R.
Published: July 2019

Antimicrobial resistance (AMR) is a growing threat to global public health, and the overuse of antibiotics in animals has been identified as a major risk factor. With high levels of international trade and direct connectivity to the aquatic environment, shrimp aquaculture may play a role in global AMR dissemination. The vast majority of shrimp production occurs in low‐ and middle‐income countries, where antibiotic quality and usage is widely unregulated, and where the integration of aquaculture with family livelihoods offers many opportunities for human, animal and environmental bacteria to come into close contact. Furthermore, in shrimp growing areas, untreated waste is often directly eliminated into local water sources. These risks are very different to many other major internationally‐traded aquaculture commodities, such as salmon, which is produced in higher income countries where there are greater levels of regulation and well‐established management practices. Assessing the true scale of the risk of AMR dissemination in the shrimp industry is a considerable challenge, not least because obtaining reliable data on antibiotic usage is very difficult. Combating the risks associated with AMR dissemination is also challenging due to the increasing trend towards intensification and its associated disease burden, and because many farmers currently have no alternatives to antibiotics for preventing crop failure. In this review, we critically assess the potential risks the shrimp industry poses to AMR dissemination. We also discuss some of the possible risk mitigation strategies that could be considered by the shrimp industry as it strives for a more sustainable future in production.
Intestinal surgery in small animals: historical foundations, current thinking, and future horizons
Authors: Ellison Gary W. , Case J. Brad , Regier Penny J.
Published: July 2019

Intestinal wounds require precise closure after intestinal biopsy, enterotomy, or enterectomy in small animals. Preexisting factors such as intra‐abdominal sepsis and hypoalbuminemia as well as poor surgical technique increase the risk of intestinal dehiscence, with considerable negative impact on patient morbidity and mortality. Live dog studies have demonstrated the dangers of mucosal eversion especially in the septic abdomen. Approximating patterns preserve luminal diameter, heal optimally, and have equal bursting strength compared with inverting patterns after 24 hours. Simple interrupted and simple continuous suture patterns and disposable skin staples are established alternatives for manual wound closure. Knotless quilled suture currently used in laparoscopic gastropexy techniques shows bursting strength equal to monofilament sutures in dog cadaveric intestine. Dehiscence rates with hand sewn vs titanium automated stapling anastomosis are similar in uncomplicated cases; however, auto stapling devices may be the preferred method of anastomosis when preexisting abdominal sepsis is present and when patient size allows it. Regardless of the technique, current standard of care involves leak testing and omental wrapping, followed by early postoperative feeding. The past decade has ushered in an exciting new era of laparoscopic assisted techniques that have the potential to reduce postoperative pain and patient morbidity. An understanding of these applications will establish the future of minimally invasive small animal intestinal surgery for veterinary specialists. In summary, surgeons have a variety of methods at their disposal for optimal clinical outcome in small animal intestinal surgery.
Extended long‐term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog
Authors: Moore Elisabeth V. , Weeren Robert , Paek Matthew
Published: July 2019

Objective

To report extended long‐term outcomes of dogs with cranial cruciate ligament rupture treated by tibial plateau leveling osteotomy (TPLO) or tibial tuberosity advancement (TTA).

Study design

Retrospective clinical cohort study.

Animals

Client‐owned dogs with ≥3 years follow‐up (118 dogs, 166 stifles).

Methods

Records from June 2012 to May 2015 were reviewed. Follow‐up examination and radiography were performed in dogs meeting the inclusion criteria. Measures of outcomes included a radiographic osteoarthritis score (preoperative, 8 weeks postoperative, and ≥3 years postoperative), the Canine Brief Pain Inventory, and the Canine Orthopedic Index.

Results

Ninety‐four dogs treated with TPLO (133 stifles) and 24 dogs treated with TTA (33 stifles) met the inclusion criteria. All dogs underwent meniscal release or partial medial meniscectomy. Osteoarthritis score progressed more after TTA (P = .003) and in dogs with bilateral surgery (P = .022). Long‐term outcomes that were better after TPLO compared with TTA included average pain in the last 7 days (P = .007), interference with walking (P = .010), morning stiffness (P = .004), jumping (P = .003) and climbing (P = .040), limping during mild activities (P = .001), and overall quality of life (P = .045).

Conclusion

Osteoarthritis progressed more after TTA and in dogs with bilateral stifle surgery. Dogs treated with TPLO subjectively seemed to have less pain and fewer mobility issues.

Clinical significance

Tibial plateau leveling osteotomy provides a better long‐term radiographic and functional outcome than TTA.
The functional and pragmatic contexts of world Englishes
Authors: Valentine Tamara
Published: July 2019

Drawing on the concepts of the ‘context of situation’ of J. R. Firth and the Hallidayan meaning of ‘linguistic performance’, the early works of Braj Kachru presented a sociologically oriented linguistic model to the study of Indian English. Giving Indianness ‘functional relevance and formal “manifestation”’, Kachru laid the foundation for contextualizing world Englishes within a sociolinguistic framework. This paper revisits the early cultural wars of language, and Kachru's efforts to explain language variation in the multilingual, multicultural contexts of English around the world within the scope of ‘pragmatism and linguistic realism’ (Kachru, 1986, p. 32). This paper examines the research, studies and insights of scholars who have contributed to furthering the functional and pragmatic contexts in which world Englishes are used.
Kachru's redeeming myth of world Englishes
Authors: Webster Jonathan J.
Published: July 2019

Michael Halliday once stated that all theories employ metaphors in order to express their essence, which might be restated as ‘every theory is a myth for what it is theorizing’. In his early work, Braj Kachru set out to creatively and critically ‘de‐mythologize’ the English canon, and in its stead introduced the new metaphor of the ‘Three Circles’, and the innovative, and redeeming, myth of ‘world Englishes’, changing the history of English studies in the process.