bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilizing patient advocates in Parkinson’s disease: A proposed framework for patient engagement and the modern metrics that can determine its success
Authors: Feeney Megan , Evers Christiana , Agpalo Danielle , Cone Lisa , Fleisher Jori , Schroeder Karlin
Published: May 2020

The wide application of patient engagement and its associated benefits has increased across government, academic and pharmaceutical research. However, neither an identified standard practice for the process of engagement, nor utilization of common metrics to assess associated outcomes, exists. Parkinson's Foundation developed a patient engagement framework and metrics to assess engagement within the academic research and drug development sectors. This approach was developed over the course of several years through assessing the literature, acquiring feedback from researchers and people with Parkinson's disease and adapting practices to be relevant and generalizable across patient engagement projects. This framework includes the: 1) creation of a scope of work, 2) establishment of guiding principles, 3) selection and training of participants, 4) co‐determination of project metrics, 5) execution of the project and 6) dissemination of project findings. Parkinson's Foundation has also worked with academic, government and pharmaceutical stakeholders to identify metrics that assess both the quality of patient engagement and outcomes associated with patient engagement on projects. By improving patient engagement project methodologies and metrics, global clinical trials can have access to evidence‐based patient engagement practices to more efficiently capture the needs of, and potentially benefit, the patient community.
Passive filler loaded polysilazane‐derived glass/ceramic coating system applied to AISI 441 stainless steel, part 2: Oxidation behavior in synthetic air
Authors: Parchovianský Milan , Petríková Ivana , Švančárek Peter , Lenz Leite Mateus , Motz Günter , Galusek Dušan
Published: May 2020

This article features the oxidation behavior of ferritic stainless steel grade AISI 441 coated with protective polymer‐derived ceramics (PDC). Two PDC compositions are studied with respect to their oxidation resistance in a flow‐through atmosphere of synthetic air at temperatures of up to 1000°C. The coatings contain a combination of six passive fillers: Y‐containing ZrO2, glass microspheres, alumina‐yttria‐zirconia (AYZ) powder, and three commercial glasses. They are pyrolyzed in air for 1 hour at 800°C with heating and cooling rates of 3 K/min. Detailed microstructural examination of the oxide products formed at the surface of samples after exposure to air at 900°C, 950°C, and 1000°C for 1‐48 hours is analyzed. Both uncoated steel and steel coated with two of the protective systems described in part 1 of this article are investigated. Fe, Cr2O3, TiO2, and a spinel of the composition (Mn,Cr)3O4 are identified at the oxidized surface of the steel substrate using X‐ray diffraction. A significant weight gain of the unprotected steel is measured after all experiments, while oxidation tests of the coated steel show a negligible weight gain after 900°C and 950°C. During the early stages of coating oxidation, the monoclinic‐to‐tetragonal ratio in the zirconia filler is shifted toward the monoclinic modification. Longer exposures and higher temperatures lead to the formation of yttrium aluminum garnet (YAG) due to glass microsphere crystallization and solid state reactions in the AYZ powder. The crystallization of the three commercial glasses functioning as sealants leads to the formation of Ba(AlSiO4)2 also known as hexacelsian, which subsequently transforms to celsian. YZr8O14 is also formed. The protective effect of the PDC coatings applied to the stainless steel is demonstrated up to 950°C.
The Compassion Competence Scale Arabic version: A validation study among student nurses and interns in Saudi Arabia
Authors: Alabdulaziz Hawa , Alquwez Nahed , Cruz Jonas Preposi , Tumala Regie , Albougami Abdulrhman , Albloushi Monirah
Published: May 2020

Aim

The aim of this study is to assess the validity and reliability of the Compassion Competence Scale Arabic version for Saudi nursing students and interns.

Background

Compassion is an essential element of quality health care in which training nursing students to deliver compassionate care is important. Assessment of compassion competence of Arabic‐speaking nursing students requires a valid and reliable tool.

Design

This is a descriptive and cross‐sectional study.

Methods

This investigation was conducted from April to May 2019 in two universities in Saudi Arabia involving nursing students and interns. Cultural adaptation was performed using a forward–backward translation method. Content validity and construct validity through exploratory factor analysis were established. Internal consistency, stability and reliability were also determined for the scale.

Results

The Arabic version has an excellent content validity. The exploratory factor analysis supported a three‐factor solution that accounts for 50.62% of the scale's variance. The Cronbach's alpha of the scale was 0.806, whereas the Cronbach's alpha of the subscales ranged from 0.739 to 0.797. The intraclass correlation coefficient of the two‐week test–retest scores was 0.84. The university, gender, year level and family type predicted the students' compassion competence.

Conclusion

The Arabic version can be used to measure Arabic‐speaking nursing students' compassion competence in clinical areas.
Social work and sustainable rural development: The practice of social economy in China
Authors: Ku Hok Bun , Kan Karita
Published: May 2020

The impact of globalisation on local agriculture and food systems has brought issues such as food security and rural sustainability to the forefront of policy‐making in developing countries. In China, the restructuring of domestic agriculture and liberalisation of trade following accession to the World Trade Organization have led to the growing reliance on imported food and raised concerns for food self‐sufficiency and safety. Inspired by the concept of social economy, social workers in China have explored alternative pathways towards sustainable food production and consumption through local initiatives. Based on participatory action research in a Chinese village, this study examines the potential contribution of social work intervention in responding to China’s agrarian challenges. It is shown that by linking rural cooperatives with the local food system and allowing farmers to sell directly to urban consumers at fairer prices, social economy initiatives provide a viable pathway for sustainable transformation by empowering rural producers while giving urban consumers access to sustainably produced food.
Identification of a new oxidation/ dissolution mechanism for boria‐accelerated SiC oxidation
Authors: McFarland Bohuslava , Angelici Avincola Valentina , Morales Madeline , Opila Elizabeth
Published: May 2020

Boria effects on accelerated SiC oxidation kinetics were investigated by conducting thermogravimetric analysis on SiC substrates coated with sol‐gel derived borosilicate glass isothermally exposed to dry O2 and argon at 800°C and 1200°C for 100 hours. Boria concentrations in the glass coatings were 0, 14‐38, and 92‐94 mol%, balance silica. Accelerated weight gain was observed for SiC exposures in dry O2 at 800°C when boria concentrations were ≥ 92 mol%, corroborated by oxide thickness ranging from 3.5 to 10 µm. The oxide thickness predicted for pure SiC exposed to these conditions in the absence of boria is 0.15 µm. Microstructural analysis of SiC surfaces after oxide removal revealed that boria etched the underlying SiC substrate. Oxidation exposures at 1200°C in dry O2 suppressed boria effects on accelerating SiC oxidation kinetics due to rapid boria volatilization coupled with the formation of a protective thermally grown silica scale. Accelerated weight gain or oxide growth did not occur with argon exposures at either temperature. A new mechanism for boria‐accelerated SiC surface‐reaction kinetics is presented based on evidence for boria etching of SiC.
Introduction: Symposium on Causation in War
Authors: Frowe Helen , Renzo Massimo
Published: May 2020

This article links to the Symposium on Causation in War by Carolina Sartorio, Helen Beebee and Alex Kaiserman, and Lars Christie.
High‐fat diet affects skeletal muscle mitochondria comparable to pressure overload‐induced heart failure
Authors: Heyne Estelle , Schrepper Andrea , Doenst Torsten , Schenkl Christina , Kreuzer Katrin , Schwarzer Michael
Published: May 2020

In heart failure, high‐fat diet (HFD) may exert beneficial effects on cardiac mitochondria and contractility. Skeletal muscle mitochondrial dysfunction in heart failure is associated with myopathy. However, it is not clear if HFD affects skeletal muscle mitochondria in heart failure as well. To induce heart failure, we used pressure overload (PO) in rats fed normal chow or HFD. Interfibrillar mitochondria (IFM) and subsarcolemmal mitochondria (SSM) from gastrocnemius were isolated and functionally characterized. With PO heart failure, maximal respiratory capacity was impaired in IFM but increased in SSM of gastrocnemius. Unexpectedly, HFD affected mitochondria comparably to PO. In combination, PO and HFD showed additive effects on mitochondrial subpopulations which were reflected by isolated complex activities. While PO impaired diastolic as well as systolic cardiac function and increased glucose tolerance, HFD did not affect cardiac function but decreased glucose tolerance. We conclude that HFD and PO heart failure have comparable effects leading to more severe impairment of IFM. Glucose tolerance seems not causally related to skeletal muscle mitochondrial dysfunction. The additive effects of HFD and PO may suggest accelerated skeletal muscle mitochondrial dysfunction when heart failure is accompanied with a diet containing high fat.
Secukinumab maintains superiority over ustekinumab in clearing skin and improving quality of life in patients with moderate to severe plaque psoriasis: 52‐week results from a double‐blind phase 3b trial (CLARITY)
Authors: Bagel J. , Blauvelt A. , Nia J. , Hashim P. , Patekar M. , de Vera A. , Ahmad K. , Paguet B. , Xia S. , Muscianisi E. , Lebwohl M.
Published: May 2020

Background

Secukinumab demonstrated superior efficacy over ustekinumab in the treatment of moderate to severe plaque psoriasis over 16 weeks in the CLARITY study and over 52 weeks in the CLEAR study.

Objective

To compare the efficacy and safety of secukinumab vs. ustekinumab over 52 weeks in CLARITY.

Methods

Analysis of 52‐week data from CLARITY (NCT02826603), a phase 3b study in which patients were randomized to receive secukinumab 300 mg (n = 550) or ustekinumab 45/90 mg (n = 552) per label.

Results

At week 52, secukinumab was superior to ustekinumab in the proportion of patients who achieved ≥ 90% improvement in Psoriasis Area and Severity Index (73.2% vs. 59.8%; odds ratio [OR], 1.84 [95% CI, 1.41–2.41]; P < 0.0001), Investigator’s Global Assessment modified 2011 responses of clear (0) or almost clear (1) skin (76.0% vs. 60.2%; OR, 2.12 [95% CI, 1.61–2.79]; P < 0.0001) and Dermatology Life Quality Index response of no effect (0/1) (69.9% vs. 61.2%; P = 0.0028). Proportions of patients with any adverse events were comparable between treatment arms.

Conclusions

This second head‐to‐head study confirmed the superior efficacy of secukinumab over ustekinumab in skin clearance and quality of life through 52 weeks, with safety comparable to that reported in previous trials. Clinicaltrials.gov identifier: NCT02826603.
Non‐invasive clinical and microscopic evaluation of the response to treatment with clobetasol cream vs. calcipotriol/betamethasone dipropionate foam in mild to moderate plaque psoriasis: an investigator‐initiated, phase IV, unicentric, open, randomized clinical trial
Authors: Yélamos O. , Alejo B. , Ertekin S. S. , Villa‐Crespo L. , Zamora‐Barquero S. , Martinez N. , Domínguez M. , Iglesias P. , Herrero A. , Malvehy J. , Puig S.
Published: May 2020

Background

Treatment response for psoriasis is typically evaluated using clinical scores. However, patients can relapse after clinical clearance, suggesting persistent inflammation. Dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) can non‐invasively improve treatment response assessment.

Objectives

To compare the clinical and non‐invasive microscopic features in a psoriatic target lesion treated with clobetasol cream or calcipotriol/betamethasone dipropionate foam (Cal/BD foam).

Methods

Prospective, unicentric, open, randomized clinical trial comparing clinical data [total clinical score (TCS)] and microscopic data (dermoscopy, RCM and OCT) in psoriasis patients treated with clobetasol or Cal/BD foam.

Results

We included 36 adult patients (22 men). At week 4, more patients treated with Cal/BD foam achieved TCS ≤1 than with clobetasol (63.2% vs. 18.8%, P = 0.016). Treatment satisfaction was higher with Cal/BD foam (P < 0.03). Microscopically, Cal/BD foam induced more reduction in epidermal thickness at week 4 (P < 0.049). Dilated horizontal blood vessels were more common with clobetasol than with Cal/BD foam at week 8 (69.2% vs. 31.2%, P = 0.159). If epidermal hyperplasia was noted at baseline, the response was poorer with clobetasol (P = 0.029).

Limitations

Small sample size, open study, imaging sampling bias.

Conclusion

Cal/BD foam is more effective than clobetasol, has better patient satisfaction and induces greater reduction in the hyperkeratosis/acanthosis, regardless of baseline epidermal hyperplasia.
Skin cancer risk and shade: comparing the risk of foresters with other outdoor workers
Authors: Tizek L. , Schielein M.C. , Berger U. , Ege M.J. , Schneider S. , Zink A.
Published: May 2020

Background

Keratinocyte carcinoma (KC) is an increasingly important public health problem with an especially high prevalence in outdoor workers. In contrast to other occupations, foresters spend most of their outdoor time under the shade of trees.

Objectives

We aimed to compare the unique sun exposure patterns and sun protection behaviour of foresters with those of other outdoor workers and their relation to the KC risk.

Methods

In July 2018, a cross‐sectional study was conducted at an international forestry fair using a questionnaire about health awareness and skin cancer screening by dermatologists to assess the prevalence of KC.

Results

A total of 591 participants (78.7% male; mean age 46.8 ± 16.2 years) including 193 foresters were enrolled. Of all foresters, 72% experienced sunburns (solar erythema) within the past year and 50% of them experienced the worst sunburn during work. Foresters were most likely to often/always wear protective clothes (29.0%) but were least likely to often/always avoid midday sun (23.8%) and stay in the shade (31.1%). Having an outdoor profession or spending hours outside for leisure was negatively associated with sun protection. Skin examination revealed an overall KC prevalence of 16.7%, with 16.5% of foresters being affected.

Conclusion

Despite being protected by trees, the risk of KC for foresters is comparable to that of other professional groups. Shade alone may not provide sufficient protection. Additional sun protection measures are necessary.
A multinational, prospective, observational study to estimate complete skin clearance in patients with moderate‐to‐severe plaque PSOriasis treated with BIOlogics in a REAL world setting (PSO‐BIO‐REAL)
Authors: Seneschal J. , Lacour J.‐P. , Bewley A. , Faurby M. , Paul C. , Pellacani G. , De Simone C. , Horne L. , Sohrt A. , Augustin M. , Hammond E. , Reich K.
Published: May 2020

Background

Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis.

Objective

The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months.

Methods

PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12.

Results

At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased.

Conclusion

Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis.
Non‐lethal loop‐mediated isothermal amplification assay as a point‐of‐care diagnostics tool for Neoparamoeba perurans, the causative agent of amoebic gill disease
Authors: Cano Irene , McCullough Robin , Mulhearn Brian , Gunning Susie , Waine Ava , Joiner Claire , Paley Richard
Published: May 2020

Neoparamoeba perurans is the causative agent of amoebic gill disease (AGD). Two loop‐mediated isothermal amplification (LAMP) assays targeting the parasite 18S rRNA and the Atlantic salmon EF1α, used as internal control, were designed. The N. perurans LAMP assay did not amplify close relatives N. pemaquidensis and N. branchiphila, or the host DNA. This assay detected 106 copies of the parasite 18S rRNA gene under 13 min and 103 copies under 35 min. Five “fast‐and‐dirty” DNA extraction methods were compared with a reference method and further validated by TaqMan™ qPCR. Of those, the QuickExtract buffer was selected for field tests. Seventy‐one non‐lethal gill swabs were analysed from AGD‐clinically infected Atlantic salmon. The pathogen was detected under 23 min in fish of gill score >2 and under 39 min for lower gill scores. About 1.6% of the tests were invalid (no amplification of the internal control). 100% of positives were obtained from swabs taken from fish showing gill score ˃3, but only ~50% of positives for lower gill scores. The present LAMP assay could be implemented as a point‐of‐care test for the on‐site identification of N. perurans; however, further work is required to improve its performance for lower scores.
Use of corn flour and polydextrose in fried extrudate making: Effects of polydextrose content in the blend and extrusion temperature on the product quality
Authors: Yang Jin Han , Tran Thi Thu Tra , Le Van Viet Man
Published: May 2020

High fiber snack food has attracted great attention due to many health benefits. In this study, the effects of polydextrose content and extrusion temperature on proximate composition, physical and sensory properties of the fried corn snack were investigated. Firstly, the polydextrose content in the blend was varied from 0 to 10% while the extrusion temperature was fixed. Then the blend formula was fixed while the die temperature was changed from 60 to 110°C. An increase in polydextrose content in the blend from 0 to 10% augmented the product density and decreased its radial and axial expansion ratio and crispness. Moreover, small air cells and thick cell walls were observed in the texture of the product with high polydextrose content. An increase in die temperature from 60 to 100°C reduced the product bulk density and enhanced the radial and axial expansion ratio, hardness, and crispness. High die temperature also resulted in large air cells and thin cell walls in the product texture as well as high water absorption and water solubility index of the snack. However, further, an increase in die temperature from 100 to 110°C reduced the expansion ratio, hardness, and crispness of the fried extrudate. It can be concluded that snack quality was greatly influenced by polydextrose content and extrusion temperature. The use of polydextrose is the potential for the development of high fiber snack food.

Practical application

Recently, many studies focus on the possibility of the application of various dietary fiber sources in the production of extruded snack food. Most of the investigated fiber materials are whole grain cereal flour, cereal bran or fruit, and vegetable fibers. Nowadays, commercial soluble dietary fiber preparations are well‐known in food industry. Their proximate composition and properties are stable and highly standardized. However, their use in extruded snack production has not been considered. In this study, corn flour and polydextrose were extruded to produce snack with high fiber content. The effects of polydextrose ratio in the blend and extrusion temperature on proximate composition, physical and sensory properties of the fried extrudate were investigated. The obtained results would be useful for food scientists and technologists who look for a potential dietary fiber source in the production of snack food with high fiber content.
The role of solid debris in endoscopic ultrasound‐guided drainage of walled‐off necrosis: A large cohort study
Authors: Zhu Huiyun , Xie Pei , Wang Yuxin , Jin Zhendong , Li Zhaoshen , Du Yiqi
Published: May 2020

Background and Aim

The effect of solid debris on walled‐off necrosis (WON) drainage remains unknown. Our study evaluated the role of solid debris in endoscopic ultrasound (EUS)‐guided drainage of WON compared lumen‐apposing metal stent (LAMS) with double‐pigtail plastic stent (DPPS).

Methods

We retrospectively evaluated consecutive patients with WON who underwent EUS‐guided drainage in our endoscopic center over a 9‐year period. The amount of solid debris in WON was assessed with computed tomography or magnetic resonance imaging and EUS images.

Results

From 2011 to 2019, 84 WON patients were included. In WON with < 20% solid debris, the short‐term clinical success of LAMSs (96.8%) was significantly higher than DPPSs (66.7%) (P = 0.03), and LAMSs were safer than DPPSs with less early adverse events (P = 0.02) and late adverse events (P = 0.03). On multivariable analysis, DPPS (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.04–0.65; P = 0.01) and solid debris > 40% (OR, 0.11; 95% CI, 0.02–0.62; P = 0.01) were the predictors for failure of resolution of WON after adjusting for age and cyst size. The number of DPPSs used was significantly higher than LAMSs in managing WONs (P < 0.001).

Conclusion

For WON with < 20% solid debris, LAMSs might superior to DPPSs in terms of efficacy and safety.
Front of pack nutritional labelling schemes: a systematic review and meta‐analysis of recent evidence relating to objectively measured consumption and purchasing
Authors: Croker H. , Packer J. , Russell Simon J. , Stansfield C. , Viner R. M.
Published: May 2020

Background

Front of pack labelling (FOPL) provides visible nutritional information and appears to influence knowledge and reformulation. However, a recent Cochrane review found limited and inconsistent evidence for behaviour change. The present review aimed to examine studies published subsequent the Cochrane review, focusing on prepackaged foods, examining the impact of FOPL on purchasing and consumption.

Methods

Controlled experimental/intervention and interrupted time series (ITS) studies were included, with no age/geography restrictions. Exposures were FOPL with objectively measured consumption/purchasing outcomes. Thirteen databases were searched (January 2017 to April 2019) and forward citation searching was undertaken on the included studies. Purchasing data from experimental studies were meta‐analysed. Two series of meta‐analyses were undertaken; combined FOPL versus no‐FOPL and specific FOPL scheme versus no‐FOPL. Outcomes were sugar (g 100 g−1), calories (kcal 100 g−1), saturated fat (g 100 g−1) and sodium (mg 100 g−1).

Results

We identified 14 studies, reporting consumption (experimental; n = 3) and purchasing (n = 8, experimental; n = 3, ITS). Meta‐analysis of experimental studies showed sugar and sodium content of purchases was lower for combined FOPL versus no‐FOPL (−0.40 g sugar 100 g−1, P < 0.01; −24.482 mg sodium 100 g−1, P = 0.012), with a trend for lower energy and saturated fat (−2.03 kcal 100 g−1, P = 0.08; −0.154 g saturated fat 100 g−1, P = 0.091). For specific FOPL, products purchased by ‘high in’ FOPL groups had lower sugar (−0.67 g sugar 100 g−1, P ≤ 0.01), calories (−4.43 kcal 100 g−1, P < 0.05), sodium (−33.78 mg 100 g−1, P = 0.01) versus no‐FOPL; Multiple Traffic Light had lower sodium (−34.94 mg 100 g−1, P < 0.01) versus no‐FOPL. Findings regarding consumption were limited and inconsistent. FOPL resulted in healthier purchasing in ITS studies.

Conclusions

This review provides evidence from experimental and ‘real‐life’ studies indicating that FOPL encourages healthier food purchasing. PROSPERO CRD42019135743.
Impact of nutritional status/risk and post‐operative nutritional management on clinical outcomes in patients undergoing gastrointestinal surgery: a prospective observational study
Authors: Narendra K. , Kiss N. , Margerison C. , Johnston B. , Chapman B.
Published: May 2020

Background

Malnutrition is prevalent in patients undergoing gastrointestinal (GI) surgery and has been linked to adverse outcomes. The present study aimed to determine the association between early post‐operative nutritional status/risk, post‐operative nutritional management and clinical outcomes.

Methods

A prospective observational study was conducted in GI surgical patients with a minimum 3‐day post‐operative length of stay (LOS). Data on patient demographics, nutritional status/risk, post‐operative nutritional management and clinical outcomes were collected. Four markers of nutritional status and risk were assessed: preoperative weight loss, nutrition risk, malnutrition status and hand grip strength. Clinical outcomes included: post‐operative LOS, complication and readmissions rates. Multivariate linear and logistic regression were used to test for associations with clinical outcomes.

Results

One hundred and fifteen patients (55% female) with mean (SD) age of 60.8 (16.2) years were included. Median (IQR) post‐operative LOS was 8.0 days (4.5–11.5), 37% of participants developed at least one complication post‐operatively and 24% were readmitted within 30‐days of discharge. Mean number of nil‐by mouth (NBM) days post‐operatively was 0.7 (1.2) and the average time to commence feeding was 3.3 (2.2) days after surgery. Poor nutritional status/risk between days 3–5 post‐operatively assessed through all four markers was associated with longer post‐operative LOS (all P < 0.05). No association was found between number of NBM days, time to feeding and clinical outcomes.

Conclusion

Poor early post‐operative nutritional status/risk is associated with longer post‐operative LOS in patients undergoing GI surgery, which may facilitate simple identification of patients at high priority for nutritional intervention. The present study highlights the heterogeneity in post‐operative nutritional management practices.
Entrepreneurial Hustle: Navigating Uncertainty and Enrolling Venture Stakeholders through Urgent and Unorthodox Action
Authors: Fisher Greg , Stevenson Regan , Neubert Emily , Burnell Devin , Kuratko Donald F.
Published: May 2020

Entrepreneurs need to act under conditions of uncertainty and resource constraints to bring new, often‐unrecognizable products to market and convince an unknown set of stakeholders to support their endeavours. The type of action entrepreneurs take to navigate uncertain entrepreneurial contexts is underspecified. We analysed 48 interviews with entrepreneurs to inductively identify an action‐oriented construct we labelled as entrepreneurial hustle – an entrepreneur’s urgent, unorthodox actions that are intended to be useful in addressing immediate challenges and opportunities under conditions of uncertainty. In a follow‐up study, we use an experimental vignette approach to assess the impact of an entrepreneur’s hustle on venture stakeholders. Findings suggest that entrepreneurial hustle positively influences stakeholder perceptions of the entrepreneur’s leadership effectiveness and a venture’s legitimacy, mediated by perceptions of the entrepreneur’s ability‐based trustworthiness. We conclude that entrepreneurial hustle is a fundamental behaviour that enables entrepreneurs to enrol new venture stakeholders and lead their entrepreneurial efforts.
Usefulness of metalloproteinase‐9 and tissue inhibitor of metalloproteinase‐1 in clinical characterisation of children with newly diagnosed Crohn's disease
Authors: Daniluk Urszula , Daniluk Jaroslaw , Guzinska‐Ustymowicz Katarzyna , Pryczynicz Anna , Lebensztejn Dariusz
Published: May 2020

Aim

The aim of this study was to determine the relation of non‐invasive markers representing gut mucosal damage (metalloproteinase‐9 (MMP‐9)) and remodelling (tissue inhibitor of metalloproteinase‐1 (TIMP‐1)) with Crohn's disease (CD) phenotype, disease activity scores (clinical and endoscopic) and radiological evaluation of the ileum in newly diagnosed children.

Methods

Serum and faecal MMP‐9 and TIMP‐1 concentrations were determined with the sandwich enzyme‐linked immunoassay technique. The performance of each marker with reference to the Paris classification, disease activity scores and magnetic resonance enterography results was assessed using non‐parametric tests.

Results

A total of 32 children with CD demonstrated higher levels of serum and faecal MMP‐9 and TIMP‐1 compared with a control group including children without gastrointestinal inflammatory disease (all P < 0.05). Only the serum MMP‐9 concentration was significantly higher in children with L3 (ileocolonic) compared with children with L1 (distal ileum). The serum TIMP‐1 level was significantly higher in patients with an magnetic resonance enterography‐detected ileum involvement longer than 51 mm and in children with severe disease activity compared with other patients. The serum MMP‐9 level was lower in patients with stenosis combined with prestenotic dilation compared with children without stenosis.

Conclusion

Increased serum and faecal MMP‐9 and TIMP‐1 concentrations are some reliable markers of inflammation in newly diagnosed children with CD, but without facilitating clear phenotyping of the disease.
Development and evaluation of formal guidelines for donor selection for human milk banks
Authors: Clifford Vanessa , Sulfaro Christine , Lee June , Pink Joanne , Hoad Veronica
Published: May 2020

Aim

Donor selection for milk banks is essential to ensure the safety and nutritional quality of the donor milk, and to ensure that the prospective donor and her breastfeeding infant do not come to harm through donating. Australian Red Cross Lifeblood Milk went through a robust process to develop a set of criteria for the selection and screening of potential breast milk donors, which included development of a Donor Questionnaire (DQ), supported by a formal set of Guidelines for the Selection of Milk Donors. Key screening questions from the DQ were made available to prospective donors to self‐screen prior to the formal assessment process. The aim of this study was to review the outcomes of milk donor screening at Lifeblood Milk.

Methods

We reviewed the outcomes of our donor screening process over the first 12‐months (July 2018–June 2019) of operations.

Results

A total of 50 out of 327 donors who responded to the self‐screening questions were not able to proceed further; 201 donors were formally screened using the DQ and Guidelines for the Selection of Milk Donors, with 9 of 201 deferred based on their responses. An additional two donors were deferred (failed phlebotomy (n = 1) and reactive infectious disease serology (n = 1)), with 190 of 201 (95%) of prospective donors accepted after screening.

Conclusions

Our experience highlighted international differences in practice between milk banks and lack of strong research to inform milk donor selection. Making a set of key screening questions available to donors for self‐screening resulted in a high acceptance rate (95%) for donors who began the formal screening process. Further work is needed to better understand the impact of deferral on prospective milk donors.
Temporal and spatial dynamics of grapevine anthracnose and its relationship to pathogen survival
Authors: dos Santos Ricardo Feliciano , Amorim Lilian , Zini Priscila Barbieri , Spósito Marcel Bellato
Published: May 2020

Anthracnose, caused by Elsinoë ampelina, is an economically important grapevine disease in south and southeast Brazil. Control is achieved by lime sulphur application during grapevine dormancy and foliar fungicide sprays until the berries are half‐grown. This study assessed the temporal and spatial progress of grapevine anthracnose under field conditions in order to describe the disease dynamics and its relationship to pathogen survival. The experiment was carried out in a vineyard of table grape Vitis labrusca in Brazil, during the 2014 and 2015 growing seasons. The incidence of vines with diseased leaves, stems and berries and the disease severity on leaves were recorded from bud break to veraison. Monomolecular, logistic and Gompertz models were fitted by non‐linear regression to the incidence and severity data over time to characterize the temporal progress. Ordinary runs, dispersion index, modified Taylor's power law and spatial hierarchy analyses were used to characterize the spatial pattern of diseased plants. The monomolecular model showed the best fit for the incidence progress, with disease progress rates ranging from 0.051 to 0.136 per day. In both seasons, the incidence of diseased plants reached 100% 1 month after bud break. However, the incidence of diseased leaves per plant was around 60% and leaf disease severity was lower than 5% for both years. Ordinary runs and dispersion index analyses revealed that diseased grapevines were distributed randomly on the majority of the assessment dates. Meanwhile, a slight aggregation of diseased vines was observed in the modified Taylor's power law analysis. Our results suggested that the progress of anthracnose incidence and severity over time was governed mainly by the income of the primary inoculum, which survived in the vineyard. Therefore, anthracnose control measures in Brazilian vineyards should be focused on the reduction in inoculum within the vineyard.
The effect of dietary supplementation with globin and spray‐dried porcine plasma on performance, digestibility and histomorphological traits in broiler chickens
Authors: Dabbou Sihem , Trocino Angela , Xiccato Gerolamo , Nery Joana , Madrid Josefa , Martinez Silvia , Hernández Fuensanta , Kalmar Isabelle D. , Capucchio Maria Teresa , Colombino Elena , Biasato Ilaria , Bailoni Lucia , Gasco Laura , Mugnai Cecilia , Schiavone Achille
Published: May 2020

This study evaluated the effects of globin and spray‐dried porcine plasma (SDPP) on growth performance, digestibility, nitrogen retention, energy retention efficiency (ERE) and intestinal morphology of broiler chickens. A total of 336‐day‐old male broiler chickens were reared from 1 to 40 days of age and fed 3 diets (8 replicates/diet, 14 birds/replicate) during 3 feeding phases: starter (1–12 days), grower (12–25 days) and finisher (25–40 days). Isonitrogenous diets were formulated by replacing gluten protein isolate contained in the control diet (C diet) with 2% (starter) or 1% (grower and finisher) spray‐dried porcine plasma in the plasma diet (SDPP diet). The globin diet (G diet) was obtained by adding globin on the top of C diet at a dose of 0.08% for the whole rearing period. Total tract apparent digestibility (aD), nitrogen retention and ERE were assessed during the three growing phases. At 12  and 40 days of age, one bird per pen was slaughtered to sample gut, liver, spleen and bursa of Fabricius for histomorphological investigations. The SDPP diet increased body weights of chickens at 12 (+60 g; p < .001), 25 (+101 g; p < .001) and 40 days (+130 g; p = .018) of age compared to C and G diets. Also SDPP improved crude protein aD (+9.7%) and ERE (+12.3%) during the starter phase (p < .001). Dietary globin and SDPP inclusion did not affect either the gut morphology or the histopathological findings in birds at 12 and 40 days of age, despite a numerical (+6.90% and +7.40% respectively) villus height improvement in the SDPP group. Overall, these results confirm that dietary supplementation with SDPP and, to a lesser extent, with globin can improve growth performance and dietary protein and energy utilization in broiler chickens without effect on gut functionality.
Entecavir and tenofovir on renal function in patients with hepatitis B virus‐related hepatocellular carcinoma
Authors: Jeon Mi Young , Lee Jae Seung , Lee Hye Won , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Han Kwang‐Hyub , Ahn Sang Hoon , Kim Seung Up
Published: May 2020

The use of tenofovir disoproxil fumarate (TDF) is associated with a risk of renal dysfunction. We investigated whether TDF is associated with the deterioration of renal function in patients with hepatitis B virus (HBV)‐related hepatocellular carcinoma (HCC) requiring frequent computed tomography (CT) evaluations and transarterial chemoembolization (TACE) sessions, when compared to entecavir (ETV). Between 2007 and 2017, 493 patients with HBV‐related HCC were enrolled. The number of CT evaluations and TACE sessions were collected through 3 years of follow‐up. The median age of the study population (373 men and 120 women; 325 with ETV and 168 with TDF) was 56.5 years. TDF was significantly associated with a serum creatinine increase (≥25% from the baseline; unadjusted hazard ratio [uHR] = 1.620) and an estimated glomerular filtration rate (eGFR) reduction (<20% from the baseline) (uHR = 1.950) (all P < .05), when compared to ETV. In addition, CT evaluations ≥4 times/year were significantly associated with a serum creatinine increase (uHR = 2.709), eGFR reduction (uHR = 3.274) and chronic kidney disease (CKD) progression (≥1 CKD stage from the baseline) (uHR = 1.980) (all P < .05). In contrast, TACE was not associated with all renal dysfunction parameters (all P > .05). After adjustment, TDF use was independently associated with the increased risk of eGFR reduction (adjusted HR [aHR] = 1.945; P = .023), whereas CT evaluation ≥4 times/year was independently associated with the increased risk of serum creatinine increase (aHR = 2.898), eGFR reduction (aHR = 3.484) and CKD progression (aHR = 1.984) (all P < .01). In conclusion, patients with HBV‐related HCC treated with TDF and frequent CT evaluations should be closely monitored for the detection of associated renal dysfunction.
Continuing to Explore the Multidimensional Nature of Lexical Sophistication: The Case of Oral Proficiency Interviews
Authors: EGUCHI MASAKI , KYLE KRISTOPHER
Published: May 2020

Lexical sophistication has been an important indicator of productive lexical proficiency for almost 30 years. Although lexical sophistication has most often been operationalized as the proportion of low frequency words in a text, a growing body of research has indicated that a number of indices such as concreteness, hypernymy, and n‐gram association strengths meaningfully contribute to the construct. While the increase in available indices has expanded our understanding of the multidimensional construct, the sheer number of indices presents a practical barrier for researchers. Although some studies have begun to address this issue, most have been confined to the analysis of argumentative tasks, which are not necessarily representative of the range of tasks learners may encounter. This study therefore investigates the structure of lexical sophistication indices in a large learner corpus of English second language (L2) oral proficiency interviews (OPIs). An exploratory factor analysis identified 10 factors, 7 of which explained approximately 58% of the variance in OPI scores in a follow‐up regression analysis. The results suggest that while some features of lexical sophistication (e.g., concreteness) may be task independent, others (e.g., frequency) may be task specific.
A randomized trial of Lactobacillus rhamnosus IDCC 3201 tyndallizate (RHT3201) for treating atopic dermatitis
Authors: Jeong Kyunguk , Kim Mincheol , Jeon Se Ah , Kim Young‐Hoo , Lee Sooyoung
Published: May 2020

Background

Probiotic therapies, mainly live bacteria, have been proven to be effective in treating atopic dermatitis (AD) with some controversies. Killed probiotics or postbiotics would have immunomodulatory effect in allergic diseases including AD. This study was performed to evaluate the therapeutic effect and safety of tyndallized Lactobacillus rhamnosus (IDCC 3201, isolated from the feces of a Korean breastfed infant, repeated heat‐treated and incubated, RHT3201) in children with AD.

Methods

In a randomized, double‐blind, placebo‐controlled study, RHT3201 at a dose of 1.0 × 1010 CPU/d or placebo was given in children (aged 1‐12 years) with moderate AD for 12 weeks. SCORing of AD (SCORAD) scores, allergic inflammatory markers, and safety parameters were evaluated.

Results

For evaluating the therapeutic effects of RHT3201, 33 subjects in each group were analyzed. The change of SCORAD total score at 12 weeks (primary outcome) from baseline was significantly greater in the RHT3201 group (−13.89 ± 10.05) compared to the control group (−8.37 ± 9.95). Levels of eosinophil cationic protein (ECP) and interleukin (IL)‐31 showed tendency to decrease in the RHT3201 group and significant decreases in subgroup analysis in AD for ≥50 months. For safety analysis, a total of 100 subjects (50 in the treated group and 50 in the control group) were evaluated, and there were no significant differences in safety parameters between two groups.

Conclusion

In children with moderate AD, oral administration of RHT3201 showed the therapeutic effect on AD, the effects in part correlated with decrement of ECP and IL‐31, and the effect was more remarkable in subgroup analysis.
New reference ranges of procalcitonin excluding respiratory failure in neonates
Authors: Naramura Tetsuo , Tanaka Kenichi , Inoue Takeshi , Imamura Hiroko , Yoshimatsu Hidetaka , Mitsubuchi Hiroshi , Nakamura Kimitoshi , Iwai Masanori
Published: May 2020

Background

Existing reference data on serum procalcitonin (PCT) in neonates include the effects of respiratory disorders commonly occurring during birth. We aimed to determine new 95% reference intervals in neonates after excluding the influence of respiratory failure at birth, and to investigate the effects of gestational age (GA) and respiratory condition at birth on postnatal transient serum PCT elevation.

Methods

Samples were obtained from term and preterm neonates during the first 3 days of life. Neonates were classified into reference, respiratory failure, and bacterial infection groups. In the reference group, the correlation between PCT level and GA was investigated.

Results

The median PCT level within the 95% range 12–36 h after birth was 1.05 ng/mL (0.14–4.39) in term neonates (143 samples) and 1.01 ng/mL (0.15–4.44) in preterm neonates (95 samples). There was no correlation between GA and serum PCT level during 1–48 h after birth. There was a significant difference in median serum PCT level during 12–36 h after birth between the respiratory failure (9.56 ng/mL) and bacterial infection (49.82 ng/mL) groups in preterm neonates but no difference between term neonates (respiratory failure 6.83 ng/mL, and bacterial infection 7.43 ng/mL).

Conclusions

Respiratory failure is the main effector for the transient elevation in serum PCT levels at 3 days of life. After excluding the influence of respiratory failure, the chronological pattern and range were very similar between term and preterm neonates. Procalcitonin can be useful for clinicians in distinguishing bacterial infection from respiratory failure, aiding decisions on appropriate antibiotic use.
Consistent Routing and Scheduling with Simultaneous Pickups and Deliveries
Authors: Emadikhiav Mohsen , Bergman David , Day Robert
Published: May 2020

We study the planning and scheduling of order shipments among laboratories of an instrument‐calibration company. To address a generic version of the company’s combined routing and scheduling problem, we introduce a model variant with simultaneous pickups and deliveries in which consistency of site visits is also desired. We provide alternative formulations of the problem and propose branch‐and‐check and branch‐and‐price implementations, with an analysis of the instance characteristics for which each of these algorithms outperforms the other. Using the data collected from the company, our results indicate that the proposed framework can help the company to significantly reduce transportation costs and shipment times. We also investigate the influence of consistency and tardiness bounds on transportation costs, showing that while tardiness bounds significantly increase transportation costs, the enforcement of consistency requirements results in more consistent solutions at only slightly higher cost. The impact of enforcing consistency requirements increases when tighter tardiness bounds are imposed.
Bronchial thermoplasty versus mepolizumab: Comparison of outcomes in a severe asthma clinic
Authors: Langton David , Sha Joy , Guo Suzy , Sharp Julie , Banks Ceri , Wang Wei , Plummer Virginia , Thien Francis
Published: May 2020

Background and objective

BT and interleukin‐blocking monoclonal antibodies are both effective therapies for severe asthma, but there have been no direct comparisons between the two treatments. The aim of this study was to compare the efficacy and safety of BT and mepolizumab, in a real‐world setting.

Methods

Patients with severe asthma despite optimized inhaler therapy were drawn from a severe asthma clinic in a tertiary hospital. Every patient commencing therapy with BT or mepolizumab was prospectively included in a national registry. At predetermined assessment points over a 12‐month period, assessments were made of ACQ, spirometry, oral corticosteroid requiring exacerbations, reliever medication and maintenance oral corticosteroid use.

Results

A total of 91 patients with severe asthma participated: mean ACQ score 3.5 ± 1.0, FEV1 51.4 ± 17.7%, maintenance oral steroids 48.3% and 11.5 ± 10.0 inhalations/day reliever therapy. Forty‐seven patients received mepolizumab and 44 received BT. Baseline characteristics were similar except significantly higher blood eosinophil count in the mepolizumab group. At 12 months, there were no differences between treatment outcomes for ACQ (1.9 ± 1.3 mepolizumab vs 1.7 ± 1.3 BT), exacerbation rate (0.9 ± 1.1 vs 0.9 ± 1.5), reduction in reliever use (−6.3 ± 10.5 vs −5.0 ± 8.8 puffs/day) or reduction in oral corticosteroids (−3.3 ± 7.5 vs − 5.8 ± 6.7 mg/day). The FEV1 improved equally (160 ± 290 vs 150 ± 460 mL). Readmission or prolonged admission was observed in 18.2% of BT patients, whilst 25.5% of mepolizumab patients had discontinued treatment at 12 months, 14.9% due to an adverse event or non‐compliance.

Conclusion

The results suggest that BT is as efficacious as mepolizumab for the treatment of severe asthma.