bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a Qigong program on sleep quality among community-dwelling older adults with mild to moderate depression
Authors: Phansuea Phenphop , Tangwongchai Sookjaroen , Rattananupong Thanapoom , Lohsoonthorn Vitool , Lertmaharit Somrat
Published: February 2020

Purpose

The purpose of this study was to determine the effectiveness of a Qigong program on older adults in the Thai community suffering from mild to moderate depression.

Design/methodology/approach

A randomized controlled trial study was conducted in a public health service (PHS) center setting. Sixty-six older adults aged 60–90 years with mild to moderate depressive symptoms measured by the Thai Geriatric Depression Scale (TGDS: scores 13–24) were recruited and randomly allocated into two groups. The subjective sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (TPSQI). The Qigong program group was given 12 weeks of Qigong training including three sessions per week, while the control group followed normal PHS activities (singing and praying). The outcome measure was the change in the TGDS from baseline to 12 weeks.

Findings

Participants in the Qigong program group had a significantly improved TPSQI global score (p < 0.001), subjective sleep quality (p < 0.001), and sleep latency (p < 0.05) after 12 weeks of intervention, while those in the control group showed no significant difference in sleep quality. Compared with the control group, the Qigong program group reported significantly better sleep quality throughout the 12-week period. The prevalence of poor sleep quality in this population was 82 percent.

Originality/value

This study confirmed that the Qigong program could improve sleep quality in older adults with mild to moderate depressive symptoms as the Qigong program conferred more significant improvements than the usual program.
An interpretive structural modeling of drivers and barriers of sustainable supply chain management
Authors: Soni Gunjan , Prakash Surya , Kumar Himanshu , Singh Surya Prakash , Jain Vipul , Dhami Sukhdeep Singh
Published: February 2020

Purpose

The Indian marble and stone industry has got the potential to contribute well to the development of the emerging economy. However, unlike the other Indian industries, stone and marble industries are highly underrated sectors, which may become a critical factor for development. This paper analyses the sustainability factors in supply chain management practices.

Design/methodology/approach

A literature review is used to identify the barriers and drivers in sustainable supply chain management practices. Interpretive structural modeling has been used to obtain a hierarchy of barriers and drivers along with driving power and dependence power analysis. Further, MICMAC analysis is used for segregating the barriers and drivers in terms of their impact on sustainability.

Findings

The findings of the work of this research are that the attention of society, government, and commercial banks should be more toward the unorganized condition of stone and marble sector. There should be an increase in the commitment of stakeholders to reduce pollution and install safety, by enforcing more relevant laws and regulations and creating the importance of environmental awareness.

Originality/value

The main contribution of this research is to identify the barriers and drivers of sustainable supply chain management in a stone and marble industry. The paper proposes a sound mathematical model to prioritize the critical factors for responsible production and consumption of resources from sustainability perspectives of stone industry.
Optimization of design variables for carbon/glass hybrid composites laminates using the Taguchi Technique
Authors: Patil Sagar Dnyandev , Bhalerao Yogesh J. , Takale Adik
Published: February 2020

Purpose

The purpose of this paper is to analyze the significance of disparate design variables on the mechanical properties of the composite laminate. Four design variables such as stacking sequence, stacking angle, types of resins and thickness of laminate have been chosen to analyze the impact on mechanical properties of the composite laminate. The detailed investigation is carried out to analyze the effect of a carbon layer in stacking sequence and investigate the impact of various resins on the fastening strength of fibers, stacking angles of the fibers and the thickness of the laminate.

Design/methodology/approach

The Taguchi approach has been adopted to detect the most significant design variable for optimum mechanical properties of the hybrid composite laminate. For this intend, L16 orthogonal array has been composed in statistical software Minitab 17. To investigate an effect of design variables on mechanical properties, signal to noise ratio plots were developed in Minitab. The numerical analysis was done by using the analysis of variance.

Findings

The single parameter optimization gives the optimal combination A1B1C4D2 (i.e. stacking sequence C/G/G/G, stacking angle is 00, the type of resin is newly developed resin [NDR] and laminate thickness is 0.3 cm) for tensile strength; A4B2C4D2 (i.e. stacking sequence G/G/G/C, stacking angle is 450, the type of resin is NDR and laminate thickness is 0.3 cm) for shear strength; and A2B3C4D2 (i.e. stacking sequence G/C/G/G, stacking angle is 900, the type of resin is NDR and thickness is 0.3 cm) for flexural strength. The types of resins and stacking angles are the most significant design variables on the mechanical properties of the composite laminate.

Originality/value

The novelty in this study is the development of new resin called NDR from polyethylene and polyurea group. The comparative study was carried out between NDR and three conventional resins (i.e. polyester, vinyl ester and epoxy). The NDR gives higher fastening strength to the fibers. Field emission scanning electron microscope images illustrate the better fastening ability of NDR compared with epoxy. The NDR provides an excellent strengthening effect on the RCC beam structure along with carbon fiber (Figure 2).
Association between radiographic anterior cruciate ligament tear and joint symptoms: Data from the osteoarthritis initiative
Authors: Johnson Victoria L. , Guermazi Ali , Roemer Frank W. , Hunter David J.
Published: February 2020

Introduction

Symptomatic osteoarthritis (OA) in the knee is defined as the presence of OA radiographic features in combination with knee symptoms. Pain has not been shown to correlate meaningfully to radiographic severity. We aimed to determine the relationship between a tear of the anterior cruciate ligament (ACL) with knee symptoms and radiographic OA.

Methods

A within‐person, between‐knee cross‐sectional study of 37 participants from the Osteoarthritis Initiative (OAI) with a complete or partial ACL tear detected on magnetic resonance imaging in 1 knee (index knee) were included. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Knee Injury and Osteoarthritis Outcome Score (KOOS) and radiographs of both knees, 1 with an ACL tear and one without (control knee) were scored for OA severity (Kellgren‐Lawrence Grading) and symptoms. A generalized estimating equation with linear regression was used to compare symptom scores within individuals as well as to radiographic severity.

Results

Thirty‐seven individuals (40% female, average age = 60.7years, body mass index = 31.0 kg/m2) reported no difference in knee symptoms (WOMAC pain odds ratio [OR] =1.92, 95%CI 0.699‐5.248, P = .21; KOOS symptoms OR = 2.12, 95%CI 0.740‐6.065, P = .09), stiffness (OR = 1.67, 95%CI 0.653‐5.583, P = .35) or functional disability (OR = 1 0.97, 95%CI 0.515‐7.508, P = .32) in the knee that exhibited an ACL tear compared to the control knee. Only knee function and disability (WOMAC Disability OR = 1.12, 95%CI 1.003‐1.249, P = .04) were associated with radiographic severity between index and control knees.

Conclusion

Individuals did not report an increase in knee pain, stiffness or disability in their ACL‐deficient knee. Only disability was associated with worsening severity of radiographic OA in ACL‐deficient knees.
Association between COX‐2 and 15‐PGDH polymorphisms and SLE susceptibility
Authors: Sandoughi Mahnaz , Saravani Mohsen , Rokni Mohsen , Nora Mehrangiz , Mehrabani Mehrnaz , Dehghan Azizallah
Published: February 2020

Aims

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease. Prostaglandins E2 (PGE2), the product of the cyclo‐oxygenase 2 (COX‐2) enzyme, has critical roles in the etiology of autoimmune diseases. PGE2 level is controlled by a balance between its synthesis mediator (COX‐2 enzyme) and its catabolic key enzyme (15‐hydroxyprostaglandin dehydrogenase [15‐PGDH] enzyme). In the present study, the associations of genotypic polymorphisms in COX‐2 and 15‐PGDH with SLE were investigated.

Methods

One hundred and sixty SLE patients and 160 healthy controls participated in the study. The polymerase chain reaction ‐ restriction fragments length polymorphism method was used for genotyping. The COX‐2 rs2745557 G/A and 15‐PGDH rs8752 G/A polymorphisms were investigated.

Results

Regarding the COX‐2 rs2745557 single nucleotide polymorphism, there was no significant association between COX‐2 rs2745557 polymorphism and SLE. However, the dominant models showed a marginally significant relation (P = .048, odds ratio = 0.63, 95% CI = 0.4‐1.0). Regarding GA genotype of 15‐PGDH rd8752 polymorphism, there was a significant difference between two groups with a 4.5‐fold increase in SLE development (P = .0001). The frequency of the A allele was higher in SLE patients than that in controls, showing a 1.4‐fold increase in SLE development (P = .018).

Conclusion

All results showed the protective effects of the dominant model of COX‐2 rs2745557 polymorphism and risk factor of 15‐PGDH rs8752 polymorphism on SLE development.
Accuracy of Biomarkers for the Diagnosis of Adult Community‐acquired Pneumonia: A Meta‐analysis
Authors: Ebell Mark H. , Bentivegna Michelle , Cai Xinyan , Hulme Cassie , Kearney Maggie
Published: February 2020

Background

Biomarkers such as C‐reactive protein (CRP) and procalcitonin may help distinguish community‐acquired pneumonia (CAP) from other causes of lower respiratory tract infection.

Methods

We performed a systematic review of the literature to identify prospective studies evaluating the accuracy of a biomarker in patients with acute cough or suspected CAP. We performed parallel abstraction of data regarding study inclusion, characteristics, quality, and test accuracy. Study quality was evaluated using QUADAS‐2. Bivariate meta‐analysis was performed using the mada package in R, and summary receiver operating characteristic (ROC) curves were created.

Results

Fourteen studies met our inclusion and exclusion criteria; three were at low risk of bias and four at moderate risk of bias, largely due to failure to prespecify diagnostic thresholds. Considering all studies regardless of the cutoff used, CRP was most accurate (area under the ROC curve = 0.802), followed by leukocytosis (0.777) and procalcitonin (0.771). Lipopolysaccharide‐binding protein and fibrinogen are promising, but were only studied in a single report. For CRP and procalcitonin, the positive and negative likelihood ratios (LR+ and LR–, respectively) varied inversely based on the cutoff. For CRP, LR+ and LR− were 2.08 and 0.32 for a cutoff of 20 mg/L, 3.64 and 0.36 for a cutoff of 50 mg/L, and 5.89 and 0.47 for a cutoff of 100 mg/L. For procalcitonin, LR+ and LR− were 2.50 and 0.39 for a cutoff of 0.10 µg/L, 5.43 and 0.62 for a cutoff of 0.25 µg/L, and 8.25 and 0.76 for a cutoff of 0.50 µg/L. The combination of CRP >49.5 mg/L and procalcitonin >0.1 µg/L had LR+ of 2.24 and LR− of 0.44.

Conclusions

The best evidence supports CRP as the preferred biomarker for diagnosis of outpatient CAP given its accuracy, low cost, and point‐of‐care availability.
A Choice‐Based Measure of Issue Importance in the Electorate
Authors: Hanretty Chris , Lauderdale Benjamin E. , Vivyan Nick
Published: February 2020

Measuring how much citizens care about different policy issues is critical for political scientists, yet existing measurement approaches have significant limitations. We provide a new survey‐experimental, choice‐based approach for measuring the importance voters attach to different positional issues, including issues not currently contested by political elites. We combine information from (a) direct questions eliciting respondents' positions on different issues with (b) a conjoint experiment asking respondents to trade off departures from their preferred positions on those issues. Applying this method to study the relative importance of 34 issues in the United Kingdom, we show that British voters attach significant importance to issues like the death penalty that are not presently the subject of political debate and attach more importance to those issues associated with social liberal–conservative rather than economic left–right divisions.
Letter: inflammatory bowel disease and risk of myocardial infarction
Authors: Wei Bo , Wang Junxue , Zhang Yanda , Zhao Jian
Published: February 2020

LINKED CONTENT

This article is linked to Choi et al paper. To view this article, visit https://doi.org/10.1111/apt.15446.
‘We Could be Rich’: Unemployment, Roadblocks and the Rhythms of Hydrocarbon Work among the Guaraní of the Argentine Chaco
Authors: Diz Agustin
Published: February 2020

In the Argentine Chaco, indigenous Guaraní lives are deeply entangled with the oil and gas industry. In response to the hydrocarbon sector's shifting dynamics, unemployed Guaraní have found innovative ways to make claims and mobilise for temporary employment. This article emphasises the perspectives of these mobilised populations and describes the political difficulties that precarious labour forces confront. It also draws attention to the temporalities of extraction and to the accompanying rhythms of flexible employment. In doing so, it extends the concept of precarity to highlight continuities between the impermanence of employment and the instability of mobilisation.
Economic evaluation of a tertiary prevention program for occupational skin diseases in Germany
Authors: Andrees Valerie , John Swen M. , Nienhaus Albert , Skudlik Christoph , Brans Richard , Augustin Matthias , Krensel Magdalene ,   for the ROQ‐Study group
Published: February 2020

Background

Occupational skin diseases (OSDs) are the most common work‐related diseases in Germany and responsible for a large individual and financial burden. Therefore, a tertiary individual prevention program (TIP) is offered to patients with severe OSD who are at increased risk of abandoning their profession.

Objectives

To define cost of illness (COI) of OSD in Germany and to economically evaluate the TIP from a societal perspective.

Methods

In this study, data on patients taking part in the TIP (September 2005 to December 2009) were collected. Sociodemographic and medical data, costs, disease severity (Osnabrueck Hand Eczema Severity Index), and quality of life (QoL; Dermatology Life Quality Index) were assessed. COI and cost‐effectiveness analyses were performed with a simulated control group.

Results

In the analysis, 1041 patients were included. Intervention costs per person were €15 009 with decreasing COI over time. The incremental cost‐effectiveness ratio revealed expenses per patient of €8942 for a reduction in severity level and €9093 for an improvement in QoL in the base case. Considering costs for retraining, the break‐even point is reached if the TIP prevents retraining in approximately 64% of participants.

Conclusions

The decreased COI in this long‐term evaluation indicates that the TIP is cost‐effective in patients with severe OSD.
Ecology and movement of juvenile salmonids in beaver‐influenced and beaver‐free tributaries in the Trøndelag province of Norway
Authors: Malison Rachel L. , Halley Duncan J.
Published: February 2020

There is concern that expanding beaver (Castor fiber) populations will negatively impact the important economic, recreational and ecological resources of Atlantic salmon (Salmo salar) and sea trout (Salmo trutta) populations in Europe. We studied how beaver dams influenced habitat, food resources, growth and movement of juvenile Atlantic salmon and trout on three paired beaver‐dammed and beaver‐free (control) tributaries of important salmon rivers in central Norway. Lotic reaches of beaver‐dammed and control sites were similar in habitat and benthic prey abundance, and ponds were small (<3,000 m2). Though few juvenile salmonids were detected in ponds, trout and salmon were present in habitats below and above ponds (comprising 9%–31% and 0%–57% of the fish collected respectively). Trout dominated control sites (79%–99%), but the greatest proportion of Atlantic salmon were upstream of beaver ponds (0%–57%). Growth rates were highly variable, with no differences in growth between lotic reaches of beaver‐dammed and control sites. The condition and densities of juvenile salmon and trout were similar in lotic reaches of beaver‐dammed and control sites, though one beaver‐dammed site with fine sediment had very few juvenile salmonids. Beaver dams did not block the movement of juvenile salmonids or their ability to use upstream habitats. However, the degree of repeated movements and the overall proportion of fish moving varied between beaver‐dammed and control sites. The small scale of habitat alteration and the fact that fish were able to move past dams makes it unlikely that beaver dams negatively impact the juvenile stage of salmon or trout populations.
Sanitary infrastructures and the decline of mortality in Germany, 1877–1913†
Authors: Gallardo‐Albarrán Daniel
Published: February 2020

Clean water provision is considered crucial for eradicating waterborne diseases. However, the benefits of piped water can be limited in environments characterized by the inadequate storage and disposal of waste. This article studies the impact of waterworks and sewerage on mortality in German cities during the period 1877–1913. The results show that the supply of safe drinking water reduced the number of deaths, although to a lower extent than suggested previously. In the absence of efficient systems of sewage removal, contact with faeces and water contamination created a favourable environment for the spread of enteric ailments, offsetting some of the positive effects of waterworks. Moreover, the study shows that sanitary investments had important heterogeneous effects. First, their impact was markedly lower in municipalities with high levels of economic inequality and employment in the textile sector. Second, cities located in non‐Prussian territories experienced lower declines in mortality following the construction of sanitary infrastructures. The results in this article highlight the importance of analysing public health measures jointly as well as their interaction with local socioeconomic and institutional factors to understand historical progress against ill health and premature death.
Embedded Standard Setting: Aligning Standard‐Setting Methodology with Contemporary Assessment Design Principles
Authors: Lewis Daniel , Cook Robert
Published: February 2020

In this paper we assert that the practice of principled assessment design renders traditional standard‐setting methodology redundant at best and contradictory at worst. We describe the rationale for, and methodological details of, Embedded Standard Setting (ESS; previously, Engineered Cut Scores. Lewis, 2016), an approach to establish performance standards that augments and is embedded within existing principled assessment design practices. Under ESS, achievement level descriptor writing and the targeting of items to specified achievement levels are viewed as the fundamental standard‐setting activities and cut scores are estimated by optimizing the relationship between the item targets and the empirically based grouping of items. If the relationship between item targets and empirical data are sufficiently strong, then the traditional standard‐setting workshop is either unnecessary or altered in nature and significantly reduced in scope. We provide empirical evidence supporting the efficacy of ESS and describe how ESS is embedded throughout the assessment lifecycle.
A randomized double‐blind clinical trial to evaluate the efficacy of chlorhexidine, antioxidant, and hyaluronic acid mouthwashes in the management of biofilm‐induced gingivitis
Authors: Abdulkareem Ali A. , Al Marah Zaid A. , Abdulbaqi Hayder R. , Alshaeli Ali J. , Milward Mike R.
Published: February 2020

Objectives

To investigate the antiplaque and antigingivitis efficacy in addition to evaluating side effects and subjects’ perceptions of three commercially available mouthwashes.

Methods

This study was a double‐blind, parallel, and short‐term trial. A total of 75 dental students with biofilm‐induced gingivitis were included in the final analysis of the current study. Clinical parameters (plaque index and bleeding on probing) and the staining effect were measured at baseline and after 7 days. In addition, a VAS‐based assessment questionnaire was completed by the participants.

Results

All interventions significantly reduced plaque scores, but chlorhexidine (CHX) had a significantly higher effect than the hyaluronic acid (HA) and antioxidant mouthwashes. However, all mouthwashes significantly reduced the total bleeding scores to <10% in 53% of the patients, compared to the baseline record. Additionally, teeth underwent shade changes in association with all interventions by the end of the study. Analysis of feedback about the mouthwashes showed that the participants seemed to prefer the HA mouthwash over the other mouthwashes.

Conclusions

CHX remains the most effective antiplaque mouthwash although HA and antioxidants are as effective as CHX in reducing bleeding. In addition, based on its better acceptance by the participants, HA is potentially a good alternative to CHX.
National survey of pharmacists, intern pharmacists and pharmacy students in Australia: the nature and extent of stress and well-being
Authors: Chapman Colin B , Wilson Sally G , Wilson David I , Dunkley M Kay
Published: February 2020

Objectives

A national survey of the Australian pharmacy workforce was conducted to determine the extent to stress experienced, the extent to which it is work-related, how stress is managed, the barriers to getting help and how well prepared the workforce is for stressful situations. There were three objectives: provision of guidance on possible interventions; provision of a baseline for further studies; and provision of information to the Australian Health Practitioner Regulation Authority (AHPRA).

Methods

An online survey incorporating the 10-item Perceived Stress Scale was developed, piloted and launched in October 2016. Pharmacy-related organisations alerted their members to the voluntary survey. Popular pharmacy social media was used. Responses were analysed using SPSS and Excel. The a priori for significance was P < 0.05.

Key findings

In relation to the nature and extent of stress in the workforce and work-life balance, information provided by 1246 respondents out of a workforce of 29 819 revealed high levels of stress (PSS-10 score 20.1 ± 7.3), with those under 30 years of age and/or with 10 years or less in the pharmacy workforce reporting the highest levels. Just under half the respondents reported dissatisfaction with their work-life balances.

Conclusions

Workplace stress is high, particularly among younger members of the workforce. Professional pharmacy associations, schools of pharmacy at Australian universities and AHPRA have been alerted to this issue. The survey should be repeated reasonably soon to determine if any of the key characteristics have changed, particularly if interventions are made to reduce the occurrence of workplace-related stress.
Engineering defect‐enabled 3D porous MoS2/C architectures for high performance lithium‐ion batteries
Authors: Tao Kai , Wang Xiangfei , Xu Yifeng , Liu Jing , Song Xuefeng , Fu Chaopeng , Chen Xiaoqi , Qu Xingzhou , Zhao Xiaofeng , Gao Lian
Published: February 2020

Designing defect‐rich MoS2/C architectures with three‐dimensional (3D) porous frame effectively improve the electrochemical performance of lithium‐ion batteries (LIBs) owing to the improved conductivity and decreased diffusion distance of Li+ ions for lithium storage. Herein, we report a reliable morphology engineering method combining with tunable defects to synthesize defect‐rich MoS2 nanosheets with a few layers entrapped carbon sheath, forming a 3D porous conductive network architecture. The defect‐rich MoS2 nanosheets with expanded interlayers can provide a shortened ion diffusion path, and realize the 3D Li+ diffusion with faster kinetics. A 3D conductive interconnected carbon network is able to improve interparticle conductivity, concurrently maintaining the structural integrity. Benefiting from these intriguing features, the as‐prepared MoS2/C architectures exhibit excellent electrochemical performance: a high reversible capacity of 1163 mAh g−1 at a current density of 0.1 A g−1 after 100 cycles and a high rate capability of 800 mAh g−1 at 5 A g−1. Defect content in MoS2/C architectures can be obtained by changing H2 concentration. Compared with the counterparts with few defects, the defect‐rich MoS2/C architectures show improved electrochemical stability with a superior cycle life, illustrating a highly reversible capacity of 751 mAh g−1 at 0.5 A g−1 after 500 cycles.
Conversations about health–Sharing the personal experiences of women with intellectual disabilities
Authors: Cytowska Beata , Zierkiewicz Edyta
Published: February 2020

Background

The text presents the opinions of women with intellectual disabilities about their lives and experiences in Polish society. The key recurring issue in the participants’ statements was health in the light of their disability and femininity.

Methods

For the purpose of this study, focus group interviews were conducted with 20 women with intellectual disabilities. The collected interviews were analysed with the use of constructivist grounded theory.

Results

During the analysis, five general thematic areas were distinguished: appearance and beauty, health and sickness, intimate relationships, friends and acquaintances, and self‐determination.

Conclusions

The results of this research suggest that neither womanhood nor disability, as such, are perceived by the study's participants as a burden or health problem in any of the aforementioned areas. Moreover, the participants identified sources of oppression, as well as the means of opposing them, for example cooperation, and claiming the right to self‐determination.
Adherence to endocrine therapy and its relation to disease‐free survival among breast cancer patients visiting an out‐patient clinic at Khartoum Oncology Hospital, Sudan
Authors: Mohamed Kamal E. H. , Elamin Amany
Published: February 2020

Rationale

Adherence to endocrine therapy provides substantial reduction in breast cancer (BC) relapses and improve survival. Hence, non‐adherence remains an under reported issue mainly in developing countries.

Aims and Objectives

The aim of this study is to evaluate the adherence to endocrine therapy (tamoxifen [TAM] and aromatase inhibitors [AIs]) among BC patients visiting an out‐patient clinic (2015‐2016) in Khartoum Oncology Hospital, Sudan.

Methods

Adherence was assessed using pills count and self‐reporting methods. A total of 172 patients were interviewed. Also, records were reviewed for demographic and other cancer characteristics.

Results

The patients' mean age at diagnosis was 53 years, with the highest frequency at (41‐60) years. Invasive ductal carcinoma 69.2% formed the main pathological diagnosis. T2 tumour size (51.2%) and lymph node involvement (N1) (31.4%) were most evident. Also, the majority of patients were stage III (45.9%) and grade II (48%). The studied women were postmenopausal (49.4%) and premenopausal (47.7%). Regarding hormonal receptors, about 68% were oestrogen (ER)+/progesterone (PR)+ and 23.3% were ER+/PR−. Studying adherence, almost (93%) of the studied group were ≥80% adherent to TAM and AIs. The hormonal therapy persistence mean was 27.2 ± 22.5 months (40‐96). While adherence percentage mean was 93.7 ± 13.6% (0%‐100%). Also disease‐free survival (DFS) mean was 36.3 ± 32.7 months (4‐312). Adherence to hormonal therapy and persistence were significantly correlated (P < .000). Also, statistically significant association was found between hormonal therapy adherence (≥80%) and patient poor to average economic status (P = .006), and the marital status “married” (P = .008).

Conclusions

A high rate of adherence (93%) to endocrine therapy was estimated in the present study. Also, a positive association was found between the hormonal therapy persistence, and the DFS year's groups (P = .000), and the hormonal therapy types (P = .000). Adherence to hormonal therapy and persistence were significantly correlated (P < .000).
Engineering intervention for production of virgin coconut oil by hot process and multivariate analysis of quality attributes of virgin coconut oil extracted by various methods
Authors: Ramesh S. V. , Pandiselvam R. , Thushara Ramayyan , Manikantan M. R. , Hebbar K. B. , Beegum Shameena , Mathew A. C. , Neenu Sathyan , Shil Sandip
Published: February 2020

ICAR‐Central Plantation Crops Research Institute, India, has designed and developed a virgin coconut oil (VCO) cooker for the extraction of oil by the hot process. However, a number of VCO production processes being followed in India and elsewhere cause variations in the physicochemical properties, which in turn potentially affect the nutritional and medicinal properties of VCO. The physical and biochemical properties of VCO from the hot process (VCO‐Hot), fermentation (VCO‐Fer), expelled from dried gratings (VCO‐EDG), centrifugation (VCO‐Cen), and conventionally prepared copra coconut oil (CCO) were investigated in light of the design concept of the VCO cooker. The nutritionally important total phenolic content (mg GAE/100 g) and antioxidant capacity of all the VCOs were found to be in the range of 0.446 ± 0.041 (VCO‐Cen) to 2.867 ± 0.152 (VCO‐Hot) and 3.87 mM Trolox equivalent (TE) (VCO‐Cen) to 11.31 mM TE (VCO‐Hot), respectively. Multivariate analysis revealed that quality attributes viz., total phenol, total flavonoid, and cupric ion reducing antioxidant capacity of VCO‐Hot defined by principal component 1. Hierarchical clustering showed that the VCO‐Hot belonged to the group with high total phenolic and flavonoids content and strong antioxidant capacity. Comparative biochemical properties along with multivariate analysis differentiated the various VCO samples.

Practical Applications

Production of virgin coconut oil (VCO) by the hot process has been standardized by ICAR‐CPCRI and the technology has been successfully adopted by several entrepreneurs. VCO has a tremendous export potential and hence has a greater demand in the international market. The quantum of VCO export from India has been 818 MT to various destinations such as the United States, Japan, Australia, United Kingdom, and Middle East (https://www.coconutboard.in). The export earnings of VCO have reached over Rs. 260 million in 2015–2016. The consumers are not aware of the different VCO production methods and the resultant properties of VCO (Manikantan et al., Virgin Coconut Oil: Hot and Fermentation Process, Technical Bulletin No. 108, Centenary Publication 43, ICAR‐CPCRI & AICRP on PHET, Kasaragod). Considering the commerce potential and nutraceutical importance, the quality profile of VCO produced in different methods has to be compared among and with the coconut oil produced from copra. Additionally, it is crucial to discriminate the various VCO samples based on their quality profile.
Physical exercise prepartum to support metabolic adaptation in the transition period of dairy cattle: A proof of concept
Authors: Goselink Roselinde M. A. , Schonewille Jan Thomas , van Duinkerken Gert , Hendriks Wouter H.
Published: February 2020

In dairy cattle, the hormonal changes around calving induce large metabolic changes to support milk production. Mobilization of adipose reserves is one of the changes involved, imposing a metabolic load on the liver. We hypothesized that the risk for excessive lipolysis and hepatic lipidosis postpartum can be reduced by starting fat mobilization and processing during the prepartum period by physical exercise, especially in cows with a high body condition score (BCS). As a proof of concept, 32 pregnant Holstein‐Friesian dairy cows were selected for a 2 × 2 experimental design. Sixteen cows had a BCS < 3.25 (group LOW) and 16 cows a BCS ≥ 3.25 (group HIGH). Cows within each group were randomly allocated to one of two treatments: group STEP was walked twice daily for 45 min during the dry period while group CON remained indoors. Treatment was stopped at calving and cows were monitored until 6 weeks after calving. Liver biopsies were taken in a subset of 16 cows to determine liver triglyceride (TG) concentration. We found that calculated energy balance was more negative for group STEP prepartum, resulting in higher plasma non‐esterified fatty acids and β‐hydroxybutyrate concentrations. During the first 6 weeks postpartum, neither dry matter intake nor milk yield was affected by exercise. As expected, the cows in group HIGH had increased liver TG concentrations postpartum relative to group LOW with increased plasma non‐esterified fatty acids directly after calving. Exercise during the dry period mitigated postpartal liver TG accumulation, but this did not seem to be related to increased plasma lipoprotein transport. We conclude that substantial physical activity prepartum can induce lipolysis and lipid utilization, thereby starting an early adaptation to lactation. This may be instrumental to reduce the risk for excessive liver TG accumulation postpartum, especially in cows with a high BCS at dry‐off.
Differentiation of lymphocytic‐plasmacytic enteropathy and small cell lymphoma in cats using histology‐guided mass spectrometry
Authors: Marsilio Sina , Newman Shelley J. , Estep James Scot , Giaretta Paula R. , Lidbury Jonathan A. , Warry Emma , Flory Andi , Morley Paul S. , Smoot Katy , Seeley Erin H. , Powell Matthew J. , Suchodolski Jan S. , Steiner Jörg M.
Published: February 2020

Background

Differentiation of lymphocytic‐plasmacytic enteropathy (LPE) from small cell lymphoma (SCL) in cats can be challenging.

Hypothesis/Objective

Histology‐guided mass spectrometry (HGMS) is a suitable method for the differentiation of LPE from SCL in cats.

Animals

Forty‐one cats with LPE and 52 cats with SCL.

Methods

This is a retrospective clinicopathologic study. Duodenal tissue samples of 17 cats with LPE and 22 cats with SCL were subjected to HGMS, and the acquired data were used to develop a linear discriminate analysis (LDA) machine learning algorithm. The algorithm was subsequently validated using a separate set of 24 cats with LPE and 30 cats with SCL. Cases were classified as LPE or SCL based on a consensus by an expert panel consisting of 5‐7 board‐certified veterinary specialists. Histopathology, immunohistochemistry, and clonality testing were available for all cats. The panel consensus classification served as a reference for the calculation of test performance parameters.

Results

Relative sensitivity, specificity, and accuracy of HGMS were 86.7% (95% confidence interval [CI]: 74.5%‐98.8%), 91.7% (95% CI: 80.6%‐100%), and 88.9% (95% CI: 80.5%‐97.3%), respectively. Comparatively, the clonality testing had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 72.8%‐98.7%), 33.3% (95% CI: 14.5%‐52.2%), and 61.5% (95% CI: 48.3%‐74.8%) relative to the panel decision.

Conclusions and Clinical Importance

Histology‐guided mass spectrometry was a reliable technique for the differentiation of LPE from SCL in duodenal formalin‐fixed paraffin‐embedded samples of cats and might have advantages over tests currently considered state of the art.
Mean‐field games with differing beliefs for algorithmic trading
Authors: Casgrain Philippe , Jaimungal Sebastian
Published: February 2020

Even when confronted with the same data, agents often disagree on a model of the real world. Here, we address the question of how interacting heterogeneous agents, who disagree on what model the real world follows, optimize their trading actions. The market has latent factors that drive prices, and agents account for the permanent impact they have on prices. This leads to a large stochastic game, where each agents performance criteria are computed under a different probability measure. We analyze the mean‐field game (MFG) limit of the stochastic game and show that the Nash equilibrium is given by the solution to a nonstandard vector‐valued forward–backward stochastic differential equation. Under some mild assumptions, we construct the solution in terms of expectations of the filtered states. Furthermore, we prove that the MFG strategy forms an ε‐Nash equilibrium for the finite player game. Finally, we present a least square Monte Carlo based algorithm for computing the equilibria and show through simulations that increasing disagreement may increase price volatility and trading activity.
The Interaction of Policy Narratives, Moral Politics, and Criminal Justice Policy Beliefs
Authors: Knackmuhs Eric , Farmer James , Knapp Doug
Published: February 2020

Criminal justice reform is one of the many contentious issues we face in an increasingly polarized political climate. Differing perceptions of issues like these may be explained by underlying belief systems and expressed through narratives. This study employs the Narrative Policy Framework (NPF) by Moral Politics Theory as the theoretical underpinning for policy narratives. Moral Politics Theory states that policy beliefs are shaped by either a Strict Father (individual responsibility) or Nurturant Parent (societal responsibility) worldview. Visitors to Eastern State Penitentiary Historic Site read one criminal justice narrative from each worldview and selected which was more persuasive. Worldview and policy beliefs predicted which narrative was found persuasive; however, the analysis revealed there may be bilateral support for a combination of individual and societal responsibilities. Finally, this study supports and expands the NPF to a new context and population.

Related Articles

Ertas, Nevbahar. 2015. “Policy Narratives and Public Opinion Concerning Charter Schools.” Politics & Policy 43 (3): 426‐451. https://doi.org/10.1111/polp.12120

McBeth, Mark K., Donna L. Lybecker, and Kacee Garner. 2010. “The Story of Good Citizenship: Framing Public Policy in the Context of Duty‐Based versus Engaged Citizenship.” Politics & Policy 38 (1): 1‐23. https://doi.org/10.1111/j.1747-1346.2009.00226.x

Shanahan, Elizabeth A., Mark K. McBeth, and Paul L. Hathaway. 2011. “Narrative Policy Framework: The Power of Policy Narratives in Influencing Public Opinion.” Politics & Policy 39 (3): 373‐400. https://doi.org/10.1111/j.1747-1346.2011.00295.x
Multilevel analyses of related public health indicators: The European Surveillance of Congenital Anomalies (EUROCAT) Public Health Indicators
Authors: Best Kate E. , Rankin Judith , Dolk Helen , Loane Maria , Haeusler Martin , Nelen Vera , Verellen‐Dumoulin Christine , Garne Ester , Sayers Gerardine , Mullaney Carmel , O'Mahony Mary T. , Gatt Miriam , De Walle Hermien , Klungsoyr Kari , Carolla Olatz Mokoroa , Cavero‐Carbonell Clara , Kurinczuk Jennifer J. , Draper Elizabeth S. , Tucker David , Wellesley Diana , Zymak‐Zakutnia Nataliia , Lelong Nathalie , Khoshnood Babak
Published: February 2020

Background

Public health organisations use public health indicators to guide health policy. Joint analysis of multiple public health indicators can provide a more comprehensive understanding of what they are intended to evaluate.

Objective

To analyse variaitons in the prevalence of congenital anomaly‐related perinatal mortality attributable to termination of pregnancy for foetal anomaly (TOPFA) and prenatal diagnosis of congenital anomaly prevalence.

Methods

We included 55 363 cases of congenital anomalies notified to 18 EUROCAT registers in 10 countries during 2008‐12. Incidence rate ratios (IRR) representing the risk of congenital anomaly‐related perinatal mortality according to TOPFA and prenatal diagnosis prevalence were estimated using multilevel Poisson regression with country as a random effect. Between‐country variation in congenital anomaly‐related perinatal mortality was measured using random effects and compared between the null and adjusted models to estimate the percentage of variation in congenital anomaly‐related perinatal mortality accounted for by TOPFA and prenatal diagnosis.

Results

The risk of congenital anomaly‐related perinatal mortality decreased as TOPFA and prenatal diagnosis prevalence increased (IRR 0.79, 95% confidence interval [CI] 0.72, 0.86; and IRR 0.88, 95% CI 0.79, 0.97). Modelling TOPFA and prenatal diagnosis together, the association between congenital anomaly‐related perinatal mortality and TOPFA prevalence became stronger (RR 0.70, 95% CI 0.61, 0.81). The prevalence of TOPFA and prenatal diagnosis accounted for 75.5% and 37.7% of the between‐country variation in perinatal mortality, respectively.

Conclusion

We demonstrated an approach for analysing inter‐linked public health indicators. In this example, as TOPFA and prenatal diagnosis of congenital anomaly prevalence decreased, the risk of congenital anomaly‐related perinatal mortality increased. Much of the between‐country variation in congenital anomaly‐related perinatal mortality was accounted for by TOPFA, with a smaller proportion accounted for by prenatal diagnosis.
Effects of a lifestyle development program designed to reduce the risk factors for cognitive decline on the mental health of elderly individuals
Authors: Takeda Shinya , Fukushima Haruhiko , Okamoto Chihiro , Kitawaki Yasushi , Nakayama Shigeki
Published: February 2020

Background

The incidence of Alzheimer's disease (AD) along with depression is high in the elderly. In the present study, a program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline was applied to the participants to evaluate its effect on the mental health of these individuals.

Methods

The participants were randomly assigned to an intervention group and a control group. The program was conducted during 7 months in the intervention group, and it had seven times of group activities, performed once a month for about 1 h, and individual activities to reduce the risk factors for cognitive decline, performed every day. To evaluate the effects of the program on the mental health of the participants, the Geriatric Depression Scale (GDS) and Philadelphia Geriatric Center Morale Scale (PGC) were used. These two scales were applied twice to the intervention and control groups.

Results

The GDS score revealed no change in the score in the intervention group before and after the 7‐month program implementation; however, in the control group, the score was significantly higher after program implementation than that before. The PGC score revealed no change in the intervention group before and after 7‐month program implementation; however, in the control group, the score was significantly lower after program implementation than that before. Additionally, it revealed no change in the GDS score in the depression‐prone control group before and after 7‐month program implementation; however, in the depression‐prone intervention group, the GDS score was significantly lower after program implementation than that before.

Conclusions

The intervention program that allows the elderly individuals to voluntarily manage and develop lifestyles that may reduce the risk factors for cognitive decline is expected to maintain mental health in elderly individuals.
Multiscale drivers of restoration outcomes for an imperiled songbird
Authors: McNeil Darin J. , Rodewald Amanda D. , Ruiz‐Gutierrez Viviana , Johnson Kirsten E. , Strimas‐Mackey Matt , Petzinger Sharon , Robinson Orin J. , Soto Gerardo E. , Dhondt Andre A. , Larkin Jeffery L.
Published: February 2020

Habitat restoration is a cornerstone of conservation, particularly for habitat‐limited species. However, restoration efforts are seldom rigorously monitored at meaningful spatial scales. Poor understanding of how species respond to habitat restoration programs limits conservation efficacy for habitat‐restricted species like the Golden‐winged Warbler (Vermivora chrysoptera, GWWA). We provide one of the first concerted assessments of a national conservation program aimed at restoring songbird habitat across its breeding range. We studied GWWA response to forest habitat restoration across two broad regions with opposing population trajectories and assessed factors driving species use of restored habitats across multiple spatial scales. From 2015 to 2017, we conducted 1,145 (n= 457 locations) and 519 point counts (n= 215 locations) across the Appalachian Mountains and Great Lakes (respectively) within restored habitats. Warbler abundance within restored habitats across the Great Lakes varied with latitude, longitude, elevation, forest type, and number of growing seasons. In the Appalachian Mountains, occupancy () varied with longitude, elevation, forest type, and number of growing seasons. Detections were restricted to areas within close proximity to population centers (usually <24 km) in the Appalachian Mountains, where GWWAs are rare (= 0.22, 95% confidence interval [CI]: 0.20–0.25), but not in the Great Lakes, where GWWAs remain common (= 0.87, 95% CI: 0.84–0.90). Our study suggests that, even when best management practices are carefully implemented, restoration outcomes vary within/across regions and with multiscale habitat attributes. Although assessments of concerted habitat restoration efforts remain uncommon, our study demonstrates the value of monitoring data in the adaptive management process for imperiled species.
Women in medicine: The Henry Higgins problem
Authors: Ingelfinger Julie R.
Published: February 2020

See related Article
A novel approach to medical mentoring
Authors: Polley Clare , Cisternino Angela , Gray Amy
Published: February 2020

Background

Mentoring is integral to the development of doctors in complex, pressured, work‐based environments. At the Royal Children's Hospital (RCH), anecdotally mentoring was successful in informal relationships, but a formalised small group programme was not seen as effective by junior doctors (residents). Drawing from corporate and medical literature, as well as considering survey data from our junior and senior doctor cohorts, we surmised that a self‐selected online approach would empower both the mentor and the mentee.

Method

Junior resident medical officers (JRMOs), in postgraduate year 2–4 (PGY 2–4) at RCH, are invited to participate in a self‐selected dyad mentoring programme. The mentors volunteer their time and knowledge and come from the registrar (PGY3 and 4) and fellow (PGY5 and 6) cohorts. This programme ran in 2017 for 10 months and the mentees were advised to be in contact with their mentor every 6–8 weeks. Thirty JRMO mentees and 36 mentors opted in to the programme, resulting in 30 matched pairs. The group participants were able to access a range of online tools when establishing and conducting their mentoring relationship.

Results

The self‐selected dyad model, using mentor videos and online resources housed on the RCH learning management system, was designed to maximise the flexibility, sustainability and accessibility of the programme. A brokering and support system for the mentors and the mentees is part of the model.

Conclusion

An opt‐in, self‐selected online mentoring programme for junior residents at a tertiary paediatric hospital is an effective and sustainable model of mentoring.