bluuebunny/crossref_metadata_2025 huggingface dataset:
Shaping Plastic Surgery in British Columbia—The Courtemanche Legacy
Authors: Sardiwalla Yaeesh , Morris Steven F.
Published: March 2019

Dr Albert Douglas Courtemanche was born in Gravenhurst, Ontario on November 16, 1929. In 1949, he was accepted to the University of Toronto Medical School, graduating in 1955. After completing his internship at the Toronto General Hospital and at the Hospital for Sick Children, he completed his surgical training in Vancouver and in the United Kingdom. When Dr Courtemanche returned from his training in 1962, he joined Dr Cowan on the surgical staff at the Vancouver General Hospital. He was responsible for establishing a new plastic surgery ward, a dedicated operating room (OR), an integrated burn unit and also starting the UBC plastic surgery training program. Dr Courtemanche became involved in working with the Royal College, first as an examiner and then as the Chairman of the Plastic Surgery Exam Board in 1981. He eventually became the first and only plastic surgeon to ever hold the position as President of the Royal College. Dr Courtemanche emphasized throughout his career the importance of teaching and role modeling. A very proud moment in Dr Courtemanche’s career was when his son Douglas became a pediatric plastic surgeon. After retiring Dr Courtemanche became a volunteer at the VanDusen Botanical Garden and completed their Master Gardeners Program.
The influence of the CT scan in the evaluation and treatment of nondisplaced femoral neck fractures in the elderly
Authors: Zamora Tomas , Klaber Ianiv , Ananias Joaquin , Bengoa Francisco , Botello Eduardo , Amenabar Pedro , Schweitzer Daniel
Published: March 2019

Background:

The management of nondisplaced femoral neck fractures (FNFs) has evolved, with emphasis in radiographic features such as posterior displacement. However, the role of advanced imaging in this scenario is still not well defined. Therefore, our objective is to assess the impact of a computed tomography scan (CT) on interobserver agreement (IA) of fracture classification, posterior tilt measurement, and treatment decisions in nondisplaced FNF in elderly patients.

Methods:

Eleven patients with a nondisplaced (Garden 1–2) FNF were assessed by six hip surgeons. On a first stage, fracture classification, posterior tilt, and treatment plan (fixation/arthroplasty) were determined only with clinical information and X-rays. On a second stage, a CT was added. The kappa coefficient ( κ) and intraclass correlation coefficient (ICC) were used to determine IA.

Results:

IA for Garden classification was only slight in X-rays and with the addition of a CT, with a κ = 0.13 (0–0.28) and 0.18 (0.03–0.33), respectively. Conversely, posterior tilt measurement agreement was excellent in both schemes, with an ICC = 0.92 (0.83–0.98) and 0.92 (0.82–0.98). The IA for the proposed treatment was slight with X-rays ( κ = 0.44; 0.29–0.6), but moderate with the addition of a CT scan ( κ = 0.67; 0.52–0.82). Changes in surgical decision where made in 14 of 66 evaluations with an OR = 1.4 (0.62–3.2) for choosing an arthroplasty if a CT was used.

Conclusion:

IA for fracture classification and posterior tilt evaluation in nondisplaced FNF was not altered by the usage of a CT. There is improvement in treatment agreement when a CT scan is added to conventional imaging, with changes in treatment in 21% of cases.
Surgical outcomes of cervical myelopathy due to ossification of posterior longitudinal ligament: Anterior decompression and fusion versus posterior laminoplasty
Authors: Xu Ping , Zhuang Jing-Shen , Huang Yu-Sheng , Tu Chen , Chen Jian-Ting , Zhong Zhao-Ming
Published: March 2019

Background:

The purpose of this study was to compare the surgical outcomes of anterior decompression and fusion (ADF) with that of posterior laminoplasty (LAMP) for cervical myelopathy caused by ossification of posterior longitudinal ligament (OPLL).

Methods:

We retrospectively assessed the medical records of patients who underwent surgery for cervical myelopathy owing to OPLL between 2007 and 2016 at our institution. Fifty patients were included in this study, including 17 patients in ADF group and 33 patients in LAMP group. Surgical outcomes were assessed under the Japanese Orthopaedic Association (JOA) score. The radiologic and clinical data were compared between two groups.

Results:

There was no significant difference in age, follow-up time, operation time, blood loss, length of stay, preoperative JOA score, occupying ratio of OPLL, diameter of spinal canal, preoperative and final follow-up C2-C7 Cobb angles, and the change of C2-C7 Cobb angle before and after operation between ADF and LAMP groups. The final follow-up JOA score and the neurological recovery rate were significantly higher in ADF group than in LAMP group, particularly in patients with segmental-type OPLL. Cerebrospinal fluid leakage is a major complication after ADF, C5 paralysis, and axial pain frequently results from LAMP.

Conclusion:

Compared with LAMP, ADF shows better improvement of neurological function in patients with cervical myelopathy due to OPLL, especially in patients with segmental-type cervical OPLL.
Intergenerational Wealth Mobility and Racial Inequality
Authors: Pfeffer Fabian T. , Killewald Alexandra
Published: March 2019

The black-white gap in household wealth is large and well documented. Here, we visualize how this racial wealth gap persists across generations. Animating the flow of individuals between the relative wealth position of parents and their adult children, we show that the disadvantage of black families is a consequence both of wealth inequality in prior generations and race differences in the transmission of wealth positions across generations: Black children both have less wealthy parents on average and are far more likely to be downwardly mobile in household wealth. By displaying intergenerational movements between parental and offspring wealth quintiles, we underline how intergenerational fluctuation coexists with the maintenance of a severely racialized wealth structure.
Wrapping Blocks: A Fun Way to Teach Job Design
Authors: Yanson Regina , Mann Melissa J.
Published: March 2019

This article provides an overview of job design and offers an experiential teaching exercise to help students develop a better comprehension of job design and redesign, as well as learn the importance and challenges of such undertakings. Understanding the core elements of job design is especially important because job design serves as the foundational block for a deeper understanding and application of other organizational phenomenon such as the job characteristics model. This exercise is intended for the introductory undergraduate and graduate-level human resource management course as well as any courses covering “staffing.” Additionally, this activity may be used in the undergraduate Principles of Management or associated introductory management class.
William Pettigrew: Mythicizing the Man and His Work
Authors: Kapai Yuimirin
Published: March 2019

William Pettigrew was the first missionary to work among the hill tribes of the former Manipur Kingdom in India. He arrived in Manipur in 1894, established a mission center in 1896, married Alice Goreham later that year, and lived in Manipur until 1933. He did pioneering works in various fields—religion, education, literature, and social services. This article gives an overview of his work and achievements, an episodic narrative of his life among the hill tribes (who were once known as headhunters), and a critique of how he is remembered by the peoples he served.
Role of CYP3A4 in bone marrow microenvironment–mediated protection of FLT3/ITD AML from tyrosine kinase inhibitors
Authors: Chang Yu-Ting , Hernandez Daniela , Alonso Salvador , Gao Minling , Su Meng , Ghiaur Gabriel , Levis Mark J. , Jones Richard J.
Published: March 2019

An intriguing aspect of the clinical activity of FMS-like tyrosine kinase 3 inhibitors (FLT3 TKIs) is their apparent higher activity against peripheral blasts from FLT3/internal tandem duplication (ITD) acute myeloid leukemia than marrow disease in the same patients. Accordingly, studies showed that the bone marrow microenvironment plays a role in FLT3 TKI resistance, although the underlying mechanisms are unclear. We recently identified a previously undescribed mechanism by which the bone marrow microenvironment can contribute to drug resistance: expression of cytochrome P450 enzymes (CYPs). In fact, bone marrow stromal cells (BMSCs) expressed most CYPs, including CYP3A4. Because hepatic CYP3A4 plays a role in the inactivation of several FLT3 TKIs, we explored the potential role of CYP3A4 in bone marrow microenvironment–mediated FLT3 TKI resistance. We found that CYP3A4 plays a major role in BMSC-mediated inhibition in the activity of 3 different FLT3 TKIs (sorafenib, quizartinib, and gilteritinib) against FLT3/ITD acute myeloid leukemia (AML). Furthermore, clarithromycin, a clinically active CYP3A4 inhibitor, significantly reversed the protective effects of BMSCs. We show, for the first time, that bone marrow stromal CYP3A4 contributes to FLT3 TKI resistance in the bone marrow. These results suggest that combining FLT3 TKIs with CYP3A4 inhibitors could be a promising strategy toward improving the activity of FLT3 TKIs.
Efficacy of heel lifts versus calf muscle eccentric exercise for mid‐portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial
Authors: Rabusin Chantel L. , Menz Hylton B. , McClelland Jodie A. , Evans Angela M. , Landorf Karl B. , Malliaras Peter , Docking Sean I. , Munteanu Shannon E.
Published: March 2019

Background

Mid‐portion Achilles tendinopathy is a common musculoskeletal condition characterised by degeneration of the Achilles tendon, which causes pain and disability. Multiple non‐surgical treatments have been advocated for this condition including calf muscle eccentric exercise and in‐shoe heel lifts. Although adherence is challenging, there is evidence to suggest that calf muscle eccentric exercise is effective in decreasing pain and improving function in people with Achilles tendinopathy. Heel lifts reduce ankle joint dorsiflexion and Achilles tendon strain, however their efficacy in the management of Achilles tendinopathy is unclear. This article describes the design of a parallel‐group randomised trial comparing the efficacy of heel lifts to calf muscle eccentric exercise for Achilles tendinopathy.

Methods

Ninety‐two participants with Achilles tendinopathy will be randomised to one of two groups: (i) a heel lift group that will receive pre‐fabricated 12 mm in‐shoe heel lifts (Clearly Adjustable®), or (ii) an exercise group that will be advised to carry out a calf muscle eccentric exercise program (twice a day, 7 days a week, for 12 weeks). Outcome measures will be obtained at baseline, 2, 6 and 12 weeks; the primary endpoint for assessing efficacy being 12 weeks. The primary outcome measure will be the total score of the Victorian Institute of Sport Assessment – Achilles (VISA–A) questionnaire. Secondary outcome measures will include thickness and integrity of the Achilles tendon (using ultrasound tissue characterisation [UTC]), participant perception of treatment effect on pain and function (using the 7‐point Patient Global Impression of Change scale), severity of pain at the Achilles tendon (using a 100 mm visual analogue scale) in the previous week, health status (using the EuroQol‐5D‐5L™ questionnaire), physical activity levels (using the 7‐day Recall Physical Activity Questionnaire) and calf muscle function (using the standing heel rise test). Data will be analysed using the intention to treat principle.

Discussion

The HEALTHY trial (Heel lifts versus calf muscle eccentric Exercise for AchiLles TendinopatHY) is the first randomised trial to compare the efficacy of heel lifts to calf muscle eccentric exercise in reducing pain and improving function in people with Achilles tendinopathy. A pragmatically designed trial was developed to ensure that if the interventions are found to be effective, the findings can be readily implemented in clinical practice.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12617001225303. Registered on August 22nd, 2017.
A pragmatist's guide to the assessment of decision-making capacity
Authors: Zhong Rocksheng , Sisti Dominic A. , Karlawish Jason H.
Published: March 2019

Choice, understanding, appreciation and reasoning compose the standard model of decision-making capacity. Difficulties in determining capacity can arise when patients exhibit partial impairment. We suggest that a pragmatic approach, focusing on how capacity status affects the ultimate decision to override the patient's wishes, can help evaluators resolve difficult cases.

Declaration of interest

None.
Experiences of in-patient mental health services: systematic review
Authors: Staniszewska Sophie , Mockford Carole , Chadburn Greg , Fenton Sarah-Jane , Bhui Kamaldeep , Larkin Michael , Newton Elizabeth , Crepaz-Keay David , Griffiths Frances , Weich Scott
Published: March 2019

Background

In-patients in crisis report poor experiences of mental healthcare not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support. There is little high-quality evidence on what is important to patients to inform recovery-focused care.

Aims

To conduct a systematic review of published literature, identifying key themes for improving experiences of in-patient mental healthcare.

Method

A systematic search of online databases (MEDLINE, PsycINFO and CINAHL) for primary research published between January 2000 and January 2016. All study designs from all countries were eligible. A qualitative analysis was undertaken and study quality was appraised. A patient and public reference group contributed to the review.

Results

Studies (72) from 16 countries found four dimensions were consistently related to significantly influencing in-patients' experiences of crisis and recovery-focused care: the importance of high-quality relationships; averting negative experiences of coercion; a healthy, safe and enabling physical and social environment; and authentic experiences of patient-centred care. Critical elements for patients were trust, respect, safe wards, information and explanation about clinical decisions, therapeutic activities, and family inclusion in care.

Conclusions

A number of experiences hinder recovery-focused care and must be addressed with the involvement of staff to provide high-quality in-patient services. Future evaluations of service quality and development of practice guidance should embed these four dimensions.

Declaration of interest

K.B. is editor of British Journal of Psychiatry and leads a national programme (Synergi Collaborative Centre) on patient experiences driving change in services and inequalities.
Cross-sectional and prospective relationships of passive and mentally active sedentary behaviours and physical activity with depression
Authors: Hallgren Mats , Nguyen Thi-Thuy-Dung , Owen Neville , Stubbs Brendon , Vancampfort Davy , Lundin Andreas , Dunstan David , Bellocco Rino , Lagerros Ylva Trolle
Published: March 2019

Background

Sedentary behaviour can be associated with poor mental health, but it remains unclear whether all types of sedentary behaviour have equivalent detrimental effects.

Aims

To model the potential impact on depression of replacing passive with mentally active sedentary behaviours and with light and moderate-to-vigorous physical activity. An additional aim was to explore these relationships by self-report data and clinician diagnoses of depression.

Method

In 1997, 43 863 Swedish adults were initially surveyed and their responses linked to patient registers until 2010. The isotemporal substitution method was used to model the potential impact on depression of replacing 30 min of passive sedentary behaviour with equivalent durations of mentally active sedentary behaviour, light physical activity or moderate-to-vigorous physical activity. Outcomes were self-reported depression symptoms (cross-sectional analyses) and clinician-diagnosed incident major depressive disorder (MDD) (prospective analyses).

Results

Of 24 060 participants with complete data (mean age 49.2 years, s.d. 15.8, 66% female), 1526 (6.3%) reported depression symptoms at baseline. There were 416 (1.7%) incident cases of MDD during the 13-year follow-up. Modelled cross-sectionally, replacing 30 min/day of passive sedentary behaviour with 30 min/day of mentally active sedentary behaviour, light physical activity and moderate-to-vigorous activity reduced the odds of depression symptoms by 5% (odds ratio 0.95, 95% CI 0.94–0.97), 13% (odds ratio 0.87, 95% CI 0.76–1.00) and 19% (odds ratio 0.81, 95% CI 0.93–0.90), respectively. Modelled prospectively, substituting 30 min/day of passive with 30 min/day of mentally active sedentary behaviour reduced MDD risk by 5% (hazard ratio 0.95, 95% CI 0.91–0.99); no other prospective associations were statistically significant.

Conclusions

Substituting passive with mentally active sedentary behaviours, light activity or moderate-to-vigorous activity may reduce depression risk in adults.
AUGMENT: A Phase III Study of Lenalidomide Plus Rituximab Versus Placebo Plus Rituximab in Relapsed or Refractory Indolent Lymphoma
Authors: Leonard John P. , Trneny Marek , Izutsu Koji , Fowler Nathan H. , Hong Xiaonan , Zhu Jun , Zhang Huilai , Offner Fritz , Scheliga Adriana , Nowakowski Grzegorz S. , Pinto Antonio , Re Francesca , Fogliatto Laura Maria , Scheinberg Phillip , Flinn Ian W. , Moreira Claudia , Cabeçadas José , Liu David , Kalambakas Stacey , Fustier Pierre , Wu Chengqing , Gribben John G. ,   for the AUGMENT Trial Investigators
Published: March 2019

PURPOSE

Patients with indolent non-Hodgkin lymphoma typically respond well to first-line immunochemotherapy. At relapse, single-agent rituximab is commonly administered. Data suggest the immunomodulatory agent lenalidomide could increase the activity of rituximab.

METHODS

A phase III, multicenter, randomized trial of lenalidomide plus rituximab versus placebo plus rituximab was conducted in patients with relapsed and/or refractory follicular or marginal zone lymphoma. Patients received lenalidomide or placebo for 12 cycles plus rituximab once per week for 4 weeks in cycle 1 and day 1 of cycles 2 through 5. The primary end point was progression-free survival per independent radiology review.

RESULTS

A total of 358 patients were randomly assigned to lenalidomide plus rituximab (n = 178) or placebo plus rituximab (n = 180). Infections (63% v 49%), neutropenia (58% v 23%), and cutaneous reactions (32% v 12%) were more common with lenalidomide plus rituximab. Grade 3 or 4 neutropenia (50% v 13%) and leukopenia (7% v 2%) were higher with lenalidomide plus rituximab; no other grade 3 or 4 adverse event differed by 5% or more between groups. Progression-free survival was significantly improved for lenalidomide plus rituximab versus placebo plus rituximab, with a hazard ratio of 0.46 (95% CI, 0.34 to 0.62; P < .001) and median duration of 39.4 months (95% CI, 22.9 months to not reached) versus 14.1 months (95% CI, 11.4 to 16.7 months), respectively.

CONCLUSION

Lenalidomide improved efficacy of rituximab in patients with recurrent indolent lymphoma, with an acceptable safety profile.
Mutational Landscape in Resected Periampullary Adenocarcinoma: Relationship With Morphology and Clinical Outcome
Authors: Lundgren Sebastian , Hau Sofie Olsson , Elebro Jacob , Heby Margareta , Karnevi Emelie , Nodin Björn , Eberhard Jakob , Holm Karolina , Staaf Johan , Jönsson Göran B. , Jirström Karin
Published: March 2019

PURPOSE

Periampullary adenocarcinomas encompass a heterogeneous group of tumors with dismal prognosis and limited treatment options. Emerging evidence shows that tumor morphology (ie, intestinal type [I-type] or pancreatobiliary type [PB-type]) is a more relevant prognostic factor than tumor origin. Knowledge is sparse, however, on whether key mutations differ according to morphology.

MATERIALS AND METHODS

Next-generation sequencing was applied to assess the mutational status of 70 genes in 102 tumors from a retrospective cohort of 175 patients with resected periampullary adenocarcinoma. Brahma-related gene 1 protein expression was examined by immunohistochemistry on tissue microarrays with primary tumors from the original cohort.

RESULTS

APC mutations were significantly more common in I-type than in PB-type tumors (27.5% v 0%; P < .001), as were ERBB3 mutations (20.8% v 4.8%; P = .016), whereas CDKN2A mutations were more common in PB-type than in I-type tumors (19.4% v 2.5%; P = .013). KRAS mutation was an independent factor of poor prognosis in I-type tumors (hazard ratio, 3.73; 95% CI, 1.10 to 12.67). In PB-type tumors, SMARCA4 mutation was an adverse prognostic factor in patients not receiving adjuvant chemotherapy, and there was a significant treatment interaction between expression of Brahma-related gene 1 protein, the protein encoded by SMARCA4, and adjuvant chemotherapy ( Pinteraction = .007).

CONCLUSION

To our knowledge, this is the first description of the mutational landscape in the full spectrum of periampullary adenocarcinoma that demonstrates that the distribution and prognostic and predictive significance of commonly mutated genes differ by morphology. The results emphasize that morphology is an important factor to consider in the search for novel biomarkers and targeted personalized treatment of these patients. In addition, the findings support the concept that molecular profiling of these tumors could be of clinical benefit.
Investigation of the influence of a glutathione S-transferase metabolic resistance to pyrethroids/DDT on mating competitiveness in males of the African malaria vector, Anopheles funestus
Authors: Tchouakui Magellan , Tene Fossog Billy , Ngannang Brigitte Vanessa , Djonabaye Doumani , Tchapga Williams , Njiokou Flobert , Wondji Charles S.
Published: March 2019

Background:Metabolic resistance is a serious challenge to current insecticide-based interventions. The extent to which it affects natural populations of mosquitoes including their reproduction ability remains uncharacterised. Here, we investigated the potential impact of the glutathione S-transferase L119F-GSTe2 resistance on the mating competitiveness of maleAnopheles funestus, in Cameroon.

Methods:Swarms and indoor resting collections took place in March, 2018 in Tibati, Cameroon. WHO tube and cone assays were performed on F1mosquitoes from indoor collected females to assess the susceptibility profile of malaria vectors. Mosquitoes mated and unmated males collected in the swarms were genotyped for the L119F metabolic marker to assess its association with mating male competitiveness.

Results: Susceptibility and synergist assays, showed that this population was multiple resistant to pyrethroids, DDT and carbamates, likely driven by metabolic resistance mechanisms. Cone assays revealed a reduced efficacy of standard pyrethroid-nets (Olyset and PermaNet 2.0) with low mortality (<25%) whereas synergist PBO-Nets (Olyset Plus and PermaNet 3.0) retained greater efficacy with higher mortality (>80%). The L119F-GSTe2 mutation, conferring pyrethroid/DDT resistance, was detected in thisAn. funestuspopulation at a frequency of 28.8%. In addition, a total of 15 mating swarms were identified and 21An. funestuscouples were isolated from those swarms.  A comparative genotyping of the L119F-GSTe2 mutation between mated and unmated males revealed that heterozygote males 119L/F-RS were less able to mate than homozygote susceptible (OR=7.2, P<0.0001). Surprisingly, heterozygote mosquitoes were also less able to mate than homozygote resistant (OR=4.2, P=0.010) suggesting the presence of a heterozygote disadvantage effect. Overall, mosquitoes bearing the L119-S susceptible allele were significantly more able to mate than those with 119F-R resistant allele (OR=2.1, P=0.03).

Conclusion:This study provides preliminary evidences that metabolic resistance potentially exerts a fitness cost on mating competiveness in resistant mosquitoes.
Creating High-Density Large Square Bales by Recompression
Authors: McAfee Joshua R. , Shinners Kevin J. , Friede Joshua C. , Walters Chase P.
Published: March 2019

Abstract.

Creating high-density biomass bales would reduce the number of bales handled, stored, and transported to biorefineries, thereby reducing costs. Recompression of large square bales is one approach to increase bale density; however, recompression research on large bales is limited. Recompression of common biomass crops in 80 cm × 90 cm nominal cross-section bales was used to quantify pressure-density and stress relaxation relationships as well as restraining forces required to maintain compressed densities. Linear, power, and exponential models were fit to the pressure-density data, with the linear model providing the best representation of the recompression process. When bales were recompressed soon after bale formation, density increased by an average of 134%, and the target dry-basis density of 205 kg m-3 was exceeded at the end of recompression with all crops. While still compressed, bales were wrapped with four steel cables configured with load cells to measure the restraining force after release of pressure followed by bale re-expansion. Total restraining forces ranged from 18 to 40 kN. Bale density decreased by an average of 17% due to re-expansion after pressure was released. Strain relief induced by allowing the bale to re-expand by approximately 10% before placing the cables around the bales reduced the required restraining force by an average of 35%. Although the forces applied were great (>560 kN), the dry-basis specific energy requirements were comparatively low (0.18 to 0.29 kWh Mg-1) because recompression took place over a relatively long duration of approximately 20 to 25 s. Recompressing large square bales is a low-energy method to achieve bale densities that should ensure weight-limited biomass transport. Keywords: Bales, Biomass, Compression, Energy.
Performance and Environmental Impact of Rice Straw Fiber Mulching Films Manufactured with a Warming Agent
Authors: Ming Xianglan , Chen Haitao , Ju Dianming
Published: March 2019

Abstract. This research evaluates the effects of adding various warming agents to rice straw fiber (RSF) films as sustainable alternatives to polyethylene-based films. The results for the mechanical properties of the RSF films with various warming agents show that the mean values of dry tensile strength and bursting strength of the films significantly differed according to the warming agent; in contrast, the mean wet tensile strengths and tearing strengths were not significantly different. The dry tensile strengths of films containing titanium dioxide were 9.7% and 26.8% higher than those of the films containing talc and kaolin, respectively. Additionally, the bursting strengths of the films containing titanium dioxide, calcium carbonate, and talc were 10.5%, 4.4%, and 15.8% higher, respectively, than those of the films containing kaolin. Thus, titanium dioxide was considered the best of the four warming agents for implementation in these films. The absorption peaks of the films with and without titanium dioxide were similar, with some differences in the peak position and relative intensities by Fourier transform infrared spectroscopy. Soil covering tests were conducted with films containing titanium dioxide (TDF), films with no added titanium dioxide, and a blank group. The degradation rate of the TDF reached grade 3 during the bolting stage of bok choy. At soil depths of 0, 5, and 10 cm, the total accumulated temperature of the TDF group was 11.53%, 7.78%, and 5.38% higher, respectively, than that of the blank group. Both TDF degradation and increased soil temperature improved the crop growth and soil microclimate. These results can serve as a reference to further improve the popularization and application of RSF film. Keywords: Degradable films, Mechanical properties, Rice straw, Soil temperature, Titanium dioxide.
Development of High-Speed Dual-Camera System for Batch Screening of Aflatoxin Contamination of Corn Using Multispectral Fluorescence Imaging
Authors: Han Deok , Yao Haibo , Hruska Zuzana , Kincaid Russell , Rajasekaran Kanniah , Bhatnagar Deepak
Published: March 2019

Abstract. Aflatoxins are fungal toxins produced by . Food and feed crops contaminated with carcinogenic aflatoxins result in economic losses as well as potentially serious health issues. Grain elevators need to unload, on average, one 2.27 metric ton (MT) truckload every 2 min. Current sampling-based analytical chemistry methods for aflatoxin detection cannot meet these large throughput screening requirements. Therefore, a high-speed, batch screening system with reliable accuracy is needed. To develop a high-speed multispectral screening system, two high-performance cameras in conjunction with dual UV excitation sources and novel image processing software were used to collect fluorescence images of corn samples. Each camera simultaneously captures a single-band fluorescence image (436 nm or 532 nm) from corn kernel samples, and the detection software processes the images to automatically detect contaminated kernels using a normalized difference fluorescence index (NDFI). The system was tested with various commercial samples collected from different locations in the U.S. and baseline samples that were prepared by artificial field inoculation. Each sample was imaged and screened four times, and the screened samples were chemically analyzed for aflatoxin content. All samples were shuffled between imaging repetitions to increase the likelihood of screening both the germ and endosperm sides of every kernel. Processing time for each screening was less than 1 s. Sensitivity and specificity were measured over given thresholds for NDFI, and the results were promising. High sensitivity (0.987) and specificity (0.96) were achieved for the baseline samples, and high sensitivity (0.75 to 1) and somewhat lower specificity were obtained for the commercial samples. Keywords: Aflatoxin, Corn, Dual cameras, Fluorescence image, Multispectral image, Rapid and non-destructive detection, detection.
Understanding Decision Making Among Individuals With Intellectual and Developmental Disabilities (IDD) and Their Siblings
Authors: Burke Meghan M. , Lee Chung eun , Hall Sarah A. , Rossetti Zach
Published: March 2019

Many siblings anticipate fulfilling caregiving roles for their brothers and sisters with intellectual and developmental disabilities (IDD). Given these roles and the importance of supported decision making, it is crucial to understand how individuals with IDD and their siblings make decisions. Using dyadic interviews, we examined the perspectives of nine sibling dyads (N = 18) about decision making in relation to self-determination, independent living, and employment. The ages of participants ranged from 19 to 57. Data were analyzed using constant comparative analysis to identify themes. Decision making was characterized by: parents and siblings primarily identifying courses of action; the probability of respective consequences based on the person-environment fit; and the role of the sibling in making the final decision. Characteristics related to the individual with IDD, the family, the sibling, and the environment impacted decision making. Individuals with IDD were more likely to make their own decisions about leisure activities; however, siblings were more likely to make formal decisions for their brothers and sisters.
Active Support Training, Staff Assistance, and Engagement of Individuals With Intellectual and Developmental Disabilities in the United States: Randomized Controlled Trial
Authors: Qian Xueqin , Larson Sheryl A. , Tichá Renáta , Stancliffe Roger , Pettingell Sandra L.
Published: March 2019

Two non-U.S. quasi-experimental studies reported Active Support training was associated with increased engagement in individuals with IDD, but no randomized controlled trials (RCTs) exist. We evaluated effects of Active Support training on staff assistance, and social and nonsocial engagement in 75 individuals with intellectual and developmental disabilities (IDD) in U.S. group homes. We detected no significant effects of active support training. Individuals with more skills and less challenging behavior engaged more in nonsocial activities. Younger individuals with more skills living in homes with fewer staff changes were more socially engaged. Factors associated with nonsocial engagement mirrored those reported in Qian, Tichá, Larson, Stancliffe, & Wuorio, (2015). Staffing-related implementation challenges and statistical power limited our ability to detect differences.
#ADA25 Campaign: Using Social Media to Promote Participation, Social Inclusion, and Civic Engagement of People With Intellectual and Developmental Disabilities
Authors: Williamson Heather J. , Fisher Kim W. , Madhavni Devanshi , Talarico Lori
Published: March 2019

Social media is used for civic engagement and building social inclusion. Twitter is one social media tool that facilitates conversations on important societal events. A digital divide between the general population and people with intellectual and developmental disabilities (IDD) remains. Given the divide, we sought to understand the inclusion of the community of people with IDD in the conversations around the 25th anniversary of the Americans with Disabilities Act of 1990 (ADA). We conducted a content analysis of tweets associated with the anniversary and few tweets referenced the community of people with IDD. Our findings suggest that people with IDD are not included in larger civic conversations. Implications include targeted social media training for people with IDD and their support networks.
Intimate Relationships of People With Disabilities
Authors: Friedman Carli
Published: March 2019

Despite the difficulties people with disabilities may have garnering intimate relationships, intimate relationships may be particularly beneficial for people with disabilities as they result in greater self-acceptance, less internalized stigma, and more camaraderie. The aim of this study was to explore the intimate relationships of adults with disabilities (n = 1,443) in its many forms (from intimate friendships to romantic relationships). We particularly explored what factors increased the odds of adults with disabilities having intimate relationships, what supports resulted in increased likeliness to have intimate relationships, and what factors resulted in the presence of favorable intimate relationship outcomes. Our analysis revealed service organizations are key to enhancing the social and intimate relationships of adults with disabilities.
Do tree cavity density and characteristics vary across topographical habitats in the tropics? A case study from Xishuangbanna, southwest China
Authors: Liu Junyan , Tang Junfeng , Chen Si-Chong , Ma Wenbao , Zheng Zheng , Dong Tingfa
Published: March 2019

Despite the influence of cavities on the survival and distribution of cavity-dependent fauna, the variation in the density and characteristics of tree cavities across different habitat types in tropical forests is unknown. In this study, we surveyed 26â312 living trees from 376 species and compared cavity density and characteristics (height, size, type, and orientation) across five habitat types (valley, low-slope, high-slope, high-gully, and high-plateau) in a 20-hectare tropical rainforest in southwest China. From a total of 2047 cavities, we found that cavity density was mainly driven by habitat rather than tree species richness or diameter at breast height (DBH), and the characteristics of cavities were not uniformly distributed across habitats. Cavities were significantly more abundant in high- and low-slope than high-plateau habitats. Compared with other habitats, more âbutt hollowâ cavity types were found in high-slope habitat and they occurred at a lower tree height, whereas more âcrackâ cavities were found in low-slope habitat and they had a narrower entrance diameter. Although the mean orientation of cavities faced towards the northeast, cavity orientation varied significantly across habitat types. Our results indicate that certain types of cavities are concentrated in specific habitat types, which can provide avenues for forest management and biodiversity conservation. We highlight the importance of habitat heterogeneity in providing resources for cavity nesters.
Hubungan Status Gizi dan Stimulasi Tumbuh Kembang dengan Perkembangan Balita
Authors: Hairunis Mirham Nurul , Salimo Harsono , Dewi Yulia Lanti Retno
Published: March 2019

Latar belakang. Perkembangan dasar yang terjadi pada masa balita akan memengaruhi dan menentukan perkembangan anak selanjutnya. Status gizi dan stimulasi merupakan dua faktor yang memengaruhi tumbuh kembang balita. Tujuan. Penelitian ini bertujuan menganalisis hubungan status gizi dan stimulasi tumbuh kembang dengan perkembangan anak Balita di Provinsi Nusa Tenggara Barat (NTB).Metode. Jenis penelitian ini adalah studi penelitian analitik observasional dengan pendekatan cross-sectional. Penelitian ini dilaksanakan pada bulan Februari–April 2018. Sampel dipilih secara simple random sampling sebanyak 114 subjek penelitian. Teknik pengumpulan data menggunakan kuesioner dan dianalisis dengan regresi logistik.Hasil. Berdasarkan hasil analisis multivariat antara status gizi (TB/U) dan stimulasi tumbuh kembang dengan perkembangan didapatkan hasil (b=1,68; IK95%:1,10-2,57; p=0,016) untuk status gizi dan (b=3,48; IK95%:1,42-8,52; p=0,006) untuk stimulasi tumbuh kembang. Kesimpulan. Balita dengan perawakan normal memiliki peluang 1,6 kali mengalami perkembangan yang sesuai dibandingkan anak dengan perawakan pendek dan sangat pendek (stunting). Balita yang mendapatkan stimulasi tumbuh kembang sering memiliki peluang 3,4 kali mengalami perkembangan yang sesuai dibandingkan dengan anak yang mendapatkan stimulasi jarang.
Pengaruh Pemberian Vitamin B6 dan Vitamin B12 Terhadap Konsentrasi Homosistein Serum pada Pasien Leukemia Limfoblastik Akut
Authors: Muhi Julispen Syafruddin , Oenzil Fadil , Izzah Amirah Zatil
Published: March 2019

Latar belakang. Leukemia merupakan 35% keganasan pada anak. Persentase terbanyak adalah Leukemia limfoblastik akut (LLA) yang mencapai 80%. Pedoman kemoterapi LLA berdasarkan Indonesian Childhood ALL-Protocol 2013 menggunakan metotreksat (MTX) intratekal dan intravena, bekerja menghambat enzim dihidrofolat reduktase (DHFR) menyebabkan peningkatan konsentrasi homosistein yang mempunyai efek neurotoksisitas. Vitamin B6 dan B12 adalah kofaktor enzim yang berperan pada remethylation dan transsulferation yang dapat menurunkan konsentrasi homosistein. Tujuan. Mengetahui pengaruh vitamin B6 dan B12 terhadap konsentrasi homosistein pada pasien LLA yang mendapat MTX intratekal (MTX IT) dan MTX intravena dosis tinggi (high dose/MTX HD).Metode. Penelitian case control study pre dan post control group design pada pasien LLA yang dirawat di bagian Anak RS Dr. M.Djamil Padang dari Januari-Juni 2017. Jumlah sampel kelompok kontrol dan perlakuan 10 orang. Kelompok perlakuan mendapat vitamin B6 20 mg/hari dan B12 0,5 mg/hari selama 6 minggu. Hasil. Konsentrasi homosistein awal kelompok kontrol 11,72±1,7067 µmol/L dan setelah 6 minggu 11,630±1,4765 µmol/L, tidak berbeda bermakna secara statistik (p>0,05). Kelompok perlakuan, konsentrasi awal 12,05±2,0919 µmol/L dan setelah 6 minggu 10,07±1,6526 µmol/L, berbeda bermakna secara statistik (p<0,05). Pemberian vitamin B6 20 mg/hari dan B12 0,5 mg/hari menurunkan rerata konsentrasi homosistein 1,98±0,8108 µmol/L, bermakna secara statistik (p<0,05). Kesimpulan. Pemberian vitamin B6 dan B12 pada pasien LLA yang mendapatkan MTX IT dan MTX HD dapat menurunkan rerata konsentrasi homosistein.
Pengaruh Lactobacillus reuteri DSM 17938 Terhadap Kadar Calprotectin Feses sebagai Penanda Inflamasi Intestinal pada Bayi Kurang Bulan
Authors: Savitri Tisa Rahmawaty , Hidajat Sjarif , Alam Anggraini
Published: March 2019

Latar belakang. Bayi kurang bulan (BKB) berisiko mengalami inflamasi intestinal akibat imaturitas fungsi saluran cerna. Penelitian terdahulu melaporkan pro-kontra probiotik yang dapat menurunkan kejadian penyakit inflamasi intestinal pada BKB, seperti enterokolitis nekrotikans dan sepsis. Pengukuran calprotectin feses sebagai penanda penyakit inflamasi merupakan metode noninvasif, cepat, dan mudah dilakukan.Tujuan. Mengetahui pengaruh Lactobacillus reuteri DSM 17938 terhadap kadar calprotectin feses pada BKB. Metode. Penelitian eksperimental acak terkontrol pada BKB yang lahir di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Maret sampai Juni 2018. Kelompok probiotik diberikan Lactobacillus reuteri DSM 17938 selama 14 hari dan kelompok kontrol diberikan plasebo. Kadar calprotectin feses diperiksa sebelum dan sesudah perlakuan. Calprotectin diperiksakan menggunakan metode enzymed-linked immunosorbent assay (ELISA). Data dianalisis menggunakan uji Mann-Whitney dan Wilcoxon Signed Rank, tingkat kemaknaan hasil uji ditentukan berdasarkan nilai p<0,05.Hasil. Empat puluh bayi diikutsertakan, 4 di antaranya mengalami dropout. Tiga puluh enam bayi yang dianalisis terbagi menjadi kelompok probiotik (n=18) dan nonprobiotik (n=18). Karakteristik dasar tidak berbeda antara kedua kelompok. Sebelum perlakuan, kadar calprotectin feses kedua kelompok tidak berbeda secara signifikan (p=0,88). Kadar calprotectin feses kelompok probiotik lebih rendah secara signifikan dibandingkan dengan kelompok nonprobiotik setelah perlakuan (p<0,001).Kesimpulan. Pemberian Lactobacillus reuteri DSM 17938 dapat menurunkan kadar calprotectin feses.
Probiotik Pada Gangguan Saluran Cerna Fungsional
Authors: Andrea Valerie , Hegar Badriul
Published: March 2019

Probiotik memiliki kemampuan untuk memengaruhi komposisi mikroflora saluran cerna. Ketika dikonsumsi dalam jumlah adekuat, probiotik memiliki efek positif terhadap kesehatan pejamu. Terdapat beberapa penelitian yang menilai efek terapeutik probiotik terhadap berbagai macam penyakit, termasuk gangguan saluran cerna fungsional pada anak. Gangguan saluran cerna fungsional adalah gangguan yang dianggap terkait dengan saluran cerna, namun tidak dapat dijelaskan oleh kelainan struktural maupun biokimia. Penelitian besar menggunakan probiotik pada gangguan saluran cerna fungsional telah banyak dilakukan. Penggunaan probiotik juga dianggap aman dan hampir tidak pernah dilaporkan efek samping pada rawat jalan. Beragam strain, dosis, dan metodelogi penelitian menjadikan kesulitan dalam menerjemahkan dan menyimpulkan secara keseluruhan hasil penelitian yang ada. Walaupun demikian, beberapa penelitian dengan metodelogi yang baik memperlihatkan fakta bahwa peran probiotik terhadap beberapa gangguan saluran cerna fungsional tidak dapat diabaikan.
Peran Pemeriksaan Immature Platelet Fraction dalam Imun Trombositopenia
Authors: Saidah Fatimah , Sjakti Hikari Ambara
Published: March 2019

Latar belakang. Pemeriksaan immature platelet fraction (IPF) untuk mengetahui produksi trombosit dapat membedakan trombositopenia yang disebabkan gangguan trombopoiesis atau peningkatan destruksi trombosit. Nilai diagnostik IPF pada imun trombositopenia (ITP) belum dapat dibuktikan secara konsisten. Tujuan. Mengetahui manfaat pemeriksaan IPF dalam penegakan diagnosis ITP pada anak. Metode. Pencarian artikel dilakukan menggunakan instrumen PubMed, Cochrane, dan Google Cendekia dengan kata kunci yang sesuai. Seleksi dilakukan sesuai kriteria inklusi dan eksklusi serta telaah judul dan abstrak. Telaah kritis dilakukan dengan evaluasi validity, importance, dan applicability. Hasil. Diperoleh dua artikel berupa studi potong lintang dan studi retrospektif. Kedua studi melaporkan nilai IPF yang lebih tinggi pada pasien ITP dibandingkan dengan kelompok kegagalan sumsum tulang maupun kontrol (p<0,001). Studi pertama mendapatkan nilai IPF 9,4% bersifat diagnostik untuk ITP dengan sensitivitas 88%, spesifisitas 85,7%. Dari studi kedua didapatkan nilai IPF >8,45% memiliki sensitivitas 80,4% dan spesifisitas 79,9% untuk membedakan ITP dengan penyebab trombositopenia lainnya. Kesimpulan. Nilai IPF yang meningkat dapat bermanfaat untuk membantu diagnosis pada kasus ITP yang tidak disebabkan ganggguan trombopoiesis. Nilai IPF yang normal atau rendah tidak selalu dapat menyingkirkan diagnosis ITP mengingat kemungkinan adanya gangguan trombopoiesis pada ITP.
Prevalensi, Spektrum Klinis dan Gambaran Neurofisiologi Kasus Neuromuskular
Authors: Dewi Mia Milanti , Widodo Dwi Putro , Amardiyanto Roy , Sinaga Nurcahaya , Hidayah Nurul
Published: March 2019

Latar belakang. Sebagian kasus neuromuskular dapat ditegakkan berdasarkan klinis. Pemeriksaan penunjang, pemeriksaan imunologi dan analisis genetik sangat penting diperiksa untuk memastikan diagnosis. Ini merupakan penelitian pertama mengenai prevalensi penyakit neuromuskular di Indonesia.Tujuan. Mengetahui prevalensi, spektrum klinis, dan gambaran neurofisiologi kasus neuromuskular di RSCM periode Januari – Desember 2017.Metode. Penelitian ini bersifat retrospektif dari Januari – Desember 2017.Hasil. Di tahun 2017 terdapat 179 pasien (usia 1 bulan – 18 tahun) yang dirujuk untuk dilakukan pemeriksaan elektromiografi, dan 130 pasien memenuhi kriteria diagnostik penyakit neuromuskular. Dari seluruh pasien kelainan neuromuskular yang sering ditemukan berturut-turut adalah neuropati perifer (22,2%), Duchenne muscular dystrophy (15,6%), brachialis plexus injury (15,2%), Bell’s palsy (7,6%), Erb Palsy (6,1%), chronic inflamatory demyelinating polyneuropathy (5,4 %), spinal muscular atrophy type 1 (4,6 %), spinal muscular atrophy type 2 (3,8%), miastenia gravis okular (3,8%), Limb Girdle muscular dystrophy (3,1%), sindrom Guillain Barre (3,1%), sindrom Guillain Barre-tipe acute motor axonal neuropathy (2,3%), sindrom Guillain Barre-tipe acute motor-sensory axonal neuropathy (1,5%), miastenia gravis umum (1,5%), Charcot Marie tooth (1,5%), miotonia kongenital (1,5%), dan miositis viral akut (1,5%). Kesimpulan. Prevalensi kelainan neuromuskular anak RSCM sebesar 2,6 % dari seluruh pasien yang dilakukan datang ke poli saraf anak. Lima terbanyak kelainan neuromuskular adalah neuropati perifer, Ducchenne Muscular dystrophy, spinal muskular atrofi, sindrom Guillain Barre, dan chronic inflamatory demyelinating polyneuropathy.
Pewarnaan Gram Urin untuk Diagnosis Infeksi Saluran Kemih pada Anak Usia 2 Bulan hingga 2 Tahun
Authors: Trihono Partini P , Alkamdani Riki , Hendarto Aryono , Astrawinata Dalima Ari Wahono
Published: March 2019

Latar belakang. Infeksi saluran kemih (ISK) merupakan salah satu penyakit infeksi yang sering ditemukan pada anak usia 2 bulan hingga 2 tahun. Kondisi ini sulit dideteksi karena manifestasi klinis yang tidak spesifik. Kultur urin sebagai baku emas menegakkan diagnosis ISK membutuhkan waktu yang lama dan biaya yang mahal. Pewarnaan Gram urin adalah metode yang mungkin dapat digunakan untuk diagnosis dini ISK pada bayi dan anak. Tujuan. Membandingkan metode pewarnaan Gram dan kultur urin untuk mendiagnosis ISK pada anak usia 2 bulan hingga 2 tahun. Metode. Penelitian ini merupakan uji diagnostik dengan metode potong lintang di Rumah Sakit Cipto Mangunkusumo, Jakarta, Indonesia, dari Mei 2016 -Desember 2017. Penelitian ini melibatkan 59 anak usia 2 bulan hingga 2 tahun yang dicurigai menderita ISK yang direkrut dengan metode consecutive sampling. Sampel urin diambil dengan kateterisasi uretra dan dilakukan pemeriksaan urinalisis, pewarnaan Gram, dan pemeriksaan biakan urin. Hasil. Prevalens ISK didapatkan sebesar 38,9%. Pewarnaan Gram urin memiliki sensitivitas 47,8% (95% IK 26,8-69,4%), spesifisitas 97,2% (95% IK 85,5-99,9%), nilai duga positif 91,7% (95% IK 60,3-98,8%), nilai duga negatif 74,5% (95% IK 60,3-98,8%), LR(+) 17,2 (95% IK 2,4-124,6), LR(-) 0,54 (95% IK 0,36-0,8), dan akurasi sebesar 78%. Kesimpulan. Terdapat korelasi yang baik antara pewarnaan Gram urin dan hasil biakan urin untuk mendiagnosis ISK pada anak usia 2 bulan hingga 2 tahun. Antibiotik dapat segera diberikan setelah pewarnaan Gram menunjukkan hasil positif.