bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravitreal ziv-aflibercept in diabetic vitreous hemorrhage
Authors: Mansour Ahmad M. , Ashraf Mohammed , El Jawhari Khalil M. , Farah Michel , Souka Ahmed , Sarvaiya Chintan , Singh Sumit Randhir , Banker Alay , Chhablani Jay
Published: January 2020

Background

To evaluate the safety and efficacy of intravitreal ziv-aflibercept (IVZ) in the management of vitreous hemorrhage (VH) in eyes with previously lasered proliferative diabetic retinopathy (PDR).

Methods

In a prospective multicenter study, previously lasered eyes who had dense VH from PDR underwent intravitreal injection of ziv-aflibercept (IVZ) (1.25 mg aflibercept). Demographic characteristics of the patients, baseline and final logMar visual acuity, number of injections, VH clearance time, and need for vitrectomy were recorded.

Results

Twenty-seven eyes of 21 patients were included in the study. Mean age of study patients was 61.3 ± 14.1 years with mean duration of diabetes mellitus of 22.6 ± 7.8 years. Mean logMAR BCVA at baseline was 1.41 ± 1.26 (Snellen equivalent 20/514) and at the last visit 0.55 ± 0.61 (Snellen equivalent 20/70) with a mean gain of 0.86 EDTRS line (paired student t test = 5.1; p ≤ 0.001). Mean number of IVZ 2.4 ± 1.6 (range 1–6). The mean follow-up time was 11.7 ± 11.1 months (range 1–34). Mean time for visual recovery and/or VH clearance was 5.7 ± 3.3 weeks. Eyes, which required multiple injections, the interval period between injections for recurrent VH was 6.4 ± 5.2 months. No subject required vitrectomy. No ocular or systemic adverse effects were noted.

Conclusions

IVZ injections had good short-term safety and efficacy for the therapy of new or recurrent VH in previously lasered eyes with PDR reducing somewhat the need for vitrectomy.

Trial registration: NCT02486484
Comparison of clinical effects between icodextrin and glucose solutions on outcomes of peritoneal dialysis: systematic review and meta-analysis of randomized controlled trials
Authors: Kanno Atsuhiro , Tsujimoto Yasushi , Fujii Takayuki , Fujikura Emi , Watanabe Kimio , Yuasa Hidemichi , Ryuzaki Munekazu , Ito Yasuhiko , Nakamoto Hidetomo
Published: January 2020

Background

Icodextrin enhances peritoneal filtration for patients on peritoneal dialysis (PD). However, clinically important outcomes have not yet been analyzed using authentic, objective statistical methods. The present systematic review aimed to determine the risks and benefits of icodextrin compared with a glucose-based solution with respect to clinically important and patient-centered outcomes.

Methods

We systematically investigated only randomized controlled trials (RCTs) by adopting the Cochrane Database of Systematic Review (2014) and searched the CENTRAL, MEDLINE, and EMBASE databases for eligible studies reported in the literature. The quality of the evidence was assessed using the GRADE approach.

Results

We finally evaluated important outcomes in 13 RCTs. Icodextrin significantly decreased the number of reported episodes of uncontrolled fluid overload in four RCTs that involved 236 patients (relative risk [RR], 0.31; 95% confidence interval [CI], 0.12 to 0.82; moderate certainty evidence). However, the inclusion of icodextrin for peritoneal ultrafiltration did not significantly differ in six RCTs involving 252 patients (mean difference [MD], 186.76 mL; 95% CI, − 47.08 to 420.59; low certainty evidence). Regarding other clinically important outcomes, all-cause mortality in 10 RCTs involving 1106 patients (RR, 0.75; 95% CI, 0.33 to 1.71; low certainty evidence) and technical survival in five RCTs involving 470 patients (RR, 0.57; 95%CI, 0.29 to 1.12; low certainty evidence) were not significant. Urine volume in four RCTs involving 136 patients, residual renal function in five RCTs involving 181 patients and peritoneal function measured as the ratio of solute concentration in dialysate and plasma (D/P ratio) in two RCTs involving 105 patients were not specifically affected by icodextrin, and the results for adverse events were similar between icodextrin and glucose PD solutions.

Conclusion

Icodextrin could relieve uncontrolled fluid overload without adding risk. However, a significant effect on clinically relevant outcomes such as technical survival and overall patient survival was not suggested. More trials are required to increase the statistical power and to verify the value of icodextrin in clinical practice.

Trial registration

PROSPERO,CRD42018104360
Molecular disparities among Botrytis species involved in onion umbel blight disease and its management using Bacillus subtilis PHYS7
Authors: Abo-Elyousr Kamal A. M. , Alamri Saad A. M. , Hussein Mohamed M. A. , Hassan Mohamed A. H. , Abd El-Fatah Bahaa E. S. , Hashem Mohamed
Published: January 2020

A study of molecular variation among Botrytis spp., the causal pathogen of scape and umbel blights of onion, as well as the biocontrol of the virulent pathogen using Bacillus subtilis PHYS7 under greenhouse conditions was carried out. Twenty-three isolates of Botrytis spp. were recovered from onion plants showing umbel blight symptoms. They were able to infect onion plants with varied severity. All Botrytis spp. produced cellulases; however, almost all of them produced pectinase. The highest activities of cellulases and pectinase were achieved by B. allii PHYOA1; however, B. cinerea PHYOC3 showed a high activity of cellulases but it failed to produce pectinase. The genetic variability among the pathogens was assessed by random amplified polymorphic DNA (RAPD) markers, using 5 random 10-mer primers: OPA03, OPA05, OPA06, OPI09, and OPW15. The results showed that 50 DNA bands ranging from 100 bp (OPA03) to 1600 bp (OPA05) were generated by the 5 primers that differentiated 9 isolates of Botrytis spp. The dual culture test showed that Bacillus subtilis PHYS77 and PHYS78 had a high antagonistic potentiality against the pathogen and involved in 60–62% reduction in its growth. Application of Ridomil Gold MZ and Bacillus subtilis PHYS77 on onion plants, 2 days after or before infection with the pathogen, significantly reduced the disease severity than the control. The study approved the molecular tool as a reliable and quick method to differentiate among the virulent and non-virulent strains of Botrytis spp. The application of B. subtilis PHYS77 as an effective biocontrol agent in the management of the onion blight disease can be recommended.
The myth and truth of a comprehensive stroke scale
Authors: Zakieldine Hani M. , Turk Mohamed A. , Hashem Rana F. , Shafik Mohamed A.
Published: January 2020

Background and purpose

The National Institutes of Health Stroke Scale (NIHSS) has been found to be biased toward the left hemispheric and motoric functions providing minimal assessment to the right hemispheric language and cognitive functions. The need to complement the role of the NIHSS is necessary in accurate and rapid assessment of AIS patients and better management. We hypothesized that combining the NIHSS with a quantitative analysis of Spoken Picture Description scale of Comprehensive Aphasia Test (SPD-CAT) could provide valuable data regarding side, site, and size of stroke.

Subjects and methods

Eighty-six AIS patients presented within 48 h of onset of stroke were enrolled from Stroke Units of Ain-Shams University Hospitals (ASUHS). Clinical Assessment with NIHSS and SPD-CAT were correlated with the radiological MRI Brain lesions of stroke regarding (site, side, size/volume and lesion volume percent to the whole brain volume “LV% WBV”).

Results

Total and subscale scores of NIHSS and SPD-CAT have a highly statistically significant correlation with the ischemic “LV% WBV.” Quantitative analysis (content units) of SPD-CAT may help in prediction of the lobar site of the stroke with higher significance in the tempro-parietal and brainstem regions. Right hemispheric strokes have clinically and statistically significant scores on SPD-CAT in comparison to NIHSS scores. Also, the left to right ratio of content units of information carrying words (ICWs) in SPD-CAT gives a significant difference between right and left hemispheric strokes. Recording and analysis time of SPD-CAT makes it easy and rapidly applicable in emergency room (ER) and stroke units.

Conclusion

Combining the quantitative analysis of NIHSS and SPD-CAT can better predict the side, size, and site of AIS within reasonable time table and without urgent MRI for AIS assessment and management.
Value of magnetic resonance spectroscopy in geriatric patients with cognitive impairment
Authors: Kotb Mamdouh Ali , Kamal Ahmed M. , Aldossary Nasser M. , Alsify Ayman A. , Ahmed Yassmin M.
Published: January 2020

Background

Mild cognitive impairment is a transitional stage prior to dementia, and it is reported in depressed patients. Early diagnosis could predict the reversible etiologies and prevent further deterioration. Proton magnetic resonance spectroscopy has been used for early diagnosis and differential diagnosis of cognitive impairment.

Objective

We aimed to study the difference of hippocampal and frontal white matter metabolites between patients with Alzheimer’s disease, mild cognitive impairment, and cognitive impairment associated with depression, and if those metabolites can differentiate between them.

Subjects and methods

Geriatric patients with cognitive impairment were recruited from neurology and psychiatry clinics. All subjects underwent comprehensive medical evaluations, neuropsychological testing, laboratory tests as well as brain MRI and 1H-MRS studies.

Results

The present study included 85 subjects. Patients with MCI and AD had lower hippocampal NAA and NAA/Cr ratio than patients with depression and normal controls, while, frontal NAA and NAA/Cr ratio were lower in all patient’s subgroups compared to normal control.

Conclusion

Hippocampal NAA and NAA/Cr ratio might help to differentiate between MCI and cognitive impairment associated with depression.
MRI-based or CT-based patient-specific instrumentation in Total knee Arthroplasty: How do the two systems compare?
Authors: Kang Dong-Geun , Kim Kang-Il , Bae Jung-Kwon
Published: January 2020

Background

Patient-specific instrumentation (PSI) has been introduced into total knee arthroplasty (TKA) to improve accuracy in restoration of alignment. PSI in TKA refers to custom-made cutting jigs manufactured according to anatomic configuration of the patient’s bone based on preoperative magnetic resonance imaging (MRI) or computed tomography (CT) scans. The purpose of this study was to compare the MRI- or CT-based PSI to see if they could reproduce accurate bone resection and postoperative outcomes.

Methods

Seventy-one patients who received elective TKA using a PSI system for primary osteoarthritis with varus deformity were prospectively enrolled for this study. We randomly allocated those patients to MRI-based PSI group (36 patients) and CT-based PSI group (35 patients). The actual resection thickness and planned resection thickness by preoperative PSI electronic program were compared between the two groups. Radiographic findings of the postoperative limb alignment, three-dimensional position of the implants, and related complications were also evaluated. Clinical evaluation was also performed before and 2 years after the surgery.

Results

There were no significant differences in the resection thickness in femur and tibia between actual resection and planned resection in both groups. Furthermore, there were no significant differences between two groups in terms of coronal, sagittal and rotational alignment of the components. All clinical assessments revealed no differences between two groups 2 years after the operation. No specific complication related to PSI was observed.

Conclusions

Although MRI allows for visualization of cartilage, MRI-based PSI system did not show better accuracy in predicting the thickness of bone resection than CT-based PSI. Moreover, there were no differences in radiographic and clinical outcomes between the two groups.
Tracking activity patterns of a multispecies community of gymnotiform weakly electric fish in their neotropical habitat without tagging
Authors: Henninger Jörg , Krahe Rüdiger , Sinz Fabian , Benda Jan
Published: January 2020

Field studies on freely behaving animals commonly require tagging and often are focused on single species. Weakly electric fish generate a species- and individual-specific electric organ discharge (EOD) and therefore provide a unique opportunity for individual tracking without tagging. We here present and test tracking algorithms based on recordings with submerged electrode arrays. Harmonic structures extracted from power spectra provide fish identity. Localization of fish based on weighted averages of their EOD amplitudes is found to be more robust than fitting a dipole model. We apply these techniques to monitor a community of three species, Apteronotus rostratus, Eigenmannia humboldtii, and Sternopygus dariensis, in their natural habitat in Darién, Panamá. We found consistent upstream movements after sunset followed by downstream movements in the second half of the night. Extrapolations of these movements and estimates of fish density obtained from additional transect data suggest that some fish cover at least several hundreds of meters of the stream per night. Most fish, including Eigenmannia, were traversing the electrode array solitarily. From in-situ measurements of the decay of the EOD amplitude with distance of individual animals we estimated that fish can detect conspecifics at distances of up to 2 m. Our recordings also emphasize the complexity of natural electrosensory scenes resulting from the interactions of the EODs of different species. Electrode arrays thus provide an unprecedented window into the so-far hidden nocturnal activities of multispecies communities of weakly electric fish at an unmatched level of detail.
Substrate analogs that trap the 2′-phospho-ADP-ribosylated RNA intermediate of the Tpt1 (tRNA 2′-phosphotransferase) reaction pathway
Authors: Dantuluri Swathi , Abdullahu Leonora , Munir Annum , Katolik Adam , Damha Masad J. , Shuman Stewart
Published: January 2020

The enzyme Tpt1 removes an internal RNA 2′-PO4 via a two-step reaction in which: (i) the 2′-PO4 attacks NAD+ to form an RNA-2′-phospho-(ADP-ribose) intermediate and nicotinamide; and (ii) transesterification of the ADP-ribose O2″ to the RNA 2′-phosphodiester yields 2′-OH RNA and ADP-ribose-1″,2″-cyclic phosphate. Because step 2 is much faster than step 1, the ADP-ribosylated RNA intermediate is virtually undetectable under normal circumstances. Here, by testing chemically modified nucleic acid substrates for activity with bacterial Tpt1 enzymes, we find that replacement of the ribose-2′-PO4 nucleotide with arabinose-2′-PO4 selectively slows step 2 of the reaction pathway and results in the transient accumulation of high levels of the reaction intermediate. We report that replacing the NMN ribose of NAD+ with 2′-fluoroarabinose (thereby eliminating the ribose O2″ nucleophile) results in durable trapping of RNA-2′-phospho-(ADP-fluoroarabinose) as a “dead-end” product of step 1. Tpt1 enzymes from diverse taxa differ in their capacity to use ara-2″F-NAD+ as a substrate.
Contraceptive implant failures among women using antiretroviral therapy in western Kenya: a retrospective cohort study
Authors: Pfitzer Anne , Wille Jacqueline , Wambua Jonesmus , Stender Stacie C , Strachan Molly , Ayuyo Christine Maricha , Muhavi Timothy F. Kibidi , Wabwile Valentino , Mehta Supriya D. , Sasser Elizabeth
Published: January 2020

Background: Women living with HIV have the right to choose whether, when and how many children to have. Access to antiretroviral therapy (ART) and contraceptives, including implants, continues to increase in Kenya. Studies have reported drug-drug interactions leading to contraceptive failures among implant users on ART. This retrospective record review aimed to determine unintentional pregnancy rates among women 15-49 years of age, living with HIV and concurrently using implants and ART in western Kenya between 2011 and 2015.

Methods: We reviewed charts of women with more than three months of concurrent implant and ART use. Implant failure was defined as implant removal due to pregnancy or birth after implant placement, but prior to scheduled removal date. The incidence of contraceptive failure was calculated by woman-years at risk, assuming a constant rate.

Results: Data from 1,152 charts were abstracted, resulting in 1,190 implant and ART combinations. We identified 115 pregnancies, yielding a pregnancy incidence rate of 6.32 (5.27–7.59), with 9.26 among ETG and 4.74 among LNG implant users, respectively. Pregnancy incidence rates did not differ between EFV- and NVP-based regimens (IRR=1.00, CI: 0.71-1.43). No pregnancies were recorded among women on PI-based regimens, whereas pregnancy rates for efavirenz and nevirapine-containing regimens were similar, at 6.41 (4.70–8.73) and 6.44 (5.13–8.07), respectively. Pregnancy rates also differed significantly by implant type, with LNG implant users half as likely to experience pregnancy as ETG implant users (0.51, CI: 0.33-0.79, p>0.01).

Conclusions: Our findings highlight the implications of drug-drug interaction on women’s choices for contraception.
An interdisciplinary mixed-methods approach to developing antimicrobial stewardship interventions: Protocol for the Preserving Antibiotics through Safe Stewardship (PASS) Research Programme
Authors: Shallcross Laura , Lorencatto Fabiana , Fuller Christopher , Tarrant Carolyn , West Jonathan , Traina Rosanna , Smith Catherine , Forbes Gillian , Crayton Elise , Rockenschaub Patrick , Dutey-Magni Peter , Richardson Emma , Fragaszy Ellen B. , Michie Susan , Hayward Andrew C. ,   PASS Research Group
Published: January 2020

Behaviour change is key to combating antimicrobial resistance. Antimicrobial stewardship (AMS) programmes promote and monitor judicious antibiotic use, but there is little consideration of behavioural and social influences when designing interventions.  We outline a programme of research which aims to co-design AMS interventions across healthcare settings, by integrating data-science, evidence- synthesis, behavioural-science and user-centred design.

The project includes three work-packages (WP):

WP1 (Identifying patterns of prescribing):  analysis of electronic health-records to identify prescribing patterns in care-homes, primary-care, and secondary-care. An online survey will investigate consulting/antibiotic-seeking behaviours in members of the public.

WP2 (Barriers and enablers to prescribing in practice): Semi-structured interviews and observations of practice to identify barriers/enablers to prescribing, influences on antibiotic-seeking behaviour and the social/contextual factors underpinning prescribing. Systematic reviews of AMS interventions to identify the components of existing interventions associated with effectiveness. Design workshops to identify constraints influencing the form of the intervention. Interviews conducted with healthcare-professionals in community pharmacies, care-homes, primary-, and secondary-care and with members of the public. Topic guides and analysis based on the Theoretical Domains Framework.  Observations conducted in care-homes, primary and secondary-care with analysis drawing on grounded theory.  Systematic reviews of interventions in each setting will be conducted, and interventions described using the Behaviour Change Technique taxonomy v1. Design workshops in care-homes, primary-, and secondary care.

WP3 (Co-production of interventions and dissemination). Findings will be integrated to identify opportunities for interventions, and assess whether existing interventions target influences on antibiotic use. Stakeholder panels will be assembled to co-design and refine interventions in each setting, applying the Affordability, Practicability, Effectiveness, Acceptability, Side-effects and Equity (APEASE) criteria to prioritise candidate interventions. 

Outputs will inform development of new AMS interventions and/or optimisation of existing interventions.  We will also develop web-resources for stakeholders providing analyses of antibiotic prescribing patterns, prescribing behaviours, and evidence reviews.
Implementation barriers for mHealth for non-communicable diseases prevention and management in low and middle income countries: a scoping review and field-based views from implementers
Authors: van Olmen Josefien , Erwin Erica , García-Ulloa Ana Cristina , Meessen Bruno , Miranda J. Jaime , Bobrow Kirsty , Iwelunmore Juliet , Nwaozuru Ucheoma , Obiezu Umeh Chisom , Smith Carter , Harding Chris , Kumar Pratap , Gonzales Clicerio , Hernández-Jiménez Sergio , Yeates Karen
Published: January 2020

Background: Mobile health (mHealth) has been hailed as a potential gamechanger for non-communicable disease (NCD) management, especially in low- and middle-income countries (LMICs). Individual studies illustrate barriers to implementation and scale-up, but an overview of implementation issues for NCD mHealth interventions in LMICs is lacking. This paper explores implementation issues from two perspectives: information in published papers and field-based knowledge by people working in this field.

Methods: Through a scoping review publications on mHealth interventions for NCDs in LMICs were identified and assessed with the WHO mHealth Evidence Reporting and Assessment (mERA) tool. A two-stage web-based survey on implementation barriers was performed within a NCD research network and through two online platforms on mHealth targeting researchers and implementors.

Results: 18 studies were included in the scoping review. Short Message Service (SMS) messaging was the main implementation tool. Most studies focused on patient-centered outcomes. Most studies do not report on process measures and on contextual conditions influencing implementation decisions. Few publications reported on implementation barriers. The websurvey included twelve projects and the responses revealed additional information, especially on practical barriers related to the patients’ characteristics, low demand, technical requirements, integration with health services and with the wider context. Many interventions used low-cost software and devices with limited capacity that not allowing linkage with routine data or patient records, which incurred fragmented delivery and increased workload.

Conclusion: Text messaging is a dominant mHealth tool for patient-directed of quality improvement interventions in LMICs. Publications report little on implementation barriers, while a questionnaire among implementors reveals significant barriers and strategies to address them. This information is relevant for decisions on scale-up of mHealth in the domain of NCD. Further knowledge should be gathered on implementation issues, and the conditions that allow universal coverage.
Some new Hermite–Hadamard type inequalities for functions whose nth derivatives are convex
Authors: Meftah B. , Merad M. , Ouanas N. , Souahi A.
Published: January 2020

We first create an integral identity for n-times differentiable functions. Relying on this identity, we establish some new Hermite–Hadamard type inequalities for functions whose nth derivatives are convex.
Estimating probability of fatigue failure of steel structures
Authors: Kala Z.
Published: January 2020

The article deals with the analysis of failure probability of the effect of random factors in uencing fatigue crack propagation in a steel element under bending moment. The theoretical model of fatigue crack progression is based on linear fracture mechanics. When determining the required degree of failure probability, it is possible to specify the time of the first inspection of the construction, which will focus on the fatigue damage. Using a conditional probability, subsequent inspection times are specified. The failure probability is examined using a fairly new sensitivity analysis subordinated to a contrast. The importance ranking of the input random variables to the failure probability is investigated. Fatigue properties of steel are taken from recent experimental research. Numerical results are obtained using the Monte Carlo simulation.
КОРПОРАТИВНОЕ УПРАВЛЕНИЕ В ЖЕЛЕЗНОДОРОЖНОМ ТРАНСПОРТЕ
Authors: Sapozhnikova Svetlana Mikhailovna
Published: January 2020

Состояние вопроса. Корпоративное управление в условиях реформировании крупных государственных предприятий в коммерческие корпорации обусловило потребность в выработке новых методов и подходов в деятельности крупных транспортных компаний, в управлении всеми операциями / процессами на уровне подразделений и в целом по организации.Особенно серьезные изменения затронули железнодорожный транспорт, где происходит постепенная реорганизация структуры, а последние изменения коснулись преобразования стратегического управления на базе функционально-стоимостного подхода (с выделением Дирекций, которые управляют отдельными функциями и затратами, выполняемыми центрами затрат, находящихся в их подчинении). Стратегическое управление в корпорации и выступило объектом исследования.Материалы и методы исследования. Для оценки эффективности стратегического управления были использованы формальная логика, системный подход, анкетирование и анализ статистических данных, которые позволили выявить следующие проблемы.Результаты исследования. Выработанная стратегия управления, направленная на улучшение управляемости подразделений, совершенствование взаимоотношений между уровнями иерархии системы управления и оптимизацию затрат негативно отразилась на развитии подразделений.Обсуждение. По нашему мнению, это связано с неэффективным распределением денежных потоков между центром и подразделениями, что, при недостаточном финансировании, привело к росту потерь, сверхурочной работы при относительно невысоких уровнях оплаты труда основных работников, непроизводительных расходов и простоев в центрах затрат.Такое положение, по нашему мнению, требует осуществления определенных изменений, прежде всего через стратегическое управление по методу «снизу вверх» и создания структурных отделов на местах по нормированию затрат с учетом материально-технической базы каждого конкретного центра затрат и согласование их в рамках общекорпоративного бюджета. Такое положение позволит стабильно развиваться дивизионам, улучшать их социально-экономическое развитие.Заключение. В целом можно отметить рациональность применения функционально-стоимостного подхода в стратегическом управлении железнодорожной корпорации. При этом особое внимание необходимо уделять оптимизации распределения денежных потоков между звеньями корпорации.
Redesigning the Market for Volunteers: A Donor Registry
Authors: Heger Stephanie A. , Slonim Robert , Garbarino Ellen , Wang Carmen , Waller Daniel
Published: January 2020

This paper addresses volunteer labor markets where the lack of price signals, nonpecuniary motivations to supply labor, and limited fungibility of supply lead to market failure. To address the causes of the market failure, we conduct a field experiment with volunteer whole blood donors where we introduce a market-clearing mechanism (henceforth: the Registry). Our intention-to-treat estimates suggest that subjects invited to the Registry, regardless of joining, are 66% more responsive to critical shortage appeals than control subjects. While the Registry increases supply during a critical shortage episode, it does not increase supply when there is no shortage; thus, the Registry significantly improves coordination between volunteer donors and collection centers, thereby improving market outcomes. We find evidence that the Registry’s effectiveness stems from crowding-in volunteers with purely altruistic motives and volunteers with a preference for commitment.

This paper was accepted by Yan Chen, decision analysis.
Insights for implementing change in healthcare
Authors: DaCosta Joanna
Published: January 2020

Healthcare systems are complex; this is reflected in their diverse structures, cultures and services. Organisational culture is an important aspect to consider when planning any intervention changes. Working in and with teams that include members from different professional and organisational backgrounds, and successfully managing these potential tensions, can be challenging. This article reviews the elements required to instigate organisational change when planning an intervention and the possible barriers preventing doctors from full engagement in these projects. It discusses the model of ‘planned change’, which was first described by Lewin in 1947, and its evolution through recent decades as a framework for organisational change. It also emphasises the importance of workplace culture in the successful implementation of change within healthcare services and argues that a stronger emphasis on management skills is needed in doctor training. Doctors are an underused resource in healthcare management and should be encouraged to take a more proactive role.
Is your healthcare organisation using sound quality assurance principles? Part 2: coping with the unexpected
Authors: Collins John Michael
Published: January 2020

This is the second article in a two-part series that proposes how healthcare organisations could implement a quality assurance approach based on the requirements of a thus far unwritten healthcare modification of the 2015 International Organization for Standardization (ISO 9001). This second article will address the issue of unexpected failures of manufactured medical implants and medication delivery devices. Issues facing the quality assured supply of medical equipment, as well as the failure of implants during fitting or use and the failure or malfunction of powered syringes or drips, is discussed. At the end of the article, a list of self-audit questions is proposed to allow readers to make an assessment of how their own organisation has responded to the failure of medical implants or devices in the past, and whether action has been taken to prevent any problems reoccurring.
Burnout across the healthcare workforce
Authors: Winter George
Published: January 2020

Mental and physical exhaustion—known as burnout—has become a major hindrance to healthcare professionals. George Winter outlines current research into the clinical workplace demands and culture which can lead to burnout and considers what healthcare managers can do to alleviate these problems.
Salmonella enterica serovar Paratyphi A isolated from a hard-to-heal diabetic ulcer: a case report
Authors: Dilhari Ayomi , Pathirage Sujatha , Gunasekara Chinthika , Fernando Neluka , Weerasekara Deepaka , McBain Andrew , Weerasekera Manjula
Published: January 2020

Chronically infected diabetic wounds have a polymicrobial aetiology. However, Salmonella Paratyphi A is a very rare cause of wound infection. A 76-year-old female patient with type II diabetes presented with a wound on the left leg of two months' duration. The wound was painful, erythematous and a thick, foul-smelling discharge was present. There was a history of delayed wound healing. Salmonella Paratyphi A and Pseudomonas aeruginosa were isolated from the wound tissue. The patient was treated with cefuroxime and cloxacillin empirically and following the antibiotic susceptibility testing (ABST) report, ciprofloxacin was given for 10 days. The wound was treated with multiple debridements and topical antiseptic. On follow-up, the patient remained afebrile with subsiding discharge from the ulcer. This is the first reported case of Salmonella Paratyphi A from an infected diabetic ulcer in Sri Lanka and it serves to further define the spectrum of illnesses caused by this uncommon pathogen.
Role of inflammatory markers in the healing time of diabetic foot osteomyelitis treated by surgery or antibiotics
Authors: Tardáguila-García Aroa , García-Álvarez Yolanda , Sanz-Corbalán Irene , Álvaro-Afonso Francisco Javier , Molines-Barroso Raúl Juan , Lázaro-Martínez José Luis
Published: January 2020

Objective:

To analyse the predictive role of inflammatory markers in the healing time of diabetic foot osteomyelitis treated by surgery or antibiotics.

Methods:

An observational study of patients with diabetic foot ulcers (DFU) and clinically suspected osteomyelitis. The patients underwent surgical or antibiotic treatment for bone infection in a specialised diabetic foot unit. Blood samples were taken from each patient to analyse biomarkers. The main outcome was the number of weeks until healing occurred.

Results:

A total of 116 patients took part in the study. The number of weeks until healing was similar for both groups (surgical n=96 and antiobiotic n=20, treatments). No association was observed among biomarkers as predictors of time-to-healing.

Conclusion:

There is not enough evidence to define the prognostic role of inflammatory markers in the healing time of DFUs complicated with diabetic foot osteomyelitis, regardless of the treatment administered.
Evaluation of apocynin in vitro on high glucose-induced oxidative stress on tenocytes
Authors: Kurosawa Takashi , Mifune Yutaka , Inui Atsuyuki , Nishimoto Hanak , Ueda Yasuhiro , Kataoka Takeshi , Yamaura Kohei , Mukohara Shintaro , Kuroda Ryosuke
Published: January 2020

Aims

The purpose of this study was to evaluate the in vitro effects of apocynin, an inhibitor of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and a downregulator of intracellular reactive oxygen species (ROS), on high glucose-induced oxidative stress on tenocytes.

Methods

Tenocytes from normal Sprague-Dawley rats were cultured in both control and high-glucose conditions. Apocynin was added at cell seeding, dividing the tenocytes into four groups: the control group; regular glucose with apocynin (RG apo+); high glucose with apocynin (HG apo+); and high glucose without apocynin (HG apo–). Reactive oxygen species production, cell proliferation, apoptosis and messenger RNA (mRNA) expression of NOX1 and 4, and interleukin-6 (IL-6) were determined in vitro.

Results

Expression of NOX1, NOX4, and IL-6 mRNA in the HG groups was significantly higher compared with that in the RG groups, and NOX1, NOX4, and IL-6 mRNA expression in the HG apo+ group was significantly lower compared with that in the HG apo– group. Cell proliferation in the RG apo+ group was significantly higher than in the control group and was also significantly higher in the HG apo+ group than in the HG apo– group. Both the ROS accumulation and the amounts of apoptotic cells in the HG groups were greater than those in the RG groups and were significantly less in the HG apo+ group than in the HG apo– group.

Conclusion

Apocynin reduced ROS production and cell death via NOX inhibition in high-glucose conditions. Apocynin is therefore a potential prodrug in the treatment of diabetic tendinopathy. Cite this article: Bone Joint Res 2020;9(1):23–28.
The Rise and Fall of Unproductive Activities in the US Economy 1964–2015: Facts, Theory and Empirical Evidence
Authors: Tsoulfidis Lefteris , Tsimis Achilleas , Paitaridis Dimitris
Published: January 2020

The general idea about unproductive labor and the activities associated with it is that they tend to expand and by expanding, reduce the investible product and the growth potential of the economy, however, little is known about the determinants of their movement. In this study, we take a closer look at the US unproductive labor and activities in general during the 1964–2015 period. As possible determinants of the movement of unproductive activities, we consider the economy-wide average rate of profit, the real interest rate and the degree of capacity utilization. The Toda Yamamoto causality tests, as well as the ARDL econometric model, lend support to the view that the unproductive expenditures and activities are determined by rather than determine the above variables. Furthermore, the error correction term indicates that a long run equilibrium relationship exists, and it is attainable after the passage of not too long a time.
Towards a Theoretical Framework for Understanding Capitalist Violence against Child Labor
Authors: Das Raju , Chen Ashley
Published: January 2020

More than 150–200 million children work for a living in the world. A large number of them experience violence. The economic aspect of child labor has received much attention (as has the topic of violence against children as children), and rightly so. But the extra-economic aspect of child labor (i.e., the sheer violence against children as workers in the market-place and the workplace) has been relatively neglected. It is necessary to conduct empirical studies on the topic, which, however, require prior theoretical work. The aim of this paper is to provide a theoretical framework on violence against child labor. Central to this framework are three inter-connected arguments: the fact that under certain circumstances, and contrary to a widely-prevalent standpoint, capitalism produces, and makes use of, a pool of workers who lack the freedom to enter and exit a labor contract; the universal logic of capitalist accumulation interacting with the context where some workers are children; and finally, the fact that violence against child labor is enabled by a specific cultural aspect of capitalist society, “childism.”
Ultracompact polarization-insensitive power splitter using subwavelength-grating-based MMI couplers on an SOI platform
Authors: Zhong Wanqin , Xiao Jinbiao
Published: January 2020

An ultracompact and polarization-insensitive power splitter using a subwavelength-grating-based multimode interference (MMI) coupler on an SOI platform is proposed and analyzed in detail. By properly tailoring the structural parameters of the subwavelength gratings embedded in the center of the MMI coupler, the effective reflective indices for TE and TM modes supported by this MMI coupler can be engineered, leading to equal coupling lengths for the two polarizations and an efficient reduction in length for the used MMI coupler. As a result, an ultracompact polarization-insensitive power splitter can be realized. Moreover, to effectively minimize the loss, tapered waveguides are used, and two right angles are cut at both corners of the used MMI coupler. Results show that a footprint of

2

.

2

µ

m

×

3

.

8

µ

m

for the MMI region is achieved with an insertion loss of 0.07 dB for both TE and TM modes (polarization dependent loss

∼

0

d
B

) and a reflection loss of

−

28

.

29

d
B

(

−

31

.

25

d
B

) for TE mode at the wavelength of 1.55 µm. Insertion loss below 0.3 dB is obtained over the bandwidth of 200 nm, covering the C-band. In addition, fabrication tolerances to the structural parameters are analyzed, and the injected light propagating through the power splitter is also presented.
Fundamental design parameters of two-component optical systems: theoretical analysis
Authors: Mikš Antonín , Pokorný Petr
Published: January 2020

The paper presents a detailed theoretical analysis of two-component optical systems of Petzval objective, tele-objectives, reverse tele-objectives, and objectives of anallactic type. This type of optical system is popular in practice, especially in the field of photographic technologies and surveying devices (theodolites, levelling devices, etc.), where anallactic telescopes with inner focusing are used. The paper presents methods of designing of fundamental parameters of the objective, i.e., focal distances of the objective’s components and their mutual distance, and radii of curvatures of individual surfaces if the components are cemented doublets. Further, a detailed analysis of aberration properties of those optical systems is presented.
Tritan color vision deficiency may be associated with an OPN1SW splicing defect and haploinsufficiency
Authors: Neitz Maureen , Krekling Elise D. , Hagen Lene A. , Pedersen Hilde R. , Rowlan Jessica , Barborek Rachel , Neitz Jay , Crain Adam , Baraas Rigmor C.
Published: January 2020

Here we present evidence implicating disrupted RNA splicing as a potential cause of inherited tritan color vision. Initially we tested 51 subjects for color vision deficiencies. One made significant tritan errors; the others were classified as normal trichromats. The putative tritan subject was the only one of the 51 subjects found to be heterozygous for an OPN1SW gene mutation that disrupts RNA splicing in an in vitro assay. In order to gather further support for the role of the splicing mutation in tritan color vision, the putative tritan subject’s mother and sister were examined. They also made tritan errors and had the same OPN1SW gene mutation.
Relative contributions of melanopsin to brightness discrimination when hue and luminance also vary
Authors: DeLawyer Tanner , Tsujimura Sei-ichi , Shinomori Keizo
Published: January 2020

A large number of studies have shown the effect of melanopsin-dependent retinal ganglion cells on humans performing brightness discrimination tasks. These studies often utilized targets that only differ in their melanopsin activation levels, and not in their luminance or hue, which are both factors that make large contributions to brightness discrimination. The purpose of the present study was to evaluate the relative contribution of melanopsin activation to brightness discrimination when luminance and hue are also varying in addition to melanopsin activation. Using an apparatus consisting of three separate high luminance projectors, we were able to manipulate melanopsin-isolating stimulation, and L-, M-, and S-cone stimulation separately, thus allowing us to vary stimuli in their melanopsin activation, luminance, and hue category independently. We constructed three sets of target stimuli with three different levels of melanopsin activation (100%, 131%, and 167% relative melanopsin excitation) and five levels of luminance. We then had subjects do a two-alternative forced choice task where they compared the previously described target stimuli set to a set of four comparison stimuli that varied in their hue category but had identical luminances. We found that in our stimuli set the overall contribution of melanopsin activity to brightness discrimination was small (an average of 6% increase in likelihood to call a high melanopsin activity stimulus brighter compared to a low melanopsin activity stimulus) when luminance and hue also varied. However, a significant interaction showed that when the comparison was between stimuli differing only in melanopsin stimulation (with luminance and hue unchanged) the contribution of melanopsin to brightness judgments was about 3 times larger (an average of 18% increase in likelihood to call a high melanopsin activity stimulus brighter compared to a low melanopsin activity stimulus). This suggests that although luminance and hue have large effects on brightness discrimination such that the melanopsin contribution can become hard to detect, when there are minimal cone-dependent signals available, melanopsin can make a large contribution to brightness discrimination.
Caustics of the vortex beams generated by vortex lenses and vortex axicons
Authors: Kharitonov Sergey I. , Khonina Svetlana N. , Volotovskiy Sergey G. , Kazanskiy Nikolay L.
Published: January 2020

In this work, the propagation of vortex beams is treated using a
catastrophe theory approach. Analytic expressions are deduced to
describe caustic surfaces produced by vortex lenses and vortex
axicons. The obtained analytics allow us to explain the formation of
the shadow region along the optical axis for vortex beams using
geometric optics (previously, the zero axial intensity was explained
just by diffraction effects). Thus, the presence of a vortex eikonal
leads to a fundamental change in the type of axial caustic. Another
important distinction of the caustics produced by vortex beams from
those produced by nonvortex radial beams has been shown to consist in
wavelength-dependence. The results of numerical simulation show that
the propagation operator defined using a geometrical optics
approximation agrees well with the numerical simulation results
obtained using a nonparaxial diffraction operator based on the conical
wave expansion.
Dual-input concave diffraction grating demultiplexer based on dielectric multidirectional reflectors: publisher’s note
Authors: Mao Yuzheng , Zhu Jingping , Li Ke , Zhang Yang , Hou Xun
Published: January 2020

This publisher’s note corrects an affiliation in J. Opt. Soc. Am. A
36, 1585 (2019)JOAOD60740-323210.1364/JOSAA.36.001585.
A heterogeneously integrated silicon photonic/lithium niobate travelling wave electro-optic modulator
Authors: Boynton Nicholas , Cai Hong , Gehl Michael , Arterburn Shawn , Dallo Christina , Pomerene Andrew , Starbuck Andrew , Hood Dana , Trotter Douglas C. , Friedmann Thomas , DeRose Christopher T. , Lentine Anthony
Published: January 2020

Silicon photonics is a platform that enables densely integrated photonic components and systems and integration with electronic circuits. Depletion mode modulators designed on this platform suffer from a fundamental frequency response limit due to the mobility of carriers in silicon. Lithium niobate-based modulators have demonstrated high performance, but the material is difficult to process and cannot be easily integrated with other photonic components and electronics. In this manuscript, we simultaneously take advantage of the benefits of silicon photonics and the Pockels effect in lithium niobate by heterogeneously integrating silicon photonic-integrated circuits with thin-film lithium niobate samples. We demonstrate the most CMOS-compatible thin-film lithium niobate modulator to date, which has electro-optic 3 dB bandwidths of 30.6 GHz and half-wave voltages of 6.7 V×cm. These modulators are fabricated entirely in CMOS facilities, with the exception of the bonding of a thin-film lithium niobate sample post fabrication, and require no etching of lithium niobate.
Surface templated inverse photonic glass for saturated blue structural color
Authors: Shang Guoliang , Furlan Kaline Pagnan , Janßen Rolf , Petrov Alexander , Eich Manfred
Published: January 2020

To substitute conventional pigments, which often are toxic or suffer from fading in ultraviolet light, non-iridescent structural colors should demonstrate high spectral selectivity, while being also mechanically stable. However, conventional photonic glass (PhG) shows low color saturation due to the gradual transition in the reflection spectrum and low mechanical stability due to weak interparticle attachment. Here, a PhG with sharp spectral transition in comparison with the conventional full sphere PhG is designed by a conformal coating via atomic layer deposition (ALD) onto an organic PhG template. The ALD deposition allows to control the film thickness precisely for the highly saturated color. This structure can be described by hollow particle motifs with the effective size larger than the interparticle distance. Such unusual PhG is motivated by the achievable features in the spatial Fourier transform of a disordered assembly of such motifs. The surface-templated inverse PhG shows much higher color saturation than the direct PhG from full spheres. Moreover, the dense and solid connected shell will be beneficial for mechanical stability. These results pave the way for highly saturated structural colors. The demonstrated sharp spectral selection feature can be also considered for many related applications such as sunscreens, photovoltaics and radiative cooling by adjusting the reflection transition to the required wavelength. This can be achieved by proportionally scaling the motif and lattice dimensions as well as the film thickness.
Laser-based synchrotron X-ray radiation experimental scaling
Authors: Fourmaux S. , Hallin E. , Chaulagain U. , Weber S. , Kieffer J. C.
Published: January 2020

We review the results obtained in several experimental campaigns with the INRS high-power laser system and determine the X-ray emission scaling from synchrotron radiation produced during laser wakefield acceleration (LWFA) of electrons. The physical processes affecting the generation of intense and stable X-ray beams during the propagation phase of the high-intensity ultrashort pulse in the gas jet target are discussed. We successfully produced stable propagation in the gas jet target of a relativistic laser pulse through self-guiding on length larger than the dephasing and depletion lengths, generating very intense beams of hard X-rays with up to 200 TW on target. The experimental scaling law obtained for the photon yield in the 10-40 keV range is presented and the level of X-ray emission at the 1 PW laser peak power level, now available at several laser facilities, is estimated.