bluuebunny/crossref_metadata_2025 huggingface dataset:
Mesoporous magnesium carbonate for use in powder cosmetics
Authors: Bamford Erik , Grahn Alexander , Århammar Cecilia , Ajaxon Ingrid , Annerén Cecilia
Published: October 2020

Objective

In the present study, we describe the features and functional properties of a new powder cosmetic ingredient, an amorphous mesoporous magnesium carbonate (MMC, also named Upsalite®) with regard to physical characteristics as well as functional attributes.

Methods

Physical and functional characterization of MMC, as compared to other common powder cosmetic ingredients (silica, mica, kaolin, talc and starch), was assessed using nitrogen gas adsorption, powder X‐ray diffraction, particle size distribution by laser diffraction, scanning electron microscopy (SEM), and oil and moisture uptake tests. The powder ingredients were also applied on human skin and analysed for short‐ and long‐term mattifying effect, and a new method was developed to measure flashback effect. MMC was tested for skin irritation using an in vitro cell model as well as in vivo, through the Human Repeated Insult Patch Test on 50 human volunteers.

Results

Mesoporous magnesium carbonate has a high surface area and pore volume. It has an excellent absorption capacity and can take up both oil and water simultaneously. It provides instant and long‐lasting mattifying effect when applied on human skin without drying or irritating skin and exhibits no measured flashback effect.

Conclusion

Mesoporous magnesium carbonate has good sensory and visual characteristics as well as excellent absorbing and mattifying properties, suggesting that it has great potential to replace other powder ingredients currently used as fillers and absorbers in powder cosmetics.
Production, iron analysis and consumer perception of functional Thai Sinlek iron rice (Oryza sativa) drink
Authors: Koonyosying Pimpisid , Flemming Ben , Kusirisin Winthana , Lerttrakarnnon Peerasak , Utama‐ang Niramon , Fucharoen Suthat , Srichairatanakool Somdet
Published: October 2020

We produced the iron rice (IR) drink, determined the relevant chemical composition and antioxidant activity and tested the consumers’ degree of satisfaction. IR grains were digested with α‐amylase and analysed chemical composition and antioxidant activity, while the hydrolysate (pH 4.0) and flavouring agents were added for final preparation of the IR drink. The IR hydrolysate contained a total iron content of 13.9 mg g−1, a total phenolic content of 1.33 ± 0.07 mg gallic acid equivalent g−1 and γ‐oryzanol of 70.12 ± 2.7 mg kg−1 rice grain, all of which inhibited the generation of free radicals in a concentration‐dependent manner. The IR drink was composed of flavonoids and phenolic acids for which kaempferol was predominant. The members of all three groups of elderly subjects who consumed the low‐dose IR (1.47 mg iron/100 mL), high‐dose IR (2.74 mg iron/100 mL) and white rice (WR; 0.5 mg iron/100 mL) drinks expressed satisfaction and interest with the beverages at 91.2%, 100% and 88.9%, respectively. In terms of sensory evaluation, the low‐dose IR drink revealed a higher acceptance rating than high‐dose IR and WR (P < 0.05). Notably, the Sinlek rice drink was abundant with iron, anti‐oxidative phenolics and γ‐oryzanol, for which consumers expressed an overall degree of acceptance (8.1 ± 1.1).
Coated alginate–chitosan particles to improve the stability of probiotic yeast
Authors: Santos Matheus A. S. , Machado Mariana T. C.
Published: October 2020

External ionic gelation is a technique with a great potential for the protection of probiotics for use in food and pharmaceutic products. In this study, particles containing Saccharomyces boulardii produced using sodium alginate and a chitosan coating were evaluated. The physical–chemical parameters (moisture/water activity/hygroscopicity) of the dried particles, stability during 120 days of storage and yeast resistance to simulated gastrointestinal conditions were analysed. During storage (30 °C), greater yeast protection in the alginate–chitosan particles was observed, with a reduction of 1.05 log. Although the free cells presented low resistance, the encapsulated yeast was resistant to the simulated gastrointestinal conditions. At the end of the gastrointestinal simulation, the concentration ranged around 9.15–8.01 and 9.25–8.82 logCFU g−1 in alginate and alginate–chitosan particles, respectively. The S. boulardii particles showed greater resistance to environmental factors, allowing the delivery of an ingredient that could be used to add value to food products.
Inactivation of pectin Methylesterase and Lactobacillus Plantarum by ohmic heating in pomelo juice
Authors: Doan Khue Nhu , Lai Dat Quoc , Kim Le Phung T. , Le Tam Nhat
Published: October 2020

The use of ohmic heating (OH) to inactivate damaging elements in pomelo juice was evaluated. The work investigated the effect of frequencies (50–20 000 Hz) on pectin methylesterase (PME) and Lactobacillus plantarum (L. plantarum) in pomelo juice at 30 V cm−1 of electric field strength. The results show that frequency does not affect PME inactivation (P > 0.05) but affects bacterial reduction and has the most efficiency at 60 Hz, followed by 50 Hz, and in the frequency range at or higher than 500 Hz (P < 0.05). Additionally, the inactivation kinetics of PME and L. plantarum and the impact of nonthermal factors were given. The nonthermal element has contributed to the inactivation enhancement of L. plantarum and PME to reduce the necessary treatment temperature and time. The major spoilage bacteria and enzyme destruction in pomelo juice occurred faster under OH than under conventional heating (CH) suggesting that OH can be effectively used to pasteurise pomelo juice.
Fast‐acting γδ T‐cell subpopulation and protective immunity against infections
Authors: Shen Ling , Huang Dan , Qaqish Arwa , Frencher James , Yang Rui , Shen Hongbo , Chen Zheng W.
Published: October 2020

Unique Vγ2Vδ2 (Vγ9Vδ2) T cells existing only in human and non‐human primates, account for the majority of circulating γδ T cells in human adults. Vγ2Vδ2 T cells are the sole γδ T‐cell subpopulation capable of recognizing the microbial (E)‐4‐hydroxy‐3‐methyl‐but‐2‐enyl pyrophosphate (HMBPP) produced by selected pathogens during infections. Recent seminal studies in non‐human primate models have demonstrated that the unique HMBPP‐specific Vγ2Vδ2 T cells are fast‐acting, multi‐functional, and protective during infections. This article reviews the recent seminal observations of Vγ2Vδ2 T cells in protective mechanisms against tuberculosis and other infections.
Power‐controlled flash spark plasma sintering of gadolinia‐doped ceria
Authors: Tyrpekl Vaclav , Cologna Marco , Holzhäuser Michael , Svora Petr
Published: October 2020

Electric field‐assisted sintering (FAST) is a rapidly growing scientific and engineering domain. In the present paper, we describe the process of flash sintering (FS) in a configuration of classical spark plasma sintering (SPS) (graphite punch and boron nitride (BN) die), also called flash spark plasma sintering (FSPS). The densification process of Gd0.1Ce0.9O2‐x powder is studied in detail with a focus on the transition from FAST to FS. We discuss the electrical, geometrical, and thermal evolution of the process and the characteristics of the final compacts. Low electrical fields are sufficient for the onset of FS. Ceria is a material difficult to sinter by FAST techniques due to its known mechanochemical transformations. We observed the disintegration of pellets after experiments with well‐pronounced flash event.
Systematic review: Effects of sustained nurse home visiting programs for disadvantaged mothers and children
Authors: Molloy Carly , Beatson Ruth , Harrop Christopher , Perini Nicholas , Goldfeld Sharon
Published: October 2020

Aims

To systematically evaluate published experimental studies of sustained nurse home visiting (SNHV) programs. This review summarizes the evidence and identifies gaps in the literature to inform practice, policy, and future research.

Design

Restricted systematic review with narrative summary.

Data Sources

Databases searched were Medline, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials. Year of publication was originally restricted from 2008 to the date of search (13 February 2018, with supplementary searches conducted to identify more recent publications (up to 2019). Several reputable evidence clearinghouses were also searched.

Review Methods

Studies were included if they used a randomized or cluster‐randomized controlled trial to evaluate a home visiting program that: (a) targeted disadvantaged mothers; (b) commenced during pregnancy or prior to the child's first birthday; (c) had an intended duration of at least 12 months from the time of enrolment; and (d) was substantively delivered by nurses or midwives. Meta‐analyses and reviews of studies meeting these criteria were also included. A quality appraisal was conducted for all studies.

Results

Of 1,393 total articles, 30 met inclusion criteria. Seven specific SNHV programs were identified. Each demonstrated evidence of a positive statistical effect on at least one child or maternal outcome.

Conclusion

Sustained nurse home visiting programs benefit disadvantaged families, though effects vary across outcomes and subgroups. Further research is needed to discern the critical components of effective programs.

Impact

As SNHV programs have gained policy appeal, the need to evaluate the evidence‐base supporting such interventions has become imperative. The findings of this review will assist policy‐makers and practitioners in high‐income countries to make evidence‐informed decisions about which programs are best suited to addressing specific maternal and child outcomes for disadvantaged families. This should in turn ameliorate some of the inequalities in child development that have significant social and economic costs.
Quantitative systematic review: Sources of inaccuracy in manually measured adult respiratory rate data
Authors: Kallioinen Noa , Hill Andrew , Christofidis Melany J. , Horswill Mark S. , Watson Marcus O.
Published: October 2020

Aims

To identify the potential sources of inaccuracy in manually measured adult respiratory rate (RR) data and quantify their effects.

Design

Quantitative systematic review with meta‐analyses where appropriate.

Data Sources

Medline, CINAHL, and Cochrane Library (from database inception to 31 July 2019).

Review Methods

Studies presenting data on individual sources of inaccuracy in the manual measurement of adult RR were analysed, assessed for quality, and grouped according to the source of inaccuracy investigated. Quantitative data were extracted and synthesized and meta‐analyses performed where appropriate.

Results

Included studies (N = 49) identified five sources of inaccuracy. Theawareness effectcreates an artefactual reduction in actual RR, andobservation methodsinvolving shorter counts cause systematic underscoring. Individual RR measurements can differ substantially in either direction between observations due tointer‐orintra‐observer variability.Value bias, where particular RRs are over‐represented (suggesting estimation), is a widespread problem.Recording omissionis also widespread, with higher average rates in inpatient versus triage/admission contexts.

Conclusion

This review demonstrates that manually measured RR data are subject to several potential sources of inaccuracy.

Impact

RR is an important indicator of clinical deterioration and commonly included in track‐and‐trigger systems. However, the usefulness of RR data depends on the accuracy of the observations and documentation, which are subject to five potential sources of inaccuracy identified in this review. A single measurement may be affected by several factors. Hence, clinicians should interpret recorded RR data cautiously unless systems are in place to ensure its accuracy. For nurses, this includes counting rather than estimating RRs, employing 60‐s counts whenever possible, ensuring patients are unaware that their RR is being measured, and documenting the resulting value. For any given site, interventions to improve measurement should take into account the local organizational and cultural context, available resources, and the specific measurement issues that need to be addressed.
CSF‐1R inhibition disrupts the dialog between leukaemia cells and macrophages and delays leukaemia progression
Authors: Li Kun , Xu Wenfu , Lu Ke , Wen Yuxi , Xin Tianqing , Shen Yaqing , Lv Xueyan , Hu Shimin , Jin Runming , Wu Xiaoyan
Published: October 2020

Research in the last few years has revealed that leukaemic cells can remodel the bone marrow niche into a permissive environment favouring leukaemic stem cell expansion. Tumour‐associated macrophages (TAMs) are prominent components of the tumour microenvironment and play an important role in the onset and progression of solid tumours. However, little is known about their role in the development of acute lymphoblastic leukaemia (ALL). Using a unique mouse model of T‐ALL induced by injection of EL4 T‐cell lymphoma cells to syngeneic C57BL/6 mice, we report herein that ALL leads to the invasion of leukaemia‐associated monocyte‐derived cells (LAMs) into the bone marrow and spleen of T‐ALL mice. Furthermore, we found that leukaemia cells could polarize bone marrow–derived macrophages (BMDMs) into LAMs. In turn, LAMs were able to protect leukaemia cells from drug‐induced apoptosis in vitro. Therapies targeted against the TAMs by inhibiting colony stimulating factor‐1 receptor (CSF‐1R) have emerged as a promising approach for cancer treatment. In this study, we demonstrate that CSF‐1R inhibition inhibits the viability of BMDMs, blocks LAMs polarization and reduces the abundance of LAMs in T‐ALL mice. In vivo, combination treatment of CSF‐1R inhibitor and vincristine (VCR) dramatically increased the survival of T‐ALL mice and delayed leukaemia progression compared with VCR monotherapy. Finally, these data reinforce the role of microenvironments in leukaemia and suggest that macrophages are a potential target for the development of novel therapeutic strategies in T‐ALL.
3D wide‐field multispectral photoacoustic imaging of human melanomas in vivo: a pilot study
Authors: Park B. , Bang C.H. , Lee C. , Han J.H. , Choi W. , Kim J. , Park G.S. , Rhie J.W. , Lee J.H. , Kim C.
Published: October 2020

Background

The Breslow depth is an important parameter to determine the excision margin and prognosis of melanoma. However, it is difficult to accurately determine the actual Breslow depth before surgery using the existing ocular micrometer and biopsy technique.

Objectives

To evaluate the use of 3D wide‐field multispectral photoacoustic imaging to non‐invasively measure depth and outline the boundary of melanomas for optimal surgical margin selection.

Methods

Six melanoma patients were examined in vivo using the 3D multispectral photoacoustic imaging system. For five cases of melanomas (one in situ, three nodular, and one acral lentiginous type melanoma), the spectrally unmixed photoacoustic depths were calculated and compared against histopathological depths.

Results

Spectrally unmixed photoacoustic depths and histopathological depths match well within a mean absolute error of 0.36 mm. In particular, the measured minimum and maximum depths in the in situ and nodular type of melanoma were 0.6 and 9.1 mm, respectively. In the 3D photoacoustic image of one metastatic melanoma, feeding vessels were visualized in the melanoma, suggesting the neovascularization around the tumour.

Conclusions

The 3D multispectral photoacoustic imaging not only provides well‐measured depth and sizes of various types of melanomas, it also visualizes the metastatic type of melanoma. Obtaining accurate depth and boundary information of melanoma before surgery would play a useful role in the complete excision of melanoma during surgery.
Primary prevention of bleeding from esophageal varices in patients with liver cirrhosis: An update and review of the literature
Authors: Garbuzenko Dmitry Victorovich , Arefyev Nikolay Olegovich
Published: October 2020

All patients with liver cirrhosis and portal hypertension should be stratified by risk groups to individualize different therapeutic strategies to increase the effectiveness of treatment. In this regard, the development of primary prophylaxis of variceal bleeding and its management according to the severity of portal hypertension may be promising. This paper is to describe the modern principles of primary prophylaxis of esophageal variceal bleeding in patients with liver cirrhosis. The PubMed and EMbase databases, Web of Science, Google Scholar, and the Cochrane Database of Systematic Reviews were used to search for relevant publications from 1999 to 2019. The results suggested that depending on the severity of portal hypertension, patients with cirrhosis should be divided into those who need preprimary prophylaxis, which aims to prevent the formation of esophageal varices, and those who require measures that aim to prevent esophageal variceal bleeding. In subclinical portal hypertension, therapy should be etiological and pathogenetic. Cirrhosis with clinically significant portal hypertension should receive nonselective β‐blockers if they have small esophageal varices and risk factors for variceal bleeding. Nonselective β‐blockers are the first‐line drugs for the primary prevention of bleeding from medium to large‐sized esophageal varices. Endoscopic band ligation is indicated for the patients who are intolerant to nonselective β‐blockers or in the case of contraindications to pharmacological therapy. In summary, the stratification of cirrhotic patients by the severity of portal hypertension and an individual approach to the choice of treatment may increase the effectiveness of therapy as well as improve survival rate of these patients.
Effect of tube wall material on electrostatic separation of plant raw‐materials
Authors: Xing Qinhui , Kyriakopoulou Konstantina , de Wit Martin , Boom Remko M. , Schutyser Maarten A. I.
Published: October 2020

The influence of charging tube materials and diameter on the separation efficiencies of a gluten‐starch model mixture and lupine flour was studied. Offline analysis of tribo‐charging with different tube materials showed that gluten takes a positive and starch a negative charge. However, the charge of the mixture was found not equal to the sum of the charge of the individual components and measured charges could not be related to the triboelectric series. During electrostatic separation significant protein enrichment was observed for both plant raw‐materials. For the model mixture differences in protein, enrichment were observed between tube materials, but this was not the case for lupine flour. The lupine protein content increased from 37 to 65 g/100 g dry flour. Concluding, electrostatic separation needs to be evaluated during separation experiments, as particle‐particle interactions dominate the charging process and thus separation of mixtures.

Practical applications

The combination of dry milling and electrostatic separation is investigated as a sustainable and mild route for protein fractionation. The results of this study showed that offline charging tube experiments could not predict separation performance of for example finely milled lupin flours. Instead, performance should be directly assessed during separation experiments, which is explained as charging is rather related to differences in material or triboelectric charging properties between powder particles than to charging tube wall properties. The results of this study benefit development of new applications for electrostatic separation.
Opportunistic upper endoscopy during colonoscopy as a screening strategy for countries with intermediate gastric cancer risk
Authors: Lau Joel Wen Liang , Khoo Mark Junn Wei , Leong Xue Hao , Lim Tian Zhi , Shabbir Asim , Yeoh Khay Guan , Koh Calvin Jianyi , So Jimmy Bok Yan
Published: October 2020

Background and Aim

Screening upper endoscopy can detect esophagogastric (OG) cancers early with improved outcomes. Recent cost‐utility studies suggest that opportunistic upper endoscopy at the same setting of colonoscopy might be a useful strategy for screening of OG cancers, and it may be more acceptable to the patients due to cost‐saving and convenience. We aim to study the diagnostic performance of this screening strategy in a country with intermediate gastric cancer risk.

Methods

A retrospective cohort study using a prospective endoscopy database from 2015 to 2017 was performed. Patients included were individuals age > 40 who underwent opportunistic upper endoscopy at the same setting of colonoscopy without any OG symptoms. Neoplastic OG lesions are defined as cancer and high‐grade dysplasia. Pre‐neoplastic lesions include Barrett's esophagus (BE), intestinal metaplasia (IM), and atrophic gastritis (AG).

Results

The study population involved 1414 patients. Neoplastic OG lesions were detected in five patients (0.35%). Pre‐neoplastic lesions were identified in 174 (12.3%) patients. IM was found in 146 (10.3%) patients with 21 (1.4%) having extensive IM. The number needed to scope to detect a neoplastic OG lesion is 282.8 with an estimated cost of USD$141 400 per lesion detected. On multivariate regression, age ≥ 60 (RR: 1.84, 95% CI: 1.29–2.63) and first‐degree relatives with gastric cancer (RR: 1.64, 95% CI: 1.06–2.55) were independent risk factors for neoplastic or pre‐neoplastic OG lesion.

Conclusion

For countries with intermediate gastric cancer risk, opportunistic upper endoscopy may be an alternative screening strategy in a selected patient population. Prospective trials are warranted to validate its performance.
Endoscopic findings in the soft palatal mucosa are associated with the risk of esophageal squamous cell carcinoma
Authors: Waki Kotaro , Ishihara Ryu , Maekawa Akira , Inoue Takahiro , Shoji Ayaka , Matsueda Katunori , Miyake Muneaki , Fukuda Hiromu , Shichijo Satoki , Kanesaka Takashi , Takeuchi Yoji , Higashino Koji , Uedo Noriya , Michida Tomoki
Published: October 2020

Background and Aim

We investigated endoscopic findings of the soft palatal mucosa to identify factors associated with esophageal squamous cell carcinoma (ESCC).

Methods

This study was conducted during endoscopic examinations of subjects at Osaka International Cancer Institute from January 2020 through May 2020. We took endoscopic images of the soft palate under non‐magnifying and mild‐magnifying observations. Subjects with ESCC or a history of ESCC were defined as the ESCC group. Two endoscopists who were blinded to subjects' clinical information interpreted 10 endoscopic findings: melanosis, brownish changes, whitish epithelium, vasodilation, circular alignment of dilated vessels, uneven surface, uneven epithelial color, uneven vessel visibility, palate ridge, and erosion. Subjects were interviewed about their alcohol use, smoking, and flushing reactions.

Results

Two hundred eighty‐two subjects, including 151 in the ESCC group and 131 in the non‐ESCC group, were included in the analysis. Univariate analyses and multivariate logistic regression demonstrated that melanosis, whitish epithelium, and vasodilation were significantly associated with ESCC. The positive likelihood ratios (PLRs) of melanosis, whitish epithelium, and vasodilation were 3.3, 4.2, and 2.8, respectively. Additionally, the PLRs for three of the endoscopic findings in subjects with drinking and smoking habits were higher than in those without these habits—PLRs ranging from 7.23 to 19.1. High PLRs for three endoscopic findings suggested a high possibility of ESCC. Interobserver agreement was substantial for whitish epithelium, moderate for melanosis, and fair for vasodilation.

Conclusions

Three endoscopic findings in soft palate were considered to be useful as alarming signs that indicate ESCC risk.
Benefits of phone consultation for endoscopy‐related clinics in the COVID‐19 pandemic
Authors: Zorron Cheng Tao Pu Leonardo , Singh Gurpreet , Rajadurai Anton , Terbah Ryma , De Silva Rahil , Vaughan Rhys , Efthymiou Marios , Chandran Sujievvan
Published: October 2020

Background and Aim

During COVID‐19 outbreak, restrictions to in‐person consultations were introduced with a rise in telehealth. An indirect benefit of telehealth could be better attendance. This study aimed to assess “failure‐to‐attend” (FTA) rate and satisfaction for two endoscopy‐related compulsory telehealth clinics during the COVID‐19 outbreak.

Methods

Consecutive patients booked for endoscopy‐related telehealth clinics at a tertiary hospital were prospectively assessed. In‐person clinic control data were assessed retrospectively. Sample size was calculated to detect an anticipated increase in attendance of 8%. Secondary outcomes included FTA differences between clinics and evaluation of patients and doctors satisfaction. Satisfaction was assessed based on six Likert scale questions used in previous telehealth research and asked to both patients and doctors (6Q_score). This study was exempt from IRB review after institutional IRB review.

Results

There were 691 patients booked for appointments in our endoscopy clinics during the study periods (373 in 2020). FTA rates were lowered by half during the compulsory telehealth clinics (12.6% to 6.4%, P < 0.01). The patient 6Q_score was higher for the advanced endoscopy clinic (84.6% vs 73.8%, P < 0.01), while the doctor 6Q_score was similar between both advanced clinics and post endoscopy clinics (91.1% vs 92.5% respectively, P = 0.80). An in‐person follow‐up consultation was suggested for 3.5% of the appointments, while the necessity of physical examination was flagged in 5.1%.

Conclusions

The use of phone consultations in endoscopy‐related clinics during the COVID‐19 outbreak has improved FTA rates while demonstrating high satisfaction rates. The need for in‐person follow‐up consultations and physical examination were low.
Effect of a Multifactorial Fall Injury Prevention Intervention on Patient Well‐Being: The STRIDE Study
Authors: Gill Thomas M. , Bhasin Shalender , Reuben David B. , Latham Nancy K. , Araujo Katy , Ganz David A. , Boult Chad , Wu Albert W. , Magaziner Jay , Alexander Neil , Wallace Robert B. , Miller Michael E. , Travison Thomas G. , Greenspan Susan L. , Gurwitz Jerry H. , Rich Jeremy , Volpi Elena , Waring Stephen C. , Manini Todd M. , Min Lillian C. , Teresi Jeanne , Dykes Patricia C. , McMahon Siobhan , McGloin Joanne M. , Skokos Eleni A. , Charpentier Peter , Basaria Shehzad , Duncan Pamela W. , Storer Thomas W. , Gazarian Priscilla , Allore Heather G. , Dziura James , Esserman Denise , Carnie Martha B. , Hanson Catherine , Ko Fred , Resnick Neil M. , Wiggins Jocelyn , Lu Charles , Meng Can , Goehring Lori , Fagan Maureen , Correa‐de‐Araujo Rosaly , Casteel Carri , Peduzzi Peter , Greene Erich J.
Published: October 2020

BACKGROUND/OBJECTIVES

In the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study, a multifactorial intervention was associated with a nonsignificant 8% reduction in time to first serious fall injury but a significant 10% reduction in time to first self‐reported fall injury relative to enhanced usual care. The effect of the intervention on other outcomes important to patients has not yet been reported. We aimed to evaluate the effect of the intervention on patient well‐being including concern about falling, anxiety, depression, physical function, and disability.

DESIGN

Pragmatic cluster‐randomized trial of 5,451 community‐living persons at high risk for serious fall injuries.

SETTING

A total of 86 primary care practices within 10 U.S. healthcare systems.

PARTICIPANTS

A random subsample of 743 persons aged 75 and older.

MEASUREMENTS

The well‐being measures, assessed at baseline, 12 months, and 24 months, included a modified version of the Fall Efficacy Scale, Patient‐Reported Outcomes Measurement Information System (PROMIS) anxiety and depression scales, and Late‐Life Function and Disability Instrument.

RESULTS

Participants in the intervention (n = 384) and control groups (n = 359) were comparable in age: mean (standard deviation) of 81.9 (4.7) versus 81.8 (5.0) years. Mean scores were similar between groups at 12 and 24 months for concern about falling, physical function, and disability, whereas the intervention group's mean scores on anxiety and depression were .7 points lower (i.e., better) at 12 months and .6 to .8 points lower at 24 months. For each of these outcomes, differences between the groups' adjusted least square mean changes from baseline to 12 and 24 months, respectively, were quantitatively small. The overall difference in means between groups over 2 years was statistically significant only for depression, favoring the intervention: −1.19 (99% confidence interval, −2.36 to −.02), with 3.5 points representing a minimally important difference.

CONCLUSIONS

STRIDE's multifactorial intervention to reduce fall injuries was not associated with clinically meaningful improvements in patient well‐being.
Antibiotic Use Among Residents Receiving Skilled Nursing Care in 29 U.S. Nursing Homes
Authors: Song Sunah , Wilson Brigid M. , Bej Taissa , Gravenstein Stefan , Carter Rebecca R. , Marek Joseph , Jump Robin L. P.
Published: October 2020

BACKGROUND

Data describing antibiotic use in U.S. nursing homes remain limited. We report antibiotic use among skilled nursing facility residents from 29 U.S. nursing homes and assessed correlations between antibiotics prescribed to residents in skilled care and nursing home characteristics.

DESIGN

Retrospective cohort study.

SETTING

Twenty‐nine U.S. nursing homes in the same healthcare corporation.

PARTICIPANTS

Residents receiving skilled care in 2016.

MEASUREMENTS

We used pharmacy invoice and nursing home census data to calculate the days of antibiotic therapy per 1,000 days of skilled care (1,000 DOSC), the rate of antibiotic starts per 1,000 DOSC, the length of antibiotic therapy, and the average antibiotic spectrum index. We also assessed correlations between antibiotic use and nursing home characteristics.

RESULTS

Antibiotics accounted for an average of 9.6% (±0.6%) of systemic medications prescribed among residents receiving skilled care. On average, 26.8% (±2.9%) of antibiotics were intravenous. Fluoroquinolones were prescribed at the highest rates (19% across all facilities), followed by beta‐lactam/beta‐lactamase inhibitors (11%), first‐ and second‐generation cephalosporins, sulfonamides, and oral tetracyclines (each at 9%). Both the proportion of residents using enrolled in Medicare and number of unique prescribers responsible for systemic prescriptions positively correlated with the rate of antibiotic starts.

CONCLUSIONS

Our study demonstrates that pharmacy invoices represent a useful and preexisting source of data for assessing antibiotic prescriptions among individuals receiving skilled nursing care. The correlation between the number of unique prescribers and antibiotic starts suggests that prescribers are central to efforts to improve antibiotic use in nursing homes.
Cancer cachexia: an overview of diagnostic criteria and therapeutic approaches for the accredited practicing dietitian
Authors: van der Meij B. S. , Teleni L. , McCarthy A. L. , Isenring E. A.
Published: October 2020

Background

Cancer cachexia (CC) is a multifactorial syndrome characterised by ongoing skeletal muscle loss that leads to progressive functional impairment driven by reduced food intake and abnormal metabolism. Despite the traditional use of non‐volitional weight loss as the primary marker of CC, there is no consensus on how to diagnose and manage CC.

Methods

The aim of this narrative review was to describe and discuss diagnostic criteria and therapeutic approaches for the accredited practicing dietitian with respect to identifying and managing CC.

Results

Available diagnostic criteria for cachexia include the cancer‐specific (Fearon and Cachexia Score) and general criteria (Evans and Global Leadership Initiative on Malnutrition). These include phenotypic criteria [weight loss, body mass index, (objective) muscle mass assessments, quality of life] and aetiological criteria (disease burden, inflammation, energy expenditure, anorexia and inadequate food intake) and can be incorporated into the nutrition care process (NCP). This informs the nutrition diagnosis of ‘chronic disease‐ or condition‐related malnutrition (undernutrition) as related to increased nutrient needs, anorexia or diminished intake due to CC’. Optimal nutrition care and management of CC is multidisciplinary, corrects for increased energy expenditure (via immunonutrition/eicosapentaenoic acid), suboptimal protein/energy intake and poor nutrition quality of life, and includes a physical exercise intervention. Monitoring of intervention efficacy should focus on maintaining or slowing the loss of muscle mass, with weight change as an alternative gross indicator.

Conclusions

Dietitians and the NCP can play an essential role with respect to identifying and managing CC, focusing on aspects of nutrition screening, assessment and intervention.
From Car Wash to Bolsonaro: Law and Lawyers in Brazil's Illiberal Turn (2014–2018)
Authors: DE SA E SILVA FABIO
Published: October 2020

Law and lawyers tend to be seen as either preferential victims of or key counterforces to rising illiberalism. Brazil offers a good testbed for these claims. Brazilian democracy has deteriorated considerably, as epitomized by the election of Jair Bolsonaro in 2018. Yet, since 2014, law and lawyers have become ever more central to Brazil's field of state power. As the anti‐corruption initiative Car Wash (Lava Jato) gained momentum, Brazilian judges and prosecutors were celebrated, locally and globally, as champions of transparency, accountability, and ‘the rule of law’. Following a closer look at Car Wash, this article questions such idealization of law and lawyers. Drawing on research on press interviews and statements by Car Wash legal officers, I find that, throughout the case, they produced a ‘political grammar’ that is closer to illiberalism than many would predict. Based on recent developments in the sociology of fields, I argue that the production of these grammars yields societal effects that deserve scholarly and civic attention.
System‐Spanning Values Work and Entrepreneurial Growth in Family Firms
Authors: Raitis Johanna , Sasaki Innan , Kotlar Josip
Published: October 2020

Culture and values are key drivers of corporate entrepreneurship in early stages of family firm development, but value conflicts often arise over time that progressively inhibit their entrepreneurial efforts. How can family firms reconcile conflicting values to sustain corporate entrepreneurship over time? Our 45‐year longitudinal case study of a large global family firm shows that family business leaders’ practices of invoking and flexibly using family and business values were crucial to achieve sustained entrepreneurial behaviour and growth over an extended period of time. We theorize these efforts as system‐spanning values work enfolding through specific family, business, and temporal mechanisms. By identifying and elucidating three types of values work (i.e., rooting, revitalizing, and spreading), our study advances current understanding of the micro‐foundations underpinning the relationship between values and entrepreneurship in family firms.
Marginal and Internal Adaptation of Lithium Disilicate Endocrowns Fabricated By Heat‐Pressable and Subtractive Techniques
Authors: El Ghoul Wiam , Salameh Ziad
Published: October 2020

Purpose

To evaluate and to compare the marginal and the internal fit of milled (MLE) and heat‐pressed lithium disilicate endocrowns (PLE).

Materials and Methods

Thirty mandibular molars were prepared following the circumferential butt margin endocrown preparations; the cervical margin is parallel to the occlusal surface without ferrule design. A digital scan of molars was made using an intraoral digital scanner. The samples were separated into two groups (n = 15 per group); MLE: endocrowns were milled using LDS blocks and a 5‐axis milling machine, PLE: endocrowns were heat‐pressed using lost wax technique and LDS ingots. Marginal and internal adaptation were assessed using a replica technique and a stereomicroscope, selecting 32 measurements on each endocrown. Data were analyzed with one‐way repeated measures ANOVA, two‐way repeated measures ANOVA, student's t‐test and paired student t‐test (α = 0.05).

Results

Statistically significant interactions were recorded between fabrication technique and region (p < 0.05), F (1.97, 27.69) = 5.462. Group MLE displayed significantly smaller gaps than PLE in all regions (p < 0.001). The largest gap was observed at the pulpal floor in both groups. The internal gap was significantly larger than the marginal gap in MLE group (p < 0.001), while no statistically significant difference was observed in PLE group (p = 0.082).

Conclusion

Heat‐pressed and milled lithium disilicate endocrowns are clinically suitable, but the milled technique displayed a better fit than heat‐pressed technique when marginal and internal adaptation were examined.
Association of human papillomavirus vaccination with exposure to dental or medical visits
Authors: Shukla Anubhuti , McKenna Maria , Hayes Catherine , Klevens Ruth Monina
Published: October 2020

Background

Human papillomavirus (HPV) infection is associated with oropharyngeal cancers. The Centers for Disease Control and Prevention (CDC) estimate that >15,000 new cases of HPV‐associated oropharyngeal cancers are diagnosed in the United States annually. We evaluated an association between HPV vaccination and dental visits in the previous year.

Methods

Data were analyzed from the 2012, 2014, and 2016 Massachusetts Behavioral Risk Factor Surveillance System (MA‐BRFSS) datasets. We created four categories of exposures to healthcare services in the past 12 months: a) both medical and dental visits, b) medical visit only, c) dental visit only, d) neither. Outcomes were HPV vaccination ever or influenza vaccination within the past 12 months. Logistic regression, controlled for race and education, was used to measure the association between medical/dental visits and vaccination status. Separate models were generated by sex.

Results

Crude and adjusted odds ratio of influenza and HPV vaccination were highest among males and females with both medical and dental visits. Women with both medical and dental provider visits had 3.7 times higher odds of being vaccinated for influenza and 1.7 times higher odds of being vaccinated for HPV. There were no differences in crude or adjusted odds among both males and females if the type of healthcare visits were only medical or only dental.

Conclusion

No difference in association between vaccination and medical or dental healthcare exposures suggests that oral health professionals might partner in promotion of positive health behaviors, including HPV vaccination. The type of provider did not affect the outcome as per this study.
Fibroblast growth factor‐23 as an early marker of CKD‐mineral bone disorder in dogs: preliminary investigation
Authors: Miyakawa H. , Nagatani Y. , Ogawa M. , Nagakawa M. , Sakatani A. , Akabane R. , Miyagawa Y. , Takemura N.
Published: October 2020

Objectives

To examine the relationship between fibroblast growth factor‐23 levels, chronic kidney disease severity and mineral metabolic disorders associated to chronic kidney disease in dogs.

Materials and Methods

Fifteen control and 75 chronic kidney disease dogs were retrospectively included. Serum fibroblast growth factor‐23 concentration and other phosphate metabolite parameters were compared between controls and each International Renal Interest Society stage. Multiple regression analysis was performed to determine the predictors of fibroblast growth factor‐23.

Results

Serum fibroblast growth factor‐23 concentrations were significantly higher in dogs with IRIS stages 2, 3 and 4 chronic kidney disease than those in dogs in control group and with stage 1 and increased along with the severity of chronic kidney disease. Compared with control dogs, serum intact parathyroid hormone significantly increased from stage 2 and serum phosphorus concentrations increased in dogs with stage 4. In dogs with stage 2, fibroblast growth factor‐23 levels significantly increased in those with hyperphosphatemia compared with those with normophosphatemia. While eight of 26 (30.8%) dogs with stage 2 developed hyperparathyroidism (intact parathyroid hormone>8.5 ng/L), 19 (73.1%) dogs with stage 2 had elevated fibroblast growth factor‐23 levels above the reference range (>528 pg/mL). Log creatinine, log intact parathyroid hormone and log product of total calcium and phosphorus were independent predictors of log fibroblast growth factor‐23.

Clinical Significance

This preliminary study suggests that canine fibroblast growth factor‐23 might be involved in mineral metabolic disorders associated to chronic kidney disease in dogs, and this factor could be potentially used as an early marker for this condition.
A Meta‐Analysis of Single‐Case Research on Mathematics Word Problem‐Solving Interventions for English Learners with Learning Disabilities and Mathematics Difficulties
Authors: Lei Qingli , Mason Rose A. , Xin Yan Ping , Davis John L. , David Marie , Lory Catharine
Published: October 2020

This single‐case meta‐analysis is the first to provide a quantitative synthesis of the published literature on mathematics word problem‐solving intervention studies for English learners with learning disabilities and mathematics difficulties. A total of ten single‐subject studies were included for analysis. The current study investigated the magnitude of the effect of mathematics interventions targeting the improvement of students’ mathematics word problem‐solving performance, and analyzed variables that moderated this effect. Results indicate a moderate overall effect size of 0.81 (95% CI [0.71, 0.90]) on word problem‐solving performance for English learners with learning disabilities and mathematics difficulties. Moderator variables such as the implementer of the interventions, instructional focus, and word problem‐solving content significantly moderated the mathematics intervention effects.
Is medicinal ketamine associated with urinary dysfunction issues? Assessment of both the European Medicines Agency (EMA) and the UK Yellow Card Scheme pharmacovigilance database‐related reports
Authors: Schifano Nicolo' , Chiappini Stefania , Castiglione Fabio , Salonia Andrea , Schifano Fabrizio
Published: October 2020

Objective

A range of ketamine‐induced uropathy (KIU) issues have been typically described in ketamine misusers. Conversely, more knowledge is needed in terms of medicinal ketamine‐related urological disturbances, since ketamine prescribing is being increasingly considered for a range of medical and psychopathological conditions.

Methods

To assess medicinal KIU issues, we aimed at analyzing both the 2005–2017 European Medicines Agency (EMA) and the 2006–2018 UK Yellow Card Scheme (YCS) pharmacovigilance databases.

Results

A total number (eg, all categories) of 11 632 EMA ketamine‐related adverse drug reaction (ADR) reports were here identified. Out of these, some 9971 ADRs (eg, 85.7% of the total) were judged as “suspect” and were here analyzed. Some 1758 ADRs (17.7% of 9971, corresponding to 194 individual patients) referred to urological issues, relating to either kidney/ureter (922 ADRs) or bladder/urethra (837 ADRs). Ketamine was the sole drug administered in 156/194 (80.4%) cases/patients. Although most cases occurred in the 1 month‐1 year time frame following the start of ketamine prescribing, in 30 cases the ADR occurred within 48 hours. Most ADR‐related cases resolved, although both sequelae (18 cases) and fatalities (79/1758; 4.5%) were recorded. Overall, YCS data were consistent with EMA findings, with some 50/217 (23%) ADRs referring to renal/urinary disorders.

Conclusions

Current data may only represent a gross underestimate of the KIU real prevalence issues. It is here suggested that chronic treatment involving higher doses/repeated exposure to ketamine be restricted to the context of controlled trials or clinical audits.
Impaired wellness in medicine
Authors: Pitama Suzanne , Huria Tania , Patu Maira , Lacey Cameron
Published: October 2020

Effectively conceptualising impaired wellness for physicians requires review of the roles and responsibilities of teams, health service leadership and the health system as a whole.
Use of virus‐induced gene silencing to characterize genes involved in modulating hypersensitive cell death in maize
Authors: Murphree Colin , Kim Saet‐Byul , Karre Shailesh , Samira Rozalynne , Balint‐Kurti Peter
Published: October 2020

Plant disease resistance proteins (R‐proteins) detect specific pathogen‐derived molecules, triggering a defence response often including a rapid localized cell death at the point of pathogen penetration called the hypersensitive response (HR). The maize Rp1‐D21 gene encodes a protein that triggers a spontaneous HR causing spots on leaves in the absence of any pathogen. Previously, we used fine mapping and functional analysis in a Nicotiana benthamiana transient expression system to identify and characterize a number of genes associated with variation in Rp1‐D21‐induced HR. Here we describe a system for characterizing genes mediating HR, using virus‐induced gene silencing (VIGS) in a maize line carrying Rp1‐D21. We assess the roles of 12 candidate genes. Three of these genes, SGT1, RAR1, and HSP90, are required for HR induced by a number of R‐proteins across several plant–pathogen systems. We confirmed that maize HSP90 was required for full Rp1‐D21‐induced HR. However, suppression of SGT1 expression unexpectedly increased the severity of Rp1‐D21‐induced HR while suppression of RAR1 expression had no measurable effect. We confirmed the effects on HR of two genes we had previously validated in the N. benthamiana system, hydroxycinnamoyltransferase and caffeoyl CoA O‐methyltransferase. We further showed the suppression the expression of two previously uncharacterized, candidate genes, IQ calmodulin binding protein (IQM3) and vacuolar protein sorting protein 37, suppressed Rp1‐D21‐induced HR. This approach is an efficient way to characterize the roles of genes modulating the hypersensitive defence response and other dominant lesion phenotypes in maize.
Sensory features of the human louse antenna: new contributions and comparisons between ecotypes
Authors: Ortega‐Insaurralde I. , Picollo M. I. , Barrozo R. B.
Published: October 2020

Body and head lice are known to be exclusive ectoparasites of human hosts. Current genomic and transcriptomic data suggest that both louse types represent ecotypes of the same species. They exhibit morphological and physiological differences that probably arose from living in different biotopes. Sensory traits represent suitable candidates to be affected by environmental heterogeneity. Therefore, through scanning electron microscope studies, this study analysed and compared the sensory structures of both ecotypes' antennae. Seven types of sensory structures were identified in both ecotypes: bristles, tuft organs, pore organs, single pore and three morphotypes of sensilla basiconica. Notably, the single pore and the morphotypes of sensilla basiconica were described for the first time in the body louse antenna. This study's comparative analysis mainly revealed size differences across the sensory structures of the ecotypes. Bristles of the flagellomere 2 of the body louse antenna were longer than the head louse bristles. In addition, the pore organs of the head louse antenna presented a higher diameter than those of the body louse. The possible relevance of size differences regarding the biotopes exploited by the body louse and the head louse is discussed. Yet, physiological studies may help to fully understand the phenotypical differences of both ecotypes.