bluuebunny/crossref_metadata_2025 huggingface dataset:
Microsurgical Resection of Vestibular Schwannomas, Presentation of Cases in 3D: 3-Dimensional Operative Video
Authors: Campero Alvaro , Baldoncini Matias
Published: September 2019

Vestibular schwannomas are the most common benign tumors of the pontocerebellar angle,
1,2
their microsurgical complexity is related to their size and neurovascular relationships. The purpose of this work is to analyze the clinical, anatomic characteristics, microsurgical treatment, and the postoperative results according to the Hannover gradual scale in 4 patients with vestibular schwannomas. The 4 patients gave their consent to the procedure and all consented to the use of their surgical videos, preoperative and postoperative studies, and postoperative pictures.

Case 1: A 39-yr-old woman, with left ear hearing loss. Magnetic resonance imaging (MRI) showed small Intracanalicular schwannoma (T1 classification by Hannover). Microsurgery was performed and resection through a retrosigmoid approach
2,3
with anatomic and functional preservation of the facial and cochlear nerve.

Case 2: A 40-yr-old woman, with left ear hypoacusia. MRI showed an extrameatal schwannoma reaching the brainstem (T3b Hannover classification). The complete re-section through retrosigmoid approach were performed.

Case 3: A 69-yr-old woman, without hearing in the right ear. RM: Medium schwannoma (T4a classification of Hannover). Microsurgery was performed with anatomic and functional preservation of the facial nerve.
4-6

Case 4: A 32-yr-old woman, without hearing in the left ear. In addition, cerebellar syndrome and headache. RM: Large schwannoma (T4b classification of Hannover). Sur-gery was performed, anatomic preservation of the facial nerve, with moderate paresis in the postoperative period.

Microsurgical resection with functional preservation of the facial and cochlear nerve is the main objective
7
when addressing this pathology.
Trabecular bone score improves fracture risk assessment in glucocorticoid-induced osteoporosis
Authors: Florez Helena , Hernández-Rodríguez José , Muxi Africa , Carrasco Josep Lluis , Prieto-González Sergio , Cid Maria C , Espinosa Gerard , Gómez-Puerta Jose A , Monegal Ana , Guañabens Núria , Peris Pilar
Published: September 2019

Objective

To analyse the clinical utility of trabecular bone score (TBS) evaluation for fracture risk assessment in glucocorticoid (GC)-treated patients compared with BMD assessment.

Methods

One hundred and twenty-seven patients on GC treatment were included [mean age 62 (18) years, 63% women] in this cross-sectional study. The medical history, anthropometric data, lumbar and femoral BMD (DXA) [considering osteoporosis (OP): T-score ⩽−2.5], TBS (considering degraded microarchitecture: <1.230) and dorsolumbar X-ray [to assess vertebral fractures (VF)] were evaluated. BMD and TBS sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were evaluated to determine the diagnostic accuracy of the two methods.

Results

All patients were receiving GC treatment for autoimmune diseases during 47.7 (68.9) months at a mean daily dose of 14.5 mg; 17% had VF, 28% any type of fragility fracture (VF + non-VF), 29% OP and 52% degraded microarchitecture. Degraded microarchitecture was significantly more frequent than densitometric OP in patients with VF (76% vs 38%) and with any fragility fracture (69% vs 36%). For VF, TBS and BMD sensitivity, specificity, PPV, and NPV were 0.76, 0.53, 0.25 and 0.92, and 0.38, 0.72, 0.22 and 0.85, respectively. Specificity increased to 0.89 for VF and 0.9 for any fragility fracture on combining BMD+TBS. TBS had better ability than BMD to discriminate between patients with fracture, especially VF (area under the curve = 0.73).

Conclusion

TBS seems to have greater discriminative power than BMD for fracture risk assessment in GC-treated patients, confirming the utility of this method as a complementary tool in the diagnosis of GC-induced OP.
DANSAC A/S v SALTS HEALTHCARE LTD
Authors:   Chancery Division
Published: September 2019

H1 Trade marks – Infringement – Parallel imports – Medical devices – Ostomy bags – Strike out application – Sale in original unopened boxes – Some boxes re-labelled – Whether the BMS conditions applied – Whether any risk to guarantee of origin – “Legitimate reasons” for opposing further dealings – Whether breach of Medical Devices Regulations of itself sufficient – Whether likelihood of damage or serious damage necessary
Beneficiary disputes: Lines v Wilcox
Authors: Perselli Francesca
Published: September 2019

What is a trustee’s role when there is a dispute to be brought on behalf of the estate which is in the interests of one beneficiary at the expense of another? If the dispute is essentially one between the beneficiaries, can the trustee adopt a neutral position and leave the beneficiaries to litigate between themselves? Do the beneficiaries have standing to bring claims that properly belong to the estate? This article addresses these questions, which were recently considered by HHJ Paul Matthews (sitting as a Judge of the High Court) in Lines v Wilcox [2019] EWHC 1451 (Ch).
The Respect That Other Deserves
Authors: Sampaio Carlos A.
Published: September 2019

Caring for people with diminished faculties and forms of disease and handicap that break down their personality places high demands on care staff. Anchored in a caring science with a holistic and humanistic approach, this article analyzes the trajectories of control that emerge in nurse care interactions. A suggested answer is the responsibility of the nurse to be aware of the power inequality, to recognize the potential for patients to feel intimidated, and to create a therapeutic alliance. The right use of power in the nurse-patient interaction guarantees that the patient's needs are foremost and the patient's vulnerability is sheltered.
Association of Total Zinc Intake with Myopia in U.S. Children and Adolescents
Authors: Burke Niamh , Butler John S. , Flitcroft Ian , McCartney Daniel , Loughman James
Published: September 2019

SIGNIFICANCE

This present study advances our knowledge on the role of lifestyle factors in myopia (short-sightedness), specifically dietary factors. It has been suggested in previous studies that lower zinc status is associated with myopia; however, this article shows no relationship between dietary zinc intake and myopia in U.S. adolescents.

PURPOSE

It has been suggested that low zinc levels may contribute to the development of myopia. The aim of the present study is to examine, for the first time in a Western population, the association of total dietary and supplement zinc intake with myopia.

METHODS

A total of 1095 children/adolescents aged 12 to 19 years who participated in the U.S. National Health and Nutrition Examination Survey from 2007 to 2008 were enrolled in this study. Multivariate logistic regression analysis was performed to examine the relationship between total zinc intake and myopia after adjustment for potential confounders. In addition, the association between total zinc intake and spherical equivalent refractive error was examined in the myopia group through multiple linear regression.

RESULTS

Among study participants, 30% were found to be myopic (≤−1.00 D). Although median total daily zinc intake was lower among myopes (10.8 [10.2] mg/d) than among nonmyopes (11.1 [10.8] mg/d), the difference was not statistically significant (P = .11). In multiple logistic regression analyses, zinc and copper intakes were not significantly associated with myopia after adjustment for age, sex, body mass index, ethnicity, family income, recreational activity, copper intake, and daily energy intake (in kilocalories per day). In multiple linear regression, spherical equivalent refractive error was not associated with total zinc intake in the myopic group after adjustment for confounding factors (P = .13).

CONCLUSIONS

In contrast to previous Asian studies, total zinc intake is not associated with the presence of myopia in U.S. adolescents/children.
Targeting the Id1-Kif11-Aurka axis in triple negative breast cancer using combination therapy
Authors: Murali Reshma , Varghese Binitha Anu , Karthikeyan Nitheesh , Archana PT , Teo Wee Siang , McFarland Andrea , Roden Daniel L , Holliday Holly , Konrad Christina , Cazet Aurelie , Dodson Eoin , George Jason T , Levine Herbert , Jolly Mohit Kumar , Swarbrick Alexander , Nair Radhika
Published: September 2019

Evidence points to breast cancer following a hierarchical model, with Cancer Stem Cells (CSCs) driving critical phenotypes of the bulk tumor. Chemoresistant CSCs are not an abstract concept but have clinical consequences as they drive relapse and ultimately lead to mortality in patients, making it imperative to understand how these subpopulations of cells survive. Our previous work (1-2) has demonstrated that the bHLH transcription factor, Inhibitor of Differentiation 1 (Id1) and it’s closely related family member Id3, have an important role in maintaining the CSC phenotype in the Triple Negative breast cancer (TNBC) subtype. A genetic screen conducted to further elucidate the molecular mechanism underlying the Id (Id1/3) mediated CSC phenotypes in TNBC revealed critical cell cycle genes such as Kif11 and Aurka as putative Id targets. We take this work forward by investigating how alteration in Kif11 and Aurka via Id proteins promotes the CSC phenotype in TNBC. Cells lacking Id are poised in a state of G0/G1 arrest from which they can re-enter the cell cycle. Intriguingly, depletion of Kif11 and Aurka independently did not phenocopy the G0/G1 arrest observed in Id knockdown (Id KD) cells. We have further explored the hypothesis that we can deplete the chemo resistant Id expressing CSC population by combining chemotherapy with targeted therapy using existing small molecule inhibitors (against Id target Kif11) to more effectively debulk the entire tumor. This work opens up exciting new possibilities of targeting Id targets like Kif11, in the TNBC subtype which is currently refractory to chemotherapy.
Accumulation of genetic variants associated with immunity in the selective breeding of broilers
Authors: Zou Angela , Nadeau Kerry , Wang Pauline W. , Lee Jee Yeon , Guttman David S. , Sharif Shayan , Korver Doug , Brumell John H. , Parkinson John
Published: September 2019

To satisfy an increasing demand for dietary protein, the poultry industry has employed genetic selection to increase the growth rate of broilers by over 400% in the past 50 years. Although modern broilers reach a marketable weight of ∼2 kg in a short span of 35 days, a speed twice as fast as a broiler 50 years ago, the expedited growth has been associated with several negative detrimental consequences. Aside from heart and musculoskeletal problems, which are direct consequences of additional weight, the immune response is also thought to be altered in modern broilers. Given that identifying the underlying genetic basis responsible for a less sensitive innate immune response would be economically beneficial for poultry breeding, we decided to compare the genomes of two unselected meat control strains that are representative of broilers from 1957 and 1978, and a current commercial broiler line. Through analysis of genetic variants, we developed a custom prioritization strategy to identify genes and pathways that have accumulated genetic changes and are biologically relevant to immune response and growth performance. Our results highlight two genes, TLR3 and PLIN3, with genetic variants that are predicted to enhance growth performance at the expense of immune function. Placing these new genomes in the context of other chicken lines, reveal genetic changes that have specifically arisen in selective breeding programs that were implemented in the last 50 years.
Short Neuropeptide F regulates the starvation mediated enhanced locomotor Activity in Drosophila
Authors: Geo Anna , Pathak Himani , Kujur Anamika Elizabeth , Sudhakar Sreesha R , Kannan Nisha N
Published: September 2019

The circadian clock regulates various behavioral, metabolic and physiological processes to occur at the most suitable time of the day. Internal energy stores and nutrient availability modulates the most apparent circadian clock mediated locmotor activity rhythm in Drosophila. Although previous studies unraveled the role of circadian clock in metabolism and activity rest rhythm, the precise pathway through which the circadian neuropeptidergic signaling regulates internal energy storage and the starvation-mediated increase in activity resembling foraging remains largely unclear. This study was aimed to elucidate the role of circadian neuropeptide, short neuropeptide F (sNPF) in triglyceride metabolism, starvation resistance and starvation-mediated increased locomotor activity in Drosophila. The results showed that snpf transcripts exhibits significant rhythmicity in wild type flies under 12:12 hour light-dark cycles (LD) and constant darkness (DD) whereas snpf transcript level in period null flies did not exhibit any significant rhythmicity under LD. Knockdown of sNPF in circadian clock neurons reduced the triglyceride level, starvation resistance and increased the starvation-mediated hyperactivity response after 24 hour of starvation. Further studies showed that knock down of sNPF receptors (sNPFR) expressed in insulin producing cells (IPC) increased the starvation resistance and reduced starvation-induced hyperactivity response after 24 hour of starvation. Collectively, our results suggest that transcriptional oscillation of snpf mRNA is endogenously controlled by the circadian clock and elucidate the role of sNPF in modulating locomotor activity in accordance with the nutrient availability in Drosophila.
Evolutionary insights into PtdIns3P signaling through FYVE and PHOX effector proteins from the moss Physcomitrella patens
Authors: Agudelo-Romero Patricia , Fortes Ana Margarida , Suárez Trinidad , Lascano Hernán Ramiro , Saavedra Laura
Published: September 2019

Phosphatidylinositol 3-phosphate (PtdIns3P) is one of the five different phosphoinositides (PPIs) species in plant cells, which regulate several aspects of plant growth and development, as well as responses to biotic and abiotic stresses. The mechanistic insights underlying PtdIns3P mode of action, specifically through PtdIns3P-binding effectors such as FYVE and PHOX proteins have been partially explored in plants with main focus on Arabidopsis thaliana. Additionally, they have been underexplored in other plant organisms such as bryophytes, the earliest diverging group of terrestrial flora.

In this study, we searched for genes coding for FYVE and PHOX domains containing sequences from different photosynthetic organisms in order to gather evolutionary insights on these PPI binding domains, followed by an in silico characterization of the FYVE and PHOX gene family in the moss Physcomitrella patens. Phylogenetic analysis showed that PpFYVE proteins can be grouped in 7 subclasses, with an additional subclass whose FYVE domain was lost during evolution to higher plants. On the other hand, PpPHOX proteins are classified into 5 subclasses. Expression analyses based on RNAseq data together with the analysis of cis-acting regulatory elements and transcription factor binding sites in promoter regions suggest the importance of these proteins in regulating stress responses but mainly developmental processes in P. patens. The results provide valuable information and robust candidate genes for future functional analysis aiming to further explore the role of this signaling pathway mainly during growth and development of tip growing cells and during the transition from 2D to 3D growth, which could provide ancestral regulatory players undertaken during plant evolution.
Functional divergence and potential mechanisms of the duplicaterecAgenes inMyxococcus xanthus
Authors: Sheng Duo-hong , Wang Yi-xue , Qiu Miao , Zhao Jin-yi , Yue Xin-jing , Li Yue-zhong
Published: September 2019

RecA is a ubiquitous multifunctional protein for bacterial homologous recombination and SOS response activation.Myxococcus xanthusDK1622 possesses tworecAgenes, and their functions and mechanisms are almost unclear. Here, we showed that the transcription ofrecA1(MXAN_1441) was less than one-tenth ofrecA2(MXAN_1388). Expressions of the tworecAgenes were both induced by ultraviolet (UV) irradiation, but in different periods. Deletion ofrecA1did not affect the growth, but significantly decreased the UV-irradiation survival, the homologous recombination ability, and the induction of the LexA-dependent SOS genes. Comparably, the deletion ofrecA2markedly prolonged the lag phase for cellular growth and antioxidation of hydrogen peroxide, but did not change the UV-irradiation resistance and the SOS-gene inducibility. The two RecA proteins are both DNA-dependent ATPase enzymes. We demonstrated that RecA1, but not RecA2, hadin vitroDNA recombination capacity and LexA-autolysis promotion activity. Transcriptomic analysis indicated that the duplicate RecA2 has evolved to mainly regulate the gene expressions for cellular transportation and antioxidation. We discuss the potential mechanisms for the functional divergence. This is the first time to clearly determine the divergent functions of duplicatedrecAgenes in bacterial cells. The present results highlight that the functional divergence of RecA duplicates facilitates the exertion of multiple RecA functions.

Author summary

Myxobacteria has a large-size genome, contains many DNA repeats that are rare in the prokaryotic genome. It encodes bacterial RecA that could promote recombination between homologous DNA sequences. How myxobacteria avoid the undesired recombination between DNA repeats in its genome is an interesting question.M. xanthusencodes two RecA proteins, RecA1 (MXAN_1441) and RecA2 (MXAN_1388). Both RecA1 and RecA2 shows more than 60% sequence consistency withE. coliRecA (EcRecA) and can partly restore the UV resistance ofE. coli recAmutant. Here, our results proved their divergent functions of the two RecAs. RecA1 retains the ability to catalyze DNA recombination, but its basal expression level is very low. RecA2 basal expression level is high, but no recombination activity is detected in vitro. This may be a strategy forM. xanthusto adapt to more repetitive sequences in its genome and avoid incorrect recombination.

Highlights

M. xanthushas tworecAs, which are expressed with significantly different levels. BothrecAs are inducible by UV irradiation, but in different stages.

The absence ofrecA1reduces bacterial UV-irradiation resistance, while the absence ofrecA2delays bacterial growth and antioxidant capacity.

RecA1 retains the DNA recombination and SOS induction abilities, while RecA2 has evolved to regulate the expression of genes for cellular transport and antioxidation.
WormQTL2: an interactive platform for systems genetics inCaenorhabditis elegans
Authors: Snoek Basten L. , Sterken Mark G. , Hartanto Margi , van Zuilichem Albert-Jan , Kammenga Jan E. , de Ridder Dick , Nijveen Harm
Published: September 2019

Quantitative genetics provides the tools for linking polymorphic loci (QTLs) to trait variation. Linkage analysis of gene expression is an established and widely applied method, leading to the identification of expression quantitative trait loci (eQTLs). (e)QTL detection facilitates the identification and understanding of the underlying molecular components and pathways, yet (e)QTL data access and mining often is a bottleneck. Here we present WormQTL2 (www.bioinformatics.nl/WormQTL2/), a database and platform for comparative investigations and meta-analyses of published (e)QTL datasets in the model nematode wormC. elegans. WormQTL2 integrates six eQTL studies spanning 11 conditions as-well-as over 1000 traits from 32 studies and allows experimental results to be compared, reused, and extended upon to guide further experiments and conduct systems-genetic analyses. For example, one can easily screen a locus for specific cis-eQTLs that could be linked to variation in other traits, detect gene-by-environment interactions by comparing eQTLs under different conditions, or find correlations between QTL profiles of classical traits and gene expression.
Discovering Differences and Similarities among Species Based on Numeric Features of microRNAs
Authors: Zhu Rongsheng , Zhang Zhanguo , Xin Dawei , Li Yang , Chen Qingshan
Published: September 2019

Numeric features of microRNA (miRNA) are different from the other RNAs and play a key role in the course of miRNA recognition. Are there significant differences about such numeric features between different species? Are there some species specific about it? In order to answer questions, we implemented the Kolmogorov-Smirnov test for 32 species based on 132 numeric features of miRNAs. Results demonstrate that almost all kinds of miRNA secondary structures matching frequencies show highly similar, and this means that such secondary structure tend to be specific to miRNAs. Length of pre-miRNA, minimal free energy (MFE), and number of stacks show bigger difference between different species, and this means that such features tend to be species-specific. In order to discover differences and similarities among species based on numeric features of miRNAs, we design two tools-species difference map and feature difference map. By species difference map, we find that numeric features of miRNAs can represent class attribute of species and the map basically describe relationship between different species. By feature difference map, we find that there are huge difference about difference of every numeric feature between different species, and this means that strength of such difference is not uniform. Meantime, it means that numeric feature of miRNAs can represent different attributes of corresponding species. Our study present relationship between different species by brand new style-numeric features of miRNAs.
The emerging importance of risk management and enterprise risk management strategies in the Indian hospitality industry
Authors: Vij Madhu
Published: September 2019

Purpose

The purpose of this paper is to discuss the outlook for risk management and enterprise risk management (ERM) within the hospitality sector including how ERM is being balanced with the need to innovate, and what boards of directors are doing to become more engaged in risk oversight. The implementation of ERM is about taking a strategic view of risk and linking it to business goals and value creation.

Design/methodology/approach

An interviewer-administered survey was used to collect data from 33 senior risk professionals and other industry experts who had a clear understanding of both risk management and ERM. A structured and semi-structured questionnaire consisting of three sections was personally administered to 33 respondents in 2018 to collect information from risk professionals and other industry experts.

Findings

It is important to create a culture of risk awareness and to incorporate risk planning into business decisions. The complexity of modern business necessitates that managers in the hospitality sector have greater skill levels than ever before. This research should help hospitality managers to better understand the core risks and link them to strategy. ERM creates an environment where the organization as a whole can support the value creation process with a sharper focus on risk management.

Practical implications

The growing role of technology along with human connections is shaping the hospitality sector and redefining the travel ecosystem. Future travel experiences are likely to be influenced by a blend of technology and human experiences. Many Indian companies are applying the traditional risk management model in their businesses, while ERM is their future goal. The evolution from a traditional risk management model to ERM is challenging, and so it is important to have an appropriate framework in place for its implementation.

Originality/value

Hospitality managers need to know how to proactively manage risk management and ERM as the sector is increasingly vulnerable to internal risks. ERM creates a direct linkage between risks and opportunities required for decision-making in a dynamic environment. With growing competition on a global level, the hospitality industry should aim to manage risks strategically to increase the likelihood that organizational objectives can be achieved.
Influence of loading conditions on wear behaviour of H11 tool steel
Authors: Joshy Sam , K.R. Jayadevan , A. Ramesh , D. Mahipal
Published: September 2019

Purpose

In hot forging, a significant amount of forging force is used for overcoming frictional force at the die-billet interface. The high frictional force along with thermomechanical stress lead to wear, plastic deformation, mechanical fatigue and cracks, which reduce the service life of hot forging dies. Of all these different types of issues, wear is the predominant mode of failure in hot forging dies. This paper aims to describe mechanisms of wear transition in different loads at near forging temperature, occurring during sliding of chromium-based H11 tool steel specimens.

Design/methodology/approach

High temperature pin-on-disc tests are performed with pin specimens machined from bars of X38CrMoV5 steel, heat treated to surface hardness of 40-42 HRc. The disc is made of EN 31 steel with hardness of 60-62 HRc. Tests are performed at constant temperature of 500°C, and the normal load was varied from 20 to 70 N.

Findings

Scanning electron microscopy investigations on worn surface have revealed that wear is primarily due to abrasion and plastic deformation. The test results show an increasing trend in wear rate with increase in load up to 30 N, followed by a reversal in trend until 50 N. This transition in wear rate is caused by development of wear resistant layers, which are formed by compaction of wear debris particles on to the worn surfaces. These compact layers are found to be stable during load range from 40 and 50 N. However, with further increase in load, abrasive wear tracks are observed without any evidence of protective layers. As a result, there is an increase in wear rate with increase in loads above 50 N. In addition, plastic shearing was dominant over abrasive wear at this load regime.

Originality/value

The study on wear behaviour of H11 hot forging steel at 20 to 70 N will be an input to the research in hot forming industries.
A nonlinear approach to the U.S.–Australia commodity trade and the J‐curve: Evidence from 123 industries
Authors: Bahmani‐Oskooee Mohsen , Harvey Hanafiah
Published: September 2019

The application of nonlinear models and asymmetric analysis have recently proven to yield results that are superior to those of the linear and symmetric analysis. However, the new approaches in testing the J‐curve between Australia and the rest of the world or between Australia and her trading partners such as the United States did not yield any significant outcomes. Suspecting that those results suffer from aggregation bias, we apply new methods to the trade flows of 123 industries that trade between the United States and Australia and give evidence of an asymmetric J‐curve in 28 industries. Furthermore, we find short‐run asymmetric effects of exchange rate changes on the trade balance of almost all studies, short‐run impact asymmetric effects in 27 industries and significant long‐run asymmetric effects in 56 industries. Our findings are industry‐specific.
Culture, Race, and Health: Implications for Racial Inequities and Population Health
Authors: COGBURN COURTNEY D.
Published: September 2019

Policy Points

Racism is a fundamental cause of health inequities and disease, which requires policy solutions that address this cause directly rather than only targeting mechanisms.

Cultural systems, such as cultural racism, undergird the social conditions that shape racial inequities in health, including social and health policy decision making, governance, practice, and public reception.

Policies targeting racial health equity benefit from integrating social theory and meaningful assessments of the social context concerning race, racism, and health.

Context

Improving the health of the total population may be insufficient in eliminating racial disparities in population health. An expanding commitment to understanding social determinants of health aims to address the social conditions that produce racialized patterns in health inequity. There is also a resurging and evolving interest in the influence of cultural barriers and assets in shaping racial inequities in health. The meaning and function of culture, however, remains underspecified.

Methods

This paper synthesizes analogous but fragmented concepts of cultural threat related to social and racial inequity as examined in public and population health, psychology, sociology, communications, media studies, and law. It draws on an existing typology of culture and social inequity to organize concepts related to cultural racism. Employing a transdisciplinary approach, the paper integrates multiple scholarly perspectives on cultural threat to frame cultural racism as cultural systems that promote false presumptions of white superiority relative to non‐whites.

Findings

The lack of shared conceptual grounding and language regarding cultural threats to health hinders a more precise identification and measurement of cultural processes as well as comparisons of relative prevalence and influence of pathways linking cultural processes and social inequity. Evaluating intersections among culture, structures, and racism is a valuable analytical tool for understanding the production of social and racial inequities in health. To adequately address health inequities rooted in systemic racism, it is imperative to discuss the function of cultural racism in shaping population health in the United States.

Conclusions

Building a culture of health and achieving health equity requires that we assess cultural racism in a more meaningful way. Cultural processes are commonly referenced in health inequity scholarship, but the empirical literature generally lags behind the conceptual emphasis. A rich literature across disciplines has substantively engaged conceptualizations of culture and cultural processes, the importance of these processes as part of a system of racism, and mechanisms that may link cultural threats to health. When integrated, this literature offers essential insights for ways population health may address the complex issue of eradicating racial disparities in health.
Development of an innovative apparatus using UV‐C for controlling the number of microorganisms in raw milk after milking
Authors: Makarapong David , Tantayanon Supawan , Gowanit Chupun , Inchaisri Chaidate
Published: September 2019

This study was conducted to investigate the effect of UV‐C irradiation on the reduction of microorganisms in raw milk. The experiments were carried out by varying the flow rates of 2, 4 and 7 L/min with 39W and 48W UV‐C. The number of microorganisms was reduced by 4.70 (39W) and 4.60 log10 CFU/mL (48W) at 120 min. With the residence time of 4.95 s and the UV‐C doses of 98 and 109.9 mJ/cm2 at 253.74 nm, the reduction of microorganism was clearly observed with no significant influence of different UV‐C power settings on the oxidation of milk fat.
The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high‐income setting: a prospective cohort study
Authors: Sullivan EA , Vaughan G , Li Z , Peek MJ , Carapetis JR , Walsh W , Frawley J , Rémond MGW , Remenyi B , Jackson Pulver L , Kruske S , Belton S , McLintock C
Published: September 2019

Objective

To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ).

Design

Prospective population‐based study.

Setting

Hospital‐based maternity units throughout A&NZ.

Population

Pregnant women with RHD with a birth outcome of ≥20 weeks of gestation between January 2013 and December 2014.

Methods

We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De‐identified antenatal, perinatal and postnatal data were collected and analysed.

Main outcome measures

Prevalence of RHD in pregnancy. Perinatal morbidity and mortality.

Results

There were 311 pregnancies associated with women with RHD (4.3/10 000 women giving birth, 95% CI 3.9–4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10 000, 95% CI 50.7–70.0), while in New Zealand 90% were Māori or Pasifika (27.2/10 000, 95% CI 22.0–32.3). One woman (0.3%) died and one in ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1000 births) and two neonatal deaths (6.5/1000 births). Sixty‐six (21%) live‐born babies were preterm and one in three was admitted to neonatal intensive care or special care units.

Conclusion

Rheumatic heart disease in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at‐risk pregnant women are essential for good maternal and baby outcomes.

Tweetable abstract

Rheumatic heart disease in pregnancy persists in First Nations people in Australia and New Zealand and is associated with major cardiac and perinatal morbidity.
H.A. Hawkes—A pioneer of field ecology
Authors: Hedges Peter D.
Published: September 2019

This article outlines the life and career of H.A. (Bert) Hawkes, who has been referred to as one of the founders of field ecology, due to the work he conducted in the late 1940s and 1950s, investigating the fly nuisance emanating from biological filters. Following an overview of his life, there is a focus on his core research, carried out over a period of some 50 years, on two aspects of river pollution control—the prevention of pollution by sewage biological filtration and the monitoring of river pollution by biological surveillance.
Ergometrine stability in postpartum haemorrhage kits: Does temperature and light matter?
Authors: Donnan Finbarr , Senarathna S.M.D.K. Ganga , Ware Benjamin , Rawlins Matthew D.M. , Dontham Chandrakala , Chuang Victor T.G. , Batty Kevin T.
Published: September 2019

Background

Postpartum haemorrhage (PPH) kits containing uterotonics are used on obstetric units for the timely management of PPH. Visible discolouration of ergometrine and ergometrine‐oxytocin injections was observed in PPH kits stored in medical refrigerators on the obstetric unit at our hospital.

Aim

To investigate the stability of ergometrine and ergometrine‐oxytocin injections in PPH kits under simulated clinical storage conditions and to determine the potency of ampoules quarantined from PPH kits on our obstetric unit.

Material and methods

Ergometrine and ergometrine‐oxytocin injection ampoules were stored exposed to and protected from light at 4°C and room temperature (25°C) for up to three months, and assayed by high‐performance liquid chromatography. Stability was based on the time for the ergometrine or oxytocin concentration to fall to 90% of the original concentration (t90). The potency of quarantined discoloured ampoules also was determined.

Results

Ergometrine was stable at both temperatures for >6 months, when stored protected from light in simulated clinical conditions. When exposed to light, ergometrine was stable for approximately 4 days at 25°C and 10 days at 4°C. Discoloured ergometrine and ergometrine‐oxytocin injection ampoules were found to be <90% of the nominal concentration.

Conclusion

Stability of ergometrine in PPH kits is largely unaffected by temperature fluctuations (at 4°C and 25°C) over 6 months when protected from light. Ergometrine and ergometrine‐oxytocin ampoules should be inspected prior to use and any discoloured ampoules discarded.
Reflection on the current status of endometrial cancer in New Zealand
Authors: Henry Claire , Filoche Sara , Thunders Michelle , Kenwright Diane , Ekeroma Alec
Published: September 2019

Incidence of endometrial cancer is increasing rapidly in the developed world and is the most common gynaecological cancer in Australia and New Zealand. In line with obesity rates, the landscape and average age of women diagnosed with endometrial cancer are changing. There is still unmet need in early diagnosis, directed treatment, management of comorbidities and prevention strategies. This opinion piece aims to reflect on the current status of endometrial cancer in New Zealand in parallel to Australia, drawing out areas for future research and discussion.
PodCast: A rural and regional service model for podiatrist‐led total contact casting
Authors: McLean Adam , Gardner Marcus , Perrin Byron
Published: September 2019

Problem

Diabetes‐related foot disease causes significant health system costs and is a leading cause of morbidity and disproportionately affects rural populations. Total contact casts or instant total contact casts are gold standard for management of foot ulcerations resulting from diabetes‐related foot disease. The aim of this study was to evaluate the impact of a podiatrist‐led casting service model within a rural and regional setting.

Design

The implementation of the service model was evaluated over a 12‐month period using a quality improvement approach, informed by multiple methods. Quantitative and qualitative methods were used.

Setting

An outpatient high‐risk foot clinic and community‐based podiatry services within a large regional health service. The location was central Victoria, servicing rural communities within the Loddon Mallee region.

Key measures for improvement

Patient‐related data included information relating to demographics, diabetes and foot pathologies. Service‐related data included occasions of service, locations and the number and type of casts applied.

Strategies for change

Upskilling podiatrists to provide the service in a safe, supportive and sustainable manner and ensuring the podiatrist‐led casting service model was sufficiently adaptable for patients to access at the rural sites.

Effects of change

Increased access to total contact casts and instant total contact casts, comparable wound healing times to other studies and the model was able to be sustained.

Lessons learnt

Podiatrist‐led casting resulted in increased utilisation of total contact casts and instant total contact casts. The increased use of instant total contact casts in particular may help address the lack of uptake of this treatment for people with diabetes‐related foot disease, thereby improving rural health outcomes.
Anti‐tumor necrosis factor treatment increases both the Th17 and Th22 T helper subsets in spondyloarthritis
Authors: Andersen Thomas , Østgård René Drage , Aspari Maithri Prasad , Kragstrup Tue Wenzel , Glerup Henning , Jurik Anne Grethe , Johansen Claus , Hvid Malene , Deleuran Bent Winding
Published: September 2019

The aim was to examine anti‐tumor necrosis factor α (anti‐TNFα) therapy influence changes on Th17 and Th22 cells in patients with spondyloarthritis (SpA), and its correlation with changes in clinical and magnetic resonance imaging (MRI) activity and chronicity scores. The Th17 and Th22 cells were assessed at baseline, after 12 and 52 weeks of anti‐TNFα therapy by flow cytometry (ClinicalTrials.gov NCT4682724). The percentages of both Th17 and Th22 cells were increased by 70% at baseline compared with healthy controls (both p < 0.01). During treatment, these two subsets increased further to be 170% (Th17) and 123% (Th22) above levels in healthy controls (both p < 0.01). The same subsets decrease their expression of IL‐23R significantly during the observation period (p < 0.05). High levels of Th17 and Th22 cells at baseline were associated with the degree of chronic changes in the sacroiliac joints on MRI and a good clinical response to anti‐TNFα treatment after one year. Plasma levels were not associated with clinical changes. Th17 cells, and Th22 subsets, increased during one year of anti‐TNF‐α therapy in SpA, regardless of their clinical improvement. This supports that both the Th17 and Th22 subsets could be involved in the progression in SpA.
Testing the assumptions of an indicator of unmet need for obstetric surgery in Ghana: A cross‐sectional study of linked hospital and population‐based delivery data
Authors: Cavallaro Francesca L. , Hurt Lisa S. , Cresswell Jenny A. , Edmond Karen , Amenga‐Etego Seeba , Kirkwood Betty R. , Ronsmans Carine
Published: September 2019

Background

The Unmet Obstetric Need (UON) indicator has been widely used to estimate unmet need for life‐saving surgery at birth; however, its assumptions have not been verified. The objective of this study was to test two UON assumptions: (a) Absolute maternal indications (AMIs) require surgery for survival and (b) 1%‐2% of deliveries develop AMIs, implying that rates of surgeries for AMIs below this threshold indicate excess mortality from these complications.

Methods

We used linked hospital and population‐based data in central Ghana. Among hospital deliveries, we calculated the percentage of deliveries with AMIs who received surgery, and mortality among AMIs who did not. At the population level, we assessed whether the percentage of deliveries with surgeries for AMIs was inversely associated with mortality from these complications, stratified by education.

Results

A total of 380 of 387 (98%) hospital deliveries with recorded AMIs received surgery; an additional eight women with no AMI diagnosis died of AMI‐related causes. Among the 50 148 deliveries in the population, surgeries for AMIs increased from 0.6% among women with no education to 1.9% among women with post‐secondary education (P < .001). However, there was no association between AMI‐related mortality and education (P = .546). Estimated AMI prevalence was 0.84% (95% CI: 0.76%‐0.92%), below the assumed 1% minimum threshold.

Discussion

Obstetric providers consider AMIs absolute indications for surgery. However, low rates of surgeries for AMIs among less educated women were not associated with higher mortality. The UON indicator should be used with caution in estimating the unmet need for life‐saving obstetric surgery; innovative approaches are needed to identify unmet need in the context of rising cesarean rates.
Burial and exhumation of the Hoh Xil Basin, northern Tibetan Plateau: Constraints from detrital (U‐Th)/He ages
Authors: Dai Jin‐Gen , Fox Matthew , Shuster David L. , Hourigan Jeremy , Han Xu , Li Ya‐Lin , Wang Cheng‐Shan
Published: September 2019

The uplift and associated exhumation of the Tibetan Plateau has been widely considered a key control of Cenozoic global cooling. The south‐central parts of this plateau experienced rapid exhumation during the Cretaceous–Palaeocene periods. When and how the northern part was exhumed, however, remains controversial. The Hoh Xil Basin (HXB) is the largest late Cretaceous–Cenozoic sedimentary basin in the northern part, and it preserves the archives of the exhumation history. We present detrital apatite and zircon (U‐Th)/He data from late Cretaceous–Cenozoic sedimentary rocks of the western and eastern HXB. These data, combined with regional geological constraints and interpreted with inverse and forward model of sediment deposition and burial reheating, suggest that the occurrence of ca. 4–2.7 km and ca. 4–2.3 km of vertical exhumation initiated at ca. 30–25 Ma and 40–35 Ma in the eastern and western HXB respectively. The initial differential exhumation of the eastern HXB and the western HXB might be controlled by the oblique subduction of the Qaidam block beneath the HXB. The initial exhumation timing in the northern Tibetan Plateau is younger than that in the south‐central parts. This reveals an episodic exhumation of the Tibetan Plateau compared to models of synchronous Miocene exhumation of the entire plateau and the early Eocene exhumation of the northern Tibetan Plateau shortly after the India–Asia collision. One possible mechanism to account for outward growth is crustal shortening. A simple model of uplift and exhumation would predict a maximum of 0.8 km of surface uplift after upper crustal shortening during 30–27 Ma, which is insufficient to explain the high elevations currently observed. One way to increase elevation without changing exhumation rates and to decouple uplift from upper crustal shortening is through the combined effects of continental subduction, mantle lithosphere removal and magmatic inflation.
DOES EXPERIENCE MATTER? SALARY DISPERSION, COACHING, AND TEAM PERFORMANCE
Authors: Bykova Anna , Coates Dennis
Published: September 2019

Using Major League Soccer as a unique dataset, this study examines the direct and indirect role of coaches' experience in determining team performance. Inspired by labor market studies, we applied traditional indicators of team salary structure and, unlike previous studies, empirically test the hypothesis that coach experience affects the way in which team salary distribution influences performance. Our results suggest that coaches with experience as professional soccer players improve team performance directly but worsen the negative effect of a skewed salary distribution. Moreover, experience as a player is more important than coaching experience. (JEL D3, J3, M5)
Hume's emotivist theory of moral judgements
Authors: Chamberlain James
Published: September 2019

Hume is believed by many to hold an emotivist thesis, according to which all expressions of moral judgements are expressions of moral sentiments. However, most specialist scholars of Hume either deny that this is Hume's position or believe that he has failed to argue convincingly for it. I argue that Hume is an emotivist and that his true arguments for emotivism have been hitherto overlooked. Readers seeking to understand Hume's theory of moral judgements have traditionally looked to the first section of Book 3 of hisTreatise, which discusses the relation between morality and reason. I argue that there is evidence elsewhere that better supports Hume's emotivist thesis. Hume's arguments for emotivism focus more on the causes of moral sentiments than on their relation to reason or belief, and he argues that moral sentiments are such as to arise whenever we contemplate morally relevant objects. He also holds that the presence of moral sentiments precludes any possibility of moral belief, because moral beliefs could only be less vivid copies of moral sentiments, and these cannot simultaneously exist. Hume concludes that all moral judgements must be expressions of sentiments.