bluuebunny/crossref_metadata_2025 huggingface dataset:
Venture capital certification of small and medium‐sized enterprises towards banks: evidence from China
Authors: Wu Long , Xu Lei
Published: May 2019

Through a proprietary dataset of small and medium‐sized enterprises (SMEs) on China's National Equities Exchange and Quotations (NEEQ), we examine the impact of venture capital (VC) backup on access to bank loans by SMEs. We find that VC backup can help SMEs obtain more bank loans under better conditions and significantly relieve their financing constraint. This is especially meaningful for private SMEs, those in high‐tech, in regions of less‐developed banking industry, or with lower quality accounting information. This study may have policy implications as a pilot ‘combined debt‐equity financing’ discussion in the context of the largest bank‐based economy.
Understanding participation in accounting standard‐setting: the case of AASB ED 192 Revised Differential Reporting Framework
Authors: Handley Karen , Evans Elaine , Wright Sue
Published: May 2019

This paper explores the motives of participants in the standard‐setting process, based on the premise that standard‐setters strive for standards that are useful for decision‐making by a wide range of financial statement users. Our setting is the development of a contentious but contained Australian accounting standard, Reduced Disclosure Requirements. A consultative process initiated by the Australian Accounting Standards Board to create a specific Australian accounting standard for differential reporting provided an opportunity for interested parties to participate. We analyse the motives of participants through semi‐structured interviews with members of the Australian Accounting Standards Board and comment letter writers who responded to the relevant exposure draft. Our findings identify participants’ economic and political motivations and question the ability of the current standard‐setting process to extract decision‐making requirements from a wide range of users of financial statements and to reflect these in financial reporting standards. We find that the perspectives gathered are homogenised and that the process privileges the voices of powerful elites.
Getting ahead of the oral health game: it starts before we're born?
Authors: Silva MJ , Riggs E , Kilpatrick NM
Published: May 2019

Dental caries is one of the most common chronic diseases affecting individuals of all ages. Caries in the primary dentition is one of the main risk factors for caries in the permanent dentition. Preventing the development of the first carious lesion is fundamental not only to long term health and wellbeing but to reducing the burden of this disease on individuals, families and the community. Described as the developmental origins of health and disease, events from the prenatal period are increasingly recognised as having a significant impact on later health outcomes. While social and behavioural factors from this period have long been linked with oral health, emerging evidence of the influence of epigenetics and early life programming of microbiome and host response suggests that the prenatal period provides a timely opportunity for preventive interventions. Pregnancy is an ideal time to focus on health promoting activities as most women have regular interaction with health care professionals who can target risk factors before the onset of disease. This paper summarizes contemporary understanding of the role of pre‐ and perinatal factors on child oral health and describes how this evidence might be used by all health professionals to ensure infants start life ahead in the oral health game.
Restorative treatment of primary teeth: an evidence‐based narrative review
Authors: Finucane D
Published: May 2019

Various methods, with a variety of materials, exist for restoring carious primary teeth. Successful restoration of primary teeth is dependent on accurate diagnosis, knowledge of the caries process, knowledge of dental materials, and treatment choice. The purpose of this evidence‐based review is to present evidence that will help clinicians to make an appropriate diagnosis, from which the optimum treatment plan can be made; to explore the literature regarding restoration of carious primary teeth; and to try and draw conclusions as to which materials and methods can be recommended. This review will primarily deal with the restoration of carious cavities in primary molars. A short discussion on restoration of primary incisors is included, with presentation of what limited evidence there is relating to this.
Dyadic associations reveal clan size and social network structure in the fission–fusion society of spotted hyaenas
Authors: Stratford Ken , Stratford Sabina , Périquet Stéphanie
Published: May 2019

Estimating the size and dynamics of populations is of paramount importance in ecology. In species with uniquely marked individuals, capture–recapture methods can be used to establish population size and to explore associations between individuals. However, very few studies have used cameras traps to focus on group composition in social carnivores, despite being of particular interest in species characterised by “fission–fusion” formation of sub‐groups. Here, we provide estimates of (a) population size, (b) density, (c) clan size, (d) association patterns and (e) social network structure in spotted hyaenas (Crocuta crocuta) based on images from camera traps deployed at waterholes on Ongava Game Reserve (northern Namibia). In a 15 week study period, we identified 32 individuals. Dyadic associations and the resulting social network showed that all but two hyaenas associated directly or indirectly with each other, indicating the presence of one clan of at least 30 individuals, resulting in a density of 8.1 hyaenas/100 km2. We found a very high variability in the tendency of individuals to associate with others. This study confirms a highly dynamic fission–fusion society in spotted hyaenas. We argue that camera traps can provide relevant insights into large carnivore social network structure where associations between individuals are difficult to observe directly.
Net energy content of five fiber‐rich ingredients fed to pregnant sows
Authors: Wang Zhenyu , Chen Yifan , Ding Jian , Liu Hu , Lyu Zhiqian , Dong Wenxuan , Wang Zijie , Zhang Shuai , Wang Fenglai
Published: May 2019

The present study was conducted to determine the net energy (NE) values and energy efficiency of wheat bran (WB), sugar beet pulp (SBP), corn gluten feed (CGF), soybean hulls (SBH), and defatted rice bran (DFRB) fed to pregnant sows. Thirty‐six multiparous pregnant sows were randomly assigned to six dietary treatments with six replicates per treatment. Each period lasted for 21 days including 14 days for adaptation. On day 15, sows were moved into respiration chambers for heat production (HP) measurement and provided feed at 544 kJ/kg BW0.75/day. On day 20, sows were fasted to measure the fasting heat production (FHP). Experimental diets included corn‐soybean meal basal diet and five diets containing 29.20% WB, SBP, CGF, SBH, and DFRB, respectively. Results showed that inclusion of WB, SBP, CGF, SBH, and DFRB to basal diet decreased (p < 0.05) the apparent total tract digestibility of energy and nutrients. The average adjusted total HP and FHP were 418 kJ/kg BW0.75/day and 326 kJ/kg BW0.75/day, respectively. The average NE:ME ratio of experiment diets was 82.5%. In conclusion, the NE values of WB, SBP, CGF, SBH, and DFRB were 9.05, 8.59, 8.37, 7.64, and 7.93 MJ/kg DM, respectively.
Student satisfaction with learning management systems: A growth model of belief and use
Authors: Yuen Allan H. K. , Cheng Miaoting , Chan Fred H. F.
Published: May 2019

Learning management systems (LMSs) have been launched in universities and other schools. However, because the use of such technology in schools is relatively new in the blended context, it is essential to understand whether students will accept and continue to use it. In this study, longitudinal latent growth modelling was used to examine the relationship between changes to LMS use and belief, and satisfaction with LMS among 1179 students, mostly between 12 and 13 years old, from 25 Hong Kong schools. Both LMS use and belief had positive linear growth over time. We observed individual differences in the students’ initial level of belief and the rate at which their belief changed. In addition, individual differences in the students’ initial level of LMS use were observed. However, there were no individual differences in their rate of change for LMS use. The initial level of belief and increased LMS use were directly associated with system and learning satisfaction with LMS. Changes to LMS use mediated the relationship between changes to beliefs and system and learning satisfaction with LMS.

Practitioner Notes

What is already known about this topic

Extensive studies of technology acceptance have been conducted taking a cross‐sectional approach.

Previous technology acceptance studies are focused on users in organisations or students in higher education.

Technology acceptance studies explored users’ continuance technology use as the extension of initial acceptance, and a set of determinants have been established to predict and explain users’ acceptance and continued use of technologies, and user satisfaction.

What this paper adds

A growth model of belief and use to explore the dynamic changes of LMS belief and use and how they impact on satisfaction was proposed.

The model was tested by a three‐wave longitudinal survey data set, which is a random sample that covered diverse academic ability levels of junior secondary students from 25 schools in Hong Kong.

This study would make a significant contribution towards a better understanding about students’ acceptance and continuance of LMS and e‐learning technology.

Implications for practice and/or policy

Facilitating students to form positive LMS/e‐learning beliefs is critical to ensure satisfaction and the continuance use of LMS/e‐learning technologies.

It is important for teachers and system designers to put more effort towards supporting students’ belief in perceived ease of use, so that they would find LMS easy to use.

Teachers should endeavour to create positive LMS use experiences and encourage more frequent use of the LMS for different learning tasks.
α7 nicotinic ACh receptors are necessary for memory recovery and neuroprotection promoted by attention training in amyloid‐β‐infused mice
Authors: Telles‐Longui Milena , Mourelle Danilo , Schöwe Natalia Mendes , Cipolli Gabriela Cabett , Malerba Helena Nascimento , Buck Hudson Sousa , Viel Tania Araujo
Published: May 2019

Background and Purpose

Attention training reverses the neurodegeneration and memory loss promoted by infusion of amyloid‐β (Aβ) peptide in rats and increases the density of α7 nicotinic ACh receptors (α7nAChRs) in brain areas related to memory. Hence, we aimed to assess the role of α7nAChRs in the memory recovery promoted by attention training.

Experimental Approach

C57Bl/6 mice were chronically infused with Aβ, Aβ plus the α7 antagonist methyllycaconitine (MLA), or MLA alone. Control animals were infused with vehicle. Animals were subjected weekly to the active avoidance shuttle box for 4 weeks (attention training). The brain and serum were collected for biochemical and histological analysis.

Key Results

Aβ caused cognitive impairment, which was reversed by the weekly training, whereas Aβ + MLA also promoted memory loss but with no reversal with weekly training. MLA alone also promoted memory loss but with only partial reversal with the training. Animals infused with Aβ alone showed senile plaques in hippocampus, no change in BDNF levels in cortex, hippocampus, and serum, but increased AChE activity in cortex and hippocampus. Co‐treatment with MLA increased AChE activity and senile plaque deposition in hippocampus as well as reducing BDNF in hippocampus and serum, suggesting a lack of α7nAChR function leads to a loss of neuroprotection mechanisms.

Conclusions and Implications

The α7nAChR has a determinant role in memory recovery and brain resilience in the presence of neurodegeneration promoted by Aβ peptide. These data support further studies concerning these receptors as pharmacological targets for future therapies.
Children's and Adolescents’ Evaluations of Intergroup Exclusion in Interracial and Interwealth Peer Contexts
Authors: Burkholder Amanda R. , Elenbaas Laura , Killen Melanie
Published: May 2019

Children and adolescents (N = 153, ages 8–14 years, Mage = 11.46 years) predicted and evaluated peer exclusion in interwealth (high‐wealth and low‐wealth) and interracial (African American and European American) contexts. With age, participants increasingly expected high‐wealth groups to be more exclusive than low‐wealth groups, regardless of their depicted race. Furthermore, children evaluated interwealth exclusion less negatively than interracial exclusion, and children who identified as higher in wealth evaluated interwealth exclusion less negatively than did children who identified as lower in wealth. Children cited explicit negative stereotypes about high‐wealth groups in their justifications, while rarely citing stereotypes about low‐wealth groups or racial groups. Results revealed that both race and wealth are important factors that children consider when evaluating peer exclusion.
Response of passerine birds and chicks to larvae and pupae of ladybirds
Authors: Aslam Muhammad , Veselý Petr , Nedvěd Oldřich
Published: May 2019

1. Few, if any, experimental tests have demonstrated the anti‐predator protection of the developmental stages of ladybirds (Coleoptera: Coccinellidae) against vertebrates, despite the fact that both the visual appearance of ladybirds and the content of defensive compounds fulfil the definition of an aposematic prey.

2. In this study, avian predators of three species were confronted with fourth‐instar larvae and pupae of the harlequin ladybird (Harmonia axyridis) – a large, conspicuous, and toxic ladybird species.

3. The selected predators differed in their individual experience and attitude to ladybirds. Wild‐caught great tits (Parus major) strongly avoided attacking ladybirds in general, whereas wild‐caught tree sparrows (Passer montanus) were willing to include ladybirds in their diet. Domestic chicks (Gallus gallus domesticus) have never been confronted with ladybirds but usually show avoidance of aposematic signals. In this study, great tits and domestic chicks avoided both developmental stages, but in the case of chicks the avoidance had to be learned over the course of repeated encounters. Sparrow avoidance was significantly lower, with more than one‐third of the prey being attacked and eaten.

4. The protection of both developmental stages of ladybirds is similar to adults, despite substantially different visual appearance.
Inadequate supply and increasing demand for textiles and clothing: second‐hand trade at auctions as an alternative source of consumer goods in Sweden, 1830–1900
Authors: Lilja Kristina , Jonsson Pernilla
Published: May 2019

Drawing on a study of historical national accounts and statistics, this article shows that a growing supply of mass‐consumption textiles and clothing in Sweden during industrialization did not fully meet increasing demand. As a result, high demand for second‐hand items remained even at the turn of the twentieth century. Records from a local auction house from 1830 to 1900 show that, even in the 1880s, more affluent urban consumers were still active on the second‐hand market. Thereafter, they turned to the market for new goods, while potential demand from labourers and servants continued to be provided for by the second‐hand market. Mechanization meant that more items entered this market. It changed the range and quality of objects available, consequently affecting the attractiveness of second‐hand textiles and clothing. After the 1870s, falling and converging prices can be discerned, while more durable fabrics largely retained their value. We conclude that the consumer revolution (in a broader sense) had by this stage gained a foothold among ordinary Swedish urban households. The auction trade was part of a democratization of consumption. The general lesson is that understanding mass consumption requires research not only into second‐hand consumption, but also into different regional settings.
The use of phenylephrine in the treatment of nephrosplenic entrapment of the large colon in horses
Authors: Pye J. , Nieto J.
Published: May 2019

Nephrosplenic entrapment is a commonly diagnosed cause of acute colic that may be corrected using surgical or non‐surgical methods and has a good prognosis for survival. Intravenous administration of phenylephrine at doses ranging from 20–60 μg/kg given over 5–15 min often followed by forced exercise, various rolling techniques under general anaesthesia, or a combination of therapies has been reported. Correction of the entrapment via exploratory celiotomy may be challenging in certain cases and is hampered by marked splenic enlargement. The case report by Loomes and Anderson (2019) in this issue described a novel method of reducing the size of the spleen by direct intra‐splenic injection of phenylephrine, in a case non‐responsive to intravenous phenylephrine administration, which facilitated surgical correction of the nephrosplenic entrapment.
Macroecological patterns and correlates of ant–tree interaction networks in Neotropical savannas
Authors: Dáttilo Wesley , Vasconcelos Heraldo L.
Published: May 2019

Aim

Similar to species richness, ecological interactions can vary across latitudinal and environmental gradients. Knowing the patterns and drivers of such variation could help us to better understand the role of species interactions in maintaining biodiversity. In this study, we analysed the macroecological patterns of the structure and interaction beta diversity of interaction networks involving trees and ants.

Location

Twenty‐nine sites encompassing 20 degrees of latitude throughout the Neotropical savanna.

Time period

2010–2015.

Major taxa studied

Trees and arboreal nesting ants.

Methods

For each site, we built an interaction network and calculated network size, interaction diversity (Shannon diversity of interactions), specialization, modularity, nestedness, and interaction dissimilarity (contribution of each network to the regional pool of possible interactions). We also determined how interaction beta diversity varied among all sampling sites. Net primary productivity (NPP), temperature and rainfall were evaluated as potential correlates of the observed changes in network descriptors and interaction beta diversity.

Results

We found no latitudinal gradient in network specialization, nestedness or modularity. However, sites at higher latitudes had larger networks, higher interaction diversity and higher interaction dissimilarity, and this was correlated mainly with the latitudinal variation in NPP. Interaction rewiring generated by the reassembly of the interactions between the same species in different sites was the main contributor to the total interaction beta diversity. However, the level of interaction rewiring was independent of the geographical and environmental distance between sampling sites.

Main conclusions

Ant–tree network structure remained relatively invariant across the latitudinal and environmental gradient possibly due to high interaction rewiring among the partners. Moreover, our findings show that more productive sites, located at higher latitudes, have high dissimilarity to the regional pool of possible interactions (i.e., strong interaction filtering), indicating that these sites significantly contribute to the maintenance of interaction biodiversity in Neotropical savannas.
The nutraceutical value of grain legumes: characterisation of bioactives and antinutritionals related to diabesity management
Authors: Bosi Sara , Bregola Valeria , Dinelli Giovanni , Trebbi Grazia , Truzzi Francesca , Marotti Ilaria
Published: May 2019

Beyond the nutritional value, legumes and particularly common beans are found in several dietary supplements used to treat diabesity (diabetes and obesity). These products contain not only inhibitors of carbohydrate‐hydrolising enzymes (α‐amylase, α‐glucosidase), but also antinutritional factors that can cause adverse effects on human health. In the present research, twenty‐two accessions of grain legumes were screened for bioactive (α‐amylase and α‐glucosidase inhibitors) and antinutritional (lectins, flatulence‐producing sugars, trypsin inhibitors) phytochemicals. Results showed that four accessions had high α‐amylase inhibiting activities (AI > 30%), and particularly the common bean ‘Great Northern’ resulted of interest for its high carbo‐blocker activity (AI = 42.6 ± 0.5%), absence of lectins, low amounts of flatulence‐producing oligosaccharides (2.5 ± 0.2 g/100 g DW) and low anti‐trypsin activity (22.5 ± 4.3 trypsin inhibiting unit/mg DW). The knowledge offered from this work provides leads to the ultimate goal of developing new, more effective and safer dietary supplements for diabesity management.
The effect of simulated digestion on the composition of phenolic compounds and antioxidant activities in lychee pulp of different cultivars
Authors: Su Dongxiao , Luo Mukang , Liu Hesheng , Qi Xiangyang , Zeng Qingzhu , He Shan , Fen Shilun , Zhang Jie
Published: May 2019

Simulated gastric fluid (SGF) and intestinal fluid (SIF) digestion were used to evaluate the effects of digestion on the composition of phenolic compounds and antioxidant capacities of the pulp of six lychee cultivars. Caffeic acid, ferulic acid, procyanidin B2, epicatechin, A‐type procyanidin trimer, procyanidin A2, quercetin‐3‐rutinose‐7‐rhamnoside, rutin and isoquercitrin were quantified using HPLC‐DAD. Lychee pulp had high concentrations of procyanidin B2 (0.30~15.53 mg g−1), procyanidin A2 (0.29~0.52 mg g−1) and quercetin‐3‐rutinose‐7‐rhamnoside (0.16~0.45 mg g−1). SGF and SIF Digestion, which significantly decreased the concentration of procyanidin B2, epicatechin and quercetin‐3‐rutinose‐7‐rhamnoside. But observably increased the concentration of procyanidin A2. Compared with deionized water treatment (DW), the total phenolic content (TPC) and total flavonoid content (TFC) of different lychee pulps significantly increased after SGF and SIF digestion. After SGF digestion, the ferric ion reducing antioxidant power (FRAP) of lychee pulps increased while the ABTS+ free radical scavenging ability (ABTS) had a slight decline. This shows that simulated digestion improves the bioactive component and antioxidant activity of different varieties of lychee pulp.
Occupational radiation exposure to the head is higher for scrub nurses than cardiologists during cardiac angiography
Authors: Wilson‐Stewart Kelly , Hartel Gunter , Fontanarosa Davide
Published: May 2019

Aims

This study aimed to compare the head dose of a cardiologist to scrub and scout nurses during cardiac angiography.

Design

A correlational longitudinal quantitative design was used to examine the relationship between the variable of occupational dose to the medical operator when compared with the dose to the scrub and scout nurses.

Methods

A quantitative analysis was performed on data collected during coronary angiograms (N = 612) for one cardiologist and 22 nurses performing either the scrub or scout role between May 2015 and February 2017. Analysis was based on log‐transformed dose levels and reported as geometric means and associated 95% confidence intervals.

Results

It was found that scrub nurses received on average 41% more head dose than the cardiologist during diagnostic procedures and 52% higher doses during interventional cases.

Conclusion

Nurses working in fluoroscopic cardiovascular procedures should be provided with appropriate training and protective equipment, notably lead skull caps, to minimize their occupational radiation exposure.

Impact

There is a notable lack of research evaluating the occupational head and eye exposure to nurses involved in fluoroscopic procedures. This study found that during diagnostic coronary angiograms, the scrub nurses received 41% more occupational head dose than the cardiologist and 52% higher head doses during interventional cases. Radial access resulted in higher doses to scrub nurses than femoral artery access. It is advisable that staff wear protective lead glasses and skull caps and use appropriately positioned ceiling mounted lead shields to minimize the risk of adverse effects of occupational exposure to ionizing radiation.
Secreted factors from cultured dental pulp stem cells promoted neurite outgrowth of dorsal root ganglion neurons and ameliorated neural functions in streptozotocin‐induced diabetic mice
Authors: Miura‐Yura Emiri , Tsunekawa Shin , Naruse Keiko , Nakamura Nobuhisa , Motegi Mikio , Nakai‐Shimoda Hiromi , Asano Saeko , Kato Makoto , Yamada Yuichiro , Izumoto‐Akita Takako , Yamamoto Akihito , Himeno Tatsuhito , Kondo Masaki , Kato Yoshiro , Nakamura Jiro , Kamiya Hideki
Published: May 2019

Aims/Introduction

Transplantation of stem cells promotes axonal regeneration and angiogenesis in a paracrine manner. In the present study, we examined whether the secreted factors in conditioned medium of stem cells from human exfoliated deciduous teeth (SHED‐CM) had beneficial effects on diabetic polyneuropathy in mice.

Materials and Methods

Conditioned medium of stem cells from human exfoliated deciduous teeth was collected 48 h after culturing in serum‐free Dulbecco's modified Eagle's medium (DMEM), and separated into four fractions according to molecular weight. Dorsal root ganglion neurons from C57BL/6J mice were cultured with SHED‐CM or DMEM to evaluate the effect on neurite outgrowth. Streptozotocin‐induced diabetic mice were injected with 100 μL of SHED‐CM or DMEM into the unilateral hindlimb muscles twice a week over a period of 4 weeks. Peripheral nerve functions were evaluated by the plantar test, and motor and sensory nerve conduction velocities. Intraepidermal nerve fiber densities, capillary number‐to‐muscle fiber ratio, capillary blood flow and morphometry of sural nerves were also evaluated.

Results

Conditioned medium of stem cells from human exfoliated deciduous teeth significantly promoted neurite outgrowth of dorsal root ganglion neurons compared with DMEM. Among four fractions of SHED‐CM, the only fraction of <6 kDa promoted the neurite outgrowth of dorsal root ganglion neurons. In addition, SHED‐CM significantly prevented decline in sensory nerve conduction velocities compared with DMEM in diabetic mice. Although SHED‐CM did not improve intraepidermal nerve fiber densities or morphometry of sural nerves, SHED‐CM ameliorated the capillary number‐to‐muscle fiber ratio and capillary blood flow.

Conclusions

These results suggested that SHED‐CM might have a therapeutic effect on diabetic polyneuropathy through promoting neurite outgrowth, and the increase in capillaries might contribute to the improvement of neural function.
Osmotic membrane distillation for retention of antioxidant potential in Nagpur mandarin (Citrus reticulata Blanco) fruit juice concentrate
Authors: Kumar Dinesh , Ladaniya Milind S. , Gurjar Manju , Mendke Sachin , Kumar Sunil
Published: May 2019

Consumers desire for processed fruit juices which are of higher quality, nutritionally rich, and convenient to prepare and store. Membranes have found many applications throughout the food processing industry. The present study describes the potential use of osmotic distillation process for concentrating Nagpur mandarin (Citrus reticulata Blanco) juice for the first time and to study its impact on ascorbic acid content and antioxidant activity assessed by ABTS, DPPH, FRAP, and TPC assays. The flux and concentration factor was also determined to evaluate the performance of the OD process. The juice clarified by the ultrafiltration technique having a TSS of 9.0°Brix was concentrated up to 60.4°Brix. The ascorbic acid content (15.5 mg/100 mL) and antioxidant activity by ABTS (9.69 mmolL−1 Trolox), DPPH (2.77 mmolL−1 Trolox), FRAP (1.33 mmolL−1 Trolox), and TPC content (13 mg GAE L−1) was retained, thus suggesting the use of membrane technology for concentrating fruit juice providing an alternative to the traditionally employed thermal evaporation processes.

Practical applications

This work offers an alternative to the thermal evaporation method for concentrating Nagpur mandarin juice with less energy consumption, low equipment cost, and less damage to the product and retention of antioxidant compounds, for example, ascorbic acid, which plays an important role in human health. The Nagpur mandarin juice was transformed to concentrate with the osmotic membrane distillation (OD) technique. The concentrate so produced is significantly potential to the food processing industry with retained nutritional qualities, and is suitable for many purposes due to its reduced weight and volume, less handling and storage costs and reduced in water activity with enhancement of product stability. Production of Nagpur mandarin juice concentrate also broadens its potential applications in food industry and its good quality renders it easily acceptable to consumers.
Moisture sorption isotherm and shelf‐life prediction of anticaking agent incorporated spray‐dried soursop (Annona muricata L.) powder
Authors: Chang Lee S. , Karim Roselina , Sabo Mohammed Abdulkarim , Chai Kong F. , Ghazali Hasanah M.
Published: May 2019

The moisture sorption isotherm (MSI) and shelf lives of soursop powders that had been incorporated with two commercial anticaking agents, calcium silicate (CS) and tricalcium phosphate (TCP), and inserted into aluminum laminated polyethylene pouches under room (RT, 25 ± 1°C) and elevated (ET, 38 ± 1°C) temperature, maintained at 93 ± 1% RH, were investigated. The powder possessed a Type III Brunauer's classification isotherm curve. The monolayer moisture content (Mo) was 0.023 ± 0.001 g H2O/g ds. A combination of low mean relative percent deviation modulus, E (2.18–3.75%), small sum of square residual, SSR (1.03 × 10−5–8.51 × 10−6), and high coefficient of determination (R2 > .99) indicating the moisture sorption data was sufficiently good fit using GAB model. Powder without anticaking agent stored at ET has the shortest estimated shelf life (~86 days) while 1.0 g/100 g TCP stored at RT exhibited the longest shelf life (~316 days). This study demonstrated that the incorporation of anticaking agents is effective to maintain the quality of powder by extending the shelf life by lowering moisture adsorption. The acceptability of reconstituted soursop powder based on hedonic test showed the scores for all attributes were higher than six.

Practical applications

Up to date, limited information describes the preservative effect of anticaking agents throughout the storage period. Hence, this work provides an insight to look into detail of how the incorporation of anticaking agents improve or retain the quality of the dried powder especially the moisture sorption isotherm (MSI) behavior. To achieve this, enzymatic pre‐treated spray‐dried powder was incorporated with anticaking agent. MSI was carried out and the behavior was determined by fitting the data into Guggenheim–Anderson–de Boer (GAB) model. Prediction of shelf life was studied by considering the critical moisture content (X
c), which is the moisture content of powder that undergoes transition changed. The outcome of this work was expected to be beneficial to food powder industry to comprehend the protective effect of anticaking agents as a functional additive. Production of anticaking agent treated spray‐dried soursop powder was expected to broaden its potential applications as functional ingredient.
Recombinant human interleukin 17A enhances the anti‐Candida effect of human oral mucosal epithelial cells by inhibiting Candida albicans growth and inducing antimicrobial peptides secretion
Authors: Jiang Lanlan , Fang Meifei , Tao Renchuan , Yong Xiangzhi , Wu Tiantian
Published: May 2019

Background

Candida albicans (C albicans) is the most common fungal pathogen causing opportunistic infections. IL17 (IL17A) is a vital mediator of antifungal immunity. The aim of the study was to investigate the effect of recombinant human interleukin 17A (rhIL17A) on human oral mucosal epithelial cells (hOMECs) defending against C albicans infection.

Methods

Human oral mucosal epithelial cells were divided into four groups: C albicans+ (MOI = 0.1), rhIL17A+ (100 μg/L), rhIL17A + C albicans+ (MOI = 0.1, rhIL17A:100 μg/L) and blank control. Then, C albicans growth was observed after 24 hours. Human beta‐2 defensin (hBD‐2), S100A8 and LL‐37 in supernatants and their mRNAs in cells were measured by enzyme‐linked immunosorbent assay and reverse transcription‐polymerase chain reaction, respectively.

Results

In C albicans+ group, C albicans hyphae formation and the death of infected hOMECs were observed. However, in the rhIL17A + C albicans+ group, IL17 inhibited both hypha formation, and C albicans from infecting hOMECs and its further growth. There was no statistical significance in adhesion rates of C albicans to hOMECs. Compared with the control group, the level of hBD‐2 mRNA has increased, while hBD‐2 and hBD‐2 mRNA levels in the rhIL17A + C albicans+ group were the highest. Both hBD‐2 and hBD‐2 mRNA levels were higher in the rhIL17A+ group than in the C albicans+ group. S100A8 and LL‐37 mRNAs have similar trend, and both upregulated after treatment with rhIL17A; however, protein levels were undetectable.

Conclusion

Recombinant human interleukin 17A may inhibit C albicans from infecting hOMECs by affecting the growth and reproduction of C albicans as well as the formation of hyphae. Besides, rhIL17A might induce hBD‐2, S100A8 and LL‐37 secretion from hOMECs to strengthen their anti‐infective ability.
Effect of Surface Treatment and Cement on Fracture Load of Traditional Zirconia (3Y), Translucent Zirconia (5Y), and Lithium Disilicate Crowns
Authors: Lawson Nathaniel C. , Jurado Carlos A. , Huang Chan‐Te , Morris Geoffrey P. , Burgess John O. , Liu Perng‐Ru , Kinderknecht Keith E. , Lin Chee Paul , Givan Daniel A.
Published: May 2019

Purpose

To determine if surface treatment and cement selection for traditional 3 mol% yttria partially stabilized zirconia (3Y‐PSZ), “translucent” 5 mol% yttria‐stabilized zirconia (5Y‐Z), or lithium disilicate crowns affected their fracture load.

Materials and Methods

Crowns with 0.8 mm uniform thickness (96, n = 8/group) were milled of 3Y‐PSZ (Lava Plus), 5Y‐Z (Lava Esthetic), or lithium disilicate (e.max CAD) and sintered/crystallized. Half the crowns were either particle‐abraded with 30 µm alumina (zirconias) or etched with 5% hydrofluoric acid (lithium disilicate), and the other half received no surface treatment. Half the crowns from each group were luted with resin‐modified glass ionomer (RMGI, RelyX Luting Plus) and half were luted with a resin cement (RelyX Unicem 2) to resin composite dies. Crowns were load cycled (100,000 cycles, 100 N force, 24°C water) and then loaded with a steel indenter until failure. A three‐way ANOVA examined the effects of material, cement, and surface treatment on fracture load. Post‐hoc comparisons were performed with the Tukey‐Krammer method.

Results

Fracture load was signficiantly different for materials and cements (p < 0.0001) but not surface treatments (p = 0.77). All lithium disilicate crowns luted with RMGI failed in fatigue loading cycling; 3Y‐PSZ and 5Y‐Z crowns luted with resin showed a higher fracture load compared with RMGI (p < 0.001). With resin cement, there was no signficant difference in fracture load between 5Y‐Z and lithium disiliciate (p = 1) whereas 3Y‐PSZ had a higher fracture load (p < 0.0001).

Conclusions

Cement type affected fracture load of crowns but surface treatment did not. The 0.8 mm uniform thick crowns tested benefited from using resin cement regardless of type of ceramic material. Crowns fabricated from 5Y‐Z may be particle‐abraded if luted with resin cement.
Imperforate hymen: Retrospective review from a single tertiary centre of presenting symptoms and diagnostic process
Authors: Lazanyi Mikhaila , Grover Sonia R
Published: May 2019

Aim

To review presentations, diagnostic processes and time to diagnosis of presentations of imperforate hymen at one tertiary paediatric hospital over a 10‐year period. The aim was to improve knowledge, enable targeted education and reduce unnecessary tests and diagnostic delay for this congenital obstructive disorder of the female reproductive tract.

Methods

A pragmatic, retrospective, observational study was conducted of all female patients, aged younger than or equal to 18 years of age, presenting to the Royal Children's Hospital, Melbourne, over an 18‐year period. Presenting symptom(s), time to diagnosis, investigations ordered and number of health‐care professionals consulted prior to diagnosis were recorded.

Results

A total of 27 patients met eligibility criteria, and 85% presented with pain (23/27). Pain was frequently associated with other symptoms (15/23). Over three quarters of patients consulted more than one health‐care professional prior to diagnosis (22/27). Of the 27 patients, 19 had imaging undertaken prior to diagnosis.

Conclusions

Paediatric and adolescent females managed at our tertiary paediatric hospital are experiencing diagnostic uncertainty and the unnecessary ordering of imaging prior to a diagnosis of imperforate hymen. Targeted education is recommended to health professionals managing female paediatric and adolescent patients.
Impact of paediatric tonsillectomy perioperative management on pain, nausea and recovery: A prospective cohort study
Authors: Richards Julianne , Lang Mary , Andresen Elizabeth , O'Leary Kathryn , Jauncey‐Cooke Jacqueline , Anderson Nicole , Burns Hannah , Slee Nicola , Ullman Amanda J , Cooke Marie
Published: May 2019

Aim

Tonsillectomy procedures are a core element of paediatrics; however, perioperative management differs. This study aimed to describe tonsillectomy management, including the burden of pain, nausea and delayed recovery.

Methods

A prospective cohort study was undertaken through an audit of tonsillectomy perioperative practice and recovery and survey interviews with family members 7–14 days post‐surgery. The study was undertaken at an Australian tertiary referral paediatric hospital between June and September 2016.

Results

The audit included 255 children undergoing tonsillectomy, with 127 family members interviewed. Most participants underwent adenotonsillectomy (n = 216; 85%), with a primary diagnosis of obstructive sleep apnoea (n = 205; 80%) and a mean age of 7 years (standard deviation; 3.9). A variety of intra‐operative pain relief and antiemetics was administered. Pain was present in 29% (n = 26) of participants at ward return, increasing to 32–45% at 4–20 h and decreasing to 21% (n = 15) at discharge. A third of the children (32%; n = 41) had moderate to severe pain at post‐discharge interview, and 30% (n = 38) experienced nausea at home. Most parents (82%; n = 104) were still giving regular paracetamol at 7 days post‐operatively, and 31% (n = 39) had finished their oxycodone. Of the participants, 14% (n = 26) presented to the emergency department within 7 days of discharge; 8% (n = 20) of the total cohort were re‐admitted.

Conclusions

There was variety in perioperative and post‐discharge care. Pain scores were infrequently documented post‐tonsillectomy, and parents are generally dissatisfied with the management of post‐operative pain and nausea. Further research is needed to provide a more consistent approach to perioperative management to promote recovery.
Exploring the associations between shift work disorder, depression, anxiety and sick leave taken amongst nurses
Authors: Booker Lauren A. , Sletten Tracey L. , Alvaro Pasquale K. , Barnes Maree , Collins Allison , Chai‐Coetzer Ching Li , Naqvi Aqsa , McMahon Marcus , Lockley Steven W. , Rajaratnam Shantha M. W. , Howard Mark E.
Published: May 2019

This study aimed to evaluate the association between shift work disorder and mental health in hospital‐based nurses. Staff completed an online survey comprising demographic questions, the Shift Work Disorder Questionnaire, Patient Health‐9 and the General Anxiety Disorder‐7 scale. Sick leave data were collected from archival records from the Human Resources Department. Two hundred and two nurses (95% female; age M = 35.28 years ± SD = 12) participated (42% of eligible staff). Those at high risk of shift work disorder had higher depression (M = 7.54 ± SD = 4.28 vs. M = 3.78 ± SD = 3.24; p < 0.001) and anxiety (M = 5.66 ± SD = 3.82 vs. M = 2.83 ± SD = 3.33, p < 0.001) compared to those at low risk. Linear regression models showed that being at high risk of shift work disorder was the most significant predictor of depression, explaining 18.8% of the variance in depression (R2 = 0.188, adjusted R2 = 0.184, F(1, 200) = 46.20, p < 0.001). Shift work disorder combined with the number of night shifts and alcoholic drinks on non‐work days accounted for 49.7% of the variance in anxiety scores (R2 = 0.497, adjusted R2 = 0.453, F(3, 35) = 11.51, p < 0.001). Mean sick leave in those with high risk of shift work disorder was 136.17 hr (SD = 113.11) versus 103.98 hr (SD = 94.46) in others (p = 0.057). Depression and years of shift work accounted for 18.9% of the variance in sick leave taken (R2 = 0.189, adjusted R2 = 0.180, F(2, 175) = 20.36, p < 0.001). Shift work disorder is strongly associated with depression and anxiety, providing a potential target to improve mental health in shift workers. Depression, in turn, is a significant contributing factor to sick leave.
Effectiveness of the spaced education pedagogy for clinicians’ continuing professional development: a systematic review
Authors: Phillips Jane L , Heneka Nicole , Bhattarai Priyanka , Fraser Claire , Shaw Tim
Published: May 2019

Context

Ensuring clinical practice reflects current evidence is challenging given the rapid proliferation of new knowledge. Changing entrenched clinical behaviours and facilitating the adoption of best practice evidence requires a range of strategies, including affordable, scalable and effective continuing professional development (CPD). Yet, identifying the CPD delivery method most likely to effectively change and improve patient outcomes is difficult given the variability in the evidence for different learning approaches. Although there is moderate level evidence for outreach education, audit and feedback, and face‐to‐face or online learning, little is known about the capacity of spaced education to change ineffective clinical practice(s). Spaced education harnesses the power of spacing, repetition and testing learning content to increase topic‐specific knowledge. Although spaced education is widely used in undergraduate and postgraduate medical programmes, its effectiveness as a CPD delivery method that improves patient outcomes is less certain.

Aim

To determine the effectiveness of the spaced education CPD programmes to change targeted clinical knowledge and practice(s) to improve patient outcomes.

Method

A systematic review, appraising the spaced education CPD evidence generated from searching six specialist medical and psychosocial databases. Studies published in English peer‐reviewed journals from 1 January, 2000 to 31 August, 2018 were eligible for inclusion. A modified Kirkpatrick four levels of evaluation framework assisted with appraising the effect of spaced education CPD interventions on clinicians and patients.

Results

Of the 2396 studies identified, 17 met the inclusion criteria, involving 2701 practising clinicians from multiple disciplines and specialties. Five randomised controlled trials generated level II evidence, with the remaining 12 studies generating lower levels of evidence. The majority of studies (n = 14) involved the delivery of online spaced education. All studies were evaluated using the modified Kirkpatrick four levels of evaluation framework with: 10 studies demonstrating significant increases in participants’ knowledge; seven studies reporting significant changes in clinician behaviour; four studies showing significant increases in clinician confidence; and three studies identifying significant and sustained increases in participants’ clinical skills. Only two studies reported positive improvements in patient outcomes.

Conclusion

Spaced education via an online platform offers a scalable CPD format that can increase clinical knowledge and change practice. However, further adequately powered randomised controlled trials are required to confirm that spaced education CPD can impact positively on patients’ reported outcomes.
Posaconazole therapeutic drug monitoring in clinical practice and longitudinal analysis of the effect of routine laboratory measurements on posaconazole concentrations
Authors: Märtson Anne‐Grete , Veringa Anette , van den Heuvel Edwin R. , Bakker Martijn , Touw Daan J. , van der Werf Tjip S. , Span Lambert F. R. , Alffenaar Jan‐Willem C.
Published: May 2019

Posaconazole is indicated for prophylaxis and treatment of invasive aspergillosis. Therapeutic drug monitoring (TDM) of posaconazole is used to optimise drug exposure. The aim of this study was to analyse and describe the TDM practices and exposure of posaconazole tablets. Patients who received posaconazole for treatment or prophylaxis of fungal infections were included in the study. The following therapeutic window was defined: if concentration was low (<0.7 mg/L for prophylaxis or < 1.5 mg/L for treatment) or high (>3.75 mg/L), the hospital pharmacist provided the physician with dosage advice, which implementation to patient care was analysed. A longitudinal analysis was performed to analyse if different confounding variables had an effect on posaconazole concentrations. Forty‐seven patients were enrolled resulting in 217 posaconazole trough concentrations. A median of 3 (IQR 1‐7) samples was measured per patient. The median concentration was 1.7 mg/L (IQR 0.8‐2.7) for prophylaxis and 1.76 mg/L (IQR 1.3‐2.3) for treatment. Overall, 78 posaconazole concentrations were out of the therapeutic window. For 45 (54%) of these concentrations, a dosage change was recommended. In the longitudinal analysis, the laboratory markers and patient baseline variables did not have an effect on posaconazole concentrations. Adequate posaconazole exposure was shown in 64% (affected 28 patients) of the measured concentrations. TDM practice of posaconazole can be improved by increasing the implementation rate of dose recommendation by a multidisciplinary antifungal stewardship team.