bluuebunny/crossref_metadata_2025 huggingface dataset:
Interfacial and emulsifying properties of whey protein concentrate by ultrafiltration
Authors: Kilian Josiane , Aparecida Fernandes Ilizandra , Luize Lupatini Menegotto Anne , Steffens Clarice , Abirached Cecilia , Steffens Juliana , Valduga Eunice
Published: April 2020

The aim of this study was to concentrate whey protein by ultrafiltration process, evaluating the pressure at 1–3 bar and temperature of 10–20℃. In the conditions that show the more protein concentration were evaluated the interfacial and emulsifying properties at pH 5.7 and 7.0. The whey concentrate at 10℃ and 1.5 bar showed the higher protein value 36% (w/w), with soluble protein of 33.82% (solubility of 93.94%) for pH 5.7 and 34% (solubility of 94.4%) for pH 7.0, respectively. The whey concentrate powder present particle size distribution between 0.4-110 um. The whey at pH 5.7 and 7.0 was not observed significant differences in the resistance parameters of the oil/water layer interface. The interfacial film formed by the proteins presented an essentially elastic behavior in both pH, and in pH 5.7 the emulsion was more stable with lower diameter droplets. The concentrate whey showed techno-functional properties (emulsification and solubility), which allow the use as ingredients in products of industrial interest in food products such as mayonnaise, ice cream, sauces, and others.
Dirofilarioses in cats: European guidelines from the ABCD on prevention and management
Authors: Pennisi Maria Grazia , Tasker Séverine , Hartmann Katrin , Belák Sándor , Addie Diane , Boucraut-Baralon Corine , Egberink Herman , Frymus Tadeusz , Hofmann-Lehmann Regina , Hosie Margaret , Lloret Albert , Marsilio Fulvio , Thiry Etienne , Truyen Uwe , Möstl Karin
Published: April 2020

Overview:

Dirofilaria immitis and Dirofilaria repens are the most important filarial worms, causing heartworm disease and subcutaneous dirofilariosis, respectively. D repens is currently considered an emerging zoonotic agent in Europe.

Life cycle and infection:

Filarial worms infect mainly dogs, but also cats, ferrets, wild carnivores and humans. The life cycle involves an intermediate mosquito host. Compared with dogs, cats are imperfect hosts for dirofilarial worms. After inoculation, only a low number of L3 larvae develop to the adult stage in a small percentage of cats. Heartworm disease in cats may be associated with severe pulmonary thromboembolism and an eosinophilic inflammatory response in the lungs, potentially leading to sudden death. Otherwise self-cure occurs in most cases after 18–48 months. Subcutaneous dirofilariosis may present as subcutaneous nodules or dermatitis.

Diagnosis and treatment:

Diagnosis in cats is more difficult compared with dogs and needs a multistep approach (antigen and antibody tests, as well as diagnostic imaging). Cats with acute heartworm disease require stabilisation within an intensive care unit. Cats with respiratory signs or suggestive radiographic changes should receive prednisolone and follow-up with a similar multistep approach. Adulticidal therapy is not safe in cats.

Prevention:

In endemic areas cats should receive year-round chemoprophylaxis from 2 months of age.
Evidence-informed health care policy and practice: using record linkage to uncover new knowledge
Authors: Mitchell Rebecca , Braithwaite Jeffrey
Published: April 2020

Record linkage of health data has been beneficial to inform the design, delivery and evaluation of health care practices, and to improve the quality of clinical care and patient outcomes. We discuss some of the key strengths and limitations of using record linkage as the basis of an evidentiary approach for improved health services, and for conducting health services research. We illustrate the benefits of linking information from disparate administrative data collections, uncovering new knowledge, and influencing health policy or clinical practice, or both. Continued advancement of data methods and models, infrastructure to support research, and, above all, making administrative data accessible, will help ensure more effective delivery of health care services.
Enriching evaluation practice through care ethics
Authors: Abma Tineke A. , Visse Merel , Hanberger Anders , Simons Helen , Greene Jennifer C.
Published: April 2020

Recently, several authors have called for a critical assessment of the normative dimensions of evaluation practice. This article responds to this call by demonstrating how evaluation practice can be enriched through deliberate engagement with care ethics. Care ethics has a relational and practice view of morality and places caring relationships and responsibilities at the forefront of our being in the world. We will demonstrate how care ethics, in particular Joan Tronto’s moral-political theory of democratic caring, can help evaluators to reshape our way of working by placing caring and relationality at the centre of our evaluative work. Care ethics as a normative orientation for evaluation stretches beyond professional codes of conduct, and rule- or principled-based behaviour. It is part of everything we do or not do, how we interact with others, and what kinds of relationships we forge in our practice. This is illustrated with two examples: a democratic evaluation of a programme for refugee children in Sweden; and a responsive evaluation of a programme for neighbours of people with an intellectual disability in The Netherlands. Both examples show that a caring ethos offers a promising pathway to address the larger political, public issues of our times through the interrogation of un-caring practices. We conclude a caring ethos can help evaluators to strengthen a caring society that builds on people’s deeply felt need to care, to relate, and to connect within and across communities.
Increasing the transparency, openness and replicability of psychological research: Mandatory data sharing for empirical studies in the Journal of Health Psychology
Authors: Marks David F
Published: April 2020

This editorial announces this journal’s policy on transparency, openness and replication. From 1 July 2020, authors of manuscripts submitted to Journal of Health Psychology (JHP) are required to make the raw data fully accessible to all readers. JHP will only consider manuscripts which follow an open publication model defined as follows: M = Mandatory, I = Inclusion (of), R = Raw, D = Data (MIRD). All data and analytical procedures must be sufficiently well described to enable a third party with the appropriate expertise to replicate the data analyses. It is expected that findings and analyses in the JHP will be fully capable of being accurately reproduced.
A qualitative study on perspective of parents of children with autism on the nature of parent–professional relationship in Kerala, India
Authors: Ramachandran Rajani
Published: April 2020

This study explored the nature of relationship between parents of children with autism and professionals who provide therapy-based service for autism in Kerala, India. Thematic analysis of semi-structured interview with 21 parents of children with autism whose age ranged between 5.8 and 17.3 years helped identify three themes related to the nature of parent–professional relationship—information, responsibility, and personal growth. There was a dearth of scheduled, in-depth, and personalized one-on-one interaction between the parent and the professional. Though parents were involved hands on in their child’s training under professional direction, they remained mere information providers in decision making. The parent–professional relationship did not nurture parent’s self efficacy. This led to parents feeling inadequate to provide for their child’s developmental needs and being apprehensive about adulthood. The customary nature of parent–professional relationship observed may be a reflection of the collectivist culture in India. The need for parent-mediated interventions and for it to focus on enabling parents to break cultural barriers that might be holding them back from partnering with professionals on equal terms is discussed.

Lay Abstract

This study explored the nature of relationship between parents of children with autism and professionals who provide therapy-based services for autism in Kerala, India. Given the shortage of professionally qualified therapists and educators (particularly in the case of autism) in low- and medium-income countries, parent-mediated interventions where professionals and parents work as partners are recommended as an effective means to meet the demand. However, for parent-mediated interventions to be effective, we first need to understand the customary nature of parent–professional relationship and develop the intervention accordingly. It is within this context that parents of 21 children with autism whose age ranged between 5.8 and 17.3 years were interviewed in order to understand the customary nature of parent–professional relationship. There was a dearth of scheduled, in-depth, and personalized one-on-one interaction between the parent and the professional. Though parents were involved hands on in their child’s training under professional direction, they remained mere information providers in decision making. The parent–professional relationship did not nurture parent’s self efficacy. This led to parents feeling inadequate to provide for their child’s developmental needs and being apprehensive about adulthood. The customary nature of parent–professional relationship observed may be a reflection of the collectivist culture in India. The findings suggest that parent-mediated interventions will need to focus on enabling parents to break cultural barriers that might be holding them back from partnering with professionals as equals.
Racial profiling in the racial welfare state: Examining the order of policing in the Nordic region
Authors: Schclarek Mulinari Leandro , Keskinen Suvi
Published: April 2020

This article builds on two interview studies on racial profiling conducted in Finland and Sweden. It examines policing practices in order to elaborate on the understanding of what we define as the ‘racial welfare state’. The analysis draws attention to the ways that bordering practices reproduce racial orders, within and beyond the nation-state. The embeddedness of the Nordic region in the western sphere, with its colonial legacies, is highlighted through the empirical material that focuses on the consequences of internal and external migration controls, as well as more general police stop-and-search practices. The study underlines the need to investigate racial profiling as a practice that enforces an imagined community based not on whiteness in general, but on Nordic whiteness in particular as the norm against which the bodies of ‘others’ are measured.
Determination of cost-efficient cooling power range for improving the performance of internally cooled ultrasonic atomization liquid desiccant dehumidifiers
Authors: Yang Zili , Chen Lu-An , Tao Ruiyang , Zhong Ke
Published: April 2020

Liquid desiccant dehumidifiers (LDDs) can be improved by adding internal cooling. However, the addition of excessive cooling power may deteriorate the system‘s cost-efficiency, whereas the addition of insufficient cooling power leads to negligible performance improvements. The objective of this study is to determine the suitable cost-efficient cooling power range for improving the performance of internally cooled LDDs (IC-LDDs). A novel method and a set of criteria related to the moisture removal rate, cooling-power efficiency ( ηc) and coefficient of dehumidification performance from cooling power ( DCOPcooling) were proposed to determine cost-efficient cooling power. The internally cooled ultrasonic atomization liquid desiccant system (IC-UADS), together with a well-validated model based on the conservation laws of mass and energy and the sensible heat balance, was adopted to demonstrate the analysis. The results showed that, although the dehumidification performance improves with increasing cooling power, the improvement rate decreases, while ηcand DCOPcoolingdecline quickly (by 87.9%). For cost-efficient improvement, the necessary power proportion of internal cooling to the system‘s target dehumidification capacity tends to be stable, which was about 29% for the IC-UADS, and independent of the operating conditions. The results may help to determine the reasonable cooling power range for cost-efficient improvement of IC-LDDs.
Police science as an emerging scientific discipline
Authors: Nägel Christof , Vera Antonio
Published: April 2020

This article examines the epistemological and institutional configuration of police science. Our results indicate that although police science fulfills the epistemological prerequisites for a scientific discipline, the corresponding institutionalization, which is a necessary condition of its consolidation, has taken place only partially and in a few Western countries. Institutional establishment of police science fails primarily because of the lack of a collective definition of the field, but also because of deficits in the density of interorganizational contacts and the flow of information. This has several theoretical, but also practical implications, mainly on the issue of institutional legitimacy, which are discussed at the end of this article.
The impact of driving cessation for people with dementia – An integrative review
Authors: Holden Alison , Pusey Helen
Published: April 2020

At the point of diagnosis of dementia many people will be driving and go on to experience the significant life transition from driver to non-driver. Driving plays an important role in society enhancing independence, quality of life and general health and well-being. Hence cessation from driving can be a very difficult life transition to make. The aim of this integrative review was to summarise what is known about the impact and experience for people with dementia and their carers in the ‘post-cessation’ phase of retiring from driving. Thematic analysis utilised themes identified in previous life transition research focusing on driving cessation and these included processes, influences, emotions, roles and programmes. Analysis revealed a lack of formal processes to follow in surrendering one’s licence and that the medical professions and multi-disciplinary teams should take more responsibility for the legal processes of driving cessation and supporting individuals at the point of and following this disclosure. People with dementia and their carers experience a significant impact upon their life roles and considerable emotional and psychological consequences. The review also suggested that there are a variety of influences affecting the life transition period from driver to non-driver such as family support and access to alternative forms of transport and that there is a need for development for interventions/programmes to support individuals with dementia post-driving cessation.
Social interactions of persons with dementia living in special care units in long-term care: A mixed-methods systematic review
Authors: Adlbrecht Laura , Bartholomeyczik Sabine , Hildebrandt Christiane , Mayer Hanna
Published: April 2020

Background

Special care units are a well-utilized approach in the long-term care for persons with dementia. A therapeutic goal of such settings is to provide meaningful engagement and a sense of community that is crucial for the overall quality of life. In recent years, several studies followed this notion by investigating residents’ social interactions and the influence of the environment on these interactions.

Aims

This review aims to synthesize the literature on the social interactions of persons with dementia living in special care units.

Design

A mixed-methods systematic review was conducted.

Methods

Literature was searched in PubMed, CINAHL, PsycINFO, the Cochrane Library and Web of Science databases. Additionally, reference lists of relevant articles were searched. Studies were screened, data were extracted and the quality was appraised. Separate syntheses were conducted for qualitative and quantitative studies, which were subsequently merged in the final mixed-methods synthesis.

Results

In total, 18 articles were included, investigating large-scale, small-scale and homelike special care units and green care farms. Residents in special care units experience few social interactions but more than those in the comparative groups. Opportunities to interact are only marginally seized. Interactions typically occur in small groups and are facilitated by familiarity and the organizational environment. Residents mainly rely on staff members to create social interaction, for example initiating or facilitating resident-to-resident interaction.

Conclusion

Although the evidence base is increasing, it is still fragmented and built on different concepts, interventions, control groups and measurements. Nevertheless, the first conclusions suggest a positive impact of special care units on residents’ social interactions. Although the review yielded a more comprehensive picture of residents’ social life, further high-quality research built on a sound theoretical background is needed.
Acceptability and feasibility of a Japanese version of STrAtegies for RelaTives (START-J): A manualized coping strategy program for family caregivers of relatives living with dementia
Authors: Kashimura Masami , Rapaport Penny , Nomura Toshiaki , Ishiwata Akiko , Tateno Amane , Nogami Akane , Yamashita Mari , Kawanishi Tomoya , Kawashima Yoshitaka , Kitamura Shin , Livingston Gill
Published: April 2020

The rising older population in Japan is associated with a rise in cases of dementia. Support for the increased number of family caregivers of people living with dementia is crucial, as caring may negatively affect a family caregiver’s health. This study seeks to evaluate the feasibility and applicability of a recently developed Japanese version of START (STrAtegies for RelaTives). START is a psychosocial coping intervention program developed in the United Kingdom that has been shown to improve caregivers’ mood and quality of life in a randomized controlled trial. We made changes to START (e.g., idioms, linguistic nuance, and providing care insurance information suited for Japan) to make it culturally appropriate. Fourteen Japanese female family caregivers of relatives with mild dementia (n = 10) or mild cognitive impairment (n = 4) were referred to the study, but six were excluded owing to illness and busyness. This single-arm study had a before–after trial evaluating psychological outcomes including depression, anxiety, quality of life, and subjective care burden. The acceptance retention and satisfaction rate suggest the feasibility and acceptability of the START program; 8/14 (>55%) eligible, prospective participants consented and were included in this study, all (8/8) of whom completed all START sessions. The mean program satisfaction score was 30.25 (standard deviation = 2.25) out of a potential 32. The results suggest that it is feasible and acceptable to deliver START in Japanese and based on the results of analysis using a linear mixed model, there is initial indication that the intervention improved family caregivers’ quality of life, depressive symptoms, and care burden.
Development and characterization of thermoset nanocomposites reinforced with cotton fibres recovered from textile waste
Authors: Kamble Zunjarrao , Behera Bijoya Kumar , Kimura Teruo , Haruhiro Ino
Published: April 2020

The present research reports thermoset nanocomposites reinforced with cotton fibres extracted from textile waste called as ‘shoddy’ and graphite oxide nanoparticles as filler. The oriented fibre web of shoddy was produced by using the carding machine and it was used as reinforcement. The thermoset epoxy composites with four different fibre volume fraction values namely 0.1, 0.2, 0.3 and 0.4 were developed. These composites were characterized by mechanical properties to optimize the fibre volume fraction. Further, thermoset epoxy nanocomposites were developed by incorporating graphite oxide nanoparticles as filler in four different weight percentages, namely 0.1, 0.3, 0.5 and 1%. All the composites were characterized for mechanical properties, dynamic mechanical properties, thermal degradation behaviour and water absorption behaviour. It has been found that the developed composites can be used in items of furniture materials and to develop some visible and non-visible automotive components.
Low-Dose Image-Guided Pediatric CNS Radiation Therapy: Final Analysis From a Prospective Low-Dose Cone-Beam CT Protocol From a Multinational Pediatrics Consortium
Authors: Alcorn Sara R. , Zhou Xian Chiong , Bojechko Casey , Rubo Rodrigo A. , Chen Michael J. , Dieckmann Karin , Ermoian Ralph P. , Ford Eric C. , Kobyzeva Daria , MacDonald Shannon M. , McNutt Todd R. , Nechesnyuk Alexey , Nilsson Kristina , Sjostrand Hakan , Smith Koren S. , Stock Markus , Tryggestad Erik J. , Villar Rosangela C. , Winey Brian A. , Terezakis Stephanie A.
Published: April 2020

Background:

Lower-dose cone-beam computed tomography protocols for image-guided radiotherapy may permit target localization while minimizing radiation exposure. We prospectively evaluated a lower-dose cone-beam protocol for central nervous system image-guided radiotherapy across a multinational pediatrics consortium.

Methods:

Seven institutions prospectively employed a lower-dose cone-beam computed tomography central nervous system protocol (weighted average dose 0.7 mGy) for patients ≤21 years. Treatment table shifts between setup with surface lasers versus cone-beam computed tomography were used to approximate setup accuracy, and vector magnitudes for these shifts were calculated. Setup group mean, interpatient, interinstitution, and random error were estimated, and clinical factors were compared by mixed linear modeling.

Results:

Among 96 patients, with 2179 pretreatment cone-beam computed tomography acquisitions, median age was 9 years (1-20). Setup parameters were 3.13, 3.02, 1.64, and 1.48 mm for vector magnitude group mean, interpatient, interinstitution, and random error, respectively. On multivariable analysis, there were no significant differences in mean vector magnitude by age, gender, performance status, target location, extent of resection, chemotherapy, or steroid or anesthesia use. Providers rated >99% of images as adequate or better for target localization.

Conclusions:

A lower-dose cone-beam computed tomography protocol demonstrated table shift vector magnitude that approximate clinical target volume/planning target volume expansions used in central nervous system radiotherapy. There were no significant clinical predictors of setup accuracy identified, supporting use of this lower-dose cone-beam computed tomography protocol across a diverse pediatric population with brain tumors.
Spatio-temporal voxel layer: A view on robot perception for the dynamic world
Authors: Macenski Steve , Tsai David , Feinberg Max
Published: April 2020

The spatio-temporal voxel grid is an actively maintained open-source project providing an improved three-dimensional environmental representation that has been garnering increased adoption in large, dynamic, and complex environments. We provide a voxel grid and the Costmap 2-D layer plug-in, Spatio-Temporal Voxel Layer, powered by a real-time sparse occupancy grid with constant time access to voxels which does not scale with the environment’s size. We replace ray-casting with a new clearing technique we dub frustum acceleration that does not assume a static environment and in practice, represents moving environments better. Our method operates at nearly 400% less CPU load on average while processing 9 QVGA resolution depth cameras as compared to the voxel layer. This technique also supports sensors such as three-dimensional laser scanners, radars, and additional modern sensors that were previously unsupported in the available ROS Navigation framework that has become staples in the roboticists’ toolbox. These sensors are becoming more widely used in robotics as sensor prices are driven down and mobile compute capabilities improve. The Spatio-Temporal Voxel Layer was developed in the open with community feedback over its development life cycle and continues to have additional features and capabilities added by the community. As of February 2019, the Spatio-Temporal Voxel Layer is being used on over 600 robots worldwide in warehouses, factories, hospitals, hotels, stores, and libraries. The open-source software can be viewed and installed on its GitHub page at https://github.com/SteveMacenski/spatio_temporal_voxel_layer .
Accomplishing leadership-in-interaction by mobilizing available information and communication technology objects in a virtual context
Authors: Arvedsen Lise D , Hassert Liv O
Published: April 2020

Leadership-in-interaction is a somewhat underdeveloped area of research which to date has concentrated on talk-in-interaction to the detriment of other modalities. Consequently, this paper seeks to illustrate how social actors make use of different modalities to accomplish leadership, which we conceptualize as the creation of direction, alignment, and commitment. Through multimodal conversation analysis this paper explores interactions between actors in virtual contexts, a particularly interesting empirical setting as the context offers specific constraints on everyday workplace interaction. By zooming in on the interaction using transcripts of naturally occurring interaction, we find that the accomplishment of leadership, direction, alignment, and commitment, in a constrained virtual context can appear mundane. However, at the same time the accomplishment of leadership calls for the mobilization of several multimodal resources (both talk and information and communication technology objects). The analysis makes it evident that the actors mobilize objects to draw on their situated affordances, in the accomplishment of direction, alignment, and commitment. With a fine-grained analysis of naturally occurring data, we illustrate that leadership is a collective achievement. We also expand the understanding of leadership in practice, especially in virtual contexts, by demonstrating how actors utilize objects and verbal resources in the co-production of leadership.
Group II metabotropic glutamate receptor expressing neurons in anterior cingulate cortex become sensitized after inflammatory and neuropathic pain
Authors: Chen Sisi , Kadakia Feni , Davidson Steve
Published: April 2020

The anterior cingulate cortex is a limbic region associated with the emotional processing of pain. How neuropathic and inflammatory pain models alter the neurophysiology of specific subsets of neurons in the anterior cingulate cortex remains incompletely understood. Here, we used a GRM2Cre:tdtomato reporter mouse line to identify a population of pyramidal neurons selectively localized to layer II/III of the murine anterior cingulate cortex. GRM2encodes the group II metabotropic glutamate receptor subtype 2 which possesses analgesic properties in mouse and human models, although its function in the anterior cingulate cortex is not known. The majority of GRM2-tdtomato anterior cingulate cortex neurons expressed GRM2gene product in situ but did not overlap with cortical markers of local inhibitory interneurons, parvalbumin or somatostatin. Physiological properties of GRM2-tdtomato anterior cingulate cortex neurons were investigated using whole-cell patch clamp techniques in slice from animals with neuropathic or inflammatory pain, and controls. After hind-paw injection of Complete Freund’s Adjuvant or chronic constriction injury, GRM2-tdtomato anterior cingulate cortex neurons exhibited enhanced excitability as measured by an increase in the number of evoked action potentials and a decreased rheobase. This hyperexcitability was reversed pharmacologically by bath application of the metabotropic glutamate receptor subtype 2 agonist (2R, 4R)-4-Aminopyrrolidine-2,4-dicarboxylate APDC (1 µM) in both inflammatory and neuropathic models. We conclude that layer II/III pyramidal GRM2-tdtomato anterior cingulate cortex neurons express functional group II metabotropic glutamate receptors and undergo changes to membrane biophysical properties under conditions of inflammatory and neuropathic pain.
Does the use of periarticular anesthetic cocktail provide adequate pain control following shoulder arthroplasty?
Authors: Klag Elizabeth A , Okoroha Kelechi R , Kuhlmann Noah A , Sheena Gabriel , Chen Chaoyang , Muh Stephanie J
Published: April 2020

Background

Interscalene nerve block and liposomal bupivacaine have been found to provide adequate pain control following shoulder arthroplasty. We hypothesized that local infiltration of a periarticular cocktail would provide equivalent pain control compared to interscalene nerve block and liposomal bupivacaine.

Methods

Eighty-seven patients undergoing primary shoulder arthroplasty were treated with local infiltration of a periarticular cocktail (200 mg of 0.5% ropivacaine, 1 mg epinephrine, and 30 mg ketorolac), local infiltration of liposomal bupivacaine, or preoperative interscalene nerve block. The outcomes of the study were postoperative visual analog scale scores, opioid consumption, length of stay, and complications.

Results

A total of 30 patients receiving local infiltration of a periarticular cocktail, 26 receiving liposomal bupivacaine, and 31 receiving interscalene nerve block were included in the study. Patients who received local infiltration of a periarticular cocktail had a significantly lower mean visual analog scale when compared to interscalene nerve block and liposomal bupivacaine on postoperative day 0 (2.5 versus 4.0 versus 4.8, P = 0.001 and P < 0.001). Pain scores between postoperative day 0–3 were lower in patients who received local infiltration of a periarticular cocktail, but not significantly. Patients who received local infiltration of a periarticular cocktail required significantly less opioids than the interscalene nerve block group on postoperative day 0 ( P < 0.001).

Discussion

A decrease in early postoperative pain and opioid consumption was found with local infiltration of a periarticular cocktail when compared with interscalene nerve block and liposomal bupivacaine after shoulder arthroplasty. Level of evidence: Level II
The Real-World Impact of Artificial Intelligence on Diabetic Retinopathy Screening in Primary Care
Authors: Cuadros Jorge
Published: April 2020

The study by Shah et al published in this issue of the Journal of Diabetes Science and Technology validates the IDx autonomous diabetic retinopathy (DR) screening program in a real-world setting. The study found high sensitivity (100%) but low specificity (82%) for referable DR. The resulting positive predictive value of 19% means that four out of five patients without referable DR would be referred to ophthalmology causing a significant burden to ophthalmologists, primary care clinics, and patients. Artificial intelligence programs that provide better specificity, multiple levels of DR, and annotations of where lesions are located in the retina may function better than a simple referral/no referral output. This will allow for better engagement of patients through the difficult process of adhering to treatment recommendations and control their diabetes.
Effective Compounds From Caesalpinia sappan L. on the Tyrosinase In Vitro and In Vivo
Authors: Niu Yun , Wang Shengfeng , Li Changqin , Wang Jinmei , Liu Zhenhua , Kang Wenyi
Published: April 2020

Caesalpinia sappan L. has been used as an herbal medicine to treat skin damage as a facial cleanser. In this study, 8 known compounds (1-8), (3 R,4 S)-3-(3′,4′-hydroxybenzyl)-3,4-dihydro-2″,3″-dimethyl-3 H-[1,3]dioxolo [4,5-c]chromen-7-ol (1), brazilin (2), protosappanin A (3), protosappanin C (4), protosappanin B (5), caesalpin J (6), sappanone B (7), and sappanchalcone (8), were isolated from the 70% ethanol extract of C. sappan. The effects of 8 compounds and extracts of C. sappan on tyrosinase were assayed in vitro and in vivo. The results indicated that compounds 1, 2, 4, and 7 had activating effects on the tyrosinase. The experiments of enzyme kinetics showed that compounds 3 and 6 were competitive inhibitors on tyrosinase, while compound 6 was anticompetitive inhibitor. The 70% ethanol extract of C. sappan could reduce the contents of tyrosinase in rat serum, ie, the 70% ethanol extracts of C. sappan could inhibit the formation of melanin in vivo. Compounds 2, 3, 5, and 6 promoted the formation of tyrosinase in rat serum, while compound 7 inhibited the synthesis of tyrosinase in rat serum.
The entrepreneurial lie of the land
Authors: Phelps Nicholas A , Miao Julie T
Published: April 2020

Our original piece has a stronger focus on the economic than the political or governance issues implicated in urban entrepreneurialism. Ultimately, it is also more focused on an interest in land and land value capture than the financialization that might be thought to be consequent upon them. Without denying an element of relationality in urban entrepreneurial affairs, it is also conservative in its ostensibly scalar reading of urban entrepreneurialism. If these are criticisms that can be levelled at our piece, they also raise as many questions as they answer.
Endoscopic treatment with transmural drainage and necrosectomy for walled‐off necrosis provides favourable long‐term outcomes on pancreatic function
Authors: Bartholdy Andreas , Werge Mikkel , Novovic Srdan , Hadi Amer , Nøjgaard Camilla , Borch Anders , Feldager Erik , Gluud Lise Lotte , Schmidt Palle Nordblad
Published: April 2020

Background and aims

Several studies have shown improved short‐term outcome with endoscopic transmural drainage and necrosectomy for the treatment of walled‐off pancreatic necrosis. However, knowledge on the long‐term prognosis after such treatment is limited. The aim of present study was to evaluate long‐term outcomes in patients endoscopically treated with transmural drainage and necrosectomy.

Methods

We retrospectively follow up 125 patients with walled‐off pancreatic necrosis treated with endoscopic transmural drainage and necrosectomy in 2010–2017. All patients received plastic pigtail stents and nasocystic catheter. Additional external drainage was performed in 41 patients. Main outcomes were survival, pancreatic function, development of co‐morbidities, ability to work and social status.

Results

During a median follow‐up of 4.3 years, nine (7%) patients died. Seven deaths were unrelated to pancreatic disease, and two patients died of pancreatic cancer. Twenty‐two (18%) patients developed exocrine pancreatic insufficiency. Thirty‐six (32%) previous non‐diabetics developed endocrine insufficiency. Endoscopic necrosectomy during admission (odds ratio (OR) = 1.28, 95% confidence interval (CI) 1.05–1.56; p  = 0.015) and therapy on the main pancreatic duct (OR = 8.08, 95% CI 2.43–26.9; p  < 0.001) during follow‐up predicted development of exocrine insufficiency. Severity on computed tomography predicted endocrine insufficiency (OR = 1.61, 95% CI 1.24–2.09; p  < 0.001). Most patients regained their working capacity and preserved their marital status.

Conclusions

This study provides robust data on the long‐term outcome of patients with walled‐off pancreatic necrosis treated with endoscopic transmural drainage and necrosectomy. The favourable outcomes on survival, pancreatic function and social status support current recommendations of endoscopic transmural drainage and necrosectomy being the treatment of choice for walled‐off pancreatic necrosis.
Adherence to Antiretroviral Therapy Among HIV-Positive Pregnant Women on followup at Mizan Tepi University Teaching and Tepi General Hospitals, Southwest Ethiopia
Authors: Aferu Temesgen , Doang Gatluak , Zewudie Ameha , Nigussie Tadesse
Published: April 2020

Background: The introduction of highly active antiretroviral therapy has not only improved longevity in human immunodeficiency virus (HIV)–infected individuals but in addition has had a significant impact on the rate of mother-to-child transmission of the infection. Objective: To assess antiretroviral therapy adherence among HIV-positive pregnant women on follow-up at antiretroviral therapy clinic of Mizan Tepi University Teaching and Tepi General Hospitals. Methods: A descriptive cross-sectional study was undertaken in antiretroviral therapy clinics of Mizan Tepi University Teaching and Tepi General Hospitals from April to May 2018. Data were collected through face to face interview using structured and pretested questionnaires and analyzed using Statistical Package for Social Sciences version 20. Results: Majority of the patients had good adherence to their antiretroviral therapy, 68 (66.00%). Medication side effects, 12 (34.00%) and forgetfulness and distance of the hospital from home, each accounting 11 (31.00%) were the main reasons for nonadherence among nonadherent patients. Frequency of counseling ( P = .000), CD4 count (χ2 = 37.529, P = .000), World Health Organization’s clinical stage (χ2 = 17.515, P = .000), stigma (χ2 = 70.426, P = .000), and family support (χ2 = 46.383, P = .000) were found to be associated with patients’ medication adherence. Conclusion: The overall patient adherence to antiretroviral therapy in the study facilities was good. Collaborative work among patients, health care organizations, and the public are necessary to tackle the adherence obstacles and enhance patient adherence to the prescribed medication.
Pelvic tilt after total hip arthroplasty in patients with osteoarthritis of the hip
Authors: Tateiwa Toshiyuki , Endo Kenji , Matsuoka Yuji , Ishida Tsunehito , Shishido Takaaki , Yamamoto Kengo
Published: April 2020

Background:

It is important to understand postoperative global sagittal spinal alignment after total hip arthroplasty (THA) to prevent not only the following hip complications but also progressing lumbar degeneration. The purpose of this study was to progress the analysis of the global sagittal spinal alignment between before and after THA in patients without large lower limbs discrepancy.

Subjects and methods:

The subjects were 87 patients with bilateral hip osteoarthritis (OA) before unilateral primary THA. We measured sagittal vertical axis (SVA), lumbar lordotic angle, sacral slope, pelvic tilt (PT), and pelvic incidence (PI) and compared the postoperative change of those parameters. Excluded criteria were Crowe classification types II, III, and IV and more than 10 mm of leg length difference, spinal scoliosis (Cobb angle > 25°), and lumbar kyphosis.

Results:

The correlation coefficient between preoperative factors and postoperative sagittal alignments revealed that postoperative SVA has correlation with age ( r = 0.46, p < 0.008) and preoperative PT ( r = 0.42, p = 0.015). Postoperative PT had a correlation with preoperative PI ( r = 0.46, p = 0.007). The change of PT after operation had negative correlation to preoperative PT ( r = −0.47, p < 0.01) and PI ( r = −0.38, p = 0.03). Multiple regression analysis revealed that the change of PT = 4.979 − 0.235 × preoperative PT ( p < 0.05). Therefore, when preoperative PT was less than 20°, the postoperative PT would become larger than the preoperative one.

Conclusion:

(1) In patient with hip OA without large lower limbs discrepancy, the postoperative PT after THA correlated with PI. (2) The postoperative change of PT was influenced by preoperative PT.
Opioid Consumption After Arthroscopic Meniscal Procedures and Anterior Cruciate Ligament Reconstruction
Authors: Lovecchio Francis , Premkumar Ajay , Uppstrom Tyler , Stepan Jeffrey , Ammerman Brittany , McCarthy Moira , Stein Beth Shubin , Pearle Andrew , Taylor Samuel , Kumar Kanuypria , Albert Todd , Hannafin Jo
Published: April 2020

Background:

Procedure-specific opioid-prescribing guidelines have the potential to decrease the number of unused pills in the home without compromising patient satisfaction. However, there is a paucity of data on the minimum necessary quantity to prescribe for outpatient orthopaedic surgeries.

Purpose:

To prospectively record daily opioid use and pain levels after arthroscopic meniscal procedures and anterior cruciate ligament reconstruction (ACLR) at a single institution.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 95 adult patients who underwent primary arthroscopic knee surgery (meniscectomy, repair, or ACLR) were enrolled. Patients with a history of opioid dependence were ineligible. Daily opioid consumption and Numeric Rating Scale pain scores were collected through an automated text-messaging platform starting on postoperative day 1 (POD1). At 6 weeks or at patient-reported cessation of opioid use, final survey questions were asked. Patients who failed to complete data collection were excluded. Opioid use was converted into “pills” (oxycodone 5-mg equivalents) to facilitate comparisons and clinical applications. Factors associated with high and low opioid use were compared.

Results:

Of the 95 patients enrolled, 71 (74.7%) were included in the final analysis. Of these, 40 (56.3%) underwent meniscal surgery and 31 (43.7%) underwent ACLR. After outpatient arthroscopic meniscectomy or repair, the total median postdischarge opioid use was 0.3 pills (oxycodone 5-mg equivalents), with 75% of patients consuming 3.3 or fewer pills (range, 0-19 pills). For ACLR, the median postdischarge consumption was 7 pills (75th percentile, 23.3 pills; range, 0-41 pills). Almost one-third of patients (32.3%) took no opioids after surgery (3 ACLR, 20 meniscus). All meniscus patients and 71% of ACLR patients ceased opioid consumption by postoperative day 7.

Conclusion:

Opioids may not be necessary in all patients, particularly after meniscal surgery and in comparison with ACLR. For patients requesting opioids for pain relief, reasonable prescription quantities are 5 oxycodone 5-mg pills after arthroscopic meniscal procedures and 20 5-mg pills after ACLR. Slowing the current opioid epidemic and preventing future crises is dependent on refining prescribing habits. Clinicians should strongly consider patient education regarding expected pain as well as pain management strategies.
The impact of the DWI-FLAIR-mismatch in the ECASS-4 trial – A post hoc analysis
Authors: Pfaff Johannes AR , Bendszus Martin , Donnan Geoffrey , Molina Carlos , Leys Didier , Schellinger Peter D , Schwab Stefan , Toni Danilo , Wahlgren Nils , Hacke Werner , Ringleb Peter Arthur
Published: April 2020

Introduction

To investigate the impact of a mismatch between diffusion-weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) on functional outcome in patients with acute stroke in a prolonged time window or unknown time of symptom onset randomized to intravenous thrombolysis or placebo.

Patients and Methods

We performed a post-hoc analysis of the European Cooperative Acute Stroke Study-4 (ECASS-4) trial. ECASS-4 was an investigator driven, phase 3, multi-center, double-blind, placebo-controlled study which randomized ischemic stroke patients presenting within 4.5 and 9h of stroke onset or unknown time-window to either rt-PA or placebo after MR-imaging. Two subgroups “no mismatch” (nMM) and “any mismatch” (aMM) were created by applying a DWI-FLAIR-mismatch criterion. We calculated frequency of nMM and aMM and performed a univariate analysis (Fisher's Test) for excellent clinical outcome (mRS 0-1) and mortality (mRS=6).

Results

MR-Imaging of n=111/119 (93.2%) patients was suitable for this analysis. DWI-FLAIR mismatch was found in 49 patients (44.1%). Proportions of mismatch nMM and aMM were comparable in treatment-groups (aMM: Placebo 46.3%, Alteplase 42.1%; p=0.70). Patients with nMM showed no benefit of rt-PA-treatment (OR (95%CI) mRS 0-1: 0.95 (0.29-3.17)). Patients with aMM showed a point estimate of the odds ratio in favour of a treatment benefit of rt-PA (mRS 0-1: OR (95%CI) 2.62 (0.68-11.1)). Mortality within 90 days was not different in patients treated with rt-PA if nMM (15.2%) or aMM (12.5%) was present.

Discussion

In this analysis no significant evidence, but subtle indication towards patients treated with rt-PA in a prolonged time window reaching an excellent clinical outcome if a DWI-FLAIR-mismatch is present on initial stroke MR-imaging.

Conclusion

A DWI-FLAIR mismatch in the region of ischemia as imaging based surrogate parameter for patient selection for i.v. rt-PA should be strongly pursued.
Hegemonic Past: Exclusion of Subaltern Histories in NCERT Textbooks
Authors: Patil Swarali
Published: April 2020

History textbooks are always a site of contestation. Therefore, present political struggles for maintaining hegemony or overthrowing it play on the site of history. History as discipline has always been dominated by androcentric values. Therefore, feminist historiography was emerged which not only criticized existing androcentric historiographies but suggested new ways to do history. This article tries to analyze inclusions and exclusions within history textbooks. In the first part of the article I will try to analyze why certain histories never became part of the textbook and what are the sources that are used to write history. In this article I will analyze VIII standard NCERT history textbooks in India (Central level Government textbooks) through caste and gender lenses. In 2005 the theme of NCERT History textbooks changed from ‘our past’ (singular) to ‘our pasts’ (plural). However, this change does not reflect in the content of the textbook. I am using content analysis as a method to analyze pictures and texts. I will also try to contextualize the text within time and space. The exclusion and inclusion of history in the textbooks depends on the contemporary caste, patriarchal hegemony in our society. The dominant mainstream history has become part of these textbooks, but subaltern history is excluded from it. In this article I will also talk about the Dalit histories, Dalit women histories and tribal histories which are silenced as ‘other’ and remained part of counterculture but did not become part of these mainstream textbooks. In the later part of the article, I will try to look in what way the histories are altered to fit in a particular framework especially the histories of subalterns. At the end I will focus on how textbooks always build the idea of hegemonic nation and nationalism in students mind. Therefore, through this article I will analyze the ways through which the ‘other’ is being silenced in history textbooks.
Building Multitemporal Awareness and Reflexivity in Family Business: A Visual Sensemaking Exercise
Authors: Lefebvre Vincent , Radu-Lefebvre Miruna , Gartner William B. , Clarke Jean
Published: April 2020

This article presents an exercise designed for successors and other business family members with the aim to enable them to communicate their understandings of their family and family business’ past legacies and to express their future-related projections. First initiated in France in 2014, then duplicated in United States in 2019, the exercise has been used in undergraduate, graduate, and executive education courses, with national and international cohorts. While the exercise has typically focused on classes composed of successors, it has also been used in executive education courses with business family members from older and younger generations. The learning activity asks participants to draw three consecutive images of their family business—past, present, and future—to develop a visual narrative of the family and family business legacies and future. Participants are then invited to tell the story of their family business and to depict its imagined future using the three drawings as guides, within the group setting. This visual sensemaking exercise enables participants to access tacit modes of relating to past legacies and contributes to developing multitemporal awareness and reflexivity in multigenerational family businesses.