bluuebunny/crossref_metadata_2025 huggingface dataset:
Long‐term outcomes of pediatric‐onset primary sclerosing cholangitis: A single‐center experience in Japan
Authors: Umetsu Shuichiro , Notohara Kenji , Nakazawa Takahiro , Tsunoda Tomoyuki , Sogo Tsuyoshi , Komatsu Haruki , Tanaka Atsushi , Tazuma Susumu , Takikawa Hajime , Inui Ayano , Fujisawa Tomoo
Published: August 2019

Aim

Primary sclerosing cholangitis (PSC) is very rare in Japan. Although a large‐scale cohort study of 781 pediatric‐onset PSC patients in Europe and North America showed that the 5‐year survival with native liver was 88%, the long‐term outcomes of pediatric‐onset PSC in Japan are unknown. Here, we evaluated the clinical outcomes of pediatric‐onset PSC in Japan.

Methods

We carried out a retrospective cohort study with a medical records review of pediatric PSC patients diagnosed between 1986 and 2017 at a single center. The PSC diagnoses were based on cholangiography, liver histology, and biochemical findings. The patients' survival was analyzed using the Kaplan–Meier method. Prognostic factors were determined by univariate and multivariate analyses using the Cox proportional hazards regression model.

Results

We identified 39 pediatric‐onset PSC patients (22 boys, 17 girls). The median age at diagnosis was 9 years (interquartile range 6.0–13.5 years). The median follow‐up period was 5.5 years (interquartile range 3.4–8.7 years). The phenotypes of PSC‐autoimmune hepatitis, PSC‐inflammatory bowel disease, and small‐duct PSC were diagnosed in 13 (33.3%), 36 out of 38 (94.8%), and three (7.7%) patients, respectively. The 5‐year liver transplantation‐free survival of the whole cohort was 93.5%. Nine patients underwent liver transplantation, and four of these nine cases resulted in death. Both the univariate and multivariate analyses showed that the phenotype of “PSC‐autoimmune hepatitis overlap” was an independent poor prognostic factor.

Conclusions

The overall survival of pediatric‐onset PSC in Japan was comparable to those in Western countries. The phenotype of PSC‐autoimmune hepatitis was identified as a prognostic factor associated with a poorer long‐term outcome.
Impact of social media use on student satisfaction in Higher Education
Authors: Rahman Shahedur , Ramakrishnan Thiagarajan , Ngamassi Louis
Published: August 2019

Social media has transformed the communication landscape for institutions of Higher Education by providing improved teaching and learning experience. However, very little is known as to whether the use of social media by Higher Education students improves their satisfaction. Grounded in social media, risk and technology acceptance literature, this paper examines Higher Education students' perceptions of social media use (SMU) and the impact of SMU on their satisfaction. Data collected from the students were analysed using Structural Equation Modelling. The study finds that: (1) perceived usefulness of social media has positive effect on the use of social media in student learning; (2) perceived risk of using social media discourages the use of the tool, and (3) SMU has positive effect on student satisfaction. The study further discusses the theoretical and practical implications of these findings.
A classification of chronic rhinosinusitis with nasal polyps based on structured histopathology
Authors: Brescia Giuseppe , Alessandrini Lara , Giacomelli Luciano , Parrino Daniela , Zanotti Claudia , Tealdo Giulia , Franz Leonardo , Carraro Valentina , Barion Umberto , Marioni Gino
Published: August 2019

Aims

In chronic rhinosinusitis with nasal polyps (CRSwNP), tools based on objective evidence, such as histopathology, are needed to assist clinical decision‐making. The main aim of this exploratory investigation was to determine whether structured histopathology could be used to classify CRSwNP in homogeneous histological clusters.

Methods and results

A cohort of 135 CRSwNP patients was assessed, on the basis of clinicopathological features: allergic fungal rhinosinusitis (17 patients); non‐steroidal anti‐inflammatory drug‐exacerbated respiratory disease (19 patients); intrinsic asthma (18 patients); extrinsic asthma (21 patients); allergy (21 patients); histologically eosinophilic (22 patients); and histologically non‐eosinophilic (17 patients). For structured histopathology, we considered: the degree of inflammation; eosinophil count; eosinophil aggregates; neutrophil infiltration; goblet cell hyperplasia; basement membrane thickening; fibrosis; hyperplastic/papillary changes; squamous metaplasia; mucosal ulceration; and subepithelial oedema. Cluster analysis identified four distinct sets of cases. On discriminant analysis, the global error rate was 1.48%, and the stratified error rates were 4.34%, 0%, 0%, and 0% for clusters 1, 2, 3 and 4, respectively. Cluster 1 was characterised by infrequent fibrosis (<4.5% of cases). Cluster 2 mainly featured neutrophil infiltration in 100% of cases, hyperplastic/papillary changes in 70% of cases, and fibrosis in 65% of cases. Cluster 3 showed fibrosis in 100% of cases. Cluster 4 showed hyperplastic/papillary changes in 100% of cases, and fibrosis in 92% of cases.

Conclusions

This study shows that cluster analysis can identify different histotypes among CRSwNP patients. The next step will be to investigate, in a larger series, the clinical (e.g. prognostic) implications of identifying such homogeneous clusters of patients with CRSwNP on the basis of their structured histopathology.
Age‐dependent optimal policies for hepatitis C virus treatment
Authors: Mondschein Susana , Yankovic Natalia , Matus Omar
Published: August 2019

In recent years, highly effective treatments for hepatitis C virus (HCV) have become available. However, high prices of new treatments call for a careful policy evaluation when considering economic constraints. Although the current medical advice is to administer the new therapies to all patients, economic and capacity constraints require an efficient allocation of these scarce resources. We use stochastic dynamic programming to determine the optimal policy for prescribing the new treatment based on the age and disease progression of the patient. We show that, in a simplified version of the model, new drugs should be administered to patients at a given level of fibrosis if they are within prespecified age limits; otherwise, a conservative approach of closely monitoring the evolution of the patient should be followed. We use a cohort of Spanish patients to study the optimal policy regarding costs and health indicators. For this purpose, we compare the performance of the optimal policy against a liberal policy of treating all sick patients. In this analysis, we achieve similar results in terms of the number of transplants, HCV‐related deaths, and quality of adjusted life years, with a significant reduction in overall expenditure. Furthermore, the budget required during the first year of implementation when using the proposed methodology is only 12% of that when administering the treatment to all patients at once. Finally, we propose a method to prioritize patients when there is a shortage (surplus) in the annual budget constraint and, therefore, some recommended treatments must be postponed (added).
Does closed incision negative wound pressure therapy in non‐traumatic major lower‐extremity amputations improve survival rates?
Authors: Stenqvist Charlotte P , Nielsen Camilla T , Napolitano George M , Larsen Bo M , Flies Mitchell J , Brander Ditte C , Lynge Elsebeth , Pallesen Per
Published: August 2019

Closed incision negative pressure wound therapy (CINPWT) has been shown to be clinically effective compared with the traditional gauze dressing, reducing surgical site infections and wound complications. We evaluated the effect of CINPWT compared with gauze dressing on the need for revision surgery and survival after non‐traumatic major lower amputation. We included 309 patients undergoing 403 major lower amputations in a retrospective study from January 1, 2010 to November 23, 2017. A total of 139 patients received CINPWT, and 170 patients received stump bandage. There was no statistically significant difference between the two groups regarding the need for revision surgery (P = .45). Fourteen stump bandage patients and 15 CINPWT patients died in hospital (P = .57). One year after amputation, 55 CINPWT patients and 66 stump bandage patients had died (P = .82). Survival probabilities adjusted for age and gender 2 years after amputation were .52 (.43‐.61) and .49 (.42‐.58), respectively, and 3 years after amputation were .36 (.25‐.50) and .39 (.32‐.47), respectively. We also found no significant difference in the need for revision surgery in survival probabilities up till 3 years after amputation between patients treated with CINPWT and patients treated with gauze bandage postoperatively.
The effect of oxidative stress and Raftlin levels on wound healing
Authors: Bilgen Fatma , Ural Alper , Kurutas Ergul B. , Bekerecioglu Mehmet
Published: August 2019

Reactive oxygen species (ROS) are crucial in all wound‐healing processes. Raftlin also plays an important role in the induction of the autoimmune response and the vascular inflammatory response. Inflammatory mediators induce continuous synthesis and secretion. To the best of our knowledge, although there are studies in the literature on antioxidant enzyme levels (superoxide dismutase [SOD], catalase [CAT]) and oxidative stress markers, there are no studies on the comparison of these levels in wound patients with the activities of Raftlin, which is known to play a role in the vascular endothelial response. The aim of this study was to compare the levels of oxidative stress and antioxidant response between wound patients and a control group and to compare the levels of Raftlin between the two groups, which is a new biomarker in inflammatory diseases. Between January 2018 and September 2018, 30 healthy control patients and 30 patients with wounds were enrolled in the study as volunteers. Tissue samples were collected and were sent to the biochemistry laboratory to determine the levels of oxidative stress, antioxidant enzymes, and Raftlin, which play an important role in wound healing. The following were evaluated: SOD and CAT levels (as a measure of antioxidant enzymes); malondialdehyde (MDA) levels (as a measure of free oxygen radicals); and Raftlin, which is a lipid raft protein used in determining the level of inflammatory and autoimmune response. The analyses determined a statistically significant correlation between MDA, SOD, CAT, and Raftlin values in wound patients (p<0.05). Raftlin was a considerable parameter in determining the prognostic process of wound healing. The levels of tissue Raftlin were significantly higher in wounded patients. A significant increase in MDA, SOD, and CAT activities of the wounded patients also suggested that the oxidant and antioxidant effect was balanced and that external antioxidant supplementation was not required.
Antibacterial effects of lidocaine and adrenaline
Authors: Kesici Sevgi , Demirci Mehmet , Kesici Ugur
Published: August 2019

The most commonly used local anaesthetics (LAs) for postoperative analgesia and surgical anaesthesia are lidocaine and bupivacaine. Adrenaline is a vasopressor agent, which is widely used in anaesthesia for many purposes. This study aims to determine the antibacterial efficacy of lidocaine, mupirocin, adrenaline, and lidocaine + adrenaline combination. In our study, the in vitro antimicrobial effect of 1 mL of sterile saline, 20 mg/mL mupirocin, 20 mg/mL lidocaine, 1 mg/mL adrenaline, and 20 mg/mL lidocaine and adrenaline were tested against Staphylococcus aureus American‐type culture collection (ATCC) 29213, Pseudomonas aeruginosa ATCC 27853, and Escherichia coli ATCC 25922, classified as Group C (control), Group M (mupirocin), Group L (lidocaine), Group A (adrenaline), and Group LA (lidocaine+adrenaline), respectively. S. aureus ATCC 29213, P. aeruginosa ATCC 27853, and E. coli ATCC 25922 were cultured on Mueller‐Hinton agar (Oxoid, UK) plates for 18 to 24 hours at 37°C. Colonies from these plates were suspended in sterile saline, and a 0.5 McFarland turbidity standard suspension (corresponding to 1.5 × 108 CFU/mL) of each isolate was prepared. In terms of inhibition zone diameters, S. aureus ATCC 29213 values obtained after 12 and 24 hours of incubation were significantly different between groups (P < .001). According to inhibition zone diameters, Group M > Group LA > Group L > Group C = Group A. P. Aeruginosa ATCC 27853 values obtained after 12 and 24 hours of incubation were significantly different between groups (P < .001). According to inhibition zone diameters, Group M > Group LA > Group L = Group C = Group A. E. coli ATCC 25922 values obtained after 12 and 24 hours of incubation were significantly different between groups (P < .001). According to inhibition zone diameters, Group M > Group LA > Group L > Group C = Group A. It is known that LAs have antimicrobial effect potential in addition to their anaesthetic, analgesic, antiarrhythmic, and anti‐inflammatory effects. There are also studies showing the antimicrobial effects of vasopressor agents, which are frequently used, particularly in intensive care unit (ICUs). However, it has been observed in the present study that adrenaline alone did not have any antimicrobial effect. Adrenaline, when used in combination with lidocaine, provides a stronger and broad‐spectrum antimicrobial activity, suggesting that its combined use in proper indications will be clinically significant. Because the prevention and treatment of wound infections make a positive contribution to wound healing, the potential of antimicrobial effect of LAs can provide successful results in the prevention and treatment of ICU and wound infections. Thus, an important contribution can be made in terms of reducing the costs of antibacterial treatment and reducing morbidity.
Necrotising fasciitis of the thigh caused by duodenum invasion of renal cell carcinoma: A case report
Authors: Okkabaz Nuri , Turgut Mehmet Alim
Published: August 2019

Necrotising fasciitis, widespread necrosis of the skin, subcutaneous tissue, and superficial fascia, may be caused by many factors, among which underlying malignancy is observed rarely. We report a case with necrotising fasciitis of the lower extremity because of a duodenum to retroperitoneum fistula caused by renal cell carcinoma invasion. A 62‐year‐old male with newly diagnosed renal cell carcinoma was diagnosed with necrotising fasciitis at the end of 2 days in hospital. One day after debridement surgery, biliary contamination of dressings and tomography demonstrated fistulation from the duodenum to retroperitoneum and then to the right thigh because of renal tumour invasion. The second operation was performed to repair the duodenum. Intravenous antibiotics and hydration were maintained postoperatively. Although there was no surgical complication, the patient died because of respiratory collapse at the 12th day postoperatively. Renal cell carcinoma may invade the duodenum and, with retroperitoneal fistulation, may be the cause of necrotising fasciitis of the thigh. Laparotomy may be needed to control the origin of infection. However, necrotising fasciitis may be fatal in spite of aggressive treatment. The fasciitis should be diagnosed early to initiate timely aggressive treatment, and a possible endogenous source should be kept in mind.
Nowotny phase Mo3+2xSi3C0.6 dispersed in a porous SiC/C matrix: A novel catalyst for hydrogen evolution reaction
Authors: Feng Yao , Yu Zhaoju , Schuch Jona , Tao Shasha , Wiehl Leonore , Fasel Claudia , Jaegermann Wolfram , Riedel Ralf
Published: August 2019

The ternary Nowotny phase (NP), with a composition Mo3+2xSi3C0.6 (x = 0.9‐0.764), is found to be catalytically active in the field of electrochemical water splitting. The NP embedded in a porous SiC/C nanocomposite matrix is synthesized via a single‐source‐precursor approach which involves the reaction of allylhydridopolycarbosilane with MoO2(acac)2. Thermal treatment of the single‐source‐precursor up to 1400°C in a protective atmosphere results in the in situ formation of nanocrystalline Mo3+2xSi3C0.6 immobilized in a thermally and corrosion‐stable SiC/C matrix. The weight fractions of the observed crystalline phases Mo3+2xSi3C0.6 and SiC amount to ca. 28 (26) and 72 (74) wt%, respectively, when prepared at 1400°C (1350°C). The porosity of the formed nanocomposite is adjusted by the addition of polystyrene (PS) as a pore former to the single‐source‐precursor resulting in a specific surface area up to 206 m2/g. The electrocatalytic activity of the Mo3+2xSi3C0.6/C/SiC nanocomposite with respect to the hydrogen evolution reaction (HER) is characterized by low over potentials of 22 and 138 mV vs reversible hydrogen electrode (RHE) for applying 1 and 10 mA cm−2 of current density, respectively. The analyzed electrocatalytic performance exceeds that of most Mo‐based electrocatalysts and shows high stability (over 90%) during 35 hours.
Reactive, nonreactive, and flash spark plasma sintering of Al2O3/SiC composites—A comparative study
Authors: Torosyan Karen S. , Sedegov Alexey S. , Kuskov Kirill V. , Abedi Mohammad , Arkhipov Dmitry I. , Kiryukhantsev‐Korneev Philipp V. , Vorotilo Stepan , Moskovskikh Dmitry O. , Mukasyan Alexander S.
Published: August 2019

The influence of different SPS‐based methods, that is, conventional spark plasma sintering (SPS), flash SPS (FSPS), and reactive SPS (RSPS) on the properties of Al2O3/SiC composite was investigated. It was shown that the application of preliminary high energy ball milling of the powders significantly enhances the sinterability of the ceramics. It was also demonstrated that FSPS provides unique conditions for rapid, that is, less than a minute, consolidation of refractory ceramics. The Al2O3‐20 wt% SiC composite produced by FSPS possesses the highest relative density (~99%), fracture toughness (7.5 MPa m1/2), hardness (20.3 GPa) and wear resistance among all ceramics produced by other SPS‐based approaches with dwelling time 10 minutes. The RSPS ceramics hold the highest Young's modulus (390 GPa). Substitution of micron‐sized Al2O3 particles by nano alumina does not lead to measurable enhancement of the mechanical properties.
Cryptic phylogeographic history sheds light on the generation of species diversity in sky‐island mountains
Authors: He Kai , Gutiérrez Eliécer E. , Heming Neander M. , Koepfli Klaus‐Peter , Wan Tao , He Shuiwang , Jin Wei , Liu Shao‐Ying , Jiang Xue‐Long
Published: August 2019

Aim

The aim of this study was to conduct comprehensive phylogeographic and demographic analyses to examine the degree to which topographic and climatic conditions have affected the patterns of diversification and migration in a strictly montane inhabitant, the montane long‐tailed mole (Scaptonyx fusicaudus).

Location

The mountains of south‐western China and adjacent mountains including Mts. Bashan, Dalou and Qinling also known as the sky islands in south‐western China.

Taxon

The long‐tailed mole (S. fusicaudus), a semi‐fossorial mammal distributed in the sky islands of south‐western China, is a relict species and the sole representative of the tribe Scaptonychini.

Methods

We sequenced one mitochondrial and six nuclear genes from 113 samples across the species’ range. We estimated phylogenetic relationships and divergence times, conducted genetic structuring and species delimitation using multiple approaches and used Approximate Bayesian Computation to test potential gene flow. We conducted ecological niche modelling to predict the species’ potential distribution in the present, the last glacial maximum and the last interglacial (LIG).

Results

The species comprises a minimum of 17 operational taxonomic units which are isolated in different mountain ranges. The lowlands and large rivers act as barriers to dispersal, and have isolated evolutionary lineages for up to 11 million years. Long‐distance dispersal is evident among a few discrete montane archipelagos. Suitable climatic conditions during the LIG are limited to only a few sites, thus geographically restricting climatic stable areas across geological periods (from the LIG to the present).

Main conclusions

For low‐vagility species, the complex topography of the sky islands has promoted exceptional diversification through a combination of eco‐environmental stability as well as geographic fragmentation. The mountains have acted as a buffer against climate change, and have provided continuously suitable habitats for S. fusicaudus since the early Late Miocene, supporting the hypothesis that the sky islands constitute “museums” of ancient lineages. Lowlands and river valleys have acted as barriers preventing gene flow, while the montane archipelagos could have provided stepping stones to facilitate dispersal.
The impact of perceived stress on skin ageing
Authors: Lee C.M. , Watson R.E.B. , Kleyn C.E.
Published: August 2019

Skin ageing can be divided according to phenotypical features into intrinsic (by the passage of time) and extrinsic (with the addition of the effects of environmental factors). Photoageing is by far the most researched factor of extrinsic ageing but the additional impact of other factors such as cigarette smoking and exposure to air pollution ought to be taken into account. One of the least researched topics in relation to extrinsic skin ageing is the impact of psychological stress. A contemporary review of response of human skin to stress describes the molecular mechanisms of extrinsic skin ageing, but has fallen short of explaining resilience to stress exhibited by people. Mechanisms to regulate gene expression, define cellular identity and promote functionality are responsible for the adaptive response to stressful events. Conversely, maladaptive response of human tissues to chronic stress appears to have an impact on gene regulation. Epigenetics is the study of heritable changes in organisms due to modifications in gene activity and expression, as opposed to the genetic code (DNA genome). Chronic stress appears to be an important factor in determining an individual's vulnerability to ageing and age‐related comorbidities via epigenetic modifications. Forerunners in epigenetic research recognized the necessity of a reliable biomarker in order to develop a better understanding of the role of epigenomics in ageing. Genomic DNA methylation patterns (DNAm) appear to be valuable in age prediction but variability in specificity exists across species of mammals, human races and tissues. Neuroscience research appears to be leading the way in epigenomics whilst the lack of a valid and reliable DNAm‐associated age predictor compatible with human skin tissue hinders research endeavours for the epigenetics of skin ageing.
Long‐term clinical outcomes of imiquimod 5% cream vs. diclofenac 3% gel for actinic keratosis on the face or scalp: a pooled analysis of two randomized controlled trials
Authors: Gollnick H. , Dirschka T. , Ostendorf R. , Kerl H. , Kunstfeld R.
Published: August 2019

Background

Actinic keratosis (AK) is an early in situ epidermal cancer which can progress to invasive squamous cell carcinoma (SCC). Imiquimod 5% cream (IMIQ) and diclofenac 3% gel (DIC) are frequently used to treat AK; however, their long‐term effects following repeated treatment cycles have never been compared.

Objective

To compare IMIQ and DIC in the treatment of AK with respect to the risk of change to grade III AK or invasive SCC, after 3 years.

Methods

Data were pooled from two randomized, active‐controlled, open‐label, multicentre, multinational, phase IV studies (Clinicaltrials.gov NCT00777127/NCT01453179), with two parallel groups. Studies were conducted between 2008 and 2015 and were almost identical in design. Patients eligible for inclusion were immunocompetent adults with 5–10 visible AK lesions on the face/scalp and grade I/II AK. The primary endpoint was inhibition of histological change to grade III AK or invasive SCC in the study treatment area, observed until month 36. Patients applied either IMIQ or DIC for a maximum of six treatment cycles.

Results

In total, 479 patients (IMIQ 242; DIC 237) were included in the full analysis set. Histological change to grade III AK or invasive SCC was observed until month 36 in 13 (5.4%) patients treated with IMIQ, compared with 26 (11.0%) patients treated with DIC (absolute risk difference –5.6% [95% confidence interval –10.7%, –0.7%]). Time to histological change was greater in the IMIQ group than the DIC group (P = 0.0266). Frequency of progression to invasive SCC was lower with IMIQ than with DIC at all time points. Initial clearance rate was higher in the IMIQ group compared with the DIC group, while recurrence rate was lower. Both treatments were well tolerated.

Conclusions

Over 3 years, IMIQ was superior to DIC in clearing AK lesions and preventing histological change to grade III AK or invasive SCC and recurrence.
Can plants mediate the humoral immunity and biochemical metabolism of entomopathogen‐infected caterpillars?
Authors: Wan Nian‐Feng , Zhou Jin‐Yi , Deng Jian‐Yu , Wang Jin‐Yan , Ji Xiang‐Yun , Zhang Hao , Chen Yi‐Juan , Jiang Jie‐Xian
Published: August 2019

Plant‐insect herbivore‐entomopathogen interactions are one of the hot topics in biological control and humoral immunity, and biochemical metabolism are important responses of herbivores to pathogen infection. Entomopathogens are key biocontrol agents of caterpillars, but how plants affect the responses of caterpillars to these organisms is not well understood. We studied hormonal immunity (lysozyme and phenoloxidase activities) and biochemical metabolism (total protein and lipid contents) of Beauveria bassiana‐infected beet armyworm (Spodoptera exigua) larvae that feed on five different host plants (soya bean, Chinese cabbage, edible amaranth, water convolvulus and pepper). Results indicated that plant species differentially affected lysozyme and phenoloxidase activity and lipid content, but had no effect on protein content of pathogen‐infected caterpillars. Both lysozyme and phenoloxidase activities were generally higher in entomopathogen‐infected larvae that feed on edible amaranth or water convolvulus compared with the other three plants from days 1 to 5 after treatment. Plant species did not affect in regular changes during the 5 days in the lipid content of infected or non‐infected caterpillars. Our study reveals that plants fail to affect the biochemical metabolism but plants can mediate the humoral immunity of caterpillars to defend against pathogens. This study provides insight into plant‐mediated effects on the response of herbivores to pathogens.
Optimization of calcium–magnesium–inulin formulation on wheat flour dough rheological properties
Authors: Codină Georgiana Gabriela , Ropciuc Sorina , Dabija Adriana
Published: August 2019

The aim of our study was to optimize the inulin (In), calcium lactate (Ca), and magnesium gluconate (Mg) content in order to obtain the best wheat flour dough rheological properties by using response surface methodology. The Farinograph, Falling Number, Amylograph, and Rheofermentometer properties were evaluated. The results of the study revealed that from the three independent variables used, In has the most significant effect on response variables. The increase in In, Ca, and Mg content produced a decrease of water absorption and of all Rhefermentometer parameters studied. Mg presented a significant (p < .1) positive effect on Amylograph properties. An interaction effect of the combined In and Mg (p < .01), Mg and Ca (p < .05) was observed on maximum height of gaseous production. The optimum formulation obtained in order to achieve the desirable dough rheological properties contained 1.46 g/kg Ca, 1.34 g/kg Mg, and 5.74 g/100 g In.

Practical applications

Incorporation of inulin, a prebiotic with calcium and magnesium salts in wheat flour facilitates obtaining of bakery products with health effect on the human body. Also, the use of inulin in combination with calcium and magnesium salts improves calcium and magnesium bioavailability, a fact that help us combat calcium and magnesium deficiency. Knowledge of dough rheological properties of wheat flour dough with inulin in combination with calcium and magnesium salts will provide a better understanding of bread making process during mixing, pasting, and fermentation in order to obtain bakery products of a good quality. The information presented in this work will be useful for the bakery industry in order to predict bread making process engineering and bread quality.
A novel method based on passive diffusion that reduces the moisture content of stingless bee (Heterotrigona itama) honey
Authors: Baroyi Syahrul A. H. M. , Yusof Yus A. , Ghazali Hasanah M. , Chin Nyuk L. , Othman Siti H. , Chang Lee S. , Ghazali Nashratul S. M.
Published: August 2019

Stingless bee honey from Heterotrigona itama exhibits a high moisture content (>27.0%) and therefore, is highly susceptible to undesirable microbial fermentation unless it is reduced to less than 20%. This study aims to reduce the moisture content of honey using a novel method based on passive diffusion and monitor the subsequent changes in several properties of honey. To achieve this, approximately 50 mL of freshly harvested honey samples was placed in clay pots (4 cm diameter × 6 cm height), covered with lids, and stored at temperatures of either 25 ± 1°C, 60% relative humidity (RH), or 35 ± 1°C, 25% RH. The results showed that the moisture content and Aw of honey after storage were significantly reduced (p ≤ .05) from 25.8 to 19.5% and from 0.79 to 0.70, respectively. A similar level of reduction was achieved at 25°C, although this process took 21 days and resulted in some losses of honey solids due to cross‐wall diffusion. The reduction in moisture content also resulted in a decrease in pH and free acidity of honey and an increase in viscosity. The data obtained in this study indicate the feasibility of using clay pots as an alternative method to reduce the moisture content in honey and protect it against fermentative deterioration.

Practical Applications

Stingless bee honey is highly popular in Malaysia and many other countries as it is high in carbohydrates and possesses many health benefits such as antioxidants and antimicrobial properties. However, the honey is susceptible to fermentation as its moisture content often exceeds the level required for microbial stability. Traditionally, the moisture content of stingless bee honey is reduced by drying the honey in shallow trays at elevated temperatures. However, this leads to contamination if the drying is performed under unhygienic conditions. Therefore, this study proposed the application of a passive diffusion method that serves as an effective alternative for moisture reduction in honey. It is anticipated that this method will not only reduce the moisture content but also retain most of its properties when the filtration process is performed under appropriate conditions.
Modeling the microbiological effect of essential peppermint oil‐supplemented chitosan film on Bonito fish (Sarda sarda) fillets and analysis via image processing methods
Authors: Kalkan Selin , Akben Selahaddin Batuhan , Çanga Demet
Published: August 2019

In this study, the effect of chitosan films supplemented with essential peppermint oil on the microbiological properties of Bonito (Sarda sarda) fillets was investigated. Samples of fish fillets were divided into six groups. These are the only fillet (control group), chitosan film coated with fillets, and fillets coated with chitosan films containing essential peppermint oil of 0.5, 1, 1.5, and 2%. Samples were stored at +4°C along 12 days and microbiological values were measured on 0, 3rd, 6th, 9th, and 12th days. Microbial values measured are total mesophilic aerobic bacteria, psychrotrophic bacteria, Pseudomonas spp., lactic acid bacteria, and yeast–mold. The methods used for analysis are modeling the microbial values caused by the chitosan and essential peppermint oil and transforming the data predicted using model equations into images. According to the results of this analysis method, the shelf life was extended approximately 2 days using only chitosan film coating and it was extended approximately 6 days using chitosan film coating supplemented with essential peppermint oil between 1.75 and 2%. In addition, it has not been achieved to 7 log cfu/g, which is the limit of microbial spoilage on the 12th storage day, thanks to the essential peppermint oil‐added chitosan film coating.

Practical Applications

The shelf life of the Bonito fish stored in the refrigerator conditions (+4°C) can be increased up to 6 days using chitosan film supplemented with essential peppermint oil between 1.75 and 2%.
Acceptability, tolerability, and safety of fecal microbiota transplantation in patients with active ulcerative colitis (AT&S Study)
Authors: Sood Ajit , Singh Arshdeep , Mahajan Ramit , Midha Vandana , Mehta Varun , Gupta Yogesh Kumar , Narang Vikram , Kaur Kirandeep
Published: August 2019

Background and Aim

Fecal microbiota transplantation (FMT) targets gut microbiome dysbiosis and is an emerging therapy for ulcerative colitis (UC). Although initial results with FMT in patients with active UC are encouraging, data regarding its acceptability, tolerability, and safety are scant.

Methods

A retrospective analysis of patients with active UC (Mayo clinic score ≥ 4), who received multisession FMT (at weeks 0, 2, 6, 10, 14, 18, and 22) via colonoscopy between June 2016 and June 2018, was performed. Patient acceptability, tolerability, and immediate and long‐term safety of the therapy were assessed.

Results

Of the 129 patients with active UC who were offered FMT, 101 patients consented, giving acceptability of 78.3%. Fecal slurry retention time improved with each session (3.27 ± 1.06 h for the first session vs 5.12 ± 0.5 h for the seventh session). Abdominal discomfort, flatulence, abdominal distension, borborygmi, and low‐grade fever (30.8%, 15.9%, 9.8%, 7.9%, and 7.6%, respectively) were the most common post‐procedural short‐term adverse events. Long‐term adverse events included new‐onset urticaria (n = 2, 4.3%), arthritis/arthralgia (n = 3, 6.5%), depression (n = 1, 2.2%), partial sensorineural hearing loss (n = 1, 2.2%), and allergic bronchitis (n = 1, 2.2%). Thirteen (12.9%) patients dropped out because of adverse events.

Conclusion

Fecal microbiota transplantation appears to be a safe and well‐tolerated procedure, with good acceptability in patients with active UC.
A tipping point for agricultural expansion? Technological changes and capital accumulation in Argentina's rural sector
Authors: Cáceres Daniel M. , Gras Carla
Published: August 2019

Drawing upon a case study located in central Argentina, we analyse in what ways technology is contributing to the accumulation of capital in a context where prevailing strategies resting on farm‐scale extension are no longer effective. We identify two major technological phases that go along with changes in actors' strategies aiming at re‐establishing expanded capital accumulation. These phases allow a better understanding of the mediating role of technology between capital accumulation and the appropriation of nature. In a context of increasing depletion of agro‐ecological conditions, the call for a new wave of innovations can be seen as an attempt to restore that mediating role. As we suggest, this entails broader changes in multiple levels.
Hospital nurses' professional accountability while using the National Early Warning Score: A qualitative study with a hermeneutic design
Authors: Jensen Jørghild Karlotte , Skår Randi , Tveit Bodil
Published: August 2019

Aim

To explore general hospital ward nurses' experiences with the National Early Warning Score and to determine its impacts on their professionalism.

Background

The National Early Warning Score has broad appeal; it is a patient safety initiative designed to ensure early identification of and response to deteriorating patients in hospitals. However, it is still unclear how the tool impacts nurses' professionalism.

Methods

A qualitative study with a hermeneutic design was conducted in autumn 2017; the study consisted of semi‐structured, in‐depth interviews with 14 hospital nurses. The data were analysed thematically to understand and interpret the nurses' experiences. Methods are reported using COREQ guidelines (see Appendix S1).

Results

The study examined nurses' experience with the National Early Warning Score and its perceived impact on their professionalism. Four themes were identified: (a) the National Early Warning Score and clinical judgement in patient assessment, (b) responding to the National Early Warning Score standard, (c) involving the professional community and (d) adjusting the tool.

Conclusion

The National Early Warning Score may impact nurses' professionalism in diverse ways. Nurses are aware of the importance of incorporating all of their professional competence, comprising clinical judgement, discretion and accountability, with the National Early Warning Score to accurately assess patients' conditions. Findings indicated that the National Early Warning Score was beneficial to nurses' professional practice; however, accountability to this standard alone does not ensure quality care and patient safety.

Relevance to clinical practice

A greater understanding of the role of nurses' professional accountability when using the National Early Warning Score is needed to improve practice and ensure patient safety.
Experiences of the older hospitalised person on nursing pain care: An ethnographic insight
Authors: Harmon Joanne , Summons Peter , Higgins Isabel
Published: August 2019

Aims and objectives

To present an ethnographic insight into the older hospitalised person (those aged over 65 years) perceptions and experiences of pain care provision by nurses in acute care.

Background

Pain care provision by nurses remains less than optimal for the older hospitalised person despite numerous evidence‐based guidelines. There is a paucity of research providing input from the experiences of the older hospitalised person in relation to their perspectives of pain care provision by nurses in acute care. Pain care research needs more involvement from those older persons with documented diagnoses of dementia, delirium or cognitive impairment, and intellectual disabilities and those in their end stage of palliation.

Design

A focused ethnographic study. The consolidated criteria for reporting qualitative research (COREQ) were used to report the findings of this study.

Methods

A focused ethnographic study was conducted in 8 acute care units within 2 large tertiary referral hospitals on the east coast of Australia. Consisting of semi‐structured interviews (n = 12) of cognitively intact older persons (11 hr). Twenty‐three (23) semi‐structured interviews with nine (9) RN participants (12 hr and 38 min). Participant observation period totalled 1,041 hr.

Results

The older persons’ experiences of receiving pain care were based on a formulaic assessment process focusing on intensity of pain and pain management options provided often lacked their input. The older persons often did not perceive their pain care provision as being of benefit to themselves. The nurses lacked insight and understanding on the nature of pain for the older person.

Conclusion

Understanding was gained into how the older persons’ pain care was hampered due to the lack of appropriate, and meaningful pain care provision and provides insight into why the older hospitalised person continues to experience a less than optimal experience.

Relevance to clinical practice

Older hospitalised persons can gain continuity of pain care when nurses negotiate with them to repattern or restructure their nursing routines for pain care provision. Older people need inclusion into pain care decisions. All vulnerable older persons require nurses to use an evidence‐based pain assessment tool.
Factors for self‐management activities among rural patients with chronic hepatitis B: A cross‐sectional study
Authors: Kong Ling‐Na , He Shan , Li Lin , Lei Qing‐Song , Wang Tian , Yao Yu
Published: August 2019

Aims and objectives

To assess the self‐management activities among rural patients with chronic hepatitis B (CHB), and the influence of psychosocial and demographic factors on their self‐management activities.

Background

Chronic hepatitis B is a serious public health concern. Rural patients may have limited access to healthcare services. Although self‐management is important for controlling chronic hepatitis B, few studies focus on the self‐management activities among rural patients with chronic hepatitis B. Understanding self‐management activities and related factors in this population are important to design and implement appropriate intervention strategies.

Design

A cross‐sectional study.

Methods

From June–December 2017, totally 236 rural patients with chronic hepatitis B were recruited from hepatology department in two hospitals in Chongqing, China. The questionnaire included demographic characteristics, Chronic Hepatitis B Self‐Management Scale, Self‐Efficacy for Managing Chronic Disease, and Social Support Rating Scale. The study followed the STROBE checklist.

Results

Rural patients with chronic hepatitis B reported poor self‐management activities for the score indexes of symptom management (57.36%), lifestyle management (54.89%), psychosocial coping (54.84%) and disease information management (53.11%) were all below 60%. Self‐efficacy, objective support, subjective support, gender, education level and marital status showed significant effect on self‐management activities.

Conclusion

Rural patients with chronic hepatitis B were found to perform insufficient self‐management activities. Self‐efficacy, social support, gender, education level and marital status were identified to influence their self‐management activities.

Relevance to clinical practice

Self‐management activities should be promoted among rural patients with chronic hepatitis B. The factors that were identified in this study should be addressed when developing interventions to promote the performance of self‐management activities for rural patients with chronic hepatitis B.
Myelin Water Fraction and Intra/Extracellular Water Geometric Mean T2Normative Atlases for the Cervical Spinal Cord from 3T MRI
Authors: Liu Hanwen , Ljungberg Emil , Dvorak Adam V. , Lee Lisa Eunyoung , Yik Jackie T. , MacMillan Erin L. , Barlow Laura , Li David K.B. , Traboulsee Anthony , Kolind Shannon H. , Kramer John L.K. , Laule Cornelia
Published: August 2019

BACKGROUND AND PURPOSE

Acquiring and interpreting quantitative myelin‐specific MRI data at an individual level is challenging because of technical difficulties and natural myelin variation in the population. To overcome these challenges, we used multiecho T2myelin water imaging (MWI) to create T2metric healthy population atlases that depict the mean and variation of myelin water fraction (MWF), and intra‐ and extracellular water mobility as described by geometric mean T2(IEGMT2).

METHODS

Cervical cord MWI was performed at 3T on 20 healthy individuals (10M/10F, mean age: 36 years) and 3 relapsing remitting multiple sclerosis (RRMS) participants (1M/2F, age: 39/42/37 years). Anatomical data were collected for the purpose of image segmentation and registration. Atlases were created by coregistering and averaging T2metrics from all controls. Voxel‐wisez‐score maps from 3 RRMS participants were produced to demonstrate the preliminary utility of the MWF and IEGMT2atlases.

RESULTS

The average MWF atlas provides a representation of myelin in the spinal cord consistent with well‐known spinal cord anatomical characteristics. The IEGMT2atlas also depicted structural variations in the spinal cord.Z‐score analysis illustrated distinct abnormalities in MWF and IEGMT2in the 3 RRMS cases.

CONCLUSIONS

Our findings highlight the potential for using a quantitative T2relaxation metric atlas to visualize and detect pathology in spinal cord. Our MWF and IEGMT2atlases (URL:https://sourceforge.net/projects/mwi-spinal-cord-atlases/) can serve as normative references in the cervical spinal cord for other studies.
Melatonin receptor activation protects against low potassium‐induced ventricular fibrillation by preserving action potentials and connexin‐43 topology in isolated rat hearts
Authors: Prado Natalia Jorgelina , Egan Beňová Tamara , Diez Emiliano Raúl , Knezl Vladimír , Lipták Boris , Ponce Zumino Amira Zulma , Llamedo‐Soria Mariano , Szeiffová Bačová Barbara , Miatello Roberto Miguel , Tribulová Narcisa
Published: August 2019

Hypokalemia prolongs the QRS and QT intervals, deteriorates intercellular coupling, and increases the risk for arrhythmia. Melatonin preserves gap junctions and shortens action potential as potential antiarrhythmic mechanisms, but its properties under hypokalemia remain unknown. We hypothesized that melatonin protects against low potassium‐induced arrhythmias through the activation of its receptors, resulting in action potential shortening and connexin‐43 preservation. After stabilization in Krebs‐Henseleit solution (4.5 mEq/L K+), isolated hearts from Wistar rats underwent perfusion with low‐potassium (1 mEq/L) solution and melatonin (100 μmol/L), a melatonin receptor blocker (luzindole, 5 μmol/L), melatonin + luzindole or vehicle. The primary endpoint of the study was the prevention of ventricular fibrillation. Electrocardiography was used, and epicardial action potentials and heart function were measured and analyzed. The ventricular expression, dephosphorylation, and distribution of connexin‐43 were examined. Melatonin reduced the incidence of low potassium‐induced ventricular fibrillation from 100% to 59%, delayed the occurrence of ventricular fibrillation and induced a faster recovery of sinus rhythm during potassium restitution. Melatonin prevented QRS widening, action potential activation delay, and the prolongation of action potential duration at 50% of repolarization. Other ECG and action potential parameters, the left ventricular developed pressure, and nonsustained ventricular arrhythmias did not differ among groups. Melatonin prevented connexin‐43 dephosphorylation and its abnormal topology (lateralization). Luzindole abrogated the protective effects of melatonin on electrophysiological properties and connexin‐43 misdistribution. Our results indicate that melatonin receptor activation protects against low potassium‐induced ventricular fibrillation, shortens action potential duration, preserves ventricular electrical activation, and prevents acute changes in connexin‐43 distribution. All of these properties make melatonin a remarkable antifibrillatory agent.
Motivation Gaps and Implementation Traps: The Paradoxical and Time‐Varying Effects of Family Ownership on Firm Absorptive Capacity
Authors: Kotlar Josip , De Massis Alfredo , Frattini Federico , Kammerlander Nadine
Published: August 2019

We present a theoretical framework of family ownership as a driver of the heterogeneity (between‐firm differences) and variability (within‐firm differences over time) of absorptive capacity (AC). Building on our analysis of the multiple dimensions of family ownership influence on firm behavior and the mechanisms that can shape the firm willingness and ability to acquire, assimilate, transform, and exploit external knowledge, we introduce the concepts of motivation gap and implementation gap to explain why, paradoxically, family ownership can cause both upward and downward divergences in AC. Our contingency framework identifies conditions under which the positive and negative effects of family ownership on AC are likely to prevail and adds a temporal perspective suggesting that AC varies depending on the duration of family ownership and ownership succession.