bluuebunny/crossref_metadata_2025 huggingface dataset:
AUDIT Scotland 10 years on: explaining how funding decisions link to increased risk for drug related deaths among the poor
Authors: McPhee Iain , Sheridan Barry
Published: September 2020

Purpose

In response to Scottish Government assertions that an ageing cohort explained increases in drug-related death (DRD), the previous research by the authors established that socio-economic inequalities were additional risk factors explaining the significant increases in DRD in Scotland. This paper aims to subject the drug policy narratives provided by Scottish Government in relation to the governance of drug and alcohol services to critical scrutiny and reveal the social consequences of the funding formula used to direct funding to services via NHS Scotland Boards, and Alcohol and Drug Partnerships (ADP).

Design/methodology/approach

The paper provides a narrative review in the context of the AUDIT Scotland reports “Drug and Alcohol Services in Scotland” from 2009 and follow-up report published in 2019. The authors refer to the recommendations made in the 2009 report on effectiveness of drug and alcohol services and subject Scottish Government funding processes, and governance of drug and alcohol services to critical scrutiny.

Findings

This analysis provides robust evidence that Scottish Government funding processes and governance of drug and alcohol services increased risk to vulnerable drug users and document evidence that link these risk factors to increased DRD.

Research limitations/implications

The authors have focused on Scottish drug policy and drug services funding. Alcohol services funding is not subject to critical analysis due to limitations of time and resources.

Practical implications

This case study investigates AUDIT Scotland’s recommendations in 2009 to Scottish Government to provide researchers, government policy advisors and media with robust critical analysis that links drug policy decisions to increased DRD.

Social implications

Drug policy governance by the Scottish Government and NHS Scotland since 2009 have disproportionately affected communities of interest and communities of place already experiencing stark inequalities. These budget decisions have resulted in widening inequalities, and increased DRD within communities in Scotland. The authors conclude that in diverging politically and ideologically from Public Health England, and the Westminster Parliament, Scottish Government drug policy and financial governance of drugs services contributes to increased risk factors explaining DRD within deprived communities.

Originality/value

The 2009 AUDIT Scotland recommendations to Scottish Government subject their governance of drug services to critical scrutiny. This analysis provides a counterpoint to the explanations that rising DRD are unconnected to drug policy and drug services governance.
An empirical study on the correlation between teacher efficacy and ICT infrastructure
Authors: Kundu Arnab , Bej Tripti , Dey Kedar Nath
Published: September 2020

Purpose

Self-efficacy is one's belief in one's ability. In this context, information and communication technology (ICT) self-efficacy is the judgment of one's capability to use ICT – the familiar and effective teaching tools for the 21st century classrooms. The purpose of this empirical study was to investigate the correlation between teachers' ICT self-efficacy and perceived ICT infrastructure in school.

Design/methodology/approach

The study employed a descriptive survey method within ex post facto research design by taking 100 purposively selected Indian government run secondary schools and 400 teachers as participants. The data were analyzed descriptively and inferentially. A correlation analysis was conducted between teachers' ICT self-efficacy and their perception of ICT infrastructure to determine the relationship between the two.

Findings

Findings revealed that the participant teachers' overall ICT self-efficacy along with its three domains – technological efficacy, pedagogical efficacy, integration efficacy – was moderately low and their perception of ICT infrastructure in their respective schools was also far below the expected level. The investigation finally found a moderately high and positive correlation between teachers' ICT self-efficacy and their overall perception of ICT infrastructure. All three domains of efficacy also found positively correlated with the three selected domains of ICT infrastructure.

Originality/value

This paper reports an original empirical survey conducted in India and the write-up is based strictly on the survey findings only. The authors believe this is a new approach to view ICT integration in school pedagogy and recommendations that enhanced teacher efficacy accelerates strengthening ICT infrastructure, improving apposite culture and understanding of the pedagogical value of ICT integrated teaching.
Place, mobility and social support in refugee mental health
Authors: Nolas Sevasti-Melissa , Watters Charles , Pratt-Boyden Keira , Maglajlic Reima Ana
Published: September 2020

Purpose

This review and theoretical analysis paper aims to bring together literatures of place, mobility, refugees and mental health to problematise the ways in which social support is practised on the ground and to rethink its possibilities.

Design/methodology/approach

This paper draws on an interdisciplinary understanding of social support that focusses on the social networks and significant and intimate relationships that mitigate negative mental health and well-being outcomes. The authors explore the dialectic relationship between place and mobility in refugee experiences of social support.

Findings

The authors argue that, in an Euro-American context, practices of social support have historically been predicated on the idea of people-in-place. The figure of the refugee challenges the notion of a settled person in need of support and suggests that people are both in place and in motion at the same time. Conversely, attending to refugees’ biographies, lived experiences and everyday lives suggests that places and encounters of social support are varied and go beyond institutional spaces.

Research limitations/implications

The authors explore this dialectic of personhood as both in place and in motion and its implications for the theorisation, research and design of systems of social support for refugees.

Originality/value

This paper surfaces the dialectics of place and mobility for supporting refugee mental health from an interdisciplinary perspective.
How innovation intermediaries support start-up internationalization: a relational proximity perspective
Authors: Schepis Daniel
Published: September 2020

Purpose

This paper aims to examine how innovation intermediary activities increase relational proximity between start-ups and foreign partners to support start-up internationalization.

Design/methodology/approach

The paper applies a case study methodology to examine an international network of innovation intermediaries in the resources sector. Interviews were conducted with 59 start-ups, corporate and intermediary managers in four countries, supplemented by secondary data. A two-stage analysis process was performed to first identify activities relating to start-up internationalization and then apply a theoretically derived coding framework based on five proximity dimensions.

Findings

The case identifies several innovation intermediary activities, which facilitate relationship development between start-ups and partners in new markets. Findings outline how activities increase relational proximity across different dimensions, while also indicating a number of interrelations between dimensions, given the complexity of international business relationships.

Originality/value

This paper establishes interdisciplinary bridges between business networks, international business and economic geography perspectives. It provides a valuable empirical foundation for relational proximity, demonstrating its application to understanding start-up internationalization and its influence by intermediary-led activities.
The impacts of a new type of actor as an intermediary in public–private collaboration in health-care prevention
Authors: Dóra Tímea Beatrice , Szalkai Zsuzsanna
Published: September 2020

Purpose

This paper aims to investigate the dyadic relationships of actors engaged in public–private (P-P) collaboration in health-care prevention. The purpose is to characterize a new type of actor as an intermediary that connects different actors in P-P collaboration and to compare P-P collaboration based on results expected with and without the inclusion of this new actor.

Design/methodology/approach

For the investigation, the Industrial Marketing and Purchasing Group approach to business relationships is used. The substance (activities-resources-actors) and the functions (dyadic, single actor and network) of business relationships are applied as a research framework. The analysis is based on these theories through a case study.

Findings

This study delivers four important findings: the relationship with this new type of actor results in new resources for all of the participants that are involved, the new actor is a key channel for generating corporate social responsibility recommendations for private actors, relationships with this new type of actor are a great basis on which private firms may build relationships with the public that involve higher levels of health care and also generate sponsorship for public causes, thereby increasing social welfare and the new type of actor can cause potential tensions that require constant and coordinated management.

Originality/value

The paper contributes to the conceptualization of the “interacted actor” through characterizing a new type of actor and its renewing network in P-P collaboration.
Equity market-related economic uncertainty and the “economic contagion phenomenon”
Authors: Abaidoo Rexford , Alade Ayodele
Published: September 2020

Purpose

This study examines potential causal interactions between a dominant economy and its trading partners, with the view of verifying surmised economic contagion effects traditionally presumed to emanate from dominant economies toward trading partners.

Design/methodology/approach

The study used the Toda–Yamamoto Wald test approach to bi-variate causality analysis.

Findings

This study verified the existence of the economic contagion phenomenon; Estimated empirical evidence failed to fully support the presumption that such contagion effects mostly emanates from dominant economies toward trading partners, all things being equal. For instance, although this study found significant economic contagion effects emanating from the US economy toward the Chinese economy, the authors also detected six different uni-directional causal interactions with the direction of causality emanating from trading partners toward the US economy.

Originality/value

The uniqueness of this study stems not from its verification of the economic contagion phenomenon using equity market-related economic uncertainty as the potential contagion. This study fills a gap in the present literature by focusing on the happenings in the equity market as the potential candidate of the economic contagion phenomenon between a dominant economy and its key trading partners.
Simulation training for police and ambulance services to improve mental health practice
Authors: Uddin Tasnim , Saadi Amina , Fisher Megan , Cross Sean , Attoe Chris
Published: September 2020

Purpose

Emergency services face increasing frontline pressure to support those experiencing mental health crises. Calls have been made for police and ambulance staff to receive training on mental health interventions, prevention of risk and inter-professional collaboration. Mental health simulation training, a powerful educational technique that replicates clinical crises for immersive and reflective training, can be used to develop competencies in emergency staff. This study aims to evaluate the effectiveness of mental health simulation training for police and ambulance staff.

Design/methodology/approach

In total, 199 participants from the London Metropolitan Police Service and London Ambulance Service attended a one-day simulation training course designed to promote effective and professional responses to mental health crises. Participants took part in one of six simulated scenarios involving mental health crisis before completing structured debriefs with expert facilitators. Participants’ self-efficacy and attitudes towards mental illness were measured quantitatively using pre- and post-course questionnaires while participants’ perceived influence on clinical practice was measured qualitatively using post-course open-text surveys.

Findings

Statistically significant improvements in self-efficacy and attitudes towards mental illness were found. Thematic analyses of open-text surveys found key themes including improved procedural knowledge, self-efficacy, person-centred care and inter-professional collaboration.

Originality/value

This study demonstrates that mental health simulation is an effective training technique that improves self-efficacy, attitudes and inter-professional collaboration in police and ambulance staff working with people with mental health needs. This technique has potential to improve community-based responses to mental health crises.
Mega-events brand meaning co-creation: the Olympic case
Authors: Tjandra Nathalia Christiani , Rihova Ivana , Snell Sarah , Den Hertog Claire S. , Theodoraki Eleni
Published: September 2020

Purpose

This paper aims to explore a multi-stakeholder perspective on brand meaning co-creation in the context of the Olympic Games as a unique mega sports event brand with a strong brand identity, to understand how the brand manager may integrate such co-created meanings in a negotiated brand identity.

Design/methodology/approach

Using a qualitative methodology, the paper provides a tentative framework of co-created Olympic brand meanings by exploring the narratives of stakeholders’ brand experiences of the brand. Sixteen semi-structured interviews with a purposive sample of Olympic stakeholders were conducted and analysed to identify key meanings associated with the Olympic brand.

Findings

Through their transformational and social experiences of the Olympic brand, stakeholders co-create brand meanings based on Olympic values of excellence, friendship and respect. However, at the same time, they offer their own interpretations and narratives related to competing meanings of spectacle, exclusion and deceit. Alternative brand touchpoints were identified, including blogs; fan and sports community forums; educational and academic sources; and historical sources and literature.

Practical implications

The brand manager must become a brand negotiator, facilitating multi-stakeholder co-creation experiences on a variety of online and offline engagement platforms, and exploring how alternative brand touchpoints can be used to access co-created brand meanings.

Originality/value

The study contributes to tourism branding literature by providing exploratory evidence of how brand meanings are co-created in the relatively under-researched multi-stakeholder sports mega-event context.
Implementation of capacitance as simultaneous sensing and actuating tool in tapered microelectrode arrays for dielectrophoresis-on-a-chip application
Authors: Buyong Muhamad Ramdzan , Larki Farhad , Hakimi Zainal Muhamad Ikhmal , Almahi Abdelaziz Yousif Ahmed , Ismail Ahmad Ghadafi , Hamzah Azrul Azlan , Kayani Aminuddin Ahmad Kayani , Caille Céline Elie , Yeop Majlis Burhanuddin
Published: September 2020

Purpose

This paper aims to present the capacitance characterization of tapered dielectrophoresis (DEP) microelectrodes as micro-electro-mechanical system sensor and actuator device. The application of DEP-on-a-chip (DOC) can be used to evaluate and correlate the capacitive sensing measurement at an actual position and end station of liquid suspended targeted particles by DEP force actuator manipulation.

Design/methodology/approach

The capability of both, sensing and manipulation was analysed based on capacitance changes corresponding to the particle positioning and stationing of the targeted particles at regions of interest. The mechanisms of DEP sensor and actuator, designed in DOC applications were energized by electric field of tapered DEP microelectrodes. The actual DEP forces behaviour has been also studied via quantitative analysis of capacitance measurement value and its correlation with qualitative analysis of positioning and stationing of targeted particles.

Findings

The significance of the present work is the ability of using tapered DEP microelectrodes in a closed mode system to simultaneously sense and vary the magnitude of manipulation.

Originality/value

The integration of DOC platform for contactless electrical-driven with selective detection and rapid manipulation can provide better efficiency in in situ selective biosensors or bio-detection and rapid bio-manipulation for DOC diagnostic and prognostic devices.
Resource partitioning among avian predators of the Arctic tundra
Authors: Seyer Yannick , Gauthier Gilles , Fauteux Dominique , Therrien Jean‐François
Published: September 2020

Interspecific competition can play a key role in structuring ecological communities. The Arctic tundra is a low productivity ecosystem supporting simple food webs, but several predators often feed on the same prey species, lemmings, known for their large‐amplitude population fluctuations.

We examined mechanisms involved in reducing intra‐guild competition and allowing coexistence of four avian predators (snowy owls, glaucous gulls, rough‐legged hawks and long‐tailed jaegers) feeding on a pulsed resource (brown and collared lemmings). We compared the size and species of prey consumed by predators to see if resource partitioning occurred. We also verified if spatial segregation in nesting areas could be another mechanism allowing coexistence. Finally, we tested if the absence of the snowy owl, a dominant and irruptive species, triggered a competitive release on the smallest predator, the jaeger, with respect to prey size and nesting area used.

We monitored the breeding of predators and lemming abundance over a 14‐year period on Bylot Island, Canada. We mapped their nesting sites and collected regurgitation pellets to recover lemming mandibles, which were used to infer prey species and size.

The size of lemmings consumed varied among species with the largest predators consuming the largest lemmings and the smallest predators consuming the smallest lemmings. All predators consumed more collared than brown lemmings compared to their availability although owls and jaegers consumed relatively more brown lemmings compared to gulls and hawks. Jaegers consumed larger lemmings in the absence of owls than in their presence, suggestive of a short‐term competitive release. We found moderate to low overlap in nesting areas among predators and no evidence of their expansion in the absence of owls, suggesting that spatial distribution is caused by species‐specific habitat preferences.

The main mechanism to partition food resources among these avian predators is spatial segregation, and secondarily prey size and species. However, we found evidence that food competition is still present and leads to a niche shift in the smallest predator of the guild. Interspecific competition may thus be a pervasive force in simple, low productivity food webs characterized by pulsed resources.
When form does not predict function: Empirical evidence violates functional form hypotheses for marine macroalgae
Authors: Ryznar Emily R. , Fong Peggy , Fong Caitlin R.
Published: September 2020

Functional groups are widely used to reduce complexity and generalize across ecological communities. These models assume that shared traits among species correspond to some ecological role, process or function, and that these traits can be leveraged to generate meaningful and distinct functional groups so that intergroup trait variation exceeds intragroup variation.

We sought to validate the assumptions of the widely used functional group model (FGM) for marine macroalgae, which groups species based on morphological complexity, by testing the predictions of the FGM for several traits assumed to correspond with morphological complexity. The FGM predicts increased resistance to disturbance and herbivory as morphological complexity (tensile strength and thallus toughness, respectively) increases. The FGM also predicts a trade‐off between complexity and growth rate. To test predictions, we measured (a) thallus toughness (force to penetrate), (b) tensile strength (force to break) and (c) relative growth for both tropical and temperate macroalgae from different functional groups.

Thallus toughness followed model predictions at the functional group level, though there was significant variability among species. However, the model did not predict tensile strength at any level for either tropical or temperate macroalgae. Furthermore, relative growth did not follow predictions; rather it was highly variable among species and functional groups.

Synthesis. The assumptions of the FGM that differences in morphological complexity can be used to generate distinct functional groups and that intergroup trait variation outweighs intragroup variation were violated, providing strong evidence that individual species responses need to be considered. Furthermore, violations of assumptions indicate that functional groups should not be used to predict community responses to ecological drivers and/or species contributions to ecosystem function. Our study challenges the usefulness of functional form groups for marine macroalgae and emphasizes the need for a different conceptual framework.
Accuracy of qualitative and quantitative cranial ultrasonographic markers in first‐trimester screening for open spina bifida and other posterior brain defects: a systematic review and meta‐analysis
Authors: Mace P , Mancini J , Gorincour G , Quarello E
Published: September 2020

Background

The significant number of qualitative and quantitative ultrasound markers described for first‐trimester screening of open spina bifida (OSB) and other posterior brain defects (oPBD) has resulted in their complex implementation and interpretation for a widespread screening and in a lack of consensus regarding diagnostic accuracy.

Objectives

To assess and compare the accuracy of qualitative and quantitative cranial sonographic markers at 11–14 weeks of gestation for the detection of OSB and oPBD.

Search strategy

A systematic literature search was performed in MEDLINE and COCHRANE from 2009 to April 2020.

Selection criteria

Studies assessing the diagnostic accuracy of quantitative and/or qualitative ultrasound signs to predict OSB and oPBD were included. Cohort studies and case–control studies were also considered.

Data collection and analysis

Two reviewers independently extracted data and assessed the risk of bias. The overall pooled estimate and a summary receiver operating characteristic curve was estimated for each subgroup (qualitative and quantitative assessment).

Main results

Twenty‐three studies were included in our meta‐analysis. The pooled sensitivity and specificity for qualitative assessment were 76.5% and 99.6%, and for quantitative assessment were 84.5% and 96.3%, respectively; specificity for the qualitative ultrasound signs was significantly higher (P = 0.001). The overall sensitivity of cranial sonographic markers for the screening of oPBD was 76.7% and specificity was 97.5%.

Conclusions

The qualitative approach demonstrated greater specificity, so this would appear to be more appropriate for daily screening, as a first‐line tool, whereas the quantitative approach should be reserved for expert ultrasound.

Tweetable abstract

This study highlights the relevance of first‐trimester qualitative ultrasound signs in the screening of open spina bifida.
Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study
Authors: Schillinger Dean , Balyan Renu , Crossley Scott A. , McNamara Danielle S. , Liu Jennifer Y. , Karter Andrew J.
Published: September 2020

Objective

To develop novel, scalable, and valid literacy profiles for identifying limited health literacy patients by harnessing natural language processing.

Data Source

With respect to the linguistic content, we analyzed 283 216 secure messages sent by 6941 diabetes patients to physicians within an integrated system's electronic portal. Sociodemographic, clinical, and utilization data were obtained via questionnaire and electronic health records.

Study Design

Retrospective study used natural language processing and machine learning to generate five unique “Literacy Profiles” by employing various sets of linguistic indices: Flesch‐Kincaid (LP_FK); basic indices of writing complexity, including lexical diversity (LP_LD) and writing quality (LP_WQ); and advanced indices related to syntactic complexity, lexical sophistication, and diversity, modeled from self‐reported (LP_SR), and expert‐rated (LP_Exp) health literacy. We first determined the performance of each literacy profile relative to self‐reported and expert‐rated health literacy to discriminate between high and low health literacy and then assessed Literacy Profiles’ relationships with known correlates of health literacy, such as patient sociodemographics and a range of health‐related outcomes, including ratings of physician communication, medication adherence, diabetes control, comorbidities, and utilization.

Principal Findings

LP_SR and LP_Exp performed best in discriminating between high and low self‐reported (C‐statistics: 0.86 and 0.58, respectively) and expert‐rated health literacy (C‐statistics: 0.71 and 0.87, respectively) and were significantly associated with educational attainment, race/ethnicity, Consumer Assessment of Provider and Systems (CAHPS) scores, adherence, glycemia, comorbidities, and emergency department visits.

Conclusions

Since health literacy is a potentially remediable explanatory factor in health care disparities, the development of automated health literacy indicators represents a significant accomplishment with broad clinical and population health applications. Health systems could apply literacy profiles to efficiently determine whether quality of care and outcomes vary by patient health literacy; identify at‐risk populations for targeting tailored health communications and self‐management support interventions; and inform clinicians to promote improvements in individual‐level care.
The mourning process and “living with the dead”: Two case reports and a review of the literature
Authors: Bosco Caterina , Tattoli Lucia , Di Vella Giancarlo , Ventura Francesco , Verde Alfredo , Rocca Gabriele
Published: September 2020

The discovery of mummified bodies in domestic settings is not unusual in the medico‐legal context. It is often a marker of social isolation, even in our urban modern society, and usually occurs among elderly people living alone or in precarious conditions. However, bereaved subjects can sometimes be found managing their grief by deliberately keeping the corpses of their loved ones at home. Investigation of these atypical cases can be challenging and often requires a multidisciplinary effort by different forensic specialists. We report two cases of people who lived for several months with the mummified remains of a relative. In both cases, the judge ordered a forensic psychiatry assessment of the survivors’ competency and the reasons for this peculiar behavior, which is regarded as abnormal in our society. Case 1 describes a shared psychosis, which developed out of a condition of extreme seclusion of the entire family. Case 2 shows that even a mild personality disorder on which a series of traumatic events operates can trigger psychotic decompensation, causing extreme denial of the reality of death. The analysis of these cases contributes to our knowledge of the scantly studied phenomenon of “Living with the Dead” and raises questions about the psychopathology behind it. It is useful to identify subjects who are more prone to developing this “deviant” behavior, in order to distinguish people with mental illness from those who merely want to profit from the death of a loved one.
In search of identity: The field of forensic anthropology in Brazil—Profession and practice
Authors: Górka Katarzyna , Plens Cláudia Regina
Published: September 2020

The existing divergencies in the development of forensic anthropology (FA) around the world justify an analysis of its situation in each country/region. Our objective is to report information gathered directly from professionals acting in the field of forensic anthropology in Brazil, with the aim of highlighting the challenges of the discipline and contributing to its advancement. The research consisted of personal visits in Medico‐Legal Institutes (IMLs) in nine states of the country and semi‐structured interviews with 16 professionals. Detailed analysis of the Results suggests the field of forensic anthropology, despite the engagement and dedication of its professionals, cannot yet be considered a well‐structured discipline across the country. The academic background of professionals is highly heterogenous. The applied methods vary, and common protocol is not always followed. The demand highly exceeds the available human resources. The lack of comparative material Results in high percentage of cases remaining unsolved. Important divergences exist in terms of infrastructure and professional resources between the states. The limited cooperation between different IMLs and between different sections of the same IML—together with a general disbelief in the usefulness of anthropological examination in forensic cases—hampers FA’s development. There is a great openness for scientific collaboration and an abundance of material for research. Our research demonstrated structural, political, and academic limitations that affect the FA field in Brazil. However, the expertise and dedication of professionals point to human potential as the chief strength of this discipline that supports and enables research, providing high‐quality services in a challenging context.
Functional properties of syrup from malted and unmalted rice of different varieties: A comparative study
Authors: Ofoedu Chigozie E. , Osuji Chijioke M. , Omeire Gloria C. , Ojukwu Moses , Okpala Charles Odilichukwu R. , Korzeniowska Małgorzata
Published: September 2020

The continued increase in Nigeria's rice production makes product diversification very fitting, even to underutilized indigenous/local varieties. Further, rice converted to malt can bring about useful products like syrup with enhanced characteristics. In this context, a comparative study involving some functional properties of syrup from malted and unmalted rice of different varieties was carried out. Syrup from either filtered or centrifuged starch hydrolysates of enzyme hydrolyzed rice (malted/unmalted) flours gave rise to filtered unmalted (FUHR), filtered malted (FMHR), centrifuged unmalted (CUHR), and centrifuged malted hydrolyzed rice (CMHR) groups. From these, functional properties, that is, pH, total soluble proteins (TSP), total dissolved solids (TDS), total solids (TS), dextrose equivalent (DE), titratable acidity (TA), apparent brix (°B), specific gravity (SG), syrup yield (SY), and some minerals [calcium (Ca), iron (Fe), magnesium (Mg), and zinc (Zn)] were determined. Results showed syrup from malted with significantly higher (P < 0.05) SY, Brix, pH, SG, TS, TDS, and TSP, but significantly lower (P < 0.05) TA, DE, and mineral contents (Ca, Zn, Fe, and Mg) over the unmalted group. Some significant interactions (P < 0.05) were found, between rice variety, treatment and separation method (TS, TDS, DE, Brix, SY, and Ca), rice variety and treatment (TSP, Zn, Mg, and Fe), as well as rice variety and separation method (TSP, pH). In addition, some positive and negative significant (P < 0.05) correlations between the studied functional properties were found. Overall, malting and processing methods can influence the functional properties of rice syrup—an acceptable specialty ingredient for brewing/beverage production.

Practical Application

Through the application of exogenous enzymes, rice syrup has been successfully produced from locally bred/improved rice varieties commercially available in Nigeria. By comparing some functional properties of syrup from malted and/or unmalted rice, the current research provides useful evidence that locally available rice varieties are potential candidates for product diversification to the food/brewing, pharmaceuticals, and other industries, not only in Nigeria but also in the West Africa subregion.
Ketamine for post‐operative pain treatment in spinal surgery. A protocol for a systematic review with meta‐analysis and trial sequential analysis
Authors: Pind Alison Holten , Laursen Christina Cleveland , Andersen Cheme , Maagaard Mathias , Mathiesen Ole
Published: September 2020

Background

Post‐operative pain treatment with ketamine has been demonstrated to have post‐operative opioid‐sparing and anti‐hyperalgesic effects. However, evidence regarding the beneficial and harmful effects and the optimal dose and timing of perioperative treatment with ketamine for patients undergoing spinal surgery is unclear. The objective of this systematic review is to assess the analgesic, serious and non‐serious adverse effects of perioperative pain treatment with ketamine for patients undergoing spinal surgery.

Methods

This protocol for a systematic review is written according to The Preferred Reporting Items for Systematic Review and Meta‐Analysis Protocols guidelines. We will search Embase, CENTRAL, PubMed, WHO’s ICTRP, EU Clinical Trial Register and ClinicalTrials.gov to identify relevant randomised clinical trials. We will include all randomised clinical trials assessing perioperative ketamine treatment versus placebo or no intervention for patients undergoing spinal surgery. Two authors will independently screen trials for inclusion using Covidence, extract data and assess risk of bias using Cochrane's RoB tool. We will analyse data using Review Manager and Trial Sequential Analysis. Meta‐analysis will be performed according to the Cochrane guidelines and results will be validated according to the eight‐step procedure suggested by Jakobsen et al. We will present our primary findings in a ‘summary of findings’ table. We will evaluate the overall certainty of evidence using the GRADE approach.

Discussion

This systematic review will assess the beneficial and harmful effects of perioperative pain treatment with ketamine for patients undergoing spinal surgery and have the potential to inform best practice and advance research.
The effect of mannitol on oxidation‐reduction potential in patients undergoing deceased donor renal transplantation—A randomized controlled trial
Authors: Reiterer Christian , Hu Karin , Sljivic Samir , Falkner von Sonnenburg Markus , Fleischmann Edith , Kabon Barbara
Published: September 2020

Background

Mannitol, an osmotic diuretic, is proposed to be an oxygen radical scavenger. Mannitol is often used in renal transplantation to attenuate oxidative stress and thus to protect renal graft function. We tested the hypothesis that mannitol reduces overall oxidative stress during deceased donor renal transplantation.

Methods

We randomly assigned 34 patients undergoing deceased donor renal transplantation to receive a solution of mannitol or placebo shortly before graft reperfusion until the end of surgery. We evaluated oxidative stress by measuring the static oxidative‐reduction potential (sORP) and the capacity of the oxidative‐reduction potential (cORP). sORP and cORP were measured pre‐operatively, before and within 10 minutes after graft reperfusion, and post‐operatively.

Results

Seventeen patients were enrolled in the mannitol group and 17 patients were enrolled in the placebo group. Mannitol had no significant effect on sORP (148.5 mV [136.2; 160.2]) as compared to placebo (143.6 mV [135.8; 163.2], P = .99). There was also no significant difference in cORP between the mannitol (0.22 µC [0.16; 0.36]) and the placebo group (0.22 µC [0.17; 0.38], P = .76).

Conclusion

Mannitol showed no systemic redox scavenging effects during deceased donor renal transplantation. To evaluate the direct effect of mannitol on the renal graft further studies are needed.

Trial registration: ClinicalTrials.gov NCT02705573.
A clinical trial with valproic acid and hydralazine in combination with gemcitabine and cisplatin followed by doxorubicin and dacarbazine for advanced hepatocellular carcinoma
Authors: Liu Yao‐Chung , Su Chien‐Wei , Ko Po‐Shen , Lee Rheun‐Chuan , Liu Chia‐Jen , Huang Yi‐Hsiang , Gau Jyh‐Pyng , Liu Jin‐Hwang
Published: September 2020

Background

Survival benefit from chemotherapy in advanced hepatocellular carcinoma (HCC) was limited till now. New chemoregimens with cytotoxicity modulators were explored to improve efficacy. Chemotherapy modulated with valproic acid (VA) as a deacetylation inhibitor of histone and DNA damage response proteins, and hydralazine (HZ) as a DNA hypomethylating agent, hypothetically suppressing DNA repair, were used in phase II trial here for advanced HCC.

Methods

Between July 2008 and March 2016, patients with chemo‐naive advanced HCC, regardless of previous sorafenib treatment, not amenable to local therapy and with Child Pugh score ≤7, were treated with VA (200 mg thrice per day) and HZ (12.5 mg twice per day) in conjunction with gemcitabine and cisplatin (GCGG): gemcitabine (1000 mg/m2, D1; 800 mg/m2 D8, 15) and cisplatin (70 mg/m2, D1) every 28 days till disease progression and then with Dox‐DTIC: doxorubicin (45 mg/m2) and dacarbazine (450 mg/m2) every 28 days. The primary endpoint was overall survival (OS); the secondary endpoints were safety, progression‐free survival (PFS) and response rate (RR).

Results

Thirty‐seven patients with 16 sorafenib‐experienced, underwent GCGG treatment, and 30 of them underwent the following Dox‐DTIC treatment. The median OS was 14.6 months (95% confidence interval: 6.0–23.1). The median PFSs for patients treated with VA‐ and HZ‐combined GCGG and Dox‐DTIC were 3.7 and 4.2 months, respectively; the RRs were 10/37 (27.0%) and 7/30 (23.3%); and grade 3/4 neutropenia were 54% and 51%. However, there were no chemotherapy‐related deaths.

Conclusion

VA‐ and HZ‐combined sequential chemotherapy was effective in advanced HCC with manageable toxicities.
Women’s experiences of decision‐making and beliefs in relation to planned caesarean section: A survey study
Authors: Coates Dominiek , Donnolley Natasha , Thirukumar Purshaiyna , Lainchbury Anne , Spear Virginia , Henry Amanda
Published: September 2020

Background

The caesarean section (CS) rate is over 25% in many high‐income countries, with a substantial minority of CSs occurring in women with low‐risk pregnancies. CS decision‐making is influenced by clinician and patient beliefs and preferences, and clinical guidelines increasingly stipulate the importance of shared decision‐making (SDM). To what extent SDM occurs in practice is unclear.

Aims

To identify women’s birth preferences and SDM experience regarding planned CS.

Material and Methods

Survey of women at eight Sydney hospitals booked for planned CS. Demographic data, initial mode of birth preferences, reason for CS, and experiences of SDM were elicited using questions with multiple choice lists, Likert scales, and open‐ended responses. Quantitative data were analysed using descriptive statistics and qualitative data using content analysis. Responses of women who perceived their CS as 'requested' vs 'recommended' were compared.

Results

Of 151 respondents, repeat CS (48%) and breech presentation (14%) were the most common indications. Only 32% stated that at the beginning of pregnancy they had a definite preference for spontaneous labour and birth. Key reasons for wanting planned CS were to avoid another emergency CS, prior positive CS experience, and logistical planning. Although 15% of women felt pressured (or were unsure) about their CS decision, the majority reported positive experiences, with over 90% indicating they were informed about CS benefits and risks, had adequate information, and understood information provided.

Conclusions

The majority (85%) of women appeared satisfied with the decision‐making process, regardless of whether they perceived their CS as requested or recommended.
The Strategic Performance Management System in Selected Philippine National Government Agencies: Assessment and Policy Recommendations
Authors: Torneo Ador R. , Mojica Brian J.
Published: September 2020

This study assessed the Strategic Performance Management System (SPMS) based on a systematic review and synthesis of its implementation in selected Philippine national government agencies, specifically the Department of Interior and Local Government, the Department of Education, and the Commission on Higher Education. It provides an overview, discusses the cultural and administrative context, summarizes previous assessments done from 2013 to 2017, and offers recommendations. Overall, SPMS is theoretically viable but has several flaws preventing effective implementation in these agencies. To mitigate adverse effects, SPMS should be redesigned to appeal to intrinsic motivators and focus on individual improvement. Performance management processes should be streamlined, and a more agile methodology adopted. In the long term, the SPMS should be updated over time so that it aligns well with Filipino culture and the goals of the Philippine bureaucracy.
Gestation as mothering
Authors: Murphy Timothy F. , Parks Jennifer A.
Published: September 2020

Some commentators maintain that gestational surrogates are not ‘mothers’ in a way capable of grounding a claim to motherhood. These commentators find that the practices that constitute motherhood do not extend to gestational surrogates. We argue that gestational surrogates should be construed as mothers of the children they bear, even if they fully intend to surrender those children at birth to the care of others. These women stand in a certain relationship to the expected children: they live in changed moral circumstances by reason of their pregnancy, and they engage in the practices said to define motherhood in the post‐birth context. By contrast, ovum donors and embryo donors are not similarly ‘mothers’ because they do not find themselves involved in these circumstances. Not all women involved in three‐parent in vitro fertilization qualify as mothers either. Given this analysis of mothering, we note that transmen who gestate children are engaged in mothering activity even if they otherwise function as a father to those children. By itself, this defence of the maternity of gestational surrogates does not confer moral title to the children they bear; gestation would not by itself override the contractual arrangements gestational surrogates have made regarding the disposition of their children. This interpretation of gestational surrogates as mothers does, however, undercut cultural understandings of these women as mere ‘vessels’, devoid of entitlement to respect as persons and parents. We also consider the meaning of mothering for ‘brain‐dead’ women kept alive to give birth and for the prospect of extracorporeal gestation.
Diagnostic performance of 18F‐FDG‐PET/CT compared to standard skeletal survey for detecting bone destruction in smouldering multiple myeloma: time to move forward
Authors: Hill Elizabeth , Mena Esther , Morrison Candis , Dew Alexander , Choyke Peter , Lindenberg Liza , Kazandjian Dickran
Published: September 2020

Skeletal survey (SS) continues to be used in the community to detect bone disease in patients with multiple myeloma (MM). While the false‐negative rate is high, the specificity of SS is less well characterised. Here, we compare the diagnostic accuracy of SS compared to 18F‐FDG‐PET/CT (positron emission tomography/computed tomography) in 79 patients referred to our tertiary centre with a diagnosis of smouldering MM. SS had a specificity of 83·1% (95% confidence interval: 72·0–90·5%). This study reinforces the importance of using more specific imaging techniques to avoid inaccurate diagnosis that could lead to the risks associated with unnecessary therapy in patients with smouldering MM.
The biology of human hair greying
Authors: O'Sullivan James D. B. , Nicu Carina , Picard Martin , Chéret Jérémy , Bedogni Barbara , Tobin Desmond J. , Paus Ralf
Published: September 2020

Hair greying (canities) is one of the earliest, most visible ageing‐associated phenomena, whose modulation by genetic, psychoemotional, oxidative, senescence‐associated, metabolic and nutritional factors has long attracted skin biologists, dermatologists, and industry. Greying is of profound psychological and commercial relevance in increasingly ageing populations. In addition, the onset and perpetuation of defective melanin production in the human anagen hair follicle pigmentary unit (HFPU) provides a superb model for interrogating the molecular mechanisms of ageing in a complex human mini‐organ, and greying‐associated defects in bulge melanocyte stem cells (MSCs) represent an intriguing system of neural crest‐derived stem cell senescence. Here, we emphasize that human greying invariably begins with the gradual decline in melanogenesis, including reduced tyrosinase activity, defective melanosome transfer and apoptosis of HFPU melanocytes, and is thus a primary event of the anagen hair bulb, not the bulge. Eventually, the bulge MSC pool becomes depleted as well, at which stage greying becomes largely irreversible. There is still no universally accepted model of human hair greying, and the extent of genetic contributions to greying remains unclear. However, oxidative damage likely is a crucial driver of greyingviaits disruption of HFPU melanocyte survival, MSC maintenance, and of the enzymatic apparatus of melanogenesis itself. While neuroendocrine factors [e.g. alpha melanocyte‐stimulating hormone (α‐MSH), adrenocorticotropic hormone (ACTH), ß‐endorphin, corticotropin‐releasing hormone (CRH), thyrotropin‐releasing hormone (TRH)], and micropthalmia‐associated transcription factor (MITF) are well‐known regulators of human hair follicle melanocytes and melanogenesis, how exactly these and other factors [e.g. thyroid hormones, hepatocyte growth factor (HGF), P‐cadherin, peripheral clock activity] modulate greying requires more detailed study. Other important open questions include how HFPU melanocytes age intrinsically, how psychoemotional stress impacts this process, and how current insights into the gerontobiology of the human HFPU can best be translated into retardation or reversal of greying.