bluuebunny/crossref_metadata_2025 huggingface dataset:
Idiopathic myointimal hyperplasia is a distinct cause of chronic colon ischaemia
Authors: Anderson B. , Smyrk T. C. , Graham R. P. , Lightner A. , Sweetser S.
Published: May 2019

Aim

Colon ischaemia (CI) is most commonly an acute and reversible manifestation of a transient, non‐occlusive decrease of blood flow in the colonic microvasculature. Irreversible complications are uncommon and the progression to chronic CI remains controversial. Our objective was to identify cases of chronic CI and assess for distinct clinicopathological features.

Method

A retrospective review was performed of CI patients having symptom chronicity of ≥ 1 month and ischaemic histology at our institution from 1994 to 2015. Demographic, clinical, endoscopic, radiological, pathological and outcome variables were abstracted. Histological evaluation was performed by two gastrointestinal pathologists.

Results

Fifteen patients (n = 9; 67% men) with a median age of 65 years (range 22–88) were identified. The most common presenting symptoms were diarrhoea and abdominal pain (n = 6, 86%; n = 5, 71%, respectively). The typical endoscopic appearance was segmental ulceration of the sigmoid colon (n = 6, 75%). Vascular imaging showed patent mesenteric vessels in all patients. Histopathological evaluation revealed venous intimal hyperplasia consistent with idiopathic myointimal hyperplasia of the mesenteric veins (IMHMV) in eight patients; the remainder showed non‐specific ulceration and fibrosis. Surgical resection was performed in seven IMHMV patients, resulting in symptom resolution. On re‐review of pre‐resection biopsies, all IMHMV patients had characteristic changes of hyperplastic, thick‐walled, hyalinized vessels in the lamina propria.

Conclusions

IMHMV is a unique histopathological entity causing chronic CI. The small vessel histological changes in IMHMV are distinctive in colonic resections and undetectable by routine vascular imaging. Preoperative diagnosis of IMHMV is possible with endoscopic biopsy and segmental colon resection is curative.
Long‐term donor quality of life after living donor liver transplantation in Japan
Authors: Morooka Yuki , Umeshita Koji , Taketomi Akinobu , Shirabe Ken , Yoshizumi Tomoharu , Yamamoto Mayumi , Shimamura Tsuyoshi , Oshita Akihiko , Ohdan Hideki , Kawagishi Naoki , Hagiwara Kuniko , Eguchi Hidetoshi , Nagano Hiroaki
Published: May 2019

Aims

This study examined the long‐term quality of life (QOL) of living liver donors (LLDs) in Japan using both generic and LLD‐specific instruments.

Methods

The sample comprised 374 LLDs from five university hospitals in Japan who underwent surgery more than a year previously. QOL was evaluated using the Short Form‐36 health survey (SF‐36) and LLD‐QOL scale.

Results

SF‐36 results indicated that the overall long‐term QOL of LLDs was significantly better than the Japanese standard. When comparing by donor factors, LLDs whose recipients were children scored higher for “satisfaction” than those whose recipients were adults on the LLD‐QOL scale. LLDs with complications had lower QOL for “scars” and “burden” on the LLD‐QOL scale but no differences in SF‐36 scores. LLDs with longer hospital stay had lower physical QOL on SF‐36 and lower QOL for “scars” and “after‐effects” on the LLD‐QOL scale. LLDs whose recipients have died showed lower mental QOL on SF‐36 and lower “satisfaction” and greater “lack of understanding of donor health” on the LLD‐QOL scale.

Conclusions

Our multicenter study clarified the long‐term QOL of LLDs and suggested that donors’ QOL was related to the donors’ and recipients’ ages, donor's complications and hospital stay length, and recipient's prognosis.
Noninvasive estimation of pulmonary vascular resistance improves portopulmonary hypertension screening in liver transplant candidates
Authors: DesJardin Jacqueline T. , Manicardi Marcella , Svetlichnaya Yana , Kolaitis Nicholas A. , Papolos Alexander I. , Selby Van N. , Zier Lucas S. , Klein Liviu , Aras Mandar A. , Yao Francis Y. , Roberts John P. , De Marco Teresa
Published: May 2019

Despite limitations in sensitivity and specificity, estimation of the pulmonary artery systolic pressure (ePASP) on echocardiography is used for portopulmonary hypertension (PoPH) screening in liver transplant (LT) candidates. We proposed that alternative echocardiographic models, such as estimated pulmonary vascular resistance (ePVR), may provide improved testing characteristics in PoPH screening. In a retrospective analysis of 100 LT candidates, we found that the formula ePVR = ePASP/VTIRVOT + 3 if MSN (VTIRVOT = right ventricular outflow tract time velocity integral; MSN = mid‐systolic notching of the VTIRVOT Doppler signal) significantly improves accuracy of PoPH screening compared to ePASP. We determined the optimal ePVR cutoff for PoPH screening to be 2.76 Wood units, as this cutoff provided 100% sensitivity and 73% specificity in screening for clinically significant PoPH. Comparatively, ePASP at a cutoff of 40 mm Hg provided 91% sensitivity and 48% specificity. We devised a new screening algorithm based on the use of ePVR at intermediate ePASP values (35‐54 mm Hg), and we confirmed the testing characteristics of this algorithm in a separate validation cohort of 50 LT candidates. In screening LT candidates for PoPH, the ePASP lacks accuracy, leading to unnecessary RHCs and undiagnosed cases of PoPH. A screening algorithm which incorporates the ePVR may be more reliable.
Pneumocystis jiroveci in solid organ transplantation: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice
Authors: Fishman Jay A. , Gans Hayley ,   the AST Infectious Diseases Community of Practice
Published: May 2019

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of Pneumocystis jiroveci fungal infection transplant recipients. Pneumonia (PJP) may develop via airborne transmission or reactivation of prior infection. Nosocomial clusters of infection have been described among transplant recipients. PJP should not occur during prophylaxis with trimethoprim‐sulfamethoxazole (TMP‐SMX). Without prophylaxis, PJP risk is greatest in the first 6 months after organ transplantation but may develop later. Risk factors include low lymphocyte counts, cytomegalovirus infection (CMV), hypogammaglobulinemia, treated graft rejection or corticosteroids, and advancing patient age (>65). Presentation typically includes fever, dyspnea with hypoxemia, and cough. Chest radiographic patterns generally reveal diffuse interstitial processes best seen by CT scans. Patients generally have PO2 < 60 mm Hg, elevated serum lactic dehydrogenase (LDH), and elevated serum (1 → 3) β‐d‐glucan assay. Specific diagnosis uses respiratory specimens with direct immunofluorescent staining; invasive procedures may be required. Quantitative PCR is a useful adjunct to diagnosis. TMP‐SMX is the drug of choice for therapy; drug allergy should be documented before resorting to alternative therapies. Adjunctive corticosteroids may be useful early. Routine PJP prophylaxis is recommended for at least 6‐12 months post–transplant, preferably with TMP‐SMX.
Surgical site infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice
Authors: Abbo Lilian M. , Grossi Paolo Antonio ,   the AST ID Community of Practice
Published: May 2019

These guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of post‐operative surgical site infections (SSIs) in solid organ transplantation. SSIs are a significant cause of morbidity and mortality in SOT recipients. Depending on the organ transplanted, SSIs occur in 3%‐53% of patients, with the highest rates observed in small bowel/multivisceral, liver, and pancreas transplant recipients. These infections are classified by increasing invasiveness as superficial incisional, deep incisional, or organ/space SSIs. The spectrum of organisms implicated in SSIs in SOT recipients is more diverse than the general population due to other important factors such as the underlying end‐stage organ failure, immunosuppression, prolonged hospitalizations, organ transportation/preservation, and previous exposures to antibiotics in donors and recipients that could predispose to infections with multidrug‐resistant organisms.

In this guideline, we describe the epidemiology, clinical presentation, differential diagnosis, potential pathogens, and management. We also provide recommendations for the selection, dosing, and duration of peri‐operative antibiotic prophylaxis to minimize post‐operative SSIs.
Use of crystal violet solution for identifying the distal excision line during esophageal submucosal tunnel resection
Authors: Kobara Hideki , Mori Hirohito , Masaki Tsutomu
Published: May 2019

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Ethnic differences in intrahepatic lipid and its association with hepatic insulin sensitivity and insulin clearance between men of black and white ethnicity with early type 2 diabetes
Authors: Hakim Olah , Bello Oluwatoyosi , Bonadonna Riccardo C. , Mohandas Cynthia , Shojaee‐Moradie Fariba , Jackson Nicola , Boselli Linda , Whitcher Brandon , Shuaib Haris , Alberti Kurt George M. M. , Peacock Janet L. , Umpleby Anne Margot , Charles‐Edwards Geoffrey , Amiel Stephanie A. , Goff Louise M.
Published: May 2019

Intrahepatic lipid (IHL) is linked with reduced hepatic insulin sensitivity and insulin clearance. Despite their high risk for type 2 diabetes (T2D), there have been limited investigations of these relationships in black populations. We investigated these relationships in 18 white European (WE) and 18 black West African (BWA) men with T2D <5 years. They underwent magnetic resonance imaging to quantify IHL, a hyperinsulinemic euglycaemic clamp with [6,6 2H2] glucose infusion to assess hepatic insulin sensitivity and a hyperglycaemic clamp to assess insulin clearance. BWA men had lower IHL than WE men (3.7 [5.3] vs 6.6 [10.6]%, P = 0.03). IHL was inversely associated with basal hepatic insulin sensitivity in WE but not BWA men (BWA: r = −0.01, P = 0.96; WE: r = −0.72, P = 0.006) with a significant interaction by ethnicity (Pinteraction = 0.05); however, IHL was not associated with % suppression of endogenous glucose production by insulin in either ethnicity. IHL showed a trend to an association with insulin clearance in BWA only (BWA: r = −0.42, P = 0.09; WE: r = −0.14, P = 0.58). The lack of association between IHL and hepatic insulin sensitivity in BWA men indicates IHL may play a lesser detrimental role in T2D in BWA men.
Evidence of an emerging female preference for an artificial male trait and the potential for spread via mate choice copying in Poecilia latipinna
Authors: MacLaren Ronald D.
Published: May 2019

The initial purpose of the project described herein was to assess the preference of female Poecilia latipinna for an artificial novel male trait—an orange‐colored distal fringe added to the caudal fin of an otherwise wild‐type conspecific. Analysis of the preliminary data revealed consistent individual differences in the strength of female preference for either orange‐tailed or wild‐type males. This finding inspired the study's second aim—to evaluate whether the preference for orange‐tailed males observed among a subset of females could spread via mate choice copying to others in the population that initially preferred wild‐type males. Two experiments and a control were conducted wherein females were simultaneously presented with an orange‐tailed and a wild‐type dummy male using a standard dichotomous choice design. In the first experiment, female preference was assessed on two separate occasions in order to characterize the variability and consistency in preference for orange‐tailed versus wild‐type males. The second experiment addressed mate choice copying: Female preference was again assessed on two separate occasions, but involved pairing a model female with the non‐preferred male for a period of time between preference tests. A third set of control tests were conducted using the same protocol as the copying experiment except that subject females were unable to see the model paired with the non‐preferred male. Results showed that, although females collectively preferred neither the orange‐tailed nor the wild‐type dummy male in the first round of preference tests, the majority showed relatively strong individual preferences. The subset of females that preferred the orange‐tailed over the wild‐type male in the first round of testing all maintained their preferences in the second round whether or not they had observed a model in association with the non‐preferred wild‐type male between tests. However, females that preferred the wild type over the orange male in the first round of testing copied the model's choice of the non‐preferred orange‐tailed male in their second round of preference testing. These results highlight the importance of recognizing the likelihood that only a subset of females will express a preference as it first emerges within a population. In such instances, the preference may not be detected at the population level—a point frequently overlooked in studies of mate choice. Additionally, these data highlight the importance of assessing the preferences of individual females and their capacity to drive evolutionary change within populations. Lastly, this study offers evidence of a possible mechanism by which a novel male trait might spread via mate choice copying by exploiting an emerging sensory bias within a subset of females in the population.
Equity issues when in distress
Authors: Walker Mark D. , Wu Qingqing
Published: May 2019

We investigate the role of financial distress in the seasoned equity market. We find that distressed firms comprise about 40% of SEOs and these distressed issuers have worse abnormal announcement returns than non‐distressed issuers. Stock return volatility is an important determinant for announcement returns for non‐distressed SEO issuers but not for distressed SEO issuers. Signals of firm quality are associated with better announcement returns, larger issues, increased investment, improved operating performance, and lower likelihood of delisting for distressed SEO firms as compared to non‐distressed firms. Our findings suggest equity finance is valuable for financially distressed firms with strong growth prospects.
Renewed diversification following Miocene landscape turnover in a Neotropical butterfly radiation
Authors: Chazot Nicolas , Willmott Keith R. , Lamas Gerardo , Freitas André V. L. , Piron‐Prunier Florence , Arias Carlos F. , Mallet James , De‐Silva Donna Lisa , Elias Marianne
Published: May 2019

Aim

The landscape of the Neotropical region has undergone dynamic evolution throughout the Miocene, with the extensive Pebas wetland occupying western Amazonia between 23 and c. 10 Ma and the continuous uplift of the Andes mountains. The complex interaction between the Andes and Amazonia probably influenced the trajectory of Neotropical biodiversity, but evidence from time‐calibrated phylogenies of groups that diversified during this period is lacking. We investigate the role of these landscape transformations in the dynamics of diversification in the Neotropical region using a 26‐Myr‐old endemic butterfly radiation.

Location

Neotropics.

Time period

Oligocene to present.

Major taxa studied

Ithomiini butterflies.

Methods

We generated one of the most comprehensive time‐calibrated molecular phylogenies of a large clade of Neotropical insects, the butterfly tribe Ithomiini, comprising 340 species (87% of extant species) and spanning 26 Myr of diversification. We applied a large array of birth–death models and historical biogeography estimations to assess the dynamics of diversification and biotic interchanges, especially at the Amazonia–Andes interface.

Results

Our results suggest that the Amazonian Pebas wetland system played a major role in the timing and geography of diversification of Ithomiini, by constraining dispersal and diversification in the Amazon basin until c. 10 Ma. During the Pebas wetland period, Ithomiini diversification mostly took place in the Andes, where terrestrial habitats were not affected. An explosion of interchanges with Amazonia and with the Northern Andes accompanied the demise of the Pebas system (11–8 Ma) and was followed by local diversification in those areas, which led to a substantial renewal of diversification.

Main conclusions

Many studies on Neotropical diversity have focused only on the Andes, whereas we show that it is the waxing and waning of the Pebas mega‐wetland, interacting with Andean uplift, that determined the timing and patterns of regional interchanges and diversification in Ithomiini.
Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double‐Blind, Placebo‐Controlled, Multicenter Trial
Authors: Yarnitsky David , Dodick David W. , Grosberg Brian M. , Burstein Rami , Ironi Alon , Harris Dagan , Lin Tamar , Silberstein Stephen D.
Published: May 2019

Objective

To assess the efficacy and safety of a remote electrical neuromodulation (REN) device for the acute treatment of migraine.

Background

There is a significant unmet need for novel effective well‐tolerated acute migraine treatments. REN is a novel acute migraine treatment that stimulates upper arm peripheral nerves to induce conditioned pain modulation – an endogenous analgesic mechanism in which conditioning stimulation inhibits pain in remote body regions. A recent pilot study showed that REN can significantly reduce headache. We have conducted a randomized, double‐blind, sham‐controlled study to further evaluate the efficacy and safety of REN for the acute treatment of migraine.

Methods

This was a randomized, double‐blind, sham‐controlled, multicenter study conducted at 7 sites in the United States and 5 sites in Israel. Two hundred and fifty‐two adults meeting the International Classification of Headache Disorders criteria for migraine with 2‐8 migraine headaches per month were randomized in a 1:1 ratio to active or sham stimulation. A smartphone‐controlled wireless device was applied for 30‐45 minutes on the upper arm within 1 hour of attack onset; electrical stimulation was at a perceptible but non‐painful intensity level. Migraine pain levels were recorded at baseline, 2, and 48 hours post‐treatment. Most bothersome symptoms (MBS) were also recorded. The primary efficacy endpoint was the proportion of participants achieving pain relief at 2 hours post‐treatment (improvement from severe or moderate pain to mild or none, or from mild pain to none). Relief of MBS and pain‐free at 2 hours were key secondary endpoints.

Results

Active stimulation was more effective than sham stimulation in achieving pain relief (66.7% [66/99] vs 38.8% [40/103]; therapeutic gain of 27.9% [CI95%, 15.6‐40.2];P< .0001), pain‐free (37.4% vs 18.4%,P= .003), and MBS relief (46.3% vs 22.2%,P= .0008) at 2 hours post‐treatment. The pain relief and pain‐free superiority of the active treatment was sustained 48 hours post‐treatment. The incidence of device‐related adverse events was low and similar between treatment groups (4.8% [6/126] vs 2.4% [3/126],P= .499).

Conclusions

REN provides superior clinically meaningful relief of migraine pain and MBS compared to placebo, offering a safe and effective non‐pharmacological alternative for acute migraine treatment.
Basal cell carcinoma of the groin and buttocks: a clinical and histological analysis of a rare presentation of a common tumor
Authors: Tidwell W. James , Sutton Adam , Gilbertson Ryan , Humberson Cora , Greenway Hubert
Published: May 2019

Background

Basal cell carcinoma (BCC) is a common tumor but rarely presents on nonexposed skin. We sought to identify and characterize the traits of the malignancy over a 10‐year period.

Methods

A retrospective chart review of all BCCs between 2007 and 2017 was performed. Clinical characteristics and histological features were evaluated.

Results

Of all BCCs biopsied in a 10‐year period, 53 tumors in 50 patients were diagnosed in the groin or buttocks. This accounts for 0.094% of all BCCs during this time period. None of the cases had genetic diseases prone to skin cancer development or were immunosuppressed. The most common location was the buttocks, and the most frequently diagnosed histological subtype was nodular (49%).

Conclusion

To our knowledge, this is the largest report of BCC of the groin and buttocks. In this rare presentation of a common tumor, the histological characteristics of it are not more aggressive than other sites on the body.
A series of 33 older patients with lip venous lake treated by sclerotherapy
Authors: Fernandes Diego Tetzner , Hebling Eduardo , Santos‐Silva Alan Roger , Lopes Márcio Ajudarte
Published: May 2019

Background

Venous lake lesion is a venous ectasia that can occur on the lips of older people. Although different therapies have been used, there is no guideline for treating this lesion. The purpose of this study was to evaluate whether sclerotherapy is an effective and acceptable option for treatment of venous lake lesions of the lips in older patients.

Methods

Medical records and images were retrieved from the archives of a geriatric dentistry clinic between 2005 and 2017. A total of 33 older patients treated with 5% ethanolamine oleate were included. Clinical information was selected and described.

Results

The female gender was predominant (64%), and the patients’ age ranged from 66 to 90 years. The majority of the patients were Caucasian (91%), and 82% were under treatment for hypertension. In 91% of the cases, the lesions were located on the lower lip and varied from 3 to 10 mm in diameter. A complaint period lasting longer than 2 years was reported by 58% of the patients. Color alteration was the most common type of esthetic complaint. Only one application of sclerotherapy was performed in 85% of the cases. For the remaining patients, two sessions were necessary. The total dose ranged from 0.3 to 0.9 ml. Complete regression of the lesions was observed in all cases. No complications or recurrences were reported.

Conclusion

Sclerotherapy with ethanolamine oleate is an effective, affordable, and predictable treatment for venous lake lesions of the lips in older patients.
Deservingness in the eye of the beholder: A vignette study on the moderating role of cultural profiles in supporting activation policies
Authors: Gielens Erwin , Roosma Femke , Achterberg Peter
Published: May 2019

People support welfare policy if its beneficiaries are perceived as deserving of support. This study found that individuals’ cultural worldviews play a role in assessing the deservingness of welfare recipients. We investigated whether four different cultural profiles find some beneficiaries to be more deserving than others and how this relates to support for social rights (welfare benefit, retraining, job coach) and obligations (mandatory volunteering). A Dutch vignette experiment showed that reasons for supporting social rights differ between people with different cultural profiles: equality advocates grant support if beneficiaries areneedy, while the centre and trusting groups do so when beneficiariesreciprocate. We found that irrespective of deservingness, people with equality‐advocating and trusting profiles tend to be more supportive of social rights, whereas socially discontented citizens tend to emphasise the importance of obligations. In general, obliging beneficiaries to do volunteer work was deemed appropriate by almost all respondents in the study, whereas their cultural values determined the ways in which they considered social rights to have been earned.
Uncertainty assessment of soya bean yield gaps using DSSAT‐CSM‐CROPGRO‐Soybean calibrated by cultivar maturity groups
Authors: Teixeira Wilson Wagner Ribeiro , Battisti Rafael , Sentelhas Paulo Cesar , de Moraes Milton Ferreira , de Oliveira Junior Adilson
Published: May 2019

Soya bean yield gap can be caused by different factors resulting in uncertainties when the objective is to use such information for farm decision‐making and reference yield determination. Thus, this study aimed to quantify the soya bean yield gap for four sites, located in Southern and Midwestern Brazil, as well as the uncertainties of that related to cultivars, sowing dates, soil types and reference yields. The crop simulation model DSSAT‐CSM‐CROPGRO‐Soybean was calibrated for cultivars with similar maturity groups, based on the data obtained from the best farmers at the county level. The yield gap by water deficit (YGWD) was obtained through the difference between potential and attainable yields, and that one caused by sub‐optimum crop management (YGCM) by subtracting actual yield of each county, obtained from official statistics between 1989/90 and 2014/15 growing seasons, from the estimated attainable yield. The yield was simulated using four sowing dates, three soil types and two soya bean maturity groups by county. The reference yield uncertainty was quantified using yield reference from crop model and regional winners of the soya bean yield context, conducted by CESB (Brazilian Soybean Strategic Committee), for the growing seasons from 2013/14 to 2015/16. The crop model showed a good agreement between measured and simulated crop development and growth using calibration by maturity group, with low root mean square error (347 kg/ha). Southern sites had a mean YGWD of 1,047 kg/ha, while in the Midwest, it was lower than 100 kg/ha. The YGCM was 1,067, 528, 984 and 848 kg/ha, respectively, for Castro, PR, Mamborê, PR, Montividiu, GO and Primavera do Leste, MT, representing the opportunity for yield gain when having the best farmers as reference. The maturity groups, sowing dates and soil types showed to be an important source of uncertainty for yield gap determination, being recommended to investigate the farms in detail for an appropriate quantification. The reference yield showed expressive uncertainties, with some farmers presenting conditions to increase their soya bean yields by more than 3,000 kg/ha, when considering as reference the yields obtained by the winners’ farmers. These results show that uncertainties must be reduced when assessing farm yield gaps, in order to ensure that expected rate of soya bean yield growth could be reached by adopting the same technologies from CESB winners and best farmers in the county as a reference.
Systematic Review: Expressive arts interventions to address psychosocial stress in healthcare workers
Authors: Phillips Carolyn S. , Becker Heather
Published: May 2019

Aims

To synthesize evidence about the effectiveness of expressive arts interventions used to reduce psychosocial stress among healthcare workers.

Design

Quantitative systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines.

Data Sources

SocINDEX, PsycINFO, Pubmed, CINAHL.

Review Methods

Databases were searched from 1997–2017. Fourteen studies met the criteria for final selection.

Results

Most studies occurred in the US (N = 11). Of the 897 participants, 59% were nurses. Two studies were randomized controlled trials and the others were a variation of a 1‐group or 2‐group pre‐ or quasi‐experimental study. The intervention characteristics included 50% art‐based, 29% music‐based, and 21% used storytelling or narrative. The length of intervention varied from 1 hr to 13 weeks; 5 lasted 6 weeks. Improved outcomes were found in 13 of 14 studies reviewed and the greatest improvements were seen in burnout, stress, and emotional outcomes. Overall, music and art‐based interventions had greater impact on well‐being than storytelling or narrative.

Conclusions

This systematic review provides preliminary evidence for the effectiveness of expressive arts interventions.

Impact

Care for others is a preeminent value in health care; however, this can come at the expense of caring for oneself. Psychosocial stress poses a significant threat to the well‐being of the healthcare workforce. Expressive arts interventions provide a creative means for reducing caregiver stress to remain well and able to provide high quality care to patients. The use of arts for healing has global application because expressive arts intervention can be culturally tailored and relevant.
Alignment in the Base of the Pyramid Producer Supply Chains: The Case of the Handloom Sector in Odisha, India
Authors: Mahapatra Santosh , William Winfred S. , Padhy Ramakrushna
Published: May 2019

This investigation seeks to explore the effectiveness of alternative approaches to supply chain management for developing the base of the pyramid (BoP) community. Using case research methodology, we investigate the issue of supply chain alignment when the supply base consists of BoP producers. We consider the handloom supply chains in Odisha, India, as the context of our analysis. The study analyzes the supply chains of four handloom retailers. The retailers represent cooperative and private organizational systems with varied levels of operational integration. In light of the insights from these case studies, we theorize factors contributing to operational cost‐effectiveness and conceptualize approaches and considerations for improving the BoP community. Specifically, we clarify the usefulness of alternative supply chain alignment practices in promoting efficiency, innovation, and equitability among the BoP constituents and advance a set of propositions linking the motivations, strategies, practices, and performance in handloom supply chains. Limitations, theoretical and managerial contributions, and future research directions are discussed.
A scale for measuring evidence‐searching capability: A development and validation study
Authors: Tsai Yu‐Shiun , Fang Tien‐Pei , Chi Ching‐Chi
Published: May 2019

Rationale

The ability to acquire the best evidence efficiently is an important competency for busy health‐care professionals who must make decisions quickly.

Aims and objectives

We aimed to develop and validate a scale for measuring evidence‐searching capability.

Methods

We first developed a scale for measuring evidence‐searching capability by using the modified Delphi technique. Seven experts commented on a draft 33‐item scale on a 5‐point scale. All items rated less than three by any expert were removed. The items were modified or merged considering experts' feedback. When all items were rated greater than or equal to 3 by all experts with an interquartile range of less than or equal to 1, a consensus on the scale was achieved with the content validity constructed. We performed a pilot test and a formal test, and evaluated the inter­rater, intra‐rater, and internal reliability by calculating the intra‐cluster correlation coefficient (ICC), kappa correlation coefficient, and Cronbach's α.

Results

We developed a scale consisted of 15 items and a global rating score, with an average scale‐content validity index of 0.98. In the pilot test, the ICC for inter‐rater and intra‐rater reliability was 0.91 and 1, respectively. The Cronbach's α was 0.90. In the formal test, the ICC for inter‐rater reliability ranged from 0.61 to 1 and the weighted kappa correlation coefficient ranged from 0.27 to 1, with a Cronbach's α of 0.97.

Conclusions

This study is the first to develop and validate a scale for measuring evidence‐searching skills through a systematic approach. The scale is composed of 15 items and a global rating score that can be easily used in objective assessment of knowledge‐acquiring ability.
Whose Responsibility Is It? Balancing Individual, Family, and Societal Needs for Supporting Seriously Ill Older Adults
Authors: Gitlin Laura N.
Published: May 2019

This commentary comments on the article byJanice Bell et al.
Commentary on the Future of the Home Care Workforce: Training and Supporting Aides as Members of Home‐Based Care Teams
Authors: Snyder Rani E.
Published: May 2019

This commentary comments on the article by Robyn Stone et al.
Label‐free distribution of anti‐amyloid D‐AIP in Drosophila melanogaster: prevention of Aβ42‐induced toxicity without side effects in transgenic flies
Authors: Zhong Yifei , Shobo Adeola , Hancock Mark A. , Multhaup Gerhard
Published: May 2019

Soluble oligomers of the 42‐amino acid amyloid beta (Aβ42) peptide are highly toxic and suspected as the causative agent of synaptic dysfunction and neuronal loss in Alzheimer's disease (AD). Previously, we have shown that a small, D‐amino acid Aβ42‐oligomer interacting peptide (D‐AIP) can neutralize human Aβ42‐mediated toxicity using in vitro and cell‐based assays. In the present longitudinal study using a transgenic Drosophila melanogaster model, advanced live confocal imaging and mass spectrometry imaging (MALDI‐MSI) showed that the eight amino acid D‐AIP can attenuate Aβ42‐induced toxicity in vivo. By separating male and female flies into distinct groups, the resultant distribution of ingested D‐AIP was different between the sexes. The Aβ42‐induced ‘rough eye’ phenotype could be rescued in the female transgenics, likely because of the co‐localization of D‐AIP with human Aβ42 in the female fly heads. Interestingly, the phenotype could not be rescued in the male transgenics, likely because of the co‐localization of D‐AIP with a confounding male‐specific sex peptide (Acp70A candidate in MSI spectra) in the gut of the male flies. As a novel, more cost‐effective strategy to prevent toxic amyloid formation during the early stages of AD (i.e. neutralization of toxic low‐order Aβ42 oligomers without creating larger aggregates in the process), our longitudinal study establishes that D‐AIP is a stable and highly effective neutralizer of toxic Aβ42 peptides in vivo.

image

Cover Image for this issue: doi: 10.1111/jnc.14512.
Hysteroscopic morphological pattern reflects histological grade of endometrial cancer
Authors: Miyamoto Taito , Abiko Kaoru , Murakami Ryusuke , Furutake Yoko , Baba Tsukasa , Horie Akihito , Hamanishi Junzo , Mandai Masaki
Published: May 2019

Aim

To examine the hysteroscopic morphological features in each histological grade of endometrial cancer, and to distinguish high‐ and low‐grade cancer and low‐grade cancer and atypical endometrial hyperplasia (AEH), using hysteroscopy.

Methods

In total, 135 patients who underwent hysterectomy after hysteroscopy were analyzed. They were divided into four categories: benign lesion; AEH; low‐grade cancer, including endometrioid carcinoma grades 1 and 2 (G1/2); and high‐grade cancer, including endometrioid carcinoma grade 3 and other high‐grade carcinomas (G3/others). Three blinded gynecologic oncologists independently evaluated hysteroscopic video images for abnormal vessels, surface smoothness, papillary structure and polypoid structure. Prevalence rates of each finding were compared between the four categories. The accuracy of blind biopsy in outpatient settings and hysteroscopic endometrial biopsy in the four categories were also investigated.

Results

The number of patients with benign lesions, AEH, G1/2 and G3/others was 8, 7, 84 and 36, respectively. Patients with G3/others exhibited more polypoid (86% vs 61%, P = 0.0095) and less papillary (59% vs 80%, P = 0.023) structures than those exhibited by patients with G1/2. AEH and G1/2 were indistinguishable using hysteroscopy. Hysteroscopic biopsy was more accurate than outpatient biopsy in patients with G3/others (84% vs 52%, respectively, P = 0.010). Both biopsies were not sufficiently accurate to diagnose AEH (outpatient; 0%, hysteroscopic; 57%).

Conclusion

Hysteroscopic papillary and polypoid structures can help distinguish between high‐ and low‐grade cancer. Hysteroscopic differentiation between AEH and low‐grade cancer is difficult. These findings are considerable in preoperative assessment to determine adequate surgical strategies.
Uterine cervical ulceration caused by group C streptococcal infection during pregnancy: A case report
Authors: Yoon Soonna , Tsubouchi Hiroaki , Tsunehiro Azusa , Ohyagi Chifumi , Fukuda Aya , Tsutsui Tateki
Published: May 2019

Causes of cervical ulceration include infection, collagen disease, malignant tumors and external stimuli. Cervical ulceration during pregnancy is rare. We present a case of cervical ulceration caused by group C streptococcal infection during pregnancy. A 36‐year‐old woman (gravida 1, para 0) complained of metrorrhagia, and a circular cervical ulcer of about 1.5 cm in diameter was detected on her cervix at 37 weeks' gestation. A biopsy and a cultivation test of the ulcer were performed, and pathological diagnosis was made as suppurative inflammation, and group C streptococcal infection was detected by the cultivation test. The ulcer had expanded to about 3 cm in diameter at the onset of labor at 40 weeks' gestation. An emergency cesarean section was performed because of failed induction of labor, and she was delivered of a male baby. The ulcer became gradually smaller after delivery, and completely disappeared on the 35th day after delivery.
Redesigning Public Libraries in Flanders: Triggering the Societal Context Awareness of Interior Students
Authors: Vallet Nathalie , Somers Inge , Corthaut Michel
Published: May 2019

Developing societal context awareness in interior architecture students is one of the main objectives of the bachelor thesis at the University of Antwerp (Belgium). By means of a 2–year project on public libraries (2014–2016), the coaches of the design studio initiated research into the changing role of public libraries and the societal embedding of interior architecture, as well as the empathic role of the designer. The article is based on data acquired by the use of various qualitative research techniques, such as focus group debates with the studio coaches, analysis of the coaching sessions with the students, and analysis of the comments of the expert jury in the first research year, supported by half–structured individual interviews with students in the second research year. Based on an initial explorative evaluation of this research project it is clear that the development of societal context awareness in students is hindered by three phenomena: an activated selective perception, a dominant comfort–zone reflex, and copy–cat behavior. The article subsequently reports on (a) the subject of the bachelor thesis (i.e. Flemish public libraries and their societal challenges), (b) the pedagogical design of the renewed bachelor thesis, (c) the ex–ante and ex–post perceived societal awareness of the students, and (d) an initial set of identified enablers and disablers of the learning process. The article concludes that interior educators should continue to invest in triggering and developing societal awareness in their students if the interior discipline aspires to “the social compact to do good.”
Conservative management in hypertriglyceridemia‐associated pancreatitis
Authors: Berberich A. J. , Ziada A. , Zou G. Y. , Hegele R. A.
Published: May 2019

Background

Severe hypertriglyceridemia (serum triglyceride >10 mmol L−1) is implicated in ~9% of acute pancreatitis cases. Certain guidelines list severe hypertriglyceridemia as an indication for plasmapheresis.

Objective

We assembled the natural trajectory of triglyceride levels in patients with acute pancreatitis due to severe hypertriglyceridemia who were managed conservatively without plasmapheresis to evaluate the effectiveness of this approach.

Methods

A retrospective chart review was performed on 22 hospital admissions for acute pancreatitis episodes considered to be caused by severe hypertriglyceridemia. Patients were managed supportively, with cessation of oral intake (NPO) and intravenous hydration. Insulin infusion was used in 12 patients to manage concurrent hyperglycaemia.

Results

Triglyceride levels for the group were evaluated using a mixed‐effects model. The average triglyceride level fell from 45.4 mmol L−1 on presentation to 13.3 mmol L−1 within 48 h, corresponding to a mean 69.8% decrease. Regression analysis showed a triglyceride half‐life of 30.6 h. Findings were similar for NPO‐only and insulin infusion subgroups.

Conclusion

Patients with severe hypertriglyceridemia and acute pancreatitis can be conservatively managed safely and effectively without plasmapheresis.
Aging and Brain Atrophy in Multiple Sclerosis
Authors: Ghione Emanuele , Bergsland Niels , Dwyer Michael G. , Hagemeier Jesper , Jakimovski Dejan , Paunkoski Ivo , Ramasamy Deepa P. , Carl Ellen , Hojnacki David , Kolb Channa , Weinstock‐Guttman Bianca , Zivadinov Robert
Published: May 2019

BACKGROUND AND PURPOSE

Brain atrophy accelerates at the age of 60 in healthy individuals (HI) and at disease onset in multiple sclerosis (MS) patients. Whether there is an exacerbating effect of aging superimposed on MS‐related brain atrophy is unknown. We estimated the aging effect on lateral ventricular volume (LVV) and whole brain volume (WBV) changes in MS patients.

METHODS

1,982 MS patients (mean follow‐up: 4.8 years) and 351 HI (mean follow‐up: of 3.1 years), aged from 20 to 79 years old (yo), were collected retrospectively. Percent LVV change (PLVVC) and percent brain volume change (PBVC) on 1.5T and 3T MRI scanners (median of 3.9 scans per subject) were calculated. These were determined between all‐time points and subjects were divided in six‐decade age groups. MRI differences between age groups were calculated using analysis of covariance (ANCOVA).

RESULTS

Compared to HI, at first MRI, MS patients had significantly increased LVV in the age groups: 30–39 yo, 40–49 yo, 50–59 yo, 60–69 yo (all P < .0001), and 70–79 yo (P = .029), and decreased WBV in the age groups: 20–29 yo (P = .024), 30–39 yo (P = .031), 40–49 yo, and 50–59 yo (all P < .0001). Annualized PLVVC was significantly different between the age groups 20–59 and 60–79 yo in MS patients (P = .005) and HI (P < .0001), as was for PBVC in MS patients (P = .001), but not for HI (P = .521). There was a significant aging interaction effect in the annualized PLVVC (P = .001) between HI and MS patients, which was not observed for the annualized PBVC (P = .380).

CONCLUSIONS

Development of brain atrophy manifests progressively in MS patients, and occurs with a different pattern, as compared to aging HI. PLVVC increased across age in HI as compared to MS, while PBVC decreased across ages in both HI and MS.
Patients’ experiences of therapeutic jaw exercises in the treatment of masticatory myofascial pain—A postal questionnaire study
Authors: Lindfors Erik , Magnusson Tomas , Ernberg Malin
Published: May 2019

Background

The most common non‐dental pain in the orofacial region is pain associated with temporomandibular disorders (TMD), and jaw exercises are a common treatment in these cases. Since masticatory myofascial pain has components of an affective and cognitive nature, knowledge about the patients’ experiences of the condition and treatment is important.

Objective

The aim was to study the patients’ experiences of jaw exercises in the treatment of masticatory myofascial pain.

Methods

A questionnaire, containing 24 statements that should be answered according to a five‐item verbal Likert scale, was sent to 150 consecutive patients with masticatory myofascial pain according to the Research Diagnostic Criteria for TMD after they had been treated with jaw exercises for 3‐12 months.

Results

The response rate was 73% (n = 109), and 79% of the responders were women. 71% of the patients reported that it was easier to remember the jaw exercises if they put them in conjunction with an already established routine. Before examination, 49% of the patients suspected serious disease behind their symptoms, but these concerns were greatly relieved by the information provided. As a result, 78% reported that information about the underlying cause of their symptoms made them more involved in the treatment. Finally, 72% of the respondents reported that the jaw exercises were effective in reducing their symptoms.

Conclusions

Information about the cause of the symptoms and the treatment is important to reassure and make the patient involved in the treatment. Most patients report that jaw exercises are an effective treatment and they appreciated to have tools to tackle the problems themselves if the symptoms should return.
Influence of bacterial starter cultures on the sensory characteristics of doenjang, a fermented soybean paste, and their impact on consumer hedonic perception
Authors: Lee Jong‐Hoon , Jeong Do‐Won , Kim Mina K.
Published: May 2019

The objective of this study was to determine the influence of starter cultures on the sensory characteristics of doenjang and their impact on consumer hedonic perception. Six doenjang samples (AB, AE, ABE, ABS, AES, and ABES) were prepared with different combinations of Aspergillus oryzae, Bacillus licheniformis, Enterococcus faecium, and Staphylococcus succinus cultures. A descriptive sensory analysis using a highly trained panel (n = 6) was conducted, followed by consumer acceptance testing (n = 83). Strain‐specific aromatics in doenjang samples were identified: B. licheniformis inoculated doenjang samples exhibited the traditional doenjang‐like flavors that included ammonia‐like, balsamic, meju, and soy sauce. E. faecium inoculated doenjang samples developed traditional doenjang‐like flavors similar to B. licheniformis‐inoculated samples. Solvent aromatic was noted only in doenjang samples with E. faecium. Addition of S. succinus resulted in the decrease of the traditional doenjang‐like aromatics. Consumers preferred doenjang samples with low intensities of traditional doenjang‐like aromatics.

Practical applications

Doenjang is one of the most consumed, Korean traditional food ingredients, based on soybean fermentation. Different starter cultures and microbial community are involved during doenjang fermentation. Yet, the influence of specific strain of bacterial starter cultures on the sensory characteristics of doenjang has not been intensively studied. Current study reports the effect of three distinctive bacterial starter cultures including B. licheniformis, E. faecium, and S. succinus, on the aroma characteristics of Doenjang using human subjects. Also, this work suggests bacterial starter culture that produced the sensory aroma characteristics appealing to Korean consumers. This work provided the information on linkage between bacterial starter cultures and sensory characteristics of doenjang, and can guide the selection of starter cultures on doenjang fermentation.
Whole community estimates of macroalgal pigment concentration within two southern New Zealand kelp forests1
Authors: Desmond Matthew J. , Pajusalu Liina , Pritchard Daniel W. , Stephens Tiffany A. , Hepburn Christopher D.
Published: May 2019

Light availability is a fundamental factor that controls the productivity and distribution of macroalgae and is highly variable, both spatially and temporally, in subtidal coastal systems. Our comprehension of how macroalgae respond to such variability is a significant knowledge gap that limits our understanding of how light influences the structure and productivity of these environments. Here, we examined the pigment characteristics of individual species, and for the first time the whole community, within one low‐light, and one high‐light kelp‐forest system in southern New Zealand. The aim was to quantify the range of pigmentation seen within the two kelp‐forests which differed in irradiance regime. Light availability was 33% and 64% greater at the high‐light compared to the low‐light site at 2 and 10 m depth, respectively. Results suggested Phaeophyceae species at deeper depths in the low‐light site may be living at the edge of their photosynthetic ability and pigment synthesis appeared significantly restricted. Even with greater investment in the pigment fucoxanthin, biomass of Phaeophyceae species was significantly lower in the low‐light site. Highly pigmented Rhodophyceae species made a greater proportional contribution to community biomass within the low‐light site where they likely possessed a photosynthetic advantage. This work helps explain discrepancies in community structure between the two study sites and explores the complex relationship between irradiance and photoacclimation. The comparison of community pigment concentration holds potential as a tool for assessing the relative degree of photoacclimation occurring between sites and provides a proxy of photosynthetic cost under a specific light regime.