bluuebunny/crossref_metadata_2025 huggingface dataset:
Landscape planning of tobacco plantation based on erosion potential in Eastern Region of Mount Sindoro Temanggung
Authors: Budiyanto G , Aini L N , Setyawan H
Published: December 2019

Mount Sindoro slope is a tobacco plantation area. Based on variations in slope, there is erosion potential on most of the slopes. This study aimed to determine the way of structuring tobacco plantations in the eastern region of Mount Sindoro due to intensive land use. This research was conducted in Gunungsari Village, Bansari District, Temanggung Regency, from April to July 2018. This research was conducted using a survey method and continued with the determination of the level of soil erosion potential on area A (more than 20% slope), area B (15-20%slope) and area C (less than 15% slope) using USLE method. Landscape planning was carried out based on the application of land conservation methods with the main purpose of reducing the level of erosion potential using agronomic and mechanical methods. The results show that the actual erosion potential of area A, B and C is 42.67 tons/ha/year, 44.81 tons/ha/year and 31.80 tons/ha/year, respectively, and is categorized as moderate to severe erosion level. The application of agronomic methods in the form of intercropping systems of tobacco and peanuts could reduce the erosion potential from 42.67 to 32.43 tons/ha/year (area A); from 44.81 to 33.61 tons/ha/year (area B) and from 31.80 to 23.85 tons/ha/year (area C). Meanwhile, the application of the ridge terraces and bench terraces, consecutively, reduced erosion potential from 42.67 to 6.40 and 1.71 tons/ha/year (area A); from 44.81 to 6.72 and 1.79 tons/ha/year (area B); and from 31.80 to 4.77 and 1.27 tons/ha/year (area C). Thus, it can be concluded that bench terraces is more effective in reducing erosion potential than ridge terraces.
Water content prediction of ‘crystal’ guava using visible-near infrared spectroscopy and chemometrics approach
Authors: Kusumiyati  , Hadiwijaya Y , Putri I E , Mubarok S
Published: December 2019

The purpose of the research was to apply the visible-near infrared (vis-nir) spectroscopy and chemometrics approach to predict the water content of crystal guava rapidly and non-destructively. The absorbance spectra were collected from intact ‘crystal’ guava fruits in wavelength from 381 to 1065 nm. Spectra pre-treatment was used to enhance the prediction accuracy. Several spectra pre-treatment methods were arranged to the original absorbance spectra such as multiplicative scatter correction (MSC), standard normal variate (SNV), second derivative absorbance (d2a), MSC+d2a, and SNV+d2a. Calibration model was developed by partial least squares regression (PLSR). Validation was done by K-fold cross-validation. The results presented that vis-nir spectroscopy combined with chemometrics approach gave accurate water content prediction of ‘crystal’ guava. The best calibration model was provided by spectra pre-treatment of SNV+d2a with coefficient of determination (R2) and ratio performance deviation (RPD) of 0.74 and 1.60, respectively. It concluded that vis-nir spectroscopy and chemometrics approach can be performed to predict the water content of ‘crystal’ guava rapidly and non-destructively by replacing the standard laboratory analysis.
QUALITY OF SIMPLICIAN BIOACTIVE COMPONENTS AND LIQUID EXTRACT OF KECOMBRANG FLOWER POWDER FROM TEMPERATURE AND TIME OPTIMIZATION RESULTS
Authors: Intan Pertiwi Dwiana , Naufalin Rifda , Arsil Poppy , Erminawati  , Wicaksono Rumpoko , Auliya Taslimatul
Published: December 2019

Kecombrang flower has benefits as an antioxidant and antimicrobial. This capability can be maximized by processing through drying and liquid extraction. In the drying and extraction of liquid, the temperature and time that is not right can affect the content of bioactive components of the product. This study aims to determine the quality of bioactive components of powder and liquid extract of kecombrang flowers quantitatively and qualitatively based on temperature and time. The experimental design used in kecombrang flower powder is a Completely Randomized Design (CRD) with 9 treatment and 3 replication as long as the liquid extract of kecombrang flowers using the Responsse Surface Method (RSM) method with Expert Design 10 software. Central Composit Design (CCD) produced 13 optimization formulas. Factors that were tested on drying are 50°C, 60°C, 70°C, and time is 4, 5 and 6 hours. Liquid extraction temperature is 40oC, 50oC, 60oC and time is 3, 4 and 5 hours. Based on the results of the study the highest total phenol simplisia and liquid extract of kecombrang flowers namely 27.93 TAE1100 g sample and 64.458 mg TAEI100 g. The highest total of flavonoids is simplicia and liquid extract of kecombrang flower which is 2.073 QE1100 g sample and 35.120 mg QE1100 g and pH value (3.9). The compounds in the optimum formula product are phenolic, flavonoids, alkaloids, terpenoids and tannins.
Relationship of Sedimentation Rate to The Structure of Macrozoobenthos Community On Transitional in Ciletuh Bay, Sukabumi District, West Java
Authors: Yuniarti  , Nurul Ihsan Yudi , Harahap Syawaludin A. , Suhanda Delilla
Published: December 2019

Ciletuh is a coastal area located in Sukabumi Regency, West Java, which is currently included in the Geopark region in West Java. Ciletuh is a name of a bay that faces directly to the Indian Ocean, hence the similarity of its ocean characteristic. At present Ciletuh Bay has undergone massive sedimentation due to the large amount of sediment entering the surrounding bay coming from Ciwaru and Cimarinjung River and the existence of many floating net cages around the Ciletuh Bay, all of which empties into Ciletuh Bay. High sedimentation rate will disrupt environmental conditions especially organism found in sediments such as benthos. This research was designed using descriptive analytic methods in the form of field observations to determine the research station, sediment sampling and supporting parameters carried out at the research station point. The study was conducted at 5 sampling stations based on different characteristics. The purpose of this research is to see the relationship between sedimentation rate and structure of the macrozoobenthos community. Result presented that the species dominating the bay areas are Nassarius sp., Cerithium sp. Clypeamorus sp. Rhinodavis sp. Certhiidae, Coralliophila sp., Turricula sp., Olivia caerullea., Thais sp., Phos roseatus, Hemifusus sp. Diplomariza sp, Neritadae, Donax sp., Pyramidella sp., Terebia sp. Sedimentation rate calculated as 0,11 gr/cm2/day; 0,13 gr/cm2/day; 0,07 gr/cm2/day; and 0,3 gr/cm2/day. Based on sediment grain size, types of sediment founded on each station are (1) gravely mud, (2) sandy mud, (3) sandy mud with slight gravels, (4) mud with slight gravels, and; (5) sandy silt.
Key performance indicator of sustainability in the Malaysian food supply chain
Authors: Baba Anis Anizah Mohammad , Ma’aram Azanizawati , Ishak Fatin ‘Izzati , Sirat Rozlina Md. , Kadir Aini Zuhra Abdul
Published: December 2019

The food supply chain in Malaysia plays a significant function in the nation’s economy. Since the industry is dominated by small and medium sized enterprises (SME), the local food supply chain must satisfy consumer demand. In order to help Malaysia to become more self-sufficient, improvements in the supply chain in terms of key performance indicators (KPIs) are important. However, it is common that strategic and operational KPIs are different and a disparity often exists between them. To be more successful for measuring the entire supply chain, the linkage of strategic objectives to operational objectives must be aligned to ensure the appropriate KPIs measure a proper connection between what they do and what the business achieves. The objective of this article is to propose a preliminary key indicator to measure sustainable performance within the perspective of Malaysian food supply chain. Key indicators have been summarized based on the previous researches focusing on the issue between 2007 until 2018. An overall of nine perspectives on sustainable performance measures in the food supply chain involved employee, supplier, health and safety, community, customer, cost effectiveness, quality, compliance and efficiency. These perspectives can be classified into three hierarchies; namely, strategic, tactical and operational. This paper proposes integration of key indicators as a starting point to evaluate the generic performance of Malaysia food supply chain.
Exploring Quality Influencing Factors for Frozen Food Industry
Authors: Aziz Aishah Abdul , Daud Sarbani , Sorooshian Shahryar
Published: December 2019

Quality is the grade of excellence or level of acceptability by the buyers. For the frozen food industry, it can be defined as the composite of those features which have significance in determining the level of acceptability by the consumer. This study was to analyse the relationship between storage, transportation, stock control, packaging, and raw material on the quality of frozen food. The research methodology of this work was a combination of observation and interview, and survey from 55 Malaysian frozen-food small-enterprise. From the findings, only two factors, Packaging, and raw material came to significantly and positively affect the quality of the frozen food. The findings of this study could be an asset for food industries to have a better understanding of the quality control of their products.
Nitrogen and group-IV (Si, Ge) vacancy color centres in nano-diamonds: photoluminescence study at high temperature (25 °C–600 °C)
Authors: Zaghrioui Mustapha , Agafonov Viatcheslav N , Davydov Valery A
Published: December 2019

Raman scattering and photoluminescence measurements have been carried out on nano-diamonds containing Nitrogen-vacancy (NV−), Silicon-Vacancy (SiV−) and Germanium-vacancy (GeV−) synthesized by high pressure and high temperature method. Optical zero-phonon-line transition of these negatively charged centres were measured from room temperature up to 600 °C under air. The results show that all nano-diamonds are stable at this temperature range and spectra are reproducible for heating and cooling cycles. Thermal behaviors of linewidth and zero phonon line, for SiV− and GeV− centres, are well described by the second-order electron-phonon interactions involving two-phonon and elastic processes.
Chemical vapor deposition growth and characterization of graphite-like film
Authors: Zhang Yanhui , Shu Haibo , Chen Zhiying , Mu Gang , Sui Yanping , Liang Yijian , Hu Shike , Li Jing , Kang He , Yu Guanghui , Peng Songang , Jin Zhi , Liu Xinyu
Published: December 2019

Thick graphene film can be widely used in surface protection, heat dissipation, heating devices and other fields. Here we present a study on the growth and characterization of large area continuous and patterned graphite-like films prepared on Ni foil through CVD. Effects of parameters on the material growth are studied experimentally and theoretically in detail. Thickness of the graphite-like film in this work can reach 500 nm and can be regulated by growth process. Characterization results show that the graphite-like film is formed by free stacking of large area graphene continuous films and possesses strong mechanical strength, chemical stability, good electrical conductivity and flexibility. The graphite-like film shows potential for application in metal surface protection, flexible conduction, heating and electromagnetic shielding.
Alternative (To) Punishment: Assessing Punishment Experiences in Youth Diversion Programmes
Authors: Sandøy Thomas Anton
Published: December 2019

This study explores the penal character of diversion programmes through the subjective experiences of young drug-law offenders. Specifically, punishment experiences are investigated through qualitative interviews with 24 offenders who were arrested between the ages of 15 and 17. The diverted adolescents described four experiences of punishment attending the programmes: (1) deprivation of time; (2) deprivation of social bonds; (3) deprivation of dignity and (4) deprivation of self. These subjective experiences of punishment, which all reflect the supervisory character of alternative penal sanctioning, differed in severity across programmes, individuals and abstraction levels. Punishment is largely an unspoken aspect of diversionary practices, emphasizing the importance of a subjectivist approach to assessments of penal character.
Unfeignable biomarkers in functional neurological disorder: drifting back to Pierre Janet
Authors: Stone Jon
Published: December 2019

This scientific commentary refers to ‘Reduced drift rate: a biomarker of impaired information processing in functional movement disorders’, by Sadnicka et al. (doi: 10.1093/brain/awz387).
Identification of the Most Cost-effective Position of Vedolizumab Among the Available Biologic Drugs for the Treatment of Ulcerative Colitis
Authors: Scott Frank I , Luo Michelle , Shah Yash , Lasch Karen , Vajravelu Ravy K , Mamtani Ronac , Fennimore Blair , Gerich Mark E , Lewis James D
Published: December 2019

Background and Aims

There are limited data on the most cost-effective sequencing of biologics for ulcerative colitis [UC].

Methods

We used Markov modelling to identify the most cost-effective position for vedolizumab among biologics for steroid-dependent UC, with a base-case of a 35-year-old male. We assessed three treatment algorithms, with vedolizumab use: prior to an initial anti-tumour necrosis factor alpha [anti-TNFα] and azathioprine [Algorithm 1]; prior to a second anti-TNF and azathioprine [Algorithm 2]; and prior to colectomy [Algorithm 3]. The initial anti-TNF could be either infliximab or adalimumab. Transition probabilities, costs, and quality-adjusted life-year estimates were derived from published estimates, Medicare, and the Nationwide Inpatient Sample. Primary analyses included 100 trials of 100 000 individuals over 1 year, with a willingness-to-pay threshold of US$100,000. Multiple sensitivity analyses were conducted to assess our findings.

Results

From a population perspective, when both infliximab and adalimumab are available, vedolizumab was preferred as the first biologic if ≥14% of initial anti-TNF use was adalimumab. If infliximab is the primary biologic, vedolizumab use after infliximab [Algorithm 2] and prior to adalimumab was the most cost-effective strategy. All models were sensitive to biologic pricing.

Conclusions

This simulation demonstrated that the most cost-effective strategy in UC depends on the proportion of patients using adalimumab as the initial anti-TNF. If adalimumab was ≥14%, vedolizumab was preferred as the first biologic. When only infliximab was available for first-line therapy, the most cost-effective position of vedolizumab was prior to cycling to adalimumab.
Evaluation of mandibular symmetry and morphology in adult patients with unilateral posterior crossbite: a CBCT study using a surface-to-surface matching technique
Authors: Leonardi Rosalia , Muraglie Simone , Lo Giudice Antonino , Aboulazm K S , Nucera R
Published: December 2019

Objectives

To investigate mandibular morphology in adults affected by posterior unilateral crossbite (PUXB) and to evaluate the hemi mandibular volumes from the crossbite (CB) and non-CB sides of the same patients.

Methods

Thirty-eight cone beam computed tomography (CBCT) images were consecutively recruited and the Digital Imaging and Communications in Medicine (DICOM)-formatted scans were volume rendered into a surface three-dimensional (3D) mesh model and volumes to obtain the 3D model of the mandibular bone. To achieve the surface point-to-point analysis of the mandibular models, a reverse engineering software was used. The same procedure was performed for an age-matched control group (19 CBCT images).

Results

Total mandibular volume showed a difference of 2.46 cm3 between patients and controls, which was not statistically significant. A mean difference of 1.53 cm3 was found comparing the hemi mandibular volumes from the CB and non-CB sides of PUXB patients, this difference was statistically significant (P ≤ 0.01). Findings for the surface-to-surface deviation analysis, demonstrated a higher percentage of mismatch in patients PUXB, over 10% at 0.5 mm tolerance level.

Limitations

Limitations are related to the intrinsic surfaces matching methodology, that make difficult to evaluate discrepancies among different mandibular anatomical units.

Conclusion

Adult patients affected by PUXB show a greater mandibular structural asymmetry compared to controls because of a lower matching percentage obtained from the surface-to-surface matching technique.

Implications

Treatment of adult patients affected by PUXB should take into consideration the possibility of a mild mandibular asymmetry mainly localized at the condyle and gonial angle levels.
Prognostic model for multiple myeloma progression integrating gene expression and clinical features
Authors: Sun Chen , Li Hongyang , Mills Ryan E , Guan Yuanfang
Published: December 2019

Background

Multiple myeloma (MM) is a hematological cancer caused by abnormal accumulation of monoclonal plasma cells in bone marrow. With the increase in treatment options, risk-adapted therapy is becoming more and more important. Survival analysis is commonly applied to study progression or other events of interest and stratify the risk of patients.

Results

In this study, we present the current state-of-the-art model for MM prognosis and the molecular biomarker set for stratification: the winning algorithm in the 2017 Multiple Myeloma DREAM Challenge, Sub-Challenge 3. Specifically, we built a non-parametric complete hazard ranking model to map the right-censored data into a linear space, where commonplace machine learning techniques, such as Gaussian process regression and random forests, can play their roles. Our model integrated both the gene expression profile and clinical features to predict the progression of MM. Compared with conventional models, such as Cox model and random survival forests, our model achieved higher accuracy in 3 within-cohort predictions. In addition, it showed robust predictive power in cross-cohort validations. Key molecular signatures related to MM progression were identified from our model, which may function as the core determinants of MM progression and provide important guidance for future research and clinical practice. Functional enrichment analysis and mammalian gene-gene interaction network revealed crucial biological processes and pathways involved in MM progression. The model is dockerized and publicly available at https://www.synapse.org/#!Synapse:syn11459638. Both data and reproducible code are included in the docker.

Conclusions

We present the current state-of-the-art prognostic model for MM integrating gene expression and clinical features validated in an independent test set.
To Credit or to Blame? The Asymmetric Impact of Government Responsibility in Economic News
Authors: Damstra Alyt , Boukes Mark , Vliegenthart Rens
Published: December 2019

This article studies the asymmetric effects of credit and blame attributions in economic news on government evaluations. We rely on a dataset combining a manual content analysis of Dutch economic news (print, television, online; N = 5,630) with a three-wave panel survey (N = 3,240) that was fielded in 2015. Results show that people who are exposed to news in which the government is blamed for the economy tend to adopt this frame by assigning responsibility to the government for the economic crisis. In addition, exposure to blame attributions leads to more negative government evaluations. This effect is partly mediated through the attribution of crisis responsibility. Credit attributions in the news do not have any effect on public opinion.
Pyruvate dehydrogenase kinase is a negative regulator of interleukin-10 production in macrophages
Authors: Na Yi Rang , Jung Daun , Song Juha , Park Jong-Wan , Hong Jung Joo , Seok Seung Hyeok
Published: December 2019

Interleukin-10 (IL-10) is the most potent anti-inflammatory cytokine in the body and plays an essential role in determining outcomes of many inflammatory diseases. Cellular metabolism is a critical determinant of immune cell function; however, it is currently unclear whether metabolic processes are specifically involved in IL-10 production. In this study, we aimed to find the central metabolic molecule regulating IL-10 production of macrophages, which are the main producers of IL-10. Transcriptomic analysis identified that metabolic changes were predominantly enriched in Kupffer cells at the early inflammatory phase of a mouse endotoxemia model. Among them, pyruvate dehydrogenase kinase (PDK)-dependent acute glycolysis was negatively involved in IL-10 production. Inhibition or knockdown of PDK selectively increased macrophage IL-10 expression. Mechanistically, PDK inhibition increased IL-10 production via profound phosphorylation of adenosine monophosphate (AMP)-activated protein kinase alpha 1 (AMPKα1) by restricting glucose uptake in lipopolysaccharide-stimulated macrophages. AMPKα1 consequently activated p38 mitogen-activated protein kinase, c-Jun N-terminal kinase, and cyclic AMP-responsive element-binding protein to regulate IL-10 production. Our study uncovers a previously unknown regulatory mechanism of IL-10 in activated macrophages involving an immunometabolic function of PDK.
Cellular network across cementum and periodontal ligament elucidated by FIB/SEM tomography
Authors: Hirashima Shingo , Ohta Keisuke , Kanazawa Tomonoshin , Togo Akinobu , Tsuneyoshi Risa , Kusukawa Jingo , Nakamura Kei-ichiro
Published: December 2019

Cementocytes in cementum form a lacuna-canalicular network. However, the 3D ultrastructure and range of the cementocyte network are unclear. Here, the 3D ultrastructure of the cementocyte network at the interface between cementum and periodontal ligament (PDL) was investigated on the mesoscale using FIB/SEM tomography. The results revealed a cellular network of cementocytes and PDL cells. A previous histomorphological study revealed the osteocyte-osteoblast-PDL cellular network. We extended this knowledge and revealed the cementum-PDL-bone cellular network, which may orchestrate the remodeling and modification of periodontal tissue, using a suitable method for imaging of complex tissue.
Being Normal: Stigmatization of Lord’s Resistance Army Returnees as ‘Moral Experience’ in Post-war Northern Uganda
Authors: Macdonald Anna , Kerali Raphael
Published: December 2019

The literature on Lord’s Resistance Army (LRA) returnees in Acholiland, northern Uganda tells us that those who returned from the rebel group are likely to experience stigma and social exclusion. While the term is deployed frequently, ‘stigma’ is not a well-developed concept and most of the evidence we have comes from accounts of returnees themselves. Focusing instead on the ‘stigmatizers’, this article theorizes stigmatization as part of the ‘moral experience’ of regulating post-war social repair. Through interview-based and ethnographic methods, it finds that stigmatization of LRA returnees takes many forms and serves multiple functions, calling into question whether this catch-all term actually obscures more than it illuminates. While stigmatization is usually practised as a form of ‘social control’, its function can be ‘reintegrative’ rather than purely exclusionary. Through the northern Uganda case study, this article seeks to advance conceptual and empirical understanding of the manifestations and functions of stigmatization in spaces of return, challenging the logic underpinning those interventions that seek to reduce it.
Role of intrauterine administration of transfected peripheral blood mononuclear cells by GM-CSF on embryo implantation and pregnancy rate in mice
Authors: Rezaee Delsuz , Bandehpour Mojgan , Kazemi Bahram , Salehi Mohammad
Published: December 2019

One of the effective treatments in women with recurrent implantation failure (RIF) is the use of immune cells to facilitate embryo implantation. Previous studies have shown that intrauterine transmission of peripheral blood mononuclear cells (PBMC) increased the embryo implantation rate. In this study using B6D2F1 (C57BL/6 × DBA2) mice, a fragment of the granulocyte macrophage colony-stimulating factor (Gm-csf) gene was cloned into an enhanced green fluorescent protein vector (pEGFP-N1) and then transfected into PBMC. The protein level of GM-CSF was evaluated in the transfected PBMC and untransfected PBMC by ELISA. Attachment of mouse embryos and the mRNA expression levels of leukemia inhibitory factor (Lif), vascular endothelial growth factor (Vegf), matrix metalloproteinase 9 (Mmp9), Gmcsf-receptor (Gmcsf-r) and interleukin 6 (Il6) in vitro were assessed by real-time PCR in endometrial cells. To determine the pregnancy rate and number of implantation sites in vivo, the mouse uterine horns were analyzed on Day 7.5 post coitum. A greater amount of GM-CSF was produced in PBMC transfected with recombinant vector (552 pg/mL) compared with the untransfected PBMC (57 pg/mL) and PBMC transfected with empty vector (34 pg/mL) (P < 0.05). The data showed that the embryo attachment rate and mRNA expression levels (Vegf [1.7-fold], Mmp9 [1.4-fold], Lif [1.5-fold], Gm-csf r [1.6-fold] and Il6 [1.2-fold]) in the in vitro study (P < 0.01), pregnancy rate (P < 0.01) and number of implantation sites (P < 0.01) in the in vivo investigation (P < 0.05) were increased in PBMC transfected with recombinant vector compared with the PBMC group. The study demonstrated that, in mice, endometrium immunotherapy with transfected PBMC that contained recombinant GM-CSF before embryo implantation was effective in improving embryo implantation and endometrial receptivity.
Handgrip strength is a comorbidity marker in systemic necrotizing vasculitides and predicts the risk of fracture and serious adverse events
Authors: Henriquez Soledad , Dunogué Bertrand , Porcher Raphael , Régent Alexis , Cohen Pascal , Berezne Alice , Kolta Sami , Le Jeunne Claire , Mouthon Luc , Roux Christian , Guillevin Loïc , Briot Karine , Terrier Benjamin ,   for the French Vasculitis Study Group (FVSG)
Published: December 2019

Objective

Sarcopenia has been associated with poor outcomes in various medical and surgical conditions. However, its impact in systemic necrotizing vasculitides (SNV) had never been characterized. We aimed to assess the prevalence, associated factors and prognostic impact of sarcopenia in SNV.

Methods

Patients with SNV were successively included in a prospective longitudinal study assessing comorbidities. At inclusion, we evaluated sarcopenia by assessing skeletal muscle mass index using DXA and muscle strength using handgrip strength. Vasculitis and treatments-related events were recorded and analysed using Cox models.

Results

One hundred and twenty patients were included. At inclusion, low handgrip strength (<30 kg for men and 20 kg for women) was identified in 28 (23%) patients, while no patient exhibited low skeletal muscle mass index (<7.23 kg/m2 for men and 5.67 kg/m2 for women). Low handgrip strength was associated with age (P <0.0001), type of vasculitis (P =0.01), vasculitis damage index (P =0.01), history of falls (P =0.0002), osteoporosis (P =0.04), low serum albumin (P =0.003) and prealbumin (P =0.0007), high CRP (P =0.001), high FRAX® tool (P =0.002) and low bone mineral density at femoral neck (P =0.0002). After median follow-up of 42 months, low handgrip strength was associated with higher risk of bone fracture [HR 4.25 (1.37–13.2), P =0.01] and serious adverse events [HR 2.80 (1.35–5.81), P =0.006].

Conclusion

Handgrip strength is associated in SNV with nutritional status and comorbidities such as bone disease, and seems to predict, as in other medical conditions, the risk of fracture and serious adverse events during follow-up. In contrast, assessment of skeletal muscle mass index in this population remains uncertain.
New Drugs 2020, part 1
Authors: Hussar Daniel A.
Published: December 2019

This article reviews seven drugs recently approved by the FDA, including indications, precautions, adverse reactions, and nursing considerations.
The effectiveness of a low-dose esketamine versus an alfentanil adjunct to propofol sedation during endoscopic retrograde cholangiopancreatography
Authors: Eberl Susanne , Koers Lena , van Hooft Jeanine , de Jong Edwin , Hermanides Jeroen , Hollmann Markus W. , Preckel Benedikt
Published: December 2019

BACKGROUND

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most complex gastrointestinal endoscopic procedures. Currently, it is still unclear which sedation regimen best facilitates an ERCP. TheN-methyl-d-aspartate receptor antagonist esketamine has anaesthetic, analgesic and sympathomimetic properties and is known to cause less cardiorespiratory depression than other sedatives. It could therefore be an ideal adjunct to propofol for deep sedation.

OBJECTIVE

To assess the effectiveness of esketamine versus alfentanil as an adjunct to propofol target-controlled infusion (TCI) for deep sedation during ambulant ERCP.

DESIGN

A randomised controlled multicentre study.

SETTING

Endoscopic intervention suite at an academic and general hospital in the Netherlands.

PARTICIPANTS

Adult, American Society of Anesthesiologists Physical Status I to III patients scheduled to undergo ERCP.

INTERVENTION

Consecutive patients were randomly assigned to receive sedation for an ERCP with propofol TCI and alfentanil (group A) or with propofol TCI and esketamine (group E).

MAIN OUTCOME MEASURES

The primary outcome was effectiveness of the sedation regimen expressed as the total dose of propofol – as a surrogate parameter – necessary to perform ERCP in a satisfactory manner for endoscopist and patients. Secondary outcomes were recovery time, patients’ and endoscopists’ satisfaction with sedation, side effects (e.g. psychotomimetic effects, nausea and vomiting) and the number of respiratory and cardiovascular adverse events.

RESULTS

Data from 162 patients were analysed. The total dose of propofol required was significantly lower in group E (n=83) (8.3 mg kg−1 h−1) than in group A (n=79) (10.5 mg kg−1 h−1) (P < 0.001). There were no significant differences in recovery time, patients’ and endoscopists’ satisfaction, side effects, psychotomimetic effects and the number of sedation-related adverse events.

CONCLUSION

Low-dose esketamine reduces the total amount of propofol necessary for sedation during ERCP in American Society of Anesthesiologists I and II patients without affecting recovery time, satisfaction of patients and endoscopists, side effects and respiratory or cardiovascular adverse events, when compared with alfentanil.

TRIAL REGISTRATION

The Netherlands Trial Register (NTR5486).
Physical and Visual Characteristics of the Neck Predicting Gender Perception
Authors: Amir Ofer , Shemer Kim , Roziner Ilan , Primov-Fever Adi
Published: December 2019

Background:

The association between neck characteristics (physical and visual) and the perception of gender is unclear. This association is critical, especially when the perception of the speakers’ gender is of interest, such as in transgender patients. This study was the first to provide basic empirical data on this association among cisgender men and women.

Methods:

The necks of 30 adult men and women were measured physically and then photographed and evaluated visually by a group of 10 judges. These judges also evaluated voice recordings of the same speakers. Another group of 124 judges rated the visual and auditory masculinity/femininity of the necks and the voices.

Results:

While most physical measures of the neck were larger for men, neck-length did not significantly differ between genders. A stepwise multiple regression model revealed that the singlephysicalmeasure that consistently differed between genders was neck-girth (P< 0.0001). The singlevisual-appearancemeasure that consistently differed between genders was thyroid-protrusion (P= 0.0003). Neck-girth was the only physical characteristic that significantly correlated with gender differences in voice. Furthermore, the size of the thyroid prominence (ie, Adam’s apple) was not associated with gender differences in voice.

Conclusions:

Neck characteristics (both physical and visual) are significantly associated with the perception of gender. While larger necks are typically perceived as masculine,neck-lengthis neither associated with gender nor with the speaker’s voice characteristics. These findings highlight the importance of examining various physical and visual characteristics of the neck, when considering a feminization confirmation procedure for transgender patients.
The risk and prevention of sudden death in patients with heart failure with reduced ejection fraction
Authors: Davis Jason , Sapp John
Published: December 2019

Purpose of review

Patients with heart failure are at increased risk of sudden cardiac death. The methods to predict patients at high risk of sudden cardiac death in heart failure are neither sensitive nor specific; both overestimating risk in those with ejection fractions less than 35% and not identifying those at risk with ejection fractions greater than 35%.

Recent findings

The absolute risk of sudden cardiac death in patients with heart failure have decreased over the past 20 years. New novel tools are being developed and tested to identify those at higher risk of sudden cardiac death. Reduction in the risk of sudden cardiac death has been achieved with the use of beta-blockers, spironolactone, sacubitril–valsartan, cardiac resynchronization and implantable cardioverter defibrillators.

The use of contemporary treatments for patients with heart failure can reduce the risk of sudden cardiac death, but research is required to identify those at highest risk.
Airway advanced training: experiences from a UK-based tertiary referral head and neck center
Authors: Keane Oliver , Muldoon Sarah , Ahmad Imran
Published: December 2019

Debate exists in the anesthetic community as to whether certain aspects of airway management should be considered an advanced or subspecialist area of practice, with only a small number of anesthetists specifically trained and routinely practicing in this area. In the United Kingdom, the Royal College of Anaesthetists does consider Airway Management to be a distinct area of training that can be delivered as an Advanced Training Module. This means that a number of Anesthetic Specialist Trainees, in their penultimate or final years of training, will receive 6–12 months of dedicated experience and training in advanced airway skills. We present our experience of delivering such an Advanced Training Module at Guy’s Hospital, London, UK, a tertiary center with a large Head and Neck service. We will discuss the clinical, educational, and research opportunities that we are able to provide. We will also review the educational theories which allow us to assess whether our registrars are able to convert these opportunities into a “mastery” of the skills required to become a Specialist Airway Anesthetist.
Airway Management: Isn’t that what anesthesiologists do?
Authors: Straker Tracey
Published: December 2019

Airway management is an expected skillset of anesthesiologists—and rightfully so. Anesthesiologists are considered airway management experts. Although this is an expected skill, usually there is not a concentrated period of time dedicated to airway management in in residency. It is expected that you become facile with airway management “along the way” in your residency. More recently residencies are providing airway rotations ranging from 2 weeks to a month in the residency. Given the range of cases that involve advanced airway techniques, I submit that 1 month of intense airway management is not enough to prepare the resident for the breadth of cases involving complex management skills and techniques. As such, yearlong fellowships in airway management are beginning to materialize in the United States.
Impact of Accessory Pathway Location on Electrophysiologic Characteristics and Ablation Success
Authors: Behjati Ardakani Mohammadamin , Dehghani Faezeh , Sarebanhassanabadi Mohammadtaghi , Yalameh Azam , Behjat Mehrnoosh , Behjati Ardakani Mostafa , Shafiee Mohammad , Seyed Hosseini Seyed-Mostafa
Published: December 2019

Background:

To investigate the relationship between the location of accessory pathways, electrophysiologic characteristics, and ablation success in Wolfe-Parkinson-White (WPW) syndrome.

Methods:

Electrophysiologic study was performed in 178 patients for a pre-excitation syndrome. Accessory pathway location, anterograde or retrograde conduction, ablation success, and recurrence rate were evaluated.

Results:

Among 178 patients with WPW syndrome, the most frequent location of the accessory pathway was left lateral (39.3%) which had high ablation success rate (97%) and low recurrence rate (1%). A meaningful relationship exists between accessory pathway location and electrophysiologic characteristics. Ablation success rate was 89.7% and was statistically related to accessory pathway location. Recurrent occurred in 2.9% of our patients and was more frequent in right free wall and PJRT.

Conclusions:

The location of accessory pathways has a great impact on conductivity, ablation success, and recurrence rate in WPW syndrome.
Protective Effects of Cyclosporine A Emulsion Versus Cyclosporine A Cationic Emulsion Against Desiccation Stress in Human Corneal Epithelial Cells
Authors: Hwang Sae-Byeok , Park Jin Hyoung , Kang Soon-Suk , Kang Dong Hyun , Lee Jae Hyuck , Oh Soo Jin , Lee Ji-Yoon , Kim Jae Yong , Tchah Hungwon
Published: December 2019

Purpose:

To compare the protective effects of cyclosporine A emulsion (Restasis: 0.05% cyclosporine A) (CsAE) and cyclosporine A cationic emulsion (Ikervis: 0.1% cyclosporine A) (CsACE) on cellular inflammation, apoptosis, proliferation, and survival in an in vitro dry eye model.

Methods:

The concentration of CsA in CsAE and CsACE was verified using a liquid chromatography tandem mass spectrometry system. Human corneal epithelial cells were subjected to desiccation stress. Human corneal epithelial cells were incubated with or without 3 groups of cyclosporine A medium (CsAE 1:50, CsACE 1:50, and CsACE 1:100). p-NF-κB p65, p-IκBα, Bax, Bcl-xL, p-Erk1/2, and p-Akt levels were determined using Western blots, and TNF-α levels were quantified using an enzyme-linked immunosorbent assay.

Results:

The CsA concentration of CsACE 1:100 was nearly the same as that of CsAE 1:50. Compared with CsAE 1:50 (0.78 ± 0.19 fold), the p-NF-κB p65 level was further reduced in CsACE 1:50 (0.38 ± 1.20 fold) and 1:100 (0.29 ± 0.11 fold) as well as p-IκBα. Levels of TNF-α were also lower in CsACE 1:50 and 1:100 than in CsAE 1:50. Induction of the apoptotic protein Bax was significantly decreased in CsACE 1:50 and 1:100 compared with CsAE 1:50, whereas that of the antiapoptotic protein Bcl-xL was increased in CsACE 1:50 and 1:100. p-ERK1/2 and p-Akt levels were higher in CsACE 1:50 and 1:100 than in CsAE 1:50.

Conclusions:

CsACE had more potent anti-inflammatory and antiapoptotic effects than CsAE in a transwell desiccation stress model. CsACE also enhanced proliferation and survival factors under desiccation stress compared with CsAE in this in vitro dry eye model.
Fremanezumab and its isotype slow propagation rate and shorten cortical recovery period but do not prevent occurrence of cortical spreading depression in rats with compromised blood–brain barrier
Authors: Melo-Carrillo Agustin , Schain Aaron J. , Stratton Jennifer , Strassman Andrew M. , Burstein Rami
Published: December 2019

Most centrally acting migraine preventive drugs suppress frequency and velocity of cortical spreading depression (CSD). The purpose of the current study was to determine how the new class of peripherally acting migraine preventive drug (ie, the anti-CGRP-mAbs) affect CSD—an established animal model of migraine aura, which affects about 1/3 of people with migraine—when allowed to cross the blood–brain barrier (BBB). Using standard electrocorticogram recording techniques and rats in which the BBB was intentionally compromised, we found that when the BBB was opened, the anti-CGRP-mAb fremanezumab did not prevent the induction, occurrence, or propagation of a single wave of CSD induced by a pinprick, but that both fremanezumab and its isotype were capable of slowing down the propagation velocity of CSD and shortening the period of profound depression of spontaneous cortical activity that followed the spreading depolarization. Fremanezumab's inability to completely block the occurrence of CSD in animals in which the BBB was compromised suggests that calcitonin gene-related peptide (CGRP) may not be involved in the initiation of CSD, at least not to the extent that it can prevent its occurrence. Similarly, we cannot conclude that CGRP is involved in the propagation velocity or the neuronal silencing period (also called cortical recovery period) that follows the CSD because similar effects were observed when the isotype was used. These finding call for caution with interpretations of studies that claim to show direct central nervous system effects of CGRP-mAbs.
Complications in Posterior Cruciate Ligament Injuries and Related Surgery
Authors: Marom Niv , Ruzbarsky Joseph J. , Boyle Caroline , Marx Robert G.
Published: December 2019

Posterior cruciate ligament (PCL) injury, especially in isolation, is a less frequent injury than injury to the anterior cruciate ligament and other ligaments of knee. In addition, the complex injury patterns involving the PCL, the technically demanding nature of surgical treatments, the anatomic proximity to vital neurovascular structures and the controversy surrounding optimal management of PCL injuries, make these injuries and their treatment potentially prone to more complications. This chapter will review the common complications of PCL injuries and related surgery.
Posterior Cruciate Ligament All-Inside Reconstruction
Authors: Martin R. Kyle , Melugin Heath P. , Freychet Benjamin , Krych Aaron J. , Stuart Michael J. , Levy Bruce A.
Published: December 2019

Several techniques for posterior cruciate ligament (PCL) reconstruction have been described. Reported clinical outcomes for the various techniques are often affected by concomitant injuries. Therefore, the optimal surgical technique choice remains controversial. Variations include transtibial versus tibial inlay, single-bundle versus double-bundle, and autograft versus allograft. The all-inside technique has recently been described as a transtibial method that uses adjustable loop suspensory fixation through sockets rather than tunnels on both the femur and tibia. This technique preserves more bone and may decrease the risk of tunnel convergence during multiligament reconstruction or concomitant meniscus procedures. This paper outlines the options available to surgeons performing PCL reconstruction and describes the authors’ preferred technique for all-inside PCL reconstruction.
Diagnosing PCL Injuries: History, Physical Examination, Imaging Studies, Arthroscopic Evaluation
Authors: Verhulst Fleur V. , MacDonald Peter
Published: December 2019

Isolated posterior cruciate ligament (PCL) injuries are uncommon and can be easily missed with physical examination. The purpose of this article is to give an overview of the clinical, diagnostic and arthroscopic evaluation of a PCL injured knee. There are some specific injury mechanisms that can cause a PCL including the dashboard direct anterior blow and hyperflexion mechanisms. During the diagnostic process it is important to distinguish between an isolated or multiligament injury and whether the problem is acute or chronic. Physical examination can be difficult in an acutely injured knee because of pain and swelling, but there are specific functional tests that can indicate a PCL tear. Standard x-ray’s and stress views are very useful imaging modalities but magnetic resonance imaging remains the gold standard imaging study for detecting ligament injuries. Every knee scope should be preceded by an examination under anesthesia. Specific arthroscopic findings are indicative of a PCL tear such as the “floppy ACL sign” and the posteromedial drive through sign. History, physical examination and imaging should all be combined to make an accurate diagnosis and initiate appropriate treatment.
Analysis of an American College of Surgeons Committee on Trauma (ACS-COT) Approved Pilot Project: Increasing Provider Communication During Interhospital Transfer
Authors: Fletcher Brian , West Sarah K. , Roberts Christina , Pencil Kristie , Spalding M. Chance , Martin Stacey , Bonta Marco , O'Mara Michael “Shay”
Published: December 2019

The American College of Surgeons Committee on Trauma requires physician-to-physician communication prior to interhospital transfer. This requirement can be difficult to achieve in high-volume trauma centers. This pilot project utilizes trauma advanced practice providers (APPs) as the primary communicator, in lieu of the trauma surgeon, prior to interhospital transfer. The hypothesis suggests that APPs can provide safe recommendations and accurately triage patients for the highest level trauma alert. From January to April 2018, a total of 1,145 patients were transferred to a Level I or Level II trauma center. All interhospital trauma transfers were dispatched through a designated transfer center APP (TCAPP). Descriptive statistics were used to describe the frequency of core TCAPP recommendations, including reversal agents for anticoagulants, antibiotics for open fractures, direct admission criteria, administration of blood products, and triaging to the highest level of trauma activation. TCAPP triage accuracy was analyzed and reported as percentages. Percentages are compared between independent groups using a chi-square test. Prior to implementation of the TCAPP role, provider-to-provider communication occurred in less than 1% of interhospital transfers; TCAPP-to-provider communication occurred 92% of the time (p < .001). During the study period, the TCAPP made 398 care-related recommendations. Three (<1%) TCAPP recommendations were deemed inappropriate. The TCAPP (89.7%) and physician (89.9%) triage accuracy was not significantly different (p = .43). Interhospital transfer communication and recommendations can be performed safely and accurately by a trauma trained APP.
Use of Social Media for Injury Prevention: An Integrative Review
Authors: Zazzera Erin
Published: December 2019

Traumatic injury is a substantial burden for public health. Injury prevention can reduce the risk of injury by promoting healthy behaviors. It is unknown whether injury prevention education shared on social media is effective at promoting behavior change to reduce injuries. The purpose of this integrative review is to identify the influence of social media in providing injury prevention education to the public. An integrative literature review was conducted. The following databases were searched: CINAHL, PubMed, MEDLINE, and Applied Science & Technology Source. Studies were included if they were published between 2006 and 2018. Exclusion criteria included self-inflicted or intentional injuries, postinjury online interventions, support groups, online surveys, blogs, editorial content, YouTube videos, or studies of online surveillance tools.

The initial search yielded 583 studies. Twelve studies met inclusion criteria. Two major themes were identified: social media content analysis and injury prevention through social media.

The public is actively discussing injuries on social media, although unregulated online content may deliver inaccurate or false messages. Online conversation intensifies when major news stories are released, particularly when a celebrity or athlete is involved. Public health should use these patterns of major news stories to influence and shape online conversations about injury. Social media offers opportunity to understand, and trend, public perception of injuries. Additional research is needed to measure the effect of injury prevention delivered over social media.