bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyse The Waste Potential of Felling Community Forest In Cendana District of Enrekang Region
Authors: Mujetahid A , Dalya N
Published: May 2019

This study aimed to determine the volume of felling waste, the waste utilization prospects and the factors that influence the amount of felling waste in community forests. This study was conducted in December 2017 through February 2018 in the community forests in Pinang village, Cendana District of Enrekang Region. The method used in this research was descriptive and quantitative analysis. The descriptive analysis aimed to describe and explain teak logging activities while quantitative analysis carried was undertaken for the diameter measurement and calculate of waste volume generally observed in this study are community forest enforce be felled within the study site. The results of this study showed that the total volume of waste was 0.128 m3 with the percentage of 18.492% derived from stump waste, waste of main stem, branch and above the bole waste. Prospects of utilization of felling waste especially waste branch at Bangka Trading Business can be created as a furniture raw material and firewood. Factors that influence the amount of felling waste were labor and industrial demand factor.
Typology of Deforestation in Riau Province
Authors: Rijal S
Published: May 2019

Deforestation assessments based on the rate number and extent of the deforestation area. This assessment of deforestation has the potential to provide wrong information about the condition of a region’s forests. High deforestation rates are known as the area with high forest destruction. Otherwise, the area with low rates of deforestation are known as the areas with better forest conditions. The rate of zero deforestation was known as a non-deforestation area. In fact, a low rate deforestation in a region are not necessarily mean having a better forest. This study was aimed to determine the typology of deforestation in Riau Province. The research method was done by analyzing land cover data with Geographic Information System. Deforestation typology assessments were conducted by using the variables of the proportion of the initial forest area of a regency, the incidence of deforestation and the rate of deforestation. The deforestation typology of the regency level in Riau Province has shown in 5 deforestation profiles. The highest typology is Large-Lately-Low Deforestation (5 regencies), which is indicating that the incidence of deforestation in Riau Province occurred in large forest areas, mostly occurred in the second period of observation with high rate. Riau Province is the province with the highest number of forest area in Sumatra (1990) and the highest rate of deforestation (68.18%). Deforestation in Riau Province from 1990 to 2013 is the deforestation typology of Early deforestation.
Remote Chlorophyll-a and SST to Determination of Fish Potential Area in Makassar Strait Waters Using MODIS Satellite Data
Authors: Selao A , Malik A A , Yani F I , Mallawa A , Safruddin
Published: May 2019

The objective of this research was to analyze integrated geospatial data using MODIS Satellite data and field data observation to the determination of potential fish area. This study applied in Makassar Strait 118° 0’ 0” E-119° 37’ 0” E, 3°0’0” S – 4°45’0” S. The methods of this research was conducted using MODIS combine the depth of map waters survey direct interviews and people who participate in fishing activities monthly in January, February, March, April, May, and June. Data were analyzed by using software: Statistics, SeaDas, ENVI, and GIS. The result showed that the horizontal distribution of sea surface temperature (SST) spread evenly or divergent. The distribution of sea temperature in the coastal area was relatively warm in the sea around Barru and Pangkep was ranged 31 to 32 °C. Sea surface temperature dominates in the range of 30 - 31°C. SST correlation coefficient was 0.79 between MODIS and value of observation field data.
Institutional Synergy Model of Awota Forest Management Unit in South Sulawesi Province
Authors: Supratman  , Alam S , Emban Ibnu R , Adrayanti S , Sahide M A K
Published: May 2019

Overlapping of Community Plantation Forest (HTR) reserves with Forest Management Unit (KPH) areas, will create conflict in forest management if the institutional management of HTR is not synergized with KPH institutions. This study aims to form a descriptive model of institutional synergy in the management of HTR within the KPH Awota Area. The study was carried out in the village of Minanga Tellue, Maniangpajo District, Wajo Regency. Field observations, in-depth interviews, Focus Group Discussion (FGD), workshops, and documentation studies were conducted to collect primary and secondary data. Map analysis, institutional analysis, and stakeholder analysis were carried out to achieve the research objectives. The results of the study found a descriptive model of the synergy of forest management institutions, including components: (1) input models in the form of policies, potential, problems, strategic issues, institutions, and stakeholders, (2) management prescriptions include site management and institutional synergy, and (3) model output, namely wood, mulberry and food products. The model needs to be tested and further studied regarding the potential economic efficiency created and the value of economic benefits received by each stakeholder on the implementation of the model.
Internal and External Implementation Strategy of Collaboration Management Model in Hasanuddin University Educational Forest
Authors: Yusran  , Sabar A
Published: May 2019

The management of educational forest with multiple stakeholder approaches is expected to contribute to the success of educational forest management. The results of previous studies recommended the need to strengthen multiple parties to build a collaborative management model by considering aspects of needs and clarifying the role of stakeholders, so that common perceptions were developed in managing the area and anticipating overlapping in carrying out their respective roles. This study aims to analyze the internal and external strategies for implementing the collaboration management model in the Hasanuddin University Educational Forest area. The methodological approach using descriptive policy analysis, internal and external strategy analysis (review of IFAS-EFAS) were chosen to achieve the expected goals. The results of IFAS-EFAS strategy analysis proposed four main strategies. The first one is a strategy which maximizes the power to seize opportunities (SO), namely a plan for empowering the surrounding forest community through the Social Forestry scheme in a strategic plan and utilizing the human resources to promote and jointly developing eco-tourism potential. The second one is a strategy that utilizes maximum use of power to anticipate or deal with threats and try to make threats as opportunities (ST), namely to make experts and other human resources as mediators or facilitators to relevant parties so that mutual understanding can be developed regarding management objectives. The third one is a strategy that minimizes weaknesses to seize opportunities (WO), namely improvements in the funding area through fundraising to improve the quality of educational forest management, including the improvement of supporting facilities and infrastructure through the concept of partnership with the community, and massive promotion of eco-tourism potential. The fourth one is a strategy that minimizes weaknesses to avoid threats well (WT), namely managing budget that is right on target, accountable, and transparent, to avoid negative stigma from the community.
Identification of the Minimum Number of Measurements Required for Thermal Comfort Assessment in Large Workplaces
Authors: Lenzuni Paolo , Tura Pierangelo , Cervino Pierfrancesco
Published: May 2019

Optimization of resources is the key to improve our ability to perform multiple tasks with limited time and money. In the context of thermal comfort assessment, optimization becomes important in large rooms where tens of individuals perform similar tasks. This work focuses on the identification of the minimum number of measurement points that allows an accurate description of the thermal environment. Accuracy of description is assumed if no significant loss of information is associated to the transition from the ‘primary’ thermal map based on all available measurement points to a ‘secondary’ thermal map based on a reduced set of measurement points. The concept of ‘no significant loss’ is quantified by requiring that the difference in PMV (Predicted Mean Vote) between the two maps is kept <0.1 in the vast majority (95%) of points. PMV is a standardized synthetic index that is used worldwide for quantifying thermal comfort (ISO 7730, 2005) taking into account both environmental (thermo-hygrometric) and personal (activity, clothing) quantities.

We show that the uncertainty induced by the degraded resolution of the thermal map has a limited impact on the overall uncertainty on PMV. Application of the method to a few test environments shows that the room size perpendicular to the main window and the windows orientation play the largest role in determining spatial inhomogeneity in thermal maps. A minor concurring factor is the room area.
Alternative reproductive tactics shape within-species variation in behavioral syndromes
Authors: Han Chang S , Jablonski Piotr G
Published: May 2019

Multiple behaviors can correlate with each other at the individual level (behavioral syndrome), and behavioral syndromes can vary in their direction between populations within a species. Within-species variation in behavioral syndromes is predicted to be associated with alternative reproductive tactics (ARTs), which evolve under different selection regimes. Here, we tested this using a water strider species, Gerris gracilicornis, in which males employ 2 ARTs that are fixed for life: signaling males (producing courtship ripples) versus nonsignaling males (producing no courtship ripples). We measured multiple behaviors in males with both of these ARTs and compared behavioral syndromes between them. Our results showed that signaling males were more active and attempted to mate more frequently than nonsignaling males. This shaped an overall behavioral syndrome between activities in mating and nonmating contexts when we pooled both ARTs. In addition, the behavioral syndromes between cautiousness and mating activity differed significantly between ARTs. In signaling males, the syndrome was significantly negative: signaling males more eager to mate tended to leave their refuges more rapidly. However, mating activity and cautiousness were not correlated in nonsignaling males. This might be because active males, in the context of predation risk and mating, were favored during the evolution and maintenance of the unique intimidating courtship tactic of G. gracilicornis males. Thus, our findings suggest that ARTs facilitate behavioral divergence and also contribute to the evolution of tactic-specific behavioral syndromes. We also show that research on ARTs and behavioral syndromes can be harmonized to study behavioral variation.
Eggshell coloration indicates female condition during egg-laying: a field experiment in blue tits
Authors: Holveck Marie-Jeanne , Guerreiro Romain , Perret Philippe , Doutrelant Claire , Grégoire Arnaud
Published: May 2019

Several selection pressures may explain the evolution of avian eggshell coloration patterns. In cavity-nesting species, there are two main non-exclusive hypotheses. The sexually selected eggshell colour hypothesis proposes that eggshell coloration is a sexually selected signal of female and offspring quality used by males that influences paternal care or future re-mating decisions. The structural function hypothesis proposes that pigments help strengthen the eggshell and are present at higher levels and at the blunt end of the egg when females face calcium shortages. We tested whether eggshell coloration (brown spots on a white ground colour) in blue tits (Cyanistes caeruleus) could reliably indicate female condition at laying by forcing females to produce two consecutive clutches, thus increasing their reproductive costs. Three measures of eggshell coloration – the area covered by spots as well as white ground UV-chroma and brightness – changed between clutches; the fourth measure, spot distribution, did not. The changes were more dramatic in young and lower-quality females. All the measures varied with female quality (i.e. body condition and/or laying date). Overall, higher-quality females produced more colourful (larger, more concentrated spotted surface area; higher UV-chroma) and less bright (i.e. putatively more pigmented) eggshells, a result that is generally in line with past research. We found a clear empirical link between eggshell coloration and female condition in blue tits, an important step in determining whether eggshell coloration is a sexual signal, but which does not exclude a potential concomitant structural function.
The cost of fidelity: foraging oligolectic bees gather huge amounts of pollen in a highly specialized cactus–pollinator association
Authors: Cerceau Isabelle , Siriani-Oliveira Samuel , Dutra Ana Laura , Oliveira Reisla , Schlindwein Clemens
Published: May 2019

Plant–pollinator interactions vary along a specialization–generalization continuum. Advances in understanding the evolutionary and ecological consequences of different degrees of specialization depend on precise data on plant–pollinator interdependency. We studied the association of Parodia neohorstii (Cactaceae) and its bee pollinators focusing on pollinator foraging behaviour, flower functioning, female and male reproductive success, and pollen fate. Parodia neohorstii showed synchronized flower opening and pollen presentation but discontinuous blooming. The apparently generalized flowers partition pollen through thigmonastic stamen movements that function as a mechanical filter against generalist bees by restricting access to the major pollen reservoir to bees that show flower handling ‘know-how’, thereby favouring the oligolectic bee Arhysosage cactorum. This pollinator adjusted its pollen foraging to flower opening, removed pollen hurriedly, and promoted maximal fruit and seed set, which was minimal in its absence. Estimates of pollen fate revealed that a huge amount of pollen flows to specialized pollinators (86.5%), and only 0.9% reaches conspecific stigmas. The specialized interaction between P. neohorstii and Arhysosage cactorum, both threatened species, is efficient but fragile. Any environmental modification that causes a mismatch between the partners is likely to result in reproductive failure.
An Integrated Safety Summary of Omadacycline, a Novel Aminomethylcycline Antibiotic
Authors: Opal Steven , File Thomas M , van der Poll Tom , Tzanis Evan , Chitra Surya , McGovern Paul C
Published: May 2019

Omadacycline is a semisynthetic tetracycline antibiotic. Phase III clinical trial results have shown that omadacycline has an acceptable safety profile in the treatment of acute bacterial skin and skin structure infections and community-acquired bacterial pneumonia. Similar to most tetracyclines, transient nausea and vomiting and low-magnitude increases in liver aminotransferases were the most frequent treatment-emergent adverse events in phase III studies but were not treatment limiting. Package insert warnings and precautions for omadacycline include tooth discoloration; enamel hypoplasia; inhibition of bone growth following use in late pregnancy, infancy, or childhood up to 8 years of age; an imbalance in mortality (2%, compared with 1% in moxifloxacin-treated patients) was observed in the phase III study in patients with community-acquired bacterial pneumonia. Omadacycline has no effect on the QT interval, and its affinity for muscarinic M2 receptors resulted in transient heart rate increases following dosing.
How do cryptochromes and UVR8 interact in natural and simulated sunlight?
Authors: Rai Neha , Neugart Susanne , Yan Yan , Wang Fang , Siipola Sari M , Lindfors Anders V , Winkler Jana Barbro , Albert Andreas , Brosché Mikael , Lehto Tarja , Morales Luis O , Aphalo Pedro J
Published: May 2019

Cryptochromes (CRYs) and UV RESISTANCE LOCUS 8 (UVR8) photoreceptors perceive UV-A/blue (315–500 nm) and UV-B (280–315 nm) radiation in plants, respectively. While the roles of CRYs and UVR8 have been studied in separate controlled-environment experiments, little is known about the interaction between these photoreceptors. Here, Arabidopsis wild-type Ler, CRYs and UVR8 photoreceptor mutants (uvr8-2, cry1cry2 and cry1cry2uvr8-2), and a flavonoid biosynthesis-defective mutant (tt4) were grown in a sun simulator. Plants were exposed to filtered radiation for 17 d or for 6 h, to study the effects of blue, UV-A, and UV-B radiation. Both CRYs and UVR8 independently enabled growth and survival of plants under solar levels of UV, while their joint absence was lethal under UV-B. CRYs mediated gene expression under blue light. UVR8 mediated gene expression under UV-B radiation, and in the absence of CRYs, also under UV-A. This negative regulation of UVR8-mediated gene expression by CRYs was also observed for UV-B. The accumulation of flavonoids was also consistent with this interaction between CRYs and UVR8. In conclusion, we provide evidence for an antagonistic interaction between CRYs and UVR8 and a role of UVR8 in UV-A perception.
Interpreting the Role of the Violin in the Ballykinlar Internment Camp during the ‘ Anglo–Irish War’ of 1919–1921
Authors: Bashford Christina
Published: May 2019

Music-making in the internment camp at Ballykinlar in Ireland during the ‘ Anglo–Irish’ conflict, 1919–21, was one of several purposeful recreational activities that the British military permitted for prisoners. Apparently cherished by its participants (including the celebrated republican Peadar Kearney) were elementary group lessons in the classical violin and Irish fiddle, which were taught by fellow inmates Martin Walton and Frank O’Higgins, using inexpensive, imported instruments funded by the Irish White Cross. Scrutinizing a range of primary sources, this essay explores how the class functioned in the harsh situation of detention, and attributes its tolerance, even encouragement, by the British to a neo-Victorian paternalistic value-system. It further considers the appeal and meaning that the violin held for students, highlighting its possible value and function as a psychological coping mechanism in the face of ‘barbed-wire disease’, a motivating connection to Irish heritage, home life, and contemporary culture, and even a means of enacting covert resistance to British oppression.
Paecilomyces/Purpureocillium keratitis: A consecutive study with a case series and literature review
Authors: Chen Yen-Ting , Yeh Lung-Kun , Ma David H K , Lin Hsin-Chiung , Sun Chi-Chin , Tan Hsin-Yuan , Chen Hung-Chi , Chen Shin-Yi , Sun Pei-Lun , Hsiao Ching-Hsi
Published: May 2019

Paecilomyces/Purpureocillium species is an emerging pathogen of fungal keratitis; the risk factor, clinical course, and outcome of Paecilomyces/Purpureocillium keratitis need more exploration. We retrospectively reviewed 12 patients with culture-proven Paecilomyces/Purpureocillium keratitis in our hospital from 2003 to 2017 and combined them with 50 previous cases reported after the review conducted by Yuan et al. in 2009. Clinical features between the previously and newly reported cases were compared using the publication by Yuan et al. as a cutoff point. The mean age of the 62 newly reported patients with Paecilomyces/Purpureocillium keratitis was 52.7 years. Of these, contact lens wear was the most common predisposing factor (n = 32, 52%), followed by a preexisting corneal disease or previous ocular surgery (n = 12, 19%), and trauma (n = 8, 13%). Fifty eyes (81%) were treated with voriconazole, of which 31 (63%) were medically cured. Twenty-one of 62 eyes (34%) required therapeutic surgery. Compared with the 42 patients reported by Yuan et al., the patients were younger (P = .025); a higher proportion of the patients were contact lens wearers (P = .005); more patients were treated with voriconazole (P = .000); fewer patients required therapeutic surgery (P = .000) in recent reports. Contact lens use has become the major risk factor for Paecilomyces/Purpureocillium keratitis. The surgical rate has been significantly lower in recent publications, probably because of the prevalent use of voriconazole.
A retrospective cohort of invasive fusariosis in the era of antimould prophylaxis
Authors: Fernández-Cruz Ana , Semiglia María Auxiliadora , Guinea Jesús , Martínez-Jiménez María del Carmen , Escribano Pilar , Kwon Mi , Rodríguez-Macías Gabriela , Chamorro-de-Vega Esther , Rodríguez-González Carmen , Navarro Raquel , Galar Alicia , Sánchez-Carrillo Carlos , Díez-Martín José Luis , Muñoz Patricia
Published: May 2019

Mould-active prophylaxis is affecting the epidemiology of invasive mycoses in the form of a shift toward less common entities such as fusariosis. We analyze the characteristics of invasive fusariosis and its association to antifungal prophylaxis in a retrospective cohort (2004–2017) from a tertiary hospital in Madrid, Spain. Epidemiological, clinical, microbiological, and antifungal consumption data were retrieved. Isolates were identified to molecular level, and antifungal susceptibility was tested. Eight cases of invasive fusariosis were diagnosed. Three periods were identified according to incidence: <2008 (three cases), 2008–2013 (zero cases), >2014 (five cases). All except one case involved breakthrough fusariosis. During the earliest period, the episodes occurred while the patient was taking itraconazole (two) or fluconazole (one); more recently, while on micafungin (three) or posaconazole (one). Early cases involved acute leukemia at induction/consolidation, recent cases relapsed/refractory disease (P = .029). Main risk factor for fusariosis (62.5%) was prolonged neutropenia (median 44 days). Galactomannan and beta-D-glucan were positive in 37.5% and 100% of cases, respectively. All isolates except F. proliferatum presented high minimal inhibitory concentrations (MICs) against the azoles and lower MIC to amphotericin B. Most patients received combined therapy. Mortality at 42 days was 62.5%. Resolution of neutropenia was associated with survival (P = .048). Invasive fusariosis occurs as breakthrough infection in patients with hematologic malignancy, prolonged neutropenia, and positive fungal biomarkers. Recent cases were diagnosed in a period of predominant micafungin use in patients who had more advanced disease and protracted neutropenia and for whom mortality was extremely high. Resolution of neutropenia was a favorable prognostic factor.
Discovery of a radio transient in M81
Authors: Anderson G E , Miller-Jones J C A , Middleton M J , Soria R , Swartz D A , Urquhart R , Hurley-Walker N , Hancock P J , Fender R P , Gandhi P , Markoff S , Roberts T P
Published: May 2019

We report the discovery of a radio transient in the spiral galaxy M81. The transient was detected in early 2015 as part of a two-year survey of M81 made up of 12 epochs using the Karl G. Jansky Very Large Array. While undetected on 2014 September 12, the source was first detected on 2015 January 2, from which point it remained visible at an approximately constant luminosity of LR, ν = 1.5 ± 0.1 × 1024 erg s−1 Hz−1 at the observing frequency of 6 GHz for at least 2 months. Assuming this is a synchrotron event with a rise-time between 2.6 and 112 d, the peak luminosity (at equipartition) corresponds to a minimum energy of 1044 ≲ Emin ≲ 1046 erg and jet power of Pmin ∼ 1039 erg s−1, which are higher than most known X-ray binaries. Given its longevity, lack of short-term radio variability, and the absence of any multiwavelength counterpart (X-ray luminosity Lx ≲ 1036 erg s−1), it does not behave like known Galactic or extragalactic X-ray binaries. The M81 transient radio properties more closely resemble the unidentified radio transient 43.78+59.3 discovered in M82, which has been suggested to be a radio nebula associated with an accreting source similar to SS 433. One possibility is that both the new M81 transient and the M82 transient may be the birth of a short-lived radio bubble associated with a discrete accretion event similar to those observed from the ULX Holmberg II X-1. However, it is not possible to rule out other identifications including long-term supernova shockwave interactions with the surrounding medium from a faint supernova or a background active galaxy.
A broad-band spectro-polarimetric view of the NVSS rotation measure catalogue – II. Effects of off-axis instrumental polarization
Authors: Ma Yik Ki , Mao S A , Stil Jeroen , Basu Aritra , West Jennifer , Heiles Carl , Hill Alex S , Betti S K
Published: May 2019

The NRAO VLA Sky Survey (NVSS) rotation measure (RM) catalogue has enabled numerous studies in cosmic magnetism, and will continue being a unique data set complementing future polarization surveys. Robust comparisons with these new surveys will however require further understandings in the systematic effects present in the NVSS RM catalogue. In this paper, we make careful comparisons between our new on-axis broad-band observations with the Karl G. Jansky Very Large Array and the NVSS RM results for 23 sources. We found that two unpolarized sources were reported as polarized at about 0.5 per cent level in the RM catalogue, and noted significant differences between our newly derived RM values and the catalogue values for the remaining 21 sources. These discrepancies are attributed to off-axis instrumental polarization in the NVSS RM catalogue. By adopting the 0.5 per cent above as the typical off-axis instrumental polarization amplitude, we quantified its effect on the reported RMs with a simulation, and found that on average the RM uncertainties in the catalogue have to be increased by ${\approx } 10\, {{\ \rm per\ cent}}$ to account for the off-axis instrumental polarization effect. This effect is more substantial for sources with lower fractional polarization, and is a function of the source’s true RM. Moreover, the distribution of the resulting RM uncertainty is highly non-Gaussian. With the extra RM uncertainty incorporated, we found that the RM values from the two observations for most (18 out of 21) of our polarized targets can be reconciled. The remaining three are interpreted as showing hints of time variabilities in RM.
Interactive web-based visualization and sharing of phylogenetic trees using phylogeny.IO
Authors: Jovanovic Nikola , Mikheyev Alexander S
Published: May 2019

Traditional static publication formats make visualization, exploration, and sharing of massive phylogenetic trees difficult. A phylogenetic study often involves hundreds of taxa, and the resulting tree has to be split across multiple journal pages, or be shrunk onto one, which jeopardizes legibility. Furthermore, additional data layers, such as species-specific information or time calibrations are often displayed in separate figures, making the entire picture difficult for readers to grasp. Web-based technologies, such as the Data Driven Document (D3) JavaScript library, were created to overcome such challenges by allowing interactive displays of complex data sets. The new phylogeny.IO web server (https://phylogeny.io) overcomes this issue by allowing users to easily import, annotate, and share interactive phylogenetic trees. It allows a range of static (e.g. such as shapes and colors) and dynamic (e.g. pop-up text and images) annotations. Annotated trees can be saved on the server for subsequent modification or they may be shared as IFrame HTML objects, easily embeddable in any web page. The principal goal of phylogeny.IO is not to produce publication-ready figures, but rather to provide a simple and intuitive annotation interface that allows easy and rapid sharing of figures in blogs, lecture notes, press releases, etc.
Comparing Human Amniotic Allograft and Standard Wound Care When Using Total Contact Casting in the Treatment of Patients with Diabetic Foot Ulcers
Authors: Thompson Patricia , Hanson Darlene S. , Langemo Diane , Anderson Julie
Published: May 2019

OBJECTIVE:

This prospective, randomized study compared two treatments for diabetic foot ulcers: total contact cast and a skin substitute versus total contact cast and standard wound care.

PARTICIPANTS:

Researchers screened 270 adult outpatients in a Midwestern wound care clinic for inclusion. Adults 18 years or older with type 1 or 2 diabetes and a diabetic foot ulcer located on the plantar surface larger than 0.5 cm2 in area were invited to participate if they had not demonstrated a 50% reduction in wound area following 4 weeks of standard treatment. Thirteen patients were randomized into two intervention groups. The majority of the participants had type 2 diabetes.

INTERVENTIONS:

Group A treatment: total contact cast and a skin substitute (human amniotic allograft); group B treatment: total contact cast and standard wound care.

OUTCOME MEASURES:

Mean ulcer surface area, time to closure, recurrence rates, satisfaction with total contact casting, infection, and hemoglobin A1c were measured.

RESULTS:

The majority of participants experienced wound closure during the course of the study (92.3%). Two participants did not achieve closure, both of whom had Charcot foot. Group A, which had a higher mean hemoglobin A1c at study outset, experienced a longer mean time to closure (29.50 days) compared with group B (26.20 days). The 90-day recurrence rates were different for the two groups, with only one recurrence for group A (14.29%) but five recurring ulcers in group B (83.33%).

CONCLUSIONS:

Although significance was not established because of sample size, there was a definite trend toward significance that merits further investigation with human amniotic allograft.
Metformin for Prevention of Hypertensive Disorders of Pregnancy in Women With Gestational Diabetes or Obesity: Systematic Review and Meta-analysis of Randomized Trials
Authors: Kalafat E. , Sukur Y. E. , Abdi A. , Thilaganathan B. , Khalil A.
Published: May 2019

(Abstracted from Ultrasound Obstet Gynecol 2018;52:706–714)

Preeclampsia is a leading cause of maternal mortality and morbidity that imposes a substantial burden on the health care system. Metformin has been reported to reduce the risk of preeclampsia.
High-Grade Cervical Intraepithelial Neoplasia in Human Papillomavirus Self-sampling of Screening Non-attenders
Authors: Lam J. U. H. , Elfström K. M. , Ejegod D. M. , Pedersen H. , Rygaard C. , Rebolj M. , Lynge E. , Juul K. E. , Kjær S. K. , Dillner J. , Bonde J.
Published: May 2019

(Abstracted from Br J Cancer 2018;118:138–144)

Denmark has an organized cervical cancer screening program; every 3 years, women aged 23 to 49 years are invited for screening, and every 5 years, women 50 to 65 years of age are invited. The large proportion of invited women who are not screened (nonattenders) is a major challenge in preventing cervical cancer.
Predicting the Likelihood of Live Birth for Elective Oocyte Cryopreservation: A Counseling Tool for Physicians and Patients
Authors: Goldman R. H. , Racowsky C. , Farland L. V. , Munné S. , Ribustello L. , Fox J. H.
Published: May 2019

(Abstracted from Hum Reprod 2017;32(4):853–859)

Embryo viability decreases as chromosomal abnormalities associated with advancing maternal age increase. Oocyte cryopreservation has increased in popularity as more women have elected to delay childbearing.
Recombinant allergens for immunotherapy: state of the art
Authors: Zhernov Yury , Curin Mirela , Khaitov Musa , Karaulov Alexander , Valenta Rudolf
Published: May 2019

Purpose of review

More than 30 years ago, the first molecular structures of allergens were elucidated and defined recombinant allergens became available. We review the state of the art regarding molecular AIT with the goal to understand why progress in this field has been slow, although there is huge potential for treatment and allergen-specific prevention.

Recent findings

On the basis of allergen structures, several AIT strategies have been developed and were advanced into clinical evaluation. In clinical AIT trials, promising results were obtained with recombinant and synthetic allergen derivatives inducing allergen-specific IgG antibodies, which interfered with allergen recognition by IgE whereas clinical efficacy could not yet be demonstrated for approaches targeting only allergen-specific T-cell responses. Available data suggest that molecular AIT strategies have many advantages over allergen extract-based AIT.

Clinical studies indicate that recombinant allergen-based AIT vaccines, which are superior to existing allergen extract-based AIT can be developed for respiratory, food and venom allergy. Allergen-specific preventive strategies based on recombinant allergen-based vaccine approaches and induction of T-cell tolerance are on the horizon and hold promise that allergy can be prevented. However, progress is limited by lack of resources needed for clinical studies, which are necessary for the development of these innovative strategies.
Laparoscopic Transabdominal Cerclage and Subsequent Pregnancy Outcomes When Left In Situ
Authors: Ades Alex , Hawkins Deborah P.
Published: May 2019

OBJECTIVE:

To evaluate obstetric outcomes of subsequent pregnancies in women who had a laparoscopic transabdominal cerclage.

METHODS:

A prospective observational study of consecutive women who became pregnant a second or third time after a laparoscopic transabdominal cerclage. Eligible women were considered not suitable for a transvaginal cerclage or had previously failed a transvaginal cerclage. The primary outcome was neonatal survival and the secondary outcome was delivery at 34 weeks of gestation or more.

RESULTS:

During the study period (2007–2018), 22 women who had undergone a laparoscopic transabdominal cerclage and completed one pregnancy with the cerclage in situ became pregnant a second or third time. In the first pregnancies with the cerclage in situ, the neonatal survival rate was 100% (22/22) and 86% (19/22) of women delivered after 34 weeks of gestation. In the second pregnancies, the neonatal survival rate was 95% (21/22) and 86% (19/22) of women delivered after 34 weeks of gestation. In the third pregnancies, the neonatal survival rate was 100% (3/3) and 100% (3/3) of women delivered after 34 weeks of gestation.

CONCLUSION:

When left in situ for subsequent pregnancies, laparoscopic transabdominal cerclage is associated with a high rate of neonatal survival.
Maternal and Neonatal Morbidity Associated With Early Term Delivery of Large-for-Gestational-Age But Nonmacrosomic Neonates
Authors: Doty Morgen S. , Chen Han-Yang , Sibai Baha M. , Chauhan Suneet P.
Published: May 2019

OBJECTIVE:

To evaluate whether, at 37–39 weeks of gestation, delivery of a neonate with a birth weight that is 90% or greater for gestational age but less than 4,000 g is associated with increased composite maternal and neonatal morbidity.

METHODS:

This retrospective cohort study used U.S. Vital Statistics datasets for the years 2011–2013. Inclusion criteria were singleton pregnancies delivered at 37–39 weeks of gestation after labor in which the neonates were nonanomalous, and either appropriate for gestational age or large for gestational age (LGA) neonates with birth weights of less than 4,000 g (our threshold for macrosomia). The coprimary outcomes were composite maternal morbidity (any of the following: maternal transfusion, ruptured uterus, unplanned hysterectomy, admission to intensive care unit, or unplanned procedure) and composite neonatal morbidity (any of the following: Apgar score less than 5 at 5 minutes, assisted ventilation for more than 6 hours, seizure or serious neurologic dysfunction, significant birth injury or neonatal mortality). Multivariable Poisson regression models were used to calculate adjusted relative risk (aRR) and 95% CI.

RESULTS:

Among the 3.9 million women who met inclusion criteria, 1.3% delivered neonates who were LGA but nonmacrosomic. The rate of composite maternal morbidity was 53% higher women who delivered nonmacrosomic LGA neonate (6.27 vs 4.09/1,000 live births; aRR 1.40, 95% CI 1.25–1.56). This increased risk of composite maternal morbidity persisted in analyses stratified by diabetes. The rate of composite neonatal morbidity was 83% higher for nonmacrosomic LGA neonates (11.09 vs 6.07/1,000 live births; aRR 1.47, 95% CI 1.35–1.60) and persisted in analyses stratified by diabetes.

CONCLUSION:

At 37–39 weeks of gestation, delivery of a neonate with a birth weight that is 90% or greater for gestational age but less than 4,000 g is associated with increased composite maternal and neonatal morbidity.
An Alternative Surgical Approach to the Jones Fracture
Authors: Dearden Paul M.C. , Ray Robbie I. , Slater Henry K.
Published: May 2019

Jones fractures of the base of the fifth metatarsal have a high reported nonunion rate. In the athletic population these injuries can lead to prolonged periods out of competition and high recurrence rates. In specific individuals, an underlying anatomic variant in the shape of the fifth metatarsal may predispose to the injury or have a high incidence of recurrence. We describe a corrective osteotomy which addresses the underlying predisposing biomechanics and which aids in achieving fracture union and reducing recurrence. The technique is relatively simple, easy to explain, and is reproducible, requiring no specialised instrumentation. The author’s experience demonstrates the technique to be effective in the general population, and in high demand athletic groups without significant or procedure specific complication.

Levels of Evidence: Diagnostic Level IV—case series. See Instructions for Authors for a complete description of levels of evidence.
The Emerging Empirical Science of Wisdom: Definition, Measurement, Neurobiology, Longevity, and Interventions
Authors: Jeste Dilip V. , Lee Ellen E.
Published: May 2019

Learning objectives

After participating in this activity, learners should be better able to:

• Assess the empirical literature on wisdom

• Evaluate a proposed model of wisdom development

This article seeks to provide an overview of the empirical literature on wisdom in terms of its definitions and measurements, possible neurobiological basis, and evolutionary value, as well as changes with aging and potential clinical interventions to enhance components of wisdom. Wisdom may be defined as a complex human trait with several specific components: social decision making, emotion regulation, prosocial behaviors, self-reflection, acceptance of uncertainty, decisiveness, and spirituality. These components appear to be localized primarily to the prefrontal cortex and limbic striatum. Emerging research suggests that wisdom is linked to better overall health, well-being, happiness, life satisfaction, and resilience. Wisdom likely increases with age, facilitating a possible evolutionary role of wise grandparents in promoting the fitness of the species. Despite the loss of their own fertility and physical health, older adults help enhance their children’s well-being, health, longevity, and fertility—the “Grandma Hypothesis” of wisdom. We propose a model of wisdom development that incorporates genetic, environmental, and evolutionary aspects. Wisdom has important implications at both individual and societal levels, and warrants further research as a major contributor to human thriving. There is a need for a greater emphasis on promoting wisdom through our educational systems from elementary to professional schools.
Words matter: Thoughts after the winter AANP Fellows meeting
Authors: Dirubbo Nancy
Published: May 2019

Critical issues facing nurse practitioners (NPs) today can be influenced by the words used about NPs every day. The words used to describe who and what NPs are can affect efforts to achieve full practice authority throughout the United States. They affect how NPs treat each other and how the public, professional colleagues, and others view them, which can have a profound effect on rules, regulations, and policies that affect NP effectiveness and practice.
A clinical research on the potential pathogenesis of somatic cancer related cerebral venous sinus thrombosis
Authors: Xian Ziqiang , Chen Yicong , Chen Li , Lu Qiuhong , Huang Gelun , Qin Qixiong , Zeng Jinsheng , Liang Zhijian
Published: May 2019

To investigate the pathogenesis of somatic solid cancer-related cerebral venous sinus thrombosis (CVST).

A total of 174 patients with CVST were recruited from the hospital between January 2006 and December 2017 and divided into two groups: (1) somatic cancer-related CVST group, defined as active somatic solid cancer patients with acute CVST; (2) cancer group (CG), defined as active somatic solid cancer patients without CVST. The cancer group patients were age and gender-matched somatic cancer-related CVST group patients. In addition, the types and amount distribution of cancer in cancer group were also matched with somatic cancer-related CVST group patients.

Compared to cancer group patients, somatic cancer-related CVST group patients had more intracranial metastasis, a higher platelet count, higher plasma D-dimer, carcinoembryonic antigen (CEA) and cancer antigen (CA) 125 levels, a greater platelet to lymphocyte ratio (PLR), and a greater platelet to neutrophil ratio (PNR). The risk for CVST in somatic cancer-related CVST group patients increased independently by 0.7% (odds ratio [OR] 1.007; 95% confidence interval [CI] 1.000, 1.015; P = .047) with a 1 ng/ml increase in D-dimer levels, by 4.6% (OR 1.046; 95% CI 1.011, 1.083; P = .010) with a 1 U/ml increase in CEA, by 2.7% (OR 1.027; 95% CI 1.003, 1.051; P = .025) with a 1 U/ml increase in CA125, and by 10.6% (OR 1.106; 95% CI 1.002, 1.220; P = .045) with a 1 unit increase in PNR.

It was suggested that together impacts of elevated plasma D-dimer, CA125, CEA levels, and a greater PNR may lead to hypercoagulability and to trigger the development of cancer-related CVST.
Combined endoscopic submucosal dissection and transanal minimally invasive surgery for the management of lower rectal adenoma extending above the dentate line
Authors: Nepal Pramod , Mori Shinichiro , Kita Yoshiaki , Tanabe Kan , Baba Kenji , Sasaki Fumisato , Nasu Yuichiro , Ido Akio , Uchikado Yasuto , Kurahara Hiroshi , Arigami Takaaki , Sakoda Masahiko , Maemura Kosei , Natsugoe Shoji
Published: May 2019

Rationale:

Minimally invasive surgery is used to treat early colorectal tumors. Endoscopic submucosal dissection (ESD) for resection of tumors extending above the dentate line (particularly those with concomitant hemorrhoids) is technically difficult. We present a case of a patient with a lower rectal adenoma extending above the dentate line, which underwent combined ESD and transanal minimally invasive surgery (TAMIS) to achieve accurate excision and prevent complications.

Patient concerns:

A 68-year-old man with a history of blood in stool over 2 to 3 years underwent colonoscopy, which revealed an adenoma measuring 3 cm in size in the lower rectum extending above the dentate line. The part extending above the dentate line was a type Is lesion and that of oral side was a type IIa lesion. Histopathologically, the lesion was diagnosed as a low-grade intramucosal tubulovillous adenoma.

Diagnosis:

Intramucosal low-grade adenoma with sessile polyp (type Is).

Interventions:

The cranial portion of the lesion was dissected via ESD and the anal portion via TAMIS with minimal bleeding. En bloc resection of the tumor was performed.

Outcomes:

His postoperative period was uneventful, and he was discharged and regularly followed-up.

Lessons:

Combined ESD and TAMIS is effective in patients with benign and early neoplastic lesions of the anorectum extending above the dentate line with concomitant hemorrhoids and can prevent complications.
Validation of an individualized reduction of falls intervention program among wheelchair and scooter users with multiple sclerosis
Authors: Rice Laura A. , Peterson Elizabeth W. , Backus Deborah , Sung JongHun , Yarnot Rebecca , Abou Libak , Van Denend Toni , Shen Sa , Sosnoff Jacob J.
Published: May 2019

Introduction:

Falls are a serious concern for wheelchair and scooter users with multiple sclerosis (MS). Approximately, 75% of the population reports at least one fall in a 6-month period and nearly half report frequent falls. Falls can result in physical injuries and contribute to activity curtailment. Despite the negative consequences, limited evidenced-based fall prevention programs designed specifically for wheelchair and scooter users with MS exist.

Purpose:

Recognizing the threat falls pose to health and well-being and the dearth of fall prevention programs, the purpose of this study is to perform a structured process evaluation and examine the feasibility and efficacy of a community-based intervention specifically designed to reduce fall incidence among wheelchair and scooter users with MS. Secondary aims of the intervention are to improve functional mobility skills associated with fall risk (e.g., transfer and wheelchair skills, balance), increase knowledge of fall risk factors, decrease fear of falling, and enhance quality of life and community participation.

Methods:

To evaluate our specific aims, a clinical trial will be performed with 160 wheelchair and scooter users with MS. (ClinicalTrials.gov Identifier: NCT03705364). Participants will be recruited to participate in a small group-style community-based program. The content of the program will be based on factors found to be associated with falls among wheelchair and scooter users with MS. These factors include but are not limited to, wheelchair/scooter related characteristics, transfer activities, impaired seated balance, and environmental factors. A physical or occupational therapist, will implement the intervention, which is comprised of 6 sessions that occur once weekly. The incidence of falls, along with an examination of wheelchair/scooter and transfer skills, seated postural control and knowledge of fall related risk factors will be compared between intervention and control participants, with assessment periods occurring prior to the intervention, 1 to 2 weeks after completion of the 6-week intervention session, and 12 weeks after the intervention period is complete.

Conclusion:

Results from this study will guide the refinement of the intervention program and inform future research among a large and diverse group of wheelchair and scooter users living with MS.