bluuebunny/crossref_metadata_2025 huggingface dataset:
Baseline characteristics of postmenopausal women with osteoporosis treated with teriparatide in a real-world setting in Latin America: a subregional analysis from the Asia and Latin America Fracture Observational Study (ALAFOS)
Authors: Cunha-Borges Joao L. , Mier Guillermo Meléndez , Casas Noemí , Medina Adriana , Molina Jose Fernando , García Maria Laura , Oliveria Lindomar Guimarães , Caselato Marcela S. , Cruz Angélica C. , Ippolito Vanessa , Flórez Sandra
Published: November 2019

Background

Osteoporosis is a major healthcare concern in Latin America. Factors such as changing demographics, fragmented healthcare systems, and financial considerations may result in a huge increase in the burden of osteoporosis in this region. The aim of this article is to describe the baseline clinical characteristics and fracture history of patients who are prescribed teriparatide in normal clinical practice in Latin America.

Methods

We conducted a prospective, multinational, observational study (the Asia and Latin America Fracture Observational Study [ALAFOS]) in 20 countries worldwide to assess the incidence of fractures in postmenopausal women with osteoporosis receiving teriparatide as a part of routine clinical practice in a real-world setting. In this subregional analysis of the ALAFOS study, we report the clinical characteristics, fracture history, risk factors for osteoporosis, comorbidities, previous osteoporosis therapies and health-related quality of life measures at baseline for patients from the four participant Latin American countries: Argentina, Brazil, Colombia, and Mexico.

Results

The Latin America subregional cohort included 546 postmenopausal women (mean [SD] age: 71.0 [10.1] years; range: 40–94 years), constituting 18% of the ALAFOS total population. The baseline mean (SD) bone mineral density T-scores were − 3.02 (1.23) at the lumbar spine and − 2.31 (0.96) at the femoral neck; 62.8% of patients had a history of low trauma fracture after the age of 40 years and 39.7% of patients had experienced ≥1 fall in the past year. Osteoporosis medications were used by 70.9% of patients before initiating teriparatide. The median (Q1, Q3) EQ-5D-5 L Visual Analog Scale (VAS) scores for perceived health status at baseline was 70 (50, 80). The mean (SD) worst back pain numeric rating scale score for the overall Latin American cohort was 4.3 (3.4) at baseline.

Conclusions

This baseline analysis of the Latin America subregion of the ALAFOS study indicates that patients who are prescribed teriparatide in the four participant countries had severe osteoporosis and high prevalence of fractures. They also had back pain and poor health-related quality of life. The proportions of patients with severe or extreme problems on the EQ-5D-5 L individual domains were lower than those in the overall ALAFOS study population.
Contact with recovered peers: buffering disempowering service experiences and promoting personal recovery in serious mental illness
Authors: McLeod Bronte , Meyer Denny , Murray Greg , Foley Fiona , Jones Nev , Thomas Neil
Published: November 2019

Background

Mental health patients can experience involuntary treatment as disempowering and stigmatising, and contact with recovered peers is cited as important for countering stigma and fostering agency and autonomy integral to recovery.

Aims

To advance understanding of the interaction between involuntary treatment and contact with recovered peers, and explore hypothesised relationships to mechanisms of self-evaluation relevant to recovery.

Method

Eighty-nine adults diagnosed with serious mental illness completed items to assess involuntary treatment experience and the extent of prior contact with recovered peers, the Internalised Stigma of Mental Illness Scale, the Self-efficacy for Personal Recovery Scale, the Questionnaire about the Process of Recovery and relevant demographic and clinical scales.

Results

Contact with recovered peers was found to moderate the effects of involuntary treatment on internalised stigma. Sequential conditional process models (i.e. moderated mediation) then demonstrated that conditional internalised stigma (i.e. moderated by contact with recovered peers) mediated the indirect effect of involuntary treatment on recovery-specific self-efficacy, which in turn influenced recovery. Compared with those with low contact with recovered peers, recovery scores were 3.54 points higher for those with high contact.

Conclusions

Although study methods limit causative conclusions, findings are consistent with proposals that contact with recovered peers may be helpful for this patient group, and suggest this may be particularly relevant for those with involuntary treatment experience. Directions for future research, to further clarify measurement and conceptual tensions relating to the study of (dis)empowering experiences in mental health services, are discussed in detail.
Health screening, cardiometabolic disease and adverse health outcomes in individuals with severe mental illness
Authors: Pearsall Robert , Shaw Richard J. , McLean Gary , Connolly Moira , Hughes Kate A. , Boyle James G. , Park John , Smith Daniel J. , Mackay Daniel
Published: November 2019

Background

Poor physical health in severe mental illness (SMI) remains a major issue for clinical practice.

Aims

To use electronic health records of routinely collected clinical data to determine levels of screening for cardiometabolic disease and adverse health outcomes in a large sample (n= 7718) of patients with SMI, predominantly schizophrenia and bipolar disorder.

Method

We linked data from the Glasgow Psychosis Clinical Information System (PsyCIS) to morbidity records, routine blood results and prescribing data.

Results

There was no record of routine blood monitoring during the preceding 2 years for 16.9% of the cohort. However, monitoring was poorer for male patients, younger patients aged 16–44, those with schizophrenia, and for tests of cholesterol, triglyceride and glycosylated haemoglobin. We estimated that 8.0% of participants had diabetes and that lipids levels, and use of lipid-lowering medication, was generally high.

Conclusions

Electronic record linkage identified poor health screening and adverse health outcomes in this vulnerable patient group. This approach can inform the design of future interventions and health policy.
Influence of Smoking on Thyroid Function in Japanese Subjects: Longitudinal Study for One Year of On-Off Smoking
Authors: Nakajima Yasuyo , Yamada Sayaka , Nishikido Ayaka , Katano-Toki Akiko , Ishida Emi , Akuzawa Masako , Sakamaki Koji , Yamada Eijiro , Saito Tsugumichi , Ozawa Atsushi , Okada Shuichi , Shimomura Yohnosuke , Kobayashi Isao , Andou Yoshitaka , Yamada Masanobu
Published: November 2019

Context

We previously identified factors affecting thyroid status, including sex, age, and smoking.

Objective

In the current study, we increased the number of subjects examined and investigated the effects of these factors, particularly smoking and the thyroid peroxidase antibody (TPO-Ab), in Japanese patients with euthyroxinemia and serum free T4 levels within the normal range.

Participants

A total of 12,289 subjects who underwent health checkups were analyzed in a cross-sectional and longitudinal study.

Results

The mean age of subjects was 50 ± 10 years (age range: 21 to 88 years). Serum TSH levels and the prevalence of positivity for TPO-Ab increased with age in Japanese subjects with euthyroxinemia. Mean serum TSH levels were significantly lower in the smoking group than in the nonsmoking group except for women older than 50 years. Serum TSH levels were significantly higher in subjects with positivity for TPO-Ab than in those with negativity at all ages and in both sexes; however, smoking did not affect free T4 levels or positivity for TPO-Ab. Among men, the rate of smokers was significantly higher in patients with subclinical hyperthyroidism (25%) than in those with subclinical hypothyroidism (10%; P < 0.05). Furthermore, the results of the longitudinal study revealed a significant decrease in serum TSH levels 1 year after the start of smoking in men (P < 0.05).

Conclusion

Because smoking appeared to lower serum TSH levels in Japanese subjects with euthyroxinemia, their smoking status warrants careful consideration when evaluating subclinical thyroid function.
Optimal Glycemic Control in a Patient With HNF1A MODY With GLP-1 RA Monotherapy: Implications for Future Therapy
Authors: Fantasia Kathryn L , Steenkamp Devin W
Published: November 2019

We present the case of a 27-year-old woman with inadequately controlled HNF1A maturity-onset diabetes of the young (MODY) who was successfully transitioned from sulfonylurea therapy to once-weekly monotherapy with dulaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA). More than a decade from diabetes diagnosis, she has maintained optimal glycemic control without hypoglycemia for >12 months while receiving GLP-1 RA therapy alone. This case illustrates the potential for successful use of GLP-1 RA monotherapy in patients with HNF1A MODY.
Effect of Oral Carbohydrate Intake During Labor on the Rate of Instrumental Vaginal Delivery: A Multicenter, Randomized Controlled Trial
Authors: Simonet Thérèse , Gakuba Clément , Desmeulles Isabelle , Corouge Julien , Beucher Gael , Morello Rémi , Gérard Jean-Louis , Ducloy-Bouthors Anne Sophie , Dreyfus Michel , Hanouz Jean-Luc
Published: November 2019

BACKGROUND:

Carbohydrate intake during physical exercise improves muscle performance and decreases fatigue. We hypothesized that carbohydrate intake during labor, which is a period of significant physical activity, can decrease the instrumental vaginal delivery rate.

METHODS:

In a multicenter, prospective, randomized, controlled trial, healthy adult pregnant women presenting with spontaneous labor were assigned to a “Carbohydrate” group (advised to drink 200 mL of apple or grape juice without pulp every 3 hours) or a “Fasting” group (water only). The primary outcome was the instrumental vaginal delivery rate. Secondary outcomes included duration of labor, rate of cesarean delivery, evaluation of maternal hunger, thirst, stress, fatigue, and overall feeling during labor by numeric rating scale (0 worst rating to 10 best rating), rate of vomiting, and hospital length of stay. Statistical analysis was performed on an intention-to-treat basis. The primary outcome was tested with the “Fasting” group as the reference group. The P values for secondary outcomes were adjusted for multiple comparisons. The differences between groups are reported with 99% confidence interval (CI).

RESULTS:

A total of 3984 women were analyzed (2014 in the Carbohydrate group and 1970 in the Fasting group). There was no difference in the rate of instrumental delivery between the Carbohydrate (21.0%) and the Fasting (22.4%) groups (difference, −1.4%; 99% CI, −4.9 to 2.2). No differences were found between the Carbohydrate and the Fasting groups for the duration of labor (difference, −7 minutes; 99% CI, −25 to 11), the rate of cesarean delivery (difference, −0.3%; 99% CI, −2.4 to 3.0), the rate of vomiting (difference, 2.8%; 99% CI, 0.2–5.7), the degree of self-reported fatigue (difference, 1; 99% CI, 0–2), self-reported hunger (difference, 0; 99% CI, −1 to 1), thirst (difference, 0; 99% CI, −1 to 1), stress (difference, 0; 99% CI, −1 to 1), overall feeling (difference, 0; 99% CI, 0–0), and the length of hospitalization (difference, 0; 99% CI, −1 to 0).

CONCLUSIONS:

Carbohydrate intake during labor did not modify the rate of instrumental vaginal delivery.
Greater Occipital Nerve Block as a Tool to Diagnose Spontaneous Intracranial Hypotension Before Epidural Blood Patch: A Case Report
Authors: Bortolato Andrea , Simonato Davide , Garrì Federica , Gabrieli Joseph Domenico , Cester Giacomo , Causin Francesco , Feltracco Paolo
Published: November 2019

Spontaneous intracranial hypotension (SIH) has been increasingly characterized in recent years. A definitive diagnostic algorithm remains controversial because several symptoms are often found to be nonspecific. When neuroimaging fails to identify a cerebrospinal fluid leak and symptoms are atypical, an epidural blood patch (EBP) may be performed but not without risks. Our case shows how greater occipital nerve block (GONB) can expedite SIH diagnosis in a man with atypical presentation by reducing the sensory input from the posterior cranial fossa. The relief provided by GONB allowed to diagnose SIH promptly and the patient underwent a curative EBP.
Incidence of Thromboembolic Events in Oncology Patients Receiving Intraoperative Tranexamic Acid During Orthopedic Surgery: A Retrospective Review at a Comprehensive Cancer Center
Authors: Ackerman Robert S. , Hirschi Michael , Trona Nathaniel , Joyce David M. , Evans Trip , Patel Sephalie Y.
Published: November 2019

Despite an abundance of evidence, routine perioperative antifibrinolytics have been avoided in oncology patients due to concern of thrombosis when given to patients with a preexisting hypercoagulable state. We present a retrospective review of 104 patients with an oncologic diagnosis who received intraoperative tranexamic acid during orthopedic surgery. Overall, complication rates were low, including deep vein thrombosis (1.0%), pulmonary embolism (4.8%), stroke (0%), and myocardial infarction (0%). This preliminary evidence shows that antifibrinolytics such as tranexamic acid may be considered perioperatively in oncology patients without increased risk of thromboembolic events; however, further prospective trials are encouraged.
Habitual foot strike pattern does not affect simulated Triceps Surae muscle metabolic energy consumption during running
Authors: Swinnen Wannes , Hoogkamer Wouter , De Groote Friedl , Vanwanseele Benedicte
Published: November 2019

Foot strike pattern affects ankle joint work and Triceps Surae muscle-tendon dynamics during running. Whether these changes in muscle-tendon dynamics also affect Triceps Surae muscle energy consumption is still unknown. In addition, as the Triceps Surae muscle accounts for a substantial amount of the whole body metabolic energy consumption, changes in Triceps Surae energy consumption may affect whole body metabolic energy consumption. However, direct measurements of muscle metabolic energy consumption during dynamic movements is hard. Model-based approaches can be used to estimate individual muscle and whole body metabolic energy consumption based on Hill type muscle models. In this study, we use an integrated experimental and dynamic optimization approach to compute muscle states (muscle forces, lengths, velocities, excitations and activations) of 10 habitual mid-/forefoot striking and 9 habitual rearfoot striking runners while running at 10 and 14 km/h. The Achilles tendon stiffness of the musculoskeletal model was adapted to fit experimental ultrasound data of the Gastrocnemius medialis muscle during ground contact. Next, we calculated Triceps Surae muscle and whole body metabolic energy consumption using four different metabolic energy models provided in literature. Neither Triceps Surae metabolic energy consumption (p>0.35), nor whole body metabolic energy consumption (p>0.14) was different between foot strike patterns, regardless of the energy model used or running speed tested. Our results provide new evidence that mid-/forefoot and rearfoot strike pattern are metabolically equivalent.
Observation of Subsurface Structure of Pt/C Catalyst Using Pair Distribution Function and Simple Modeling Techniques
Authors: Takahashi Masakuni , Ohara Koji , Yamamoto Kentaro , Uchiyama Tomoki , Tanida Hajime , Itoh Takanori , Imai Hideto , Sugawara Seiho , Shinohara Kazuhiko , Uchimoto Yoshiharu
Published: November 2019

The correlation between the Pt–Pt interatomic distance of a Pt/C catalyst and the specific activity of the oxygen reduction reaction is discussed. Total X-ray scattering measurement coupled with pair distribution function (PDF) analysis was performed to obtain subsurface information of the Pt/C catalyst, which can obtain a much longer interatomic distance than X-ray absorption fine structure (XAFS) measurement. The subsurface structure of the catalyst was previously discussed on the basis of simulations with three-dimensional complex models. In this study, the subsurface structure of Pt–Pt bonds in the catalyst could be easily obtained from experimental data by simple model fitting using the PDF. Results based on XAFS measurement showed no correlation with the specific activity. In contrast, the obtained Pt–Pt interatomic distances in the subsurface using PDF showed a strong negative correlation with the specific activity as in a previous study.
Retinal Proteins: Photochemistry and Optogenetics
Authors: Kandori Hideki
Published: November 2019

Rhodopsins, which are also called retinal proteins, are photoreceptive proteins. Their photoreactions have attracted many researchers in physics, chemistry and biology. In addition, they are now used as key tools in optogenetics. Although rhodopsin was originally named as a red-colored pigment for vision, the modern meaning of rhodopsin encompasses photoactive proteins containing a retinal chromophore in animals and microbes. Animal and microbial rhodopsins possess 11-cis and all-trans retinal, respectively, to capture light in seven transmembrane α-helices, and photoisomerizations into all-trans and 13-cis forms, respectively, initiate each function. Unlike animal rhodopsins, several kinds of microbial rhodopsins are able to transport ions in a passive or an active manner, and light-gated channels or light-driven pumps, respectively, are the main tools in optogenetics. In this article, historical aspects and recent advances of retinal protein research are reviewed. After general introduction of rhodopsins, the molecular mechanism of bacteriorodopsin, a light-driven H+ pump and the best studied microbial rhodopsin, is described. Then, molecular properties and several variants of channelrhodopsin, the light-gated ion channel, are introduced. As history has proven, understanding the molecular mechanism of microbial rhodopsins is a prerequisite for useful functional design of optogenetics tools in future.
Resistance Exercise–induced Regulation of Muscle Protein Synthesis to Intraset Rest
Authors: SALVADOR AMADEO F. , ASKOW ANDREW T. , MCKENNA COLLEEN F. , FANG HSIN-YU , BURKE SARAH K. , LI ZHONG , ULANOV ALEXANDER V. , PALUSKA SCOTT A. , PETRUZZELLO STEVEN J. , BOPPART MARNI D. , OLIVER JONATHAN M. , BURD NICHOLAS A.
Published: November 2019

During a traditional set configuration of resistance exercise (TRD), characterized by a continuous completion of repetitions, a decrease in power output tends to occur throughout a set of repetitions. Inclusion of intraset rest, otherwise known as a cluster set configuration (CLU), counteracts this power decline. However, the effect of a CLU configuration on postexercise myofibrillar protein synthesis rates (MPS) and anabolic signaling has not been investigated.

Purpose

We aimed to determine if any mechanistic differences exist between TRD and CLU signaling events associated with muscle anabolism.

Methods

In randomized crossover trials, eight resistance-trained participants (23 ± 1 yr, 81 ± 4.7 kg, body fat: 18% ± 1.9%; 1 repetition maximum [1RM], 150 ± 9.1 kg) performed an acute bout of CLU (4 sets × (2 × 5) repetitions, 30-s intraset rest, 90-s interset rest) and TRD (4 sets × 10 repetitions, 120-s interset rest) barbell back squats at approximately 70% 1RM with total volume load equated during primed continuous l-[ring-13C6]phenylalanine infusions. Blood and muscle biopsy samples were collected at rest and after exercise at 0, 2, and 5 h.

Results

There was no difference in postexercise MPS between the CLU and TRD condition (P > 0.05) and no changes in phosphorylation of mTORC1 downstream targets (p70S6K and 4EBP1). Total and phosphorylated yes-associated protein on Ser127 transiently increased (P < 0.01) immediately after exercise (t = 0) in CLU (~2.1-fold) and TRD condition (~2.2-fold).

Conclusions

Our results show that CLU is a viable anabolic option by preserving power output with similar MPS stimulation when compared with the TRD condition in trained young adults.
Protein-mediated gelation and nano-scale assembly of unfunctionalized hyaluronic acid and chondroitin sulfate
Authors: Tabet Anthony , Park June Y. , Shilts Jarrod , Sokolowski Kamil , Rana Vijay K. , Kamp Marlous , Warner Nina , Hoogland Dominique , Scherman Oren A.
Published: November 2019

Background: Hyaluronic acid (HA) is a major component of the extracellular matrix (ECM) in the central nervous system and the only purely supramolecular glycosaminoglycan. Much focus has been given to using this high molecular weight polysaccharide for tissue engineering applications. In most studies, the backbone of HA is functionalized with moieties that can facilitate network formation through physical self-assembly, or covalent crosslinking (e.g. photo-catalyzed) at concentrations where the polysaccharide does not gel on its own. However, these crosslinks often utilize functional groups not found in biological tissues.

Methods: Oscillatory rheology, dynamic light scattering, and scanning electron microscopy were used to study albumin/HA structures. Dynamic light scattering and transmission electron microscopy were used to study albumin/chondroitin sulfate (CS) structures. UV-vis spectroscopy was used to demonstrate the potential for using protein-polymer blends as an ECM-mimetic model to study transport of small molecules.

Results: We examine the intermolecular interactions of two major glycosaminoglycans found in the human brain, HA and the lower molecular weight CS, with the model protein albumin. We report the properties of the resulting micro- and nano materials. Our albumin/HA systems formed gels, and albumin/CS systems formed micro- and nanoparticles. These systems are formed from unfunctionalized polysaccharides, which is an attractive and simple method of forming HA hydrogels and CS nanoparticles. We also summarize the concentrations of HA and CS found in various mammalian brains, which could potentially be useful for biomimetic scaffold development.

Conclusions: Simple preparation of commercially available charged biomacromolecules results in interesting materials with structures at the micron and nanometer length-scales. Such materials may have utility in serving as cost-effective models of nervous system electrostatic interactions and as in vitro drug release and model system for ECM transport studies.
Case Report: Borderline tumor and primary peritoneal carcinoma - a rare synchronism
Authors: Rei Mariana , Raposo Sofia , Figueiredo Paulo , Sousa Rita , Sá Luís
Published: November 2019

Ovarian borderline serous tumors present with peritoneal involvement in 20% of cases, either as non-invasive or invasive implants, the latter also known as extraovarian low-grade serous carcinoma. The coexistence of high-grade serous carcinoma is rare, suggesting a synchronous neoplasia with a distinct and independent tumor biology and behavior. We aim to describe a case of a synchronous ovary-peritoneum neoplasia: serous borderline tumor and primary peritoneal high-grade serous carcinoma. A discussion and literature review concerning the optimal diagnostic and therapeutic approach is provided.
At Your Service on the Table: Impact of Tabletop Technology on Restaurant Performance
Authors: Tan Tom Fangyun , Netessine Serguei
Published: November 2019

Some industries, such as healthcare and financial services, have reported significant productivity gains from introduction of new technologies. However, other more traditional, labor-intensive industries are lagging behind. We use granular data to examine the impact of a customer-facing technology (a tabletop device that facilitates the table service process) on the check size and meal duration aspects of restaurant performance. The restaurant chain in our study implemented tabletop devices in a staggered manner, offering us a quasi-experimental setting in which to apply a difference-in-difference technique and identify the causal effect of the technology. We find that the tabletop technology is likely to improve average sales per check by approximately 1% (95% confidence interval is from 0.8% to 1.02%), and reduce the meal duration by close to 10% (95% confidence interval ranges from −9.94% to −9.54%). The combination of these two effects increases the sales per minute or sales productivity by approximately 11%. Various robustness checks of our empirical strategy and post hoc analyses find that tabletop technology allows low-ability waiters to improve their performance more significantly than high-ability waiters. In addition, the technology does not change the staffing level. Overall, our results indicate great potential for introducing tabletop technology in a large service industry that currently lacks digitalization.

This paper was accepted by Vishal Gaur, operations management.
Evaluating mild cachexia syndrome in the HIV-positive pregnant woman
Authors: Wilkinson Amanda L. , Pedersen Sarah H. , Mark Urassa , Denna Michael , Aura Andreasen , Jim Todd , Kinung'hi Safari M. , John Changalucha , McDermid Joann M.
Published: November 2019

Background

Immune activation and inflammation are common symptoms throughout HIV infection and lead to elevated circulating concentrations of cachectic cytokines.

Aims

To evaluate cachexia-like symptoms among HIV-positive and HIV-negative pregnant women, and investigate whether cachexic mechanisms may contribute to impaired HIV-exposed fetal and infant growth.

Methods

Pregnant women (n=114; 39% HIV-positive) were prospectively enrolled from an antenatal clinic in semi-rural Tanzania. Maternal cachexia-associated plasma cytokines and hormones, and clinical and anthropometric data were assessed. Cachexia scores were quantified using a novel adaptation of a validated cachexia scoring system. Infant growth anthropometry was measured at birth and after 6 months.

Results

Maternal cachexia score was inversely associated with infant birth weight, birth length, and weight-for-age z-score at 6 months.

Conclusions

Symptoms consistent with a mild cachectic state were associated with poorer infant outcomes. This effect was greater for HIV-exposed infants. A better understanding of the maternal cachexia burden and implications for maternal and infant health in HIV, other infections, and inflammatory conditions is needed.
Increasing the heart failure nursing workforce: recommendations by the British Society for Heart Failure Nurse Forum
Authors: Masters Jayne , Barton Carys , Blue Lynda , Welstand Jenny
Published: November 2019

There are almost 1 million people diagnosed with heart failure in the UK, and this number continues to rise. It is a common cause of hospitalisation and costs associated with those hospitalisations account for a significant proportion of the NHS budget. Studies have demonstrated that community heart failure specialist nurses improve patient outcomes and reduce the costs associated with hospitalisation. Yet, despite increased prevalence, considerable advances in therapies, and new recommendations from the National Institute for Health and Care Excellence, the recommended number of heart failure specialist nurses per 100 000 has stayed the same. This article will describe the development of community heart failure nursing in the UK, and outline the challenges currently facing heart failure specialist nurses. It makes a number of recommendations that would ensure heart failure patients are able to be seen by a heart failure specialist nurse in a timely manner, help reduce inequalities of care, reduce costs associated with heart failure hospitalisations and help ensure sustainability of heart failure services over the longer term.
‘They/them’ in the birth room
Authors: Pezaro Sally
Published: November 2019

It's not just women who are giving birth in the birth room. Here, Dr Sally Pezaro reflects on how we may be missing important opportunities to support the birthing transgender community more effectively
Neonatal resuscitation: ‘room side to motherside’
Authors: Stamoulos Suzanne , Lavelle Rachel
Published: November 2019

Delayed clamping of the neonatal umbilical cord is considered beneficial to the transition to extrauterine life in a term, uncomplicated birth. However, some neonates require resuscitation and the ability to perform this is a fundamental aspect of midwifery practice. The decision to clamp and cut the umbilical cord often precludes any resuscitative attempt, but the reasoning for this action is unclear. This article explores the purpose and place of leaving the umbilical cord intact during neonatal resuscitation. It considers the physiological basis for delaying cord clamping as well as the psychological benefits to baby, mother and family of leaving the cord intact until resuscitation is complete.
Towards appropriate nutritional prescribing: challenges and solutions
Authors: Fisher Rebecca
Published: November 2019

The appropriate prescribing of nutritional supplements is coming under increasing scrutiny due to rising costs, workforce challenges, and a product pricing model that does not meet the needs of the healthcare economy. Data show that, whilst the number of items being prescribed is marginally decreasing, the cost of these items is increasing, and the assumption that all patients discharged on nutritional borderline substances from hospital have been assessed by a dietitian cannot be made. Standards of communication are highly variable but, with increasing knowledge about best practice and digitalisation, improvements are being made. There is a disparity between adequate knowledge of nutrition, prescribing, and best use of resources to effectively manage patient-centred care and costs. A number of strategies are being trialled to improve education and the utilisation of the right workforce. The need for a clear public health message on the importance of maintaining weight in older age is essential to ensure nutritional borderline substances are appropriately used.
Prescribing for established adult patients with epilepsy
Authors: Aref Diyar , Armstrong Amanda , Gulam Rosul , Namuq Sanarya
Published: November 2019

This article examines prescribing for patients who have epilepsy and are on anti-epilepsy medication. It highlights the need to be vigilant when prescribing for patients with epilepsy, and be aware of the risks of any medication that you are prescribing and the impact it could have on the patient's epilepsy. The articles establishes that some patients are on anti-epilepsy drugs for indications other than epilepsy and therefore it is important to take a good medical and drug history before prescribing. When prescribing repeat anti-epilepsy medication for established patients, who are already under the care of a neurologist, the importance of the use of the specific brand and that it is in line with local and national policies is essential.
Democratic transitions and monetary policy: are democratic central banks different?
Authors: Bjørnskov Christian , Rode Martin
Published: November 2019

Empirical studies have shown democracies to be more supportive of pro-market institutions than authoritarian regimes; however, to date, it is virtually unknown through which channel democracy might actually create institutional improvements. In addition, causality between democracy and economic institutions is anything but clear, as competing hypotheses highlight. In this article, we examine the possible association of democratisation and political instability with sound monetary policy and the independence of central banks, both of which can be considered central pillars of an economic policy aimed at producing overall prosperity. Results mainly indicate that stable transitions to democracy are followed by strongly improved access to sound money and more independent central banks, probably because stable shifts to electoral democracy create incentives for policymakers to refrain from using monetary policy for short-run gains. Conversely, we also find evidence that especially unstable democratic transitions could impede the establishment of a more independent central bank, making inflationary policies and high money growth more likely.
Celebrating nostalgia or critiquing naivety: Reading pop music reunions through discourses of the fan life course
Authors: Driessen Simone
Published: November 2019

This study explores how fans give meaning to pop music reunions through the lens of the life course. It does so through a content analysis of forum comments about TV series The Big Reunion, which reunites chart-topping music acts from the past decades. The fans interpret The Big Reunion in three modes closely related to their life-course position: first, now young adults, the fans read the reunion as a nostalgic phenomenon. Second, they consider the reunion as an ironic event. Third, they question The Big Reunion’s formula by reflecting on it through the prism of their current position in the life course. These readings reveal how the fans celebrate a nostalgic reflection on the pop acts of their youth; yet also offer a critique on their former, ‘naïve’ teenage/child-selves.
When the Pet Shop Boys were ‘imperial’: Fans’ self-ageing and the neoliberal life course of ‘successful’ text-ageing
Authors: Hills Matt
Published: November 2019

I follow Harrington and Bielby’s (2018) call for more work on ‘texistence’ – how fans’ self-ageing and the text-ageing of pop-cultural texts become intertwined. I focus on the British pop duo Pet Shop Boys (PSB), formed in 1981. Lead singer Neil Tennant coined the term ‘imperial phase’ (2001) to describe the success of their album Actually (1987), and this terminology has been embraced by PSB fandom; enduring fans consider their fandom in relation to imperial/post-imperial phases. I consider how PSB fans desire a return of the ‘imperial’, refuting any text-ageing ‘narrative of decline’, as well as counterfactually reimagining the duo’s career success. Fannish interpretive community is based on celebrating the commercial authenticity of PSB’s music, articulating both text-ageing and fans’ self-ageing with neoliberalized concepts of the ‘successful’ life course (Clack and Paule 2019) and ‘uniqueness’ in marketized contexts (Nealon 2018). I thus argue that neoliberalism needs to be integrated into analyses of the contemporary fannish life course, even when fan objects (such as PSB) have been explicitly anti-neoliberal across their careers.
Til death do us part? Fandom and the US death system
Authors: Harrington C. Lee
Published: November 2019

This study extends scholarship on age, ageing and fandom to the end-of-life context, exploring the question of whether fan identities and practices are salient at life’s end. A focus on mortality is not new to fan studies, as research on post-object fandom, transitions and endings in fandom, and zombie fandom have opened rich new research trajectories in fan studies. In this article I focus on potentials associated with the mortality of fans themselves, framed by prior work on the social practices of personal identities in the realm of death and dying. Situated in media studies, gerontology and thanatology, I draw on interviews with members of the US death system to explore fannish possibilities in the context of human transience.
Endodontic treatment of a large periapical cyst with the aid of antimicrobial photodynamic therapy - Case report
Authors: Abu Hasna Amjad , Ferrari Carlos henrique , Talge Carvalho Cláudio Antonio
Published: November 2019

Introduction: Periapical cysts, especially those of great extension, represent a challenge for endodontics, since they are not repaired with traditional treatment. The aim of this case report was to evaluate the effectivity of antimicrobial photodynamic therapy “aPDT” when associated with calcium hydroxide Ca(OH)2 in treating such cysts. Case report:  A 40-year-old female patient complained of bulging in the upper anterior region of the mouth. The clinical examination showed an extensive swollen periodontal area, painful with digital palpation, with a negative response to thermal tests on teeth 11 and 21. After traditional treatment, the canals of 11 and 21 were filled with photosensitizer methylene blue 0.005% pre irradiation time (PIT) of 5 minutes and irradiation by low power diode laser with visible red wavelength (660 nm) during 2 minutes without intervals, using an optical fiber delivering system with a helical movement from apical to cervical. Then the canal were filled with Ca(OH)2 paste for 45 days being changed each 15 days, and repeating the radiation. Results: After 45 days, the patient already had a bulging remission, with painless resistance to apical pressure in the region and signs of bone repair at the radiographic examination, and total absence of signs or symptoms. Conclusion: the association of aPDT with Ca(OH)2 paste is effective in treating of periapical lesions of great extension and avoid surgical treatment.Keywords: Antimicrobial; Calcium hydroxide; Diode Laser; Periapical cysts; Photodynamic Therapy; Root canal treatment.
Parental perceptions of oral health-related quality of life of Brazilian children and adolescents with autism spectrum disorder
Authors: Cancio Viviane , Faker Khawana , Tostes Mônica Almeida
Published: November 2019

Objective:This paper aimed to assess the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) using the parental/caregiver perceptions questionnaire (PCPQ). Materials and methods: Children aged 2 to 14 years, enrolled in the ACOLHER/PNE project at the Fluminense Federal University, RJ, Brazil, were assessed. The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The variable was categorized as caries-free when dmft/DMFT=0 and caries experience when dmft/DMFT ? 1. Caregiver schooling, age, sex, and socioeconomic factors (Brazilian minimum wage – BMW) were the other independent variables. Quality of life (QoL) was measured using PCPQ subscales and total score. Mann-Whitney U, Kruskal-Wallis, and multivariate Poisson regression correlation analysis were performed. Results: The median age of patients was 8 (SD= 3.76). The study group consisted of 57 (76.0%) males and 18 (24.0%) females. Fifty parents (66.7%) have more than eight years of education and 35 (46.7%) earn less than 2 BWM. The impact values were significantly higher in male individuals in the oral symptoms (OS) domain and in individuals without caries experience in the social well-being (SW) domain (p<0.05). Conclusions: these results seem to suggest that individuals with ADS without caries experience in permanent dentitions in the SW domain and males in the OS domain had a higher impact quality of life.
Treatment Outcomes Based on Patient’s Oral Health Related Quality of Life (OHRQoL) after Receiving Conventional Clasp or Precision Attachment Removable Partial Dentures in Distal Extension Cases: A Randomized Controlled Clinical Trial
Authors: Mamdouh Rania Ibrahim , El-Sherbini Nancy Nader , Mady Yusr Omar
Published: November 2019

Purpose: To compare the effect of two treatment options in mandibular Kennedy class I cases regarding oral health related quality of life (OHRQoL) and the biting force, removable partial dentures retained by either precision attachment (PA-RPD) or clasps (C-RPD)Materials and methods: The study included 32 partially edentulous patients which 16 patients received PA-RPD (OT Cap Attachment) and 16 patients received C-RPD. All the patients in both groups were asked to fill the OHRQoL questionnaire after 1 week (baseline), 3 months, 6 months and 12 months after prosthesis insertion. Biting force was measured using the i-load Star Sensor one week, 3 months, 6 months and 1 year after partial denture insertion for all patients in both groups. Statistical analysis comprised Mann Whitney U test, Friedman’s test, Dunn’s test and Chi-square test.Results: The results of OHRQoL revealed that at the baseline, 3 months and 6 months the PA-RPD showed statistically significant lower mean total OHIP-14 score than the C-RPD. However, after 12 Monthes , there was no statistically significant difference between total OHIP-14 scores in the two groups. Concerning the biting force there was no statistically significant difference between the two groups.Conclusion: Within the limitations of this study it was concluded that the OHRQoL of both the PA-RPD and the C-RPD was comparable after 12 months. Similarly the biting force was the same for both treatment options.
SPATIAL ANALYSIS OF MERCURY LEVELS AS INDICATOR OF ENVIRONMENTAL CHANGES AND SOIL QUALITY IN AGROFORESTRY SYSTEMS IN SOUTHERN AMAZON
Authors: Linhares Joiada Moreira da Silva , Bastos Wanderley Rodrigues , Almeida Ronaldo de , Manzatto Angelo Gilberto , De Holanda Igor Bruno Barbosa , Recktenvald Maria Cristina , Linhares Deborah Pereira
Published: November 2019

An agroforestry system (AFS) describes the conjoint use of land for agricultural andforestry purposes. An AFS plays a strategic role in the mitigation of carbon dioxide(CO2) emissions, and stands as an alternative in land use that reduces mercury (Hg)remobilization in cultivated soils. This study evaluated the spatial variability of Hgconcentrations as indicators of environment changes and soil quality in different landcover and use systems in a rural settlement in southern Amazon, Brazil. Themethodological procedures were carried out as steps: the experimental units weredefined, physical and chemical characteristics of soil samples were analyzed, anddata were evaluated using conventional and spatial statistics. The AFS included hadbeen established 10 years before or more, and had high Hg retention capacity ,compared with Hg levels in soils on migratory agriculture or that are not fallowed .Therefore, due to low AFS improve soil quality due to the low intensity of harrowing,increasing retention of gaseous and particulate Hg in the soil.
The shift to tertiary technical and vocational education and training and the demise of South Africa’s former ‘technikon’ system
Authors: Kraak André
Published: November 2019

Post-school systems of education and training have changed dramatically across the globe, including in South Africa, over the past two decades. It is ironic, however, that as many countries chose to renew and grow ‘polytechnic-type’ post-school education and training subsystems, South Africa (together with other countries from the Anglo-Saxon world) chose to reduce their role, largely through institutional mergers and processes of academic drift. Much of this difference in approach is path-dependent, shaped by the specific histories of capitalist evolution in each country. However, it also has to do with the faulty policy logic which has guided these changes over the past two decades. This article investigates the rise in significance of tertiary technical and vocational education and training (TVET) through brief case studies of two countries in Central and Northern Europe where the polytechnic sector has been expanded, not reduced. The discussion then shifts to South Africa, where graduation outcomes (in percentage terms) in the universities of technology have remained flat for more than two decades. The shift from secondary to tertiary TVET requires a significant expansion of enrolments and graduations in key applied technology fields, not the stasis we are seeing in South African universities of technology.
Leading curriculum change in South African technical and vocational education and training colleges
Authors: Terblanche Tercia , Bitzer Eli
Published: November 2019

This article proposes that the technical and vocational education and training (TVET) collegecurriculum in South Africa needs restructuring in order for it to support more innovativeresponses to industry requirements and TVET standards. The ultimate aim of this study was todevelop a framework for leading curriculum change in the South African TVET college sector, aframework that will be able to support training and capacity-building among TVET collegeleaders to bring about long-overdue curriculum change. To achieve this aim, curriculumleadership is essential. The multi-phased, mixed-methods research design used in this studyinvolved a questionnaire survey and follow-up group interviews with TVET college staffrepresentative of five TVET colleges in the Western Cape province. Based on these data sources,the study reports on a range of current curriculum challenges in TVET colleges which formed thebasis for suggesting a research-based framework to train leaders to take the initiative in TVETcuriculum change. The study findings confirm the need for TVET college curriculum reform,which, in turn, requires competent curriculum leadership and leadership development. Theresearch therefore contributes to theory and practice in the field of South African TVETcurriculum leadership.
Editorial team
Authors: Papier Joy
Published: November 2019

Editorial team
PENENTUAN FAKTOR BERPENGARUH PADA EKSTRAKSI RIMPANG JAHE MENGGUNAKAN EXTRAKTOR BERPENGADUK
Authors: Anggista Giovani , Pangestu Ilyas Teguh , Handayani Dwi , Yulianto M. Endy , Astuti Septi Kusuma
Published: November 2019

Giovani Anggista , Ilyas Teguh Pangestu, Dwi Handayani, M. Endy Yulianto, Septi Kusuma, in this paper explain that the main part of ginger used is rhizome. Processed ginger products that can be developed are ginger oleoresin which contains components of gingerol, shogaol, zingerone, resin and essential oils. Ginger oleoresin content ranges from 3.2 - 9.5%, while the content of gingerol in oleoresin is between 14-25% and shogaol between oleoresin. 2.8-7.0%. Considering the benefits of high-antioxidant ginger which functions as an anti-inflammatory and prevents tumor growth, it is necessary to extract the ginger rhizome. The purpose of this study was to determine the factors that most influence the extraction of gingerol from the ginger rhizome using a stirred extractor and relatively good conditions. Experiments were carried out with various solvents, pH and temperature. Solvents 4 liters and 8 liters, pH 4 and 6 and temperatures 60oC and 100oC. The Gingerol content is measured by a VIS spectrophotometer. The most influential factor in extraction of ginger was determined by experimental design 23. The analysis of the results showed that for extracting 500 grams of powdered ginger using water as a solvent, the most influential factor was pH, in this case, at pH 6 containing 4% ginger.
SIMULASI PELIMPAHAN BEBAN SISTEM PMT KOPEL TO KOPEL PADA SAAT PEMELIHARAAN TRAFO BERBASIS ARDUINO MEGA 2560 MENGGUNAKAN VT SCADA 11.2
Authors: Samputro Muhammad Rizki , Subari Arkhan
Published: November 2019

Mochammad Rizki Samputro, Arkhan Subari in this paper explains that the need for electricity in everyday life demands PT. PLN to always maintain the distribution of electrical energy to customers. Therefore, it is necessary to use a strategy to prevent blackouts if the transformer is being maintained, that is by maneuvering the load through the network or by using a 20 KV coupling system. The 20 KV Coupling System consists of PMT Kopel Transformer 1 and PMT Kopel Transformer 2 or often called PMT Kopel to Kopel. In this research, a Kopel to Kopel PMT simulation tool is used to transfer transformer loads during maintenance using a LY2N DPDT 12 V relay, ZMCT103C current transformer sensor, voltage sensor, tap changer and use Arduino Mega 2560 as a delivery choice change. After the experiment, the total current size of transformer 1 and transformer 2 exceeds the capacity of transformer which is 4.29 A and the voltage difference is 0.71 V (5.9 %). Therefore it is necessary to adjust the current and voltage regulation so that it becomes 2.82 A and 0.06 V (0.5 %). After that the transfer of load Transformer 2 to Transformer 1 using PMT Kopel to Kopel can be done. The load transfer is done by entering the PMT Kopel 1 and PMT Kopel 2 simultaneously and the Incoming 2 PMT is released. For the normalization, PMT Incoming 2 is entered and PMT Kopel 1 and Kopel 2 are released simultaneously.