Multistakeholder Initiatives and Sustainability? A Governance Analysis using the German Initiative on Sustainable Cocoa (GISCO) as a Case Study.

This paper examines the Multistakeholder initiative (MSI) "German Initiative on Sustainable Cocoa (GISCO)". MSIs represent arenas in which heterogeneous actors from governments, businesses and civil society come together to achieve sustainability goals that they cannot achieve otherwise. The self-defined goals of GISCO are first, to improve the living conditions of cocoa farmers and their families; second, to conserve and protect natural resources and biodiversity; and third, to increase the share of sustainably produced cocoa.

Analyzing Healthcare Processes with Incremental Process Discovery: Practical Insights from a Real-World Application.

Abstract: Most process mining techniques are primarily automated, meaning that process analysts input information and receive output. As a result, process mining techniques function like black boxes with limited interaction options for analysts, such as simple sliders for filtering infrequent behavior. Recent research tries to break these black boxes by allowing process analysts to provide domain knowledge and guidance to process mining techniques, i.

Primate liver tissue substrate in indirect immunofluorescence diagnostics for patients with dermatitis herpetiformis and celiac disease.

Introduction: Dermatitis herpetiformis (DH) is a rare autoimmune, polymorphous blistering disorder, characterized by severe itch or burning sensation, which represents the cutaneous manifestation of celiac disease (CD). The current estimation of DH versus CD is around 1:8 and the affected individuals have a genetic predisposition. Pathogenetically, IgA autoantibodies against the epidermal transglutaminase, an essential constituent of the epidermis, cause DH and are reported to develop through cross-reaction with the tissue transglutaminase, with IgA auto-antibodies causing CD.

Long-term reversal of chronic pain behavior in rodents through elevation of spinal agmatine.

Chronic pain remains a significant burden worldwide, and treatments are often limited by safety or efficacy. The decarboxylated form of L-arginine, agmatine, antagonizes N-methyl-d-aspartate receptors, inhibits nitric oxide synthase, and reverses behavioral neuroplasticity. We hypothesized that expressing the proposed synthetic enzyme for agmatine in the sensory pathway could reduce chronic pain without motor deficits.

Lower SARS-CoV-2-specific humoral immunity in people living with HIV-1 recovered from nonhospitalized COVID-19.

People living with HIV-1 (PLWH) exhibit more rapid antibody decline following routine immunization and elevated baseline chronic inflammation than people without HIV-1 (PWOH), indicating potential for diminished humoral immunity during SARS-CoV-2 infection. Conflicting reports have emerged on the ability of PLWH to maintain humoral protection against SARS-CoV-2 coinfection during convalescence. It is unknown whether peak COVID-19 severity, along with HIV-1 infection status, associates with the quality and quantity of humoral immunity following recovery.

Pericardial Effusion Associated With Sirolimus Use After Renal Transplantation: A Single-Center Case Series.

Pericardial effusion and cardiac tamponade following renal transplantation have been recognized as a potentially serious complications associated with the use of sirolimus for immunosuppression. Our study aims to analyze the development of sirolimus-associated pericardial effusion. Patients who underwent renal transplantation at our institution between 2001 and 2014 were reviewed and the correlation between sirolimus exposure and pericardial effusion was determined.

Impact of Interhospital Transfer on Outcomes in Non-emergency Colorectal Surgery.

Background: A paucity of data exists on the impact of transfer status on outcomes for patients undergoing non-emergency (urgent) colorectal surgery. This study characterized transferred patients undergoing urgent colorectal surgery and determined which patient comorbidities significantly contributed to poor outcomes.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2013 was used.

Force Perception Thresholds in Cochlear Implantation Surgery.

Tissue trauma is a frequent complication of cochlear implantation (CI) surgery, but the relationship between intracochlear trauma, electrode insertion forces, and surgeons' ability to perceive these forces is poorly understood. In this study, we simulated CI surgery using a benchtop apparatus to repeatedly apply small forces to the subjects' hands while reducing the variability in their hand movements. We used a psychophysical testing procedure to estimate the force perception thresholds of 10 otologic surgeons and found a median threshold of 20.

Relationships between unilateral horizontal and vertical drop jumps and 20 m sprint performance.

Objectives: The purpose of this study was to compare the relationships between horizontal (HDJ) and vertical drop jumps (VDJ) to sprint performance.

Design: Exploratory Study.

Setting: Laboratory.

Initial radiographic tumor control is similar following single or multi-fractionated stereotactic radiosurgery for jugular paragangliomas.

Objective: To evaluate radiographic tumor control and treatment-related toxicity in glomus jugulare tumors treated with stereotactic radiosurgery (SRS).

Study Design: Retrospective chart review.

Setting: Tertiary academic referral center.

Distinguishing Bronchoscopic Changes of Mitral Stenosis From Carcinoma In Situ With Narrow Band Imaging.

A 75-year-old woman presented with minor hemoptysis. Past history included atrial fibrillation and rheumatic mitral stenosis. Bronchoscopy revealed a striking abnormality of widespread dilated mucosal and submucosal vessels.

Impact of 4D-(18)FDG-PET/CT imaging on target volume delineation in SBRT patients with central versus peripheral lung tumors. Multi-reader comparative study.

Purpose: Evaluation of the effect of co-registered 4D-(18)FDG-PET/CT for SBRT target delineation in patients with central versus peripheral lung tumors.

Methods: Analysis of internal target volume (ITV) delineation of central and peripheral lung lesions in 21 SBRT-patients. Manual delineation was performed by 4 observers in 2 contouring phases: on respiratory gated 4DCT with diagnostic 3DPET available aside (CT-ITV) and on co-registered 4DPET/CT (PET/CT-ITV).

A case of sensorineural hearing loss involving a fibroepithelial polyp of the middle ear.

Primary middle ear neoplasms are rare, and commonly cause conductive hearing loss. When aural masses result in sensorineural hearing loss, malignant etiologies are often suspected. Fibroepithelial polyps are benign lesions commonly found in the skin and genitourinary tract and are not commonly identified as primary lesions of the middle ear.

Rocking motion of an optical wing: theory.

The intensity-dependent rocking frequency of an illuminated semicylindrical refractive rod (or "optical wing") on a flat, nonslip surface is investigated. Both longitudinal and transverse radiation pressure forces (scatter and lift forces), as well as radiation pressure torque, transform the mechanical system into one having a bistable potential energy above a critical intensity. The equation of motion may be written as a parametrically driven nonlinear bistable harmonic oscillator, resulting in complex rocking dynamics.

Characterization of intracochlear rupture forces in fresh human cadaveric cochleae.

Hypothesis: To develop a method to measure the forces required for a probe to translocate from the scala tympani (ST) to the scala vestibuli (SV) in fresh human cochleae.

Background: Translocation of cochlear implant electrodes from the ST to the SV may lead to suboptimal audiologic outcomes. Prior work investigating the rupture forces of human intracochlear membranes comes from a single study conducted on isolated ex vivo cadaveric specimens.

Transnasal endoscopic resection of a calcifying cystic odontogenic tumor.

Calcifying cystic odontogenic tumor (CCOT) is a rare histologic subtype of odontogenic tumor. Treatment requires complete enucleation. We report what we believe is the first case of CCOT to be removed via a transnasal endoscopic approach.

Supraspinal gene transfer by intrathecal adeno-associated virus serotype 5.

We report the pattern of transgene expression across brain regions after intrathecal delivery of adeno-associated virus serotype 5 (AAV5). Labeling in hindbrain appeared to be primarily neuronal, and was detected in sensory nuclei of medulla, pontine nuclei, and all layers of cerebellar cortex. Expression in midbrain was minimal, and generally limited to isolated neurons and astrocytes in the cerebral peduncles.

Biodistribution of adeno-associated virus serotype 9 (AAV9) vector after intrathecal and intravenous delivery in mouse.

Adeno-associated virus serotype 9 (AAV9)-mediated gene transfer has been reported in central nervous system (CNS) and peripheral tissues. The current study compared the pattern of expression of Green Fluorescent Protein (GFP) across the mouse CNS and selected peripheral tissues after intrathecal (i.t.

Ultrastructural and cellular basis for the development of abnormal myocardial mechanics during the transition from hypertension to heart failure.

Although the development of abnormal myocardial mechanics represents a key step during the transition from hypertension to overt heart failure (HF), the underlying ultrastructural and cellular basis of abnormal myocardial mechanics remains unclear. We therefore investigated how changes in transverse (T)-tubule organization and the resulting altered intracellular Ca(2+) cycling in large cell populations underlie the development of abnormal myocardial mechanics in a model of chronic hypertension. Hearts from spontaneously hypertensive rats (SHRs; n = 72) were studied at different ages and stages of hypertensive heart disease and early HF and were compared with age-matched control (Wistar-Kyoto) rats (n = 34).

Protein kinase Cε is required for spinal analgesic synergy between delta opioid and alpha-2A adrenergic receptor agonist pairs.

We recently showed that spinal synergistic interactions between δ opioid receptors (δORs) and α2A adrenergic receptors (α2AARs) require protein kinase C (PKC). To identify which PKC isoforms contribute to analgesic synergy, we evaluated the effects of various PKC-isoform-specific peptide inhibitors on synergy between δORs and α2AARs using the tail flick assay of thermal nociception in mice. Only a PKCε inhibitor abolished synergy between a δOR agonist and an α2AAR agonist.