prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: What is the definition of mobile device management (MDM)?

Read the following text and answer briefly.

Context 1: Hospitals as critical infrastructures has been historically dependent on various types of devices and equipment that are being revolutionized with digitalized solutions  The digitalization of conventional healthcare equipment is added with the new inclusion of numerous new devices for data collection, analysis, communication, and so on  All in all, the futures digital hospitals in 5G will be exponentially more data-dependent and digital-intensive  For that, this paper looks to theorize how the security scenario in a futures digital hospital would look like, and what relevant business possibilities could emerge for cybersecurity providers in the healthcare context  In this paper, we open up discussions on business possibilities relevant to Internet of Things-mobile device management for critical infrastructures such as future digital hospital  We apply business models as a conceptual lens to analyze how cybersecurity business could evolve for 5G enabled IoT-Mobile device management providers as a cybersecurity vendor 
The healthcare sector has progressed significantly since the introduction of Internet and proliferation of network technologies   Among many issues, the use of data, availability of data, data mass, and access control of data in healthcare remain are critical for keeping healthcare services trustworthy and secure for the end users, both hospital staff and the patients  Disruptions in healthcare services would have severe effects on people’s lives  However, as hospital managers and professionals need to design their data-dependent and digital-intensive networks in a manner, which is highly secure, they also should provide the basis for uninterrupted service for business sustainability  Security is often observed as a tradeoff between risk and business gains   Investing in security is important in order to secure business-critical systems and data for meeting business goals and eventually for creating competitive advantage [3, 4] 
Innovative technologies have the power to disrupt industries and prompt business transformation   The coming of fifth generation (5G) of telecommunications networks is seen to result in this kind of disruption  As we are gradually moving towards 5G, it is worthwhile to theorize how the security scenario in a futures digital hospital would look like, and what relevant business possibilities could emerge from cybersecurity in the healthcare context  From this perspective, in this paper, we open up discussions on business possibilities relevant to Internet of Things mobile device management for critical infrastructures such as future digital hospital  We apply business models as a conceptual lens to analyze how cybersecurity business could evolve for 5G enabled IoT device management providers as a cybersecurity vendor 
A futures digital hospital facility is envisioned to consist tech-aided advanced critical medical devices, intelligent information systems, digital communication tools, hundreds of handheld mobile devices (smartphones, tablets), wireless clinical wearables, in addition to thousands of smart IoT nodes [6, 7]  These devices should be fully integrated to improve staff productivity, hospital functions, patient safety and privacy, and, overall improve patient experience through secure and reliable healthcare services  However, inclusion of these various kinds of digital devices to the hospital context make the overall device network quite complex and heterogeneous   Thus, from a critical infrastructures view point, to manage, configure, update and secure the immense fleet of digital devices besides all the high-tech medical equipment, the futures digital hospital will need to redefine device management policy and services  
Mobile device management (MDM) systems are usually referred to “support centralized control of an entire fleet of mobile devices (smartphones and tablets) and mobile applications by applying and ensuring pre-defined configuration settings” [8, 9]  In the scope of this paper, we broadly use the term IoT-MDM to refer to a device management system that is capable of managing, configuring and updating both handheld mobile devices and IoT devices in combination in a centralized manner  We will briefly open up the concept of MDM and IoT-MDM 
The purpose of this study is to identify business potential for IoT-MDM service providers as cybersecurity vendor in the context of the future digital hospital  In doing so, we apply the concept of business model in order to make sense of a ICT-oriented business environment   Among various available conceptualizations, business model is considered as a boundary-spanning unit of analysis that explain the underlying business logic and the value creation and value capturing logic of an organization [11–15] 
Traditionally, device management has been associated with management and configuration of handheld mobile devices , thus, mobile device management (MDM)  Gartner  perceives MDM software to be a policy tool to configure and manage mobile handheld devices  They also mark that MDM services need to ensure security in reference to connectivity and content that is being transmitted  Along with surge of smart mobile devices, the Internet of Things (IoT) is growing large during the last few years and promises to flood the market with billions of devices in the coming years too   Zhang et al   states scalability, transparency and reliability as important issues that differentiates IoT from the conventional Internet  To that end, there are several IoT platforms available currently in the market for managing, updating and configuring IoT nodes, e g  IBM Bluemix, Cumulocity, ARM mbed OS, etc    However, the transition raises the question about the differences and similarities between MDM and IoT device management as approaches 
Takalo  marks MDM and IoT device management to be quite close on a conceptual level: both need solution for automated management of large device fleets consisting different form factors, device models, and operating system  Additionally, such systems conceptually needs to support various communication channels like: WiFi, cellular network and Ethernet  However, on practical level, MDM is more strictly controlled by operating systems and device vendors  IoT device management, on the other hand, is characterized by multiple operating systems, multiple hardware platform variations, non-complete standards, multiple communication methods and protocols  This agile approach allows the coexistence of various types of devices and nodes in the same environment  Recently, services are appearing where MDM and IoT device management are brought together under the same platform, which in a way reduces the complexity in device management and also improves the overall security of the system 
While we are still in early phase of mass IoT deployment and 5G deployment is approaching, it is important to revisit some of the key security threats that has been identified in recent literature relevant mainly to IoT  Zhang et al  [19, 21] identified privacy preservation as a critical issue for information security in IoT ecosystems  They further state that conventional naming, identification and authentication policies need to be improved and rather needs approaching differently  Farooq et al   look at the four layer generic IoT architecture consisting perception layer, network layer, middle-ware layer & application layer  Additionally, they offer a list of security challenges for each layer  Some of the key challenges are: unauthorized access, tag cloning, eavesdropping, spoofing, RF jamming, sinkhole attack, sleep deprivation attack, denial of service attack, malicious code injection, man-in-the-middle attack, spear-phishing attack, sniffing attack  Backman et al   state, a comprehensive security solution needs to address endpoint security, management and monitoring security, and secure data distribution and storage 
Ortbach et al   enumerate the drivers for adoption of MDM in organization through a quantitative analysis, reflecting three broad drivers: organization, environment, and technology  From organizational perspective, the company size, mobile IT usage, employee innovativeness with IT and BYOD (bring your own device) culture were identified as important drivers  From environmental viewpoint, regulations and other business partner influence are significant drivers for MDM adoption  Finally, from technology point of view, perceived security benefits and perceived cost of the service seems to affect the managerial attitude towards MDM adoption 
MDM systems are today a very common tool to manage users’ devices  With MDM, all mobile device types, tablets and PCs with typical operating systems can be controlled centrally   It is often thought that MDM can manage only mobile phones, but actually the MDM framework includes also users’ identities and profiles  This makes MDM a viable tool for organizations to manage their employees identities, user profiles, all devices, all applications and security controls under same system 
From an emerging technology perspective, SDN (software-defined network)/NFV (network functions virtualization) based 5G Slicing will challenge some of the traditional MDM features   Especially end-to-end security from device to IT cloud is difficult to realize with MDM  Of course, it is possible to force the use of VPN in mobile device with MDM, but many aspects of communications security will be still unsolved  Thus, 5G slicing provides new tools to control and manage the end-to-end communications flow with network functions (VNFs)  In the advent of IoT, this is particularly important since the billions of IoT devices of the 2020s will have only a minimal processing power and memory compared to the smart phones of today  These IoT devices may connect to network only once a month and communicate only with network edge cloud servers  Therefore, managing these new IoT devices cannot be done with conventional MDM systems of today 
Fortunately, many features of MDM can be provided by dedicated 5G slices and their VNFs  If e g  a IoT device does not have the latest anti-virus updates, the network slice may still provide the isolation and security controls so that the IoT device can send the metering data  Moreover, if the IP flow from the IoT device includes other than actual metering data, eg  due to malware in IoT device, this IP flow can be analyzed and filtered by slice specific VNFs before passing it to IoT could 
As a summary, it can be argued that SDN/NFV based 5G Slicing will provide new tools for security management, and, when combined with IoT-MDM system functionalities, together these can deliver a better device management framework for different kinds of user devices of the 2020s 
Hospital organizations are considered as critical infrastructure (CI) to nation states [3, 25]  As a critical infrastructure, hospital organizations are prone to security threats that can affect health policies, public health, healthcare services, surgical procedures, electronic patient records, patient privacy, doctor-patient communication, etc  Lehto and Ahokangas  notes, new technology (e g  next generation mobile networks, smart data storage, IoT) adoption of CIs increases the cybersecurity touchpoints and hence making the CIs more vulnerable  Broadly, from cybersecurity perspective, the hospital organizations in future will be vulnerable from management perspective (e g  organizing healthcare services, managing huge amount of patient data, clinical data, medication data, communication between health professional and patients etc ), healthcare service delivery perspective (e g  in an unwelcoming case of denial of service attacks in hospital context: like wannacry), network perspective (e g  security of the overall hospital network), and last but not the least from an individual privacy perspective (e g  individual patient records, healthcare professional logs, etc ) 
A futures digital hospital will consist various advanced technologies, such as critical medical devices, intelligent information systems and digital communication tools, which are fully integrated to improve staff productivity, hospital operations, patient safety, and the overall patient experience  Among them, many will be wireless mobile devices, wireless wearables and thousands of smart IoT devices for various kinds of measurements  
Innovations help transform healthcare in forms of advanced telecommunications techonology, new drugs and treatments like biological sensor pills or implants, new medical devices, social media interation, etc  [1, 6, 7]  In future, hospitals and surgical tools will be revolutionized with intelligence and connectivity i e  providing more assistive functions by sensors, processors, data collection, software algorithms and interfaces which are, for example, embedded in the tools that will support surgeon’s decision-making in action   Robotic-assisted Surgery (RAS) can be considered as a good example of such transformation  The rapid adoption of Minimally Invasive Surgery (MIS) and today’s information revolution not only improves the surgical outcomes and patient’s life but also changes the patient-physician relationship 
‘Smart’ i e  IoT-based technologies are going to intellectualize medical devices and service systems into Smart Hospitals  Smart hospitals extrapolate from totally digitalized and automated data collection, tracking and delivery between systems, devices, patients, and health professionals and organization   In future, it is also envisioned that virtual hospitals and personalized medication will become part of patient care  Patients will be able to visit virtual hospitals or e-clinincs for clinical purposes without the presence of health professionals, but procedures and communication are managed via remote management and telemedicine solutions  
Other features that futures digital hospitals will include: use of different AR (augmented reality) and VR (virtual reality) applications for healthcare related purposes  While VR applications are quickly evolving in the gaming industry, some applications are deemed suitable in hospital environment too  Patients can be introduced to hospital environment through VR solutions, which can reduce patient stress prior to surgical procedures   Another application of VR in healthcare has been identified as rehabilitation support for temporary physical disabilities and mental trauma  Further, AR solutions can help patients navigate within a large hospital complex 
The term, Business model, has had its root in information systems (IS) and information communication technology (ICT) since the late 1970s originating from business informatics  However, it came into management and strategic management literature as a research interest from the mid-1990s [29, 30]  Although business model had its roots in IS and ICT, the amount of research work on cyber security as a context is still quite negligible harnessing the potential of business model concept 
The concept of business models lies at the intersection of entrepreneurship and strategy, it can be observed as a bridge between abstract strategies and the practical implementation of strategic decisions and actions amidst the uncertainties of the modern business context [11–14, 31]  For instance, Zott and Amit  conceptualize business model as a ‘boundary-spanning’ set of activities aimed at creating and appropriating value  Morris et al   viewed the concept of the business model as a set of decisions related to the venture strategy, architecture, and economics of firm (value creation and capture) that need addressing to create sustainable competitive advantage in the chosen markets and specific contexts 
As a boundary-spanning unit of analysis, business models , connects an organization with its business environment, other organizations, customers, individuals and society as well; with the overall ecosystem at large [34, 35]  Trying to bridge business models and cyber security under current context, there are two core issues  First, as almost all of the entities operating within the digital sphere face multifaceted cyber threats, how can business model approach help organizations to respond to such situations? Second, how can business model approach help to identify opportunities and monetize security in future 5G? In the next two sub-chapters, we present two business model approaches that are suitable for ICT contexts, and, can help find answers to the above mentioned questions 
As the mobile telecommunications industry advanced, so did business model related discussions in the literature about extending organizational boundaries through vertical and horizontal integration in industries   Around this, Wirtz et al   offered four mutually exclusive business models classifying Internet based business models to be precise  According to Wirtz et al  , these business models present in Web 2 0 are related to connection, content, context, and commerce  Building further, Yrjölä et al   interpreted these business models as chronological layers, where “lower” layer business models are pre-requisites for the “higher” layer business models to exist 
Figure 1 The layered 4C ICT business models archetypes [Adapted from 35, 37, 38] 
The first layer is concerned with connection-related business model where a stakeholder provides connection services   Connection- related business models are relevant to connectivity for all sorts of devices and nodes through various communication channels, e g  PCs, smartphones, tablets, IoT devices, etc  The second layer is the business model focusing on monetizing content  At the content layer, all sorts of online content services (e g  mobile video streaming) are classified (i e  relevant, up-to-date and interesting) and are accessible conveniently for the end user  The content might be peer-to-peer/user-oriented contents (i e  exchange of personal content), and web browsing content (audio, video, text etc ) 
The third, context, layer concerns the ability to create and monetize user, content, equipment/user device and system profiles and turn (big) data into meaningful information and knowledge through systemic virtual contextualization  The fourth layer concerns commerce, the ability to monetize any or all of the connection, content, or context specific resources, actors or activities related to the ongoing communications  At this layer, we identify business, consumer and public/government types of communications   Thus, B2B (business-to-business), B2C and B2G communications as well as C2B, C2C and C2G or G2B, G2C and G2G communications may be monetized at this layer 
Casdesus-Masanell and Llanes’s  offers different software business models based on the openness of core software and extension software offering  According to the mixed source software business model approach, services can be: open source (open core- open extension), open core (open core- closed extension), open extensions (closed core- open extension) and proprietary (closed core- closed extension)  Although this model was offered specifically suiting the software industry, we argue that similar approach can be useful in other ICT contexts to scale up value offering by adjusting cooperation and industrial partnering model 
Figure 2 Mixed source business model approach [Adapted form 40] 
Depending on individual organization’s choice of mixed source options, it should eventually translate the value creation and value capture logic of the firm  Casadesus-Masanell & Llanes  argues that purely proprietary models results in higher captured value for organizations but lessens the scope of value creation for users  In contrast, purely open source models can deliver the maximum value to customers but reduce captured value  The key for organizations is to locate the best mix of openness-closeness for an optimum level of value capture and creation  From the business model elements collection, the mixed source approach explain key partners, key activities, key resources and technologies used  From a strategic perspective, this approach to business modeling helps an organization to find a way to scale up or down its business activities 
This study concerns business possibilities of IoT and mobile device management in the context of futures digital hospital  Since future is elusive and the speed of technology advancements has been rapid during recent decades, we consider the most suitable method for conducting this research to be through qualitative approach  Qualitative methods helps with flexibility and sensitivity to the context that is less explored, and it can facilitate understanding of how things work in a particularly complex setting   We adopt a single qualitative case study approach for this research to explain underlying business potential of a scantly explored industrial context within the existing literature  
Interview 1 Pediatric Surgery Administration, teaching, hospital development, technology and innovations Pediatric surgery patient journey, concept development of futures digital hospital, digitalization in healthcare 
Workshop 1 Network specialists, operator service provider, cybersecurity expert Business opportunity creation, new market exploration, security aspects Digitalization in healthcare, security business opportunities in health domain, business modeling 
Workshop 2 Operator service provider, cybersecurity expert Business opportunity creation, new market exploration, security aspects Digitalization in healthcare, security business opportunities in health domain, business modeling 
Table 1 summarizes the data used for this research  The empirical data used for this study was collected through two streams  First, in order to build the conceptual case of future digital hospitals, five interviews were conducted with pediatric surgery specialists, a nurse, and a general physician from two hospital districts in Finland  These semi-structured interviews were organized between April and May 2016  These interviews also focused on understanding the journey path in a pediatrics surgery case to clarify suitability of digitalization in the future  However, in the scope of this paper, we do not discuss the patient journey pediatrics surgery in detail  Second, we explored the cybersecurity and business perspectives in two workshops that were organized with telecommunications and cybersecurity experts from the industry  One of the workshops were organized in November 2016  The other workshop took place in August 2017  While the futures digital hospital context from a security perspective relates more towards hospital management and network functionality, the IoT devices and mobile devices perspective is closer to end user security needs  This paper focuses on the cyber security related business opportunities through IoT-MDM systems/services that broadly covers the above mentioned domains  Findings and analysis from the interviews and workshops are presented next 
In this section, we present our analysis in four steps  First, we briefly discuss the relevance of Internet business models (4C)  to the context of the study, addressing how this approach can help cybersecurity providers identify business opportunities in IoT-MDM  Second, we present a 4-quadrant matrix reflecting four different 5G security-provisioning scenarios, which are also relevant to IoT-MDM  Then, we connect each scenario back to business models by applying a mixed-source business model approach  and identify different possible business models for each kind of cybersecurity provider  Finally, we connect the overall discussion back to the case of future digital hospital 
The 4C business model archetypes helps decoding the boundaries between multiple business models operating either in the same verticals of the ecosystem or in the same horizontals  These archetypes can provide with a basis to classify and analyze business models of suppliers, competitors, and, at the same time, business models of customers  For this case, the 4C business model archetypes are mostly relevant for cybersecurity providers and IoT-MDM system/service providers as a tool to analyze customer business models and identify customer needs, the hospital management style  These customer needs can eventually be turned around as business opportunities  While IoT-MDM systems and services are not only concerned about cybersecurity, there is room for service providers to customize and tailor services based on customer needs  These service providers either can target customers from one layer (connection/content/context/commerce) across multiple industries, or, they can also target a specific industry (e g  healthcare) create customized services for all the layers in that industry 
To make sense of the overall cybersecurity provisioning for future 5G, we created the 4-quadrant matrix (Figure 3) by identifying major security drivers for new business creation in future 5G  These scenarios were created in workshops with telecommunication & cybersecurity experts from the industry  While these service provisioning scenarios are relevant to overall 5G, they are also significantly related to the case of IoT-MDM system/services 
Figure 3 Scenarios for 5G cybersecurity provisioning [Adapted from 35] 
As a result, we find four major drivers of security, which potentially will come with new business opportunities in the 5G era  Device driven security comprises distributed and D2D security techniques  Platform driven security will focus on centralized and D2D security techniques  Whereas, network infrastructure driven security should focus on centralized and infrastructure security methods  Lastly, location driven security should harness distributed and infrastructure security techniques 
In a quest to identify potential business entities operating in each of the quadrants relevant to device management, we recognize a ‘secure device manufacturer/provider’ focuses on device-driven security  Currently, multiple device manufacturers are developing devices where security features are built-in, regardless of which network or websites the users are accessing  This built-in security can be offered to multiple kinds of devices including smartphones, tablets, pcs, wearables, and even to IoT devices with communication and computation capability  These secure devices are built in a way that it will control access to potentially harmful networks, websites, and content; even without any commercially available security applications installed  However, when a customer enterprise (e g  the future digital hospital) is buying a fleet of hundreds of such secure devices, the question raises how to manage and configure all these devices from time-to-time  In such a case, even the secure devices will need IoT-MDM services for proper management and seamless upgrading when needed 
For the platform-driven security, we observe a ‘traditional IoT-MDM system provider’ can be a good example  In many cases, IoT-MDM system providers are selling there device management systems to enterprises directly  And, in other cases, they are selling the service through MNO’s bundled with connectivity and/or infrastructure  While as network infrastructure-driven security, a ‘mobile network operator/carrier’ or a ‘network infrastructure vendor’ can build own IoT-MDM system to offer their clients as well  And, finally, a location-specific micro operator can offer location-driven security  Micro operators offer mobile connectivity combined with specific, local services  The operation of a micro operator is spatially confined to either its premises or to a defined area of operation  As a part of the location-specific services, these micro operators can also offer IoT-MDM services for the users through outsourcing 
Further, we attempt to connect the aforementioned classification and examples of different players offering IoT-MDM services with the mixed source business model approach  Table 2 summarizes our understanding on how each kind of cybersecurity provider can open and mix the core value creation logic for end users  As mentioned previously, the mixed-source business model options are: open source (open core, open extensions), open core (open core, closed extensions), open extensions (closed core, open extensions), and proprietary (closed core, closed extensions)  In relation to these mixed-source options, we analyze the plausible options for each of the four distinct cybersecurity providers in the context of this study 
Secure device manufacturer/provider Secure devices Proprietary (own device, own IoT-MDM platform), Open extensions (own device, outsourced IoT-MDM service) 
From a secure device manufacturer perspective, device business can be considered as the core operation whereas IoT-MDM services would be extended solution  A secure device manufacturer/provider can have either a proprietary model or an open extensions model  In the proprietary model, the secure device manufacturer will offer their own devices alongwith their own IoT-MDM system/service  This is a viable case in a sense that customers who are purchasing the fleet of secure devices might prefer the IoT-MDM service from the same vendor, which is ideally less risk prone  Generally, when a customer organization buys a fleet of secure devices, they would expect the device management functions to be offered by the same service provider since integration of multiple systems/interfaces might increase vulnerability and reduce the customer’s confidence on the system  However, in practice, not all secure device manufacturer will specialize in automated device management solutions, and new R&D expenses to develop the IoT-MDM systems could result to be financially unfeasible  So, the second option for a secure device manufacturer is to have an open extensions model, where they will still offer the secure devices but outsource the IoT-MDM services to other vendors 
A micro operator’s core business relates to location specific network, while they are offering additional location specific services as extensions  Ideally, a micro operator’s business model in this case can be considered to be open source  At one hand micro operators are dependent on appropriate available spectrum resources on carriers and NIVs, and on the other hand, outsourcing the IoT-MDM services to other vendors seems more economically feasible than building own system  In contrast, a traditional IoT-MDM system/ service provider can have either a direct-open extensions business model or an indirect-open extensions business model  Unlike the other three archetypes in this discussion, IoT-MDM system/services are the core business for this kind of actor, as device and network related issues can be considered as extensions  An IoT-MDM system/service provider is characteristically dependent on connectivity providers, i e  MNOs, NIVs  In a direct-open extensions business model, while they are selling the IoT-MDM service directly to the end users, they are using the operator connectivity, but delivering their core value directly  Alternatively, in an indirect-open extensions business model, these IoT-MDM vendors can sell the services through MNOs/NIVs/device vendors to the end users 
Finally, a mobile network operator can either have an open extensions business model, or less likely a proprietary business model for IoT-MDM services  In an open extensions business model, operators will offer own connectivity to end users while outsourcing the IoT-MDM service to vendors  In very few cases though, operators might have their own IoT-MDM system on offering and thus they can sell both connectivity and IoT-MDM service as a proprietary bundle 
Looking back at the case of futures digital hospital, it is deemed to comprise various advanced technology-aided devices, let it be for clinical purposes or communications purpose that support healthcare  With the presence of devices like smartphones, tablets, wearables, connected TVs, VR touchpoints, AR touchpoints, robotic assistance for surgeries, thousands of smart IoT devices, makes the overall device network of the digital hospital complex and need automated centralized management  This centralized management of numerous IoT and mobile devices can be delivered through IoT-MDM system/services  Using the IoT-MDM system/service, the hospital organization can configure, secure, and time-to-time update their device network 
While procuring IoT-MDM services, the above analysis shows that futures digital hospitals can source it either directly from IoT-MDM service providers or through MNOs  Alternatively, if a digital hospital also plays the role of a micro operator, besides offering other location-specific services, the micro operator can also offer device management services by sourcing it from other vendors  In other cases, the future digital hospital can procure fleet of secure devices for the hospital from whom they can also source the device management service as a bundle  From the 4C business models perspective, the hospital organization seems to be a single organizational entity where different activities can be categorized in the 4C layers  Cybersecurity providers can specify and address such issues to highlight and customize their service offering for the future digital hospital 
In this article, we have looked at the futures digital hospital context from a device management perspective, and attempted to portray business model options based on how to create and capture economic value from cybersecurity business  Though in this research, we adopt a high-level stance on cybersecurity from a technical perspective, the overall discussions on business potential are relevant to issues like information security, communication security, storage security, security at vulnerable touchpoints in hospital context (end user interface layer, IoT nodes, system layer, network layer) 
Futures digital hospitals will be vulnerable to cybersecurity threats because of its data-dependency and digital-intensive device network  Thus, the business opportunity for cybersecurity providers in this case can be considered as the need for automated and centralized IoT-MDM service  To that end, this paper presents four distinct players who can provide such service to a critical infrastructure like a digital hospital  The mixed-source business model options further open up multiple alternatives that each type of vendor can consider while tailoring services for the future digital hospital   This paper also connects the 4C ICT business model archetypes to cybersecurity business context which can be used as an analytical tool to identify customer needs and scope for value creation  
Academically, this work contributes by filling up the void in discussing business models for cybersecurity as an industry  In addition, in the existing literature the hospital context has also been less discussed from a cybersecurity business perspective  From an industrial point of view, the business model options discussed in this research are timely and relevant to the market context and need  As mentioned, the mixed source business model options show how cybersecurity providers can extend their offering for different kinds of need for the hospital context based on their core businesses  This study can prove to be helpful for cybersecurity business entities and at the same time hospital managers  The scope of this paper explains business potential of cybersecurity vendors to an emerging industry from a higher level  In this paper, authors do not attempt to analyze the technical aspect of cyber security provisioning in healthcare context, however that is a forthcoming research possibility of this study  Also, since this research is based on a conceptual phenomenon, thus its empirical validation, both qualitatively and quantitatively is still yet to come, which can be considered as a limitation of the study 
All in all, we consider that applying a business perspective to IoT-MDM systems can solve many challenges of a modern mobile IT environment, not only in healthcare but also in other kinds of critical infrastructures   These IoT-MDM systems can be provided by various kind of vendors through a balanced and timely business model 
This study has been supported by the DIMECC Cyber Trust – Digital cyber security program 
 Lehto, I , and Ahokangas, P  (2017)  “Mobile Security Business Models for Critical Infrastructures – An Ecosystemic Approach”, in Proceedings of the 24th Nordic Academy of Management Conference 2017, Bodo, Norway 
 Loebbecke, C , and Picot, A  (2015)  Reflections on societal and business model transformation arising from digitization and big data analytics: A research agenda  The Journal of Strategic Information Systems, 24, 149–157 
 Himidan, S , and Kim, P  (2015)  The evolving identity, capacity, and capability of the future surgeon  In Seminars in pediatric surgery, 24, 145–149, WB Saunders 
 Beimborn, D , and Palitza, M  (2013)  “Enterprise app stores for mobile applications-development of a benefits framework”, in Proceedings of the Nineteenth Americas Conference on Information Systems, Chicago, Illinois 
 Ortbach, K , Brockmann, T , and Stieglitz, S  (2014)  “Drivers for the adoption of mobile device management in organizations”, in proceedings of the Twenty Second European Conference on Information Systems, Tel Aviv 2014 
 Wirtz, B  W , Schilke, O , and Ullrich, S  (2010)  Strategic development of business models: implications of the Web 2 0 for creating value on the internet  Long range planning, 43, 272–290 
 Afuah, A  (2004)  Business Models: A Strategic Management Approach  McGraw-Hill/Irwin 
 Alt, R , and Zimmermann, H  D  (2001)  Preface: introduction to special section–business models  Electronic markets, 11, 3–9 
 Chesbrough, H , and Rosenbloom, R  S  (2002)  The role of the business model in capturing value from innovation: evidence from Xerox Corporation’s technology spin-off companies  Industrial and corporate change, 11, 529–555 
 Shafer, S  M , Smith, H  J , and Linder, J  C  (2005)  The power of business models  Business horizons, 48, 199–207 
 Zott, C , and Amit, R  (2010)  Business model design: an activity system perspective  Long range planning, 43, 216–226 
 Xu, T , Wendt, J  B , and Potkonjak, M  (2014)  Security of IoT systems: Design challenges and opportunities  In Proceedings of the 2014 IEEE/ACM International Conference on Computer-Aided Design, 417–423  IEEE Press 
 Zhang, Z  K , Cho, M  C  Y , Wang, C  W , Hsu, C  W , Chen, C  K , and Shieh, S  (2014)  IoT security: ongoing challenges and research opportunities  In Service-Oriented Computing and Applications (SOCA), 2014 IEEE 7th International Conference, 230–234  IEEE 
 Farooq, M  U , Waseem, M , Khairi, A , and Mazhar, S  (2015)  A critical analysis on the security concerns of internet of things (IoT)  Int  J  Computer Appl  111 
 Backman, J , Väre, J , Främling, K , Madhikermi, M , and Nykänen, O  (2016)  IoT-based interoperability framework for asset and fleet management  In Emerging Technologies and Factory Automation (ETFA), 2016 IEEE 21st International Conference, 1–4  IEEE 
 Isotalo, L  (2017)  “5G Slicing as a Tool to Test User Equipment Against Advanced Persistent Threats”, in International Conference on Network and System Security, 595–603  Springer, Cham 
 Alcaraz, C , and Zeadally, S  (2015)  “Critical infrastructure protection: requirements and challenges for the 21st century”, in International Journal of Critical Infrastructure Protection, 8, 53–66 
 Sutherland, J , and van den Heuvel, W  J  A  M  (2006)  Towards an intelligent hospital environment: adaptive workflow in the OR of the future  In System Sciences, 2006  HICSS’06, in Proceedings of the 39th Annual Hawaii International Conference, 5, 100b–100b  IEEE 
 Haq, M  M  (2008)  U S  Patent No  7,412,396  Washington, DC: U S  Patent and Trademark Office 
 Spector, N  D , Cull, W , Daniels, S  R , Gilhooly, J , Hall, J , Horn, I , and Stanton, B  F  (2014)  Gender and generational influences on the pediatric workforce and practice  Pediatrics, 133, 1112–1121 
 Wirtz, B  W  (2011)  Business model management  Design–Instrumente–Erfolgsfaktoren von Geschäftsmodellen, 2 
 Gomes, J  F , Ahokangas, P , and Owusu, K  A  (2016)  Business modeling facilitated cyber preparedness  Int  J  Business & Cyber Security, 1, 54–67 
 Richardson, J  (2008)  The business model: an integrative framework for strategy execution  Strategic change, 17, 133–144 
 Morris, M , Schindehutte, M , and Allen, J  (2005)  The entrepreneur’s business model: toward a unified perspective  J  Business Res  58, 726–735 
 Zott, C , Amit, R , and Massa, L  (2011)  The business model: recent developments and future research  J  Manage  37, 1019–1042 
 Gomes, J F , Iivari, M , Ahokangas, P , Isotalo, L , Sahlin, B , and Melen, J  (Forthcoming, in press), Cyber security business models in 5G  Comprehensive guide to 5G security, Wiley Publishers, London 
 Ballon, P  (2007)  Business modelling revisited: the configuration of control and value  info, 9, 6–19 
 Yrjölä, S , Ahokangas, P , and Matinmikko, M  (2015)  Evaluation of recent spectrum sharing concepts from business model scalability point of view  In Dynamic Spectrum Access Networks (DySPAN, in 2015 IEEE International Symposiu, 241–250  IEEE 
 Ahokangas, P , Moqaddamerad, S , Matinmikko, M , Abouzeid, A , Atkova, I , Gomes, J  F , and Iivari, M  (2016)  Future micro operators business models in 5G  The Business & Management Review, 7, 143 
 Mitola, J , Guerci, J , Reed, J , Yao, Y  D , Chen, Y , Clancy, T , and Guo, Y  (2014)  Accelerating 5G QoE via public-private spectrum sharing  IEEE Communications Magazine, 52, 77–85 
 Casadesus-Masanell, R , and Llanes, G  (2011)  Mixed source  Manage  Sci  57, 1212–1230 
 Mason, J  (2002)  Qualitative researching  Sage 
 Miles, M  B , and Huberman, A  M  (1994)  Qualitative data analysis: An expanded sourcebook  Sage 
Julius Francis Gomes is pursuing his Ph D  in international business from the University of Oulu  He currently works at the Oulu Business School as a Doctoral Student to research the futuristic business models for digital intensive industries  His research focuses on using business models as a mean to look in to future industries  He is interested to research business ecosystems in different contexts like cyber security, healthcare, future’s network etc  with a business model perspective  He received his M Sc  (2015) in international business from the University of Oulu  Prior to that he acquired MBA (2011) specializing in managing information systems in business applications  Previously, he has also enjoyed about three years in a top tier bank in Bangladesh as a channel innovator 
Marika Iivari is a postdoctoral researcher at the Martti Ahtisaari Institute within Oulu Business School  She defended her doctoral dissertation on business models in ecosystemic contexts  She holds M Sc  in International Business from the Ulster University, Northern Ireland  Her research interests are in the areas of open innovation, business models and strategy in the context of innovation ecosystems and smart cities, digital and ICT business ecosystems  She has been involved in several research projects around 5G and the Internet of Things, most recently in the health care sector  She is also an active member of the Business Model Community, the Open Innovation Community and the Society for Collaborative Networks 
Petri Ahokangas received his M Sc  (1992) and D Sc  (1998) degrees from the University Vaasa, Finland  He is currently Adjunct Professor (International software entrepreneurship) and Senior research fellow at Martti Ahtisaari Institute, Oulu Business School, University of Oulu, Finland  His research interests are in how innovation and technological change affect international business creation, transformation, and strategies in highly technology – intensive or software – intensive business domains  He has over 100 publications in scientific journals, books, conference proceedings, and other reports  He is actively working in several ICT-focused research consortia leading the business-related research streams 
Lauri Isotalo has received his M Sc  from Helsinki University of Technology (currently Aalto University) in 1992  He has also a postgraduate Diploma in Business Administration  At first Lauri worked in Nokia Corp  in Mobile Technology & System Marketing unit specializing in Intelligent Networks  In 1992 he joined Elisa Corp  where he has held several managerial positions in value added services business, system and process security and mobile network development  Since 2005 Lauri has also led Elisa SME teams in various international collaboration projects and acquired a deep knowledge of the cyber security of legacy telecommunication networks, ip core, access networks, user terminals and modern virtualized data center IT platforms/cloud systems  From 2014 Lauri has headed SDN&NFV development in Elisa 
Riikka Niemelä, M Sc , MHSc , is a cross-disciplinary health-tech professional who obtained her degrees in Electrical Engineering (Master of Science) and Medical technology (Master of Health Sciences) from the University of Oulu, Finland  After R&D engineering, she worked as a research assistant to research the national eHealth development of the Finnish healthcare  Thereafter, she has been researching and promoting the adaptation of connected health technologies in surgical processes of a Nordic future hospital, resulting in scientific publications  Currently, she works as a project manager in Tuttlingen, Germany – the world center of Medical Technology – to generate R&D and innovation projects in cooperation with the ICT and LifeScience companies from Oulu, Finland  Her aim is to promote the digitalization and internationalization of the both high-tech regions and to generate innovations serving the increasing demands for healthcare 
Journal of ICT, Vol  5_1, 107–128 
Context 3: Vitamin K - Wikipedia
(Redirected from Vitamin k)
This article needs more medical references for verification or relies too heavily on primary sources  Please review the contents of the article and add the appropriate references if you can  Unsourced or poorly sourced material may be challenged and removed  (November 2015)
This article is about the family of vitamers  For vitamin K1 the form usually used as a supplement, see Phytomenadione 
Vitamin K structures  MK-4 and MK-7 are both subtypes of K2 
Vitamin K deficiency, Warfarin overdose
Vitamin K is a group of structurally similar, fat-soluble vitamins the human body requires for complete synthesis of certain proteins that are prerequisites for blood coagulation and which the body also needs for controlling binding of calcium in bones and other tissues  The vitamin K-related modification of the proteins allows them to bind calcium ions, which they cannot do otherwise  Without vitamin K, blood coagulation is seriously impaired, and uncontrolled bleeding occurs  Low levels of vitamin K also weaken bones and promote calcification of arteries and other soft tissues[citation needed] 
Chemically, the vitamin K family comprises 2-methyl-1,4-naphthoquinone (3-) derivatives  Vitamin K includes two natural vitamers: vitamin K1 and vitamin K2 [1] Vitamin K2, in turn, consists of a number of related chemical subtypes, with differing lengths of carbon side chains made of isoprenoid groups of atoms 
Vitamin K1, also known as phylloquinone, is made by plants, and is found in highest amounts in green leafy vegetables because it is directly involved in photosynthesis  It may be thought of as the plant form of vitamin K  It is active as a vitamin in animals and performs the classic functions of vitamin K, including its activity in the production of blood-clotting proteins  Animals may also convert it to vitamin K2 
Bacteria in the gut flora can also convert K1 into vitamin K2  In addition, bacteria typically lengthen the isoprenoid side chain of vitamin K2 to produce a range of vitamin K2 forms, most notably the MK-7 to MK-11 homologues of vitamin K2  All forms of K2 other than MK-4 can only be produced by bacteria, which use these forms in anaerobic respiration  The MK-7 and other bacterially derived forms of vitamin K2 exhibit vitamin K activity in animals, but MK-7's extra utility over MK-4, if any, is unclear and is a matter of investigation 
Three synthetic types of vitamin K are known: vitamins K3, K4, and K5  Although the natural K1 and all K2 homologues and synthetic K4 and K5 have proven nontoxic, the synthetic form K3 (menadione) has shown toxicity [2]
1 2 Cardiovascular health
1 4 Coumarin poisoning
4 1 Conversion of vitamin K1 to vitamin K2
4 2 Vitamin K2
6 Absorption and dietary need
7 Dietary reference intake
10 Biochemistry
10 1 Function in animals
10 2 Gamma-carboxyglutamate proteins
10 3 Methods of assessment
10 4 Function in bacteria
11 Injection in newborns
11 3 Controversy
A review of 2014 concluded that there is positive evidence that monotherapy using MK-4, one of the forms of Vitamin K2, reduces fracture incidence in post-menopausal women with osteoporosis, and suggested further research on the combined use of MK-4 with bisphosphonates  In contrast, an earlier review article of 2013 concluded that there is no good evidence that vitamin K supplementation helps prevent osteoporosis or fractures in postmenopausal women [3]
A Cochrane systematic review of 2006 suggested that supplementation with Vitamin K1 and with MK4 reduces bone loss; in particular, a strong effect of MK-4 on incident fractures among Japanese patients was emphasized [4]
A review article of 2016 suggested to consider, as one of several measures for bone health, increasing the intake of foods rich in vitamins K1 and K2 [5]
Cardiovascular health[edit]
Adequate intake of vitamin K is associated with the inhibition of arterial calcification and stiffening,[6] but there have been few interventional studies and no good evidence that vitamin K supplementation is of any benefit in the primary prevention of cardiovascular disease [7]
One 10-year population study, the Rotterdam Study, did show a clear and significant inverse relationship between the highest intake levels of menaquinone (mainly MK-4 from eggs and meat, and MK-8 and MK-9 from cheese) and cardiovascular disease and all-cause mortality in older men and women [8]
Vitamin K has been promoted in supplement form with claims it can slow tumor growth; there is however no good medical evidence that supports such claims [9]
Coumarin poisoning[edit]
Vitamin K is part of the suggested treatment regime for poisoning by rodenticide (coumarin poisoning) [10]
Although allergic reaction from supplementation is possible, no known toxicity is associated with high doses of the phylloquinone (vitamin K1) or menaquinone (vitamin K2) forms of vitamin K, so no tolerable upper intake level (UL) has been set [11]
Blood clotting (coagulation) studies in humans using 45 mg per day of vitamin K2 (as MK-4)[12] and even up to 135 mg per day (45 mg three times daily) of K2 (as MK-4),[13] showed no increase in blood clot risk  Even doses in rats as high as 250 mg/kg, body weight did not alter the tendency for blood-clot formation to occur [14]
Unlike the safe natural forms of vitamin K1 and vitamin K2 and their various isomers, a synthetic form of vitamin K, vitamin K3 (menadione), is demonstrably toxic at high levels  The U S  FDA has banned this form from over-the-counter sale in the United States because large doses have been shown to cause allergic reactions, hemolytic anemia, and cytotoxicity in liver cells [2]
Phylloquinone (K1)[15][16] or menaquinone (K2) are capable of reversing the anticoagulant activity of the anticoagulant warfarin (tradename Coumadin)  Warfarin works by blocking recycling of vitamin K, so that the body and tissues have lower levels of active vitamin K, and thus a deficiency of vitamin K 
Supplemental vitamin K (for which oral dosing is often more active than injectable dosing in human adults) reverses the vitamin K deficiency caused by warfarin, and therefore reduces the intended anticoagulant action of warfarin and related drugs [17] Sometimes small amounts of vitamin K are given orally to patients taking warfarin so that the action of the drug is more predictable [17] The proper anticoagulant action of the drug is a function of vitamin K intake and drug dose, and due to differing absorption must be individualized for each patient [citation needed] The action of warfarin and vitamin K both require two to five days after dosing to have maximum effect, and neither warfarin or vitamin K shows much effect in the first 24 hours after they are given [18]
The newer anticoagulants dabigatran and rivaroxaban have different mechanisms of action that do not interact with vitamin K, and may be taken with supplemental vitamin K [19][20]
Vitamin K2 (menaquinone)  In menaquinone, the side chain is composed of a varying number of isoprenoid residues  The most common number of these residues is four, since animal enzymes normally produce menaquinone-4 from plant phylloquinone 
A sample of phytomenadione for injection, also called phylloquinone
The three synthetic forms of vitamin K are vitamins K3 (menadione), K4, and K5, which are used in many areas, including the pet food industry (vitamin K3) and to inhibit fungal growth (vitamin K5) [21]
Conversion of vitamin K1 to vitamin K2[edit]
Vitamin K1 (phylloquinone) – both forms of the vitamin contain a functional naphthoquinone ring and an aliphatic side chain  Phylloquinone has a phytyl side chain 
The MK-4 form of vitamin K2 is produced by conversion of vitamin K1 in the testes, pancreas, and arterial walls [22] While major questions still surround the biochemical pathway for this transformation, the conversion is not dependent on gut bacteria, as it occurs in germ-free rats[23][24] and in parenterally-administered K1 in rats [25][26] In fact, tissues that accumulate high amounts of MK-4 have a remarkable capacity to convert up to 90% of the available K1 into MK-4 [27][28] There is evidence that the conversion proceeds by removal of the phytyl tail of K1 to produce menadione as an intermediate, which is then condensed with an activated geranylgeranyl moiety (see also prenylation) to produce vitamin K2 in the MK-4 (menatetrione) form [29]
Vitamin K2[edit]
Main article: Vitamin K2
Vitamin K2 (menaquinone) includes several subtypes  The two subtypes most studied are menaquinone-4 (menatetrenone, MK-4) and menaquinone-7 (MK-7) 
Vitamin K1, the precursor of most vitamin K in nature, is a stereoisomer of phylloquinone, an important chemical in green plants, where it functions as an electron acceptor in photosystem I during photosynthesis  For this reason, vitamin K1 is found in large quantities in the photosynthetic tissues of plants (green leaves, and dark green leafy vegetables such as romaine lettuce, kale and spinach), but it occurs in far smaller quantities in other plant tissues (roots, fruits, etc )  Iceberg lettuce contains relatively little  The function of phylloquinone in plants appears to have no resemblance to its later metabolic and biochemical function (as "vitamin K") in animals, where it performs a completely different biochemical reaction 
Vitamin K (in animals) is involved in the carboxylation of certain glutamate residues in proteins to form gamma-carboxyglutamate (Gla) residues  The modified residues are often (but not always) situated within specific protein domains called Gla domains  Gla residues are usually involved in binding calcium, and are essential for the biological activity of all known Gla proteins [30]
At this time[update], 17 human proteins with Gla domains have been discovered, and they play key roles in the regulation of three physiological processes:
Blood coagulation: prothrombin (factor II), factors VII, IX, and X, and proteins C, S, and Z[31]
Bone metabolism: osteocalcin, also called bone Gla protein (BGP), matrix Gla protein (MGP),[32] periostin,[33] and the recently discovered Gla-rich protein (GRP) [34][35]
Vascular biology: growth arrest-specific protein 6 (Gas6)[36]
Unknown function: proline-rich γ-carboxyglutamyl proteins (PRGPs) 1 and 2, and transmembrane γ-carboxy glutamyl proteins (TMGs) 3 and 4 [37]
Like other lipid-soluble vitamins (A, D and E), vitamin K is stored in the fatty tissue of the human body 
Absorption and dietary need[edit]
Previous theory held that dietary deficiency is extremely rare unless the small intestine was heavily damaged, resulting in malabsorption of the molecule  Another at-risk group for deficiency were those subject to decreased production of K2 by normal intestinal microbiota, as seen in broad spectrum antibiotic use [38] Taking broad-spectrum antibiotics can reduce vitamin K production in the gut by nearly 74% in people compared with those not taking these antibiotics [39] Diets low in vitamin K also decrease the body's vitamin K concentration [40] Those with chronic kidney disease are at risk for vitamin K deficiency, as well as vitamin D deficiency, and particularly those with the apoE4 genotype [41] Additionally, in the elderly there is a reduction in vitamin K2 production [42]
The National Academy of Medicine (NAM) updated an estimate of what constitutes an adequate intake (AI) for vitamin K in 2001  The NAM does not distinguish between K1 and K2 – both are counted as vitamin K  At that time there was not sufficient evidence to set the more rigorous estimated average requirement (EAR) or recommended dietary allowance (RDA) given for most of the essential vitamins and minerals  The current daily AIs for vitamin K for adult women and men are 90 μg and 120 μg respectively  The AI for pregnancy and lactation is 90 μg  For infants up to 12 months the AI is 2–2 5 μg, and for children aged 1 to 18 years the AI increases with age from 30 to 75 μg  As for safety, the FNB also sets tolerable upper intake levels (known as ULs) for vitamins and minerals when evidence is sufficient  In the case of vitamin K no UL is set, as evidence for adverse effects is not sufficient  Collectively EARs, RDAs, AIs and ULs are referred to as dietary reference intakes [43] The European Food Safety Authority reviewed the same safety question and did not set an UL [44]
For U S  food and dietary supplement labeling purposes, the amount in a serving is expressed as a percentage of daily value (%DV)  For vitamin K labeling purposes the daily value was 80 μg, but as of May 2016 it has been revised upwards to 120 μg  A table of the pre-change adult daily values is provided at reference daily intake  Food and supplement companies have until 28 July 2018 to comply with the change 
See also: Vitamin K2 § Dietary sources
K1 (μg)[45]
Kale, cooked
Collards, cooked
Collards, raw
Swiss chard, cooked
Swiss chard, raw
Turnip greens, raw
Romaine lettuce, raw
Table from "Important information to know when you are taking: Warfarin (Coumadin) and Vitamin K", Clinical Center, National Institutes of Health Drug Nutrient Interaction Task Force [46]
Vitamin K1 is found chiefly in leafy green vegetables such as dandelion greens (which contain 778 4 μg per 100 g, or 741% of the recommended daily amount), spinach, swiss chard, lettuce and Brassica vegetables (such as cabbage, kale, cauliflower, broccoli, and brussels sprouts) and often the absorption is greater when accompanied by fats such as butter or oils; some fruits, such as avocados, kiwifruit and grapes, are also high in vitamin K  By way of reference, two tablespoons of parsley contains 153% of the recommended daily amount of vitamin K [47] Some vegetable oils, notably soybean oil, contain vitamin K, but at levels that would require relatively large calorie consumption to meet the USDA-recommended levels [48] colonic bacteria synthesize a significant portion of humans' vitamin K needs; newborns often receive a vitamin K shot at birth to tide them over until their colons become colonized at five to seven days of age from the consumption of breast milk 
The tight binding of vitamin K1 to thylakoid membranes in chloroplasts makes it less bioavailable  For example, cooked spinach has a 5% bioavailability of phylloquinone, however, fat added to it increases bioavailability to 13% due to the increased solubility of vitamin K in fat [49]
Main article: Vitamin K deficiency
Average diets are usually not lacking in vitamin K, and primary deficiency is rare in healthy adults  Newborn infants are at an increased risk of deficiency  Other populations with an increased prevalence of vitamin K deficiency include those who suffer from liver damage or disease (e g  alcoholics), cystic fibrosis, or inflammatory bowel diseases, or have recently had abdominal surgeries  Secondary vitamin K deficiency can occur in people with bulimia, those on stringent diets, and those taking anticoagulants  Other drugs associated with vitamin K deficiency include salicylates, barbiturates, and cefamandole, although the mechanisms are still unknown  Vitamin K1 deficiency can result in coagulopathy, a bleeding disorder [50]Symptoms of K1 deficiency include anemia, bruising, nosebleeds and bleeding of the gums in both sexes, and heavy menstrual bleeding in women 
Osteoporosis[51][52] and coronary heart disease[53][54] are strongly associated with lower levels of K2 (menaquinone)  Vitamin K2 (as menaquinones MK-4 through MK-10) intake level is inversely related to severe aortic calcification and all-cause mortality [8]
Function in animals[edit]
Mechanism of action of vitamin K1 
The function of vitamin K2 in the animal cell is to add a carboxylic acid functional group to a glutamate (Glu) amino acid residue in a protein, to form a gamma-carboxyglutamate (Gla) residue  This is a somewhat uncommon posttranslational modification of the protein, which is then known as a "Gla protein"  The presence of two −COOH (carboxylic acid) groups on the same carbon in the gamma-carboxyglutamate residue allows it to chelate calcium ions  The binding of calcium ions in this way very often triggers the function or binding of Gla-protein enzymes, such as the so-called vitamin K-dependent clotting factors discussed below 
Within the cell, vitamin K undergoes electron reduction to a reduced form called vitamin K hydroquinone, catalyzed by the enzyme vitamin K epoxide reductase (VKOR) [55] Another enzyme then oxidizes vitamin K hydroquinone to allow carboxylation of Glu to Gla; this enzyme is called gamma-glutamyl carboxylase[56][57] or the vitamin K-dependent carboxylase  The carboxylation reaction only proceeds if the carboxylase enzyme is able to oxidize vitamin K hydroquinone to vitamin K epoxide at the same time  The carboxylation and epoxidation reactions are said to be coupled  Vitamin K epoxide is then reconverted to vitamin K by VKOR  The reduction and subsequent reoxidation of vitamin K coupled with carboxylation of Glu is called the vitamin K cycle [58] Humans are rarely deficient in vitamin K1 because, in part, vitamin K1 is continuously recycled in cells [59]
Warfarin and other 4-hydroxycoumarins block the action of VKOR [60] This results in decreased concentrations of vitamin K and vitamin K hydroquinone in tissues, such that the carboxylation reaction catalyzed by the glutamyl carboxylase is inefficient  This results in the production of clotting factors with inadequate Gla  Without Gla on the amino termini of these factors, they no longer bind stably to the blood vessel endothelium and cannot activate clotting to allow formation of a clot during tissue injury  As it is impossible to predict what dose of warfarin will give the desired degree of clotting suppression, warfarin treatment must be carefully monitored to avoid overdose 
Gamma-carboxyglutamate proteins[edit]
Main article: Gla domain
The following human Gla-containing proteins ("Gla proteins") have been characterized to the level of primary structure: blood coagulation factors II (prothrombin), VII, IX, and X, anticoagulant proteins C and S, and the factor X-targeting protein Z  The bone Gla protein osteocalcin, the calcification-inhibiting matrix Gla protein (MGP), the cell growth regulating growth arrest specific gene 6 protein (Gas6), and the four transmembrane Gla proteins (TMGPs), the function of which is at present unknown  Gas6 can function as a growth factor to activate the Axl receptor tyrosine kinase and stimulate cell proliferation or prevent apoptosis in some cells  In all cases in which their function was known, the presence of the Gla residues in these proteins turned out to be essential for functional activity 
Gla proteins are known to occur in a wide variety of vertebrates: mammals, birds, reptiles, and fish  The venom of a number of Australian snakes acts by activating the human blood-clotting system  In some cases, activation is accomplished by snake Gla-containing enzymes that bind to the endothelium of human blood vessels and catalyze the conversion of procoagulant clotting factors into activated ones, leading to unwanted and potentially deadly clotting 
Another interesting class of invertebrate Gla-containing proteins is synthesized by the fish-hunting snail Conus geographus [61] These snails produce a venom containing hundreds of neuroactive peptides, or conotoxins, which is sufficiently toxic to kill an adult human  Several of the conotoxins contain two to five Gla residues [62]
Methods of assessment[edit]
Vitamin K status can be assessed by:
The prothrombin time (PT) test measures the time required for blood to clot  A blood sample is mixed with citric acid and put in a fibrometer; delayed clot formation indicates a deficiency  This test is insensitive to mild deficiency, as the values do not change until the concentration of prothrombin in the blood has declined by at least 50% [63]
Undercarboxylated prothrombin (PIVKA-II); in a study of 53 newborns, found "PT (prothrombin time) is a less sensitive marker than PIVKA II",[64] and as indicated above, PT is unable to detect subclinical deficiencies that can be detected with PIVKA-II testing 
Plasma phylloquinone was found to be positively correlated with phylloquinone intake in elderly British women, but not men,[65] but an article by Schurgers et al  reported no correlation between FFQ[further explanation needed] and plasma phylloquinone [66]
Urinary γ-carboxyglutamic acid responds to changes in dietary vitamin K intake  Several days are required before any change can be observed  In a study by Booth et al , increases of phylloquinone intakes from 100 μg to between 377 and 417 μg for five days did not induce a significant change  Response may be age-specific [67]
Undercarboxylated osteocalcin (UcOc) levels have been inversely correlated with stores of vitamin K[68] and bone strength in developing rat tibiae  Another study following 78 post-menopausal Korean women found a supplement regimen of vitamins K and D, and calcium, but not a regimen of vitamin D and calcium, was inversely correlated with reduced UcOc levels [69]
Function in bacteria[edit]
Many bacteria, such as Escherichia coli found in the large intestine, can synthesize vitamin K2 (menaquinone-7 or MK-7, up to MK-11),[70] but not vitamin K1 (phylloquinone)  In these bacteria, menaquinone transfers two electrons between two different small molecules, during oxygen-independent metabolic energy production processes (anaerobic respiration) [71] For example, a small molecule with an excess of electrons (also called an electron donor) such as lactate, formate, or NADH, with the help of an enzyme, passes two electrons to menaquinone  The menaquinone, with the help of another enzyme, then transfers these two electrons to a suitable oxidant, such fumarate or nitrate (also called an electron acceptor)  Adding two electrons to fumarate or nitrate converts the molecule to succinate or nitrite plus water, respectively 
Some of these reactions generate a cellular energy source, ATP, in a manner similar to eukaryotic cell aerobic respiration, except the final electron acceptor is not molecular oxygen, but fumarate or nitrate  In aerobic respiration, the final oxidant is molecular oxygen (O2), which accepts four electrons from an electron donor such as NADH to be converted to water  E  coli, as facultative anaerobes, can carry out both aerobic respiration and menaquinone-mediated anaerobic respiration 
Injection in newborns[edit]
The blood clotting factors of newborn babies are roughly 30–60% that of adult values; this may be due to the reduced synthesis of precursor proteins and the sterility of their guts  Human milk contains 1–4 μg/L of vitamin K1, while formula-derived milk can contain up to 100 μg/L in supplemented formulas  Vitamin K2 concentrations in human milk appear to be much lower than those of vitamin K1  Occurrence of vitamin K deficiency bleeding in the first week of the infant's life is estimated at 0 25–1 7%, with a prevalence of 2–10 cases per 100,000 births [72] Premature babies have even lower levels of the vitamin, so they are at a higher risk from this deficiency 
Bleeding in infants due to vitamin K deficiency can be severe, leading to hospitalization, blood transfusions, brain damage, and death  Supplementation can prevent most cases of vitamin K deficiency bleeding in the newborn  Intramuscular administration is more effective in preventing late vitamin K deficiency bleeding than oral administration [73][74]
As a result of the occurrences of vitamin K deficiency bleeding, the Committee on Nutrition of the American Academy of Pediatrics has recommended 0 5–1 mg of vitamin K1 be administered to all newborns shortly after birth [74]
In the UK vitamin K supplementation is recommended for all newborns within the first 24 hours [75] This is usually given as a single intramuscular injection of 1 mg shortly after birth but as a second-line option can be given by three oral doses over the first month [76]
Controversy arose in the early 1990s regarding this practice, when two studies suggested a relationship between parenteral administration of vitamin K and childhood cancer,[77] however, poor methods and small sample sizes led to the discrediting of these studies, and a review of the evidence published in 2000 by Ross and Davies found no link between the two [78] Doctors reported emerging concerns in 2013,[79] after treating children for serious bleeding problems  They cited lack-of newborn vitamin K administration, as the reason that the problems occurred, and recommended that breastfed babies could have an increased risk unless they receive a preventative dose 
In the early 1930s, Danish scientist Henrik Dam investigated the role of cholesterol by feeding chickens a cholesterol-depleted diet [80] He initially replicated experiments reported by scientists at the Ontario Agricultural College (OAC) [81] McFarlane, Graham and Richardson, working on the chick feed program at OAC, had used chloroform to remove all fat from chick chow  They noticed that chicks fed only fat-depleted chow developed hemorrhages and started bleeding from tag sites [82] Dam found that these defects could not be restored by adding purified cholesterol to the diet  It appeared that – together with the cholesterol – a second compound had been extracted from the food, and this compound was called the coagulation vitamin  The new vitamin received the letter K because the initial discoveries were reported in a German journal, in which it was designated as Koagulationsvitamin  Edward Adelbert Doisy of Saint Louis University did much of the research that led to the discovery of the structure and chemical nature of vitamin K [83] Dam and Doisy shared the 1943 Nobel Prize for medicine for their work on vitamin K (K1 and K2) published in 1939  Several laboratories synthesized the compound(s) in 1939 [84]
For several decades, the vitamin K-deficient chick model was the only method of quantifying vitamin K in various foods: the chicks were made vitamin K-deficient and subsequently fed with known amounts of vitamin K-containing food  The extent to which blood coagulation was restored by the diet was taken as a measure for its vitamin K content  Three groups of physicians independently found this: Biochemical Institute, University of Copenhagen (Dam and Johannes Glavind), University of Iowa Department of Pathology (Emory Warner, Kenneth Brinkhous, and Harry Pratt Smith), and the Mayo Clinic (Hugh Butt, Albert Snell, and Arnold Osterberg) [85]
The first published report of successful treatment with vitamin K of life-threatening hemorrhage in a jaundiced patient with prothrombin deficiency was made in 1938 by Smith, Warner, and Brinkhous [86]
The precise function of vitamin K was not discovered until 1974, when three laboratories (Stenflo et al ,[87] Nelsestuen et al ,[88] and Magnusson et al [89]) isolated the vitamin K-dependent coagulation factor prothrombin (factor II) from cows that received a high dose of a vitamin K antagonist, warfarin  It was shown that, while warfarin-treated cows had a form of prothrombin that contained 10 glutamate (Glu) amino acid residues near the amino terminus of this protein, the normal (untreated) cows contained 10 unusual residues that were chemically identified as γ-carboxyglutamate (Gla)  The extra carboxyl group in Gla made clear that vitamin K plays a role in a carboxylation reaction during which Glu is converted into Gla 
The biochemistry of how vitamin K is used to convert Glu to Gla has been elucidated over the past thirty years in academic laboratories throughout the world 
^ "Vitamin K Overview"  University of Maryland Medical Center  ^ a b Higdon, Jane (Feb 2008)  "Vitamin K"  Linus Pauling Institute, Oregon State University  Retrieved 12 Apr 2008  ^ Hamidi, M  S ; Gajic-Veljanoski, O ; Cheung, A  M  (2013)  "Vitamin K and bone health"  Journal of Clinical Densitometry (Review)  16 (4): 409–413  doi:10 1016/j jocd 2013 08 017  PMID 24090644  ^ Cockayne, S ; Adamson, J ; Lanham-New, S ; Shearer, M  J ; Gilbody, S; Torgerson, D  J  (Jun 2006)  "Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials"  Archives of Internal Medicine (Review)  166 (12): 1256–1261  doi:10 1001/archinte 166 12 1256  PMID 16801507  ^ O'Keefe, J  H ; Bergman, N ; Carrera Bastos, P ; Fontes Villalba, M ; Di Nicolantonio, J  J ; Cordain, L  (2016)  "Nutritional strategies for skeletal and cardiovascular health: hard bones, soft arteries, rather than vice versa"  Open Heart (Review)  3 (1): e000325  doi:10 1136/openhrt-2015-000325  PMC 4809188  PMID 27042317  ^ Maresz, K  (Feb 2015)  "Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health"  Integrative Medicine (Review)  14 (1): 34–39  PMC 4566462  PMID 26770129  ^ Hartley, L ; Clar, C ; Ghannam, O ; Flowers, N ; Stranges, S ; Rees, K  (Sep 2015)  "Vitamin K for the primary prevention of cardiovascular disease"  The Cochrane Database of Systematic Reviews (Systematic review)  9 (9): CD011148  doi:10 1002/14651858 CD011148 pub2  PMID 26389791  ^ a b Geleijnse, J  M ; Vermeer, C ; Grobbee, D  E ; Schurgers, L  J ; Knapen, M  H ; van der Meer, I  M ; Hofman, A ; Witteman, J  C  (Nov 2004)  "Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study"  Journal of Nutrition  134 (11): 3100–3105  PMID 15514282  ^ Ades, T  B , ed  (2009)  "Vitamin K"  American Cancer Society Complete Guide to Complementary and Alternative Cancer Therapies (2nd ed )  American Cancer Society  pp  558–563  ISBN 978-0-944235-71-3  ^ Lung, D  (Dec 2015)  Tarabar, A , ed  "Rodenticide Toxicity Treatment & Management"  Medscape  WebMD  ^ Rasmussen, S  E ; Andersen, N  L ; Dragsted, L  O ; Larsen, J  C  (Mar 2006)  "A safe strategy for addition of vitamins and minerals to foods"  European Journal of Nutrition  45 (3): 123–135  doi:10 1007/s00394-005-0580-9  PMID 16200467  ^ Ushiroyama, T ; Ikeda, A ; Ueki, M (Mar 2002)  "Effect of continuous combined therapy with vitamin K2 and vitamin D3 on bone mineral density and coagulofibrinolysis function in postmenopausal women"  Maturitas  41 (3): 211–221  doi:10 1016/S0378-5122(01)00275-4  PMID 11886767  ^ Asakura, H ; Myou, S ; Ontachi, Y ; Mizutani, T ; Kato, M ; Saito, M ; Morishita, E ; Yamazaki, M ; Nakao, S  (Dec 2001)  "Vitamin K administration to elderly patients with osteoporosis induces no hemostatic activation, even in those with suspected vitamin K deficiency"  Osteoporosis International  12 (12): 996–1000  doi:10 1007/s001980170007  PMID 11846334  ^ Ronden, J  E ; Groenen-van Dooren, M  M ; Hornstra, G ; Vermeer, C  (Jul 1997)  "Modulation of arterial thrombosis tendency in rats by vitamin K and its side chains"  Atherosclerosis  132 (1): 61–67  doi:10 1016/S0021-9150(97)00087-7  PMID 9247360  ^ Ansell, J ; Hirsh, J ; Poller, L ; Bussey, H ; Jacobson, A ; Hylek, E (Sep 2004)  "The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy"  Chest  126 (3 Suppl ): 204S–233S  doi:10 1378/chest 126 3_suppl 204S  PMID 15383473  ^ Crowther, M  A ; Douketis, J  D ; Schnurr, T ; Steidl, L ; Mera, V ; Ultori, C ; Venco, A ; Ageno, W  (Aug 2002)  "Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy  A randomized, controlled trial"  Annals of Internal Medicine  137 (4): 251–254  doi:10 7326/0003-4819-137-4-200208200-00009  PMID 12186515  ^ a b "Important Information to Know When You Are Taking: Warfarin (Coumadin) and Vitamin K" (PDF)  National Institute of Health Clinical Center Drug-Nutrient Interaction Task Force  Retrieved 17 Apr 2015  ^ "Guidelines For Warfarin Reversal With Vitamin K" (PDF)  American Society of Health-System Pharmacists  Retrieved 17 Apr 2015  ^ "Pradaxa Drug Interactions"  Pradaxapro com  19 Mar 2012  Retrieved 21 Apr 2013  ^ Bauersachs, R ; Berkowitz, S  D ; Brenner, B ; Buller, H  R ; Decousus, H ; Gallus, A  S ; Lensing, A  W ; Misselwitz, F ; Prins, M  H ; Raskob, G  E ; Segers, A ; Verhamme, P ; Wells, P ; Agnelli, G ; Bounameaux, H ; Cohen, A ; Davidson, B  L ; Piovella, F ; Schellong, S  (Dec 2010)  "Oral rivaroxaban for symptomatic venous thromboembolism"  New England Journal of Medicine  363 (26): 2499–2510  doi:10 1056/NEJMoa1007903  PMID 21128814  ^ McGee, W  (1 Feb 2007)  "Vitamin K"  MedlinePlus  Retrieved 2 Apr 2009  ^ Shearer, M  J ; Newman, P  (Oct 2008)  "Metabolism and cell biology of vitamin K"  Thrombosis and Haemostasis  100 (4): 530–547  doi:10 1160/TH08-03-0147  PMID 18841274  ^ Davidson, R  T ; Foley, A  L ; Engelke, J  A ; Suttie, J  W  (Feb 1998)  "Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria"  Journal of Nutrition  128 (2): 220–223  PMID 9446847  ^ Ronden, J  E ; Drittij-Reijnders, M  J ; Vermeer, C ; Thijssen, H  H  (Jan 1998)  "Intestinal flora is not an intermediate in the phylloquinone–menaquinone-4 conversion in the rat"  Biochimica et Biophysica Acta  1379 (1): 69–75  doi:10 1016/S0304-4165(97)00089-5  PMID 9468334  ^ Thijssen, H   H ; Drittij-Reijnders, M  J  (Sep 1994)  "Vitamin K distribution in rat tissues: dietary phylloquinone is a source of tissue menaquinone-4"  The British Journal of Nutrition  72 (3): 415–425  doi:10 1079/BJN19940043  PMID 7947656  ^ Will, B  H ; Usui, Y ; Suttie, J  W  (Dec 1992)  "Comparative metabolism and requirement of vitamin K in chicks and rats"  Journal of Nutrition  122 (12): 2354–2360  PMID 1453219  ^ Davidson, R  T ; Foley, A  L ; Engelke, J  A ; Suttie, J  W  (Feb 1998)  "Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria"  Journal of Nutrition  128 (2): 220–223  PMID 9446847  ^ Ronden, J  E ; Drittij-Reijnders, M  J ; Vermeer, C ; Thijssen, H  H  (Jan 1998)  "Intestinal flora is not an intermediate in the phylloquinone-menaquinone-4 conversion in the rat"  Biochimica et Biophysica Acta  1379 (1): 69–75  doi:10 1016/S0304-4165(97)00089-5  PMID 9468334  ^ Al Rajabi, Ala (2011)  The Enzymatic Conversion of Phylloquinone to Menaquinone-4 (PhD thesis)  Tufts University, Friedman School of Nutrition Science and Policy  ^ Furie, B ; Bouchard, B  A ; Furie, B  C  (Mar 1999)  "Vitamin K-dependent biosynthesis of gamma-carboxyglutamic acid"  Blood  93 (6): 1798–1808  PMID 10068650  ^ Mann, K  G  (Aug 1999)  "Biochemistry and physiology of blood coagulation"  Thrombosis and Haemostasis  82 (2): 165–174  PMID 10605701  ^ Price, P  A  (1988)  "Role of vitamin-K-dependent proteins in bone metabolism"  Annual Review of Nutrition  8: 565–583  doi:10 1146/annurev nu 08 070188 003025  PMID 3060178  ^ Coutu, D  L ; Wu, J  H ; Monette, A ; Rivard, G  E ; Blostein, M  D ; Galipeau, J (Jun 2008)  "Periostin, a member of a novel family of vitamin K-dependent proteins, is expressed by mesenchymal stromal cells"  Journal of Biological Chemistry  283 (26): 17991–18001  doi:10 1074/jbc M708029200  PMID 18450759  ^ Viegas, C  S ; Simes, D  C ; Laizé, V ; Williamson, M  K ; Price, P  A ; Cancela, M  L  (Dec 2008)  "Gla-rich protein (GRP), a new vitamin K-dependent protein identified from sturgeon cartilage and highly conserved in vertebrates"  Journal of Biological Chemistry



ground_truth: Centralized control of mobile devices and applications.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: Where was Margaret Way born and where did she die?

Read the following text and answer briefly.

Context 2: Margaret Way (b  Brisbane d  Cleveland, Queensland, Australia ) was an Australian writer of romance novels and women's fiction  A prolific author, Way wrote more than 120 novels since 1970, many through Mills & Boon, a romance imprint of British publisher Harlequin UK Ltd , owned by Harlequin Enterprises 

Biography
Before her marriage, she was a well-known pianist, teacher, vocal coach and accompanist  She began writing when her son, Laurence Way, was born, a friend took a pile of Mills & Boon books to her, she read all and decided that she also could write these types of novels  She began to write and promote her country with her stories set in Australia  She sold her first novels in 1970  Margaret Way lives with her family in her native Brisbane  Beginning in 2013, Margaret began to self-publish, releasing her first "e-book" mid-July 

Margaret died on the 10th of August 2022 in Cleveland, Queensland 

Bibliography

Single Novels
King Country (1970)
Blaze of Silk (1970)
The Time of the Jacaranda (1970)
Bauhinia Junction (1971)
Man from Bahl Bahla (1971)
Summer Magic (1971)
Return to Belle Amber (1971)
Ring of Jade (1972)
Copper Moon (1972)
Rainbow Bird (1972)
Man Like Daintree (1972)
Noonfire (1972)
Storm Over Mandargi (1973)
Wind River (1973)
Love Theme (1974)
McCabe's Kingdom (1974)
Sweet Sundown (1974)
Reeds of Honey (1975)
Storm Flower (1975)
Lesson in Loving (1975)
Flight into Yesterday (1976)
Red Cliffs of Malpara (1976)
Man on Half-moon (1976)
Swan's Reach (1976)
Mutiny in Paradise (1977)
One Way Ticket (1977)
Portrait of Jaime (1977)
Black Ingo (1977)
Awakening Flame (1978)
Wild Swan (1978)
Ring of Fire (1978)
Wake the Sleeping Tiger (1978)
Valley of the Moon (1979)
White Magnolia (1979)
Winds of Heaven (1979)
Blue Lotus (1979)
Butterfly and the Baron (1979)
Golden Puma (1980)
Temple of Fire (1980)
Lord of the High Valley (1980)
Flamingo Park (1980)
North of Capricorn (1981)
Season for Change (1981)
Shadow Dance (1981)
McIvor Affair (1981)
Home to Morning Star (1981)
Broken Rhapsody (1982)
The Silver Veil (1982)
Spellbound (1982)
Hunter's Moon (1982)
Girl at Cobalt Creek (1983)
No Alternative (1983)
House of Memories (1983)
Almost a Stranger (1984)
A place called Rambulara (1984)
Fallen Idol (1984)
Hunt the Sun (1985)
Eagle's Ridge (1985)
The Tiger's Cage (1986)
Innocent in Eden (1986)
Diamond Valley (1986)
Morning Glory (1988)
Devil Moon (1988)
Mowana Magic (1988)
Hungry Heart (1988)
Rise of an Eagle (1988)
One Fateful Summer (1993)
The Carradine Brand (1994)
Holding on to Alex (1997)
The Australian Heiress (1997)
Claiming His Child (1999)
The Cattleman's Bride (2000)
The Cattle Baron (2001)
The Husbands of the Outback (2001)
Secrets of the Outback (2002)
With This Ring (2003)
Innocent Mistress (2004)
Cattle Rancher, Convenient Wife (2007)
Outback Marriages (2007)
Promoted: Nanny to Wife (2007)
Cattle Rancher, Secret Son (2007)
Genni's Dilemma (2008)
Bride At Briar Ridge (2009)
Outback Heiress, Surprise Proposal (2009)
Cattle Baron, Nanny Needed (2009)

Legends of the Outback Series
Mail Order Marriage (1999)
The Bridesmaid's Wedding (2000)
The English Bride (2000)
A Wife at Kimbara (2000)

Koomera Crossing Series
Sarah's Baby (2003)
Runaway Wife (2003)
Outback Bridegroom (2003)
Outback Surrender (2003)
Home to Eden (2004)

McIvor Sisters Series
The Outback Engagement (2005)
Marriage at Murraree (2005)

Men Of The Outback Series
The Cattleman (2006)
The Cattle Baron's Bride (2006)
Her Outback Protector (2006)
The Horseman (2006)

Outback Marriages Series
Outback Man Seeks Wife (2007)
Cattle Rancher, Convenient Wife (2007)

Barons of the Outback Series Multi-Author
Wedding At Wangaree Valley (2008)
Bride At Briar's Ridge (2008)

Family Ties Multi-Author
Once Burned (1995)

Hitched! Multi-Author
A Faulkner Possession (1996)

Simply the Best Multi-Author
Georgia and the Tycoon (1997)

The Big Event Multi-Author
Beresford's Bride (1998)

Guardian Angels Multi-Author
Gabriel's Mission (1998)

Australians Series Multi-Author
7  Her Outback Man (1998)
17  Master of Maramba (2001)
19  Outback Fire (2001)
22  Mistaken Mistress (2002)
24  Outback Angel (2002)
33  The Australian Tycoon's Proposal (2004)
35  His Heiress Wife (2004)

Marrying the Boss Series Multi-Author
Boardroom Proposal (1999)

Contract Brides Series Multi-Author
Strategy for Marriage (2002)

Everlasting Love Series Multi-Author
Hidden Legacy (2008)

Diamond Brides Series Multi-Author
The Australian's Society Bride (2008)

Collections
Summer Magic / Ring of Jade / Noonfire (1981)
Wife at Kimbara / Bridesmaid's Wedding (2005)

Omnibus in Collaboration
Pretty Witch / Without Any Amazement / Storm Over Mandargi (1977) (with Lucy Gillen and Margaret Malcolm)
Dear Caliban / Heart of the Eagle / Swans' Reach (1978) (with Jane Donnelly and Elizabeth Graham)
The Bonds of Matrimony / Dragon Island / Reeds of Honey (1979) (with Elizabeth Hunter and Henrietta Reid)
The Man Outside / Castles in Spain / McCabe's Kingdom (1979) (with Jane Donnelly and Rebecca Stratton)
Winds From The Sea / Island of Darkness / Wind River (1979) (with Margaret Pargeter and Rebecca Stratton)
Moorland Magic / Tree of Idleness / Sweet Sundown (1980) (with Elizabeth Ashton and Elizabeth Hunter)
The Shifting Sands / Portrait of Jaime / Touched by Fire (1982) (with Jane Donnelly and Kay Thorpe)
Head of Chancery / Wild Heart / One-Way Ticket (1986) (with Betty Beaty and Doris Smith)
Heart of the Scorpion / The Winds of Heaven / Sweet Compulsion (1987) (with Janice Gray and Victoria Woolf)
One Brief Sweet Hour / Once More With Feeling / Blue Lotus (1990) (with Jane Arbor and Natalie Sparks)
Marry Me Cowboy (1995) (with Janet Dailey, Susan Fox and Anne McAllister)
Husbands on Horseback (1996) (with Diana Palmer)
Wedlocked (1999) (with Day Leclaire and Anne McAllister)
Mistletoe Magic (1999) (with Betty Neels and Rebecca Winters)
The Australians (2000) (with Helen Bianchin and Miranda Lee)
Weddings Down Under (2001) (with Helen Bianchin and Jessica Hart)
Outback Husbands (2002) (with Marion Lennox)
The Mother's Day Collection (2002) (with Helen Dickson and Kate Hoffmann)
Australian Nights (2003) (with Miranda Lee)
Outback Weddings (2003) (with Barbara Hannay)
Australian Playboys (2003) (with Helen Bianchin and Marion Lennox)
Australian Tycoons (2004) (with Emma Darcy and Marion Lennox)
A Mother's Day Gift (2004) (with Anne Ashley and Lucy Monroe)
White Wedding (2004) (with Judy Christenberry and Jessica Steele)
A Christmas Engagement (2004) (with Sara Craven and Jessica Matthews)
A Very Special Mother's Day (2005) (with Anne Herries)
All I Want for Christmas    (2005) (with Betty Neels and Jessica Steele)
The Mills and Boon Collection (2006) (with Caroline Anderson and Penny Jordan)
Outback Desire (2006) (with Emma Darcy and Carol Marinelli)
To Mum, with Love (2006) (with Rebecca Winters)
Australian Heroes (2007) (with Marion Lennox and Fiona McArthur)
Tall, Dark and Sexy (2008) (with Caroline Anderson and Helen Bianchin)
The Boss's Proposal (2008) (with Jessica Steele and Patricia Thayer)
Island Heat / Outback Man Seeks Wife / Prince's Forbidden Virgin / One Night Before Marriage / Their Lost-and-found Family / Single Dad's Marriage Wish (2008) (with Robyn Donald, Marion Lennox, Carol Marinelli, Sarah Mayberry and Anne Oliver)
Australian Billionaires (2009) (with Jennie Adams and Amy Andrews)
Cattle Baron : Nanny Needed / Bachelor Dad on Her Doorstep (2009) (with Michelle Douglas)

External links
Margaret Way at Harlequin Enterprises Ltd

Australian romantic fiction writers
Australian women novelists
Living people
Year of birth missing (living people)
Women romantic fiction writers
Context 3:  283 (52): 36655–36664  doi:10 1074/jbc M802761200  PMC 2605998  PMID 18836183  ^ Viegas, C  S ; Cavaco, S ; Neves, P  L ; Ferreira, A ; João, A ; Williamson, M  K ; Price, P  A ; Cancela, M  L ; Simes, D  C  (Dec 2009)  "Gla-rich protein is a novel vitamin K-dependent protein present in serum that accumulates at sites of pathological calcifications"  American Journal of Pathology  175 (6): 2288–2298  doi:10 2353/ajpath 2009 090474  PMC 2789615  PMID 19893032  ^ Hafizi, S ; Dahlbäck, B  (Dec 2006)  "Gas6 and protein S  Vitamin K-dependent ligands for the Axl receptor tyrosine kinase subfamily"  The FEBS Journal  273 (23): 5231–5244  doi:10 1111/j 1742-4658 2006 05529 x  PMID 17064312  ^ Kulman, J  D ; Harris, J  E ; Xie, L ; Davie, E  W  (May 2007)  "Proline-rich Gla protein 2 is a cell-surface vitamin K-dependent protein that binds to the transcriptional coactivator Yes-associated protein"  Proceedings of the National Academy of Sciences of the United States of America  104 (21): 8767–8772  doi:10 1073/pnas 0703195104  PMC 1885577  PMID 17502622  ^ "Vitamin K"  MedlinePlus  US National Library of Medicine, National Institutes of Health  Sep 2016  Retrieved 26 May 2009  ^ Conly, J; Stein, K  (Dec 1994)  "Reduction of vitamin K2 concentrations in human liver associated with the use of broad spectrum antimicrobials"  Clinical and Investigative Medicine  17 (6): 531–539  PMID 7895417  ^ Ferland, G ; Sadowski, J  A ; O'Brien, M  E  (Apr 1993)  "Dietary induced subclinical vitamin K deficiency in normal human subjects"  Journal of Clinical Investigation  91 (4): 1761–1768  doi:10 1172/JCI116386  PMC 288156  PMID 8473516  ^ Holden, R  M ; Morton, A  R ; Garland, J  S ; Pavlov, A ; Day, A  G ; Booth, S  L  (Apr 2010)  "Vitamins K and D status in stages 3-5 chronic kidney disease"  Clinical Journal of the American Society of Nephrology  5 (4): 590–597  doi:10 2215/CJN 06420909  PMC 2849681  PMID 20167683  ^ Hodges, S  J ; Pilkington, M  J ; Shearer, M  J ; Bitensky, L ; Chayen, J (Jan 1990)  "Age-related changes in the circulating levels of congeners of vitamin K2, menaquinone-7 and menaquinone-8"  Clinical Science  78 (1): 63–66  PMID 2153497  ^ "Vitamin K"  Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc (PDF)  National Academy Press  2001  p  162–196  ^ Tolerable Upper Intake Levels For Vitamins And Minerals (PDF), European Food Safety Authority, 2006 ^ a b Rhéaume-Bleue, p  42
^ "Important information to know when you are taking: Warfarin (Coumadin) and Vitamin K" (PDF)  National Institutes of Health Clinical Center  ^ "Nutrition Facts and Information for Parsley, raw"  Nutritiondata com  Retrieved 21 Apr 2013  ^ "Nutrition facts, calories in food, labels, nutritional information and analysis"  Nutritiondata com  13 Feb 2008  Retrieved 21 Apr 2013  ^ "Vitamin K"  Vivo colostate edu  2 Jul 1999  Retrieved 21 Apr 2013  ^ "Vitamin K"  Micronutrient Data Centre  ^ Ikeda, Y ; Iki, M ; Morita, A ; Kajita, E ; Kagamimori, S ; Kagawa, Y ; Yoneshima, H  (May 2006)  "Intake of fermented soybeans, natto, is associated with reduced bone loss in postmenopausal women: Japanese Population-Based Osteoporosis (JPOS) Study"  Journal of Nutrition  136 (5): 1323–1328  PMID 16614424  ^ Katsuyama, H ; Ideguchi, S ; Fukunaga, M ; Saijoh, K ; Sunami, S  (Jun 2002)  "Usual dietary intake of fermented soybeans (Natto) is associated with bone mineral density in premenopausal women"  Journal of Nutritional Science and Vitaminology  48 (3): 207–215  doi:10 3177/jnsv 48 207  PMID 12350079  ^ Sano, M ; Fujita, H ; Morita, I ; Uematsu, H ; Murota, S  (Dec 1999)  "Vitamin K2 (menatetrenone) induces iNOS in bovine vascular smooth muscle cells: no relationship between nitric oxide production and gamma-carboxylation"  Journal of Nutritional Science and Vitaminology  45 (6): 711–723  doi:10 3177/jnsv 45 711  PMID 10737225  ^ Gast, G  C ; de Roos, N  M ; Sluijs, I ; Bots, M  L ; Beulens, J  W ; Geleijnse, J  M ; Witteman, J  C ; Grobbee, D  E ; Peeters, P  H ; van der Schouw, Y  T  (Sep 2009)  "A high menaquinone intake reduces the incidence of coronary heart disease"  Nutrition, Metabolism, and Cardiovascular Diseases  19 (7): 504–510  doi:10 1016/j numecd 2008 10 004  PMID 19179058  ^ Oldenburg, J ; Bevans, C  G ; Müller, C  R ; Watzka, M  (2006)  "Vitamin K epoxide reductase complex subunit 1 (VKORC1): the key protein of the vitamin K cycle"  Antioxidants & Redox Signaling  8 (3–4): 347–353  doi:10 1089/ars 2006 8 347  PMID 16677080  ^ Suttie, J  W  (1985)  "Vitamin K-dependent carboxylase"  Annual Review of Biochemistry  54: 459–477  doi:10 1146/annurev bi 54 070185 002331  PMID 3896125  ^ Presnell, S  R ; Stafford, D  W  (Jun 2002)  "The vitamin K-dependent carboxylase"  Thrombosis and Haemostasis  87 (6): 937–946  PMID 12083499  ^ Stafford, D  W  (Aug 2005)  "The vitamin K cycle"  Journal of Thrombosis and Haemostasis  3 (8): 1873–1878  doi:10 1111/j 1538-7836 2005 01419 x  PMID 16102054  ^ Rhéaume-Bleue, p  79 
^ Whitlon, D  S ; Sadowski, J  A ; Suttie, J  W  (Apr 1978)  "Mechanism of coumarin action: significance of vitamin K epoxide reductase inhibition"  Biochemistry  17 (8): 1371–1377  doi:10 1021/bi00601a003  PMID 646989  ^ Terlau, H ; Olivera, B  M  (Jan 2004)  "Conus venoms: a rich source of novel ion channel-targeted peptides"  Physiological Reviews  84 (1): 41–68  doi:10 1152/physrev 00020 2003  PMID 14715910  ^ Buczek, O ; Bulaj, G ; Olivera, BM (Dec 2005)  "Conotoxins and the posttranslational modification of secreted gene products"  Cellular and Molecular Life Sciences  62 (24): 3067–3079  doi:10 1007/s00018-005-5283-0  PMID 16314929  ^ "Prothrombin Time"  WebMD  ^ Dituri, F ; Buonocore, G ; Pietravalle, A ; Naddeo, F ; Cortesi, M; Pasqualetti, P; Tataranno M  L ; R , Agostino (Sep 2012)  "PIVKA-II plasma levels as markers of subclinical vitamin K deficiency in term infants"  Journal of Maternal, Fetal & Neonatal Medicine  25 (9): 1660–1663  doi:10 3109/14767058 2012 657273  PMID 22280352  ^ Thane, C  W ; Bates, C  J ; Shearer, M  J ; Unadkat, N; Harrington, D  J ; Paul, A  A ; Prentice, A ; Bolton-Smith, C  (Jun 2002)  "Plasma phylloquinone (vitamin K1) concentration and its relationship to intake in a national sample of British elderly people"  British Journal of Nutrition  87 (6): 615–622  doi:10 1079/BJNBJN2002582  PMID 12067432  ^ McKeown, N  M ; Jacques, P  F ; Gundberg, C  M ; Peterson, J  W ; Tucker, K  L ; Kiel, D  P ; Wilson, P  W ; Booth, SL (Jun 2002)  "Dietary and nondietary determinants of vitamin K biochemical measures in men and women" (PDF)  Journal of Nutrition  132 (6): 1329–1334  PMID 12042454  ^ Yamano, M ; Yamanaka, Y ; Yasunaga, K ; Uchida, K  (Sep 1989)  "Effect of vitamin K deficiency on urinary gamma-carboxyglutamic acid excretion in rats"  Nihon Ketsueki Gakkai Zasshi  52 (6): 1078–1086  PMID 2588957  ^ Matsumoto, T ; Miyakawa, T ; Yamamoto, D  (Mar 2012)  "Effects of vitamin K on the morphometric and material properties of bone in the tibiae of growing rats"  Metabolism  61 (3): 407–414  doi:10 1016/j metabol 2011 07 018  PMID 21944271  ^ Je, S -H ; Joo, N -S ; Choi, B -H ; Kim, K -M ; Kim, B -T ; Park, S -B ; Cho, D -Y ; Kim, K -N ; Lee, D -J  (Aug 2011)  "Vitamin K supplement along with vitamin D and calcium reduced serum concentration of undercarboxylated osteocalcin while increasing bone mineral density in Korean postmenopausal women over sixty-years-old"  Journal of Korean Medical Science  26 (8): 1093–1098  doi:10 3346/jkms 2011 26 8 1093  PMC 3154347  PMID 21860562  ^ Bentley, R ; Meganathan, R  (Sep 1982)  "Biosynthesis of vitamin K (menaquinone) in bacteria" (PDF)  Microbiological Reviews  46 (3): 241–280  PMC 281544  PMID 6127606  ^ Haddock, B  A ; Jones, C  W  (Mar 1977)  "Bacterial respiration" (PDF)  Bacteriological Reviews  41 (1): 47–99  PMC 413996  PMID 140652  ^ Shearer, M  J  (Jan 1995)  "Vitamin K"  Lancet  345 (8944): 229–234  doi:10 1016/S0140-6736(95)90227-9  PMID 7823718  ^ Greer, J  P ; Foerster, J ; Lukens, J  N ; Rodgers, G  M ; Paraskevas, F ; Glader, B  (eds )  Wintrobe's Clinical Hematology (11th ed )  Philadelphia, Pennsylvania: Lippincott, Williams and Wilkens  ^ a b American Academy of Pediatrics Committee on Fetus Newborn  (Jul 2003)  "Controversies concerning vitamin K and the newborn  American Academy of Pediatrics Committee on Fetus and Newborn" (PDF)  Pediatrics  112 (1 1): 191–192  doi:10 1542/peds 112 1 191  PMID 12837888  ^ Logan, S ; Gilbert, R  (1998)  "Vitamin K For Newborn Babies" (PDF)  Department of Health  Retrieved 12 Oct 2014  ^ "Postnatal care: Routine postnatal care of women and their babies [CG37]"  www nice org uk  NICE  Jul 2006  Retrieved 12 Oct 2014  ^ Parker, L ; Cole, M ; Craft, A  W ; Hey, E  N  (1998)  "Neonatal vitamin K administration and childhood cancer in the north of England: retrospective case-control study"  BMJ (Clinical Research Edition)  316 (7126): 189–193  doi:10 1136/bmj 316 7126 189  PMC 2665412  PMID 9468683  ^ McMillan, D  D  (1997)  "Routine administration of vitamin K to newborns"  Paediatric Child Health  2 (6): 429–431  ^ "Newborns get rare disorder after parents refused shots"  Having four cases since February just at Vanderbilt was a little bit concerning to me ^ Dam, C  P  H  (1935)  "The Antihaemorrhagic Vitamin of the Chick: Occurrence And Chemical Nature"  Nature  135 (3417): 652–653  doi:10 1038/135652b0  ^ Dam, C  P  H  (1941)  "The discovery of vitamin K, its biological functions and therapeutical application" (PDF)  Nobel Prize Laureate Lecture  ^ McAlister, V  C  (2006)  "Control of coagulation: a gift of Canadian agriculture" (PDF)  Clinical and Investigative Medicine  29 (6): 373–377  ^ MacCorquodale, D  W ; Binkley, S  B ; Thayer, S  A ; Doisy, E  A  (1939)  "On the constitution of Vitamin K1"  Journal of the American Chemical Society  61 (7): 1928–1929  doi:10 1021/ja01876a510  ^ Fieser, L  F  (1939)  "Synthesis of Vitamin K1"  Journal of the American Chemical Society  61 (12): 3467–3475  doi:10 1021/ja01267a072  ^ Dam, C  P  H  (12 Dec 1946)  "The discovery of vitamin K, its biological functions and therapeutical application" (PDF)  Nobel Prize lecture  ^ Warner, E  D ; Brinkhous, K  M ; Smith, H  P  (1938)  "Bleeding Tendency of Obstructive Jaundice"  Proceedings of the Society of Experimental Biology and Medicine  37 (4): 628–630  doi:10 3181/00379727-37-9668P  ^ Stenflo, J; Fernlund, P ; Egan, W ; Roepstorff, P  (Jul 1974)  "Vitamin K dependent modifications of glutamic acid residues in prothrombin"  Proceedings of the National Academy of Sciences of the United States of America  71 (7): 2730–2733  doi:10 1073/pnas 71 7 2730  PMC 388542  PMID 4528109  ^ Nelsestuen, G  L ; Zytkovicz, T  H ; Howard, J  B  (Oct 1974)  "The mode of action of vitamin K  Identification of gamma-carboxyglutamic acid as a component of prothrombin" (PDF)  Journal of Biological Chemistry  249 (19): 6347–6350  PMID 4214105  ^ Magnusson, S ; Sottrup-Jensen, L ; Petersen, T  E ; Morris, H  R ; Dell, A  (Aug 1974)  "Primary structure of the vitamin K-dependent part of prothrombin"  FEBS Letters  44 (2): 189–193  doi:10 1016/0014-5793(74)80723-4  PMID 4472513  Bibliography[edit]
Rhéaume-Bleue, Kate (2012)  Vitamin K2 and the Calcium Paradox  John Wiley & Sons, Canada  ISBN 1-118-06572-7  External links[edit]
"Vitamin K: Another Reason to Eat Your Greens"  v
TPP / ThDP (B1)
FMN, FAD (B2)
NAD+, NADH, NADP+, NADPH (B3)
Coenzyme A (B5)
PLP / P5P (B6)
THFA / H4FA, DHFA / H2FA, MTHF (B9)
AdoCbl, MeCbl (B12)
Phylloquinone (K1), Menaquinone (K2)
non-vitamins
Coenzyme B
Heme / Haem (A, B, C, O)
Molybdopterin/Molybdenum cofactor
THMPT / H4MPT
Fe2+, Fe3+
vitamins: see vitamins
Antihemorrhagics (B02)
(coagulation)
Phytomenadione (K1)
Menadione (K3)
intrinsic: IX/Nonacog alfa
VIII/Moroctocog alfa/Turoctocog alfa
extrinsic: VII/Eptacog alfa
common: X
II/Thrombin
I/Fibrinogen
XIII/Catridecacog
combinations: Prothrombin complex concentrate (II, VII, IX, X, protein C and S)
Carbazochrome
thrombopoietin receptor agonist (Romiplostim
Eltrombopag)
Tetragalacturonic acid hydroxymethylester
Epinephrine/Adrenalone
amino acids (Aminocaproic acid
Aminomethylbenzoic acid)
serpins (Aprotinin
Alfa1 antitrypsin
Camostat) 



ground_truth: Margaret Way was born in Brisbane and died in Cleveland, Queensland, Australia.

prompt_front: Now, answer the following question based on the text below, only give me the answer and do not output any other words.

Question: What are the symptoms of vitamin K deficiency?

Read the following text and answer briefly.

Context 4: 

English acceded to the role of Finance Minister in the continuing wake of the financial crisis  In response to New Zealand's rising debt, English made budget deficit-reduction his main priority  His first budget outlined three focuses in New Zealand's financial recovery: "improving the business environment and removing roadblocks to growth; investment in productive infrastructure; and improving the way government works"  One of his first acts was creating the National Infrastructure Unit, charged with formulating a plan for infrastructure projects and investments  He commissioned a government-wide spending review, with an aim to reducing government expenditure—with the exceptions of a two-year stimulus package and long-term increases on infrastructure spending 

In April 2011, the Opposition criticised English for suggesting that New Zealand businesses could use New Zealand's low wages to help it compete with Australia  The National Government campaigned for re-election in 2011 on its economic record  The Government boasted growth for five consecutive quarters up to mid-2010, totalling 1 6% of real GDP 

Strong growth resulted in a surplus of $473 million for the 2015/16 financial year, projected to rise to $8 5 billion by 2020/21  In his 2016 Economic and Fiscal Update address, English stated that reducing debt and tackling the costs of the 2016 Kaikōura earthquake were higher priorities than reducing rates of tax 

Allowances issue
In 2009, the media, including TVNZ and TV3 revealed that English was receiving about NZ$900 a week as part of a living allowance for ministers, to live in his own NZ$1 2 million Wellington home  At the time, English also received $276,200 in his annual salary as Deputy Prime Minister  It was also revealed other ministers with homes in the capital city were also claiming accommodation allowances  On 3 August 2009, Prime Minister John Key started a review of the housing allowances claimed by cabinet ministers  English subsequently paid back $12,000 and only claimed about $24,000 a year in living allowances  The Auditor-General's office said in September 2009 that they were making "preliminary enquiries" into parliamentary housing expenses in response to a letter of complaint from Progressive party leader Jim Anderton  Two days later English stated that he would no longer take up any housing allowance and had paid back all the allowance he had received since the November 2008 election 

Prime Minister (2016–2017)

John Key resigned on 12 December, and endorsed English as his successor in the resulting leadership election  Following the drop-out of both Judith Collins and Jonathan Coleman from the leadership election, English was sworn in as the 39th Prime Minister of New Zealand on 12 December 2016 

English appointed his first cabinet on 18 December  In a reshuffle, he appointed Steven Joyce to succeed him as Finance Minister, while most ministerial portfolios remained the same 

In February 2017, English did not attend Waitangi Day commemorations at the historic treaty grounds, reportedly in response to the Ngāpuhi iwi's decision to stop the Prime Minister from speaking at the marae  Ngāpuhi have protested the Government's negotiation of the Trans Pacific Partnership Agreement (TPPA), which the iwi believe infringes upon Māori sovereignty, and thus does not adhere to the Treaty of Waitangi  English had been invited to attend in an official capacity; his non-attendance was criticised by a Ngāpuhi elder and Opposition leader Andrew Little 

In his first overseas trip as Prime Minister, English travelled to Europe to discuss trade ties, including a prospective New Zealand–European Union free trade agreement  He first travelled to London on 13 January 2017 to meet British Prime Minister Theresa May  Discussing trade relations, English said the two nations were "natural partners" and would "continue to forge ties" after the UK's withdrawal from the EU  He also arranged to meet with London Mayor Sadiq Khan, Belgian Prime Minister Charles Michel and German Chancellor Angela Merkel   In a meeting with Merkel, English received crucial backing from Germany for a trade deal with the EU  On 16 January, English stated that his government would continue to promote TPPA, despite the United States' decision to withdraw from the agreement  He explained that Southeast Asian countries would now be treated as a priority in negotiations—he also asserted that the United States was ceding influence to China by its rejection of the trade pact 

At a press conference at the Beehive on 1 February 2017, English announced that the 2017 general election would be held on 23 September  The Prime Minister later confirmed that his party would approach ACT, United Future and the Māori Party if confidence and supply agreements were required to form a government following the election  In his second cabinet reshuffle on 24 April, English appointed Gerry Brownlee as his new Foreign Affairs Minister; he also promoted Nikki Kaye to the portfolio of Education Minister, and moved Mark Mitchell into the cabinet to become Defence Minister  The reshuffle was perceived as an election preparation 

On 13 February 2017, English welcomed Australian Prime Minister Malcolm Turnbull to Wellington  The two leaders reaffirmed their shared trade agenda, and discussed changes to the Australian citizenship pathway which will affect permanent residents originating from New Zealand 

On 19 June, it was reported that Todd Barclay, who succeeded English as MP for Clutha-Southland, had clandestinely recorded one of his employee's conversations the previous year, and that John Key's leaders' budget was used to pay a confidential settlement after the employee resigned  English admitted that he had been aware of the illegal recording and the settlement, and thus implicated in the scandal 

During the 2017 National campaign launch, English introduced a $379 million social investment package including digital learning academies for high school students, more resources for mathematics, and boosting support for teaching second languages in schools, and maintaining National Standards in the school curriculum  Prime Minister English also sought to defend National's financial management and economic track record and claimed that the opposition Labour Party would raise taxes  Early opinion polling had forecast a poor showing in the election for the Labour Party, but in early August 37-year-old Jacinda Ardern took over as Labour leader and seemingly energised younger voters 

At the 2017 general election, National won the largest share of the party vote (44 4%) and the largest number of seats (56) in the House Representatives  However, National lacked enough seats to govern alone due to two of the party's support partners, the Māori Party and United Future, losing their parliamentary seats  In response, English stated that the party would be entering into talks to form a coalition with New Zealand First  Following talks with the two largest parties, New Zealand First entered a coalition arrangement with the Labour Party  English was succeeded as prime minister by Jacinda Ardern on 26 October 

Opposition (2017–2018)

Leader of the Opposition
English was re-elected as National Party leader on 24 October 2017  At the time of his re-election, English announced his intention to stay on as leader until the next general election  On 13 February 2018, however, he stood down as National Party leader due to personal reasons, and instructed the party to put into motion the processes to elect a new leader  He also retired from Parliament  English's resignation followed weeks of speculation that he would step aside for a new leader  On 27 February, he was succeeded as party leader by Simon Bridges as the result of the leadership election held that day 

Post-premiership 
In 2018, English joined the board of Australian conglomerate, Wesfarmers  English serves in Chairmanships of Mount Cook Alpine Salmon, Impact Lab Ltd and Manawanui Support Ltd  He is also a director of The Instillery, Centre for Independent Studies and The Todd Corporation Limited, and is a member of the Impact Advisory Group of Macquarie Infrastructure and Real Assets 

Political and social views

English is regarded as more socially conservative than his predecessor, John Key  He has stated his opposition to voluntary euthanasia and physician-assisted suicide, same-sex civil unions, and the decriminalisation of prostitution  As Prime Minister he opposed any "liberalisation" of abortion law 

In 2004, English voted against a bill to establish civil unions for both same-sex and opposite-sex couples  In 2005, he voted for the Marriage (Gender Clarification) Amendment Bill, which would have amended the Marriage Act to define marriage as only between a man and a woman  English voted against the Marriage (Definition of Marriage) Amendment Bill, a bill that legalised same-sex marriage in New Zealand  However, in December 2016 he stated, "I'd probably vote differently now on the gay marriage issue  I don't think that gay marriage is a threat to anyone else's marriage" 

In 2009, English voted against the Misuse of Drugs (Medicinal Cannabis) Amendment Bill, a bill aimed at amending the Misuse of Drugs Act so that cannabis could be used for medical purposes 

Personal life 
English met his future wife, Mary Scanlon, at university  She was studying medicine at the time, and became a general practitioner  Both her parents were immigrants, her father being Samoan and her mother Italian, born on the island of Stromboli  They have six children: a daughter and five sons 

English is a practising Roman Catholic, but has stated that he considers his religious beliefs personal and thus separate from politics 

In June 2002, English took part in TV3's Fight For Life, a celebrity boxing fundraiser to raise money for the Yellow Ribbon anti-youth-suicide campaign, influenced by the death of a teenage nephew in 1997  He lost a split decision to former university colleague Ted Clarke 

Honours
In the 2018 Queen's Birthday Honours, English was appointed a Knight Companion of the New Zealand Order of Merit, for services of over 27 years to the State 

See also

List of New Zealand governments
Politics of New Zealand

References

External links

Profile at National Party 
Profile on Parliament nz
Releases and speeches at Beehive govt nz

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

|-

1961 births
21st-century New Zealand politicians
Candidates in the 2017 New Zealand general election
Deputy Prime Ministers of New Zealand
Leaders of the Opposition (New Zealand)
Living people
Members of the Cabinet of New Zealand
Members of the New Zealand House of Representatives
New Zealand farmers
New Zealand finance ministers
New Zealand list MPs
New Zealand MPs for South Island electorates
New Zealand National Party MPs
New Zealand National Party leaders
New Zealand Roman Catholics
New Zealand people of Irish descent
People educated at St  Patrick's College, Silverstream
People from Dipton, New Zealand
People from Lumsden, New Zealand
Prime Ministers of New Zealand
University of Otago alumni
Victoria University of Wellington alumni
Knights Companion of the New Zealand Order of Merit
New Zealand politicians awarded knighthoods



ground_truth: Symptoms of vitamin K deficiency include anemia, bruising, nosebleeds, bleeding of the gums, and heavy menstrual bleeding in women.