bluuebunny/crossref_metadata_2025 huggingface dataset:
Fall Prevention for Inpatient Oncology Using Lean and Rapid Improvement Event Techniques
Authors: Wolf Laurie , Costantinou Eileen , Limbaugh Cathie , Rensing Kathy , Gabbart Phyllis , Matt Pat
Published: February 2015

OBJECTIVE:

The objective of this project was to reduce patient falls and falls with injury on three oncology divisions at a large urban teaching hospital. By standardizing assessment, intervention, and post-fall investigation processes the goal was to decrease patient falls and falls with injury rate by 50% and 30%, respectively.

BACKGROUND:

Preventing patients from being injured due to a fall during their hospitalization has been a concern in healthcare for many years. Organizations around the world such as Institute of Medicine, The Joint Commission, National Institute for Health and Clinical Excellence, National Australian Patient Safety Foundation, and the World Health Organization have been conducting research and publishing guidelines to identify evidence based interventions for fall prevention (Ulrich et al., 2008, Di Pilla, 2010). Falls are the most common cause of non-fatal injury and hospital admission for trauma. Death rates due to falls have risen sharply over the past decade due to aging of the population.

METHODS:

A Rapid Improvement Event (RIE) technique was selected to implement the fall prevention initiative because it aligned with the hospital's lean transformation initiative. There was coordination with other departmental staff (physical and occupational therapy, pharmacy, physicians, information systems, low bed equipment vendor, and clinical operations) to achieve multidisciplinary input.

RESULTS:

A 22% decrease in total fall rate and a 37% decrease in falls with injury rate were achieved in the 16-month post-intervention period. Although a 22% decrease in total falls did not meet the goal of 50% decrease, the total falls with injury decrease of 37% did exceed the goal of 30%.

CONCLUSIONS:

Falls are a multi-faceted, complex problem that needs constant vigilance and continuous improvement to sustain patient safety. Anticipating physiologic changes in patients' conditions and implementing interventions before the fall is critical to fall prevention. While well-validated screening tools performed thoroughly and accurately can help hospital staff identify patient specific fall risk factors, risk assessment alone does not prevent falls. If the prevention of patient falls is identified as important by leadership and staff at the division level and all are invested in achieving established goals, success can be achieved and sustained.
The Role of Facility Design in Preventing the Transmission of Healthcare-Associated Infections: Background and Conceptual Framework
Authors: Zimring Craig , Jacob Jesse T. , Denham Megan E. , Kamerow Douglas B. , Hall Kendall K. , Cowan David Z. , Kasali Altug , Lenfestey Nancy F. , Do Ellen , Steinberg James P.
Published: February 2015

OBJECTIVE:

To describe the conceptual framework and methodology used to conduct a comprehensive literature review of current evidence evaluating the role of the built environment in the transmission of healthcare-associated infections.

BACKGROUND:

A multidisciplinary approach to evaluating a vast and diverse dataset requires a conceptual framework to create a common understanding for interpretation. This common understanding is accomplished through the application of a “chain of transmission” model depicting temporal and physical paths of pathogens that cause healthcare-associated infections. The chain of transmission interventions model argues that infection can potentially be reduced by interrupting any of several links in the chain.

TOPICAL HEADINGS:

The key pathogens impacted by the built environment are identified. The chain of transmission and the conceptual framework are described. Opportunities for intervention through the built environment are presented, which in turn guide the subsequent methodology used to conduct the systematic literature review.

CONCLUSIONS:

The chain of transmission interventions model is a multidisciplinary conceptualization of the interaction between pathogens and the built environment, and this model facilitated a systematic literature review of a very large amount of data.
Neural Correlates of Nature Stimuli: An fMRI Study
Authors: Pati Debajyoti , O'Boyle Michael , Amor Cherif , Hou Jiancheng , Valipoor Shabboo , Fang Dan
Published: February 2015

OBJECTIVE:

Examine whether there are unique patterns of brain activation associated with exposure to photographic sky compositions (representing nature stimuli) as compared with other positive, negative, and neutral images.

BACKGROUND:

The positive impact of nature images on health outcomes traditionally has been measured using behavioral and physiological indicators. However, there is a lack of understanding of the underlying neural mechanism that explains this positive influence.

METHODS:

A combination of behavioral responses and functional magnetic resonance imaging (fMRI) technology was used to address research questions. Ten participants belonging to five age groups were subjected to short (25 seconds) exposures of 32 images while their brain activation was monitored via the BOLD response. In a separate run, participants were subjected to extended exposures (12 minutes) of a sky composition and an image of a traditional ceiling.

RESULTS:

The results show that the activation patterns produced by sky compositions and positive images were quite similar as compared to negative or neutral images. However, sky compositions also produced some unique areas of activation, including those associated with spatial cognition, the expanse of space, circadian rhythm, and perceived motion. In the extended exposure condition, sky compositions tended to activate regions associated with dreaming, while traditional ceiling images activated regions that are related to face processing and potentially visual hallucinations.

CONCLUSIONS:

Nature stimuli, with a combination of vegetation and sky, may produce unique beneficial effects not present in general positive stimuli.
One Size Does Not Fit All: A Diagnostic Post-Occupancy Evaluation Model for an Emergency Department
Authors: Guinther Lindsey , Carll-White Allison , Real Kevin
Published: February 2015

OBJECTIVE:

This study presents a detailed account of processes and multiple methodologies used in conducting a diagnostic post-occupancy evaluation (POE) in an urban hospital emergency department.

BACKGROUND:

Healthcare design POE research findings can lead to improved work environments for healthcare providers and higher levels of staff, patient, and visitor satisfaction.

METHODS:

This evaluation was conducted in two separate phases over 12 months, with data analysis occurring after each phase. Phase 1 involved 200 hours of observation, physical measurements, and occupancy counts. Phase 2 included surveys ( n = 315) of staff, visitors, and patients. In addition, eight distinct staff focus groups (e.g., Nursing, Housekeeping, Physician, etc.) were conducted.

RESULTS:

To illustrate the process, one healthcare design-related issue, privacy and confidentiality, was assessed in light of the linear design model with a central core. Phase 1 observation results indicated that most confidential conversations were contained within the linear core. However, Phase 2 focus groups revealed that many staff members had concerns regarding the level of privacy and confidentiality due to the core's open design. The use of multiple methods provided greater information and a more comprehensive picture of the emergency department environment and design.

CONCLUSIONS:

This study presents a comprehensive framework for diagnostic post-occupancy evaluation in healthcare design. The findings indicate that a systematic, multi-methodological approach developed around a conceptual framework can lead to higher quality evaluations. Diagnostic POEs should be grounded in extant literature and customized based on the setting, the client's guiding principles, and the design team's objectives. In diagnostic POEs, one size does not fit all.
Bedside to Blueprints: The Role of Nurses in Hospital Design
Authors: Clark Erin
Published: February 2015

OBJECTIVE:

To explore the role and function of nurses in the healthcare design industry.

BACKGROUND:

The design of a new hospital requires collaboration among multiple disciplines to develop an environment that allows for high-quality care to be delivered and received. This article investigates the role of nurses as an integral part of the design team when creating optimal spaces for patients and caregivers. While nurses fulfill many roles in healthcare, this investigation focused on the role of nurses as end-users, nurse leaders, and consultants.

METHODS:

An informal interview method was used to elicit information from 13 members of the healthcare design industry across disciplines and across the United States. Those interviewed included nurses, architects, and consultants.

RESULTS:

Common themes that emerged from this investigation included the importance of nurses as an integral part of the design team and a continued need to understand optimal utilization to be an effective team member. A number of organizations and events welcome nurses to help foster design innovation and interprofessional collaboration.

CONCLUSIONS:

The role of the professional nurse continues to expand and there are many opportunities for nurses to step out of their traditional role and into the industry of healthcare design.
Informing Hospital Change Processes through Visualization and Simulation: A Case Study at a Children's Emergency Clinic
Authors: Persson Johanna , Dalholm Elisabeth Hornyánszky , Johansson Gerd
Published: February 2015

OBJECTIVE:

To demonstrate the use of visualization and simulation tools in order to involve stakeholders and inform the process in hospital change processes, illustrated by an empirical study from a children's emergency clinic.

BACKGROUND:

Reorganization and redevelopment of a hospital is a complex activity that involves many stakeholders and demands. Visualization and simulation tools have proven useful for involving practitioners and eliciting relevant knowledge. More knowledge is desired about how these tools can be implemented in practice for hospital planning processes.

METHODS:

A participatory planning process including practitioners and researchers was executed over a 3-year period to evaluate a combination of visualization and simulation tools to involve stakeholders in the planning process and to elicit knowledge about needs and requirements.

RESULTS:

The initial clinic proposal from the architect was discarded as a result of the empirical study. Much general knowledge about the needs of the organization was extracted by means of the adopted tools. Some of the tools proved to be more accessible than others for the practitioners participating in the study. The combination of tools added value to the process by presenting information in alternative ways and eliciting questions from different angles.

CONCLUSIONS:

Visualization and simulation tools inform a planning process (or other types of change processes) by providing the means to see beyond present demands and current work structures. Long-term involvement in combination with accessible tools is central for creating a participatory setting where the practitioners' knowledge guides the process.
Design Research and the Globalization of Healthcare Environments
Authors: Shepley Mardelle McCuskey , Song Yilin
Published: February 2015

OBJECTIVE:

Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, “how pervasive is healthcare design research outside of the United States?”

METHOD:

The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies.

RESULTS:

While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited.

CONCLUSION:

Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered.
Effects of Revised Consultation Room Design on Patient–Physician Communication
Authors: Ajiboye Folaranmi , Dong Fanglong , Moore Justin , Kallail K. James , Baughman Allison
Published: February 2015

Objective:

To evaluate the impact of a revised consultation room design on patient–physician interaction in an outpatient setting.

Background:

The growth of ambulatory medical care makes outpatient facilities the primary point of health care contact for many Americans. However, the outpatient consultation room design remains largely unchanged, despite its increased use and the adoption of technology-mediated information sharing in clinical encounter.

Methods:

A randomized controlled trial used a postvisit questionnaire to assess six domains of interest (satisfaction with the visit and the consultation room, mutual respect, patient trust in the physician, communication quality, people–room interaction, and interpersonal–room interaction) in two different room designs (a traditional room and an experimental room in which a pedestal table had replaced the examination table).

Results:

Interpersonal–room interaction was enhanced in the experimental consultation room when compared to the traditional consultation room ( p = .0038). Participants in the experimental consultation room had better access to the computer screen, increased provider information sharing, and more time engaging providers in conversation about information on the monitor.

Conclusions:

Changing the layout of a consultation room has the potential to improve interpersonal communication through better information sharing. Clinicians who are interested in maximizing the benefits of their clinical encounter should consider changing the layout of their consultation room, especially the positioning of the computer screen.
If I Were a Band-Aid, Where Would I Be? Researching the Use and Location of Supplies on Two Patient Units
Authors: Bazuin Doug , Martinez Jessica , Harper Kathy , Okland Kathy , Bergquist Patricia , Kumar Shilpi
Published: February 2015

Objective:

The purpose of this study was to gain insight into the use and storage of supplies in the neonatal intensive care and women’s health units of Parkland Hospital in Dallas, Texas.

Background:

Construction of a new Parkland Hospital is underway, with completion of the 862-bed, 2.5-million square feet hospital in 2014. Leaders from the hospital and representatives from one of its major vendors collaborated on a research study to evaluate the hospital’s current supply management system and develop criteria to create an improved system to be implemented at the new hospital.

Method:

Approach includes qualitative and quantitative methods, that is, written survey, researcher observations, focus groups, and evaluation of hospital supply reports.

Results:

Approaching the ideal location of supplies can be best approached by defining a nurse’s activity at the point of care. Determining an optimal supply management system must be approached by understanding the “what” of caregivers’ activities and then determining the “where” of the supplies that support those activities.

Conclusions:

An ideal supply management system locates supplies as close as possible to the point of use, is organized by activity, and is standardized within and across units.
Risk Factors of Epstein-Barr Virus Infection Among United States Children
Authors: Naenifard Hesam , Arif Ahmed A. , Huber Larissa R. , Warner Jennifer
Published: February 2015

Background: Epstein-Barr virus (EBV) has become a common medical condition in adolescents and young children. The objective of this study was to examine the association of low dietary intake and food insecurity with EBV infection. Methods: Cross-sectional data were analyzed using the National Health and Nutrition Examination Survey 2009-2010 sample population (n = 1550) aged 6 to 15 years. Self-report data on dietary intake and food security were abstracted from data files. The outcome variable was measured using EBV index from the laboratory data. Multivariable logistic regression analysis was used to determine the association between exposure and outcome variables. Results: The prevalence of EBV in this population was 56.4%. In the unadjusted analyses, adolescents who consumed 100% fruit juice (OR = 1.49, 95% CI = 1.09-2.05), beans (OR = 2.35, 95% CI = 1.12-4.94), and red meat (OR = 1.57, 95% CI = 1.09-2.24) daily had statistically significant elevated odds of EBV as compared to adolescents who consumed them monthly. Furthermore, adolescents who sometimes did not get fed a balanced meal and had to rely on low-cost food had statistically significant increased odds of EBV. However, after adjusting for potential confounders the results for both dietary factors and food insecurity were no longer statistically significant. Conclusions: Certain dietary factors and food insecurity may predispose children to EBV infection.
In Other Sources
Authors: Konrad Moira , Graham-Day Kristall J. , Diegelmann Karen M. , Chan Paula E. , Bethune Lauren , Hitt Sara Beth , Bunch-Crump Kimberly
Published: February 2015

This column provides brief summaries of transition-related articles published in 2012 in other professional journals. The 44 articles included descriptive, experimental, and qualitative research as well as program descriptions, conceptual papers, and practitioner pieces. All areas of Kohler’s Taxonomy for Transition Programming were addressed: family involvement, interagency collaboration, program structure, student development, and student-focused planning.
The Mediating Role of Charismatic Leadership Communication in a Crisis: A Malaysian Example
Authors: Jamal Jamilah , Abu Bakar Hassan
Published: February 2015

This study develops a model to advance research on public organization reputation by integrating crisis responsibility with charismatic leadership communication. Based on situational crisis communication theory, the model was tested using structural equation modeling with data obtained from a sample of 383 employees of public organizations in Malaysia. The mediation model indicated that the dynamic mechanism of charismatic leadership communication partially mediated the relationship between crisis responsibility and perceived organizational reputation during a crisis. These findings validated the proposed model and, in particular, confirmed empirically the central role of charismatic leadership communication processes in organization. This study provides insights into the role of charismatic leadership communication in the organizational reputation processes. The model established can serve as an instructive guide for both organization and corporate leaders in managing a crisis and reputation. A practical implication of the findings is that, during a crisis, a crisis leader should engage in charismatic leadership communication effectively to mitigate the crisis impact and strengthen organizational reputation. More important, the findings indicate that charismatic leadership communication contributed to organizational reputation explicitly brought charismatic leadership communication to the forefront of organizational reputation management.
Arginine dependence of acute myeloid leukemia blast proliferation: a novel therapeutic target
Authors: Mussai Francis , Egan Sharon , Higginbotham-Jones Joseph , Perry Tracey , Beggs Andrew , Odintsova Elena , Loke Justin , Pratt Guy , U Kin Pong , Lo Anthony , Ng Margaret , Kearns Pamela , Cheng Paul , De Santo Carmela
Published: February 2015

Key Points

Arginase depletion with BCT-100 pegylated recombinant human arginase is cytotoxic to AML blasts.
Optimal treatment strategies for hemophilia: achievements and limitations of current prophylactic regimens
Authors: Oldenburg Johannes
Published: February 2015

Prophylactic application of clotting factor concentrates is the basis of modern treatment of severe hemophilia A. In children, the early start of prophylaxis as primary or secondary prophylaxis has become the gold standard in most countries with adequate resources. In adults, prophylaxis is reasonably continued when started as primary or secondary prophylaxis in childhood to maintain healthy joint function. Initial data support that adult patients with already existing advanced joint arthropathy benefit from tertiary prophylaxis with significantly lowered number of bleeds, almost complete absence of target joints, and less time off from work. Current prophylactic regimens, although very effective, do not completely prevent joint disease in a long-term perspective. Joint arthropathy in primary prophylaxis develops over many years, sometimes over a decade or even longer time periods. The ankle joints are the first and most severely affected joints in those patients and thus may serve in outcome assessment as an indicator of early joint arthropathy when followed by ultrasound or magnetic resonance imaging. Optimized outcome and best use of available resources is expected from individualization of therapy regimens, which comprises the individual’s bleeding pattern, condition of the musculoskeletal system, level of physical activity and the pharmacokinetic profile of the substituted coagulation factor, and most recently includes novel products with extended half-lives.
The nanostructuring of surfaces and films using interference lithography and chalcogenide photoresist
Authors: Dan’ko Viktor , Indutnyi Ivan , Myn’ko Victor , Lukaniuk Mariia , Shepeliavyi Petro
Published: February 2015

The reversible and transient photostimulated structural changes in annealed chalcogenide glass (ChG) layers were used to form interference periodic structures on semiconductor surfaces and metal films. It was shown that negative-action etchants based on amines dissolve illuminated parts of a chalcogenide film, i.e., act as positive etchants. The diffraction gratings and 2-D interference structures on germanium ChGs - more environmentally acceptable compounds than traditionally used arsenic chalcogenides - were recorded, and their characteristics were studied.
Fabrication and characterization of GaN-based light-emitting diodes without pre-activation of p-type GaN
Authors: Hu Xiao-Long , Wang Hong , Zhang Xi-Chun
Published: February 2015

We fabricated GaN-based light-emitting diodes (LEDs) without pre-activation of p-type GaN. During the fabrication process, a 100-nm-thick indium tin oxide film was served as the p-type contact layer and annealed at 500°C in N2 ambient for 20 min to increase its transparency as well as to activate the p-type GaN. The electrical measurements showed that the LEDs were featured by a lower forward voltage and higher wall-plug efficiency in comparison with LEDs using pre-activation of p-type GaN. We discussed the mechanism of activation of p-type GaN at 500°C in N2 ambient. Furthermore, x-ray photoemission spectroscopy examinations were carried out to study the improved electrical performances of the LEDs without pre-activation of p-type GaN.
Composites of silica with immobilized cholinesterase incorporated into polymeric shell
Authors: Payentko Victoriya , Matkovsky Alexander , Matrunchik Yulia
Published: February 2015

Synthetic approaches for new nanocomposite materials with relatively high cholinesterase activity have been developed. The peculiarity of the formation of such systems is the introduction of cholinesterase into polymer with subsequent incorporation on the ready-made silica particles and into the polysiloxane matrixes during sol-gel synthesis. Evaluation of the cholinesterase activity has been fulfilled through the imitation of the acetylcholine chloride decomposition reaction. Values of activity for cholinesterase nanocomposites demonstrated in this work are higher than those for the native cholinesterase. The higher activity of cholinesterase contained in nanocomposites was found for those prepared using highly dispersed silica.
Bimetallic core/shell nanoparticle-decorated 3D urchin-like hierarchical TiO2 nanostructures with magneto-responsive and decolorization characteristics
Authors: Xiang Liqin , Liu Shuo , Yin Jianbo , Zhao Xiaopeng
Published: February 2015

The semiconductors decorated with noble metals or magnetic metals have attracted increasing attention due to multifunctional properties. In this article, we prepare novel bimetallic core/shell nanoparticle (Co@Au and Co@Ag)-decorated 3D urchin-like hierarchical TiO2 nanostructures through combining electroless plating and in situ replacement processes. The morphology and structure are characterized by scanning electron microscopy, transmission electron microscopy, energy-dispersive spectroscopy, and a surface area analyzer. It demonstrates that Co@Au and Co@Ag nanoparticles are uniformly decorated on urchin-like TiO2 nanostructures. The composite nanostructures show not only surface plasmon absorption band from Au or Ag but also a magneto-responsive characteristic from Co. This allows composite nanostructures to exhibit advantages including enhanced decolorization efficiency compared to pure TiO2 nanostructures and facile separation from a solution by magnetic field.
Transcriptional profiling defines dynamics of parasite tissue sequestration during malaria infection
Authors: Pelle Karell G , Oh Keunyoung , Buchholz Kathrin , Narasimhan Vagheesh , Joice Regina , Milner Danny A , Brancucci Nicolas MB , Ma Siyuan , Voss Till S , Ketman Ken , Seydel Karl B , Taylor Terrie E , Barteneva Natasha S , Huttenhower Curtis , Marti Matthias
Published: February 2015

Background

During intra-erythrocytic development, late asexually replicating Plasmodium falciparum parasites sequester from peripheral circulation. This facilitates chronic infection and is linked to severe disease and organ-specific pathology including cerebral and placental malaria. Immature gametocytes - sexual stage precursor cells - likewise disappear from circulation. Recent work has demonstrated that these sexual stage parasites are located in the hematopoietic system of the bone marrow before mature gametocytes are released into the bloodstream to facilitate mosquito transmission. However, as sequestration occurs only in vivo and not during in vitro culture, the mechanisms by which it is regulated and enacted (particularly by the gametocyte stage) remain poorly understood.

Results

We generated the most comprehensive P. falciparum functional gene network to date by integrating global transcriptional data from a large set of asexual and sexual in vitro samples, patient-derived in vivo samples, and a new set of in vitro samples profiling sexual commitment. We defined more than 250 functional modules (clusters) of genes that are co-expressed primarily during the intra-erythrocytic parasite cycle, including 35 during sexual commitment and gametocyte development. Comparing the in vivo and in vitro datasets allowed us, for the first time, to map the time point of asexual parasite sequestration in patients to 22 hours post-invasion, confirming previous in vitro observations on the dynamics of host cell modification and cytoadherence. Moreover, we were able to define the properties of gametocyte sequestration, demonstrating the presence of two circulating gametocyte populations: gametocyte rings between 0 and approximately 30 hours post-invasion and mature gametocytes after around 7 days post-invasion.

Conclusions

This study provides a bioinformatics resource for the functional elucidation of parasite life cycle dynamics and specifically demonstrates the presence of the gametocyte ring stages in circulation, adding significantly to our understanding of the dynamics of gametocyte sequestration in vivo.
Further generalization of fixed point theorems in Menger PM-spaces
Authors: Kutbi Marwan Amin , Gopal Dhananjay , Vetro Calogero , Sintunavarat Wutiphol
Published: February 2015

In this work, we establish some fixed point theorems by revisiting the notion of ψ-contractive mapping in Menger PM-spaces. One of our results (namely, Theorem 2.3) may be viewed as a possible answer to the problem of existence of a fixed point for generalized type contractive mappings in M-complete Menger PM-spaces under arbitrary t-norm. Some examples are furnished to demonstrate the validity of the obtained results.
An alternative model of international migration: endogenous two sided borders and optimal legal systems
Authors: Chaabane Inaam , Gaumont Damien
Published: February 2015

In a 2-country and 3-period OLG model with education, we study the impact on international migration of the two sided characteristics of borders. Individuals must first “leave” their home country before “entering” the destination country. Indeed, each social planner chooses the static welfare optimal level of education, consumption, labor and capital. A unique migration flow is compatible with the market steady-state equilibrium and the maximizing social welfare solution. Difference in education generates differences in steady-state capital per capita. Consequently, both price differentials and incentives for illegal migration exist. Application to real world cases is provided.

JEL ClassificationK37, D91, F22
Savings, entrepreneurial trait and self-employment: evidence from selected Ghanaian Universities
Authors: Peprah James A , Afoakwah Clifford , Koomson Isaac
Published: February 2015

Youth unemployment is a major setback to sustainable growth. In recent times, Ghana has experienced a downward trend in youth employment in spite of several attempts made by the government to control the unemployment situation. This paper explores savings behaviour, entrepreneurial trait and the decision to be self-employed among students from selected public and private universities in Ghana. Employing the bivariate analysis and probit model on a sample of 1046 students shows that savings behaviour among the youth varies according to their programmes of study, type of institution (public and private) and family background of the students. Savings and entrepreneurial trait increase the probability of self-employment decision among university students. Policies that can address graduate unemployment should focus on helping students to save while in school. Also, incorporating entrepreneurial training into the academic programmes of these institutions has the tendency of improving the entrepreneurial traits of students and thereby, decide to be self-employed. Policy intervention needs to be designed strategically to target students into self-employment as a way of curbing youth unemployment in Ghana in order to contribute to national development.
Purinergic signaling modulates human visceral adipose inflammatory responses: implications in metabolically unhealthy obesity
Authors: Pandolfi J , Ferraro A , Lerner M , Serrano J R , Dueck A , Fainboim L , Arruvito L
Published: February 2015

Obesity is accompanied by chronic inflammation of VAT, which promotes metabolic changes, and purinergic signaling has a key role in a wide range of inflammatory diseases. Therefore, we addressed whether fat inflammation could be differentially modulated by this signaling pathway in the MUO and in individuals who remain MHO. Our results show that the necrotized VAT of both groups released greater levels of ATP compared with lean donors. Interestingly, MUO tissue SVCs showed up-regulation and engagement of the purinergic P2X7R. The extracellular ATP concentration is regulated by an enzymatic process, in which CD39 converts ATP and ADP into AMP, and CD73 converts AMP into adenosine. In VAT, the CD73 ectoenzyme was widely distributed in immune and nonimmune cells, whereas CD39 expression was restricted to immune CD45PAN+ SVCs. Although the MUO group expressed the highest levels of both ectoenzymes, no difference in ATP hydrolysis capacity was found between the groups. As expected, MUO exhibited the highest NLRP3 inflammasome expression and IL-1β production. MUO SVCs also displayed up-regulation of the A2AR, allowing extracellular adenosine to increase IL-1β local secretion. Additionally, we demonstrate that metabolic parameters and BMI are positively correlated with purinergic components in VAT. These findings indicate that purinergic signaling is a novel mechanism involved in the chronic inflammation of VAT underlying the metabolic changes in obesity. Finally, our study reveals a proinflammatory role for adenosine in sustaining IL-1β production in this tissue.
Rac1-dependent secretion of platelet-derived CCL5 regulates neutrophil recruitment via activation of alveolar macrophages in septic lung injury
Authors: Hwaiz Rundk , Rahman Milladur , Syk Ingvar , Zhang Enming , Thorlacius Henrik
Published: February 2015

Accumulating evidence suggest that platelets play an important role in regulating neutrophil recruitment in septic lung injury. Herein, we hypothesized that platelet-derived CCL5 might facilitate sepsis-induced neutrophil accumulation in the lung. Abdominal sepsis was induced by CLP in C57BL/6 mice. CLP increased plasma levels of CCL5. Platelet depletion and treatment with the Rac1 inhibitor NSC23766 markedly reduced CCL5 in the plasma of septic mice. Moreover, Rac1 inhibition completely inhibited proteasePAR4-induced secretion of CCL5 in isolated platelets. Immunoneutralization of CCL5 decreased CLP-induced neutrophil infiltration, edema formation, and tissue injury in the lung. However, inhibition of CCL5 function had no effect on CLP-induced expression of Mac-1 on neutrophils. The blocking of CCL5 decreased plasma and lung levels of CXCL1 and CXCL2 in septic animals. CCL5 had no effect on neutrophil chemotaxis in vitro, suggesting an indirect effect of CCL5 on neutrophil recruitment. Intratracheal challenge with CCL5 increased accumulation of neutrophils and formation of CXCL2 in the lung. Administration of the CXCR2 antagonist SB225002 abolished CCL5-induced pulmonary recruitment of neutrophils. Isolated alveolar macrophages expressed significant levels of the CCL5 receptors CCR1 and CCR5. In addition, CCL5 triggered significant secretion of CXCL2 from isolated alveolar macrophages. Notably, intratracheal administration of clodronate not only depleted mice of alveolar macrophages but also abolished CCL5-induced formation of CXCL2 in the lung. Taken together, our findings suggest that Rac1 regulates platelet secretion of CCL5 and that CCL5 is a potent inducer of neutrophil recruitment in septic lung injury via formation of CXCL2 in alveolar macrophages.
Oral Bisphosphonate Use and Risk of Postmenopausal Endometrial Cancer
Authors: Newcomb Polly A. , Passarelli Michael N. , Phipps Amanda I. , Anderson Garnet L. , Wactawski-Wende Jean , Ho Gloria Y.F. , O'Sullivan Mary Jo , Chlebowski Rowan T.
Published: February 2015

Purpose

Bisphosphonates are common medications used for the treatment of osteoporosis and are also used to reduce metastases to bone in patients with cancer. Several studies, including the Women's Health Initiative (WHI), have found that use of bisphosphonates is associated with reduced risk of developing breast cancer, but less is known about associations with other common malignancies. This study was aimed at examining the effects of bisphosphonates on the risk of endometrial cancer.

Methods

We evaluated the relationship between use of oral bisphosphonates and endometrial cancer risk in a cohort of 89,918 postmenopausal women participating in the WHI. A detailed health interview was conducted at baseline, and bisphosphonate use was ascertained from an inventory of regularly used medications at baseline and over follow-up. All women had an intact uterus at the time of study entry.

Results

During a median follow-up of 12.5 years, 1,123 women were diagnosed with incident invasive endometrial cancer. Ever use of bisphosphonates was associated with reduced endometrial cancer risk (adjusted hazard ratio, 0.80; 95% CI, 0.64 to 1.00; P = .05), with no interactions observed with age, body mass index, or indication for use.

Conclusion

In this large prospective cohort of postmenopausal women, bisphosphonate use was associated with a statistically significant reduction in endometrial cancer risk.
Preliminary Development and Evaluation of an Algorithm to Identify Breast Cancer Chemotherapy Toxicities Using Electronic Medical Records and Administrative Data
Authors: Mandelblatt Jeanne S. , Huang Karl , Makgoeng Solomon B. , Luta Gheorghe , Song Jun X. , Tallarico Michelle , Roh Janise M. , Munneke Julie R. , Houlston Cathie A. , McGuckin Meghan E. , Cai Ling , Clarke Hillyer Grace , Hershman Dawn L. , Neugut Alfred I. , Isaacs Claudine , Kushi Larry
Published: February 2015

If validated in other samples and health care settings, algorithms to capture toxicity could be useful in comparative and cost effectiveness evaluations of community practice–delivered treatment.
Treatment Summaries and Survivorship Care Plans: The Approach by the Commission on Cancer to Increase Use
Authors: Shulman Lawrence N. , Ferris Linda , Takanishi Danny M. , McKellar Daniel
Published: February 2015

The implementation of CoC standard 3.3 represents a paradigm shift in the care of cancer survivors, with a statement that treatment summaries and survivorship care plans are important documents for patient care and should be required.
Variation in Glucose Homeostasis Traits Associated With P2RX7 Polymorphisms in Mice and Humans
Authors: Todd Jennifer N. , Poon Wenny , Lyssenko Valeriya , Groop Leif , Nichols Brendan , Wilmot Michael , Robson Simon , Enjyoji Keiichi , Herman Mark A. , Hu Cheng , Zhang Rong , Jia Weiping , Ma Ronald , Florez Jose C. , Friedman David J.
Published: February 2015

Context:

Extracellular nucleotide receptors are expressed in pancreatic B-cells. Purinergic signaling via these receptors may regulate pancreatic B-cell function.

Objective:

We hypothesized that purinergic signaling might influence glucose regulation and sought evidence in human studies of glycemic variation and a mouse model of purinergic signaling dysfunction.

Design:

In humans, we mined genome-wide meta-analysis data sets to examine purinergic signaling genes for association with glycemic traits and type 2 diabetes. We performed additional testing in two genomic regions (P2RX4/P2RX7 and P2RY1) in a cohort from the Prevalence, Prediction, and Prevention of Diabetes in Botnia (n = 3504), which includes more refined measures of glucose homeostasis. In mice, we generated a congenic model of purinergic signaling dysfunction by crossing the naturally hypomorphic C57BL6 P2rx7 allele onto the 129SvJ background.

Results:

Variants in five genes were associated with glycemic traits and in three genes with diabetes risk. In the Prevalence, Prediction, and Prevention of Diabetes in Botnia study, the minor allele in the missense functional variant rs1718119 (A348T) in P2RX7 was associated with increased insulin sensitivity and secretion, consistent with its known effect on increased pore function. Both male and female P2x7-C57 mice demonstrated impaired glucose tolerance compared with matched P2x7-129 mice. Insulin tolerance testing showed that P2x7-C57 mice were also less responsive to insulin than P2x7-129 mice.

Conclusions:

We show association of the purinergic signaling pathway in general and hypofunctioning P2X7 variants in particular with impaired glucose homeostasis in both mice and humans.
Characterisation of detergent-insoluble membranes in pollen tubes of Nicotiana tabacum (L.)
Authors: Moscatelli Alessandra , Gagliardi Assunta , Maneta-Peyret Lilly , Bini Luca , Stroppa Nadia , Onelli Elisabetta , Landi Claudia , Scali Monica , Idilli Aurora Irene , Moreau Patrick
Published: February 2015

Pollen tubes are the vehicle for sperm cell delivery to the embryo sac during fertilisation of Angiosperms. They provide an intriguing model for unravelling mechanisms of growing to extremes. The asymmetric distribution of lipids and proteins in the pollen tube plasma membrane modulates ion fluxes and actin dynamics and is maintained by a delicate equilibrium between exocytosis and endocytosis. The structural constraints regulating polarised secretion and asymmetric protein distribution on the plasma membrane are mostly unknown. To address this problem, we investigated whether ordered membrane microdomains, namely membrane rafts, might contribute to sperm cell delivery. Detergent insoluble membranes, rich in sterols and sphingolipids, were isolated from tobacco pollen tubes. MALDI TOF/MS analysis revealed that actin, prohibitins and proteins involved in methylation reactions and in phosphoinositide pattern regulation are specifically present in pollen tube detergent insoluble membranes. Tubulins, voltage-dependent anion channels and proteins involved in membrane trafficking and signalling were also present. This paper reports the first evidence of membrane rafts in Angiosperm pollen tubes, opening new perspectives on the coordination of signal transduction, cytoskeleton dynamics and polarised secretion.
Hemoglobin S and C affect protein export in Plasmodium falciparum-infected erythrocytes
Authors: Kilian Nicole , Srismith Sirikamol , Dittmer Martin , Ouermi Djeneba , Bisseye Cyrille , Simpore Jacques , Cyrklaff Marek , Sanchez Cecilia P. , Lanzer Michael
Published: February 2015

Malaria is a potentially deadly disease. However, not every infected person develops severe symptoms. Some people are protected by naturally occurring mechanisms that frequently involve inheritable modifications in their hemoglobin. The best studied protective hemoglobins are the sickle cell hemoglobin (HbS) and hemoglobin C (HbC) which both result from a single amino acid substitution in β-globin: glutamic acid at position 6 is replaced by valine or lysine, respectively. How these hemoglobinopathies protect from severe malaria is only partly understood. Models currently proposed in the literature include reduced disease-mediating cytoadherence of parasitized hemoglobinopathic erythrocytes, impaired intraerythrocytic development of the parasite, dampened inflammatory responses, or a combination thereof. Using a conditional protein export system and tightly synchronized Plasmodium falciparum cultures, we now show that export of parasite-encoded proteins across the parasitophorous vacuolar membrane is delayed, slower, and reduced in amount in hemoglobinopathic erythrocytes as compared to parasitized wild type red blood cells. Impaired protein export affects proteins targeted to the host cell cytoplasm, Maurer's clefts, and the host cell plasma membrane. Impaired protein export into the host cell compartment provides a mechanistic explanation for the reduced cytoadherence phenotype associated with parasitized hemoglobinopathic erythrocytes.
Evolution of basal deuterostome nervous systems
Authors: Holland Linda Z.
Published: February 2015

Understanding the evolution of deuterostome nervous systems has been complicated by the ambiguous phylogenetic position of the Xenocoelomorpha (Xenoturbellids, acoel flat worms, nemertodermatids), which has been placed either as basal bilaterians, basal deuterostomes or as a sister group to the hemichordate/echinoderm clade (Ambulacraria), which is a sister group of the Chordata. None of these groups has a single longitudinal nerve cord and a brain. A further complication is that echinoderm nerve cords are not likely to be evolutionarily related to the chordate central nervous system. For hemichordates, opinion is divided as to whether either one or none of the two nerve cords is homologous to the chordate nerve cord. In chordates, opposition by two secreted signaling proteins, bone morphogenetic protein (BMP) and Nodal, regulates partitioning of the ectoderm into central and peripheral nervous systems. Similarly, in echinoderm larvae, opposition between BMP and Nodal positions the ciliary band and regulates its extent. The apparent loss of this opposition in hemichordates is, therefore, compatible with the scenario, suggested by Dawydoff over 65 years ago, that a true centralized nervous system was lost in hemichordates.
Ether-à-go-go family voltage-gated K+ channels evolved in an ancestral metazoan and functionally diversified in a cnidarian–bilaterian ancestor
Authors: Li Xiaofan , Martinson Alexandra S. , Layden Michael J. , Diatta Fortunay H. , Sberna Anna P. , Simmons David K. , Martindale Mark Q. , Jegla Timothy J.
Published: February 2015

We examined the evolutionary origins of the ether-à-go-go (EAG) family of voltage-gated K+ channels, which have a strong influence on the excitability of neurons. The bilaterian EAG family comprises three gene subfamilies (Eag, Erg and Elk) distinguished by sequence conservation and functional properties. Searches of genome sequence indicate that EAG channels are metazoan specific, appearing first in ctenophores. However, phylogenetic analysis including two EAG family channels from the ctenophore Mnemiopsis leidyi indicates that the diversification of the Eag, Erg and Elk gene subfamilies occurred in a cnidarian/bilaterian ancestor after divergence from ctenophores. Erg channel function is highly conserved between cnidarians and mammals. Here we show that Eag and Elk channels from the sea anemone Nematostella vectensis (NvEag and NvElk) also share high functional conservation with mammalian channels. NvEag, like bilaterian Eag channels, has rapid kinetics, whereas NvElk activates at extremely hyperpolarized voltages, which is characteristic of Elk channels. Potent inhibition of voltage activation by extracellular protons is conserved between mammalian and Nematostella EAG channels. However, characteristic inhibition of voltage activation by Mg2+ in Eag channels and Ca2+ in Erg channels is reduced in Nematostella because of mutation of a highly conserved aspartate residue in the voltage sensor. This mutation may preserve sub-threshold activation of Nematostella Eag and Erg channels in a high divalent cation environment. mRNA in situ hybridization of EAG channels in Nematostella suggests that they are differentially expressed in distinct cell types. Most notable is the expression of NvEag in cnidocytes, a cnidarian-specific stinging cell thought to be a neuronal subtype.