bluuebunny/crossref_metadata_2025 huggingface dataset:
Limitless: becoming remarkable in the borderless economy
Authors: Kubik George H.
Published: May 2013

Purpose

The purpose of this paper is to examine how the emerging new economy is impacting the future of human capital development and the future of work.

Design/methodology/approach

A detailed review of the literature is used to profile the changing nature of work and work requirements in the emerging new economy. Recent trends and developments in human capital development and advancements in computer‐enhanced performanceware are combined with components of the traditional apprenticeship model. The resulting silicon‐based apprenticeship model is compared and contrasted with models of formal education, training, and apprenticeship.

Findings

The fast‐paced new economy is demanding greater performance from ever‐greater percentages of the world's population. New forms of hypercompetition demand the elimination of the long lead‐times that have traditionally existed between learning and doing. The proffered silicon‐based apprenticeship model is advanced as a development that is projected to jump‐start twenty‐first century learner/performers into on‐demand, world‐class, performance.

Research limitations/implications

Speculative literature directed at the future of new economy work and workers is not cohesively linked to the literature of electronic performance enhancement, learning theory, and advancements in technology. This paper advances an approach for accelerating work performance and human capital development that may instigate future research in this area.

Practical implications

This paper identifies the value of greatly accelerating the performance of workers in the emerging new economy, while simultaneously decreasing the existing time lag between learning and performance.

Social implications

The ability to involve more individuals in the emerging new economy promises to increase both quality of life and standard of living for greater percentages of the global population.

Originality/value

The author asserts that silicon‐based apprenticeships are a necessary next step toward engaging more of the world's population in the new economy.
Ready for the future: the four principles of nomadic learning in organizations
Authors: Kramer An
Published: May 2013

Purpose

This essay aims to develop a new concept of learning for organizations. Change concepts are used to explore and find principles of learning that make employees and their organizations ready for the ever changing reality. Considering the rapid and unexpected changes of today it makes them ready for the future of work.

Design/methodology/approach

The approach is anticipatory, utilizing a dynamic knowledge development framework, combined with action research in the organization consultancy and training practice.

Findings

The article describes theory and practice of four principles of nomadic learning. It shows the connection with change theories and future of work research.

Research limitations/implications

How to realize nomadic learning within organizations and in that way make that organization a learning company is a recommended topic for new research. The consequences for the way of structuring and organizing within organizations should be taken into account.

Practical implications

When nomadic learning is applied it will change the common practice of leadership development and organizational change programs.

Social Implications

Nomadic learning has the capacity to connect people from diverse backgrounds and functions. In that way it can cope with risks of isolation and exclusion.

Originality/value

The combination of philosophic conceptualization and experienced practice makes this article special. This is simultaneously the way to “do” nomadic learning.
Heart failure in hospitalized patients with diabetic foot ulcers: Clinical characteristics and their relationship with prognosis (糖尿病足溃疡住院患者的心衰：临床特点以及它们与预后的关系)
Authors: Xu Lei , Qian Hongjie , Gu Junyi , Shi Jianyuan , Gu Xueming , Tang Zhengyi
Published: May 2013

Background

In the present study we: (i) evaluated the incidence of heart failure (HF) in patients with diabetic foot ulcer (DFU); and (ii) investigated the relationship between the clinical characteristics in these patients and prognosis.

Methods

The clinical characteristics of 330 consecutive Chinese patients (137 men, 193 women) hospitalized for DFU were collected and assessed to determine the effects of HF on DFU. All patients were followed for 3 months and rates of healing, the development of new ulcers, amputations, and mortality were calculated at the end of the follow‐up period.

Results

Heart failure was present in 64.3% of patients with DFU, with the prevalence of HF increasing with Wagner grade from Wagner 1 through to Wagner 5 (42.4%, 59.1%, 64.7%, 73.3%, and 87.0%, respectively), higher than the 33.6% prevalence in diabetic patients without DFU (Wagner 0). The presence of HF conferred a greater increased relative risk of a worse prognosis. The 3‐month healing rates of DFU in patients with and without HF were 60.3% and 75.7%, respectively. Recurrence (13.2% vs 7.5%) and amputations (28.6% vs 20.0%) were more frequent in patients with than without HF (P < 0.05). All‐cause mortality was recorded for 14 of 126 patients with HF compared with three of 70 patients without HF (11.1% vs 4.3%, respectively; P < 0.05).

Conclusions

The prevalence of HF is high in Chinese inpatients with DFU, with the presence of HF indicating a worse prognosis for these patients.
Can radiological changes in lymph node volume during treatment predict success of radiation therapy in patients with locally advanced head and neck squamous cell carcinoma?
Authors: Mishra Sanju , Hammond Alexander , Read Nancy , Venkatesan Varagur , Winquist Eric , Nichols Anthony , Warner Andrew , Palma David
Published: May 2013

Background

Assessment of nodal response after radiotherapy (RT) for head and neck squamous cell carcinoma is difficult, as both CT and positron emission tomography scanning have limited predictive value for residual disease. We sought to measure changes in nodal volume during RT to determine whether such changes are predictive of nodal disease control.

Methods

Patients with locally advanced head and neck squamous cell carcinoma treated with 70 Gy of radical RT (±chemotherapy or anti‐epidermal growth factor receptor (EGFR) antibodies) were eligible. Baseline pre‐RT scans and cone‐beam CT scans done at the outset of treatment and at weeks 3, 5 and 7 (cone‐beam CTs # 1, 2, 3 and 4, respectively) were deformably coregistered, and 3D nodal volumes were measured.

Results

Thirty‐eight eligible patients were identified. The main primary tumour site was oropharyngeal; most patients had stage IVa disease. Twenty‐seven patients received concurrent platinum‐based chemotherapy, 10 received only an EGFR inhibitor with RT and one received RT alone. Twelve patients had a failure in the neck. After week 1 of treatment, a 4% mean decrease in nodal volume was observed, increasing to 40% at week 7. Platinum‐based chemotherapy achieved significantly greater decreases in nodal volume than EGFR inhibitors (44 vs. 25%; P = 0.026). Advanced tumour stage predicted neck failure (P = 0.002), but nodal volumes did not correlate with neck control.

Conclusions

Changes in nodal volume are minimal initially during RT but accelerate during the latter weeks of therapy. This study suggests that chemotherapy achieves a greater decrease in nodal volume than EGFR inhibitors and that nodal changes do not predict disease control in the neck.
High‐powered percutaneous microwave ablation of stage I medically inoperable non‐small cell lung cancer: A preliminary study
Authors: Liu Howard , Steinke Karin
Published: May 2013

Purpose

To retrospectively evaluate the feasibility and outcome of using high‐powered percutaneous microwave ablation (MWA) in treating medically inoperable early stage non‐small cell lung cancer.

Materials and Methods

From November 2010 to June 2012, 15 patients underwent CT‐guided MWA of 15 tumours in 16 sessions. One patient had a second ablation session for local tumour progression. Each tumour had a diameter of 40 mm or less (median 24 mm). Treatment outcome was evaluated using modified response evaluation criteria in solid tumours criteria based on follow‐up contrast‐enhanced CT studies and 18‐F fluorodeoxyglucose positron emission tomography scans.

Results

Thirty‐three ablation cycles of 15 tumours were performed in 16 sessions (2.1 per session), with a median duration of 2.5 min per ablation. Treatment was completed in all cases with no 30‐day mortality. At a median follow‐up period of 1 year, local progression was identified following 5/16 (31%) ablation sessions. Eleven out of 16 (69%) of MWAs had shown local treatment response, with 9/11 displaying complete response and 2/11 displaying partial response. Local progression on follow up was predominantly seen in pleural‐based tumours that were greater than 30 mm in longest axial diameter (4/5 cases). The main adverse event was a pneumothorax, which occurred in 10/16 (63%) of procedures, but a chest tube was only required in 2/16 (13%) cases.

Conclusion

Percutaneous MWA in early stage non‐small cell lung cancer is well tolerated and has promising midterm outcomes.
Implementation of shared decision making in anaesthesia and its influence on patient satisfaction
Authors: Flierler W. J. , Nübling M. , Kasper J. , Heidegger T.
Published: May 2013

There is a lack of data about the implementation of shared decision making in anaesthesia. To assess patients' preference to be involved in medical decision making and its influence on patient satisfaction, we studied 197 matched pairs (patients and anaesthetists) using two previously validated questionnaires. Before surgery, patients had to decide between general vs regional anaesthesia and, where appropriate, between conventional postoperative pain therapy vs catheter techniques. One hundred and eighty‐six patients (94%) wished to be involved in shared decision making. One hundred and twenty‐two patients (62%) experienced the exact amount of shared decision making that they wanted; 44 (22%) were slightly more involved and 20 (10%) slightly less involved in shared decision making than they desired. Preferences regarding involvement in shared decision making were similar between patients and anaesthetists with mean (SD) points of 54.1 (16.2) vs 56.4 (27.6) (p = 0.244), respectively on a 0–100 scale; however, patients were found to have a stronger preference for a totally balanced shared decision‐making process (65% vs 32%). Overall patient satisfaction was high: 88% were very satisfied and 12% satisfied with a mean (SD) value of 96.1 (10.6) on a 0–100 scale. Shared decision making is important for providing high levels of patient satisfaction.
Evaluation of oxygen concentrators for use in countries with limited resources
Authors: Peel D. , Neighbour R. , Eltringham R. J.
Published: May 2013

Seven different models of oxygen concentrators were purchased. The manufacturer's data were evaluated by a ranking method for operation at high temperature and high relative humidity, power consumption, warranty and cost. Measurements were then made of the oxygen concentration produced at maximum operating temperature. All the concentrators were CE marked and claimed compliance with the relevant Standard ISO 8359:1996. Only two models complied with their specification. On examination of the concentrators and the accompanying documents we found that compliance with 61 points listed in ISO 8359 ranged from 85% to 98%. Oxygen concentration was measured with the machines running simultaneously under both high temperature and high humidity. All models delivered low oxygen concentrations at 40 °C and 95% relative humidity. Only two models delivered > 82% at 35 °C and 50% relative humidity. Concentrators intended for use in countries with limited resources should be evaluated before they are purchased, by independent experts, using the methods described herein.
Enteric gram‐negative bacilli suppress Candida biofilms on Foley urinary catheters
Authors: Samaranayake Y. H. , Bandara H. M. H. N. , Cheung B. P. K. , Yau J. Y. Y. , Yeung S. K. W. , Samaranayake L. P.
Published: May 2013

Mixed Candida‐bacterial biofilms in urinary catheters are common in hospitalized patients. (i) The aims of this study were to evaluate, quantitatively and qualitatively, the in vitro development of mono‐ and dual‐species biofilms (MSBs and DSBs) of Candida albicans and two enteric gram‐negative bacilli (EGNB; Pseudomonas aeruginosa or Escherichia coli) on Foley catheter (FC) discs, (ii) to determine the biofilm growth in tryptic soy broth or glucose supplemented artificial urine (AU) and (iii) to assess the inhibitory effects of EGNB and their lipopolysaccharides (LPS) on Candida biofilm growth. The growth of MSBs and DSBs on FC discs was monitored by cell counts and SEM. The metabolic activity of LPS‐treated Candida biofilms was determined by the XTT reduction assay. Candida albicans and EGNB demonstrated significant inter‐ and intra‐species differences in biofilm growth on FC discs (p < 0.01). Pseudomonas aeruginosa suppressed Candida albicans significantly (p < 0.001) in DSBs. Compared with MSBs, DSB of EGNB in glucose supplemented AU demonstrated robust growth. Escherichia coli and its LPS, significantly suppressed Candida biofilm growth, compared with Pseudomonas aeruginosa and its LPS (p < 0.001). Candida albicans and EGNB colonization in FC is significantly increased in AU with glucose, and variably modified by Escherichia coli, Pseudomonas aeruginosa and their corresponding LPS.
The novel human polyomaviruses HPyV6, 7, 9 and beyond
Authors: Ehlers Bernhard , Wieland Ulrike
Published: May 2013

Since the discovery of Merkel cell polyomavirus and its causative association with Merkel cell carcinoma (MCC), six human polyomaviruses (HPyVs) have been identified that, so far, lack any disease association, which include the human polyomaviruses (HPyV) 6, 7, 9, 10 and 12 as well as the Saint Louis polyomavirus (STLPyV). PCR studies revealed that HPyV6 and HPyV7 are shed from the skin of healthy subjects and of patients suffering from various skin tumours. HPyV6, 7 and 9 were sporadically detected in body fluids and excretions of immunocompromised patients and healthy subjects. HPyV10 was identified in papillomavirus‐induced anal condylomas, and variants of HPyV10, named MWPyV and MX polyomavirus (human) (MXPyV), as well as STLPyV were detected in faeces of diarrheal and healthy children. HPyV12 was discovered in organs of the digestive tract of patients suffering from various malignant diseases. Serological studies using capsomer‐based or virus‐like particle (VLP)‐based enzyme‐linked immunosorbent assay (ELISA) revealed that HPyV6, 7, 9 and 12 are circulating in the human population. As all other HPyVs, the novel polyomaviruses encode small and large T antigens and thus are potentially oncogenic. However, several studies have revealed a lack of association of HPyV6, 7 and 9 with numerous human tumours. In the future, it will be important to unravel the cell types and body compartments of the novel HPyVs′ reservoir and to search for possible associations with cancer and non‐malignant diseases.
Colon cancer: association of histopathological parameters and patients' survival with clinical presentation
Authors: Alexiusdottir Kristin K. , Snaebjornsson Petur , Tryggvadottir Laufey , Jonasson Larus , Olafsdottir Elinborg J. , Björnsson Einar Stefan , Möller Pall Helgi , Jonasson Jon G.
Published: May 2013

Available data correlating symptoms of colon cancer patients with the severity of the disease are very limited. In a population‐based setting, we correlated information on symptoms of colon cancer patients with several pathological tumor parameters and survival. Information on all patients diagnosed with colon cancer in Iceland in 1995–2004 for this retrospective, population‐based study was obtained from the Icelandic Cancer Registry. Information on symptoms of patients and blood hemoglobin was collected from patients' files. Pathological parameters were obtained from a previously performed standardized tumor review. A total of 768 patients entered this study; the median age was 73 years. Tumors in patients presenting at diagnosis with visible blood in stools were significantly more likely to be of lower grade, having pushing border, conspicuous peritumoral lymphocytic infiltration, and lower frequency of vessel invasion. Patients with abdominal pain and anemia were significantly more likely to have vessel invasion. Logistic regression showed that visible blood in stools was significantly associated with protecting pathological factors (OR range 0.38–0.83, p < 0.05). Tumors in patients presenting with abdominal pain were strongly associated with infiltrative margin and scarce peritumoral lymphocytic infiltration (OR = 1.95; 2.18 respectively, p < 0.05). Changes in bowel habits were strongly associated with vessel invasion (OR = 2.03, p < 0.05). Cox regression showed that blood in stools predicted survival (HR = 0.54). In conclusion, visible blood in stools correlates significantly with all the beneficial pathological parameters analyzed and with better survival of patients. Anemia, general symptoms, changes in bowel habits, acute symptoms, and abdominal pain correlate with more aggressive tumor characteristics and adverse outcome for patients.
Resistance to BH3 mimetic S1 in SCLC cells that up‐regulate and phosphorylate Bcl‐2 through ERK1/2
Authors: Liu Yubo , Zhang Zhichao , Song Ting , Liang Furong , Xie Mingzhou , Sheng Hongkun
Published: May 2013

Background and Purpose

B cell lymphoma 2 (Bcl‐2) is a central regulator of cell survival that is overexpressed in the majority of small‐cell lung cancers (SCLC) and contributes to both malignant transformation and therapeutic resistance. The purpose of this work was to study the key factors that determine the sensitivity of SCLC cells to Bcl‐2 homology domain‐3 (BH3) mimetic S1 and the mechanism underlying the resistance of BH3 mimetics.

Experimental Approaches

Western blot was used to evaluate the contribution of Bcl‐2 family members to the cellular response of SCLC cell lines to S1. Acquired resistant cells were derived from initially sensitive H1688 cells. Quantitative PCR and gene silencing were performed to investigate Bcl‐2 up‐regulation.

Key Results

A progressive increase in the relative levels of Bcl‐2 and phosphorylated Bcl‐2 (pBcl‐2) characterized the increased de novo and acquired resistance of SCLC cell lines. Furthermore, acute treatment of S1 induced Bcl‐2 expression and phosphorylation. We showed that BH3 mimetics, including S1 and ABT‐737, induced endoplasmic reticulum (ER) stress and then activated MAPK/ERK pathway. The dual function of MAPK/ERK pathway in defining BH3 mimetics was illustrated; ERK1/2 activation leaded to Bcl‐2 transcriptional up‐regulation and sustained phosphorylation in naïve and acquired resistant SCLC cells. pBcl‐2 played a key role in creating resistance of S1 and ABT‐737 not only by sequestrating pro‐apoptotic proteins, but also sequestrating a positive feedback to promote ERK1/2 activation.

Conclusions and Implications

These results provide significant novel insights into the molecular mechanisms for crosstalk between ER stress and endogenously apoptotic pathways in SCLC following BH3 mimetics treatment.
Human T‐lymphotropic virus type 1 non‐structural proteins: Requirements for latent infection
Authors: Fukumoto Risaku
Published: May 2013

It has been more than 30 years since the discovery of human T‐lymphotropic virus type 1 (HTLV‐1), the first human retrovirus identified. Human T‐lymphotropic virus type 1 infects 15–20 million people worldwide causing two major diseases: adult T‐cell leukemia/lymphoma and HTLV‐1‐associated myelopathy/tropical spastic paraparesis. Human T‐lymphotropic virus type 1 establishes several decades of latent infection, during which viral–host interaction determines disease segregation. This review highlights non‐structural proteins that are encoded on the viral genome and manage latent infection. Latent infection is a key in HTLV pathology, so that effective inhibition of these proteins might lead to successful disease management.
Whole exome sequencing and functional studies identify an intronic mutation in TRAPPC2 that causes SEDT
Authors: Davis E.E. , Savage J.H. , Willer J.R. , Jiang Y.‐H. , Angrist M. , Androutsopoulos A. , Katsanis N.
Published: May 2013

Skeletal dysplasias are challenging to diagnose because of their phenotypic variability, genetic heterogeneity, and diverse inheritance patterns. We conducted whole exome sequencing of a Turkish male with a suspected X‐linked skeletal dysplasia of unknown etiology as well as his unaffected mother and maternal uncle. Bioinformatic filtering of variants implicated in skeletal system development revealed a novel hemizygous mutation, c.341‐(11_9)delAAT, in an intron of TRAPPC2, the causative locus of spondyloepiphyseal dysplasia tarda (SEDT). We show that this deletion leads to the loss of wild‐type TRAPPC2 and the generation of two functionally impaired mRNAs in patient cells. These consequences are predicted to disrupt function of SEDLIN/TRAPPC2. The clinical and research data were returned, with appropriate caveats, to the patient and informed his disease status and reproductive choices. Our findings expand the allelic repertoire of SEDT and show how prior filtering of the morbid human genome informed by inheritance pattern and phenotype, when combined with appropriate functional tests in patient‐derived cells, can expedite discovery, overcome issues of missing data and help interpret variants of unknown significance. Finally, this example shows how the return of a clinically confirmed mutational finding, supported by research allele pathogenicity data, can assist individuals with inherited disorders with life choices.
Practical Implications of Understanding the Influence of Motivations on Commitment to Voluntary Urban Conservation Stewardship
Authors: ASAH STANLEY T. , BLAHNA DALE J.
Published: May 2013

Although the word commitment is prevalent in conservation biology literature and despite the importance of people's commitment to the success of conservation initiatives, commitment as a psychological phenomenon and its operation in specific conservation behaviors remains unexplored. Despite increasing calls for conservation psychology to play a greater role in meeting conservation goals, applications of the psychological sciences to specific conservation behaviors, illustrating their utility to conservation practice, are rare. We examined conservation volunteers’ motivations and commitment to urban conservation volunteering. We interviewed key informant volunteers and used interview findings to develop psychometric scales that we used to assess motivations and commitment to volunteer. We surveyed 322 urban conservation volunteers and used factor analysis to reveal how volunteers structure their motivations and commitment to volunteer for urban conservation activities. Six categories of motivations and 2 categories of commitment emerged from factor analysis. Volunteers were motivated by desires to help the environment, defend and enhance the ego, career and learning opportunities, escape and exercise, social interactions, and community building. Two forms of commitment, affective and normative commitment, psychologically bind people to urban conservation volunteerism. We used linear‐regression models to examine how these categories of motivations influence volunteers’ commitment to conservation volunteerism. Volunteers’ tendency to continue to volunteer for urban conservation, even in the face of fluctuating counter urges, was motivated by personal, social, and community functions more than environmental motivations. The environment, otherwise marginally important, was a significant motivator of volunteers’ commitment only when volunteering met volunteers’ personal, social, and community‐building goals. Attention to these personal, social, and community‐building motivations may help enhance volunteers’ commitment to conservation stewardship and address the pressing challenge of retaining urban conservation volunteers.

Implicaciones Prácticas del Entendimiento de la Influencia de Motivaciones sobre el Compromiso de Voluntarios de Conservación Urbana Asah & Blahna
‘Be Clear on Cancer’: the impact of the UK National Bowel Cancer Awareness Campaign
Authors: Peacock O. , Clayton S. , Atkinson F. , Tierney G. M. , Lund J. N.
Published: May 2013

Aim

The National Bowel Cancer Awareness Campaign (‘Be Clear on Cancer’) was launched by the UK government in January 2012, encouraging people with bowel symptoms to present to primary care. Our aim was to evaluate the impact of the campaign on colorectal services in secondary care.

Method

Suspected cancer 2‐week‐wait (2WW) patients 3 months before and 3 months after the launch of the campaign were included. Demographics, reason for referral, investigations performed, cost analysis and eventual diagnoses were collected.

Results

Three hundred and forty‐three patients [median age 70 (36–100) years, 194 (57%) women] were seen and investigated in the 3 months prior to the launch of the campaign at an average cost of £575 per patient. Twenty‐seven (8%) were diagnosed with lower gastrointestinal cancer and 29 (8%) with polyps. In the 3 months following the launch, 544 patients [median age 68 (30–92) years, 290 (53%) women] were reviewed (59% increase; P = 0.004). The ‘did not attend’ rate fell from 10% to 1%. Thirty‐two (6%) patients were diagnosed with a lower gastrointestinal cancer and 20 (4%) with colorectal polyps. The cost per colorectal cancer detected rose from £7585.58 before the campaign to £9662.72 after launch (P = 0.04).

Conclusion

The ‘Be Clear on Cancer’ campaign has substantially increased the number of referrals under the 2WW rule, but mainly in the worried well. This has increased demands on both resources (59% more tests) and finance. Cost per cancer detected rose by 27% with no increase in funding to support the increased activity.
Aseptic Bursaphelenchus xylophilus does not reduce the mortality of young pine tree
Authors: Zhao H. , Chen C. , Liu S. , Liu P. , Liu Q. , Jian H.
Published: May 2013

To assess the role of bacteria in pine wilt disease (PWD), aseptic M form (with a mucronated tail) and R form (with a round tail) of Bursaphelenchus xylophilus and B. mucronatus were obtained and compared, in terms of reproduction and pathogenicity, with non‐aseptic nematode. In addition, bacteria isolated from non‐aseptic nematodes and pine trees inoculated with non‐aseptic nematodes were identified. The results indicated that the bacteria associated with nematodes significantly lowered the reproduction of R form of B. xylophilus and B. mucronatus. Both the non‐aseptic and aseptic R forms of B. xylophilus induced death in all infected 7‐ to 8‐year‐old pine trees, while the non‐aseptic and aseptic M forms of B. xylophilus and B. mucronatus caused almost no plant mortality. High numbers of the non‐aseptic and aseptic R forms of B. xylophilus were distributed throughout the inoculated trees, while B. mucronatus and M form of B. xylophilus nematodes were lower in number and their distribution in stems limited within the inoculation site. Bacteria isolated from non‐aseptic nematodes were not recovered from the pine trees inoculated with these same kinds of nematodes. Two species of bacteria were both isolated from non‐aseptic B. mucronatus and from R form of B. xylophilus. Microbacterium trichotecenolyticum was common to both the control and inoculated pine trees. These results suggest that R form of B. xylophilus is the causal agent of PWD and that bacteria cannot increase the virulence of B. xylophilus and B. mucronatus.
Sleep: a synchrony of cell activity‐driven small network states
Authors: Krueger James M. , Huang Yanhua H. , Rector David M. , Buysse Daniel J.
Published: May 2013

We posit a bottom‐up sleep‐regulatory paradigm in which state changes are initiated within small networks as a consequence of local cell activity. Bottom‐up regulatory mechanisms are prevalent throughout nature, occurring in vastly different systems and levels of organization. Synchronization of state without top‐down regulation is a fundamental property of large collections of small semi‐autonomous entities. We posit that such synchronization mechanisms are sufficient and necessary for whole‐organism sleep onset. Within the brain we posit that small networks of highly interconnected neurons and glia, for example cortical columns, are semi‐autonomous units oscillating between sleep‐like and wake‐like states. We review evidence showing that cells, small networks and regional areas of the brain share sleep‐like properties with whole‐animal sleep. A testable hypothesis focused on how sleep is initiated within local networks is presented. We posit that the release of cell activity‐dependent molecules, such as ATP and nitric oxide, into the extracellular space initiates state changes within the local networks where they are produced. We review mechanisms of ATP induction of sleep‐regulatory substances and their actions on receptor trafficking. Finally, we provide an example of how such local metabolic and state changes provide mechanistic explanations for clinical conditions, such as insomnia.
Realization and Multiple Realization, Chicken and Egg
Authors: Polger Thomas W.
Published: May 2013

A common view is that the truth of multiple realization—e.g., about psychological states—entails the truth of functionalism. This is supposed to follow because what is multiply realized is eo ipso realized. I argue that view is mistaken by demonstrating how it misrepresents arguments from multiple realization. In particular, it undermines the empirical component of the arguments, and renders the multiplicity of the realization irrelevant. I suggest an alternative reading of multiple realizability arguments, particularly in philosophy of psychology. And I explain the proper way to understand the relation between realization and multiple realization.
On the Meaning of Alarm Calls: A Review of Functional Reference in Avian Alarm Calling
Authors: Gill Sharon A. , Bierema Andrea M.‐K.
Published: May 2013

A long‐standing question in animal communication is whether signals reveal intrinsic properties of the signaller or extrinsic properties of its environment. Alarm calls, one of the most conspicuous components of antipredator behaviour, intuitively would appear to reflect internal states of the signaller. Pioneering research in primates and fowl, however, demonstrated that signallers may produce unique alarm calls during encounters with different types of predators, suggesting that signallers through selective production of alarm calls provide to conspecific receivers information about predators in the environment. In this article, we review evidence for such ‘functional reference’ in the alarm calls of birds based on explicit tests of two criteria proposed in Macedonia & Evans’ (Ethology 93, 1993, 177) influential conceptual framework: (1) that unique alarm calls are given to specific predator categories, and (2) that alarm calls isolated from contextual information elicit antipredator responses from receivers similar to those produced during actual predator encounters. Despite the importance of research on birds in development of the conceptual framework and the ubiquity of alarm calls in birds, evidence for functionally referential alarm calls in this clade is limited to six species. In these species, alarm calls are associated with the type of predator encountered as well as variation in hunting behaviour; with defence of reproductive effort in addition to predators of adults; with age‐related changes in predation risk; and with strong fitness benefits. Our review likely underestimates the occurrence of functional reference in avian alarm calls, as incomplete application and testing of the conceptual framework has limited our understanding. Throughout, therefore, we suggest avian taxa for future studies, as well as additional questions and experimental approaches that would strengthen our understanding of the meaning of functional reference in avian alarm calls.
Tobacco smoke–induced skin pigmentation is mediated by the aryl hydrocarbon receptor
Authors: Nakamura Motoki , Ueda Yukiko , Hayashi Mai , Kato Hiroshi , Furuhashi Takuya , Morita Akimichi
Published: May 2013

It is widely recognized that tobacco smoke causes skin pigmentation. No studies, however, have directly evaluated the mechanisms of the changes in smoker's skin pigmentation. In this study, when cultured with water‐soluble tobacco smoke extract, the human epidermal melanocytes grew to a large size and produced more melanins. We evaluated melanocyte activation by quantifying microphthalmia‐associated transcription factor (MITF) expression by real‐time polymerase chain reaction. MITF expression was significantly and dose‐dependently increased by exposure to tobacco smoke extract. The Wnt/β‐catenin signalling pathway seemed to mediate the tobacco smoke extract–induced melanocyte activation. Immunocytochemical studies revealed that the activated melanocytes actively expressed aryl hydrocarbon receptors (AhR) around the nuclear membrane. The tobacco smoke extract–induced MITF activation was inhibited by RNA silencing of the AhR. This study provides the evidence that tobacco smoke enhances pigmentation in vitro and that the increase in pigmentation may involve β‐catenin‐ and AhR‐mediated mechanisms inside human melanocytes.
Experimental study on mechanical properties and fracture toughness of structural thick plate and its butt weld along thickness and at low temperatures
Authors: Wang Y. Q. , Liu X. Y. , Hu Z. W. , Shi Y. J.
Published: May 2013

The thick plate induces the variation of mechanical properties and fracture toughness, especially in cold regions. At the low temperature, the brittle behaviour of steel becomes worse. A series of tests (such as uniaxial tensile test and three‐point bending test) were carried out at low temperature to investigate the mechanical properties and fracture toughness of structural steel plates of Q345B with thickness of 60 to 150 mm, as well as the fracture toughness of 150 mm thick butt welded plate. The test specimens are all manufactured from plates along thickness with small size, and the tensile test specimens included through‐thickness specimens additionally. The ductility index (percentage reduction of area) and the fracture toughness index (critical CTOD values) all decrease with the temperature decreases and the distance from plate surface increases. The results obtained in this paper provide technical basis for preventing brittle fracture of thick plate steel structures in cold regions.
Impact of vitamin D insufficiency on insulin homeostasis and beta cell function in nondiabetic male HIV‐infected patients
Authors: Moreno‐Pérez O , Portilla J , Escoín C , Alfayate R , Reus S , Merino E , Boix V , Bernabeu A , Giner L , Mauri M , Sánchez‐Paya J , Picó A
Published: May 2013

Objectives

Vitamin D is thought to play a role in glucose homeostasis and beta cell function. Our aim was to examine the impact of plasma 25‐hydroxyvitamin D [25(OH)D] upon in vivo insulin sensitivity and beta cell function in HIV‐infected male patients without diabetes.

Methods

A cross‐sectional study was carried out involving a cohort of HIV‐infected patients undergoing regular assessment in a tertiary hospital. Eighty‐nine patients [mean (± standard deviation) age 42 ± 8 years] were included in the study: 14 patients were antiretroviral therapy (ART)‐naïve, while 75 were on ART. Vitamin D insufficiency (VDI) was defined as 25(OH)D < 75 nmol/L; insulin sensitivity was determined using a 2‐h continuous infusion of glucose model assessment with homeostasis (CIGMA‐HOMA), using the trapezoidal model to calculate the incremental insulin and glucose areas under the curve (AUCins and AUGglu, respectively). Beta cell function was assessed using the disposition index (DI). Abdominal visceral adipose tissue (VAT) and hepatic triglyceride content (HTGC) were measured by magnetic resonance imaging (MRI) and 1‐H magnetic resonance spectroscopy. Multivariate linear regression analysis was performed.

Results

VDI was associated with insulin resistance (IR), as indicated by a higher CIGMA‐HOMA index (odds ratio 1.1) [1.01–1.2]. This association was independent of the main confounders, such as age, Centers for Disease Control and Prevention (CDC) stage, ART, lipodystrophy, body mass index, VAT:subcutaneous adipose tissue ratio and HTGC, as confirmed by multivariate analysis (B = 12.3; P = 0.01; r2 = 0.7). IR in patients with VDI was compensated by an increase in insulin response. However, beta cell function was lower in the VDI subpopulation (33% decrease in DI).

Conclusions

VDI in nondiabetic HIV‐positive male patients is associated with impaired insulin sensitivity and a decrease in pancreatic beta cell function.
Incorporation of Migrant Students Returning From the United States to High Schools in Mexico
Authors: Bazán‐Ramirez Aldo , Galván‐Zariñana Gabriela
Published: May 2013

The purpose of this research was to identify the difficulties faced by the Mexican migrant students when incorporated into the Mexican education system after having studied in the United States of America. Thirty migrant middle school students, two principals, two social workers and one teacher participated in the study. The study (conducted in two phases) collected information regarding: school admission, adjustment to the school organization, adaptation to learning situations and the perception of school belonging.

The main problems found during the admission and enrolment procedures in Mexican schools are: language use, diagnostic assessment, didactic processes that take place in the classroom, complementary support activities, grade repetition, very little family involvement and the separation of the students from their migrant parents.
C‐reactive protein and leucocyte counts drop faster using the HeartShield® device in patients with DSWI
Authors: Lindstedt Sandra , Malmsjö Malin , Ingemansson Richard
Published: May 2013

Right ventricular heart rupture is a devastating complication associated with negative pressure wound therapy (NPWT) in cardiac surgery. The use of a rigid barrier disc (HeartShield™) has been suggested to offer protection against this lethal complication by preventing the heart from being drawn up by the negative pressure and damaged by the sharp sternum bone edges. Seven patients treated with conventional NPWT and seven patients treated with NPWT with a protective barrier disc (HeartShield) were compared with regard to bacterial clearance and infection parameters including C‐reactive protein levels and leucocyte counts. C‐reactive protein levels and leucocyte counts dropped faster and bacterial clearance occurred earlier in the HeartShield® group compared with the conventional NPWT group. Negative biopsy cultures were shown after 3·1 ± 0·4 NPWT dressing changes in the HeartShield group, and after 5·4 ± 0·6 NPWT dressing changes in the conventional NPWT group (P < 0·001). All patients were followed up with clinical check‐up after 3 months. None of the patients in the HeartShield group had any signs of reinfection such as deep sternal wound infection (DSWI) or sternal fistulas, whereas in the conventional NPWT group, two patients had signs of sternal fistulas that demanded hospitalisation. HeartShield hinders the right ventricle to come into contact with the sharp sternal edges during NPWT and thereby protects from heart damage. This study shows that using HeartShield is beneficial in treating patients with DSWI. Improved wound healing by HeartShield may be a result of the efficient drainage of wound effluents from the thoracic cavity.
Establishment of a novel rat model for deep tissue injury deterioration
Authors: Sari Yunita , Minematsu Takeo , Huang Lijuan , Noguchi Hiroshi , Mori Taketoshi , Nakagami Gojiro , Nagase Takashi , Oe Makoto , Sugama Junko , Yoshimura Kotaro , Sanada Hiromi
Published: May 2013

Deep tissue injuries (DTIs) can become significant problems because of their rapid deterioration into deep pressure ulcers. Presently, no animal model of DTI deterioration has been developed. By concentrating pressure and shear stress in deep tissues while minimising pressure and shear stress in the overlying skin, we produced an effective rat model of DTI deterioration. Two‐dimensional finite element method (FEM) simulated the distribution of pressure and shear stress under several pressure‐loading conditions. FEM showed that concentrated shear stress in deep tissue with minimum shear stress in the overlying skin could be created by using a prominence and a cushion, respectively. On the basis of the results of FEM analysis, we selected suitable conditions for testing the rat DTI deterioration model. The compressed area was macroscopically observed until day 13, and histopathologic analysis via haematoxylin and eosin (H&E) staining was performed on days 3, 7 and 13. H&E staining showed that the distribution of tissue damage was similar to the predicted FEM results. Deep ulceration and tissue damage extending from deep tissues to the overlying skin and surrounding tissues were observed in the DTI deterioration model, which are similar to the clinical manifestations of DTI deterioration. In conclusion, a representative DTI deterioration model was established by concentrating high shear stress in deep tissues while minimising shear stress in the overlying skin. This model will allow a better understanding of the mechanisms behind DTI deterioration and the development of preventative strategies.
Clinical aspects of the use of dental adhesive materials in patients with chronic xerostomia
Authors: Bogucki Zdzislaw Artur
Published: May 2013

doi: 10.1111/j.1741‐2358.2012.00659.x

Clinical aspects of the use of dental adhesive materials in patients with chronic xerostomia

Adhesives are commonly used by denture wearers to increase the retention and stability of the complete denture, to improve the chewing and masticatory abilities and to psychologically support the patient to make the complete denture more acceptable. Denture fixatives can be especially recommended for use and to aid retention for patients with dryness of the mouth, poor secretion of saliva and xerostomia (e.g. diabetes mellitus). Dental adhesives may be contaminated with bacteria, yeast and fungi during the manufacturing process, and they have been shown to initiate and promote microbial growth. Some products have been shown to release formaldehyde, which is cytotoxic to cell culture and fibroblasts and is a potent allergen. Patients with chronic xerostomia may use denture adhesives during the course of the treatment and disease. These patients are often immunocompromised, and microorganisms they are exposed to must be considered potential pathogens.
Inhibition of CK2α down‐regulates Notch1 signalling in lung cancer cells
Authors: Zhang Shulin , Long Hao , Yang Yi‐Lin , Wang Yucheng , Hsieh David , Li Weiming , Au Alfred , Stoppler Hubert J. , Xu Zhidong , Jablons David M. , You Liang
Published: May 2013

Protein kinase CK2 is frequently elevated in a variety of human cancers. The Notch1 signalling pathway has been implicated in stem cell maintenance and its aberrant activation has been shown in several types of cancer including lung cancer. Here, we show, for the first time, that CK2α is a positive regulator of Notch1 signalling in lung cancer cell lines A549 and H1299. We found that Notch1 protein level was reduced after CK2α silencing. Down‐regulation of Notch1 transcriptional activity was demonstrated after the silencing of CK2α in lung cancer cells. Furthermore, small‐molecule CK2α inhibitor CX‐4945 led to a dose‐dependent inhibition of Notch1 transcriptional activity. Conversely, forced overexpression of CK2α resulted in an increase in Notch1 transcriptional activity. Finally, the inhibition of CK2α led to a reduced proportion of stem‐like CD44 + /CD24− cell population. Thus, we report that the inhibition of CK2α down‐regulates Notch1 signalling and subsequently reduces a cancer stem‐like cell population in human lung cancer cells. Our data suggest that CK2α inhibitors may be beneficial to the lung cancer patients with activated Notch1 signalling.
A G matrix analogue to capture the cumulative effects of nongenetic inheritance
Authors: Townley S. , Ezard T. H. G.
Published: May 2013

The genetic variance‐covariance (G) matrix describes the variances and covariances of genetic traits under strict genetic inheritance. Genetically expressed traits often influence trait expression in another via nongenetic forms of transmission and inheritance, however. The importance of non‐genetic influences on phenotypic evolution is increasingly clear, but how genetic and nongenetic inheritance interact to determine the response to selection is not well understood. Here, we use the ‘reachability matrix’ – a key analytical tool of geometric control theory – to integrate both forms of inheritance, capturing how the consequences of generation‐lagged maternal effects accumulate. Building on the classic Lande and Kirkpatrick model that showed how nongenetic (maternal) inheritance fundamentally alters the expected path of phenotypic evolution, we make novel inferences through decomposition of the reachability matrix. In particular, we quantify how nongenetic inheritance affects the distribution (orientation and shape) of ellipses of phenotypic change and how these distributions influence subsequent evolution. This interweaving of phenotypic means and variances accumulates generation by generation and is described analytically by the reachability matrix, which acts as an analogue ofGwhen genetic and nongenetic inheritance both act.
Work in an intermediate unit: balancing between relational, practical and moral care
Authors: Johannessen Anne‐Kari , Werner Anne , Steihaug Sissel
Published: May 2013

Aims and objectives

To explore the activities carried out and the conditions required to enable satisfactory work in an intermediate unit for patients aged 60 and older.

Background

In recent years, several intermediate units have been established to improve the clinical pathway from hospital to home for older patients.

Design

Qualitative study.

Methods

Data were obtained from interviews with eight patients and 16 healthcare providers working in the unit and from observations in six multidisciplinary meetings and six report meetings in the unit. Transcripts of interviews and field notes were analysed using a method for systematic text condensation.

Results

Care performed as a balance between relational, practical and moral aspects seems to be important to render good service to patients and to ensure the providers’ job satisfaction. Most patients experienced their stay in the unit as positive. The providers highlighted ‘suitable patients’, an appropriate physical environment and communicating computer systems as significant factors for performing treatment and for providing nursing and rehabilitation in a caring manner.

Conclusions

When environmental and organisational conditions exert pressure on the working situation, care as a practical activity seems to be prioritised at the expense of the two other aspects. The findings indicate that unfavourable environmental and organisational conditions impede patients' recovery process and thereby a good clinical pathway.

Relevance to clinical practice

To recruit, support and retain a multidisciplinary staff to the best interest of patients, it seems to be important to perform care work as a balance between relational, practical and moral activities.