bluuebunny/crossref_metadata_2025 huggingface dataset:
eMED-DNA: Anin silicooperating system for clinical medical data storage within the human genome
Authors: Jakaria Md. , Sarker Kowshika , Uddin Mostofa Rafid , Islam Md. Mohaiminul , Das Trisha , Shakur Rameen , Bayzid Md. Shamsuzzoha
Published: October 2019

The propitious developments in molecular biology and next generation sequencing have enabled the possibility for DNA storage technologies. However, the full application and power of our genomic revolution have not been fully utilized in clinical medicine given a lack of transition from research to real world clinical practice. This has identified an increasing need for an operating system which allows for the transition from research to clinical use. We present eMED-DNA, anin silicooperating system for archiving and managing all forms of electronic health records (EHRs) within one’s own copy of the sequenced genome to aid in the application and integration of genomic medicine within real world clinical practice. We incorporated an efficient and sophisticatedin-DNA file management system for the lossless management of EHRs within a genome. This represents the firstin silicointegrative system which would bring closer the utopian ideal for integrating genotypic data with phenotypic clinical data for future medical practice.
Deglycosylation of isoflavone C–glucoside puerarin by combination of two recombinant bacterial enzymes and 3–oxo–glucose
Authors: Nakamura Kenichi , Zhu Shu , Komatsu Katsuko , Hattori Masao , Iwashima Makoto
Published: October 2019

C–Glucosides are resistant to glycoside hydrolase activity because the anomeric carbon of glucose is directly connected to aglycone via carbon-carbon bonding. A human intestinal bacterium strain PUE related to Dorea species can metabolize the isoflavone C–glucoside puerarin (daidzein 8–C–glucoside) to daidzein and glucose by more than three bacterial enzymes which have not been well-characterized. We previously reported that 3”–oxo–puerarin is an essential reaction intermediate in enzymatic puerarin degradation and characterized a bacterial enzyme of DgpB–C complex which cleaved the C–glycosidic bond in 3”–oxo–puerarin. However, the exact enzyme catalyzing the oxidation of C–3” hydroxyl in puerarin has not been identified, and the other metabolite corresponding to the precursor of D–glucose, derived from the sugar moiety in 3”–oxo–puerarin in the cleaving reaction catalyzed by the DgpB–C complex, remains unknown.

In this study, we demonstrated that recombinant DgpA, a Gfo/Idh/MocA family oxidoreductase, catalyzed puerarin oxidation in the presence of 3–oxo–glucose as the hydride accepter. In addition, enzymatic C–deglycosylation of puerarin was achieved by a combination of recombinant DgpA, DgpB–C complex, and 3–oxo–glucose. Furthermore, the metabolite derived from the sugar moiety in 3”–oxo–puerarin cleaving reaction catalyzed by DgpB–C complex was characterized as 1,5–anhydro–D–erythro –hex–1–en–3–ulose, suggesting that the C–glycosidic linkage is cleaved through a β–elimination like mechanism.

Importance

One important role of the gut microbiota is to metabolize dietary nutrients and supplements such as flavonoid glycosides. Ingested glycosides are metabolized by intestinal bacteria to more absorbable aglycones and further degradation products which show beneficial effects in humans. Although numerous glycoside hydrolases that catalyze O–deglycosylation have been reported, enzymes responsible for C–deglycosylation are still limited. In this study, we characterized enzymes involved in C–deglycosylation of puerarin from a human intestinal bacterium PUE. To our knowledge, this is the first report of the expression, purification and characterization of an oxidoreductase involved in C–glucoside degradation. This study provides new insights for the elucidation of mechanisms of enzymatic C–deglycosylation.
Protein profiling reveals the characteristic changes of complement cascade pathway in the tissues of gastric signet ring cell carcinoma
Authors: Fan Yang , Bai Bin , Ren Yan , Liu Yanxia , Zhou Fenli , Lou Xiaomin , Zi Jin , Hou Guixue , Zhao Qingchuan , Liu Siqi
Published: October 2019

Signet ring cell carcinoma (SRCC) is a histological subtype of gastric cancer that has distinct features in cellular morphology, epidemiology and clinicopathology compared with adenocarcinomas (ACs). Lacking of systematically molecular overview to this disease made a slow progress in diagnosis and therapy for SRCC. In the present proteomics study, the gastric tissues were collected from tumor and adjacent regions including 14 SRCC and 34 AC cases, and laser capture microdissection (LCM) was employed to eradicate cellular heterogeneity of the tissues. Over 6,000 proteins were quantified through data independent acquisition (DIA) mass spectrometry (MS). The quantitative profiles of proteomes in tumor tissues, either AC or SRCC, were dramatically different from that in the corresponding adjacencies, whereas the SRCC proteomes appeared not distinguishable to the AC proteomes via hierarchical clustering. However, focusing on univariate analysis and pathway enrichment unrevealed that some proteins and pathways bared the differences between SRCC and ACs. Importantly, the abundance changes for a bulk of proteins involved in complement cascade were highly associated with SRCC but not so sensitive to the AC status. A hypothesis, therefore, was proposed that the complement cascade was evoked in the SRCC microenvironment upon infiltration, while the SRCC cells survived from the complement cytotoxicity by secreting negative regulators. Moreover, an attempt was made to seek appropriate cell model for gastric SRCC, through proteomic comparison of the 15 gastric cell lines and the gastric tumors. The prediction upon supervised classifier suggested none of these gastric cell lines qualified in mimic to SRCC.
Comparative RNA-seq analysis aids in diagnosis of a rare pediatric tumor
Authors: Sanders Lauren M. , Rangaswami Arun , Bjork Isabel , Lam Du Linh , Beale Holly C. , Kephart Ellen Towle , Durbin Ann , Learned Katrina , Currie Rob , Lyle A. Geoffrey , Pfeil Jacob , Shah Avanthi Tayi , Lee Alex G. , Leung Stanley G. , Behroozfard Inge H. , Breese Marcus R. , Peralez Jennifer , Hazard Florette K. , Lacayo Norman , Spunt Sheri L. , Haussler David , Salama Sofie R. , Sweet-Cordero E. Alejandro , Vaske Olena M.
Published: October 2019

Gliomatosis peritonei is a rare pathologic finding that is associated with ovarian teratomas and malignant mixed germ cell tumors. The occurrence of gliomatosis as a mature glial implant can impart an improved prognosis to patients with immature ovarian teratoma, making prompt and accurate diagnosis important. We describe a case of recurrent immature teratoma in a 10-yr-old female patient, in which comparative analysis of the RNA sequencing gene expression data from the patient's tumor was used effectively to aid in the diagnosis of gliomatosis peritonei.
Ewing sarcoma in a child with neurofibromatosis type 1
Authors: Fernandez Karen S. , Turski Michelle L. , Shah Avanthi Tayi , Bastian Boris C. , Horvai Andrew , Hardee Steven , Sweet-Cordero E. Alejandro
Published: October 2019

We report here on a case of Ewing sarcoma (ES) occurring in a child with neurofibromatosis type 1. The sarcoma had an EWSR1-ERG translocation as well as loss of the remaining wild-type allele of NF1. Loss of the NF1 wild-type allele in the tumor suggests that activation of the Ras pathway contributed to its evolution. Review of available public data suggests that secondary mutations in the Ras pathway are found in ∼3% of ESs. This case suggests that Ras pathway activation may play a role in tumor progression in a subset of ESs.
Histone H3K36I mutation in a metastatic histiocytic tumor of the skull and response to sarcoma chemotherapy
Authors: Snuderl Matija , Dolgalev Igor , Heguy Adriana , Walsh Michael F. , Benayed Ryma , Jungbluth Achim A. , Ladanyi Marc , Karajannis Matthias A.
Published: October 2019

Recurrent somatic missense mutations in histone H3 genes have been identified in subsets of pediatric cancers. H3K36 histone mutations have recently been recognized as oncogenic drivers in rare subsets of malignant soft tissue sarcomas but have not been reported in histiocytic neoplasms. Currently, the histological and molecular spectrum, as well as the clinical behavior of H3K36-mutant soft tissue malignancies, is largely unknown. We describe a pediatric patient with a HIST1H3B K36I-mutant histiocytic tumor arising in the skull. After the failure of upfront therapy for histiocytosis and development of widely disseminated metastatic disease, the patient had an exceptional response to empiric chemotherapy and remains in complete disease remission for more than 5 years. Our report expands the histological spectrum of H3K36M/I-mutant soft tissue malignancies to histiocytic neoplasms and indicates that multiagent sarcoma-like chemotherapy can be highly effective even in the setting of widely disseminated metastatic disease.
Analyzing foreign expansion and corporate reputation: review and future research agenda
Authors: Velez-Ocampo Juan , Gonzalez-Perez Maria Alejandra
Published: October 2019

Purpose

The purpose of this paper is to review the literature on corporate reputation and internationalization to identify key research theories, contexts, characteristics, methodologies, applications, limitations and opportunities for future research on the interlinks between these two complex constructs.

Design/methodology/approach

Elements of systematic literature review and bibliometric analysis were used to analyze theories, contexts, characteristics, methodologies and opportunities for future research based on 90 articles published in 50 journals over 27 years.

Findings

The findings suggest that this is a contemporary yet expanding research field explored from a variety of theoretical, methodological and empirical standpoints, which hinders broad conclusions and warrants further research. More specifically, this paper identifies three broad research streams that link international expansion and corporate reputation and suggests avenues for future studies: cross-national institutions, strategic decisions and corporate reputation; international marketing, consumers and brand credibility; and corporate image, international trade and investment flows.

Originality/value

Reputation and internationalization are constructs with multiple applications and interpretations. The way companies build, maintain and extend their reputation and legitimacy, and the drivers, motives and difficulties faced by them when expanding operations internationally have been widely studied separately. This manuscript reviews the nascent and promising linkage between these two elements that have recently drawn the attention of business practitioners and scholars alike.
Attaining economic growth through financial development and foreign direct investment
Authors: Pradhan Rudra , Arvin Mak B. , Bahmani Sahar , Hall John H.
Published: October 2019

Purpose

The purpose of this paper is to consider the heterogeneous relationship among financial development, foreign direct investment (FDI) and economic growth, examining the possible directions of causality among them in both the short and long runs.

Design/methodology/approach

A sample of the G-20 countries over the period 1970–2016 is utilized. A vector error-correction model is used to consider the possible directions of causality among financial development, FDI and economic growth.

Findings

Results suggest a cointegrating relationship among the three series. Although short-run links among the variables are mostly non-uniform, both financial development and FDI matter in the determination of long-run economic growth.

Practical implications

Attention must be paid to policies that promote financial development. This, in turn, calls for fostering incentives to guarantee continued support to liberalize the economy and promoting capital openness. Additionally, financial infrastructure should be improved to improve financial innovation. The establishment of a well-developed financial market, including well-functioning banks and other financial institutions, can facilitate further investment and an easier means of raising capital to support the activities of FDI. Economic growth can ultimately be elevated through both financial development and FDI.

Originality/value

The study considers a sample of the G-20 countries, which have received relatively little attention in the existing literature. In addition, the study concurrently analyses the trivariate causal relationship among financial development, FDI and economic growth, a topic on which there has been a dearth of research.
Highs and Lows: A Previously Unattested Tone Split from Vowel Height in Metnyo Ambel
Authors: Arnold Laura
Published: October 2019

Ambel is a tonal Austronesian (South Halmahera‐West New Guinea) language, spoken to the west of New Guinea. There are two dialects of Ambel: Metsam and Metnyo. In this paper, the segments and tones of proto‐Ambel monosyllables are reconstructed. Proto‐Ambel had two tones, *High and *Rise; toneless monosyllables are also reconstructed. The tonal phonology of Metsam Ambel is identical with the proto‐Ambel system. The tone system of Metnyo Ambel, however, has undergone two innovations: an unconditioned merger of *Rise and toneless syllables; and a primary split affecting proto‐Ambel toneless syllables. Notably, this latter change was conditioned by vowel height: toneless monosyllables with high vowel nuclei (*i or *u) remained toneless, while those with non‐high vowel nuclei (*e, *a, or *o) merged with *High tone. The diachronic development of High tone on non‐high vowels has not previously been attested. The possible mechanisms that caused this split will therefore be given special attention. Based on experimental phonetic evidence, it will be argued that the split was caused by the neutralisation, in low‐pitched contexts, of the intrinsic differences in fundamental frequency found between high and low vowels; combined with the utilisation of Intrinsic Pitch, an auditory mechanism used to compensate for intrinsic f0 differences.
Intraabdominal pressure in non‐laboring preeclamptic vs normotensive patients undergoing cesarean section: A prospective observational study
Authors: Arora Vandna , Tyagi Asha , Ramanujam Mukundan , Luthra Ankit
Published: October 2019

Introduction

It is hypothesized that increased intraabdominal pressure (IAP) may be a cause of preeclampsia. There is, however, a paucity of clinical data regarding IAP in preeclamptics. We evaluated and compared the IAP and its effects on organ functions, in normotensive and preeclamptic patients.

Material and methods

Previously healthy non‐laboring patients with a singleton pregnancy scheduled for elective cesarean section under subarachnoid block were enrolled (preeclamptic and normotensive; n = 29 each). IAP was measured using an indwelling Foley catheter, and compared in both cohorts at four predefined time points: just before subarachnoid block, immediately after the onset of sensory block to T6 dermatomal level, just after surgery, and 2 hours later. In addition, the presence of organ dysfunction for respiratory, cardiovascular, renal, hepatic, hematopoietic and central nervous systems were evaluated for association with IAP.

Results

Although age, body mass index, gravidity, parity, serum bilirubin, serum creatinine, PaO2/FiO2 ratio and Glasgow coma score of the preeclamptic and normotensive patients were similar, the mean blood pressure was significantly higher (P < 0.001), the period of gestation less (P = 0.003) and the platelet count lower (P = 0.020) in the former. The IAP was significantly higher in the preeclamptic group at all four time points: respectively, 15.1 (1.0) vs 14.2 (0.9) mm Hg (P = 0.002); 14.9 (0.9) vs 14.1 (1.0) mm Hg (P = 0.002), 10.4 (1.0) vs 9.5 (1.3) mm Hg (P = 0.008) and 10.2 (0.8) vs 9.2 (1.2) mm Hg (P = 0.001). There was no correlation between the IAP and various organ dysfunctions.

Conclusions

Preeclampsia is associated with a significantly higher IAP in patients undergoing a cesarean section. The clinical relevance of this finding needs further investigation.
Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta‐analysis of randomized controlled trials
Authors: Nunez Nicolas A. , Singh Balwinder , Romo‐Nava Francisco , Joseph Boney , Veldic Marin , Cuellar‐Barboza Alfredo , Cabello Arreola Alejandra , Vande Voort Jennifer L. , Croarkin Paul , Moore Katherine M. , Biernacka Joanna , McElroy Susan L. , Frye Mark A.
Published: October 2019

Objective

The aim of this study was to evaluate the efficacy and safety of the dopaminergic‐enhancing agent modafinil/armodafinil (MoArm) as adjunctive treatment for bipolar depression.

Methods

A comprehensive search of major electronic databases was conducted to identify randomized controlled trials (RCTs) of adjunctive MoArm that included patients with bipolar I (BP‐I) or bipolar II (BP‐II) depression. Data for response/remission and all‐cause discontinuation were analyzed. Effect size was summarized by relative risk (RR) using a random effect model.

Results

Of 58 studies, five RCTs (N = 795 drug, N = 792 placebo) met inclusion criteria. Four armodafinil studies included only BP‐I patients and one modafinil study included both bipolar subtypes with limited heterogeneity (I2 = 34%, P = .19; I2 = 18%, P = .30). Compared to placebo, augmentation with MoArm was associated with significantly greater rates of treatment response (RR, 1.18; 95% CI, 1.01‐1.37; P = .03) and remission (RR, 1.38; 95% CI, 1.10‐1.73; P = .005). All‐cause discontinuation was not different than placebo (RR, 1.08; 95% CI, 0.89‐1.30; P = .45) with no evidence of increased risk of mood switch or suicide attempts with MoArm (RR, 0.99; 95% CI, 0.39‐2.5; P = .98; RR, 1.02; 95% CI, 0.37‐2.85; P = .97).

Conclusion

This narrower scope meta‐analysis of one drug for one disease suggests that adjunctive MoArm may represent a novel therapeutic intervention. Further studies delineating the subtypes of bipolar depression responsive to these novel dopaminergic‐enhancing agents are encouraged.
Effectiveness and Cost of Recruiting Participants to a Research Registry Using an Emergency Department Research Associate Program
Authors: Dykes Carrie , Glick Joseph , Abar Beau , Dozier Ann
Published: October 2019

We identified a novel way to recruit participants into a research registry by using an Emergency Department Research Associate (EDRA) Program. Research associates working in the Emergency Department at Strong Memorial Hospital approached patients and family members to enroll into the University of Rochester Research Participant Registry and for ResearchMatch.org. We found that 73% of individuals (574/781) approached agreed to register for either one or both registries. Those who registered were more diverse than individuals who registered through other methods. Overall, using EDRAs to enroll adult patients and their family members is an effective method for growing research participant registries.
Sex selection in India: Why a ban is not justified
Authors: Sterri Aksel Braanen
Published: October 2019

When widespread use of sex‐selective abortion and sex selection through assisted reproduction lead to severe harms to third parties and perpetuate discrimination, should these practices be banned? In this paper I focus on India and show why a common argument for a ban on sex selection fails even in these circumstances. I set aside a common objection to the argument, namely that women have a right to procreative autonomy that trumps the state's interest in protecting other parties from harm, and argue against the ban on consequentialist grounds. I perform a pairwise comparative analysis of sex selection and its plausible alternatives and argue that that the ban fails to improve the state of affairs relative to a scenario without a ban. The ban makes the situation worse, especially for mothers and their daughters. India should therefore repeal its ban on sex selection.
Crows and common ravens do not reciprocally exchange tokens with a conspecific to gain food rewards
Authors: Wascher Claudia A. F. , Feider Béatrice , Bugnyar Thomas , Dufour Valérie
Published: October 2019

Human economic transactions are based on complex forms of reciprocity, which involve the capacities to share and to keep track of what was given and received over time. Animals too engage in reciprocal interactions, but mechanisms such as calculated reciprocity have only been shown experimentally in few species. Various forms of cooperation, for example food and information sharing, are frequently observed in corvids, and they can engage in exchange interactions with human experimenters and accept delayed rewards. Here, we tested whether crows and common ravens would reciprocally exchange tokens with a conspecific in an exchange task. Birds received a set of three different types of tokens, some valuable for themselves, that is, they could exchange them for a food reward with a human experimenter, some valuable for their partner and some without value. The valuable tokens differed between the birds, which means that each bird could obtain more self‐value tokens from their partner's compartment. We did not observe any active transfers, that is one individual giving a token to the experimental partner by placing it in its beak. We only observed 6 indirect transfers, that is one individual transferring a token into the compartment of the partner (3 no‐value, 1 partner‐value and 2 self‐value tokens) and 67 “passive” transfers, that is one subject taking the token lying in reach in the compartment of the partner. Individuals took significantly more self‐value tokens compared with no‐value and partner‐value tokens. This indicates a preference for tokens valuable to focal individuals. Significantly more no‐value tokens compared with partner‐value tokens were taken, likely to be caused by experimental partners exchanging self‐value tokens with the human experimenter, and therefore, more no‐value tokens being available in the compartment. Our results presently do not provide empirical support for reciprocity in crows and ravens, most likely caused by them not understanding the potential roles of receiver and donor. We therefore suggest further empirical tests of calculated reciprocity to be necessary in corvids.
The rate of bone loss slows after 1–2 years of initial antiretroviral therapy: final results of the Strategic Timing of Antiretroviral Therapy (START) bone mineral density substudy
Authors: Carr A , Grund B , Schwartz AV , Avihingsanon A , Badal‐Faesen S , Bernadino JI , Estrada V , La Rosa A , Mallon PWG , Pujari S , White D , Wyman Engen N , Ensrud K , Hoy JF ,   the International Network for Strategic Initiatives in Global HIV Trials START bone mineral density substudy group
Published: October 2019

Objectives

Initial antiretroviral therapy (ART) causes loss of bone mineral density (BMD) over the first 1–2 years. Whether this loss continues with longer therapy is unclear. We determined changes in bone and spine BMD over 5 years in adults receiving immediate or deferred initial ART.

Methods

In the Strategic Timing of Antiretroviral Therapy (START) BMD substudy, ART‐naïve adults with CD4 counts > 500 cells/μL were randomized to immediate or deferred ART. Deferred group participants not yet on ART were offered ART after May 2015. Mean per cent changes in total hip and lumbar spine BMD (measured annually by dual‐energy X‐ray absorptiometry) were compared between groups using longitudinal mixed models. Fracture rates were also compared between groups for all START participants.

Results

Substudy participants (immediate group, n = 201; deferred group, n = 210; median age 32 years; 80% non‐white; 24% female) were followed for a mean 4.5 years until December 2016. In the immediate group, > 96% used ART throughout. In the deferred group, 16%, 58% and 94% used ART at years 1, 3 and 5, respectively. BMD decreased more in the immediate group initially; groups had converged by year 3 at the spine and year 4 at the hip by intent‐to‐treat (ITT). BMD changes after year 1 were similar in the immediate group and in those off ART in the deferred group [mean difference: spine, 0.03% per year; 95% confidence interval (CI) −0.4, 0.4; P = 0.88; hip, −0.2% per year; 95% CI −0.7, 0.3; P = 0.37]. Fracture incidence did not differ significantly between groups (immediate group, 0.86/100 person‐years versus deferred group, 0.85/100 person‐years; hazard ratio 1.01; 95% CI 0.76, 1.35; P = 0.98).

Conclusions

Significant ART‐induced bone loss slowed after the first year of ART and became similar to that in untreated HIV infection.
Temperature‐dependent dielectric and Raman spectra and microwave dielectric properties of gehlenite‐type Ca2Al2SiO7 ceramics
Authors: Song Zhengjun , Song Kaixin , Liu Bing , Zheng Peng , Barzegar Bafrooei Hadi , Su Weitao , Lin Huixing , Shi Feng , Wang Dawei , Reaney I. M.
Published: October 2019

Gehlenite‐type Ca2Al2SiO7 ceramics were prepared by the conventional solid‐state reaction. Two anomalies were found in the plot of dielectric constant vs temperature, which were associated with space charge polarization. Pure phase crystal structure and no phase transition were observed in the temperature‐dependent X‐ray diffraction (XRD) patterns and Raman spectra from room temperature (RT) to 900°C. There was relevant relation between Q × f and τƒ with the stretching vibrations of Ca‐O bond and O‐Ca‐O bending in CaO8 polyhedron. Excellent microwave dielectric properties (εr = 8.86, Q × f = 22 457 GHz, and τf = −51.06 ppm/°C) were obtained for Ca2Al2SiO7 sintered at 1440°C in air, which had the potential application to use in microwave and millimeter‐wave devices such as capacitors and substrates.
Dissolvable and edible film for long‐lasting kaffir lime aroma in food
Authors: Sabphon Chalisa , Srichoosilp Atikan , Wanichwecharungruang Supason , Sukwattanasinitt Mongkol , Vadhanasindhu Pakpachong , Ngamchuachit Panita , Thiraphibundet Pattara
Published: October 2019

A dissolvable and edible carboxymethylcellulose–alginate film with 34% (w/w) of kaffir lime oil (KLO) was prepared. The prepared films can be redissolved in warm water providing highly dispersed KLO microdroplets. The freshly prepared KLO films (KLO film‐0) and 6‐month stored KLO films (KLO film‐6) were evaluated for consumer acceptance in a Thai Tom‐yum soup recipe in comparison with fresh kaffir lime (KL) leaves and commercialised instant Tom‐Yum paste. The data analysis from 120 consumers presented the higher liking scores of the soups using the KLO film‐0 and KLO film‐6 on aroma, taste and overall preference than those using the instant Tom‐Yum paste and the KL leaves. Additionally, chefs noted a longer lasting aroma intensity of the soups prepared with KLO films. Thus, this edible KLO film can be used in place of fresh KL leaves with the additional benefits of a long shelf‐life, ease of use and better consumer preferences in Tom‐Yum soup cooking.
The Norwegian Way: Protection through Higher Education the Recognition Process for Syrian Refugees in HE
Authors: Toker Huriye
Published: October 2019

The current Syrian refugee exodus to Europe has created an urgent need for European societies to implement faster integration methods, to reduce the risk of social and economic alienation. Since the latest refugee wave includes more highly educated people, higher education institutions might serve as a strong inclusion instrument to integrate them into local communities. Norway has established a novel recognition procedure for persons without verifiable documentation. This study introduces this new methodology to policymakers and discusses its limitations, to enlarge scholarly debate on creating a joint European framework for recognizing prior qualifications. The study adopted a qualitative methodology, with a descriptive account of data derived from interviews with NOKUT officers. The findings highlight an urgent need in Europe to start an initiative for establishing a joint European qualification passport, which would be very useful due to the transferability of recognition decisions across European countries.
What does it take to scale‐up a complex intervention? Lessons learned from the Connect‐Home transitional care intervention
Authors: Leeman Jennifer , Toles Mark
Published: October 2019

Aims

To discuss the multiple phases of research done to plan for wide‐scale implementation (i.e. scale‐up) of Connect‐Home, a complex nurse‐develop intervention. Barker et al.’s (Implementation Science, 2016, 11, 12) framework for intervention scale‐up is applied to address the methods used to answer the following four questions: ‘Who’ needs to be involved in scale‐up? ‘What’ intervention and implementation strategies need to be taken to scale? ‘How’ will scale‐up be achieved? And what contextual factors influence ‘when’ scale‐up is or is not successful?

Design

Discussion paper.

Data Sources

Data sources include the experience of our research team, supported by literature and theory. The Connect‐Home team conducted multiple research studies to plan for Connect‐Home scale‐up. Early studies (2008–2015) focused on formative work to design the Connect‐Home intervention. Recent studies have involved successive pilot tests of Connect‐Home's effectiveness, implementation, and scale‐up (2015–2019).

Implications for Nursing

This article describes a systematic approach that nurse researchers can apply to plan for taking their interventions to scale.

Conclusions

Planning for scale‐up early in the process of intervention development is essential to speeding the translation of effective interventions into wide‐scale practice.

Impact

This article details the methods that nursing researchers applied to develop and test the strategies needed to plan for taking a complex intervention to scale across multiple settings. The methods described are applicable to nursing and other health researchers’ development and scale‐up of any complex intervention.
Longer apnea duration at low altitude in Tibetan and Han highlanders compared with Han lowlanders: A retrospective study
Authors: Tan Lu , Li Taomei , Lei Fei , Li Xiao , Zhou Junying , Zhang Ye , Ren Rong , Yang Linghui , Tang Xiangdong
Published: October 2019

Prolonged duration of obstructive apnea (OA) has been observed in highlanders after descending to low altitude. It is proposed that due to adaptation to a hypoxic high‐altitude environment, Tibetan highlanders (TH) and Han highlanders (HH) would manifest different OA durations at low altitude as compared to Han lowlanders (HL). Data collection on consecutive obstructive sleep apnea patients (167 TH, 210 HH and 233 HL) was performed over a period of 8 years in Chengdu (altitude 500 m). The analyses were performed with non‐matched groups and with body mass index and apnea–hypopnea index‐matched groups. Significance rankings for mean duration of OA (s) in non‐matched groups and matched groups were TH (27.7; 28.6) = HH (25.7; 26.0) > HL (21.7; 21.3), respectively. For the longest OA duration, the significance rankings across three groups with regard to the percentage of patients having a duration longer than 2 min (%) and mean values (s) were TH (26.9; 82) > HH (10.0; 67) > HL (1.3; 50). In terms of nadir and mean oxygen saturation, significant differences were found between TH and HH or HL. In addition, longest and mean OA duration were positively correlated with blood pressure and heart rate, whereas nadir and mean oxygen saturation were negatively correlated with these measures in both non‐matched and matched groups, and the correlation was more robust in TH. These findings raise important clinical questions regarding whether such significant prolongation of OA duration and a more severe hypoxic burden among highlanders, especially in TH, may lead to adverse clinical consequences when at low altitude.
Relationship between frailty and lower urinary tract symptoms among community‐dwelling adults
Authors: Soma Osamu , Hatakeyama Shingo , Imai Atsushi , Matsumoto Teppei , Hamano Itsuto , Fujita Naoki , Iwamura Hiromichi , Okamoto Teppei , Yamamoto Hayato , Tobisawa Yuki , Yoneyama Tohru , Yoneyama Takahiro , Hashimoto Yasuhiro , Nakaji Shigeyuki , Ohyama Chikara
Published: October 2019

Objectives

To evaluate the relationship between frailty and lower urinary tract symptoms (LUTS), the association of frailty and LUTS remains unclear.

Methods

This cross‐sectional study investigated LUTS and frailty in 710 individuals (249 men and 461 women, aged ≥60 years) who participated in the Iwaki Health Promotion Project between 2014 and 2015 in Hirosaki, Japan. Parameters of frailty were compared for individuals with mild and moderate to severe symptoms of LUTS. The International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) were used to evaluate LUTS. Frailty was evaluated by the frailty phenotype (FP), modified frailty index (mFI), and frailty discriminant score (FDS). The influence of frailty on LUTS was investigated by multivariate logistic regression analyses.

Results

Frailty parameters of age, renal function, and lower physical activity were significantly associated with severity of IPSS and OABSS. FP and mFI were significantly associated with severity of OABSS and IPSS, respectively. The FDS was significantly associated with severity of IPSS and OABSS. FP, mFI, and FDS were significantly associated with severity of nocturia. Multivariate logistic regression analyses revealed that FDS was independently associated with the severity of IPSS, OABSS, and nocturia, whereas FP and mFI were significantly associated with the severity of nocturia alone.

Conclusions

Individuals with LUTS are potentially frailer than those without LUTS. Although the influence of frailty on LUTS is different depending on the measurement tool, attention for frailty is necessary for subjects with LUTS.
Thunderclap headache and reversible cerebral vasoconstriction syndrome: Current theory and accumulated data
Authors: Kikui Shoji , Miyahara Junichi , Danno Daisuke , Kashiwaya Yoshihiro , Takeshima Takao
Published: October 2019

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent severe thunderclap headache and segmental vasoconstriction of cerebral arteries that resolves by 3 months. RCVS can either occur spontaneously or relate to an exogenous trigger, but the precise pathophysiology of RCVS remains unknown. Postulated mechanisms include small vessel and endothelial dysfunction, mitochondrial dysfunction with oxidative stress, hormonal and biochemical factors, and genetic predisposition. A prior history of migraine has been reported in 17%–40% of cases, suggesting that migraine and RCVS share mechanisms. Most RCVS patients have a favorable prognosis; however, for some patients, the condition may result in permanent disability or even death in a small minority of patients, secondary to complications such as ischemic stroke or intracranial hemorrhage. There is no proven treatment, so the cornerstone of RCVS management remains largely supportive, with prescription of bed rest, analgesics, and the removal of precipitating factors. The majority of clinical series studying RCVS treatment have investigated the efficacy of calcium channel antagonists. Although prescription of triptans for migraine is not suitable for patients with a history of RCVS, lasmiditan, a highly selective 5‐HT1F receptor agonist, may be suitable in such cases. Typical segmental vasoconstriction of major vessels is not seen in approximately 30% of patients eventually diagnosed with RCVS; if this diagnosis is suspected, repeat imaging should be performed. Early diagnosis of RCVS is important, as it allows progression to be prevented by the prompt removal of precipitating factors, unnecessary diagnostic procedures to be avoided, and appropriate management to be commenced.
Bruxism: a summary of current knowledge on aetiology, assessment and management
Authors: Manfredini D. , Colonna A. , Bracci A. , Lobbezoo F.
Published: October 2019

Bruxism is a common condition that clinicians come across in both adult and children. Prevalence rates in adults range from 22% to 30% for awake bruxism (AB) and from 8% to 16% for sleep bruxism (SB), while in children they raise up to 40% for SB. Currently, bruxism is considered an ‘umbrella term’ for different jaw muscle activities, occurring during sleep and/or wakefulness. They have a different aetiology, but there is agreement on their central, not peripheral, origin. In otherwise healthy individuals, bruxism can be considered a muscle behaviour, which can be harmless or represent a risk and/or protective factor for clinical consequences, rather than being a disorder per se. Nonetheless, given the merging knowledge on the interaction with several associated factors and concurrent conditions, bruxism should be investigated for being a possible sign of an underlying primary condition. Consequently, treatment should be directed to the management of the possible clinical consequences and/or to the underlying primary conditions. It is generally based on the conservative strategies. The present manuscript summarises the available knowledge on bruxism aetiology, assessment and management for both SB and AB in adults and children, with focus on the future directions to implement the clinical relevance of bruxism researches.

Clinical relevance

A narrative overview summarising such a quickly evolving topic as bruxism may be useful to help clinicians understanding the complex relationship among bruxism, the possible underlying primary conditions, and the possible clinical consequences.
Proactive yet reflective? Materializing proactive personality into creativity through job reflective learning and activated positive affective states
Authors: Li Fuli , Chen Tingting , Chen Nancy Yi‐Feng , Bai Yun , Crant J. Michael
Published: October 2019

Studies linking proactive personality to creativity have primarily taken a future‐oriented perspective, describing a process where individuals assess future opportunities and risks of creative endeavors. Complementing this approach, we draw on an attribution theory perspective to delineate how proactive personality relates to employee creativity through the serial mediating effects of job reflective learning—a backward‐looking cognitive process—and activated positive affective states. Job reflective learning captures backward‐looking self‐assessments and the underlying internal causal attributions, and it is differentiated into two valences: job reflective learning from successes and from failures. Based on two separate multi‐wave, multi‐source field studies, our findings consistently show a serial mediation process linking proactive personality to creativity through both valences of job reflective learning and activated positive affective states. Job reflective learning from successes breeds joviality, whereas job reflective learning from failures arouses attentiveness. Joviality and attentiveness—both types of activated positive affective states—in turn promote creativity. We discuss the theoretical and practical implications of how proactive employees manifest their proactivity trait into actual creativity through backward‐looking cognitive and affective processes.
Improving the immunogenicity and protective efficacy of a whole‐killed malaria blood‐stage vaccine by chloroquine
Authors: Fu Yong , Lu Xiao , Zhu Feng , Zhao Yunxiang , Ding Yan , Ye Lilin , Guo Bo , Liu Taiping , Xu Wenyue
Published: October 2019

A whole‐killed malaria blood‐stage vaccine (WKV) is promising in reducing the morbidity and mortality of malaria patients, but its efficacy needs to be improved. We found that the antimalarial drug chloroquine could augment the protective efficacy of the WKV of Plasmodium yoelii. The direct antimalarial effect of chloroquine on parasites during immunization could be excluded, as the administration of chloroquine or chloroquine plus alum every two weeks had a slight effect on parasitemia, and an immunization with NP‐KLH (4‐hydroxy‐3‐nitrophenylacetyl Keyhole Limpet Hemocyanin) plus chloroquine could significantly promote the generation of NP‐specific antibodies. Additionally, alum was required for chloroquine to augment the immunogenicity of the pRBC lysate. Chloroquine did not promote the parasite‐specific CD4+ T‐cell responses, but significantly enhanced the WKV‐induced germinal centre B cell reactions, class‐switch recombination and secretion of functionally protective antibodies to plasmodium. The elevated parasite‐specific antibodies were demonstrated to largely contribute to the chloroquine‐enhanced protective immunity. Thus, we report that chloroquine could be used as an adjuvant to enhance the protective immunity of WKVs through promoting humoral responses.
A step closer toward making many from the one
Authors: Baral Anirban
Published: October 2019

Somatic embryogenesis (SE) is a key technique used in plant biotechnology. The complex molecular changes associated with SE are uncharacterized in many crop species, and therefore, logically, formulating the culture conditions that induce these changes is difficult. In a study published in this issue of Physiologia Plantarum, Marimuthu et al. (2019) performed a proteomic study to characterize the molecular reprogramming during SE of an elite banana cultivar. Based on the results, they could customize culture conditions for optimal SE efficiency in several cultivars.
Influence of cognitive‐motor expertise on brain dynamics of anticipatory‐based outcome processing
Authors: Lu Yingzhi , Yang Tiantian , Hatfield Bradley D. , Cong Fengyu , Zhou Chenglin
Published: October 2019

Motor experience plays an important role in the ability to anticipate action outcomes, but little is known about the brain processes through which it modulates the preparation for unexpected events. To address this issue, EEG was employed while table tennis players and novices observed videos of serves in order to predict the expected ball direction based on the kinematics of a model’s movement. Furthermore, we manipulated the congruency between the model’s body kinematics and the subsequent ball trajectory while assessing the cerebral cortical activity of novices and experts to understand how experts respond to unexpected outcomes. Experts were more accurate in predicting the ball trajectories than novices and were further differentiated from novices in the cortical dynamics just prior to ball contact and during the period of observation of the ball trajectories. Consistent with the predicted response‐outcome model, experts exhibited elevated theta oscillations during the incongruent relative to the congruent trajectories, while no such differences were observed in the novices. Source estimation for theta activity revealed stronger activation in the middle frontal gyrus for the experts in response to the incongruent trajectories. Collectively, the observed differences in cortical dynamics between the groups suggest that motor experience promotes central neural system adaptations that facilitate preparation for anticipated outcomes and contributes to adaptive cognitive‐motor responses in the face of uncertainty.
Inequality in Pre‐Income Survey Times: A Methodological Proposal
Authors: Lezama Guillermo , Willebald Henry
Published: October 2019

We propose different alternatives of inequality estimation for economies with a big agricultural sector where land is a decisive factor in income generation and where we do not have enough information about personal earnings. To this end, we use the Uruguayan case to test our methodology. We propose six analytical exercises where Gini indexes are calculated, and as reference we choose the estimation that better adjusts to some theoretical and empirical conditions. Finally, we check the historical accuracy of the series by looking at income distribution explicative variables and the shape of the Inequality possibility frontier. Our results are consistent with the economic and social events of the period (1870–1912) and with previous estimates which reveal worsening trends in income distribution. However, our annual data allow capturing the dynamics of the process where breaks in the series are observed and improvements and declines alternate in the evolution of income distribution.
Salt‐tolerance diversity in diploid and polyploid cotton (Gossypium) species
Authors: Dong Yating , Hu Guanjing , Yu Jingwen , Thu Sandi Win , Grover Corrinne E. , Zhu Shuijin , Wendel Jonathan F.
Published: October 2019

The development of salt‐tolerant genotypes is pivotal for the effective utilization of salinized land and to increase global crop productivity. Several cotton species comprise the most important source of textile fibers globally, and these are increasingly grown on marginal or increasingly saline agroecosystems. The allopolyploid cotton species also provide a model system for polyploid research, of relevance here because polyploidy was suggested to be associated with increased adaptation to stress. To evaluate the genetic variation of salt tolerance among cotton species, 17 diverse accessions of allopolyploid (AD‐genome) and diploid (A‐ and D‐genome) Gossypium were evaluated for a total of 29 morphological and physiological traits associated with salt tolerance. For most morphological and physiological traits, cotton accessions showed highly variable responses to 2 weeks of exposure to moderate (50 mm NaCl) and high (100 mm NaCl) hydroponic salinity treatments. Our results showed that the most salt‐tolerant species were the allopolyploid Gossypium mustelinum from north‐east Brazil, the D‐genome diploid Gossypium klotzschianum from the Galapagos Islands, followed by the A‐genome diploids of Africa and Asia. Generally, A‐genome accessions outperformed D‐genome cottons under salinity conditions. Allopolyploid accessions from either diploid genomic group did not show significant differences in salt tolerance, but they were more similar to one of the two progenitor lineages. Our findings demonstrate that allopolyploidy in itself need not be associated with increased salinity stress tolerance and provide information for using the secondary Gossypium gene pool to breed for improved salt tolerance.
Posttransfusion hyperhemolysis is arrested by targeting macrophage activation with novel use of Tocilizumab
Authors: Lee Lauren E. , Beeler Bradley W. , Graham Brendan C. , Cap Andrew P. , Win Nay , Chen Frederick
Published: October 2019

BACKGROUND

Hyperhemolysis syndrome (HHS) is a posttransfusion complication most frequently seen in sickle cell disease (SCD), characterized by rapid destruction of transfused and autologous red blood cells (RBCs), resulting in reticulocytopenia and a decrease in hemoglobin to below pretransfusion levels. Additional RBC transfusion can be life threatening. Most patients improve with intravenous immune globulin and steroids, but in refractory cases, hyperhemolysis may result in multiorgan failure and death in the absence of salvage therapy. The exact pathophysiology of HHS remains uncertain, yet new insights suggest that RBC destruction is driven by activated macrophages. Therefore, we propose that antimacrophage therapy may represent an effective treatment.

CASE REPORT

A case of life‐threatening HHS, refractory to intravenous immune globulin and steroids, in a patient with SCD is presented. Marked elevation in ferritin, an indirect marker of macrophage activation, a negative direct antiglobulin test, and the absence of RBC alloantibodies was noted. A hemoglobin nadir of 2.1 g/dL and resultant hypoxemia‐induced organ failure prompted the use of tocilizumab, an interleukin‐6 receptor monoclonal antibody. Hemoglobin‐based oxygen carrier‐201, a cell‐free polymerized bovine hemoglobin, was used to support the patient during critical anemia.

RESULTS

Hemolysis resolved and ferritin dramatically decreased after administration of tocilizumab, which was well tolerated. A full recovery was achieved.

CONCLUSION

This case highlights both a novel and successful approach to managing refractory transfusion‐induced hyperhemolysis with tocilizumab and provides further evidence supporting the role for macrophage activation in the destruction of RBCs in antibody‐negative HHS. We propose that tocilizumab is an effective and rapid salvage therapy for refractory HHS.