bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Outcomes of Breathlessness in Older Adults: A National Population Study
Authors: Smith Alexander K. , Currow David C. , Abernethy Amy P. , Johnson Miriam J. , Miao Yinghui , Boscardin W. John , Ritchie Christine S.
Published: September 2016

Objectives

To determine the prevalence and outcomes of breathlessness in older Americans.

Setting

Community‐dwelling older adults.

Participants

Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow‐up through 2012) (N = 3,671; mean age 78).

Measurements

Breathlessness was assessed by asking the question, “How often do you become short of breath while awake?” Responses of often or sometimes were considered to represent a level of breathlessness sufficient to warrant clinical attention. The prevalence of breathlessness is described overall and in subpopulations, then rates of associated symptoms, well‐being, and health services use of participants who were breathless are compared with rates of those who were not. The risk of decline in activities of daily living (ADLs) and death through 2012 was estimated by creating a multivariable Cox proportional hazards model, adjusting for age, sex, race and ethnicity, and education.

Results

Twenty‐five percent of participants reported breathlessness. The prevalence of breathlessness was higher in certain subpopulations: chronic lung disease (63%), multimorbidity (≥2 chronic conditions) (45%), current smokers (38%), heart disease (36%), obesity (body mass index ≥30.0 kg/m2) (33%), and education less than high school (32%). Breathlessness was associated with higher rates of depression, anxiety, and severe fatigue; lower ratings of well‐being; and higher rates of clinic and emergency department visits and hospitalizations (all P < .001). Breathlessness predicted ADL decline over 5 years (adjusted hazard ratio (aHR) = 1.43, 95% confidence interval (CI) = 1.22–1.68) and death (aHR 1.62, 95% CI = 1.32–2.02).

Conclusion

One in four adults aged 70 and older in the United States experiences breathlessness, which is associated with lack of well‐being, greater health services use, and a 40% greater risk of worsened function and 60% greater risk of death over the next 5 years.
Dementia and Outcomes of Mechanical Ventilation
Authors: Lagu Tara , Zilberberg Marya D. , Tjia Jennifer , Shieh Meng‐Shiou , Stefan Mihaela , Pekow Penelope S. , Lindenauer Peter K.
Published: September 2016

Objectives

To describe the effect of dementia on hospital outcomes of individuals requiring invasive mechanical ventilation (IMV).

Design

Retrospective cohort study.

Setting

2011 Nationwide Inpatient Sample.

Participants

Hospitalized individuals with and without dementia undergoing IMV.

Measurements

The adjusted predicted probability of undergoing IMV was examined in individuals with and without dementia. Then the dataset was limited to individuals who received IMV, and a multivariable logistic regression model was created in which dementia was the primary predictor and mortality was the outcome.

Results

Of the 13,816,586 hospitalizations of older adults in the United States in 2011, 2,204,506 (16%) with a dementia diagnosis code were identified. Individuals with dementia had statistically significantly lower predicted probability of undergoing IMV (5.7%, 95% confidence interval (CI) = 5.6–5.8% than those without (6.5%, 95% CI = 6.4–6.6%). When the dataset was limited to individuals undergoing IMV, those with dementia were older (mean age 80 vs 76, P < .001) and had a higher combined Gagne comorbidity score (4.4 vs 4.1, P < .001) than those without. In a multivariable model, dementia was associated with greater likelihood of survival to hospital discharge (odds ratio (OR) = 0.79, P < .001). Individuals with dementia also had shorter mean length of stay (12.5 ± 0.2 vs 13.1 ± 0.2, P = .01) and lower cost per hospitalization for survivors ($37,213 vs $44,557, P < .001).

Conclusion

Older critically ill adults with dementia undergoing IMV had better in‐hospital outcomes than those without dementia. Because a lower adjusted percentage of individuals with dementia underwent IMV, it is likely that patient selection drove outcome differences. These findings suggest that individuals, families, and clinicians are carefully considering prognosis, quality of life, and appropriate use of intensive care unit resources when deciding whether to use IMV in individuals with dementia.
Association Between Hospital Admission Risk Profile Score and Skilled Nursing or Acute Rehabilitation Facility Discharges in Hospitalized Older Adults
Authors: Liu Stephen K. , Montgomery Justin , Yan Yu , Mecchella John N. , Bartels Stephen J. , Masutani Rebecca , Batsis John A.
Published: September 2016

Objectives

To evaluate whether the Hospital Admission Risk Profile (HARP) score is associated with skilled nursing or acute rehabilitation facility discharge after an acute hospitalization.

Design

Retrospective cohort study.

Setting

Inpatient unit of a rural academic medical center.

Participants

Hospitalized individuals aged 70 and older from October 1, 2013 to June 1, 2014.

Measurements

Participant age at the time of admission, modified Folstein Mini‐Mental State Examination score, and self‐reported instrumental activities of daily living 2 weeks before admission were used to calculate HARP score. The primary predictor was HARP score, and the primary outcome was discharge disposition (home, facility, deceased). Multivariate analysis was used to evaluate the association between HARP score and discharge disposition, adjusting for age, sex, comorbidities, and length of stay.

Results

Four hundred twenty‐eight individuals admitted from home were screened and their HARP scores were categorized as low (n = 162, 37.8%), intermediate (n = 157, 36.7%), or high (n = 109, 25.5%). Participants with high HARP scores were significantly more likely to be discharged to a facility (55%) than those with low HARP scores (20%) (P < .001). After adjustment, participants with high HARP scores were more than four times as likely as those with low scores to be discharged to a facility (odds ratio = 4.58, 95% confidence interval = 2.42–8.66).

Conclusion

In a population of older hospitalized adults, HARP score (using readily available admission information) identifies individuals at greater risk of skilled nursing or acute rehabilitation facility discharge. Early identification for potential facility discharges may allow for targeted interventions to prevent functional decline, improve informed shared decision‐making about post‐acute care needs, and expedite discharge planning.
Is there an association between dietary intake and academic achievement: a systematic review
Authors: Burrows T. , Goldman S. , Pursey K. , Lim R.
Published: September 2016

Background

The majority of literature examining the effect of dietary behaviour on academic achievement has focused on breakfast consumption only. Here, we aim to systematically review the literature investigating the broader effects of dietary intake and behaviours on school‐aged children's academic achievement.

Methods

A search was undertaken across seven databases using keywords. For studies to be included, they needed to be conducted in: school‐aged children (5–18 years); assess and report: (i) a measure of academic performance; (ii) a measure of dietary intake/behaviour; and (iii) the association between dietary intake/behaviours and academic performance. Forty studies were included in the review.

Results

The majority of studies were cross‐sectional in design (n = 33) and studied children aged >10 years, with very few reports in younger age groups. More than 30 different dietary assessment tools were used, with only 40% of those using a validated/standardised assessment method. Half the studies collected outcomes of academic achievement objectively from a recognised educational authority, whereas 10 studies used self‐reported measures. The dietary outcomes most commonly reported to have positive associations with academic achievement were: breakfast consumption (n = 12) and global diet quality/meal patterns (n = 7), whereas negative associations reported with junk/fast food (n = 9).

Conclusions

This review highlights that moderate associations exist for dietary intakes characterised by regular breakfast consumption, lower intakes of energy‐dense, nutrient‐poor foods and overall diet quality with respect to outcomes of academic achievement. Future studies should consider the use of validated dietary assessment methods and standardised reporting of academic achievement.
Previous Midlife Oestradiol Treatment Results in Long‐Term Maintenance of Hippocampal Oestrogen Receptor α Levels in Ovariectomised Rats: Mechanisms and Implications for Memory
Authors: Black K. L. , Witty C. F. , Daniel J. M.
Published: September 2016

Ovariectomised rats that have received previous administration of oestradiol in midlife display enhanced cognition and increased hippocampal levels of oestrogen receptor (ER)α months after oestradiol treatment ended compared to ovariectomised controls. The present study aimed to investigate the mechanisms by which ERα levels are maintained following midlife oestradiol exposure and the role of ERα in memory in ageing females in the absence of circulating oestrogens. Unliganded ERα has increased interaction with the ubiquitin ligase, C‐terminus of Hsc‐70 interacting protein (CHIP), leading to increased degradation of the receptor. In our first experiment, we tested the hypothesis that midlife oestradiol exposure in ovariectomised rats results in decreased interaction between CHIP and hippocampal ERα, leading to increased levels of ERα. Middle‐aged rats were ovariectomised and received oestradiol or vehicle implants. After 40 days, implants were removed. One month later, rats were killed and hippocampi were processed for whole protein western blotting and co‐immunoprecipitation, in which ERα was immunoprecipitated from lysate. As expected, ERα protein expression was increased in rats previously treated with oestradiol compared to vehicle‐treated rats. In rats treated with oestradiol, there was a decrease in CHIP–ERα interaction, suggesting that previous oestradiol treatment reduces interaction, slowing the degradation of ERα. In a second experiment, we determined the impact on memory of antagonism of ER in the absence of circulating oestrogens. Rats were ovariectomised and implanted with oestradiol capsules. Capsules were removed after 40 days. Rats received chronic i.c.v. infusion of ER antagonist, ICI 182 780, or artificial cerebrospinal fluid vehicle and were tested on a spatial memory radial‐maze task. Rats treated with ICI 182 780 had significantly worse performance (more errors). These experiments provide evidence that previous midlife oestradiol treatment maintains hippocampal ERα by decreasing its interaction with CHIP and that activation of these receptors provides cognitive benefits in the absence of circulating oestrogens.
Meeting the healthcare needs of transgender people within the armed forces: putting UK military policy into practice
Authors: Whybrow Dean , New Chris , Coetzee Rik , Bickerstaffe Paul
Published: September 2016

Aims and objectives

To explain how the healthcare needs of transgender personnel are met within the United Kingdom Armed Forces.

Background

It may be that when transgender people disclose their gender preference that they are at increased risk of social exclusion. The United Kingdom Armed Forces has an inclusive organisational policy for the recruitment and management of transgender personnel.

Design

This is a position paper about how the healthcare needs of transgender military personnel are met by the United Kingdom Armed Forces.

Methods

United Kingdom Armed Forces policy was placed into context by reviewing current research, discussing medical terminology and describing the policy. This was followed by an account of how UK AF policy is applied in practice.

Discussion

Where armed forces had an inclusive policy for the management of transgender personnel, there seemed to be little cause for secrecy and zero tolerance of discrimination when compared to nations where this was not the case. Medical terminology has changed to reflect a more inclusive, less stigmatising use of language. The United Kingdom Armed Forces policy has been described as progressive and inclusive. The application of this policy in practice may be dependent upon strong leadership and training. The wider United Kingdom Armed Forces seems capable of adopting a pragmatic and flexible approach to meeting the healthcare needs of transgender personnel.

Conclusion

The United Kingdom Armed Forces value diversity within their workforce and have a progressive, inclusive policy for the recruitment and management of transgender personnel.

Relevance to Clinical Practice

When supporting a transgender military person, healthcare professionals, civilian organisations and military line managers should consider referring to United Kingdom Armed Forces policy as early as possible. Other military and uniformed services may wish to examine the United Kingdom Armed Forces exemplar in order to consider the applicability within their own organisational setting.
Two years of unintended consequences: introducing an electronic health record system in a hospice in Scotland
Authors: Snowden Austyn , Kolb Hildegard
Published: September 2016

Aims and objectives

To explore the impact of implementing an electronic health record system on staff at a Scottish hospice.

Background

Electronic health records are broadly considered preferable to paper‐based systems. However, changing from one system to the other is difficult. This study analysed the impact of this change in a Scottish hospice.

Design

Naturalistic prospective repeated‐measures mixed‐methods approach.

Methods

Data on the usability of the system, staff engagement and staff experience were obtained at four time points spanning 30 months from inception. Quantitative data were obtained from surveys, and qualitative from concurrent analysis of free‐text comments and focus group. Participants were all 150 employees of a single hospice in Scotland.

Results

Both system usability and staff engagement scores decreased for the first two years before recovering at 30 months. Staff experience data pointed to two main challenges: (1) Technical issues, with subthemes of accessibility and usability. (2) Cultural issues, with subthemes of time, teamwork, care provision and perception of change.

Conclusions

It took 30 months for system usability and staff engagement scores to rise, after falling significantly for the first two years. The unintended outcomes of implementation included challenges to the way the patient story was both recorded and communicated. Nevertheless, this process of change was found to be consistent with the ‘J‐curve’ theory of organisational change, and as such, it is both predictable and manageable for other organisations.

Relevance to clinical practice

It is known that implementing an electronic health record system is complex. This paper puts parameters on this complexity by defining both the nature of the complexity (‘J’ curve) and the time taken for the organisation to begin recovery from the challenges (two years). Understanding these parameters will help health organisations across the world plan more strategically.
Group visits to encourage insulin initiation: targeting patient barriers
Authors: Kuo Charlotte R , Quan Judy , Kim Sarah , Tang Audrey Hui‐yu , Heuerman Deborah Payne , Murphy Elizabeth J
Published: September 2016

Aims and objectives

To evaluate the effect of an ‘insulin introduction’ group visit on insulin initiation and A1C in adults with type 2 diabetes.

Background

The clinical course of type 2 diabetes involves eventual beta‐cell failure and the need for insulin therapy. Patient psychological insulin resistance, provider‐related delays and system barriers to timely initiation of insulin are common. Group visits are widely accepted by patients and represent a potential strategy for improving insulin initiation.

Design

A single two‐hour group visit in English or Spanish, facilitated by advanced practice nurses, addressed psychological insulin resistance and encouraged mock injections to overcome needle anxiety.

Methods

A retrospective review of 273 patients referred from 2008–2012, determined characteristics of group attenders, rates of mock self‐injection, rates of insulin initiation and changes in A1C from baseline to 2–6 and 7–12 months postgroup. Change in A1C was compared to patients referred to the group who did not attend (‘nonattenders’).

Results

Of 241 patients eligible for analysis, 87·6% were racial/ethnic minorities with an average A1C of 9·99%. Group attendance rate was 66%; 92% performed a mock injection, 55% subsequently started insulin. By 2–6 months, A1C decreased by 1·37% among group attenders, and by 1·6% in those who did a mock injection and started insulin. Fewer nonattenders started insulin in primary care (40%), experiencing an A1C reduction of 0·56% by 2–6 months. A1C improvements were sustained by 7–12 months among group attenders and nonattenders who started insulin.

Relevance to clinical practice

Nurses can effectively address patient fears and engage patients in reframing insulin therapy within group visits.

Conclusions

This one‐time nurse‐facilitated group visit addressing psychological barriers to insulin in a predominantly minority patient population resulted in increased insulin initiation rates and clinically meaningful A1C reductions.
Melatonin biosynthesis in plants: multiple pathways catalyze tryptophan to melatonin in the cytoplasm or chloroplasts
Authors: Back Kyoungwhan , Tan Dun‐Xian , Reiter Russel J.
Published: September 2016

Melatonin is an animal hormone as well as a signaling molecule in plants. It was first identified in plants in 1995, and almost all enzymes responsible for melatonin biosynthesis had already been characterized in these species. Melatonin biosynthesis from tryptophan requires four‐step reactions. However, six genes, that is, TDC, TPH, T5H, SNAT, ASMT, and COMT, have been implicated in the synthesis of melatonin in plants, suggesting the presence of multiple pathways. Two major pathways have been proposed based on the enzyme kinetics: One is the tryptophan/tryptamine/serotonin/N‐acetylserotonin/melatonin pathway, which may occur under normal growth conditions; the other is the tryptophan/tryptamine/serotonin/5‐methoxytryptamine/melatonin pathway, which may occur when plants produce large amounts of serotonin, for example, upon senescence. The melatonin biosynthetic capacity associated with conversion of tryptophan to serotonin is much higher than that associated with conversion of serotonin to melatonin, which yields a low level of melatonin synthesis in plants. Many melatonin intermediates are produced in various subcellular compartments, such as the cytoplasm, endoplasmic reticulum, and chloroplasts, which either facilitates or impedes the subsequent enzymatic steps. Depending on the pathways, the final subcellular sites of melatonin synthesis vary at either the cytoplasm or chloroplasts, which may differentially affect the mode of action of melatonin in plants.
Melatonin promotes cardiomyogenesis of embryonic stem cells via inhibition of HIF‐1α stabilization
Authors: Kudová Jana , Vašíček Ondřej , Číž Milan , Kubala Lukáš
Published: September 2016

Melatonin, a molecule involved in the regulation of circadian rhythms, has protective effects against myocardial injuries. However, its capability to regulate the maturation of cardiac progenitor cells is unclear. Recently, several studies have shown that melatonin inhibits the stabilization of hypoxia‐inducible factors (HIFs), important signaling molecules with cardioprotective effects. In this study, by employing differentiating mouse embryonic stem cells, we report that melatonin significantly upregulated the expression of cardiac cell‐specific markers (myosin heavy chains six and seven) as well as the percentage of myosin heavy chain‐positive cells. Importantly, melatonin decreased HIF‐1α stabilization and transcriptional activity and, in contrast, induced HIF‐2α stabilization. Interestingly, the deletion of HIF‐1α completely inhibited the pro‐cardiomyogenic effect of melatonin as well as the melatonin‐mediated HIF‐2α stabilization. Moreover, melatonin increased Sirt‐1 levels in a HIF‐1α‐dependent manner. Taken together, we provide new evidence of a time‐specific inhibition of HIF‐1α stabilization as an essential feature of melatonin‐induced cardiomyogenesis and unexpected different roles of HIF‐1α stabilization during various stages of cardiac development. These results uncover new mechanisms underlying the maturation of cardiac progenitor cells and can help in the development of novel strategies for using melatonin in cardiac regeneration therapy.
Cancer Disparities in Rural Appalachia: Incidence, Early Detection, and Survivorship
Authors: Yao Nengliang , Alcalá Héctor E. , Anderson Roger , Balkrishnan Rajesh
Published: September 2016

Purpose

To document cancer‐related health disparities in Appalachia.

Methods

The current study investigated disparities in cancer incidence, mortality, and staging between rural Appalachians and those living outside of rural Appalachia. To accomplish this, mortality data for the United States from 1969 to 2011 were obtained from the National Center for Health Statistics (NCHS) using SEER*Stat. These data were used to compare trends in mortality between rural Appalachians, urban Appalachians, rural non‐Appalachians, and urban non‐Appalachians. Cancer incidence trends, staging, and survivorship data were compared across regions using the SEER‐18 Program, which represented 28% of the US population and includes 2 Appalachian states: Georgia and Kentucky.

Results

Cancer mortality rates declined in all regions, but disparities remained such that rural Appalachia has the highest incidence, while urban non‐Appalachia has the lowest. In all but 1 state, rural Appalachians had higher cancer mortality rates than urban non‐Appalachians. Cancer incidence declined for all regions except rural Appalachia. Rural Appalachians had lower rates of early stage breast cancer diagnoses than their urban non‐Appalachian counterparts. Finally, rural Appalachians had lower 3‐ and 5‐year survival rates than their urban non‐Appalachian counterparts.

Conclusions

Rural Appalachians are faced with poorer cancer‐related health outcomes across the continuum of cancer care. A systematic effort is needed to reduce the burden of cancer for rural Appalachia. Additional research should explore reasons for the disparities that were observed.
Hyperspectral mapping of alteration assemblages within a hydrothermal vug at the Haughton impact structure, Canada
Authors: Greenberger Rebecca N. , Mustard John F. , Osinski Gordon R. , Tornabene Livio L. , Pontefract Alexandra J. , Marion Cassandra L. , Flemming Roberta L. , Wilson Janette H. , Cloutis Edward A.
Published: September 2016

Meteorite impacts on Earth and Mars can generate hydrothermal systems that alter the primary mineralogies of rocks and provide suitable environments for microbial colonization. We investigate a calcite–marcasite‐bearing vug at the ~23 km diameter Haughton impact structure, Devon Island, Nunavut, Canada, using imaging spectroscopy of the outcrop in the field (0.65–1.1 μm) and samples in the laboratory (0.4–2.5 μm), point spectroscopy (0.35–2.5 μm), major element chemistry, and X‐ray diffraction analyses. The mineral assemblages mapped at the outcrop include marcasite; marcasite with minor gypsum and jarosite; fibroferrite and copiapite with minor gypsum and melanterite; gypsum, Fe3+ oxides, and jarosite; and calcite, gypsum, clay, microcline, and quartz. Hyperspectral mapping of alteration phases shows spatial patterns that illuminate changes in alteration conditions and formation of specific mineral phases. Marcasite formed from the postimpact hydrothermal system under reducing conditions, while subsequent weathering oxidized the marcasite at low temperatures and water/rock ratios. The acidic fluids resulting from the oxidation collected on flat‐lying portions of the outcrop, precipitating fibroferrite + copiapite. That assemblage then likely dissolved, and the changing chemistry and pH resulting from interaction with the calcite‐rich host rock formed gypsum‐bearing red coatings. These results have implications for understanding water–rock interactions and habitabilities at this site and on Mars.
Superficial Epidermolytic Ichthyosis—Hypertrichosis as a Clue to Diagnosis
Authors: Gameiro Ana , Cabral Rita , Moreno Ana , Tellechea Oscar
Published: September 2016

Superficial epidermolytic ichthyosis (SEI) is an autosomal dominant disorder caused by a mutation in the keratin 2 gene and clinically characterized by mild hyperkeratosis, superficial blisters and shedding, referred to as the moulting phenomenon. We report a case of SEI in an 18‐month‐old girl presenting with marked hypertrichosis. Although not invariably present, we believe that hypertrichosis can be an important clue for diagnosis.
Cutaneous Manifestations of Mucopolysaccharidoses
Authors: Tran Mimi C. , Lam Joseph M.
Published: September 2016

Mucopolysaccharidoses (MPSs) are a group of inherited lysosomal storage disorders characterized by deficiencies in specific enzymes involved in the catabolism of glycosaminoglycans (GAGs). These deficiencies cause excessive metabolites to accumulate in multiple organs. There are eight differentMPSdisorders, contributing to the wide variation in clinical presentation. Depending on the severity and subtype of the disease, some children live normal life spans, while others have a more grim prognosis. Children withMPScan present with neurologic, behavioral, skeletal, cardiovascular, gastrointestinal, or respiratory abnormalities. Cutaneous manifestations are mostly nonspecific and can include coarse facial features, thickened skin, and excessive hair growth. More specific skin findings include ivory‐colored “pebbly” papules found in Hunter syndrome and extensive dermal melanocytosis found in Hurler and Hunter syndromes. Early diagnosis ofMPSdisorders is extremely important to minimize the progression of the disease and for early initiation of appropriate treatment.
Is Routine Electrocardiography Necessary Before Initiation of Propranolol for Treatment of Infantile Hemangiomas?
Authors: Yarbrough Kevin B. , Tollefson Megha M. , Krol Alfons L. , Leitenberger Sabra L. , Mann Julianne A. , MacArthur Carol J.
Published: September 2016

Background

In recent years propranolol has become the treatment of choice for infantile hemangiomas (IHs). There is broad variation in the approach to propranolol initiation in clinical practice. This retrospective study explored the effectiveness of routine pre‐treatment ECG in screening infants being considered for systemic treatment with propranolol.

Methods

All patients seen in the outpatient pediatric dermatology clinics at Oregon Health and Sciences University (OHSU) and The Mayo Clinic Rochester (MCR), as well as those seen in multidisciplinary vascular anomalies clinics, who had ECGs obtained prior to planned initiation of propranolol for treatment of IH from 2008 to 2013, were identified. A total of 162 patients were included in the study.

Results

We found that 43% (69) of routine ECGs were read as abnormal, leading to 28 formal consultation appointments with pediatric cardiologists. After either formal consultation or informal discussion with cardiology, no patients with initially “abnormal” ECGs were ultimately excluded from treatment with propranolol based on routine ECG findings. Additionally no patients in our cohort experienced an adverse effect during treatment that could have been predicted or prevented by ECG prior to initiation of the propranolol.

Conclusion

Our findings suggest that routine ECG may not be necessary or helpful in the vast majority of patients treated with propranolol for IHs.
Supply Chain Coordination in the Presence of Gray Markets and Strategic Consumers
Authors: Ahmadi Reza , Iravani Foad , Mamani Hamed
Published: September 2016

The practice of diverting genuine products to unauthorized gray markets continues to challenge companies in various industries and creates intense competition for authorized channels. Recent industry surveys report that the abuse of channel incentives is a primary reason for the growth of gray market activities. Therefore, it is crucial that companies take the presence of gray markets into consideration when they design contracts to distribute products through authorized retailers. This issue has received little attention in the extensive literature on contracting and supply chain coordination. In this study, we analyze the impacts of gray markets on two classic contracts, wholesale price and quantity discount, in a supply chain with one manufacturer and one retailer when the retailer has the opportunity to sell to a domestic gray market. Our analysis provides interesting and counterintuitive results. First, a classic quantity‐discount contract that normally coordinates the supply chain can perform so poorly in the presence of a gray market that the supply chain would be better off using a wholesale price contract instead. Second, the presence of gray market can also degrade the performance of the wholesale price contract; therefore, a more sophisticated contract is needed for coordinating the supply chain. We show that contracts that solely depend on retailer's order quantity cannot coordinate the supply chain, and provide the conditions for coordinating the supply chain with price‐dependent quantity discount contracts. We also provide comparative statics and show that when there is a gray market, coordinating the supply chain enhances total consumer welfare.
An Optimization‐Based Decision‐Support Tool for Post‐Disaster Debris Operations
Authors: Lorca Álvaro , Çelik Melih , Ergun Özlem , Keskinocak Pınar
Published: September 2016

Debris generated by disasters can hinder relief efforts and result in devastating economic, environmental, and health problems. In this study, we present a decision‐support tool employing analytical models to assist disaster and waste management officials with decisions regarding collection, transportation, reduction, recycling, and disposal of debris. The tool enables optimizing and balancing the financial and environmental costs, duration of the collection and disposal operations, landfill usage, and the amount of recycled materials. In addition to post‐disaster operational decisions, the tool can also support the challenging task of developing strategic plans for disaster preparedness. We illustrate the applicability and effectiveness of the tool with a disaster scenario based on Hurricane Andrew.
The Spreading of Innovation: State Adoptions of Energy and Climate Change Policy
Authors: Bromley‐Trujillo Rebecca , Butler J. S. , Poe John , Davis Whitney
Published: September 2016

The American states are engaged in a variety of policy efforts to mitigate climate change and alter energy usage. While a number of studies have considered the reasons for adoption of renewable energy and climate change policies, they typically consider only one policy in isolation. This study examines policy adoption of 14 energy and climate change programs in a pooled event history analysis. Our primary research questions consider average effects of horizontal policy diffusion, while also identifying factors that vary across policy type. We offer a method of testing whether predictors vary across policies and use this test to incorporate interactions by policy in the statistical analysis. Our results indicate that many of the primary drivers of adoption are political in nature, including state ideology, environmental interest group membership, and diffusion via ideologically similar neighbors. In addition, we find that given policy heterogeneity, a number of determinants vary by policy type, though differences are in magnitude rather than direction.
Likelihood Inference for Multivariate Extreme Value Distributions Whose Spectral Vectors have known Conditional Distributions
Authors: Bienvenüe Alexis , Robert Christian Y.
Published: September 2016

Multivariate extreme value statistical analysis is concerned with observations on several variables which are thought to possess some degree of tail dependence. The main approaches to inference for multivariate extremes consist in approximating either the distribution of block component‐wise maxima or the distribution of the exceedances over a high threshold. Although the expressions of the asymptotic density functions of these distributions may be characterized, they cannot be computed in general. In this paper, we study the case where the spectral random vector of the multivariate max‐stable distribution has known conditional distributions. The asymptotic density functions of the multivariate extreme value distributions may then be written through univariate integrals that are easily computed or simulated. The asymptotic properties of two likelihood estimators are presented, and the utility of the method is examined via simulation.
Hobbes on the Order of Sciences: A Partial Defense of the Mathematization Thesis
Authors: Biener Zvi
Published: September 2016

Accounts of Hobbes's “system” of sciences oscillate between two extremes. On one extreme, the system is portrayed as wholly axiomatic‐deductive, with statecraft being deduced in an unbroken chain from the principles of logic and first philosophy. On the other, it is portrayed as rife with conceptual cracks and fissures, with Hobbes's statements about its deductive structure amounting to mere window‐dressing. This paper argues that a middle way is found by conceiving of Hobbes's Elements of Philosophy on the model of a mixed‐mathematical science, not the model provided by Euclid's Elements of Geometry. I suggest that Hobbes is a test case for understanding early‐modern system construction more generally, as inspired by the structure of the applied mathematical sciences. This approach has the additional virtue of bolstering in a novel way the thesis that the transformation of philosophy in the long seventeenth century was indebted to mathematics, a thesis that has come under increasing scrutiny in recent years.
Exploitation and Friendship
Authors: Valdman Mikhail
Published: September 2016

I argue that Alan Wertheimer's account of unfair advantage‐taking, though flawed, is more plausible than his critics believe. Indeed, I argue that his proposed model for assessing fair exchange—the friendship model—according to which a transaction's terms are unfair to the extent that they deviate from the terms upon which we would expect good friends to transact—is compelling and can serve as the basis for a plausible theory of wrongful exploitation. Wertheimer, I will argue, was wrong to think that friends would transact at “hypothetical market prices.” But he was right to think that friendship norms can provide a plausible account of fair exchange. In this paper, I develop a friendship‐based account of wrongful exploitation, and I argue that it has important advantages over rival theories.
Exploited: Exploitation As A Subjective Category
Authors: Deranty Jean‐Philippe
Published: September 2016

I focus on exploitation from the point of view of those who suffer from it, and so I take exploitation as a category of subjective experience. Adopting a subjective perspective on exploitation highlights important conceptual aspects about it and suggests important methodological rules on how to critically discuss social forms of exploitation. I start by introducing some key conceptual distinctions in the first two sections. These distinctions lead me to formulate a first, general definition of exploitation as a subjective category, in the third section of the paper. In the fourth section, I ask what relationship there is between the objective and subjective senses of exploitation, and I turn to the work of Marx. This is because, as I try to argue, Marx's approach is exemplary for tying together an objective and a subjective sense of exploitation. Based on a schematic rendition of Marx's use of a dual perspective on exploitation, in the last sections of the paper, I draw a number of conceptual and normative conclusions.
Role of mTOR inhibitors for the control of viral infection in solid organ transplant recipients
Authors: Pascual Julio , Royuela Ana , Fernández Ana M. , Herrero Ignacio , Delgado Juan F. , Solé Amparo , Guirado Lluis , Serrano Trinidad , de la Torre‐Cisneros Julián , Moreno Asunción , Cordero Elisa , Gallego Roberto , Lumbreras Carlos , Aguado José M. ,   the Spanish Society of Transplantation Virological and Immune Response Investigation Study Group
Published: September 2016

Appropriate post‐transplant immunosuppressive regimens that avoid acute rejection, while reducing risk of viral reactivation, have been sought, but remain a chimera. Recent evidence suggesting potential regulatory and antiviral effects of mammalian target of rapamycin inhibitors (mTORi) is of great interest. Although the concept of an immunosuppressive drug with antiviral properties is not new, little effort has been made to put the evidence together to assess the management of immunosuppressive therapy in the presence of a viral infection. This review was developed to gather the evidence on antiviral activity of the mTORi against the viruses that most commonly reactivate in adult solid organ recipients: cytomegalovirus (CMV), polyomavirus, Epstein‐Barr virus (EBV), human herpesvirus 8 (HHV8), and hepatitis C virus (HCV). A rapid review methodology and evaluation of quality and consistency of evidence based on the GRADE system was used. The existing literature was variable in nature, although indicating a potential advantage of mTORi in CMV, polyomavirus, and HHV8 infection, and a most doubtful relation with EBV and HCV infection. Several recommendations about the management of these infections are presented that can change certain current patterns of immunosuppression and help to improve the prognosis of the direct and indirect effects of viral infection in solid organ recipients.
Cryptococcal osteomyelitis of the skull in a liver transplant patient
Authors: Pudipeddi Aviv V. , Liu Ken , Watson Geoffrey F. , Davis Rebecca J. , Strasser Simone I.
Published: September 2016

Cryptococcus neoformans is an opportunistic fungal pathogen and an important cause of morbidity and mortality in immunocompromised patients. We report a case of osteomyelitis caused by C. neoformans in a liver transplant recipient who presented with a headache and scalp lump after sustaining mild head trauma. There was no evidence of central nervous system involvement or dissemination. This is the first known case report of isolated cryptococcal osteomyelitis in a liver transplant recipient.
Post‐colonial careering and urban policy mobility: between Britain and Nigeria, 1945–1990
Authors: Craggs Ruth , Neate Hannah
Published: September 2016

This paper sets out the value of the concept of ‘careering’ to understanding the global mobility of urban policy across historical and contemporary contexts. Through a case study of one colonial and post‐colonial career in urban development, we demonstrate the material and ideological connections between late colonial development in Nigeria, British reconstruction and international consultancy. Empirically, the paper provides novel post‐colonial perspectives on Britain's post‐Second World War reconstruction spanning the mid‐ to late 20th century, globalising the geographies of the British new town. Conceptually, the paper argues that careering provides a valuable tool for progressing the study of urban expertise and its mobility in four ways. First, it provides a tool for connecting geographically distant urban development projects. Second, careering allows us to explore intersections between urban development policies and geopolitical transformations. Third, careering allows us to see the impact of ideas, skills, experiences, affiliations and contacts formed at different stages of a career on later professional practice, slowing down and lengthening out our understandings of the processes though which urban policy is made mobile. Fourth, careering as a method demonstrates the continued value of biographical approaches to urban policy mobility, highlighting in particular professional lives worked with colleagues and contacts rather than in isolation, and foregrounding the everyday embodied nature of urban expertise. The article concludes by suggesting such approaches could be productive for the writing of new post‐colonial histories of geography and its allied disciplines.
Ferric carboxymaltose reduces the number of red blood cell units transfused and allows transfusion independence to be obtained in patients with iron deficiency anemia secondary to gastrointestinal chronic blood loss
Authors: Salvadori Ugo , Sandri Marco , Melli Cristina , Polese Francesca , Simeoni Maria , Capelli Stefano , Al‐Khaffaf Ahmad
Published: September 2016

BACKGROUND

The aim of this study was to evaluate the effectiveness of ferric carboxymaltose (FCM) in patients with iron deficiency anemia (IDA) secondary to gastrointestinal chronic blood loss (CBL), who received chronic transfusion support.

STUDY DESIGN AND METHODS

We retrospectively evaluated 38 patients with IDA (hemoglobin [Hb] < 10 g/dL and ferritin < 12 ng/mL or transferrin saturation [TSAT] < 16%) refractory or intolerant to oral iron therapy that necessitated transfusion support in the previous 12 months. They were treated with FCM (500‐2500 mg). The primary endpoint was to evaluate the reduction of transfusion requirements (red blood cell [RBC] units) after FCM treatment.

RESULTS

The median age of the cohort was 78 years, with a male:female ratio of 22:16. Before FCM treatment a median of 6 RBC units had been transfused. At the treatment (T0) the median value of Hb was 8.7 g/dL, the TSAT 6%, and ferritin 12 ng/mL. The median FCM dose was 1000 mg. At 5 weeks from T0 the median Hb level was 11 g/dL, with a median increase of 2.4 g/dL. With a median follow‐up of 326 days, the median transfusion requirement was 0 RBC units, significantly lower than before T0 (p < 0.001). Overall 17 patients still necessitated transfusion support. Twenty‐three patients needed retreatment with FCM for recurrence of IDA: 10 of them obtained a response again. The percentage of transfusion‐independent patients at median follow‐up was equal to 52%.

CONCLUSION

In patients with IDA secondary to CBL, FCM significantly reduces the need of transfusions and achieves transfusion independence in half of the cases.
The SHP2‐ERK2 signaling pathway regulates branched I antigen formation by controlling the binding of CCAAT/enhancer binding protein α to the IGnTC promoter region during erythroid differentiation
Authors: Liao Yi‐Jen , Lee Yen‐Hua , Chang Fu‐Ling , Ho Hsun , Huang Chin‐Han , Twu Yuh‐Ching
Published: September 2016

BACKGROUND

Phosphorylation status of the transcription factor CCAAT/enhancer binding protein α (C/EBPα) has been demonstrated in a human hematopoietic cell model to regulate the formation of branched I antigen by affecting its binding affinity to the promoter region of the IGnTC gene during erythroid and granulocytic differentiation.

STUDY DESIGN AND METHODS

The K‐562 cell line was induced to differentiate into red blood cells (RBCs) or granulocytes by sodium butyrate or retinoic acid, respectively, to study the involvement of three MAP kinase pathways in I antigen synthesis. The regulatory effects of the extracellular signal‐regulated kinase (ERK)2‐Src homology region 2 domain‐containing phosphatase 2 (SHP2) pathway on phosphorylation status and binding affinities of C/EBPα as well as the subsequent activation of IGnTC and synthesis of surface I formation were studied in wild‐type K‐562 cells and in mutant cells that overexpress ERK2 and SHP2.

RESULTS

We found that SHP2‐ERK2 signaling regulates the phosphorylation status of C/EBPα to alter its binding affinity onto the IGnTC promoter region, thereby activating the synthesis of cell surface I antigen formation during erythropoiesis.

CONCLUSION

SHP2‐ERK2 signaling acts upstream of C/EBPα as a regulator of cell surface I antigen synthesis. Such regulation is specific for RBC but not for granulocyte differentiation.
Spectral analysis of sidewall roughness during resist-core self-aligned double patterning integration
Authors: Dupuy Emmanuel , Pargon Erwine , Fouchier Marc , Grampeix H. , Pradelles J.
Published: September 2016

Double patterning technology has now proved its efficiency to go beyond the standard lithographic printing limits and address the resolution requirements of the sub-20 nm technological node. However, some data are still lacking regarding the characterization of line edge/width roughness (LER/LWR) in such integration. In this work, a detailed spectral analysis of the sidewall roughness evolution during a resist-core self-aligned double patterning (SADP) integration is presented. A 20 nm half-pitch SADP process using photoresist as the core material, and SiO2 deposited by plasma enhanced atomic layer deposition as the spacer material is developed. The LER and LWR have been characterized at each technological step involved in the SADP process flow, using a power spectral density fitting method, which provides a full description of the sidewalls roughness with the estimation of noise-free roughness amplitude (σ), correlation length (ξ), and roughness exponent (α). Results show that the SADP process allows to decrease drastically the LWR and LER amplitudes down to 2.0 nm corresponding to a reduction of about 70% and 50%, respectively, compared to the initial resist patterns. Although the SADP concept generates two asymmetric populations of lines, the final features present similar LWR, LERleft, and LERright parameters. The study also highlights the effectiveness of the SADP concept to decrease critical dimension variation and low-frequency LWR components to values inferior to 1 nm, which is an outstanding improvement compared to other single or double patterning techniques. However, this work brings out that the deposition process is the key step to ensure successful resist-core SADP integration. It must not only be as conformal as possible but also preserve the square shape of the core material. It is shown that the resist lateral erosion occurring during the deposition step introduces some random resist sidewalls angles that contribute to the formation of short range roughness during the spacer etching transfer, resulting in residual LWR mainly composed of high-and medium-frequency components. Contrary to LWR, the beneficial impact of the conformal spacer deposition on low-frequency roughness components has rather no effect on LER. The LER parameters after spacer etching mainly depend on the core ones prior to deposition. LER low-frequency components remain a key issue to address for an optimized integration.
From local to global measurements of nonclassical nonlinear elastic effects in geomaterials
Authors: Lott Martin , Remillieux Marcel C. , Le Bas Pierre-Yves , Ulrich T. J. , Garnier Vincent , Payan Cédric
Published: September 2016

In this letter, the equivalence between local and global measures of nonclassical nonlinear elasticity is established in a slender resonant bar. Nonlinear effects are first measured globally using nonlinear resonance ultrasound spectroscopy (NRUS), which monitors the relative shift of the resonance frequency as a function of the maximum dynamic strain in the sample. Subsequently, nonlinear effects are measured locally at various positions along the sample using dynamic acousto elasticity testing (DAET). After correcting analytically the DAET data for three-dimensional strain effects and integrating numerically these corrected data along the length of the sample, the NRUS global measures are retrieved almost exactly.
Imaging approaches to optimize molecular therapies
Authors: Weissleder Ralph , Schwaiger Markus C. , Gambhir Sanjiv Sam , Hricak Hedvig
Published: September 2016

New imaging approaches will optimize the drug development of tomorrow and provide individualized best-treatment plans for cancer patients.