bluuebunny/crossref_metadata_2025 huggingface dataset:
The development of whole-system integrated care in England
Authors: Kennedy Claire , Morioka Simon
Published: September 2014

Purpose

– The purpose of this paper is to detail the research and findings from a piece of work commissioned by the Local Government Association in England, in May 2013 into the current implementation of integrated care.

Design/methodology/approach

– The field research was carried out by Integrating Care, a collaborative drawn from leading academics, health and social care executives, analysts and clinicians working in the field of integrated care; along with consultancy support from public sector consultancies PPL and GE Healthcare Finnamore. It comprised a series of local interviews, workshops, modelling and analysis and ongoing engagement.

Findings

– The paper describes the outputs that were delivered to support the development of “whole-system” integrated health and social care drawing on national and international best-practice, and knowledge gained from experiences of implementation.

Social implications

– The paper concludes by drawing together the key lessons from the overarching analysis of whole-system integration. This includes the opportunities and the complexities of redesigning and re-implementing better co-ordinated health and social care provision at scale, as experienced in England currently.

Originality/value

– The paper describes the specific challenges posed through the fieldwork and ongoing development process of integration in England, and the paper reflects upon some of the deeper questions that this has led to. The paper then draws together the research and analysis with emerging, strategic questions around the concept of value in health provision; and begins to question whether this has yet been demonstrated; and, if not, what a demonstration and evidencing of “value” in this context might look like.
“Sliding Doors”: innovative approaches to supporting culture change
Authors: Walker Gill , Gillies Laura
Published: September 2014

Purpose

– Reshaping Care for Older People (RCOP) and Integration of Health and Social Care are central to providing a care system in Scotland that meets older people's current and future needs. Their implementation requires a workforce with the appropriate knowledge, skills and values to engage with older people across health and social care sectors, which requires a change in professionals’ thinking about services. The paper aims to discuss these issues.

Design/methodology/approach

– NHS Education for Scotland, the Scottish Social Services Council and a learning and development consultancy designed and delivered innovative education resources to support health and social care staff across Scotland to understand the new agenda and recognise its meaning for practice.

Findings

– Two related resources were developed: workshop using actors to depict scenarios from older people's lives to support participants to reflect on the new policy direction and outcomes-focused approaches; and an online resource using the same characters that can be delivered locally for groups and individuals. Participants were enabled to identify what they need to do differently and how they can support one another to make necessary changes. A formal evaluation has been commissioned.

Originality/value

– The resource characters represent the people the new policy is designed to affect. By following their lives through an educational drama approach, health and social care staff can understand the difference RCOP and the integration agenda can make and recognise their part in effecting change.
How exotic plants integrate into pollination networks
Authors: Stouffer Daniel B. , Cirtwill Alyssa R. , Bascompte Jordi
Published: September 2014

There is increasing world‐wide concern about the impact of the introduction of exotic species on ecological communities. Since many exotic plants depend on native pollinators to successfully establish, it is of paramount importance that we understand precisely how exotic species integrate into existing plant–pollinator communities.

In this manuscript, we have studied a global data base of empirical pollination networks to determine whether community, network, species or interaction characteristics can help identify invaded communities.

We found that a limited number of community and network properties showed significant differences across the empirical data sets – namely networks with exotic plants present are characterized by greater total, plant and pollinator richness, as well as higher values of relative nestedness.

We also observed significant differences in terms of the pollinators that interact with the exotic plants. In particular, we found that specialist pollinators that are also weak contributors to community nestedness are far more likely to interact with exotic plants than would be expected by chance alone.

Synthesis. By virtue of their interactions, it appears that exotic plants may provide a key service to a community's specialist pollinators as well as fill otherwise vacant ‘coevolutionary niches’.
Improving postpartum care for mothers and newborns in Niger and Mali: a case study of an integrated maternal and newborn improvement programme
Authors: Boucar M , Hill K , Coly A , Djibrina S , Saley Z , Sangare K , Kamgang E , Hiltebeitel S ,   USAID Applying Science to Strengthen Improve Systems University Research Co., LLC (USAID ASSIST‐URC)
Published: September 2014

Despite appropriate guidelines, healthcare services worldwide often fail to deliver high‐impact evidence‐based care. This case study describes a large‐scale programme to improve integrated postpartum care for mothers and newborns in Niger and Mali. As a result of an improvement effort based on common objectives, local ownership and shared learning to accelerate implementation of best practices, 78 facilities demonstrated rapid improvement in compliance with standards for post‐partum haemorrhage prevention and Essential Newborn Care as well as a reduction in estimated postpartum haemorrhage. This approach yields rapid results and can be efficiently spread to improve care in low‐resource settings.
Quality of maternal and neonatal care in Central Asia and Europe—lessons learnt
Authors: Bacci A
Published: September 2014

In the World Health Organization (WHO) European region despite official high coverage of essential interventions for maternal and neonatal care, there are still significant gaps in the delivery of effective interventions. Since 2001, WHO designed and implemented the Making Pregnancy Safer programme, which includes hands‐on training courses in effective perinatal care for maternity teams, development of clinical guidelines, maternal mortality and morbidity case reviews, and assessments of quality of care. This has contributed to enhancing capacity at country level to improve organisation and provision of care. This paper describes the programme's components, challenges, achievements and results.
Quality of antenatal and childbirth care in northern Ghana
Authors: Duysburgh E , Williams A , Williams J , Loukanova S , Temmerman M
Published: September 2014

The QUALMAT research project aims to improve maternal and newborn health by improving the quality of antenatal and childbirth care provided in primary healthcare facilities. Within the frame of this project, a comprehensive quality assessment took place in selected health centres in northern Ghana. The results of this assessment showed that overall quality of routine antenatal and childbirth care was satisfactory, although some critical gaps were identified. Counselling and health education practices need to be improved; laboratory investigations are often not performed; examination and monitoring of mother and newborn during childbirth are inadequate; partographs are often not used and poorly completed; and equipment to provide assisted vaginal deliveries was absent.
Using the new ICD‐MM classification system for attribution of cause of maternal death—a pilot study
Authors: Ameh CA , Adegoke A , Pattinson RC , van den Broek N
Published: September 2014

Understanding the causes of and factors contributing to maternal deaths is critically important for development of interventions that reduce the global burden of maternal mortality and morbidity. The International Classification of Diseases—Maternal Mortality (ICD‐MM) classification of cause of death during pregnancy, childbirth and the puerperium was applied to data obtained from maternal death reviews (MDR) for 4558 maternal deaths from five countries in sub‐Saharan Africa. None of the data sets identified type of maternal death. Information obtained via MDR is generally sufficient to agree on classification of cause of death to the levels of type and group. The terms ‘underlying cause of death’ and ‘contributing conditions’ were used differently in different settings and a specific underlying cause of death was frequently not recorded. Application of ICD‐MM resulted in the reclassification of 3.1% (9/285) of cases to the group ‘unanticipated complications of management’, previously recorded as obstetric haemorrhage or unknown. An increased number of cases were assigned to the groups pregnancy‐related infection (5.6–10.2%) and pregnancies with abortive outcome (3.4–4.9%) when a clear distinction was made between women who died ‘with’ HIV/AIDS of obstetric causes (direct maternal death) and AIDS‐related indirect maternal deaths (group ‘non‐obstetric complications’). Similarly, anaemia and obstructed labour were more frequently identified as contributing factors than underlying cause of death. It would be helpful if MDR forms could have explicitly stated variables called: type, group and underlying cause of death as well as a dedicated section to the most frequently occurring contributing conditions recognised in that setting.
Multilead Template‐Derived Residua of Surface ECGS for Quantitative Assessment of Arrhythmia Risk
Authors: Nearing Bruce D. , Verrier Richard L.
Published: September 2014

Background

Contemporary electrocardiographic (ECG) markers including ventricular ectopy and arrhythmias have not proved reliable in risk assessment for life‐threatening arrhythmias.

Methods

We developed the “Multilead ECG Template‐Derived Residua” approach to remove intrinsic morphologic differences and allow calculation of pathologic ECG heterogeneities among spatially separated leads. Prediction by R‐wave and T‐wave heterogeneity (RWH, TWH) analysis was tested in simulated and clinical ECGs.

Results

An enabling description of the Residua algorithm is provided. Simulated ECGs with but not without Residua produced a linear relationship (correlation coefficient r2 = 0.999) between input and output RWH and TWH values. In heart failure patients, Residua disclosed a marked crescendo in RWH from 164.1 ± 33.1 at baseline to 299.8 ± 54.5 μV and TWH from 134.5 ± 20.6 at baseline to 239.2 ± 37.0 μV at 30–45 minutes before the arrhythmia (both, P < 0.05), which remained elevated until arrhythmia onset. Without Residua, mean RWH and TWH were elevated at 1061.0 ± 222.9 and 882.5 ± 375.2 μV, respectively, throughout the recording and were not different prior to ventricular tachycardia onset.

Conclusions

Calculation of ECG‐template derived Residua provides a highly accurate means for assessing arrhythmia risk from standard ECGs. Potential widespread applications include resting diagnostic 12‐lead, ambulatory, and exercise ECGs, electrophysiologic study laboratory recordings, and implantable devices.
Significance of Fragmented QRS Complexes for Identifying Left Ventricular Hypertrophy in Patients with Hypertension
Authors: Zhang Baowei , Zhen Ya , Shen Dongli , Zhang Guohui
Published: September 2014

Background

Fragmented QRS complexes (fQRS) were associated with left ventricular mass (LVM) in hypertensive patients. Our study aimed to investigate the association between fQRS and left ventricular hypertrophy (LVH) in hypertensive patients.

Methods

Two hundred thirty‐six hypertensive patients were divided into fQRS group and non‐fQRS group. fQRS were defined as the presence of an additional R wave, notching in the R or S wave, or the presence of >1 R' in two contiguous leads. Echocardiography was used to detect LVH.

Results

Patients with fQRS had higher levels of LVM than patients without fQRS (181.55 ± 65.64 g vs. 149.21 ± 35.08 g, P < 0.001). Receiver operating characteristic curves showed areas under the curve was 0.62 for fQRS (95% CI 0.54–0.69, P = 0.003). In univariate analyses, the presence of fQRS on ECG was positively associated with LVM. Multiple regression analyses found fQRS was associated with LVM, independently.

Conclusion

fQRS is a common electrocardiographic phenomenon in patients with hypertension. Although the diagnostic value for LVH is limited, the presence of fQRS on ECG is associated with a higher risk for worse LVH.
Rare platelet GPCR variants: what can we learn?
Authors: Nisar S P , Jones M L , Cunningham M R , Mumford A D , Mundell S J ,   UK GAPP Study Group
Published: September 2014

Platelet‐expressed GPCRs are critical regulators of platelet function. Pharmacological blockade of these receptors forms a powerful therapeutic tool in the treatment and prevention of arterial thrombosis associated with coronary atherosclerosis and ischaemic stroke. However, anti‐thrombotic drug therapy is associated with high inter‐patient variability in therapeutic response and adverse bleeding side effects. In order to optimize the use of existing anti‐platelet drugs and to develop new therapies, more detailed knowledge is required relating to the molecular mechanisms that regulate GPCR and therefore platelet function. One approach has been to identify rare, function‐disrupting mutations within key platelet proteins in patients with bleeding disorders. In this review, we describe how an integrated functional genomics strategy has contributed important structure‐function information about platelet GPCRs with specific emphasis upon purinergic and thromboxane A2 receptors. We also discuss the potential implications these findings have for pharmacotherapy and for understanding the molecular basis of mild bleeding disorders.

Linked Articles

This article is part of a themed section on 5th BPS Focused Meeting on Cell Signalling. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2015.172.issue‐13
Real Time Three‐Dimensional Transthoracic Echocardiography in Assessment of Stented Coarctation of Aorta: A Case‐Based Presentation
Authors: Almomani Ahmed , Modi Shreyas , Ahmad Masood
Published: September 2014

Mini‐Abstract

The treatment for aortic coarctation has evolved from surgical repair to percutaneous endovascular balloon angioplasty and stenting. Imaging techniques are playing an important role in assessment of these patients. We present a case in whom an accurate assessment of the patency of the stent and the adequacy of flow were obtained by real time three‐dimensional echocardiography. Compared to other imaging modalities, echocardiography is inexpensive. It also avoids the risks of radiation and contrast associated with computed tomographic (CT) angiography, and the potential artifacts that may occur with cardiac magnetic resonance (MR). Real time three‐dimensional echocardiography from a transthoracic approach appears promising in evaluating morphology and functionality of the stented coarctation of the descending aorta.
Real Time Three‐Dimensional Transesophageal Echocardiography Demonstration of Membranous Septal Aneurysm Causing Severe Right Ventricular Outflow Tract Obstruction
Authors: Mahesh Saktheeswaran K. , Kumar Senthil , Satheesh Santhosh , Jayaraman Balachander
Published: September 2014

Mini‐Abstract

In addition to infundibular muscular hypertrophy and anomalous muscle bundles in the right ventricular body, large membranous septal aneurysms (MSA), sinus of Valsalva aneurysms, and aneurysms derived from the embryonic venous valve protruding through the tricuspid valve can cause right ventricular outflow obstruction in a patient with ventricular septal defect. Here we describe an adult with a small perimembranous ventricular septal defect complicated by a large MSA causing severe right ventricular outflow obstruction evaluated with real time three‐dimensional transesophageal echocardiography.
Right Ventricular Mass: Intracardiac Ectopic Thyroid Tissue: A Case Report
Authors: Rabus Murat Bulent , Poçi Nertila , Yılmaz Fatih , Yerlikhan Onur , Aktemur Tugba , Arslan Akin , Ozturk Selcuk , Oztek Ibrahim , Balkanay Mehmet
Published: September 2014

Ectopic thyroid tissue is a result of abnormal migration of thyroid tissue during the embryonic state. Most of these rare cases, almost 90% of them, are located in the base of the tongue and a minority of them is located anteriorly near the hyoid bone area. Below we report the case of a young patient with an intracardiac mass first diagnosed with three‐dimensional echocardiography and afterward successfully treated surgically. Once a careful histological examination has revealed a follicular adenoma, the prognosis is good especially if successful surgical excision is part of the management.
Real Time Three‐Dimensional Transesophageal Echocardiography Guided Coronary Sinus Cannulation during CARILLON Mitral Annuloplasty Device Therapy for a Patient with Chronic Severe Mitral Regurgitation
Authors: Mahmoud Hani M. , Al‐Ghamdi Mohammed A. , Ghabashi Abdullah E.
Published: September 2014

The coronary sinus (CS) has become a clinically important structure especially through its role in providing access for different cardiac procedures such as arrhythmia ablation, biventricular pacing and recently, percutaneous valvular interventions. Fluoroscopy with or without two‐dimensional transesophageal echocardiography is the widely used method for guidance. A 78‐year‐old female patient undergoing percutaneous CARILLON mitral annuloplasty device therapy for chronic severe symptomatic mitral regurgitation. After insertion of the CS catheter through the right internal jugular vein, multiple trials for CS cannulation guided by fluoroscopy and two‐dimensional transesophageal echocardiography were unsuccessful. So, real time three‐dimensional zoom mode was used. Then, the volume was rotated to have the anatomically oriented enface view of the interatrial septum from the right atrial perspective. The CS ostium was identified adjacent to the eustachian valve. Then the catheter was reintroduced through the superior vena cava into the right atrium then easily navigated to cannulate the CS ostium. The position was confirmed by the fluoroscopically known course of the CS plus the pattern of the invasive pressure wave form. CS cannulation is not always feasible using fluoroscopy and/or two‐dimensional Echocardiography guidance. Real time three‐dimensional transesophageal echocardiography can be used to guide CS cannulation as it provides an anatomically oriented and informative enface view of the CS ostium. It can help reducing fluoroscopic radiation time.
Bio3 Research: An Entrepreneurial Process in the Market for Patents
Authors: D'Angelo Alfredo , Benassi Mario
Published: September 2014

This case concerns Bio3 Research, a small biotechnology company established in Italy in 2001 that focuses on cardiovascular disorders, connective tissue regeneration, and renal disorders. The case reports on Dr. Pilato, founder and chief executive officer of Bio3 Research, while reflecting with his chief operating officer on the investments required to finance his patents and products pipeline. The case offers a discussion around the entrepreneurial process of Bio3 Research, from opportunity identification to opportunity development and exploitation. The case then reveals Bio3 Research's business model and examines its activities and management practices in the patent market. In a recessive world economy, Bio3 Research has an exciting portfolio of patents and products in high–growth markets but must decide between financial options, as the company cannot exploit all of these opportunities on its own.
Role of pleiotropy during adaptation of TEM‐1 β‐lactamase to two novel antibiotics
Authors: Schenk Martijn F. , Witte Sariette , Salverda Merijn L. M. , Koopmanschap Bertha , Krug Joachim , de Visser J. Arjan G. M.
Published: September 2014

Pleiotropy is a key feature of the genotype–phenotype map, and its form and extent have many evolutionary implications, including for the dynamics of adaptation and the evolution of specialization. Similarly, pleiotropic effects of antibiotic resistance mutations may affect the evolution of antibiotic resistance in the simultaneous or fluctuating presence of different antibiotics. Here, we study the role of pleiotropy during the in vitro adaptation of the enzyme TEM‐1 β‐lactamase to two novel antibiotics, cefotaxime (CTX) and ceftazidime (CAZ). We subject replicate lines for four rounds of evolution to selection with CTX and CAZ alone, and in their combined and fluctuating presence. Evolved alleles show positive correlated responses when selecting with single antibiotics. Nevertheless, pleiotropic constraints are apparent from the effects of single mutations and from selected alleles showing smaller correlated than direct responses and smaller responses after simultaneous and fluctuating selection with both than with single antibiotics. We speculate that these constraints result from structural changes in the oxyanion pocket surrounding the active site, where accommodation of CTX and the larger CAZ is balanced against their positioning with respect to the active site. Our findings suggest limited benefits from the combined or fluctuating application of these related cephalosporins for containing antibiotic resistance.
Knockdown of lecithin retinol acyltransferase increases all‐trans retinoic acid levels and restores retinoid sensitivity in malignant melanoma cells
Authors: Amann Philipp M. , Czaja Katharina , Bazhin Alexandr V. , Rühl Ralph , Skazik Claudia , Heise Ruth , Marquardt Yvonne , Eichmüller Stefan B. , Merk Hans F. , Baron Jens M.
Published: September 2014

Retinoids such as all‐trans retinoic acid (ATRA) influence cell growth, differentiation and apoptosis and may play decisive roles in tumor development and progression. An essential retinoid‐metabolizing enzyme known as lecithin retinol acyltransferase (LRAT) is expressed in melanoma cells but not in melanocytes catalysing the esterification of all‐trans retinol (ATRol). In this study, we show that a stable LRAT knockdown (KD) in the human melanoma cell line SkMel23 leads to significantly increased levels of the substrate ATRol and biologically active ATRA. LRAT KD restored cellular sensitivity to retinoids analysed in cell culture assays and melanoma 3D skin models. Furthermore, ATRA‐induced gene regulatory mechanisms drive depletion of added ATRol in LRAT KD cells. PCR analysis revealed a significant upregulation of retinoid‐regulated genes such as CYP26A1 and STRA6 in LRAT KD cells, suggesting their possible involvement in mediating retinoid resistance in melanoma cells. In conclusion, LRAT seems to be important for melanoma progression. We propose that reduction in ATRol levels in melanoma cells by LRAT leads to a disturbance in cellular retinoid level. Balanced LRAT expression and activity may provide protection against melanoma development and progression. Pharmacological inhibition of LRAT activity could be a promising strategy for overcoming retinoid insensitivity in human melanoma cells.
Reforestation with native mixed‐species plantings in a temperate continental climate effectively sequesters and stabilizes carbon within decades
Authors: Cunningham Shaun C. , Cavagnaro Timothy R. , Mac Nally Ralph , Paul Keryn I. , Baker Patrick J. , Beringer Jason , Thomson James R. , Thompson Ross M.
Published: September 2014

Reforestation has large potential for mitigating climate change through carbon sequestration. Native mixed‐species plantings have a higher potential to reverse biodiversity loss than do plantations of production species, but there are few data on their capacity to store carbon. A chronosequence (5–45 years) of 36 native mixed‐species plantings, paired with adjacent pastures, was measured to investigate changes to stocks among C pools following reforestation of agricultural land in the medium rainfall zone (400–800 mm yr−1) of temperate Australia. These mixed‐species plantings accumulated 3.09 ± 0.85 t C ha−1 yr−1 in aboveground biomass and 0.18 ± 0.05 t C ha−1 yr−1 in plant litter, reaching amounts comparable to those measured in remnant woodlands by 20 years and 36 years after reforestation respectively. Soil C was slower to increase, with increases seen only after 45 years, at which time stocks had not reached the amounts found in remnant woodlands. The amount of trees (tree density and basal area) was positively associated with the accumulation of carbon in aboveground biomass and litter. In contrast, changes to soil C were most strongly related to the productivity of the location (a forest productivity index and soil N content in the adjacent pasture). At 30 years, native mixed‐species plantings had increased the stability of soil C stocks, with higher amounts of recalcitrant C and higher C : N ratios than their adjacent pastures. Reforestation with native mixed‐species plantings did not significantly change the availability of macronutrients (N, K, Ca, Mg, P, and S) or micronutrients (Fe, B, Mn, Zn, and Cu), content of plant toxins (Al, Si), acidity, or salinity (Na, electrical conductivity) in the soil. In this medium rainfall area, native mixed‐species plantings provided comparable rates of C sequestration to local production species, with the probable additional benefit of providing better quality habitat for native biota. These results demonstrate that reforestation using native mixed‐species plantings is an effective alternative for carbon sequestration to standard monocultures of production species in medium rainfall areas of temperate continental climates, where they can effectively store C, convert C into stable pools and provide greater benefits for biodiversity.
Association Between Tension‐Type Headache and Migraine With Sleep Bruxism: A Systematic Review
Authors: De Luca Canto Graziela , Singh Vandana , Bigal Marcelo E. , Major Paul W. , Flores‐Mir Carlos
Published: September 2014

Aim

To evaluate the association between tension‐type headache and migraine with sleep bruxism (SB).

Background

The association between SB and headaches has been discussed in both children and adults. Although several studies suggested a possible association, no systematic analysis of the available published studies exists to evaluate the quantity, quality, and risk of bias among those studies.

Methods

A systematic review was undertaken, including articles that classified the headaches according to the International Classification of Headache Disorders and SB according to the criteria of the American Association of Sleep Medicine. Only articles in which the objective was to investigate the association between primary headaches (tension‐type and migraine) and SB were selected. Detailed individual search strategies for The Cochrane Library, MEDLINE, EMBASE, PubMed, and LILACS were developed. The reference lists from selected articles were also checked. A partial grey literature search was taken by using Google Scholar. The methodology of selected studies was evaluated using the quality in prognosis studies tool.

Results

Of 449 identified citations, only 2 studies, both studying adults, fulfilled the inclusion criteria. The presence of SB significantly increased the odds (study 1: odds ratio [OR] 3.12 [1.25‐7.7] and study 2: OR 3.8; 1.83‐7.84) for headaches, although studies reported different headache type.

Conclusion

There is not enough scientific evidence to either support or refute the association between tension‐type headache and migraine with SB in children. Adults with SB appear to be more likely to have headache.
The biopsy pathology of non‐coeliac enteropathy
Authors: Greenson Joel K
Published: September 2014

Tropical sprue (TS) is a malabsorption syndrome of presumed infectious aetiology that affects residents of (or visitors to) the tropics. The histological changes of TS are similar to those of coeliac disease, with increased intraepithelial lymphocytes being central to both. Unlike in coeliac disease, however, a completely flat small bowel biopsy is uncommon in TS. TS typically involves the terminal ileum, whereas coeliac disease does not. Small intestinal bacterial overgrowth (SIBO) has been defined as an increase in number and/or a change in the type of bacteria in the upper gut. Conditions that predispose to SIBO are largely those that decrease or interfere with small bowel motility. The mucosal histology is variable, and may include modest villous blunting accompanied by increased lamina propria and epithelial inflammation. Autoimmune enteropathy (AE) is a family of rare diseases that share common themes such as immunodeficiency states and autoantibodies. AE cases typically have marked villous atrophy similar to that in fully developed coeliac disease, but they lack the intense surface epithelial lymphocytosis. Apoptosis and lymphocyte infiltration at the base of the crypts, crypt abscesses and cryptitis are also seen. Patients with anti‐goblet cell antibodies can have a lack of goblet cells, endocrine cells, and Paneth cells.
Characterisation of Apatites as Potential Uranium Reference Materials for Fission‐track Dating by LA‐ICP‐MS
Authors: Soares Cleber J. , Mertz‐Kraus Regina , Guedes Sandro , Stockli Daniel F. , Zack Thomas
Published: September 2014

We report homogeneity tests on large natural apatite crystals to evaluate their potential as U reference materials for apatite fission‐track (AFT) thermochronology by laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS). The homogeneity tests include the measurements of major element concentrations by electron probe microanalysis (EPMA), whereas for U concentration, isotope dilution (ID) ICP‐MS and laser ablation (LA) ICP‐MS were employed. Two apatite crystals are potential reference materials for LA‐ICP‐MS analysis: a 1 cm3 fraction of a Durango crystal (7.5 μg g−1 U) and a 1 cm3 Mud Tank crystal (6.9 μg g−1 U). The relative standard deviation (1 RSD) of the U concentration determined by ID‐ICP‐MS of both apatite crystals was ≤ 1.5%, whereas 1 RSD for the LA‐ICP‐MS results was better than 4%, providing sufficient homogeneity for fission‐track dating. The results on the U homogeneity for two different apatite samples are an important step towards establishing in situ dating routines for AFT analysis by LA‐ICP‐MS.
Detection of Biomarkers of Pathogenic Naegleria fowleri Through Mass Spectrometry and Proteomics
Authors: Moura Hercules , Izquierdo Fernando , Woolfitt Adrian R. , Wagner Glauber , Pinto Tatiana , del Aguila Carmen , Barr John R.
Published: September 2014

Emerging methods based on mass spectrometry (MS) can be used in the rapid identification of microorganisms. Thus far, these practical and rapidly evolving methods have mainly been applied to characterize prokaryotes. We applied matrix‐assisted laser‐desorption‐ionization‐time‐of‐flight mass spectrometry MALDI‐TOF MS in the analysis of whole cells of 18 N. fowleri isolates belonging to three genotypes. Fourteen originated from the cerebrospinal fluid or brain tissue of primary amoebic meningoencephalitis patients and four originated from water samples of hot springs, rivers, lakes or municipal water supplies. Whole Naegleria trophozoites grown in axenic cultures were washed and mixed with MALDI matrix. Mass spectra were acquired with a 4700 TOF‐TOF instrument. MALDI‐TOF MS yielded consistent patterns for all isolates examined. Using a combination of novel data processing methods for visual peak comparison, statistical analysis and proteomics database searching we were able to detect several biomarkers that can differentiate all species and isolates studied, along with common biomarkers for all N. fowleri isolates. Naegleria fowleri could be easily separated from other species within the genus Naegleria. A number of peaks detected were tentatively identified. MALDI‐TOF MS fingerprinting is a rapid, reproducible, high‐throughput alternative method for identifying Naegleria isolates. This method has potential for studying eukaryotic agents.
Bringing Political Skill into Social Networks: Findings from a Field Study of Entrepreneurs
Authors: Fang Ruolian , Chi Lei , Chen Manli , Baron Robert A.
Published: September 2014

The authors integrate the entrepreneurship literature's sociological and behavioural perspectives and examine the processes through which entrepreneurs first build social networks and then use the network resources for enhancing venture performance. Field interviews of entrepreneurs during a six‐month period reveal that political skill is an important individual‐level factor that influences the construction and use of social networks. Theoretical and practical implications of the major findings are discussed.
Linguistic commodification in tourism
Authors: Heller Monica , Pujolar Joan , Duchêne Alexandre
Published: September 2014

Drawing on fieldwork conducted between 2002 and 2012 in Switzerland, Catalonia and different zones of francophone Canada in sites related to heritage and cultural tourism, we argue that tourism, especially in multilingual peripheries, is a key site for a sociolinguistic exploration of the political economy of globalization. We link shifts in the role of language in tourism to shifts in phases of capitalism, focusing on the shift from industrial to late capitalism, and in particular on the effects of the commodification of authenticity. We examine the tensions this shift generates in ideologies and practices of language, concerned especially with defining the nature of the tourism product, its public and market, and the management of the tourism process. This results in an as yet unresolved destabilization of hitherto hegemonic discourses linking languages to cultures, identities, nations and States.
Introduction: Sociolinguistics and tourism – mobilities, markets, multilingualism
Authors: Heller Monica , Jaworski Adam , Thurlow Crispin
Published: September 2014

In the introduction to this special issue on Sociolinguistics and Tourism, we focus on language in tourism as an important window into contemporary forms of economic, political, and social change. Our aim is twofold: (1) to establish and extend ‘sociolinguistics and tourism’ as another social and applied domain of sociolinguistic research; and (2) to use tourism as a lens for a broader discussion of the sociolinguistics of late modernity. To this end, we outline the contours of language and tourism research to date; we consider the (re)conceptualization of key thematics or notions in sociolinguistic research – such as ‘community’, ‘identity’, and ‘language’ itself – as particularly germane to the study of tourism's fleeting encounters; we examine the inevitable tensions between commodification and authenticity; and we explore the links between performances of ‘self’ and ‘other’, and the contestation of different identity positions with regard to social actors’ multilingual repertoires. We illustrate these issues with data examples from several tourist sites, where multilingual resources are deployed for identification, authentication and commodification. Finally, we briefly introduce the papers in this special issue and conclude by commenting on some sociolinguistic consequences of the study of language/s in tourism.
A pharmaceutical industry perspective on the economics of treatments for alcohol and opioid use disorders
Authors: Gastfriend David R.
Published: September 2014

Individuals with alcohol and/or drug use disorders often fail to receive care, or evidence‐based care, yet the literature shows health economic benefits. Comparative effectiveness research is emerging that examines approved approaches in terms of real, total healthcare cost/utilization. Comprehensive retrospective insurance claims analyses are few but tend to be nationally distributed and large. The emerging pattern is that, while treatment in general is cost effective, specific therapeutics can yield different health economic outcomes. Cost/utilization data consistently show greater savings with pharmacotherapies (despite their costs) versus psychosocial treatment alone. All FDA‐approved addiction pharmacotherapies (oral naltrexone, extended‐release naltrexone, acamprosate, disulfiram, buprenorphine, buprenorphine/naloxone, and methadone) are intended for use in conjunction with psychosocial management, not as stand‐alone therapeutics; hence, pharmacotherapy costs must offer benefits in addition to abstinence alone or psychological therapy. Patient persistence is problematic, and (despite its cost) extended‐release pharmacotherapy may be associated with lower or no greater total healthcare cost, mostly due to reduced hospitalization. The reviewed studies use rigorous case‐mix adjustment to balance treatment cohorts but lack the randomization that clinical trials use to protect against confounding. Unlike trials, however, these studies can offer generalizability to diverse populations, providers, and payment models—and are of particular salience to payers.
Detailed functional characterization of glycosylated and nonglycosylated variants of malaria vaccine candidate PfAMA1 produced in Nicotiana benthamiana and analysis of growth inhibitory responses in rabbits
Authors: Boes Alexander , Spiegel Holger , Edgue Gueven , Kapelski Stephanie , Scheuermayer Matthias , Fendel Rolf , Remarque Edmond , Altmann Friedrich , Maresch Daniel , Reimann Andreas , Pradel Gabriele , Schillberg Stefan , Fischer Rainer
Published: September 2014

One of the most promising malaria vaccine candidate antigens is the Plasmodium falciparum apical membrane antigen 1 (PfAMA1). Several studies have shown that this blood‐stage antigen can induce strong parasite growth inhibitory antibody responses. PfAMA1 contains up to six recognition sites for N‐linked glycosylation, a post‐translational modification that is absent in P. falciparum. To prevent any potential negative impact of N‐glycosylation, the recognition sites have been knocked out in most PfAMA1 variants expressed in eukaryotic hosts. However, N‐linked glycosylation may increase efficacy by improving immunogenicity and/or focusing the response towards relevant epitopes by glycan masking. We describe the production of glycosylated and nonglycosylated PfAMA1 in Nicotiana benthamiana and its detailed characterization in terms of yield, integrity and protective efficacy. Both PfAMA1 variants accumulated to high levels (>510 μg/g fresh leaf weight) after transient expression, and high‐mannose‐type N‐glycans were confirmed for the glycosylated variant. No significant differences between the N. benthamiana and Pichia pastoris PfAMA1 variants were detected in conformation‐sensitive ligand‐binding studies. Specific titres of >2 × 106 were induced in rabbits, and strong reactivity with P. falciparum schizonts was observed in immunofluorescence assays, as well as up to 100% parasite growth inhibition for both variants, with IC50 values of ~35 μg/mL. Competition assays indicated that a number of epitopes were shielded from immune recognition by N‐glycans, warranting further studies to determine how glycosylation can be used for the directed targeting of immune responses. These results highlight the potential of plant transient expression systems as a production platform for vaccine candidates.
Adult attachment styles, self‐esteem, and depressive symptoms: A comparison between postpartum and nonpostpartum women in Korea
Authors: KANG YAE‐RI , LEE JONG‐SUN , KANG MIN‐CHUL
Published: September 2014

Life stress related to child bearing has been suggested to increase the risk of maternal depression in vulnerable women who have an insecure relationship. This study examined the relationship between adult attachment security and maternal depression in postpartum women as compared to nonpostpartum women. A total of 254 Korean women were recruited from pediatric hospitals, of whom 119 were in the postpartum period. Participants completed the Relationship Questionnaire, the Beck Depression Inventory, and the Rosenberg Self‐Esteem Scale. Both preoccupied and fearful attachment styles were associated with low self‐esteem and higher levels of depressive symptoms, but a dismissing attachment style was not related to self‐esteem and depression severity. Low self‐esteem was found to mediate the relation between insecure attachment and depression severity; however, this mediating effect differed depending on the insecure attachment style. For preoccupied attachment, the role of self‐esteem as a mediator was observed only in postpartum women, not in nonpostpartum women (moderated mediation). In contrast, for fearful attachment, the mediating effects emerged in both groups. The results highlight the fact that there is a complex mechanism behind the link between interpersonal relationships and risk of maternal depression.
The “Emulator Effect” of the Uruguay Round on US Regionalism
Authors: Fugazza Marco , Robert‐Nicoud Frédéric
Published: September 2014

Using a detailed data set at the tariff line level, we find an emulator effect of multilateralism on subsequent regional trade agreements (RTAs) involving the USA. We exploit the variation in the frequency with which the US grants immediate duty free access (IDA) to its RTA partners across tariff lines. A key finding is that the US grants IDA status especially on goods for which it has cut the multilateral most favored nation (MFN) tariff during the Uruguay Round the most. Our results suggest that the Uruguay Round multilateral “concessions” have elicited subsequent preferential trade liberalization.
Financial Development and Sustainable Exports: Evidence from Firm‐product Data
Authors: Jaud Melise , Kukenova Madina , Strieborny Martin
Published: September 2014

We combine a novel measure of export‐related financial needs at the product level with a unique database of firm‐product export data (including names of the exporting firms) from five developing countries. Using the tools of survival analysis and taking into account firms' and products’ heterogeneity, we then examine the impact of financial development on the long‐term trade. Finance matters for sustainable export performance, as goods with higher export‐related financial needs disproportionately benefit from better financial development. Our results complement existing literature on finance and trade, which has relied on production‐based measures of financial dependence at the industry or firm level.
Thrombin as important factor for cutaneous wound healing: Comparison of fibrin biomatrices in vitro and in a rat excisional wound healing model
Authors: Gugerell Alfred , Pasteiner Waltraud , Nürnberger Sylvia , Kober Johanna , Meinl Alexandra , Pfeifer Sabine , Hartinger Joachim , Wolbank Susanne , Goppelt Andreas , Redl Heinz , Mittermayr Rainer
Published: September 2014

Fibrin biomatrices have been used for many years for hemostasis and sealing and are a well‐established surgical tool. The objective of the present study was to compare two commercially available fibrin biomatrices regarding the effect of their thrombin concentration on keratinocytes and wound healing in vitro and in vivo. Keratinocytes showed significant differences in adhesion, viability, and morphology in the presence of the fibrin matrices in vitro. A high thrombin concentration (800–1,200 IU/mL) caused deteriorated cell compatibility. By using a thrombin inhibitor, those differences could be reversed. In a rat excisional wound healing model, we observed more rapid wound closure and less wound severity in wounds treated with a fibrin matrix containing a lower concentration of thrombin (4 IU/mL). Furthermore, fewer new functional vessels and a lower level of vascular endothelial growth factor were measured in wounds after 7 days treated with the matrix with higher thrombin concentration. These in vivo results may be partially explained by the in vitro biocompatibility data. Additionally, results show that low thrombin biomatrices were degraded faster than the high thrombin material. Hence, we conclude that the composition of fibrin biomatrices influences keratinocytes and therefore has an impact on wound healing.
A Universal Feedback Controller for Discontinuous Dynamical Systems Using Nonsmooth Control Lyapunov Functions
Authors: Sadikhov Teymur , Haddad Wassim M.
Published: September 2014

The consideration of nonsmooth Lyapunov functions for proving stability of feedback discontinuous systems is an important extension to classical stability theory since there exist nonsmooth dynamical systems whose equilibria cannot be proved to be stable using standard continuously differentiable Lyapunov function theory. For dynamical systems with continuously differentiable flows, the concept of smooth control Lyapunov functions was developed by Artstein to show the existence of a feedback stabilizing controller. A constructive feedback control law based on a universal construction of smooth control Lyapunov functions was given by Sontag. Even though a stabilizing continuous feedback controller guarantees the existence of a smooth control Lyapunov function, many systems that possess smooth control Lyapunov functions do not necessarily admit a continuous stabilizing feedback controller. However, the existence of a control Lyapunov function allows for the design of a stabilizing feedback controller that admits Filippov and Krasovskii closed-loop system solutions. In this paper, we develop a constructive feedback control law for discontinuous dynamical systems based on the existence of a nonsmooth control Lyapunov function defined in the sense of generalized Clarke gradients and set-valued Lie derivatives.
Joint Numerical–Experimental Investigation of Enhanced Chemical Reactivity in Microfibrous Materials for Desulfurization
Authors: Duggirala Ravi K. , Roy Christopher J. , Dhage Priyanka , Tatarchuk Bruce J.
Published: September 2014

Ultra-pure hydrogen is very much required for a healthy operation of proton exchange membrane (PEM) fuel cells. The concentration of sulfur in the fuel is an important controlling factor because it leads to pollution via sulfur oxides. H2S sorbent or catalysts coated on the particles that are in the order of 100 μm diameters entrapped into a high void volume carrier structure of sintered microfibers are observed to possess significantly higher heterogeneous reaction rates than packed beds of the small particle size. Fundamental reasons for this difference are investigated in this study to determine if such differences are caused by: (1) bed channeling, (2) microscale interstitial/interparticle velocity distributions, and/or (3) effect of presence of fibers. Since microscale fluid effects are not accounted for in traditional reaction engineering formulations, more rigorous approaches to the fluid flow, gaseous diffusion and surface reaction behaviors for a ZnO-based H2S sorbent have been undertaken using computational fluid dynamics (CFD). Simulation results have been compared with carefully prepared experimental samples of microfibrous materials. The experiments involved 14 wt.% ZnO/SiO2 at an operating temperature of 400 °C and a challenge gas consisting of 0.5 vol. % of H2S in H2 and were used to validate the CFD models (both geometric and species transport). These results show that CFD predictions of chemical conversion of H2S are within 10–15% of the experimentally measured values. The effects of residence time and dilution with void on the chemical conversion have been studied. Different microfibrous materials were modeled to study the effect of fiber diameter and fiber loading on the chemical conversion and pressure drop. It is observed that the dilution with void has a negative effect on the conversion; however, the addition of fibers not only compensated for the negative effect of dilution but also increased the reaction rate. The main goal of this study is to use CFD as a tool to design new materials with enhanced reactivity and reduced pressure drop. Our work suggests that new materials with enhanced chemical reactivity for a given pressure drop should be designed with fewer, larger diameter fibers. Our results show that the logs of reduction of H2S per pressure drop increased by a factor of six for the material with 8 μm diameter fibers with 3% volume fraction relative to a packed bed with same catalyst loading.