bluuebunny/crossref_metadata_2025 huggingface dataset:
Superb electromagnetic wave-absorbing composites based on large-scale graphene and carbon nanotube films
Authors: Li Jinsong , Lu Weibang , Suhr Jonghwan , Chen Hang , Xiao John Q. , Chou Tsu-Wei
Published: May 2017

Abstarct

Graphene has sparked extensive research interest for its excellent physical properties and its unique potential for application in absorption of electromagnetic waves. However, the processing of stable large-scale graphene and magnetic particles on a micrometer-thick conductive support is a formidable challenge for achieving high reflection loss and impedance matching between the absorber and free space. Herein, a novel and simple approach for the processing of a CNT film-Fe3O4-large scale graphene composite is studied. The Fe3O4 particles with size in the range of 20–200 nm are uniformly aligned along the axial direction of the CNTs. The composite exhibits exceptionally high wave absorption capacity even at a very low thickness. Minimum reflection loss of −44.7 dB and absorbing bandwidth of 4.7 GHz at −10 dB are achieved in composites with one-layer graphene in six-layer CNT film-Fe3O4 prepared from 0.04 M FeCl3. Microstructural and theoretical studies of the wave-absorbing mechanism reveal a unique Debye dipolar relaxation with an Eddy current effect in the absorbing bandwidth.
A nano silver-xerogel (Ag nps@modified TEOS) as a newly developed nanocatalyst in the synthesis of benzopyranopyrimidines (with secondary and primary amines) and gem-bisamides
Authors: Kour Gurpreet , Gupta Monika
Published: May 2017

Silver nanoparticles have been prepared from a chemical reduction approach and supported on modified TEOS (tetraethylorthosilicate) xerogel to be studied as a nanocatalyst.
A chiral salen-based MOF catalytic material with high thermal, aqueous and chemical stabilities
Authors: Li Jiawei , Ren Yanwei , Qi Chaorong , Jiang Huanfeng
Published: May 2017

A highly stable chiral Ni(salen)-based MOF material possessing a 1D open channel can efficiently catalyze the cycloaddition of simulated industrial CO2 with epoxides, as well as the cycloaddition of epoxides with azides and alkynes under mild conditions.
Determination of zero-field splitting in Co2+ halide complexes with magnetic and far-IR measurements
Authors: Liu Jia-Jia , Meng Yin-Shan , Hlavička Ivo , Orlita Milan , Jiang Shang-Da , Wang Bing-Wu , Gao Song
Published: May 2017

The ZFS parameters are determined by magnetic measurements and far-infrared magneto-transmission spectra for Co2+ complexes with halide substitutes.
Correction: A novel, rapid and green method of phosphorylation under ultrasound irradiation and catalyst free conditions
Authors: Bouzina Abdeslem , Belhani Billel , Aouf Nour-Eddine , Berredjem Malika
Published: May 2017

Correction for ‘A novel, rapid and green method of phosphorylation under ultrasound irradiation and catalyst free conditions’ by Abdeslem Bouzina et al., RSC Adv., 2015, 5, 46272–46275.
Management der Osteoporose bei entzündlich-rheumatischen Erkrankungen
Authors: Demary Winfried
Published: May 2017

Entzündlich-rheumatische Erkrankungen, wie die rheumatoide Arthritis, die ankylosierende Spondylitis, der systemische Lupus erythematodes, die systemische Sklerose und weitere entzündliche Systemerkrankungen, gehen mit einem erhöhten Risiko für die Komorbiditäten Osteoporose und osteoporotische Frakturen einher. Eine hohe entzündliche Krankheitsaktivität, Einschränkungen der Mobilität sowie der Einsatz von Glukokortikoiden sind bei diesen entzündlich-rheumatischen Erkrankungen wesentliche Risikofaktoren für einen Anstieg des Frakturrisikos neben bereits vorhandenen Frakturrisiken. Daher ist eine frühzeitige Entzündungshemmung mit dem Ziel der Remission der Krankheitsaktivität anzustreben. Eine frühzeitige Untersuchung auf eine Osteoporose sollte essentieller Bestandteil von rheumatologischen Behandlungen sein, um eine entzündungsbedingte Osteoporose frühzeitig zu erkennen und die Risiken für osteoporotische Frakturen zusätzlich durch eine spezifische Osteoporosetherapie zu senken. Die vorhandenen Leitlinien bieten ausreichend Orientierung, um dies im Rahmen der ambulanten und stationären Versorgung der betroffenen Patienten zu erreichen.
Qualitätsmanagement für Chirurgen – Kenntnis grundlegender Zusammenhänge und innovativer Strategien fördert die Wettbewerbsfähigkeit der Fachabteilung
Authors: Hellmann Wolfgang
Published: May 2017

Effizientes Qualitätsmanagement mit dem Ziel hochwertiger Patientenversorgung ist für chirurgische Fachabteilungen ein Erfolgsfaktor. Die Kenntnis einschlägiger Begriffe und Zusammenhänge des Qualitätsmanagements ist dafür grundlegend. Die praktische Umsetzung im demografischen Wandel und bei Fachkräftemangel bleibt aber schwierig. Soweit ein effizientes internes Qualitätsmanagement im Krankenhaus implementiert ist, sollte dessen Expertise ergänzend genutzt werden. Ansonsten ist es (alleinige) Aufgabe der Fachabteilung, Qualität für Patienten, Mitarbeiter und Kooperationspartner zu gewährleisten. Der Beitrag vermittelt grundlegende Zusammenhänge zum Qualitätsmanagement, zum Risikomanagement und zur Qualitätssicherung im Kontext einschlägiger Termini. Er zeigt neue Wege zur praktischen Umsetzung auf Ebene der chirurgischen Fachabteilung auf. Ein neu entwickeltes Qualitätsmodell wird vorgestellt.
Astrocytic glycogen-derived lactate fuels the brain during exhaustive exercise to maintain endurance capacity
Authors: Matsui Takashi , Omuro Hideki , Liu Yu-Fan , Soya Mariko , Shima Takeru , McEwen Bruce S. , Soya Hideaki
Published: May 2017

Significance

Muscle glycogen fuels exercising muscles to sustain endurance capacity. The brain also stores glycogen in astrocytes to produce lactate as an energy source transported to active neurons via the monocarboxylate transporter MCT2. Although physical exercise activates brain neurons and increases their energy demand, the energetic role of astrocytic glycogen in the exercising brain remains unknown. To address this issue, we used a rat model of prolonged exhaustive exercise, microwave irradiation of brains, metabolomics, and intracerebroventricular injection of inhibitors of glycogenolysis and MCT2. Our findings provide direct evidence that lactate derived from astrocytic glycogen fuels the prolonged-exercising brain to maintain endurance capacity. This new perspective on brain energetics during endurance exercise could lead to better strategies for endurance performance.
Development and validation of an electronic medical record (EMR)-based computed phenotype of HIV-1 infection
Authors: Paul Devon W , Neely Nigel B , Clement Meredith , Riley Isaretta , Al-Hegelan Mashael , Phelan Matthew , Kraft Monica , Murdoch David M , Lucas Joseph , Bartlett John , McKellar Mehri , Que Loretta G
Published: May 2017

Background

Electronic medical record (EMR) computed algorithms allow investigators to screen thousands of patient records to identify specific disease cases. No computed algorithms have been developed to detect all cases of human immunodeficiency virus (HIV) infection using administrative, laboratory, and clinical documentation data outside of the Veterans Health Administration. We developed novel EMR-based algorithms for HIV detection and validated them in a cohort of subjects in the Duke University Health System (DUHS).

Methods

We created 2 novel algorithms to identify HIV-infected subjects. Algorithm 1 used laboratory studies and medications to identify HIV-infected subjects, whereas Algorithm 2 used International Classification of Diseases, Ninth Revision (ICD-9) codes, medications, and laboratory testing. We applied the algorithms to a well-characterized cohort of patients and validated both against the gold standard of physician chart review. We determined sensitivity, specificity, and prevalence of HIV between 2007 and 2011 in patients seen at DUHS.

Results

A total of 172 271 patients were detected with complete data; 1063 patients met algorithm criteria for HIV infection. In all, 970 individuals were identified by both algorithms, 78 by Algorithm 1 alone, and 15 by Algorithm 2 alone. The sensitivity and specificity of each algorithm were 78% and 99%, respectively, for Algorithm 1 and 77% and 100% for Algorithm 2. The estimated prevalence of HIV infection at DUHS between 2007 and 2011 was 0.6%.

Conclusions

EMR-based phenotypes of HIV infection are capable of detecting cases of HIV-infected adults with good sensitivity and specificity. These algorithms have the potential to be adapted to other EMR systems, allowing for the creation of cohorts of patients across EMR systems.
Is Mycobacterium avium paratuberculosis the Trigger in the Crohn’s Disease Spectrum?
Authors: Oken Harry A. , Saleeb Paul G. , Redfield Robert R. , Schimpff Stephen C.
Published: May 2017

We present and discuss a 30-month investigation of a patient that presented with abdominal pain, postprandial diarrhea, bloating, and night sweats and was treated for Crohn’s disease without significant improvement. The patient underwent an ileocecetomy with removal of an atonic segment with resolution of functional gastrointestinal symptoms, but profound night sweats continued postoperatively. The patient was presumptively treated for a mixed mycobacterial infection, blood cultures later grew Mycobacterium avium paratuberculosis (MAP), and she improved over time. We discuss MAP and its possible relationship to Crohn’s disease.
Reducing Postsurgical Wound Complications: A Critical Review
Authors: Delmore Barbara , Cohen Joshua Mitchell , O’Neill Daniel , Chu Andy , Pham Vinh , Chiu Ernest
Published: May 2017

GENERAL PURPOSE:

To provide information on risk factors for surgical site infections (SSIs) and actions to mitigate that risk.

TARGET AUDIENCE:

This continuing education activity is intended for surgeons, surgical teams, physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:

After participating in this educational activity, the participant should be better able to:

1. Identify modifiable risk factors associated with the development of SSIs.

2. Select steps to mitigate the risks for and morbidity from SSIs.

Given the current reimbursement structure, the avoidance of a surgical site infection (SSI) is crucial. Although many risk factors are associated with the formation of an SSI, a proactive and interprofessional approach can help modify some factors. Postoperative strategies also can be applied to help prevent an SSI. If an SSI becomes a chronic wound, there are recommended guidelines and strategies that can foster healing.
Prevention and Management of Hypertension and Diabetes Using Social Capital and Physical Activity Among Socioeconomically Disadvantaged Populations
Authors: Kamimura Akiko , Tabler Jennifer , Nourian Maziar M. , Assasnik Nushean , Wright Lindsey , Ashby Jeanie
Published: May 2017

The purpose of this study is to examine the association between physical activity adherence and social capital among uninsured primary care patients with or without hypertension and/or diabetes. Uninsured adults using a free clinic (N = 374) participated in a self-administered survey from January to April in 2016. The percentage of participants who were adherent to physical activity was low regardless of having hypertension and/or diabetes, or not. Individuals who reported a high sense of community were associated with a higher percentage of physical activity adherence. Good weight management was associated with less likelihood of physical activity adherence.
The Effects of Remifentanil on Hemodynamic Response Attenuation After Electroconvulsive Therapy Under Sevoflurane Anesthesia
Authors: Erdil Feray , Ozgul Ulku , Şanli Mukadder , Kayhan Gülay , Çolak Cemil , Durmuş Mahmut
Published: May 2017

Purpose

We evaluated the effects of a single loading dose of remifentanil (1 μg/kg) administered as an adjunct to sevoflurane, on the duration of seizure activity, recovery times, and hemodynamic profiles, during electroconvulsive therapy.

Methods

The patients were randomly allocated to receive sevoflurane-saline (Group SS) or sevoflurane-remifentanil (Group SR). Sevoflurane (8%) was initiated for anesthesia induction in both groups until loss of consciousness was achieved. Remifentanil was then administered to Group SR via a 1-μg/kg intravenous bolus. Patients in Group SS received saline in the same manner. Mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthetic induction (T1), at the loss of consciousness (T2), and at 0, 1, 3, and 10 minutes after the electrical stimuli were completed (T3, T4, T5, and T6, respectively).

Results

Compared with the baseline values, HR increased significantly in Group SS at times T2 and T4 to T6 and decreased significantly in Group SR at time T2. When the groups were compared, we found that HR decreased significantly in Group SR at T2 and T4 to T6. Compared with baseline, MAP increased in Group SS between T3 and T6, and MAP decreased in Group SR at T2 and increased at T3 to T4. Mean arterial pressure decreased to a greater extent in Group SR than in Group SS during the T2 to T6 period. There were no group differences in seizure duration or recovery time.

Conclusions

The addition of 1-μg/kg remifentanil to anesthetic induction with sevoflurane attenuated the acute hemodynamic response to electroconvulsive therapy under sevoflurane anesthesia without adversely affecting the duration of seizure activity or the recovery profile.
Salmonella DIVA vaccine reduces disease, colonization and shedding due to virulent S. Typhimurium infection in swine
Authors: Bearson Bradley L , Bearson Shawn M. D , Brunelle Brian W , Bayles Darrell O , Lee In Soo , Kich Jalusa D
Published: May 2017

Purpose. Non-host-adapted Salmonella serovars, including the common human food-borne pathogen Salmonella enterica serovar Typhimurium (S. Typhimurium), are opportunistic pathogens that can colonize food-producing animals without causing overt disease. Interventions against Salmonella are needed to enhance food safety, protect animal health and allow the differentiation of infected from vaccinated animals (DIVA).

Methodology. An attenuated S. Typhimurium DIVA vaccine (BBS 866) was characterized for the protection of pigs following challenge with virulent S. Typhimurium. The porcine transcriptional response to BBS 866 vaccination was evaluated. RNA-Seq analysis was used to compare gene expression between BBS 866 and its parent; phenotypic assays were performed to confirm transcriptional differences observed between the strains.

Results. Vaccination significantly reduced fever and interferon-gamma (IFNγ) levels in swine challenged with virulent S. Typhimurium compared to mock-vaccinated pigs. Salmonella faecal shedding and gastrointestinal tissue colonization were significantly lower in vaccinated swine. RNA-Seq analysis comparing BBS 866 to its parental S. Typhimurium strain demonstrated reduced expression of the genes involved in cellular invasion and bacterial motility; decreased invasion of porcine-derived IPEC-J2 cells and swimming motility for the vaccine strain was consistent with the RNA-Seq analysis. Numerous membrane proteins were differentially expressed, which was an anticipated gene expression pattern due to the targeted deletion of several regulatory genes in the vaccine strain. RNA-Seq analysis indicated that genes involved in the porcine immune and inflammatory response were differentially regulated at 2 days post-vaccination compared to pre-vaccination.

Conclusion. Evaluation of the S. Typhimurium DIVA vaccine indicates that vaccination will provide both swine health and food safety benefits.
Lean implementation and a process approach – an exploratory study
Authors: Rymaszewska Anna
Published: May 2017

Purpose

This paper proposes, that without acknowledging that lean adoption needs to reach beyond the shop floor, it cannot be sustained, and neither is the transformation into a truly lean enterprise possible. The purpose of this paper is to address the gap in the scientific knowledge regarding the challenges of lean adoption in manufacturing organizations. The underlying assumption is that successful and sustainable adoption of lean should be approached from the perspective of business process change (BPC). By applying the logic of BPC to manufacturing environments, and by exploring the opportunities for lean implementation that reach far beyond manufacturing, the study is expected to contribute to the development of the existing knowledge.

Design/methodology/approach

The research objectives were achieved by conducting the qualitative case study. Two case companies were chosen based on their differing approaches to the introduction and implementation of lean initiatives. Data were collected through in depth, semi-structured interviews supported by shop-floor observations.

Findings

The paper provides insights into how can lean implementation be facilitated while a systematic, BPC is utilized. By contrasting the two cases, meaningful conclusions were drawn and certain managerial implications outlined.

Originality/value

This paper presents a new approach to lean implementation and aims to bridge both the theoretical and empirical gaps between the concepts of lean implementation and business process management.
Reflections on writing and exhibiting learning disability history: commentary on “Spina Bifida and Hydrocephalus: Our Heritage”
Authors: Jarrett Simon , Grove Nicola Clare
Published: May 2017

Purpose

The purpose of this paper is to comment on the article “Spina Bifida and Hydrocephalus: Our Heritage – the role of heritage exhibitions in tackling social isolation.”

Design/methodology/approach

This provides some further reflection and points for discussion on topics arising from the themes in the original article.

Findings

Issues are raised about the medicalisation of conditions and the ways in which a social and cultural model of disability challenges preconceptions and assumptions about personhood and victim status. Reference is made to the broader context of hidden histories and the ways in which people with learning disabilities are now taking active roles in reclaiming the story of their lives in the past and now.

Originality/value

The paper aims to raise awareness of critical issues of learning disability history prompted by the original paper.
Deprivation of liberty applications concerning people with learning disabilities in England: trends over time and geographical variation
Authors: Hatton Chris
Published: May 2017

Purpose

The purpose of this paper is to analyse trends over time and geographical variation in Deprivation of Liberty Safeguards (DoLS) applications for adults with learning disabilities.

Design/methodology/approach

Secondary analysis of national- and local authority-level statistics collected and reported by NHS Digital.

Findings

There has been a sharp national increase in the number of completed and granted DoLS applications regarding adults with learning disabilities since the 2014 “Cheshire West” Supreme Court judgement, with a greater proportion of completed DoLS applications being granted. There is extreme geographical variation across local authorities in England in the rates at which DoLS applications are being made and granted.

Practical implications

The extreme variation in DoLS applications regarding adults with learning disabilities is highly unlikely to be a function of differences in mental capacity and living circumstances experienced by adults with learning disabilities across local authorities, and urgent attention needs to be paid to this variation.

Originality/value

This is the first paper to analyse the geographical variation at local authority level for completed and granted DoLS applications regarding adults with learning disabilities.
The Economy‐wide Impacts of a Rise in the Capital Adequacy Ratios of Australian Banks
Authors: Giesecke James A. , Dixon Peter B. , Rimmer Maureen T.
Published: May 2017

Regulators are requiring banks to raise additional equity to finance their activities. The benefits are understood in terms of reducing the risks of another financial crisis. But there are potential costs, including the potential for unanticipated macroeconomic impacts as banks reduce leverage. We use a financial computable general equilibrium model, containing disaggregated treatment of financial agents, to explore the economy‐wide consequences of an increase in bank capital adequacy ratios. We find that the macroeconomic consequences are small.
We Want Them All Covered! Collective Bargaining and Firm Heterogeneity: Theory and Evidence from Germany
Authors: Baumann Florian , Brändle Tobias
Published: May 2017

This article establishes a link between the degree of productivity dispersion within an industry and collective bargaining coverage of the firms in the industry. In a stylized unionized oligopoly model, we show that differences in productivity levels can affect the design of collective wage contracts a sector‐union offers to heterogeneous firms. Using German linked employer–employee data, we test a range of our theoretical hypotheses and find empirical support for them. The dispersion of sector‐level labour productivity decreases the likelihood of firms being covered by a collective bargaining agreement on the industry level, but increases the likelihood of firms being covered by firm‐level agreements. The results hold for different subsamples and (panel) estimation techniques.
Gαs signalling of the CB1 receptor and the influence of receptor number
Authors: Finlay David B , Cawston Erin E , Grimsey Natasha L , Hunter Morag R , Korde Anisha , Vemuri V Kiran , Makriyannis Alexandros , Glass Michelle
Published: May 2017

Background and Purpose

CB1 receptor signalling is canonically mediated through inhibitory Gαi proteins, but occurs through other G proteins under some circumstances, Gαs being the most characterized secondary pathway. Determinants of this signalling switch identified to date include Gαi blockade, CB1/D2 receptor co‐stimulation, CB1 agonist class and cell background. Hence, we examined the effects of receptor number and different ligands on CB1 receptor signalling.

Experimental Approach

CB1 receptors were expressed in HEK cells at different levels, and signalling characterized for cAMP by real‐time BRET biosensor –CAMYEL – and for phospho‐ERK by AlphaScreen. Homogenate and whole cell radioligand binding assays were performed to characterize AM6544, a novel irreversible CB1 receptor antagonist.

Key Results

In HEK cells expressing high levels of CB1 receptors, agonist treatment stimulated cAMP, a response not known to be mediated by receptor number. Δ9‐THC and BAY59‐3074 increased cAMP only in high‐expressing cells pretreated with pertussis toxin, and agonists demonstrated more diverse signalling profiles in the stimulatory pathway than the canonical inhibitory pathway. Pharmacological CB1 receptor knockdown and Gαi1 supplementation restored canonical Gαi signalling to high‐expressing cells. Constitutive signalling in both low‐ and high‐expressing cells was Gαi‐mediated.

Conclusion and Implications

CB1 receptor coupling to opposing G proteins is determined by both receptor and G protein expression levels, which underpins a mechanism for non‐canonical signalling in a fashion consistent with Gαs signalling. CB1 receptors mediate opposite consequences in endpoints such as tumour viability depending on expression levels; our results may help to explain such effects at the level of G protein coupling.
Right coronary artery coronary sinus fistula with coronary sinus ostium stenosis
Authors: Pu Lihong , Li Rongjuan , Yang Ya , Liu Guowen , Wang Yueli
Published: May 2017

Coronary artery fistula (CAF) is a rare anomaly of the coronary artery. The draining site of a right coronary artery (RCA) fistula may usually be the right ventricle, right atrium, or pulmonary artery. Here, we present a patient with right coronary artery to coronary sinus fistula (RCACSF) complicated by aneurysmal dilatation of the coronary sinus (CS) and stenosis of CS ostium.
Development and feasibility of smartphone application for cognitive‐behavioural case management of individuals with early psychosis
Authors: Kim Sung‐Wan , Lee Ga‐Young , Yu Hye‐Young , Jung Eun‐I , Lee Ju‐Yeon , Kim Seon‐Young , Kim Jae‐Min , Shin Il‐Seon , Yoon Jin‐Sang
Published: May 2017

Background

This article describes the development of the smartphone application for cognitive‐behavioural case management of young individuals with early psychosis and examines the acceptance and potential clinical benefits of this application through a pilot survey.

Methods

Gwangju Bukgu‐Community Mental Health Center developed and launched a smartphone application (Heal Your Mind [HYM]) for cognitive‐behavioural case management and symptom monitoring. The HYM application for clients includes 6 main modules including thought record, symptom record, daily life record, official notices, communication and scales. The key module is the “thought record” for self‐directed cognitive‐behavioural treatment. When the client writes and sends the self‐cognitive‐behavioural therapy sheet to the case manager, the latter receives a notification and can provide feedback in real time. We conducted a survey to investigate the acceptance and feasibility of this approach among young clients with early psychosis.

Results

A total of 24 clients with early psychosis participated in this survey. More than 80% of participants reported that it was easy to learn to use this application, and no one described this application as very complicated or reported that they needed a long time to learn how to use it. About 80% of participants were satisfied with this application, and 70% reported that they received help as a result of using this application.

Conclusions

This study suggests that this smartphone application is useful for young individuals with early psychosis and that it may contribute to the development of both young customer‐ and case manager‐friendly systems for this clinical population.
Comparison and optimization of in silico algorithms for predicting the pathogenicity of sodium channel variants in epilepsy
Authors: Holland Katherine D. , Bouley Thomas M. , Horn Paul S.
Published: May 2017

Objective

Variants in neuronal voltage‐gated sodium channel α‐subunits genes SCN1A, SCN2A, and SCN8A are common in early onset epileptic encephalopathies and other autosomal dominant childhood epilepsy syndromes. However, in clinical practice, missense variants are often classified as variants of uncertain significance when missense variants are identified but heritability cannot be determined. Genetic testing reports often include results of computational tests to estimate pathogenicity and the frequency of that variant in population‐based databases. The objective of this work was to enhance clinicians’ understanding of results by (1) determining how effectively computational algorithms predict epileptogenicity of sodium channel (SCN) missense variants; (2) optimizing their predictive capabilities; and (3) determining if epilepsy‐associated SCN variants are present in population‐based databases. This will help clinicians better understand the results of indeterminate SCN test results in people with epilepsy.

Methods

Pathogenic, likely pathogenic, and benign variants in SCNs were identified using databases of sodium channel variants. Benign variants were also identified from population‐based databases. Eight algorithms commonly used to predict pathogenicity were compared. In addition, logistic regression was used to determine if a combination of algorithms could better predict pathogenicity.

Results

Based on American College of Medical Genetic Criteria, 440 variants were classified as pathogenic or likely pathogenic and 84 were classified as benign or likely benign. Twenty‐eight variants previously associated with epilepsy were present in population‐based gene databases. The output provided by most computational algorithms had a high sensitivity but low specificity with an accuracy of 0.52–0.77. Accuracy could be improved by adjusting the threshold for pathogenicity. Using this adjustment, the Mendelian Clinically Applicable Pathogenicity (M‐CAP) algorithm had an accuracy of 0.90 and a combination of algorithms increased the accuracy to 0.92.

Significance

Potentially pathogenic variants are present in population‐based sources. Most computational algorithms overestimate pathogenicity; however, a weighted combination of several algorithms increased classification accuracy to >0.90.
The Benefits of Multilingualism to the Personal and Professional Development of Residents of the US
Authors: Kroll Judith F. , Dussias Paola E.
Published: May 2017

In the past two decades, new research on multilingualism has changed our understanding of the consequences of learning and using two or more languages for cognition, for the brain, and for success and well‐being across the entire lifespan. Far from the stereotype that exposure to multiple languages in infancy complicates language and cognitive development, the new findings suggest that individuals benefit from that exposure, with greater openness to other languages and to new learning itself. At the other end of the lifespan, in old age, the active use of two or more languages appears to provide protection against cognitive decline. That protection is seen in healthy aging and most dramatically in compensating for the symptoms of pathology in those who develop dementia or are recovering from stroke. In this article we briefly review the most exciting of these new research developments and consider their implications.
Identifying preferred format and source of exercise information in persons with multiple sclerosis that can be delivered by health‐care providers
Authors: Learmonth Yvonne C. , Adamson Brynn C. , Balto Julia M. , Chiu Chung‐yi , Molina‐Guzman Isabel M. , Finlayson Marcia , Riskin Barry J. , Motl Robert W.
Published: May 2017

Background

There is increasing recognition of the benefits of exercise in individuals with multiple sclerosis (MS), yet the MS population does not engage in sufficient amounts of exercise to accrue health benefits. There has been little qualitative inquiry to establish the preferred format and source for receiving exercise information from health‐care providers among persons with MS.

Objective

We sought to identify the desired and preferred format and source of exercise information for persons with MS that can be delivered through health‐care providers.

Setting and participants

Participants were adults with MS who had mild or moderate disability and participated in a range of exercise levels. All participants lived in the Midwest of the United States.

Methods

Fifty semi‐structured interviews were conducted and analysed using thematic analysis.

Results

Two themes emerged, (i) approach for receiving exercise promotion and (ii) ideal person for promoting exercise. Persons with MS want to receive exercise information through in‐person consultations with health‐care providers, print media and electronic media. Persons with MS want to receive exercise promotion from health‐care providers with expertise in MS (ie neurologists) and with expertise in exercise (eg physical therapists).

Conclusions

These data support the importance of understanding how to provide exercise information to persons with MS and identifying that health‐care providers including neurologists and physical therapists should be involved in exercise promotion.
The evolution of uncertainty in second opinions about prostate cancer treatment
Authors: Hillen Marij A. , Gutheil Caitlin M. , Smets Ellen M. A. , Hansen Moritz , Kungel Terrence M. , Strout Tania D. , Han Paul K. J.
Published: May 2017

Background

People who have cancer increasingly seek second opinions. Yet, we know little about what motivates patients to seek them and how beneficial they are. Uncertainty—experienced by patients or communicated by physician and patient—may be crucial throughout the second opinion process.

Objective

This study sought to investigate (1) how uncertainty influences men with prostate cancer to seek second opinions and (2) how second opinions may affect these patients’ sense of uncertainty and subsequent experiences with their care.

Methods

A qualitative study using semi‐structured interviews was performed. Men with localized or advanced prostate cancer (n=23) were interviewed by telephone about their motivations and experiences with seeking second opinions and the uncertainties they experienced. Analysis was performed using the constant comparative method.

Results

Patients sought second opinions because they were uncertain about receiving too little or biased information, experienced insufficient support in coming to a treatment decision, or because physicians expressed different levels of uncertainty than they did (“unshared uncertainty”). Uncertainty was reduced by the second opinion process for most patients, whereas for others, it increased or was sustained. This evolution depended on the way uncertainty was addressed during the second opinion consultation.

Conclusions

Second opinions may be a useful tool for some but not all patients. They should be used judiciously and not be viewed as a solution for current limitations to health‐care organization. An important yet challenging task for physicians is to focus less on information per se and more on how to assist patients manage irreducible uncertainty.
Alopecia areata – hyperactivity of the hypothalamic–pituitary–adrenal axis is a myth?
Authors: Bergler‐Czop B. , Miziołek B. , Brzezińska‐Wcisło L.
Published: May 2017

Introduction

Psychological stress is known to cause exacerbation of different skin pathologies including alopecia areata (AA). A hyperactivity of the hypothalamic‐pituitary‐adrenal axis (the HPA axis) in patients affected by AA (AA patients) was proposed to be a neuroendocrine response to stress. Still little is known about melanocyte‐stimulating hormone (MSH) and cortisol production in AA settings.

Aim

The aim of the study was to compare trends in a production of MSH and cortisol in patients with AA patients and healthy controls.

Material and methods

Plasma concentrations of free cortisol and MSH were measured in 43 AA patients (35.5 ± 10.6 years) and 37 healthy subjects (35.9 ± 10.5 years) selected from the Dermatology Outpatient Clinic at Medical University of Silesia in Katowice, Poland. Results were submitted to statistical analysis with Shapiro–Wilk W‐test and subsequently nonparametric (Mann–Whitney U‐test) or parametric (Student's t‐test) statistics were performed.

Results

Mean plasma level of MSH was 5.39 ng/mL in AA patients and 5.71 ng/mL in healthy controls. The difference between groups was non‐significant (P = 0.435), but the control group manifested higher values of MSH (Q75 = 13.6 ng/mL vs Q75 = 5.98 ng/mL) and this tendency was especially stronger in females. AA patients had greater mean plasma level of cortisol (157.63 ± 91.16 µg/L) than healthy controls (123.32 ± 71.28 µg/L); however, the difference between them was also non‐significant (P = 0.063). No sex‐dependent tendency to a greater production of cortisol was found.

Conclusions

Expectations of disturbances in production of MSH and cortisol were not fulfilled. Neither MSH nor cortisol plasma levels appear to be clearly changed in AA patients.
TEACHER CHARACTERISTICS AND THEIR EFFECTS ON STUDENT TEST SCORES: A SYSTEMATIC REVIEW
Authors: Coenen Johan , Cornelisz Ilja , Groot Wim , Maassen van den Brink Henriette , Van Klaveren Chris
Published: May 2017

It has become widely accepted that teachers are important in facilitating student learning. Hundreds of empirical studies have tried to explain differences in student performance by evaluating the impact of particular teacher characteristics. Yet, this topic has not been the subject of a systematic review for more than 10 years, even though most of the empirical evidence has emerged over the past decade. This study provides an up‐to‐date review, drawing on empirical findings from several countries and distinguishing between acquired and sociodemographic teacher characteristics. This review confirms the existing consensus that subject‐related degrees and knowledge, and not general teacher certifications, are positively related to student performance and particularly so for Master's degrees in math and science. A new insight is that recent findings point out that teacher experience continues to contribute to student test scores throughout a teacher's career, instead of merely the first few years. An important future research avenue would be to examine which mechanisms can explain these teacher characteristic effects.
Is oral contraceptive use associated with an increased risk of cervical cancer? An evidence‐based meta‐analysis
Authors: Peng Yunhua , Wang Xingxiu , Feng Huiqin , Yan Ge
Published: May 2017

Aim

The purpose of this meta‐analysis is to synthesize evidence‐based case–control studies to evaluate the association between oral contraceptive (OC) use and the risk of cervical cancer.

Methods

Two reviewers independently selected potentially relevant studies through PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang Data, and the Chongqing VIP databases using the core terms cervical intraepithelial neoplasia/ cervix dysplasia/ cervi* AND oral contraceptive in the article titles, abstracts, and keywords. All data were analyzed using stata 12.0. The heterogeneity was assessed by Q‐test and I2 statistic. Forest plot was used to display results graphically. Publication bias was assessed by Begg's test.

Results

In total, 16 case–control studies, including 15 619 participants (7433 cases and 8186 controls), met the eligibility criteria. Individuals with OC use were not found to have a risk of cervical cancer (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.90–1.38). In subgroup analyses, no significant associations were found for different durations of OC use (<5 years: OR, 0.84; 95%CI, 0.68–1.04; 5–10 years: OR, 1.06; 95%CI, 0.66–1.71; >10 years: OR, 1.25; 95%CI, 0.76–2.06). Additionally, using OC was not shown to increase the risk of cervical cancer among women with human papillomavirus infections (OR, 1.09; 95%CI, 0.80–1.49). However, an increased risk of cervical cancer was found in Asian populations with OC use.

Conclusion

The meta‐analysis of case–control studies did not show an association between OC use and risk of cervical cancer. However, other necessary prospective cohort studies should be conducted to assess the impact of OC use on cervical cancer risk in the future.
Survived so what? Identifying priorities for research with children and families post‐paediatric intensive care unit
Authors: Manning Joseph C , Hemingway Pippa , Redsell Sarah A
Published: May 2017

ABSTRACT

The involvement of patients and the public in the development, implementation and evaluation of health care services and research is recognized to have tangible benefits in relation to effectiveness and credibility. However, despite >96% of children and young people surviving critical illness or injury, there is a paucity of published reports demonstrating their contribution to informing the priorities for aftercare services and outcomes research. We aimed to identify the service and research priorities for Paediatric Intensive Care Unit survivors with children and young people, their families and other stakeholders. We conducted a face‐to‐face, multiple‐stakeholder consultation event, held in the Midlands (UK), to provide opportunities for experiences, views and priorities to be elicited. Data were gathered using write/draw and tell and focus group approaches. An inductive content analytical approach was used to categorize and conceptualize feedback. A total of 26 individuals attended the consultation exercise, including children and young people who were critical care survivors; their siblings; parents and carers; health professionals; academics; commissioners; and service managers. Consultation findings indicated that future services, interventions and research must be holistic and family‐centred. Children and young people advisors reported priorities that focused on longer‐term outcomes, whereas adult advisors identified priorities that mapped against the pathways of care. Specific priorities included developing and testing interventions that address unmet communication and information needs. Furthermore, initiatives to optimize the lives and longer‐term functional and psycho‐social outcomes of Paediatric Intensive Care Unit survivors were identified. This consultation exercise provides further evidence of the value of meaningful patient and public involvement in identifying the priorities for research and services for Paediatric Intensive Care Unit survivors and illuminates differences in proposed priorities between children, young people and adult advisors.
Heterogeneity of Purkinje cell simple spike–complex spike interactions: zebrin‐ and non‐zebrin‐related variations
Authors: Tang Tianyu , Xiao Jianqiang , Suh Colleen Y. , Burroughs Amelia , Cerminara Nadia L. , Jia Linjia , Marshall Sarah P. , Wise Andrew K. , Apps Richard , Sugihara Izumi , Lang Eric J.
Published: May 2017

Key points

Cerebellar Purkinje cells (PCs) generate two types of action potentials, simple and complex spikes. Although they are generated by distinct mechanisms, interactions between the two spike types exist.

Zebrin staining produces alternating positive and negative stripes of PCs across most of the cerebellar cortex. Thus, here we compared simple spike–complex spike interactions both within and across zebrin populations.

Simple spike activity undergoes a complex modulation preceding and following a complex spike. The amplitudes of the pre‐ and post‐complex spike modulation phases were correlated across PCs. On average, the modulation was larger for PCs in zebrin positive regions.

Correlations between aspects of the complex spike waveform and simple spike activity were found, some of which varied between zebrin positive and negative PCs.

The implications of the results are discussed with regard to hypotheses that complex spikes are triggered by rises in simple spike activity for either motor learning or homeostatic functions.

Purkinje cells (PCs) generate two types of action potentials, called simple and complex spikes (SSs and CSs). We first investigated the CS‐associated modulation of SS activity and its relationship to the zebrin status of the PC. The modulation pattern consisted of a pre‐CS rise in SS activity, and then, following the CS, a pause, a rebound, and finally a late inhibition of SS activity for both zebrin positive (Z+) and negative (Z−) cells, though the amplitudes of the phases were larger in Z+ cells. Moreover, the amplitudes of the pre‐CS rise with the late inhibitory phase of the modulation were correlated across PCs. In contrast, correlations between modulation phases across CSs of individual PCs were generally weak. Next, the relationship between CS spikelets and SS activity was investigated. The number of spikelets/CS correlated with the average SS firing rate only for Z+ cells. In contrast, correlations across CSs between spikelet numbers and the amplitudes of the SS modulation phases were generally weak. Division of spikelets into likely axonally propagated and non‐propagated groups (based on their interspikelet interval) showed that the correlation of spikelet number with SS firing rate primarily reflected a relationship with non‐propagated spikelets. In sum, the results show both zebrin‐related and non‐zebrin‐related physiological heterogeneity in SS–CS interactions among PCs, which suggests that the cerebellar cortex is more functionally diverse than is assumed by standard theories of cerebellar function.
Plot to redefine the kilogram nears climax
Authors: Cho Adrian
Published: May 2017

Metrologists present data needed to switch to standard based on constant of nature.
Paolo Macchiarini's academic afterlife in Russia ends
Authors: Astakhova Alla
Published: May 2017

Disgraced surgeon loses funding and job but won't face misconduct investigation.
Genome writing project confronts technology hurdles
Authors: Servick Kelly
Published: May 2017

Grand challenge founders seek advances in DNA synthesis.
Island extinctions weren't inevitable
Authors: Reese April
Published: May 2017

During the ice age, human colonizers often coexisted with vulnerable island fauna.
Global drainage patterns and the origins of topographic relief on Earth, Mars, and Titan
Authors: Black Benjamin A. , Perron J. Taylor , Hemingway Douglas , Bailey Elizabeth , Nimmo Francis , Zebker Howard
Published: May 2017

River systems reveal planetary tectonics

Earth, Mars, and Titan have all hosted rivers at some point in their histories. Rivers erode the landscape, leaving behind signatures that depend on whether the surface topography was in place before, during, or after the period of liquid flow. Black
et al.
developed two metrics to measure how well river channels align with the surrounding large-scale topography (see the Perspective by Burr). Earth's plate tectonics introduce features such as mountain ranges that cause rivers to divert, processes that clearly differ from those found on Mars and Titan.

Science
, this issue p.
727
; see also p.
708
A placental growth factor is silenced in mouse embryos by the zinc finger protein ZFP568
Authors: Yang Peng , Wang Yixuan , Hoang Don , Tinkham Matthew , Patel Anamika , Sun Ming-An , Wolf Gernot , Baker Mairead , Chien Huan-Chieh , Lai Kuan-Yu Nick , Cheng Xiaodong , Shen Che-Kun James , Macfarlan Todd S.
Published: May 2017

Embryo viability relies on placental repression

The insulin-like growth factor (IGF) signaling pathway controls maternal supply of and fetal demands for nutrients. Yang
et al.
report that the essential KRAB–zinc finger protein ZFP568 specifically and directly represses a placental-specific IGF2 transcript during early mouse development. Elimination of ZFP568 in vivo leads to the inappropriate early activation of transcription, which results in embryonic death owing to overexpression of IGF2 peptide. Thus, the specific, targeted preimplantation repression of a promoter is essential for viability.

Science
, this issue p.
757
The next energy economy
Burn Out: The Endgame for Fossil Fuels
Dieter Helm
Yale University Press, 2017. 301 pp.
Authors: Hopkins Asa S.
Published: May 2017

Mapping emerging trends in energy innovation, an economist anticipates a fossil fuel–free future
Rightsizing carbon dioxide removal
Authors: Field Christopher B. , Mach Katharine J.
Published: May 2017

Betting the future on planetary-scale carbon dioxide removal from the atmosphere is risky
Effective use of geosynthetics to increase bearing capacity of shallow foundations
Authors: Shahin Hossain Md. , Nakai Teruo , Morikawa Yukihiro , Masuda Saki , Mio Susumu
Published: May 2017

In this research, a reinforcement mechanism for shallow foundations is determined through laboratory model tests and numerical analyses. The numerical analyses are performed with the finite element program FEMtij-2D using the elastoplastic subloading tij model. The frictional behavior between the reinforcement and the ground is simulated using an elastoplastic joint element. Several tests were performed whereby the installation depth, length, roughness, and fixity conditions at the edges of the reinforcement were varied. Results show that the effectiveness of the reinforcement and the bearing capacity of the reinforced ground depend on the position, length, roughness, and fixity condition of the reinforcement. A significant increase in the bearing capacity can be achieved if the geosynthetics are properly placed at an optimum length with the boundary fixed to the ground. The effect of the loading position is also investigated because in reality the load on a foundation does not always act at the center of the foundation. The numerical results accurately describe the experimental results; the simulations accurately account for the mechanical behaviors of both the soil and reinforcement and the frictional behavior between them. Therefore, the simulation technique can be used to predict the bearing capacity of reinforced ground.