bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic burden of relapsed or refractory multiple myeloma: Results from an international trial
Authors: Robinson Don , Orlowski Robert Z. , Stokes Michael , He Jianming , Huse Samuel , Chitnis Abhishek , Kranenburg Britte , Lam Annette
Published: March 2017

Objective

The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost‐offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: (i) identify direct and indirect economic factors of RRMM, and (ii) explore longitudinal relationships between clinical, economic, and health‐related quality of life (HRQoL) assessments.

Methods

Economic questionnaire, clinical, and HRQoL data from a multisite, international, randomized, controlled study in RRMM were analyzed.

Results

Patients (n=263) were 53.6% male, 91.6% Caucasian; mean age of 62.9 years, median Eastern Cooperative Oncology Group status of 1 (56.3%). Moderate to severe pain or fatigue was reported by 30.4% and 70.6%, respectively. At baseline, ≥1 hospitalization was reported by 107 (41.8%); 182 (71.1%) and 86 (33.6%) reported specialist and family physician visits, respectively. A total of 28 (10.8%) were working: 10 (37.0%) of which reported RRMM‐driven absenteeism ≥1 day. Of those who were not working, 110 (48.2%) indicated that it was due to RRMM. Multivariate modeling showed lower hospitalization with a major tumor response (β=−1.44, CI: −2.89 to 0.01, P=.05).

Conclusions

Substantial RRMM indirect, social costs were observed. Better major tumor response may reduce hospital visits.
Adorno's Aristotle Critique and Ethical Naturalism
Authors: Whyman Tom
Published: March 2017

In this paper, I do three things. First, I unpack and outline an intriguing but neglected aspect of the thought of the Frankfurt School critical theorist Theodor W. Adorno—namely, his critique of Aristotle, which can be found in two of his lecture series: the unpublished 1956 lectures on moral philosophy and the 1965 lectures published as Metaphysics: Concept and Problems. Second, I demonstrate how Adorno's Aristotle critique constitutes a powerful critique of contemporary neo‐Aristotelian ethical naturalism, of the sort advocated by thinkers such as Philippa Foot, Michael Thompson and John McDowell. Third, I expound upon where this critique leaves the prospect of formulating a robust ethical naturalism more generally.
Sources of Entrepreneurial Courage and Imagination: Three Perspectives, Three Contexts
Authors: Miller Danny , Le Breton–Miller Isabelle
Published: March 2017

The strategy literature has been insightful in specifying the requirements for rents under uncertainty, but has concentrated less on how to meet those requirements. We argue that courage and imagination are essential drivers of such rents and that several streams in the entrepreneurship literature enlighten us as to the sources of those drivers: these are the perspectives of effectuation, entrepreneurial orientation, and strategic entrepreneurship. Although these perspectives apply to multiple organizational contexts, we suggest that their relevance to the sources of courage and imagination is especially acute in simple start–ups, dynamic high–tech innovators, and complex bureaucracies, respectively. Moreover, we call attention to other possible sources of entrepreneurial courage and imagination that have been underemphasized in the literature.
The enigmatic role of RUNX1 in female‐related cancers – current knowledge & future perspectives
Authors: Riggio Alessandra I. , Blyth Karen
Published: March 2017

Historically associated with the aetiology of human leukaemia, the runt‐related transcription factor 1 (RUNX1) gene has in recent years reared its head in an assortment of epithelial cancers. This review discusses the state‐of‐the‐art knowledge of the enigmatic role played by RUNX1 in female‐related cancers of the breast, the uterus and the ovary. The weight of evidence accumulated so far is indicative of a very context‐dependent role, as either an oncogene or a tumour suppressor. This is corroborated by high‐throughput sequencing endeavours which report different genetic alterations affecting the gene, including amplification, deep deletion and mutations. Herein, we attempt to dissect that contextual role by firstly giving an overview of what is currently known about RUNX1 function in these specific tumour types, and secondly by delving into connections between this transcription factor and the physiology of these female tissues. In doing so, RUNX1 emerges not only as a gene involved in female sex development but also as a crucial mediator of female hormone signalling. In view of RUNX1 now being listed as a driver gene, we believe that greater knowledge of the mechanisms underlying its functional dualism in epithelial cancers is worthy of further investigation.
Large but uneven reduction in fish size across species in relation to changing sea temperatures
Authors: van Rijn Itai , Buba Yehezkel , DeLong John , Kiflawi Moshe , Belmaker Jonathan
Published: March 2017

Ectotherms often attain smaller body sizes when they develop at higher temperatures. This phenomenon, known as the temperature–size rule, has important consequences for global fisheries, whereby ocean warming is predicted to result in smaller fish and reduced biomass. However, the generality of this phenomenon and the mechanisms that drive it in natural populations remain unresolved. In this study, we document the maximal size of 74 fish species along a steep temperature gradient in the Mediterranean Sea and find strong support for the temperature–size rule. Importantly, we additionally find that size reduction in active fish species is dramatically larger than for more sedentary species. As the temperature dependence of oxygen consumption depends on activity levels, these findings are consistent with the hypothesis that oxygen is a limiting factor shaping the temperature–size rule in fishes. These results suggest that ocean warming will result in a sharp, but uneven, reduction in fish size that will cause major shifts in size‐dependent interactions. Moreover, warming will have major implications for fisheries as the main species targeted for harvesting will show the most substantial declines in biomass.
Protein modelling to understand FGB mutations leading to congenital hypofibrinogenaemia
Authors: Casini A. , Vilar R. , Beauverd Y. , Aslan D. , Devreese K. , Mondelaers V. , Alberio L. , Gubert C. , de Moerloose P. , Neerman‐Arbez M.
Published: March 2017

Introduction

Congenital hypofibrinogenaemia is a quantitative fibrinogen disorder characterized by proportionally decreased levels of functional and antigenic fibrinogen. Mutations accounting for quantitative fibrinogen disorders are relatively frequent in the conserved COOH‐terminal globular domains of the γ and Bβ chains. The latter mutations are of particular interest since the Bβ‐chain is considered the rate‐limiting chain in the hepatic production of the fibrinogen hexamer.

Aim

The aim of this study was to study the molecular pattern of four patients with congenital hypofibrinogenaemia.

Methods

Four novel fibrinogen Bβ‐chain mutations leading to congenital hypofibrinogenaemia were identified in four women with heterogeneous symptoms. The human fibrinogen beta chain precursor protein sequence (P02675) was obtained from the UniProt database. The resulting models were analysed using swisspdbviewer 4.1.0.

Results

Three patients were heterozygous for different missense mutations located in the highly conserved β nodule: c.882G>C:Arg294Ser (Arg264Ser), c.1298G>T:Trp433Leu (Trp403Leu) and c.1329C>G:Asn443Lys (Asn413Lys). Modelling analyses predicted major structural modifications likely to result in impaired fibrinogen secretion. One patient was heterozygous for an intron 7 donor splice mutation (c.1244 + 1G>A), leading to the complete abolishment of the donor site.

Conclusions

Protein modelling of new causative mutations and comparison of molecular, biochemical and clinical data continue to yield valuable information on the development and course of fibrinogen disorders as well as on the choice of the most appropriate treatments.
Understanding Higher Education Institutions’ Publicness: Do Public Universities Produce More Public Outcomes than Private Universities?
Authors: Lee Young‐joo
Published: March 2017

Higher education institutions produce a broad array of public outcomes. However, little is known about the varying levels of their contribution to the public good and what explains the variation among institutions. This study uses the theory of organisational publicness and examines how these institutions’ ownership status and resource publicness explain their outcome publicness, focusing on the expenditure for teaching, research and public service activities. The analysis of four‐year public and private universities in the 2012 Integrated Postsecondary Education Data System shows that universities’ reliance on federal funding is positively associated with the percentages of the expenditure on all three activities and their reliance on state funding is positively associated with the percentages of teaching and public service expenses. The findings reveal that the proportion of tuition and fees revenue is negatively associated with the percentage of public service expenditure. The results suggest that declining state funding and increasing reliance on tuition and fees weaken these institutions’ public service function, especially in the area of community engagement.
Barriers and enablers of type 2 diabetes self‐management in people with severe mental illness
Authors: Mulligan Kathleen , McBain Hayley , Lamontagne‐Godwin Frederique , Chapman Jacqui , Haddad Mark , Jones Julia , Flood Chris , Thomas David , Simpson Alan
Published: March 2017

Background

People with diabetes and severe mental illness (SMI) experience poorer outcomes than those with diabetes alone. To improve outcomes, it is necessary to understand the difficulties that people with SMI experience in managing their diabetes.

Aims

To identify barriers and enablers to effective diabetes self‐management experienced by people with SMI and type 2 diabetes.

Method

Qualitative methodology using semi‐structured interviews was employed. Development of the interview topic guide and analysis of the transcripts were informed by the Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour.

Results

Fourteen people with SMI and type 2 diabetes took part in the study. Participants considered diabetes self‐management to be important, were aware of the risks of poor diabetes control but struggled to follow recommended advice, particularly if their mental health was poor. Support from family and health professionals was considered an important enabler of diabetes self‐management.

Conclusions

New approaches are required to support diabetes self‐management in people with SMI. This study identified some of the important domains that may be targeted in new interventions.
“I have nine specialists. They need to swap notes!” Australian patients’ perspectives of medication‐related problems following discharge from hospital
Authors: Eassey Daniela , McLachlan Andrew J. , Brien Jo‐anne , Krass Ines , Smith Lorraine
Published: March 2017

Background

Research has shown that patients are most susceptible to medication‐related problems (MRPs) when transitioning from hospital to home. Currently, the literature in this area focuses on interventions, which are mainly orientated around the perspective of the health‐care professional and do not take into account patient perspectives and experiences.

Objective

To capture the experiences and perceptions of Australian patients regarding MRPs following discharge from hospital.

Design

A cross‐sectional study was conducted using a questionnaire collecting quantitative and qualitative data. Thematic analysis was conducted of the qualitative data.

Setting and participants

Survey participants were recruited through The Digital Edge, an online market research company. Five hundred and six participants completed the survey.

Results

A total of 174 participants self‐reported MRPs. Two concepts and seven subthemes emerged from the analysis. The first concept was types of MRPs and patient experiences. Three themes were identified: unwanted effects from medicines, confusion about medicines and unrecognized medicines. The second concept was patient engagement in medication management, of which four themes emerged: informing patients, patient engagement, communication amongst health‐care professionals and conflicting advice.

Discussion and conclusion

This study provides an important insight into patients’ experiences and perceptions of MRPs following discharge from hospital. Future direction for practice and research should look into implementing patient‐centred care at the time of hospital discharge to ensure the provision of clear and consistent information, and developing ways to support and empower patients to ensure a smooth transition post‐discharge from hospital.
Neotropical mycophagous drosophilids (Diptera: Drosophilidae): DNA barcoding as a way of overcoming the taxonomic impediment
Authors: Machado Stela , Junges dos Santos João Pedro , Fonseca Pedro Mesquita , Bolzan Andreza Ribeiro , David Jean , Loreto Elgion Lucio da Silva , Gottschalk Marco Silva , Robe Lizandra Jaqueline
Published: March 2017

Within Drosophilidae, the Zygothrica genus group corresponds to a speciose mycophagous group, which remains insufficiently investigated despite its potential for ecological and evolutionary studies. The recognised gap in the knowledge of species diversity and the threat provided by global warming due to niche conservatism and stringent temperature and humidity requirements make this group an excellent candidate for testing the implementation of DNA barcoding, which is the aim of this study.

Extensive prospecting in various parts of Brazil provided 220 specimens. Considering both the morphological and molecular results, these individuals consisted of 56 species that could be distributed into three categories: 22 corresponded to previously described species, 24 very likely corresponded to undescribed species, and 10 uncertain cases corresponded mainly to one or a few females. Intra‐specific distances ranged from 0% to 5.3%, whereas inter‐specific congeneric and inter‐generic distances ranged from 2.4% to 21.7% and from 7.4% to 20% respectively. Moreover, all species were revealed as reciprocally monophyletic and presented positive barcoding gap values; 62.5% of them presented diagnostic characters. Although coalescent‐based methodologies suggested some additional splitting, species initially considered to be different were never lumped together.

Therefore, in general, DNA barcoding of mycophagous drosophilids provided results that are largely congruent throughout different molecular approaches and also with morphological boundaries. Several putative new species were revealed, highlighting the potential of cytochrome c oxidase subunit I (COI) barcodes as a tool complementary to traditional taxonomy in unravelling cryptic diversity among Neotropical mycophagous drosophilids.
Thermo‐rheological and functional properties of gamma‐irradiated wholewheat flour
Authors: Bashir Khalid , Jan Kulsum , Aggarwal Manjeet
Published: March 2017

The effects of different doses (0, 0.5, 1, 2.5, 5 and 10 kGy) of gamma irradiation on the thermal, rheological and functional properties of the wholewheat flour were evaluated. Water and oil absorption capacity of the flour increased from 85.92% to 91.44% and 1.10 to 1.91 g g−1 of flour, respectively, with increase in irradiation dose. The dough development time decreased with dose from 4.0 to 3.0 min. The transition temperatures (To, Tp and Tc) decreased as the dose increased; enthalpy of gelatinisation (∆H) decreased from 5.18 to 4.27 J g−1 with dose. The flow behaviour showed a shear‐thinning behaviour, and the hysteresis area decreased with dose. The structural recovery decreased with dose. FTIR did not show formation of any new chemical groups.
Greater early weight gain and shorter breastfeeding are associated with low adolescent adiponectin levels
Authors: Reyes M. , Burrows R. , Blanco E. , Lozoff B. , Gahagan S.
Published: March 2017

Background

Early life factors can programme future risk for cardiovascular disease.

Objectives

We explored associations between adolescent adiponectin levels and concomitant metabolic alteration and also looked at the association between early life factors and adolescent adiponectin levels.

Methods

We studied a longitudinal cohort of low‐income to middle‐income Chilean adolescents who were enroled in an infancy iron‐deficiency anaemia preventive trial and follow‐up studies at the Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile. In the 577 adolescents who were assessed as part of the 16‐year follow‐up, we evaluated independent associations between adiponectin levels and metabolic disturbances during adolescence. We also assessed the association between early life factors [short breastfeeding {<6 months} and infancy weight gain] and adolescent adiponectin levels.

Results

Participants were 16.8 years old (16.4–18.1), 48% female and 38% overweight/obese. Adolescent adiponectin levels were inversely associated with metabolic disturbances: altered homeostatic model assessment of insulin resistance and high‐density lipoprotein cholesterol [odds ratios {95% confidence interval} = 0.87 {0.79–0.95}, p‐value = 0.002, and 0.90 {0.87–0.94}, p‐value < 0.001, respectively], adjusting for sex and fat mass index. Early life factors were independently associated with adolescent adiponectin levels, which decreased 0.88 ug mL−1 per each unit increase in weight‐for‐age z‐score between 0 and 6 months and was 1.58 ug mL−1 lower among participants with short breastfeeding.

Conclusions

Higher adolescent adiponectin levels were independently associated with lower odds of metabolic disturbances. Greater weight gain during infancy and shorter breastfeeding were associated with lower adolescent adiponectin levels, supporting research indicating early life as a window of opportunity for prevention of later cardiovascular alterations. © 2017 World Obesity Federation
Interculturalism as a New Framework to reduce Prejudice in Times of Crisis in European Countries
Authors: Bello Valeria
Published: March 2017

With the socio‐economic crisis that is affecting Europe particularly negatively, immigrants have been often reported as additional threats in the job market for established residents. Theories of prejudice, such as the Theory of Self‐interest or that of the Perceived Group Threats, have suggested economic factors to explain these kinds of attitudes towards immigrants. More recently, some scholars have advanced theories of intercultural values to account for individuals’ dispositions towards those perceived as newcomers. The aim of this work is to understand whether or not intercultural values are able to modify the effects that economic factors exert on prejudice in times of crisis. The main objective is to identify whether the kinds of values instilled within societies play a stronger role than other variables, particularly economic factors. The findings show that Interculturalism plays a much greater role than economic factors in influencing attitudes towards outsiders.
“He invited me and didn't ask anything in return” Migration and Mobility as Vulnerabilities for Sexual Exploitation among Female Adolescents in Mexico
Authors: Rocha‐Jimenez Teresita , Brouwer Kimberly C. , Salazar Marissa , Boyce Sabrina C. , Servin Argentina E. , Goldenberg Shira M. , Staines‐Orozco Hugo , Vera‐Monroy Ricardo B. , Silverman Jay G.
Published: March 2017

Although human trafficking is recognized as a major human rights violation, there is limited evidence regarding the vulnerabilities that contribute to female adolescents’ risk of being forced or coerced into the sex trade. Vulnerabilities such as gender‐based violence, economic and social inequalities have been shown to shape the risk of sexual exploitation among adolescents. In‐depth interviews (n=18) with current sex workers who reported being deceived or forced into the sex trade as adolescents (<17 years old) were analysed to explore their experiences of migration and mobility in Mexico. Driven by socio‐economic and vulnerabilities in home communities, adolescents often engaged in internal migration and mobility to other Mexican communities and states. Migration and mobility further predisposed them to social isolation, economic hardship and abuse, which were used as tools to trick them into the sex trade. Policies that support safer migration for adolescents in origin, transit, and destination communities are needed.
Analyzing Equilibrium in Incomplete Markets with Model Uncertainty
Authors: Yoshikawa Daisuke
Published: March 2017

In this paper, we analyze equilibrium in incomplete markets of random endowments by adopting utility indifference pricing and utility‐based pricing. Addressing model uncertainty, we also consider agents who adopt maxmin expected utility and a risk management policy. Using this framework, we demonstrate the existence of equilibrium. Moreover, we clarify the differences in the features of equilibria derived using these methods. Further, we show that the traded amount of random endowments in equilibrium by indifference pricing depends on the degree of risk aversion, initial capital, and agents' risk limits.
Long‐term Plasmapheresis: Effects on Specific Plasma Proteins
Authors: Shanbrom E. , Lundak R. , Walford R. L.
Published: March 2017

An extensive long‐term plasmapheresis program was carried out in which the individually specific plasma proteins of 74 donors were monitored throughout an 18‐month donation perid. Hematocrit, bilirubin and weight were graphically recorded for each bleeding. Plasma samples were taken from each donor prior to plasmapheresis and every six months thereafter for laboratory analysis of specific plasma proteins. Each sample was assayed in a “blind fashion” for total protein, albumin, prealbumin, IgG, IgA, IgM, C’3, alpha 2‐macroglobulin, transferrin, and ceruloplasmin. The mean of the individual total protein remained well within normal ranges; none of the nine individually specific plasma proteins showed a significant decrease in concentration. This study indicates that chronic, large‐volume plasmapheresis does not adversely affect plasma protein homeostasis.
Correlation Between Adenylate Metabolizing Enzymes and Adenine Nucleotide Levels of Erythrocytes During Blood Storage in Various Media
Authors: Srivastava S. K. , Villacorte D. , Beutler E.
Published: March 2017

Blood from normal donors and from heterozy‐gotes for adenine phosphoribosyltransferase was stored in ACD, ACD‐adenine, and ACD‐adenine‐phosphate media. The levels of AMP, ADP and ATP along with the enzymes involved in adenine nucleotide metabolism; adenine phosphoribosyl‐transferase, ribose‐5‐P pyrophosphokinase and AMP‐deaminase, were determined at various stages of blood storage in various media. One of the heterozygotes for adenine phosphoribosyltransferase maintained ATP levels poorly in all the media, but another heterozygote maintained ATP levels in a normal fashion. No significant correlation was established between the activities of various enzymes of adenine nucleotide metabolism and the levels of adenine nucleotides at any stage of blood storage in any medium studied.

A population survey showed that the frequency of adenine phosphoribosyltransferase deficiency is of the order of 1 per cent. The heterozygote defect is not accompanied by any obvious abnormalities.
Hemostatic Abnormalities in Heroin Addicts
Authors: Puszkin E. , Gutfreund D. , Aledort L. M.
Published: March 2017

Eight of ten heroin addicts demonstrated abnormalities of platelet aggregability. Abnormalities were seen with ADP, epinephrine, collagen and, in particular, thrombin. The bleeding time was prolonged in three of these eight addicts. The acetyl moiety of heroin, 6‐monoacetylmorphine, may be responsible for these abnormalities.
Anti‐Lu5, Anti‐Lu6, and Anti‐Lu7
Authors: Marsh W. L.
Published: March 2017

A combined study, supported by blood samples from many laboratories, allowed the recognition of three “new” antibodies, anti‐Lu5, anti‐Lu6, and anti‐Lu7. The reacting antigens all appear to have a high frequency, but are absent on all Lu(a—b—) red blood cells that have been tested. Family studies have shown that Lu6 and Lu7 are inherited characters but family studies on Lu5 have not been informative. The results suggest thatLu5, Lu6, andLu7genes operate on the same precursor material as do the usual Lutheran genes but there is no evidence to show whetherLu5, Lu6, andLu7are located on the Lutheran chromosome.

A new Lutheran phenotype, Lu(w), displays weak Lutheran antigens.
Steroid Hormones in the Preservation of Human Blood
Authors: DeVenuto F. , Wilson S. M.
Published: March 2017

Units of blood were stored for 42 days under different conditions: (1) packed cells with addition of progesterone, testosterone or androsterone; (2) erythrocytes suspended in Krebs‐Ringer phosphate buffer with addition of adenine or progesterone plus adenine; and (3) whole blood with addition of progesterone. At selected intervals during storage, determinations were made of ATP levels, spontaneous lysis, and osmotic fragility. By these criteria, progesterone was effective in protecting the red blood cells during storage by reducing spontaneous lysis, changes in osmotic resistance, and loss of ATP. The greatest effect in this respect was obtained by addition of progesterone plus adenine to erythrocytes suspended in Krebs‐Ringer phosphate buffer. Testosterone and androsterone did not show any effect. The use of the “osmotic fragility index” to represent the osmotic resistance of erythrocytes is proposed.
Another Example of Anti‐M in an M‐positive Patient
Authors: Howard P. L. , Picoff R. C.
Published: March 2017

An MN patient is described whose serum contains a naturally occurring anti‐M antibody. The antibody showed marked dosage effect and reacted most strongly at 4 C and at room temperature. Chromosomal analysis failed to reveal changes in either chromosomes number 2 or number 4 which had previously been implicated as possible locus for genes determining MN antigens.
Fragmented IgG for Post‐Exposure Prophylaxis of Type A Hepatitis
Authors: Brachott D. , Mosley J. W. , Lipschitz I. , Kendrick M. A. , Sgouris J. T.
Published: March 2017

To determine whether fragmentation of IgG in immune serum globulin (ISG) preparations has an adverse effect upon protection against type A hepatitis, three materials were given to household contacts of icteric cases: (1) human albumin as a placebo; (2) normal ISG containing intact IgG; and (3) ISG from the same lot but containing IgG deliberately fragmented with fibrinolysin. Attack rates per 100 children were 4.9, 2.8, and 2.3, respectively. IgG fragmentation, therefore, had no adverse effect on overall level of protection. In addition, IgG fragmentation produced a statistically significant reduction in secondary attack rate when given as late as six days prior to expected onset (as judged from the placebo group); ISG with intact IgG had to be given 16 days or more prior to expected onset to achieve a comparably significant reduction. This result suggests that fragmentation may be advantageous for ISG preparations intended for post‐exposure prophylaxis of viral diseases.
Continuous‐flow Centrifugation Washing of Red Blood Cells
Authors: Runck A. H. , Valeri C. R. ,   With the Technical Assistance of R. J. Truver and J. N. Lute
Published: March 2017

Nonfrozen and previously frozen red blood cells were washed by continuous‐flow centrifugation in reusable, stainless steel bowls. Satisfactory washout of extracellular Evans blue dye and intracellular glycerol from the red blood cell suspension was achieved, but complete mixing in the washing bowl was not accomplished.

We studied the effects of the concentration of glycerol in the red cell suspension, the temperature (20 C or 40 C), spindle speed, flow rate, and composition of the electrolyte solution on the efficiency of washing in the reusable bowl. With this information in hand, we established automated programmed wash cycles.
Electronic Data Processing as an Aid to Statewide Blood Management
Authors: Katz A. J. , Holdt R. S. , Morse E. E.
Published: March 2017

An electronic data processing system for blood inventory information is described. The system is operative in a total supply blood program which serves all 41 hospitals in Connecticut. The hospitals have actively contributed to the development and implementation of the system. All hospitals participate, and 11 currently use their own or nearby computer terminals. Collaboration of the Connecticut Red Cross Blood Center with Connecticut Blue Cross, Inc., has permitted the use of computer terminals which were already located in a number of the larger hospitals. This report describes the daily operation of the system, and outlines the variety of information which is currently reported by computer and which is available to the Blood Center and to hospital blood banks.
An Inhibition Crossover Electrophoresis Technic for the Detection of Hepatitis‐associated Antigen
Authors: Milner L. V. , Dobie J. L. , Grobbelaar B. G.
Published: March 2017

The inhibition crossover electrophoresis technic detects more HAA than the conventional crossover electrophoresis method, yet is very simple to perform. It adds one hour to the time taken for the test, but detects as many HAA as does the complement fixation method. It has the significant advantage that it allows a standard crossover electrophoresis method to be used, with a standardized antigen/antibody system, and thus eliminates the problems associated with antigen and antibody excess due to variations in the strength of the antigens encountered when testing unknown sera.
Cardiac cell proliferation is not necessary for exercise‐induced cardiac growth but required for its protection against ischaemia/reperfusion injury
Authors: Bei Yihua , Fu Siyi , Chen Xiangming , Chen Mei , Zhou Qiulian , Yu Pujiao , Yao Jianhua , Wang Hongbao , Che Lin , Xu Jiahong , Xiao Junjie
Published: March 2017

The adult heart retains a limited ability to regenerate in response to injury. Although exercise can reduce cardiac ischaemia/reperfusion (I/R) injury, the relative contribution of cardiac cell proliferation including newly formed cardiomyocytes remains unclear. A 4‐week swimming murine model was utilized to induce cardiac physiological growth. Simultaneously, the antineoplastic agent 5‐fluorouracil (5‐FU), which acts during the S phase of the cell cycle, was given to mice via intraperitoneal injections. Using EdU and Ki‐67 immunolabelling, we showed that exercise‐induced cardiac cell proliferation was blunted by 5‐FU. In addition, the growth of heart in size and weight upon exercise was unaltered, probably due to the fact that exercise‐induced cardiomyocyte hypertrophy was not influenced by 5‐FU as demonstrated by wheat germ agglutinin staining. Meanwhile, the markers for pathological hypertrophy, including ANP and BNP, were not changed by either exercise or 5‐FU, indicating that physiological growth still developed in the presence of 5‐FU. Furthermore, we showed that CITED4, a key regulator for cardiomyocyte proliferation, was blocked by 5‐FU. Meanwhile, C/EBPβ, a transcription factor responsible for both cellular proliferation and hypertrophy, was not altered by treatment with 5‐FU. Importantly, the effects of exercise in reducing cardiac I/R injury could be abolished when cardiac cell proliferation was attenuated in mice treated with 5‐FU. In conclusion, cardiac cell proliferation is not necessary for exercise‐induced cardiac physiological growth, but it is required for exercise‐associated protection against I/R injury.
Efficacy of collagen matrix seal and collagen sponge on ridge preservation in combination with bone allograft: A randomized controlled clinical trial
Authors: Natto Zuhair S. , Parashis Andreas , Steffensen Bjorn , Ganguly Rumpa , Finkelman Matthew D. , Jeong Y. Natalie
Published: March 2017

Aim

To test whether the use of collagen matrix seal (CMS) results in similar hard and soft tissue remodelling to that with collagen sponge (CS) used as barriers 4 months following alveolar ridge preservation (ARP), in combination with freeze‐dried bone allograft (FDBA).

Materials and methods

Twenty‐eight patients were randomly assigned to the two groups. Clinical and radiographic measurements were recorded with the same stent at baseline and 4 months for standardization. The flapless technique following a traumatic extraction was used for the two types of barriers.

Results

All patients completed the study, 14 in the CMS group and 14 in the CS group. Reduction in coronal ridge width (1.21 mm‐14.91% CMS and 1.47 mm‐20.40% CS) and vertical buccal bone resorption (0.30 mm CMS and 0.79 mm CS) were not significantly different. A slight increase in buccal gingival thickness at the coronal part was observed in both groups (0.9 mm CMS and 0.5 mm CS).

Conclusions

Collagen matrix seal and CS, when combined with FDBA, significantly minimized ridge resorption in all dimensions and maintained buccal soft tissue thickness in sockets with a buccal plate loss of <2 mm in comparison to previously reported findings recorded after tooth extraction without ARP.
Genetic divergence with ongoing gene flow is maintained by the use of different hosts in phytophagous ladybird beetles genus Henosepilachna
Authors: Matsubayashi K. W. , Kohyama T. I. , Kobayashi N. , Yamasaki S. , Kuwajima M. , Katakura H.
Published: March 2017

Adaptation to different environments can promote population divergence via natural selection even in the presence of gene flow – a phenomenon that typically occurs during ecological speciation. To elucidate how natural selection promotes and maintains population divergence during speciation, we investigated the population genetic structure, degree of gene flow and heterogeneous genomic divergence in three closely related Japanese phytophagous ladybird beetles: Henosepilachna pustulosa, H. niponica and H. yasutomii. These species act as a generalist, a wild thistle (Cirsium spp.) specialist and a blue cohosh (Caulophyllum robustum) specialist, respectively, and their ranges differ accordingly. The two specialist species widely co‐occur but are reproductively isolated solely due to their high specialization to a particular host plant. Genomewide amplified fragment‐length polymorphism (AFLP) markers and mitochondrial cytochrome c oxidase subunit I (COI) gene sequences demonstrated obvious genomewide divergence associated with both geographic distance and ecological divergence. However, a hybridization assessment for both AFLP loci and the mitochondrial sequences revealed a certain degree of unidirectional gene flow between the two sympatric specialist species. Principal coordinates analysis (PCoA) based on all of the variable AFLP loci demonstrated that there are genetic similarities between populations from adjacent localities irrespective of the species (i.e. host range). However, a further comparative genome scan identified a few fractions of loci representing approximately 1% of all loci as different host‐associated outliers. These results suggest that these three species had a complex origin, which could be obscured by current gene flow, and that ecological divergence can be maintained with only a small fraction of the genome is related to different host use even when there is a certain degree of gene flow between sympatric species pairs.
Promoting resource stewardship: Reducing inappropriate free thyroid hormone testing
Authors: Gilmour Julie A. , Weisman Alanna , Orlov Steven , Goldberg Robert J. , Goldberg Alyse , Baranek Hayley , Mukerji Geetha
Published: March 2017

Rationale

Free thyroxine (fT4) and free triiodothyronine (fT3) tests are often ordered when not clinically warranted. Preventing laboratory overuse by reducing inappropriate fT4 and fT3 testing is one strategy to promote resource stewardship.

Objectives

(1) To characterize the frequency of inappropriate fT4 and fT3 testing and (2) to implement a quality improvement strategy aimed at reducing the number of these tests performed.

Methods

Quality improvement tools were used to create sequential change ideas: (1) education of physicians regarding appropriate indications for ordering fT4/fT3 and (2) implementation of a hospital‐wide laboratory and forced‐function system with a reflex fT4. This study was conducted at an academic ambulatory care hospital in Toronto, Canada.

The main outcomes were the differences in weekly median number of thyroid‐stimulating hormone, fT4, and fT3 tests performed during the preintervention, education, and reflex periods using the Kruskal‐Wallis test and analysis for special cause variation with statistical process control charts.

Results

The median number of fT4/fT3 processed per week was significantly reduced from 90/39 at baseline to 78/34 posteducation and 59/14 postreflex (P < .0001). Comparing preintervention to the reflex period, there was 34% reduction in fT4 and 64% reduction in fT3. The number of processed thyroid‐stimulating hormone tests was stable with only 2% variation. Statistical process control charts demonstrated special cause variation following implementation of the reflex system for both fT4 and fT3.

Conclusions and Relevance

Inappropriate testing of free thyroid indices occurs frequently. The implementation of a reflex fT4 strategy after education was feasible in reducing overall testing by 49% and was effective in promoting resource stewardship.
Functional Status Modifies the Association of Blood Pressure with Death in Elders: Health and Retirement Study
Authors: Wu Chenkai , Smit Ellen , Peralta Carmen A. , Sarathy Harini , Odden Michelle C.
Published: March 2017

Objective

To examine whether grip strength, gait speed, and the combination of the two physical functioning measures modified the association of systolic BP (SBP) and diastolic BP (DBP) with mortality.

Design

Nationally representative cohort study.

Setting

Health and Retirement Study.

Participants

7,492 U.S. adults aged ≥65 years.

Measurements

Grip strength was measured by a hand dynamometer and classified as normal (≥16 kg for female; ≥26 kg for male) and weak. Gait speed was assessed over a 98.5‐inch walk and classified as non‐slow (≥0.60 m/s for female; ≥0.52 m/s for male) and slow.

Results

Over an average follow‐up time of 6.0 years, 1,870 (25.0%) participants died. After adjustment for socio‐demographic, behavioral, and clinical measures, elevated SBP (≥150 mmHg) and DBP (≥90 mmHg) was associated with a 24% (95% CI, 7–43%) and 25% (95% CI, 5–49%) higher mortality among participants with normal grip strength. In contrast, elevated SBP and DBP was associated with a 6% (95% CI, 31 to −27%) and a 16% (95% CI, 46 to −26%) lower mortality among those with weak grip strength (P‐values of interactions: both=.07). The inverse relations between BP with death were most pronounced among slow walkers with weak grip strength. The HRs of elevated SBP and DBP for death was 0.85 (95% CI, 0.56–1.29) and 0.53 (95% CI, 0.30–0.96), respectively, and was substantially different from non‐slow walkers with normal grip strength (HR = 1.24 and 1.15, respectively; P‐values of interactions: both <.001). Therefore, associations of BP with death varied modestly by gait speed.

Conclusion

Grip strength modified the association of BP with death. Combination of grip strength and gait speed has incremental value for modifying the association of BP with death.
Frequency and Risk Factors for Live Discharge from Hospice
Authors: Russell David , Diamond Eli L. , Lauder Bonnie , Dignam Ritchell R. , Dowding Dawn W. , Peng Timothy R. , Prigerson Holly G. , Bowles Kathryn H.
Published: March 2017

Objectives

To report frequencies and associated risk factors for 4 distinct causes of live discharge from hospice.

Design

Retrospective cohort study using electronic medical records of hospice patients who received care from a large urban not‐for‐profit hospice agency in New York City during a 3‐year period between 2013 and 2015 (n = 9,190).

Results

Roughly one in five hospice patients were discharged alive (21%; n = 1911). Acute hospitalization was the most frequent reason for live discharge (42% of all live discharges; n = 802). Additional reasons included elective revocation to resume disease‐directed treatments (18%; n = 343), disqualification (14%; n = 271), and service transfers or moves (26%; n = 495). Multinomial logistic regression analyses revealed that risk for acute hospitalization was higher among younger patients (age AOR = 0.98 [95% CI = 0.98–0.99] P < .01), racial/ethnic minorities (Hispanic AOR = 2.23 [CI = 1.82–2.73] P < .001; African American OR = 2.46 [CI = 2.00–3.03] P < .001; Asian/other OR = 1.63 [CI = 1.25–2.11] P < .001), and patients without advance directives (AOR = 1.41 [95% CI = 0.98–0.99] P < .001). Disqualification occurred much more frequently among patients with non‐cancer diagnoses, including dementia (AOR = 13.14 [95% CI = 7.96–21.61] P < .001) and pulmonary disease (AOR = 11.68 [95% CI = 6.58–20.74] P < .001). Transfers and service moves were more common among Hispanics (AOR = 1.56 [95% CI = 1.45–2.34] P < .001), African Americans (AOR = 1.35 [95% CI = 1.03–1.79] P < .05), patients without a primary caregiver (AOR = 1.35 [95% CI = 1.09–1.67] P < .001), and those without advance directives (AOR = 1.30 [95% CI = 1.07–1.58] P < .01).

Conclusion

Further research into factors that underlie live discharge events, especially acute hospitalization, is warranted given their cost and burden for patients/families. Hospices should develop strategies to address acute medical crises and thoroughly evaluate patients’ suitability, unmet needs, and knowledge about end‐of‐life issues at the time of hospice enrollment, especially for those with non‐cancer diagnoses.
E‐cadherin‐mediated impairment increases anti‐apoptotic mechanism through upregulation of Bcl‐2: An immunohistochemical study in various patterns of invasion of oral squamous cell carcinoma
Authors: Gulati Nikita , Shetty Devi Charan , Rathore Ajit Singh , Juneja Saurabh , Jain Anshi
Published: March 2017

Background

Bcl‐2 and E‐cadherin proteins are known to be involved in the control of apoptotic cell death and invasive potential, respectively, which is an important hallmark of tumor regulation that influences their biologic behavior.

Aim

This study investigates the relationship of Bcl‐2 and E‐cadherin immunoexpression in various Bryne's patterns of invasion.

Material and Methods

Immunohistochemical analyses for Bcl‐2 and E‐cadherin were performed on paraffin‐embedded tissue sections on 40 cases (32 cases of Oral squamous cell carcinoma and eight cases of controls) and were scored using qualitative and quantitative (percentage positive) analysis.

Statistical analysis

The resulting data were analyzed using SPSS software version 19. Correlation between patterns of invasion and qualitative scores of Bcl‐2 and E‐cadherin was calculated using Spearman rho correlation. Difference of mean percentage of positive cells of Bcl‐2 and E‐cadherin in different patterns of invasion was tested by ANOVA followed by Tukey HSD test.

Results

Bcl‐2 and E‐cadherin immunoreactivity was positively correlated with Bryne's pattern of invasion (P value<.05). An inverse relation was found between Bcl‐2 and E‐cadherin expression with Bryne's patterns 1‐5 of invasion.

Conclusions

The results pointed to the antagonistic role of E‐cadherin and Bcl‐2 and thus provide the opportunity for cell survival along with increased invasive potential.
Evolution of post‐traumatic growth during the first 12 months of dialysis: A longitudinal study
Authors: Ruiz de Alegría Begoña , Basabe Nekane , De Lorenzo Elena
Published: March 2017

Background

Initiating dialysis can produce psychological benefits. These positive changes, most frequently referred to as posttraumatic growth (PTG), have not previously been explored in these patients.

Objective

To identify patterns in the temporal course of PTG in patients during their first 12 months of dialysis, and to relate to perceived stress.

Design

A prospective, longitudinal, observational study.

Setting and Methods

The sample included 98 patients, aged from 18 to 70 years, who commenced dialysis in the nine nephrology units of the Basque Country, Spain. Three assessments were carried out at 1, 6 and 12 months, using a PTG questionnaire and the Perceived Stress Scale. ANOVAs with post‐hoc analysis were performed to identify significant differences between the groups.

Results

Four groups were established based on the observed changes in PTG over time: high, increasing, decreasing and low PTG. Maintaining high PTG and decreasing PTG levels was associated with moderate levels of perceived stress.

Conclusion

Four different patterns of PTG have been identified, contributing to our understanding of the dynamics of the process of growth and enabling us to identify patients who may be more vulnerable.
Cultural Expressions of Social Class and Their Implications for Group‐Related Beliefs and Behaviors
Authors: Becker Julia C. , Kraus Michael W. , Rheinschmidt‐Same Michelle
Published: March 2017

In the wake of the Great Recession, rising inequality has increased social‐class disparities between people in society. In this research, we examine how differences in social class shape unique patterns of cultural expression, and how these cultural expressions affirm ingroup beliefs. In Study 1 (N = 113), we provide evidence that cultural expressions of social class on an online social network can signal the social class of targets: by simply viewing the cultural practices of individuals captured in uploaded Facebook photographs, individuals express their social class in ways that allow it to be perceived by strangers at levels that are above chance accuracy. In Study 2 (N = 78), we provide evidence that individuals express their own ingroup space differently based on social class: Class‐specific cultural practices (including interests in education, arts, newspapers, TV, and shopping) have implications for ingroup‐related beliefs and political organizing. Individuals who reported being lower in subjective social class, relative to those reporting higher subjective social class, show cultural practices that relate to recognizing the ingroup's relative lack of control (lower group efficacy) and, in turn, a tendency to remain politically inactive when faced with an ingroup‐related social disadvantage. In sum, our research provides evidence suggesting that expressions of culture derived from one's social class have the capacity to create and maintain social‐class boundaries between individuals. Practical and political implications are discussed.