bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of suvorexant on nighttime blood pressure in hypertensive patients with insomnia: The SUPER‐1 study
Authors: Kario Kazuomi , Yamasaki Koichiro , Yagi Kazuro , Tsukamoto Masatoshi , Yamazaki Shoji , Okawara Yukie , Tomitani Naoko , Kanegae Hiroshi 
Published: March 2019

Orexins are neuropeptides that play a role in maintaining wakefulness and contribute to central regulation of cardiovascular function. This first multicenter, randomized, double‐blind study investigated the effects of suvorexant, a reversible dual orexin receptor antagonist, on nighttime blood pressure (BP) in patients with insomnia and hypertension. After a 4‐week run‐in period, adult outpatients (n = 82) with treated hypertension (clinic SBP <160 mm Hg) and insomnia were treated with suvorexant 20 mg/d or placebo before bedtime for 2 weeks. Twenty‐four‐hour ambulatory BP monitoring was performed at baseline and the end of treatment, and home BP measurements (morning and evening) were taken daily. Nighttime systolic BP (SBP), the primary endpoint, decreased slightly from baseline to week 2 in both the suvorexant and placebo groups (−4.4 vs −1.8 mm Hg; P = 0.494). Clinic, 24‐hour, daytime and morning SBP (ambulatory blood pressure monitoring) also decreased slightly and similarly from baseline in both groups. In this study, suvorexant had no overall effect on BP in patients with insomnia and treated hypertension.
Foreground Liberalism, Background Nationalism: A Discursive‐institutionalist Account of EU Leverage and ‘Democratic Backsliding’ in East Central Europe
Authors: Dawson James , Hanley Seán 
Published: March 2019

AbstractThis article argues for a fresh approach to debates on democratic backsliding and European Union (EU) influence in East Central Europe (ECE), drawing on the discursive institutionalism of Vivien Schmidt. Underlying assumptions about backsliding in CEE largely reflect a set of ideas derived from the rational institutionalist and historical institutionalist schools. Moreover, the same theoretical assumptions were previously deployed to explain the apparent success of democratization and EU leverage in CEE. A discursive institutionalism perspective, stressing the role of actors and their discourses in making and unmaking institutions, suggests that democracy in CEE was always less secure than assumed. It also highlights the key role of liberal mainstream parties in embodying democratic institutions. Case studies of the liberal centre‐right in Bulgaria and social democrats in the Czech Republic highlight the way background ideas of ethnically exclusive titular states have increasingly impinged on foreground ideas of liberal pluralism.
Impact of an Online Training Program in Smoking Cessation Interventions in Hospitals
Authors: Martínez Cristina , Castellano Yolanda , Andrés Ana , Fu Marcela , Feliu Ariadna , Antón Laura , Ballbè Montse , Fernández Paz , Cabrera Sandra , Riccobene Ana , Gavilan Eva , Baena Antoni , Margalef Mercè , Tigova Olena , Quirós Núria , Guillen Olga , Company Assumpta , Fernández Esteve 
Published: March 2019

AbstractPurposeTo assess changes in the self‐reported performance of smoking cessation interventions according to the 5A's model (Ask; Advise; Assess; Assist; and Arrange follow‐up) among clinicians; and to identify the main barriers and facilitators in smoking cessation implementation before and after an online smoking cessation training program.DesignPre‐post evaluation.MethodsWe assessed self‐reported smoking cessation interventions in the implementation of the 5A's model among clinicians working in Catalan hospitals (Spain). In addition, we assessed individual‐, behavioral‐, and organizational‐level factors that act as barriers and facilitators in the implementation of the 5A's model. We used a questionnaire of 63 items reflecting each of the 5A's performance (scored from 0 = none to 10 = most possible). The questionnaire was completed both immediately before and 6 months after the training. We analyzed the data of those participants who had a clinical role and answered pre‐ and post‐questionnaires. We used the nonparametric test for paired data (Wilcoxon) to examine changes in scores.FindingsA total of 127 clinicians completed the pre‐post questionnaire; 63.0% were registered nurses, 17.3% were nursing assistants, 7.9% were physicians, and 11.8% were other professionals (p < .001). Overall, there were significant increases in the implementation of the assist component (from a score of 4.5 to 5.2; p < .003) and arrange a follow‐up component (from 3.6 to 4.5; p < .001) of the intervention. Scores in the perception of the level of overall preparation, preparedness in using smoking cessation drugs, level of competence, and organizational recognition improved (p < .001) at the follow‐up; however, the score in the perception that implementing smoking cessation is part of their job decreased (from 6.3 to 4.4; p < .001).ConclusionsThe online training had a positive impact on the implementation of assist and arrange follow‐up components. Although self‐preparedness in the management of smokers increased, the motivation and involvement of key professionals decreased. Organizational factors related to the incorporation of resources (such as protocols, records, etc.) should be improved for the correct progression of smoking cessation interventions within the institutions.Clinical RelevanceSmoking cessation training programs should incorporate some motivational content to increase the engagement of health professionals in smoking cessation interventions in their clinical practice.
Cytokines and Cortisol – predictors of treatment response to corticosteroids in community‐acquired pneumonia?
Authors: Urwyler S. A. , Blum C. A. , Coslovsky M. , Mueller B. , Schuetz P. , Christ‐Crain M. 
Published: March 2019

AbstractBackgroundA previous study found community‐acquired pneumonia (CAP) patients with imbalance of high inflammation and discordantly low cortisol levels to benefit most from adjunctive corticosteroid treatment. Our aim was to validate this hypothesis in a preplanned secondary analysis of the randomized controlled STEP trial.MethodsPatients included in the STEP trial receiving 50 mg prednisone or placebo for 5 days were categorized based on pro‐inflammatory cytokines (Interleukin‐6/8/MCP‐1), CRP and cortisol levels on admission into four groups (high/low inflammation and high/low cortisol). The primary combined end‐point was mortality or ICU admission within 30 days.ResultsIn total, 632 patients (315 prednisone, 317 placebo) were included in this analysis. Prednisone did not significantly reduce the risk for the primary end‐point in patients with high cytokines/low cortisol and in any other subgroups. However, we noted some differences in the strength of corticosteroid effect in the different subgroups with stronger effects in patients with high cytokines [OR 0.44 (0.10,1.72)] compared to patients with low cytokines [OR 0.68 (0.30,1.5)] (P‐interaction = 0.600). The effects did not differ according to cortisol levels.ConclusionThe imbalance of high inflammation state and low cortisol levels did not predict treatment response to corticosteroids in patients with CAP. However, in line to previous research, inflammation as measured by cytokine levels irrespective of cortisol tended to predict treatment response to corticosteroids in CAP. Whether this concept may help to personalize corticosteroids to patients most likely benefitting from this treatment needs to be tested in future intervention trials.
CD117 immunoexpression in oral and sinonasal mucosal melanoma does not correlate with somatic driver mutations in the MAPK pathway
Authors: Maldonado‐Mendoza Jessica , Ramírez‐Amador Velia , Anaya‐Saavedra Gabriela , Ruíz‐García Erika , Maldonado‐Martínez Héctor , Fernández Figueroa Edith , Meneses‐García Abelardo 
Published: March 2019

BackgroundMutations on KIT and downstream genes of MAPK pathway that overstimulate cellular proliferation have been associated with primary oral and sinonasal melanomas (POSNM), but there is limited information that allows the use of personalized therapy. Thus, the aim of the present study was to determine a possible association between the C‐KIT immunohistochemical expression with the presence of somatic driver mutations in NRAS, BRAF, KIT, MITF and PTEN on POSNM.MethodsA retrospective study included 62 tumour samples of an oncological reference centre in Mexico City (17‐year period). Immunohistochemistry stain of C‐KIT was carried out. Genomic DNA was obtained and used to assess hotspot mutations of KIT, NRAS, BRAF, MITF and PTEN through qPCR. Chi‐square, Fisher's exact and the Mann‐Whitney U tests were applied when necessary. The significance was set at P < 0.05.ResultsSixty‐two cases were included, 74% were positive for C‐KIT immunoexpression, all exhibited moderate/strong intensity. Ten (16.1%) samples harboured at least one mutation, 6.4% and 6.6% for NRASQ61R and BRAFV600E, respectively, followed by KITK624E (3.2%). No KITL576P, MITF or PTEN mutations were identified. No significant correlation was observed between mutations and immunostaining (rs = −0.057, P = 0.765).ConclusionsRegardless of the high immunoexpression of C‐KIT, there was no association with the MAPK mutations among POSNM samples. Thus, C‐KIT immunohistochemistry is not a reliable tool to detect POSNM candidates for biological therapy.
A population pharmacokinetic model of vancomycin for dose individualization based on serum cystatin C as a marker of renal function
Authors: Liu Tao-tao , Pang Hui-mei , Jing Li , Wei Wen-xing , Qin Xiao-ling , Guo Qing , Lu Hua , Cheng Dao-hai , Jiang Wei-zhe 
Published: March 2019

Abstract

Objectives
This study aimed to establish a vancomycin population pharmacokinetics (PPK) model based on serum cystatin C and to optimize dosing for achieving targeted steady-state trough concentrations (Css) of 10–15 and 15–20 mg/l.

Methods
Patients aged ≥18 years were prospectively enrolled. A vancomycin PPK model was built with glomerular filtration rate (GFR) as a renal covariate estimated by cystatin C. A new group of patients were used for external evaluation. PPK analysis and Monte Carlo simulations were performed using nonlinear mixed effect modelling programme.

Key findings
Two hundreds of patients with 514 samples were included. The final model was CL (L/h) = (5.07 × (GFR/105.5)0.524 × (AGE/48.5)−0.309 × (WT/60)0.491); V (l) = 46.3. Internal and external evaluations demonstrated good stability and predictability. The average probability of target attainment (PTA) of optimal dosing regimens for targeted Css achieving 10–15 and 15–20 mg/l were 51.2% and 40.6%, respectively. An average PTA ≥71% for targeted concentration of 10–20 mg/l was obtained.

Conclusions
A vancomycin PPK model with cystatin C as the renal marker has good stability and predictability. The new proposed dosing regimens were predicted to achieve a good PTA.
The experience of mindful yoga for older adults with depression
Authors: Lee Ka Chun , Tang Wai Kit , Bressington Daniel 
Published: March 2019

Accessible summaryWhat is known on the subject?

Mindful yoga combines yoga techniques with the mindfulness‐based stress reduction approach.

Previous studies on mindful yoga have reported improvements in depression for working‐age adults, but no studies have been conducted with older people.

What the paper adds to existing knowledge?

Mindful yoga may be a safe and acceptable intervention to improve the mental and physical health of older adults with depression.

The beneficial therapeutic ingredients of mindful yoga, included calmness, being non‐judgmental, letting go and seizing the day.

What are the implications for practice?

Single‐sex mindful yoga groups may be more acceptable for some people.

Well‐conducted feasibility studies comparing mindful yoga with an alternative group‐based approach are necessary.

AbstractIntroductionMindful yoga combines yoga techniques with the mindfulness‐based stress reduction approach. Previous studies on mindful yoga have reported improvements in depression for working‐age adults, but no studies have been conducted with older people.AimsTo explore the experiences of older adults with depression participating in a mindful yoga group to establish whether the approach has potential as a future intervention for this client group.MethodThis study adopted a qualitative descriptive method and used inductive content analysis. Eighteen in‐depth individual interviews were conducted with nine participants (each participant had one interview following the programme and another four weeks later).ResultsSix main themes emerged: “improved physical status,” “actively involved in the community,” “positive psychological effects,” “perceived therapeutic ingredients,” “facilitators of practising mindful yoga” and “barriers to practising mindful yoga.”.DiscussionMost participants reported benefitting from the programme. Two male participants expressed that exercises were too challenging and more suited to women, suggesting single‐sex groups may be more acceptable.Implications for practiceMindful yoga may be an acceptable/useful intervention for older adults with depression, but future studies are required to establish its feasibility and potential efficacy.
Dysfunctional beliefs about sleep and insomnia symptoms in early adulthood: A twin and sibling study
Authors: Schneider Melanie N. , Kovas Yulia , Gregory Alice M. 
Published: March 2019

AbstractThis study examines the associations between dysfunctional belief about sleep (DBAS), its subtypes and insomnia symptoms and estimates the relative contribution of genetic and environmental influences to these variables and the associations between them. The data came from G1219, a twin/sibling study that comprises 862 individuals (aged 22–32 years, 34% male). The Insomnia Symptoms Questionnaire was used to measure insomnia symptoms and a 10‐item version of the Dysfunctional Beliefs and Attitudes about Sleep Scale was used to assess DBAS. A higher DBAS score was associated with more insomnia symptoms. Overall DBAS showed a mainly non‐shared environmental influence (86%). The genetic correlation between overall DBAS and insomnia symptoms was large but not significant, the shared environmental correlation was very small, negative and not significant, whereas a moderate, significant overlap in the non‐shared environmental influences was evident (non‐shared environmental correlation = 0.32). For the association between the subscales of DBAS and insomnia symptoms no significant overlap for genetic (weak to strong associations) or shared environmental factors (very weak negative to strong associations) was indicated. Most of the non‐shared environmental influences on the four variables were significantly moderately correlated (non‐shared environmental correlation = 0.24–0.46). These findings help to deepen our understanding of cognitive theories of insomnia by dissecting one of its crucial elements and illuminating the factors involved in its association with insomnia symptoms.
On the Nature of Banks
Authors: Angeles Luis 
Published: March 2019

SummaryTwo views exist regarding the nature of the banking business. The dominant view defines banks as financial intermediaries – institutions in the business of transferring money from savers to borrowers. An alternative view advances that banks finance borrowers via money creation. I explain the differences between these two views and argue for the superiority of the latter one as a description of modern banking. I discuss the implications for economic analysis and explain how the connection between bank lending and money creation helps us understand the effects of banking on economic activity.
Bayesian estimation of group sizes for a coastal cetacean using aerial survey data
Authors: Boyd Charlotte , Hobbs Roderick C. , Punt André E. , Shelden Kim E. W. , Sims Christy L. , Wade Paul R. 
Published: March 2019

AbstractMany small cetacean, sirenian, and pinniped species aggregate in groups of large or variable size. Accurate estimation of group sizes is essential for estimating the abundance and distribution of these species, but is challenging as individuals are highly mobile and only partially visible. We developed a Bayesian approach for estimating group sizes using wide‐angle aerial photographic or video imagery. Our approach accounts for both availability and perception bias, including a new method (analogous to distance sampling) for estimating perception bias due to small image size in wide‐angle images. We demonstrate our approach through an application to aerial survey data for an endangered population of beluga whales (Delphinapterus leucas) in Cook Inlet, Alaska. Our results strengthen understanding of variation in group size estimates and allow for probabilistic statements about the size of detected groups. Aerial surveys are a standard tool for estimating the abundance and distribution of various marine mammal species. The role of aerial photographic and video data in wildlife assessment is expected to increase substantially with the widespread uptake of unmanned aerial vehicle technology. Key aspects of our approach are relevant to group size estimation for a broad range of marine mammal, seabird, other waterfowl, and terrestrial ungulate species.
“I DON’T WANT MY TOWN TURNED INTO A SPECTACLE”: Community Museums as Tactics
Authors: Stern Pamela , Hall Peter V. 
Published: March 2019

AbstractThe former silver mining town of Cobalt, Ontario (pop. 1,128), has four history museums. The museums, created at different times and by different constituencies, reflect citizens’ ongoing efforts to revive the town and imagine its urban future. Over the past 50 years, residents have also engaged in multiple attempts to establish the town as a mining heritage tourism destination and/or to reestablish mining. Although the museums are implicated in both aspirations, we argue that they work to situate the memory work of local history within discrete spaces. While the museums have been recruited to support tourism and heritage efforts, they sit uncomfortably within grander schemes to remake the town as a tourist destination. Indeed, we argue that the museums serve as tactics, per de Certeau, to contain and restrict tourism‐oriented development. As vernacular spaces where residents have recorded local histories, the museums serve as statements about both what the town should be and what it should not be.
MEANINGFUL DONATIONS AND SHARED GOVERNANCE: Growing the Philippine Heritage Collection through Co‐Curation at the Field Museum
Authors: Matherne Neal , Quaintance Hannah 
Published: March 2019

AbstractIn this article, we ask the question, “How does an anthropology collection grow with an interested public in the early twenty‐first century?” We discuss the relationship between the Field Museum and the Chicago‐based Filipina/o community. The Field Museum facilitates interaction between community and institution, urging interested Filipina/o individuals from outside the museum to embrace stewardship of collections, thus becoming “co‐curators.” With the active involvement of co‐curators and museum professionals, an object collection becomes a site of heritage, benefiting from the combination of community knowledge and academic scholarship. We chronicle this museum/community relationship by interpreting a recent collaborative process: Filipina/o co‐curators were asked to submit recommendations regarding new additions to the Field Museum's Philippine Heritage Collection in the summer of 2016. Discussions around this process illuminate the complex relationship between the Filipina/o community and the Field Museum. We conclude with recommendations for other institutions that wish to pursue a similar museum/community collaboration.
A pneumococcal meningoencephalitis with a small spleen
Authors: Tsunoda Keiichiro , Sato Kota , Takahashi Yoshiaki , Tadokoro Koh , Sasaki Ryo , Nomura Emi , Takemoto Mami , Hishikawa Nozomi , Ohta Yasuyuki , Yamashita Toru , Abe Koji 
Published: March 2019

AbstractStreptococcus pneumoniae is a major cause of bacterial meningitis usually in children or elder adults. We report a case of a 38‐year‐old man having pneumococcal meningoencephalitis with a small spleen (35 cm3), compared to seven previous patients with pneumococcal meningitis in our department. Among the eight patients, four cases were due to sinusitis, but the origin could not be identified in the other four cases, including the present case who was the youngest patient with the smallest splenic size. Of interest in the present analysis was the negative or positive correlation between splenic size and age, with or without sinusitis. This is the first report on pneumococcal meningoencephalitis that takes into consideration age, splenic size, and the origin of infection.
Human pluripotent stem cell–derived models and drug screening in CNS precision medicine
Authors: Silva M. Catarina , Haggarty Stephen J. 
Published: March 2019

AbstractDevelopment of effective therapeutics for neurological disorders has historically been challenging partly because of lack of accurate model systems in which to investigate disease etiology and test new therapeutics at the preclinical stage. Human stem cells, particularly patient‐derived induced pluripotent stem cells (iPSCs) upon differentiation, have the ability to recapitulate aspects of disease pathophysiology and are increasingly recognized as robust scalable systems for drug discovery. We review advances in deriving cellular models of human central nervous system (CNS) disorders using iPSCs along with strategies for investigating disease‐relevant phenotypes, translatable biomarkers, and therapeutic targets. Given their potential to identify novel therapeutic targets and leads, we focus on phenotype‐based, small‐molecule screens employing human stem cell–derived models. Integrated efforts to assemble patient iPSC‐derived cell models with deeply annotated clinicopathological data, along with molecular and drug‐response signatures, may aid in the stratification of patients, diagnostics, and clinical trial success, shifting translational science and precision medicine approaches. A number of remaining challenges, including the optimization of cost‐effective, large‐scale culture of iPSC‐derived cell types, incorporation of aging into neuronal models, as well as robustness and automation of phenotypic assays to support quantitative drug efficacy, toxicity, and metabolism testing workflows, are covered. Continued advancement of the field is expected to help fully humanize the process of CNS drug discovery.
Learning resources and talent development from a systemic point of view
Authors: Ziegler Albert , Debatin Tobias , Stoeger Heidrun 
Published: March 2019

AbstractSystem theories postulate that a system needs resources in order to evolve and function as an entirety. According to the actiotope model of giftedness, exogenous and endogenous resources needed to develop excellence include five forms of educational capital (economic, cultural, social, infrastructural, and didactic) and five forms of learning capital (organismic, telic, actional, episodic, and attentional), independent of domain and level of talent development. In three studies, we addressed several blind spots in the empirical basis of the educational and learning capital (ELC) approach. The studies were conducted in different domains, with different samples, and on various levels of talent development, as well as with regard to different functions for which resources can be used. Study 1, comprising 365 sixth graders, showed that ELC have an incremental validity beyond IQ for predicting scholastic achievement. In study 2 with 90 women holding a university degree in science, technology, engineering, and mathematics (STEM), we provide evidence that in the collegiate actiotopes of women who were later successful in STEM, more ELC had been available and was used to serve different functions than in the actiotopes of less successful women in STEM. In study 3 with 74 long‐distance runners, we found a similar pattern of results for different achievement levels in an athletics domain.