bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tiredness of Life in Older persons: A Qualitative Study on Nurses’ Experiences of Being Confronted With This Growing Phenomenon
Authors: Van Humbeeck Liesbeth , Dillen Let , Piers Ruth , Van Den Noortgate Nele 
Published: May 2019

Abstract

Background and Objectives
With worldwide aging it is imperative to understand nurses’ perceptions of tiredness of life (ToL) and their ways of dealing with an increasingly common phenomenon. Most research on ToL relates to older individuals’ experiences. This study aimed to gain insight into nurses’ (a) perceptions of, (b) attitude(s) toward, and (c) ways of dealing with ToL in older patients.

Research Design and Methods
Qualitative study with elements of constructivist grounded theory. Data were collected by means of semi-structured interviews between February 2016 and June 2017 with a purposive sample of 25 nurses working in home care and nursing homes.

Results
A careful consideration indicative of an oscillation between 3 levels (e.g., behavioral, cognitive, and affective) is present. The confrontation with persons having ToL instigates a cognitive process of searching to understand the state a person is in, which on its turn ensues in an emotional balancing between courage and powerlessness and a behavioral approach of action or dialogue.

Discussion and Implications
Our findings indicate that nurses aim to provide good care, sensitive to the older person’s needs, but this process is not without ambiguity. This study provides nurse managers with valuable guidance to (a) support nursing staff in dealing with ToL, and (b) advance opportunities for emotionally sensitive care and (individual- and team-based) reflection. Finally, this study offers suggestions for education programs to incorporate ToL in curricula.
Seismic scatterers in the lower mantle near subduction zones
Authors: Kaneshima Satoshi 
Published: May 2019

SUMMARY
We investigate the global distribution of S-to-P scatterers in the shallow to mid-lower mantle beneath subduction zones, where deep seismicity extends down to the bottom of the upper mantle. By array processing broadband and short period waveform data obtained at seismic networks, we seek anomalous later phases in the P coda within about 15–150 s after direct P waves. The later phases usually arrive along off-great circle paths and significantly later than S-to-P conversion from the ‘660 km’ discontinuity, often show positive slowness anomalies relative to direct P, and do not show a conversion depth that is consistent among nearby events. They are thus adequately regarded as scattered waves, rather than conversion at a global horizontal discontinuity. The S-to-P scattered waves often show amplitudes comparable to ‘S660P’ waves, which indicates that a spatial change in elastic properties by several percent occurs at the scatterers as abruptly as the post-spinel transformation and should arise from compositional heterogeneity. We locate prominent S-to-P scatterers beneath Pacific subduction zones and beneath southern Spain. Nearly half of 137 S-to-P scatterers located in this study and previous studies by the authors are shallower than 1000 km, and the number of scatterers decreases with depth. Scatterers deeper than 1800 km are rare and mostly weak. We examine relations between the locations of the scatterers and recently subducted slabs inferred from seismic tomography. The scatterers of mid-mantle depths, deeper than about 1000 km, are located distant from tomographic slabs. On the other hand, the majority of shallower scatterers are located beneath the slabs rather than near their fastest portions, which would indicate that chemically heterogeneous materials are not extensively entrained within thickened and folded slabs when the slabs impinge on the lower mantle. We also find scatterers near the locations where basaltic rocks of recently subducted oceanic crust are expected to exist, which suggests that oceanic crust is not delaminating when slabs impinge on the lower mantle.
How to foster informed decision making about food supplements: results from an international Delphi study
Authors: de Vries Hein , Pajor Emï¿½lia M , Curfs Kenny C J , Eggers Sander M , Oenema Anke 
Published: May 2019

Abstract
Food supplement use can have beneficial and detrimental effects, making informed decisions about supplement use important. How these decisions are made and which communication strategies can stimulate informed decision making is unclear. This study identified the important characteristics of (i) informed decision making about food supplement use and (ii) important factors indicating how to communicate about food supplements to foster informed decision making. An online three-round Delphi study was conducted. International experts within the field of (risk) communication about food supplements or related fields were recruited via email. The participants' age ranged from 25 to 69 years, and sample sizes for the three rounds were 38, 89 and 51, respectively. Experts indicated that for making an informed decision about food supplement use one needs to have knowledge of their positive and negative effects, the ability to compare these effects, knowing alternatives besides supplements, feeling informed, and feeling able (self-efficacious) to make the decision and making the decision voluntarily. Important communication strategies mentioned were: provision of information about positive and negative effects and the nature of these effects including scientific evidence, ensuring information is easily accessible, well ordered, tailored and provided by a trustworthy, credible and independent source.
Regional entrepreneurial ecosystems in China
Authors: Lai Yanzhao , Vonortas Nicholas S 
Published: May 2019

Abstract
This study focuses on regional entrepreneurial ecosystems in the largest emerging economy in the world. We use a two-stage structural model distinguishing between two sets of factors, those that have direct impact on entrepreneurial activities and those that have indirect impact. Based on an empirical analysis of 263 Chinese prefecture-level municipalities from 2008 to 2015, we find that human capital, knowledge creation, and access to finance are the main factors that drive local entrepreneurial activity. New technology-based startups are significant predictors of the regional stock of human capital and the presence of risk finance suggesting the unique role of technology-based firms in promoting sustainable growth in regional entrepreneurial ecosystems. The presence of research-intensive universities also has a strong positive impact on regional entrepreneurial ecosystems.
Bott–Samelson Varieties and Poisson Ore Extensions
Authors: Elek Balázs , Lu Jiang-Hua 
Published: May 2019

AbstractWe show that associated with any $n$-dimensional Bott–Samelson variety of a complex semi-simple Lie group $G$, one has $2^n$ Poisson brackets on the polynomial algebra $A={\mathbb{C}}[z_1, \ldots , z_n]$, each an iterated Poisson Ore extension and one of them a symmetric Poisson Cauchon–Goodearl–Letzter (CGL) extension in the sense of Goodearl–Yakimov. We express the Poisson brackets in terms of root strings and structure constants of the Lie algebra of $G$. It follows that the coordinate rings of all generalized Bruhat cells have presentations as symmetric Poisson CGL extensions. The paper establishes the foundation on generalized Bruhat cells and sets the stage for their applications to integrable systems, cluster algebras, total positivity, and toric degenerations of Poisson varieties, some of which are discussed in the Introduction.
The Role of Iron in the Susceptibility of Neonatal Mice to Escherichia coli K1 Sepsis
Authors: Michels Kathryn R , Lambrecht Nathalie J , Carson William F , Schaller Matthew A , Lukacs Nicholas W , Bermick Jennifer R 
Published: May 2019

AbstractSepsis from Escherichia coli expressing the K1 antigen is a leading cause of death in neonates. In a murine model, E. coli K1 grew rapidly in the peritoneal cavity of neonatal mice, causing fatal disease. In contrast, adult mice cleared the infection. Neonatal mice mounted a rapid and equivalent antimicrobial immune response compared to adult mice. Interestingly, peritoneal fluid from neonatal mice contained significantly more total iron than that of adult mice, which was sufficient to support enhanced E. coli growth. Transient iron overload in adult mice infected with E. coli resulted in 100% mortality. Maternal diet–induced mild iron deficiency decreased offspring peritoneal iron, decreased bacterial growth, and conferred protection against sepsis. Taken together, neonatal susceptibility to E. coli K1 sepsis is enhanced by a localized excess of peritoneal iron that allows for unchecked bacterial growth. Targeting this excess iron may provide a new therapeutic target in human patients.
Theoretical modeling reveals that regulatory T cells increase T-cell interaction with antigen-presenting cells for stable immune tolerance
Authors: Yamaguchi Tomoyuki , Teraguchi Shunsuke , Furusawa Chikara , Machiyama Hiroaki , Watanabe Tomonobu M , Fujita Hideaki , Sakaguchi Shimon , Yanagida Toshio 
Published: May 2019

Abstract
The immune system in tolerance maintains cell diversity without responding to self-antigens. Foxp3-expressing CD25+CD4+ regulatory T cells (Tregs) inhibit T-cell activation through various molecular mechanisms. However, several key questions are still not resolved, including how Tregs control the immune response on the basis of their self-skewed T-cell receptor repertoire and how Tregs avoid impeding relevant immunity against pathogens. Here, we show that Tregs promote the proliferation of conventional T cells in the presence of excessive co-stimulation when murine T cells are stimulated in vitro with allogeneic antigen-presenting cells (APCs). Antigen-specific Tregs increase the number of cells interacting with dendritic cells (DCs) by increasing the number of viable DCs and the expression of adhesion molecules on DCs. Theoretical simulations and mathematical models representing the dynamics of T-APC interaction and T-cell numbers in a lymph node indicate that Tregs reduce the dissociation probability of T cells from APCs and increase the new association. These functions contribute to tolerance by enhancing the interaction of low-affinity T cells with APCs. Supporting the theoretical analyses, we found that reducing the T-cell numbers in mice increases the ratio of specific T cells among CD4+ T cells after immunization and effectively induces autoimmune diabetes in non obese diabetes mice. Thus, as a critical function, antigen-specific Tregs stabilize the immune state, irrespective of it being tolerant or responsive, by augmenting T-APC interaction. We propose a novel regulation model in which stable tolerance with large heterogeneous populations proceeds to a specific immune response through a transient state with few populations.
Adverse drug events and medication relation extraction in electronic health records with ensemble deep learning methods
Authors: Christopoulou Fenia , Tran Thy Thy , Sahu Sunil Kumar , Miwa Makoto , Ananiadou Sophia 
Published: May 2019

AbstractObjectiveIdentification of drugs, associated medication entities, and interactions among them are crucial to prevent unwanted effects of drug therapy, known as adverse drug events. This article describes our participation to the n2c2 shared-task in extracting relations between medication-related entities in electronic health records.Materials and MethodsWe proposed an ensemble approach for relation extraction and classification between drugs and medication-related entities. We incorporated state-of-the-art named-entity recognition (NER) models based on bidirectional long short-term memory (BiLSTM) networks and conditional random fields (CRF) for end-to-end extraction. We additionally developed separate models for intra- and inter-sentence relation extraction and combined them using an ensemble method. The intra-sentence models rely on bidirectional long short-term memory networks and attention mechanisms and are able to capture dependencies between multiple related pairs in the same sentence. For the inter-sentence relations, we adopted a neural architecture that utilizes the Transformer network to improve performance in longer sequences.ResultsOur team ranked third with a micro-averaged F1 score of 94.72% and 87.65% for relation and end-to-end relation extraction, respectively (Tracks 2 and 3). Our ensemble effectively takes advantages from our proposed models. Analysis of the reported results indicated that our proposed approach is more generalizable than the top-performing system, which employs additional training data- and corpus-driven processing techniques.ConclusionsWe proposed a relation extraction system to identify relations between drugs and medication-related entities. The proposed approach is independent of external syntactic tools. Analysis showed that by using latent Drug-Drug interactions we were able to significantly improve the performance of non–Drug-Drug pairs in EHRs.
Effect of sodium ions on conformations of the cytoplasmic loop of the PomA stator protein of Vibrio alginolyticus
Authors: Mino Taira , Nishikino Tatsuro , Iwatsuki Hiroto , Kojima Seiji , Homma Michio 
Published: May 2019

AbstractThe sodium driven flagellar stator of Vibrio alginolyticus is a hetero-hexamer membrane complex composed of PomA and PomB, and acts as a sodium ion channel. The conformational change in the cytoplasmic region of PomA for the flagellar torque generation, which interacts directly with a rotor protein, FliG, remains a mystery. In this study, we introduced cysteine mutations into cytoplasmic charged residues of PomA, which are highly conserved and interact with FliG, to detect the conformational change by the reactivity of biotin maleimide. In vivo labelling experiments of the PomA mutants revealed that the accessibility of biotin maleimide at position of E96 was reduced with sodium ions. Such a reduction was also seen in the D24N and the plug deletion mutants of PomB, and the phenomenon was independent in the presence of FliG. This sodium ions specific reduction was also detected in Escherichia coli that produced PomA and PomB from a plasmid, but not in the purified stator complex. These results demonstrated that sodium ions cause a conformational change around the E96 residue of loop2–3 in the biological membrane.
Characterization and Expression of Genes Encoding Superoxide Dismutase in the Oriental Armyworm, Mythimna separata (Lepidoptera: Noctuidae)
Authors: Li Hong-Bo , Dai Chang-Geng , He Yong-Fu , Hu Yang 
Published: May 2019

Abstract
Superoxide dismutase (SOD) is an antioxidant metalloenzyme that catalyzes the dismutation of the superoxide anion O2− to O2 and H2O2. Many studies have focused on the role of SOD in response to abiotic stress, but its role during biotic stress, such as changes in organismal population density, has rarely been investigated. The oriental armyworm, Mythimna separata, is an economically important pest that exhibits phenotypic changes in response to population density. Solitary and gregarious phases occur at low and high population density, respectively. To examine the role of SODs in response to population density stress, we cloned two genes encoding SOD, MsCuZnSOD and MsMnSOD, and compared their expression in solitary and gregarious phases of M. separata. The MsCuZnSOD and MsMnSOD ORFs were 480 and 651 bp and encoded predicted protein products of 159 and 216 amino acids, respectively. The two SODs contained motifs that are typical of orthologous proteins. Real-time PCR indicated that the two SOD genes were expressed throughout developmental stages and were significantly upregulated in more mature stages of gregarious M. separata. Expression of the two SOD genes in various tissues of sixth-instar larvae was higher in gregarious versus solitary insects. Furthermore, expression of the SOD genes was significantly upregulated in response to crowding in solitary individuals, but suppressed in gregarious insects subjected to isolation. Collectively, these results suggest that population density may be key factor in the induction of SOD genes in M. separata.
Traditional Cardiovascular Risk Factors and Individual Prediction of Cardiovascular Events in Childhood Cancer Survivors
Authors: Chen Yan , Chow Eric J , Oeffinger Kevin C , Border William L , Leisenring Wendy M , Meacham Lillian R , Mulrooney Daniel A , Sklar Charles A , Stovall Marilyn , Robison Leslie L , Armstrong Gregory T , Yasui Yutaka 
Published: May 2019

Abstract

Background
Childhood cancer survivors have an increased risk of heart failure, ischemic heart disease, and stroke. They may benefit from prediction models that account for cardiotoxic cancer treatment exposures combined with information on traditional cardiovascular risk factors such as hypertension, dyslipidemia, and diabetes.

Methods
Childhood Cancer Survivor Study participants (n = 22 643) were followed through age 50 years for incident heart failure, ischemic heart disease, and stroke. Siblings (n = 5056) served as a comparator. Participants were assessed longitudinally for hypertension, dyslipidemia, and diabetes based on self-reported prescription medication use. Half the cohort was used for discovery; the remainder for replication. Models for each outcome were created for survivors ages 20, 25, 30, and 35 years at the time of prediction (n = 12 models).

Results
For discovery, risk scores based on demographic, cancer treatment, hypertension, dyslipidemia, and diabetes information achieved areas under the receiver operating characteristic curve and concordance statistics 0.70 or greater in 9 and 10 of the 12 models, respectively. For replication, achieved areas under the receiver operating characteristic curve and concordance statistics 0.70 or greater were observed in 7 and 9 of the models, respectively. Across outcomes, the most influential exposures were anthracycline chemotherapy, radiotherapy, diabetes, and hypertension. Survivors were then assigned to statistically distinct risk groups corresponding to cumulative incidences at age 50 years of each target outcome of less than 3% (moderate-risk) or approximately 10% or greater (high-risk). Cumulative incidence of all outcomes was 1% or less among siblings.

Conclusions
Traditional cardiovascular risk factors remain important for predicting risk of cardiovascular disease among adult-age survivors of childhood cancer. These prediction models provide a framework on which to base future surveillance strategies and interventions.
A multi-institutional and case-matched control study on treatment outcomes of consolidative radiotherapy after a full course of R-CHOP compared with R-CHOP alone in Stage I–II diffuse large B-cell lymphoma (KROG 17-02)
Authors: Chung Mi Joo , Cho Won Kyung , Oh Dongryul , Eom Keun-Yong , Kim Jin Hee , Kim Woo Chul , Lee Jong Hoon 
Published: May 2019

Abstract
We compared treatment outcomes between rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy alone with R-CHOP followed by consolidative radiation therapy (RT) in diffuse large B-cell lymphoma (DLBCL). We analyzed 404 patients with Stage I–II DLBCL who received six to eight cycles of R-CHOP and achieved a good response after a full course of chemotherapy. Propensity-score matching was used to assess the role of consolidative RT. The R-CHOP alone group (n = 184) was matched in a 1:2 ratio with the R-CHOP plus RT group (n = 92). Twenty-four (13.0%) of 184 patients receiving R-CHOP alone and 8 (8.7%) of 92 patients receiving R-CHOP plus RT had bulky diseases (>7.5 cm). A Deauville score of 1–2 was achieved for 159 (86.4%) of 184 patients receiving R-CHOP alone and 84 (91.3%) of 92 patients receiving R-CHOP plus RT. After a median follow-up time of 42 months, the recurrence-free survival (RFS) rate (86.7% vs 93.0%, P = 0.464) and overall survival rate (88.3% vs 95.1%, P = 0.295) at 5 years did not differ significantly between the R-CHOP alone and R-CHOP plus RT arms. In the additional multivariate analyses, large tumor size (>7.5 cm) was significantly associated with decreased RFS (hazard ratio, 2.368 and confidence interval, 1.837–6.697; P = 0.048). Consolidative radiation was not a significant factor for RFS (P = 0.563). Tumor size was a significant factor for RFS in the rituximab era. The outcome of omitting consolidative RT for good responders after six to eight cycles of R-CHOP chemotherapy was acceptable in early-stage DLBCL without a bulky disease.
Regional and Rural–Urban Variation in Opioid Prescribing in the Veterans Health Administration
Authors: Lund Brian C , Ohl Michael E , Hadlandsmyth Katherine , Mosher Hilary J 
Published: May 2019

AbstractIntroductionOpioid prescribing is heterogenous across the US, where 3- to 5-fold variation has been observed across states or other geographical units. Residents of rural areas appear to be at greater risk for opioid misuse, mortality, and high-risk prescribing. The Veterans Health Administration (VHA) provides a unique setting for examining regional and rural–urban differences in opioid prescribing, as a complement and contrast to extant literature. The objective of this study was to characterize regional variation in opioid prescribing across Veterans Health Administration (VHA) and examine differences between rural and urban veterans.Materials and MethodsFollowing IRB approval, this retrospective observational study used national administrative VHA data from 2016 to assess regional variation and rural–urban differences in schedule II opioid prescribing. The primary measure of opioid prescribing volume was morphine milligram equivalents (MME) dispensed per capita. Secondary measures included incidence, prevalence of any use, and prevalence of long-term use.ResultsAmong 4,928,195 patients, national VHA per capita opioid utilization in 2016 was 1,038 MME. Utilization was lowest in the Northeast (894 MME), highest in the West (1,368 MME), and higher among rural (1,306 MME) than urban (988 MME) residents (p &lt; 0.001). Most of the difference between rural and urban veterans (318 MME) was attributable to differences in long-term opioid use (312 MME), with similar rates of short-term use.ConclusionThere is substantial regional and rural–urban variation in opioid prescribing in VHA. Rural veterans receive over 30% more opioids than their urban counterparts. Further research is needed to identify and address underlying causes of these differences, which could include access barriers for non-pharmacologic treatments for chronic pain.