bluuebunny/crossref_metadata_2025 huggingface dataset:
What makes court-referred mediation effective?
Authors: Galin Amira
Published: February 2014

Purpose

– The purpose of this paper is to obtain insight into court-referred mediation in the Israeli Labor Courts, by analyzing its processes and outcomes, as a function of tactics used by both the disputants and the mediator.

Design/methodology/approach

– Observation of 103 court-referred mediations, for each of which a detailed process and outcome were documented. Data on disputants' refusal to participate in the mediation was also collected. At the end of each mediation case, disputants were given a questionnaire in which they expressed their satisfaction with the outcome and their evaluation of the mediator's contribution.

Findings

– A low rate of refusal to participate in court-referred mediation was found. Also, the higher the ratio of soft tactics to pressure tactics employed (by all parties involved) during the process, the higher the rate of agreements. Mediators use significantly more soft tactics than disputants, and are more active in using tactics. The two significant variables that predict the mediation's agreement are the ratio between soft tactics to pressure tactics used by all parties, and mediator contribution to the process.

Practical implications

– The significant role of soft tactics in the process, outcome, and satisfaction of court-referred mediation may serve as a guideline for disputants and mediators.

Originality/value

– This unique research, which examines the impact of tactics on court-referred mediation, may provide added and significant theoretical insight into its process and outcome, as well as a better understanding of other “hybrid” (compulsory at the beginning, voluntary at the end) mediations.
Strategy to motivate and facilitate compromise in Chinese mediation
Authors: Deng Yiheng , Xu Kaibin
Published: February 2014

Purpose

– This paper aims to explore language strategies and techniques in Chinese mediation that are adopted by mediators to motivate and facilitate compromise among disputants.

Design/methodology/approach

– Ten cases were audio-recorded on the spot, transcribed for analysis in their Chinese form, and then translated into English for English readers. The translation of excerpts used in this paper to demonstrate points was double checked to ensure accuracy. Discourse analysis was adopted to explore the meanings and functions of the utterances in these excerpts.

Findings

– It is found that power is embedded in the mediator's position and in his/her role in the mediation. Furthermore, neutrality is less of a concern as compared to justice in the mediator's terms. Finally, socio-cultural indications of the language strategies and techniques were drawn about contemporary Chinese society.

Practical implications

– When dealing with Chinese people in conflict, one may emphasize common goals and bring in external reasons such as seniority, face, and status to motivate and facilitate compromise.

Originality/value

– Studying transcripts of cases that were recorded in real time and recently is rare in studies of Chinese mediation. Studying what people actually say provides us data in reality, in contrast to the ideals as well as what they say they do in mediation.
Developing a hospital quality improvement initiative in Lesotho
Authors: Berman Joshua , Limakatso Nkabane Elizabeth , Malope Sebaka , Machai Seta , Jack Brian , Bicknell William
Published: February 2014

Purpose

– Hospital-based quality improvement (QI) programs are becoming increasingly common in developing countries as a sustainable method of strengthening health systems. The aim of this paper is to present the results and lessons learned from a QI program in a large, rural, district hospital in Lesotho, Southern Africa.

Design/methodology/approach

– Over a 15-month period, a locally-relevant, hospital-wide QI program was developed and implemented. The QI program consisted of: planning meetings with district and hospitals staff; creation of multi-disciplinary QI teams; establishment of a QI steering committee; design and implementation of a locally appropriate QI curriculum; and monthly consultation from technical advisers. Initial QI programming was developed in three distinct areas: maternity care, out-patient care, and referral systems.

Findings

– Partogram documentation in the maternity department increased by 78 percent, waiting time for critically ill patients in the out-patient department was reduced by 84 percent, and emergency referral times were reduced by 58 percent.

Originality/value

– The design and early implementation of QI programs should focus on easily achievable, locally-relevant improvement projects. It was found that early successes helped to fuel further QI gains and the authors believe that the work building sustainable QI skill sets within hospital staff could be useful in the future when attempting to tackle larger national-level quality of care indicators. The findings add to the existing evidence suggesting that an increased use of locally-relevant quality improvement programming could help strengthen health care systems in low resource settings.
ACE inhibitors and potassium foods – nurses' knowledge
Authors: Bertrand Brenda , Livingston-Bowen Carrie , Duffrin Christopher , Mann Amanda
Published: February 2014

Purpose

– According to Joint Commission standards, patients should be educated about drug-nutrient interactions. Because nurses are well-suited to educating patients, this paper aims to assess their knowledge of ACE inhibitor drugs, nutrient interactions and high- and low-potassium foods.

Design/methodology/approach

– Licensed nurses from a teaching hospital in the US south eastern Atlantic region completed a self-administered questionnaire (n=83). Means, standard deviations and 95 percent confidence intervals were calculated for continuous data and frequency and percentage distribution for discrete data. Student's t-test was used to evaluate responses by ACE inhibitor patient load and nursing education.

Findings

– Mean nurse knowledge of ACE inhibitors and potassium was 62±16 percent and identifying high- and low-potassium foods was 32±23 percent. Most identified five from 12 high-potassium foods and did not know the designation of six, one from 14 low-potassium foods and did not know the designation of 11. Knowledge scores and identifying high- and low-potassium foods were similar regardless of ACE inhibitor patient load and nursing education.

Practical implications

– ACE inhibitors are the fourth most commonly used drug class in the USA. Nurses are well positioned to recognize potential drug-nutrient interactions owing to changing or adding a drug, dose delivery method, dietary change or a patient's physical or clinical status that may indicate nutrient deficiency. The findings suggest that the nurses surveyed were proficient in identifying ACE inhibitors pharmacology, but that most were unable to identify foods that increase drug-nutrient interaction risk, and thus this is an area in which additional training might be beneficial.

Originality/value

– Case menus were used to portray real-life scenarios in which healthcare practitioners can provide patient education about ACE inhibitor drug and dietary potassium interactions.
Quality of coroner's post-mortems in a UK hospital
Authors: Al Mahdy Husayn
Published: February 2014

Purpose

– The aim of this paper was, principally, to look at the coroner's post-mortem report quality regarding adult medical patients admitted to an English hospital; and to compare results with Royal College of Pathologists guidelines.

Design/methodology/approach

– Hospital clinical notes of adult medical patients dying in 2011 and who were referred to the coroner's office to determine the cause of death were scrutinised. Their clinical care was also reviewed.

Findings

– There needs to be a comprehensive approach to coroner's post-mortems such as routinely taking histological and microbiological specimens. Acute adult medical patient care needs to improve.

Research limitations/implications

– Steps should be taken to ensure that comprehensive coroner's post-mortems are performed throughout the UK, including with routine histological and microbiological specimens examination. Additionally, closer collaboration between clinicians and pathologists needs to occur to improve emergency adult medical patient clinical care.

Originality/value

– The study highlights inadequacies in coroner's pathology services.
Adult protection training for community nurses: evaluating knowledge following delivery using participant-favoured training methods
Authors: Campbell Martin
Published: February 2014

Purpose

– The purpose of this paper is to measure nurses’ knowledge about Adult Support and Protection (Scotland) Act 2007 before and after a one-day training course using participants’ favoured methods of training activities.

Design/methodology/approach

– A repeated measures design was used to evaluate the impact of a one-day Adult Support and Protection training on pre-training knowledge of community nurses across one NHS area. Participants’ favoured methods of training activities were used in the training. Participants were community nurses working in learning disability, mental health, older people's services, acute services, substance misuse, and accident and emergency. All completed a training needs analysis and training preferences study. Individual and group scores on an Adult Support and Protection knowledge questionnaire were analysed pre- and post-training.

Findings

– There was a statistically significant increase in scores post-training (Wilcoxon's signed-ranks test). Individual increases ranged from 2.5 to 27.5 per cent, with a mean score of 15 per cent. Evaluation of the impact of nationally approved Adult Support and Protection training is needed and training should take account of participants’ existing knowledge and preferred methods of training delivery to improve the transfer of learning into practice.

Research limitations/implications

– Participants were self-selecting. Existing knowledge was not controlled for in the sample. No longitudinal follow up to measure retention of any improvements in knowledge. No control group. Training methods used were based on the expressed preferences of 40 nursing staff, but only 18 of these staff participated in the training day.

Originality/value

– There is a dearth of research in evaluating the impact of the adult protection training on staff knowledge and understanding. Designing training activities and content to take account of participant preferences, and areas where knowledge is weakest may enhance the effectiveness of training in this area. This research was funded as a Queens Nursing Institute Community Project. It builds on a pilot project
Discovering the unfolding of service innovations
Authors: von Koskull Catharina , Strandvik Tore
Published: February 2014

Purpose

– This paper aims to explore and demonstrate how an ethnographic research approach can reveal new aspects of the dynamics of service innovation processes. In contrast to the retrospective research approach found in most service innovation research, the ethnographic approach captures the innovation process as it unfolds.

Design/methodology/approach

– An ethnographical investigation of an incremental service innovation at a bank was conducted. The innovation activities were performed jointly by a team of bank members from various functions and external business partners. This was a formal project with a pre-specified plan, budget, and timetable.

Findings

– The ethnographical approach, capitalizing on its real-time, multi-methods, longitudinal, and up-close characteristics, made it possible to capture unforeseen events and issues at the micro level. The authors suggest that such critical events determine what direction the innovation process takes. The initial intentions and plans were partly realized; new issues emerged during the innovation work and were realized, while other emergent issues were finally not realized.

Research limitations/implications

– The study suggests a framework that can be used to identify four categories of micro-level processes. Critical events in the micro-level processes represent potential turning points and are important foci in practice and remain issues for further research.

Practical implications

– Managers may benefit from being open to including emergent issues and understanding the micro-level dynamics of the innovation process.

Originality/value

– This study illustrates how the ethnographic research approach captures the dynamics of innovation processes and the potential challenges and possibilities for innovation managers. This finding suggests the need to address micro-level dynamics.
Organizational processes for B2B services IMC data quality
Authors: Zahay Debra , Peltier James , S. Krishen Anjala , E. Schultz Don
Published: February 2014

Purpose

– The objective of this paper is to investigate IMC metrics in the lens of an institution-wide change management process, and to do so, the authors develop and test an organizational data quality enhancement model.

Design/methodology/approach

– Qualitative research was conducted, with a follow-on quantitative pre-test. A subsequent, larger-scale quantitative survey resulted in a total of 128 responses, 124 useable. A regression analysis was conducted using the factor scores of the six organizational dimensions as independent variables and overall data quality as the dependent variable.

Findings

– The findings show that overcoming poor IMC data quality requires a corporate culture that reduces cross-functional and departmental divides. The authors also support the idea that horizontally organized learning organizations not only have superior IMC data, but they also achieve higher rates of return on their cross-platform IMC efforts.

Research limitations/implications

– The research has limitations in terms of substantive generalizability, since it focuses on one industry within the USA. Future research can expand to other industries and expand to a global setting in order to replicate these findings.

Practical implications

– Most improvement seems to be needed in the area of sharing customer data. The findings provide a signal to marketing organizations that want to connect with their customers that data quality must be a strategic priority, with appropriate processes in place to manage data at every touch point.

Originality/value

– Research is needed that establishes effective methods for measuring the success of data-driven communication efforts to support management.
Communication technology in international business-to-business relationships
Authors: Chelariu Cristian , Osmonbekov Talai
Published: February 2014

Purpose

– This study aims to examine the antecedents and performance consequences of three types of communication technology (phone, e-mail and internet) in cross-border business-to-business relationships.

Design/methodology/approach

– Based on the proposed theoretical framework six hypotheses are advanced and tested. The authors use regression analysis on data from a survey of American exporters combined with secondary data on emerging European markets.

Findings

– This research finds that relationship-level variables are better predictors of ICT use than country-level variables, and that ICT use impacts dyadic performance. More specifically, information exchange predicted all three communication modes, while the use of warnings predicted both inter-personal communication methods. From an institutional standpoint, the authors find that bureaucratic barriers predict both phone and e-mail communication. At the firm level, it is found that firm-level technological skills are a significant predictor for the use of internet-based data exchange. The paper also finds that increased frequency of phone and e-mail communication among dyadic partners improves performance.

Research limitations/implications

– Although micro-level variables are found to be more important, country variables still bring interesting insights and should not be ignored. Also, newer technologies should be explored in future research.

Originality/value

– The authors explore antecedents of information/communication technology (ICT) use at three levels: country or macro level, dyadic (or inter-firm relationship) level, and firm capabilities (intra-firm). At the country level, the authors move beyond infrastructure to examine the impact of institutional factors, such as government red tape. At the relationship level, the authors include trust-type social norms, but extend the analysis to incorporate the use of unilateral influence attempts, such as warnings.
Pan London personalised budgets for rough sleepers
Authors: Blackender Liz , Prestidge Jo
Published: February 2014

Purpose

– The purpose of this paper is to positively confirm a new and different approach used to engage with entrenched rough sleepers, using the more personalised approach already adopted in social care.

Design/methodology/approach

– This is a first hand experience of the impact of the approach.

Findings

– That a personalised approach can achieve positive results with a hard to reach client group.

Originality/value

– This is the first published paper on this particular project.
Networked new service development process: a participant value perspective
Authors: Makkonen Hannu , Komulainen Hanna
Published: February 2014

Purpose

– The purpose of this paper is to shed light on perceived value for the participating actors during the new service development (NSD) process. The authors are particularly interested in how participant value emerges in a multi-actor NSD process and how it can be conceptualized.

Design/methodology/approach

– The empirical research design comprised three extensive living lab experiments in a real end-user environment over a three years period.

Findings

– The study is illustrative by its nature and advances two main arguments through conceptual analysis and empirical illustration: NSD can be seen as the identification of actual and emerging needs and technologies and their matching; and the matching process builds on the interaction between the participants and is characterized by their individual motives to leverage the NSD process for value-in-context.

Practical implications

– A careful investigation of the different stakeholders' expectations of the NSD process provides a basis on which to create lucrative value propositions instead of approaching potential stakeholders with technology- or product-centric arguments.

Originality/value

– The paper opens avenues for further research to develop the current conceptualizations of NSD in launching the new service emergence perspective.
Linking justice, trust and innovative work behaviour to work engagement
Authors: A. Agarwal Upasna
Published: February 2014

Purpose

– The purpose of this paper is to examine the effects of contextual variables – organisational justice (procedural justice, interactional justice and psychological contract) and trust – on work engagement.

Design/methodology/approach

– The paper reports a quantitative study of 323 managers working in manufacturing and pharmaceutical organisations based in western India. Drawing from social exchange theory, this paper tests the mediating role of trust in the justice-engagement relationship. The paper also investigates the effect of work engagement on employees' innovative work behaviour.

Findings

– Results suggest that procedural justice, interactional justice and psychological contract fulfilment are positively related to work engagement with trust as the mediating element. Engagement significantly influences employees' innovative work behaviour

Research limitations/implications

– The data were collected cross-sectionally, which means that causal inferences must be made with caution. Moreover, the data were collected from a single source. Nevertheless, the findings have implications for contemporary leadership and organisational psychology research and practice in a novel geographic context.

Originality/value

– This study is one of the rare attempts to examine the influence of three justice variables and trust on work engagement. The study also contributes in terms of its context. With an increasing number of multinationals starting operations in India, an understanding of employee motivation has become an important concern. This research examines engagement levels of Indian managerial employees.
Perceived organizational politics, emotional intelligence and work outcomes
Authors: Meisler Galit , Vigoda-Gadot Eran
Published: February 2014

Purpose

– This study aims to examine the relationship between perceived organizational politics and emotional intelligence, and their interplay in the context of work attitudes/behaviors.

Design/methodology/approach

– A sample of 368 employees was used to test a mediation effect of perceived organizational politics on the relationship between emotional intelligence on the one hand, and job satisfaction, turnover intentions and negligent behavior on the other.

Findings

– Perceived organizational politics was found to mediate the relationship between emotional intelligence and all three outcomes.

Practical implications

– Emotional intelligence training may be a powerful tool that organizations and human resource managers can employ to reduce perceived organizational politics and enhance work attitudes and performance.

Originality/value

– This research broadens the scope through which the intersection between emotion and organizational politics can be viewed, taking it beyond the role of both felt emotion and affective disposition. The findings show that emotional intelligence directly affects perceptions of politics, and indirectly affects employees' work attitudes and behaviors, through a mediation effect of perceived politics.
Organizational rewards: considering employee need in allocation
Authors: Webb Day Jillian , L. Holladay Courtney , K. Johnson Stefanie , G. Barron Laura
Published: February 2014

Purpose

– The purpose of this study is to investigate how employee need relates to rewards and employee perceptions of fairness within an organization in the USA using a pay-for-performance system.

Design/methodology/approach

– To evaluate the presence of a relationship between employee need and reward allocation in a pay-for-performance system, a questionnaire was administered to a sample of 292 employees from two departments at an academic medical center.

Findings

– The findings highlight the positive relationship between employee need and reward allocation that remains when controlling for employee performance evaluation ratings. Findings further show that employee communication with the manager about need explains this relationship.

Research limitations/implications

– The findings make two important contributions to research on reward allocation and performance management. First, the results show employee need is related to the allocation of rewards in organizational settings outside of collectivistic cultures or developing countries. Second, by demonstrating the role of employee communication with managers about need within the relationship between employee need and reward allocation, the paper provides a more detailed understanding of additional factors related to compensation decisions in a pay-for-performance system.

Originality/value

– Little research has explored the relationship between employee need and reward decisions at an individual level in organizational settings within individualistic cultures. The findings from this study address this gap by establishing the presence of this relationship in a pay-for-performance reward-based organization with service-based values. This finding is timely due to the current economic downturn experienced by organizations, and thereby the level of employee need observed in Western individualistic cultures.
Prevalence and risk of Down syndrome in monozygotic and dizygotic multiple pregnancies in Europe: implications for prenatal screening
Authors: Boyle B , Morris JK , McConkey R , Garne E , Loane M , Addor MC , Gatt M , Haeusler M , Latos‐Bielenska A , Lelong N , McDonnell R , Mullaney C , O'Mahony M , Dolk H
Published: February 2014

Objective

To determine risk of Down syndrome (DS) in multiple relative to singleton pregnancies, and compare prenatal diagnosis rates and pregnancy outcome.

Design

Population‐based prevalence study based on EUROCAT congenital anomaly registries.

Setting

Eight European countries.

Population

14.8 million births 1990–2009; 2.89% multiple births.

Methods

DS cases included livebirths, fetal deaths from 20 weeks, and terminations of pregnancy for fetal anomaly (TOPFA). Zygosity is inferred from like/unlike sex for birth denominators, and from concordance for DS cases.

Main outcome measures

Relative risk (RR) of DS per fetus/baby from multiple versus singleton pregnancies and per pregnancy in monozygotic/dizygotic versus singleton pregnancies. Proportion of prenatally diagnosed and pregnancy outcome.

Statistical analysis

Poisson and logistic regression stratified for maternal age, country and time.

Results

Overall, the adjusted (adj) RR of DS for fetus/babies from multiple versus singleton pregnancies was 0.58 (95% CI 0.53–0.62), similar for all maternal ages except for mothers over 44, for whom it was considerably lower. In 8.7% of twin pairs affected by DS, both co‐twins were diagnosed with the condition. The adjRR of DS for monozygotic versus singleton pregnancies was 0.34 (95% CI 0.25–0.44) and for dizygotic versus singleton pregnancies 1.34 (95% CI 1.23–1.46). DS fetuses from multiple births were less likely to be prenatally diagnosed than singletons (adjOR 0.62 [95% CI 0.50–0.78]) and following diagnosis less likely to be TOPFA (adjOR 0.40 [95% CI 0.27–0.59]).

Conclusions

The risk of DS per fetus/baby is lower in multiple than singleton pregnancies. These estimates can be used for genetic counselling and prenatal screening.
Neuro‐behçet's disease in South Korea: clinical characteristics and treatment response
Authors: Yoon Da‐Lim , Kim You Jae , Koo Bon San , Kim Yong‐Gil , Lee Chang‐Keun , Yoo Bin
Published: February 2014

Aim

Neuro‐behçet's disease (NBD) is a rare complication of Behçet's disease (BD) but is still important due to its morbidity and mortality. In this study, we sought to identify the characteristics of NBD by examining the clinical characteristics, and whether there were differences in the clinical characteristics or the treatment between relapsed and non‐relapsed groups.

Methods

We retrospectively reviewed the medical history of all patients diagnosed with BD at the Asan Medical Center in South Korea from January 1996 to May 2012. NBD was defined as neurological symptoms and compatible abnormalities identified by magnetic resononance imaging.

Results

Among 624 BD patients, 22 were diagnosed with NBD. The common initial neurological symptoms were headache, gait disturbance and dysarthria. The common involved sites were the diencephalon, including internal capsule, the thalamus and basal ganglia, followed by the brainstem. An increased signal intensity on T2‐weighted images was the most common finding. All patients had an improved disease state after steroid treatment, regardless of combined treatment with cyclophosphamide. However, eight patients experienced a disease recurrence at 7.3 ± 5.1 months after treatment. There were no significant differences in treatment patterns between the relapsed group and the non‐relapsed group.

Conclusions

NBD may present with various neurologic manifestations with multifocal diencephalon and brainstem involvement. Most NBD patients had a good clinical outcome after steroid treatment, with or without a cytotoxic agent, but showed a pattern of relapse–remission. Therefore, careful long‐term follow‐up is needed in most cases of NBD.
Pulmonary manifestation as initial presentation for systemic lupus erythematosus
Authors: Khor Chiew Gek , Kan Sow Lai , Tan Bee Eng
Published: February 2014

We report a 29‐year‐old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.
Caries experience, mutans streptococci and total protein concentrations in children with protein‐energy undernutrition
Authors: Ribeiro T Rodrigues , Alves K Shangela da Silva , de Miranda Mota AC , Costa D Pereira , de Carvalho C Barreto Mano , Santos CF , Monteiro AJ , Fonteles CSR
Published: February 2014

Background

The highest prevalence of protein‐energy undernutrition is observed during early childhood, being also a time in which the presence of dental caries can be unusually aggressive. The present study aimed to verify if different levels of undernutrition could influence the risk of early childhood caries (ECC), in the presence of other predisposing factors.

Methods

One hundred and twenty undernourished 12–70 month old children, with or without ECC, were selected. Undernourished children were classified as being mildly, moderately or severely undernourished. All children were examined for determination of decayed, missing and filled surfaces (dmfs). Total protein concentration in saliva was analysed by the Bradford method. For microbiological analysis, mitis salivarius‐bacitracin agar medium was used. A binary logistic regression model was applied to test the simultaneous influence of different variables over caries experience.

Results

The risk of ECC was significantly higher with an increase in age (p = 0.000) and mutans streptococci counts (p = 0.032). Comparisons with the normal‐weight group showed that mildly (p = 0.004) and severely undernourished children (p = 0.037) had a higher risk of experiencing ECC, but this risk was not significantly elevated among moderately undernourished children (p = 0.158).

Conclusions

Our results suggest that mildly and severely undernourished children have an increased risk of experiencing dental caries. Age is highly associated with the disease in this population.
Why group & save? Blood transfusion at low‐risk elective caesarean section
Authors: Stock Owen , Beckmann Michael
Published: February 2014

Women undergoing elective caesarean section (CS) routinely have a group and save ordered as part of their preoperative assessment, whereas women with expected vaginal birth do not. Our aim was therefore to determine the rate of blood transfusion at elective CS compared with vaginal birth in a large Australian maternity hospital. A retrospective cohort study was performed using routinely collected de‐identified data of 35 477 women, over 4 years, who delivered at the Mater Mothers’ Hospital, Brisbane, Australia. After excluding women with established risk factors for transfusion, the likelihood of blood transfusion following elective CS was significantly lower compared to vaginal birth (aOR 0.47 (0.29, 0.77)).
The NIFTY study: A multicentre randomised double‐blind placebo‐controlled trial of nifedipine maintenance tocolysis in fetal fibronectin‐positive women in threatened preterm labour
Authors: Parry Emma , Roos Carolien , Stone Peter , Hayward Lynsey , Mol Ben Willem , McCowan Lesley
Published: February 2014

Objective

In an unselected group of women with signs of preterm labour, maintenance tocolysis is not effective in the prevention of preterm birth and does not improve neonatal outcome. Among women with signs of preterm labour, those who are fetal fibronectin positive have an increased risk of preterm birth. We investigated whether maintenance tocolysis with nifedipine would delay delivery and improve neonatal outcome in women with threatened preterm labour and a positive fetal fibronectin status.

Study Design

Women with a singleton pregnancy in threatened preterm labour (24+0 to 33+6 weeks) with a positive fetal fibronectin test were randomised to nifedipine or placebo. Study medication was continued until 36 completed weeks' gestation. The primary endpoint was prolongation of pregnancy of seven days. Secondary endpoints were gestational age at delivery and length of NICU admission.

Results

Of the 60 participants, 29 received nifedipine and 31 placebo. Prolongation of pregnancy by >7 days occurred in 22/29 (76%) in the nifedipine group and 25/31 (81%) in the placebo group (relative risks, RR 0.94 [0.72–1.2]). Gestational age at delivery was 36.1 ± 5.1 weeks for nifedipine and 36.8 ± 3.6 weeks for placebo (P = 0.027). Length of NICU admission [median (interquartile ranges, IQR)] was 27 (24–41) days and 16 (8–37) days in nifedipine and placebo groups, respectively (P = 0.17).

Conclusion

In women with threatened preterm labour who are fetal fibronectin positive, maintenance tocolysis with nifedipine does not seem to prolong pregnancy, nor reduce length of NICU admission.
Menses, fertility and pregnancy following the use of balloon tamponade technology in the management of postpartum haemorrhage
Authors: Georgiou Christos
Published: February 2014

This manuscript describes five cases of pregnancies and births in women that have previously required the uterine‐specific Bakri™ balloon in the management of postpartum haemorrhage. In addition, this manuscript reviews the impact on menses, fertility and subsequent pregnancies as potential surrogate effects on the myometrium and endometrium, when balloon tamponade technology is used as a ‘uterine‐sparing’ second‐line approach in the management of postpartum haemorrhage.
Clinicoplacental phenotypes vary with gestational age: an analysis by classical and clustering methods
Authors: Stanek Jerzy , Biesiada Jacek , Trzeszcz Martyna
Published: February 2014

Objective

As the patterns and frequency of maternal and clinical conditions and outcomes and gross and histological placental features and lesions vary with gestational age at delivery, we aimed to study the impact of these changes on the placental diagnosis, hoping to uncover potential novel clusters of gestational age‐associated clinical and pathological diagnoses.

Design

Retrospective statistical analysis of clinicoplacental database.

Population

We analyzed 28 clinical (maternal and fetal) and 49 gross and microscopic placental variables from 3294 consecutively signed placentas received between 2001 and 2012, divided into three gestational age groups: 16–27 weeks, 697 cases; 28–36 weeks, 1365 cases; and 37+ weeks, in all 1232 cases.

Methods

Classical statistics by chi‐squared and Fischer's tests, and the Ward agglomerative hierarchical clustering and multidimensional scaling techniques, were used.

Results

The placental phenotypes clustered statistically significantly with severe preeclampsia in the second trimester; preterm premature rupture of membranes, placental abruption, and fetal growth restriction in the whole third trimester; and abnormally invasive placenta, thick meconium, maternal diabetes mellitus, and substance abuse in term pregnancies.

Conclusions

The applied statistical analyses made it possible to simultaneously compare the strength of clinicoplacental associations separately in three pregnancy intervals. Placental clinicopathological associations are strongest for the second trimester, i.e. severe preeclampsia and preterm ascending infection‐related conditions, but were not significant for other pregnancy complications such as mild preeclampsia, chronic hypertension, diabetes mellitus, or umbilical cord compromise.
Low intravitreal angiopoietin‐2 and VEGF levels in vitrectomized diabetic patients with simvastatin treatment
Authors: Tuuminen Raimo , Sahanne Sari , Loukovaara Sirpa
Published: February 2014

Purpose

To investigate the intravitreal levels of potent vasoactive, angiogenic and extracellular matrix remodelling factors in the diabetic patients with simvastatin treatment.

Methods

This is an institutional, prospective, observational case–control study. Type‐1 and type‐2 diabetic patients on lipophilic simvastatin (N = 14) compared with patients without statin medication (N = 50). Vitreous samples were subjected to protein measurements of angiopoietin (Ang)‐1 and Ang‐2, erythropoietin (EPO), transforming growth factor (TGF)‐β1, vascular endothelial growth factor (VEGF) by ELISA and matrix metalloproteinase (MMP)‐2 and MMP‐9 by gelatin zymography.

Results

Intravitreal levels of Ang‐2 (p = 0.029), VEGF (p = 0.001) and proMMP‐9 (p = 0.015) were lower in simvastatin‐treated than in non‐statin‐treated controls. In diabetics with macular oedema (DME), intravitreal Ang‐2 (p = 0.006) and VEGF (p = 0.002) levels were lower in simvastatin‐treated patients compared with non‐statin‐treated controls. In those patients with proliferative diabetic retinopathy (PDR), intravitreal Ang‐2 (p = 0.002), TGF‐β1 (p = 0.037), VEGF (p = 0.001) and pro‐ and totalMMP‐9 (p = 0.004 and p = 0.007) levels were lower when receiving simvastatin medication.

Conclusions

In diabetic patients with DME or PDR, the intravitreal levels of permeability and proangiogenic factors Ang‐2 and VEGF were lower in simvastatin‐treated than in those without statin medication. Moreover, the levels of MMP‐9 and TGF‐β1, factors involved in the breakdown of basement membrane and fibroproliferation, were lower in patients with PDR having simvastatin medication. When acetylsalicylic acid was combined with simvastatin treatment, the intraocular levels of Ang‐2 and VEGF were significantly lower than in diabetics treated with simvastatin alone. These data provide a novel insight into the potential protective mechanisms underlying simvastatin medication in patients with diabetic retinopathy complications.
Neonatal seizures: magnetic resonance imaging adds value in the diagnosis and prediction of neurodisability
Authors: Osmond Elizabeth , Billetop Amiel , Jary Sally , Likeman Marcus , Thoresen Marianne , Luyt Karen
Published: February 2014

Aim

To determine the aetiological associations, neurological sequelae and role of magnetic resonance imaging (MRI) in term newborn infants with seizures.

Methods

Cohort study of infants ≥37 weeks' gestation delivered in a tertiary level centre, prospectively identified and followed longitudinally for 18–24 months.

Results

An underlying aetiology was found in 95% of the 77 infants identified with seizures (3.0/1000 live births). The most common diagnosis was hypoxic–ischaemic encephalopathy (HIE) (65%), followed by neonatal stroke (12%). Nine infants died, 28 of the 68 survivors developed neurodevelopmental impairment (NDI), and 15 had recurrent seizures in the first 2 years, with both outcomes more likely in those with a diagnosis other than HIE. Abnormal MRI findings were found in 45 of the 70 infants imaged. The absence of major cerebral lesions was highly predictive of a normal neurological outcome.

Conclusion

We report the first cohort of term infants with seizures fully investigated by MRI. The universal use of MRI enabled a cause to be identified in 95% of cases. The probability of having NDI or recurrence of seizures was extremely low with absence of major cerebral lesions on MRI. This study demonstrates the added value of MRI for diagnosis of aetiology and the prediction of neurological outcome.
Influences of protein ingestion on glucagon‐like peptide (GLP)‐1‐immunoreactive endocrine cells in the chicken ileum
Authors: Monir Mohammad M. , Hiramatsu Kohzy , Matsumoto Sachiko , Nishimura Kei , Takemoto Chihiro , Shioji Tomomi , Watanabe Takafumi , Kita Kazumi , Yonekura Shinichi , Roh Sang Gun
Published: February 2014

Influences of a specific dietary nutrient on glucagon‐like peptide (GLP)‐1‐containing cells in the chicken intestine are not yet clear. Significance of dietary protein level on GLP‐1‐containing cells in the chicken ileum was investigated. Chickens fed control or experimental diets of varying protein levels were examined using immunohistochemical and morphometrical techniques. We show that the protein ingestion had an impact on the activities of GLP‐1‐immunoreactive cells in the chicken ileum. Weight gains declined with decreasing dietary crude protein (CP) levels, but no significant differences were detected in the daily feed intake and villous height. GLP‐1‐immunoreactive cells with a round or oval shape were frequently observed in the lower CP level groups (4.5% and 0%). Frequencies of occurrence of GLP‐1‐immunoreactive cells were 41.1 ± 4.1, 38.5 ± 4, 34.8 ± 3.1 and 34.3 ± 3.7 (cells/mm2, mean ± SD) for dietary CP level of 18%, 9%, 4.5% and 0% groups, respectively and significant differences were recognized between the control and lower CP level groups (P < 0.05). Multiple regression analysis indicated a significant correlation between the daily protein intake and frequencies of occurrence of GLP‐1‐immunoreactive cells. The protein ingestion is one of the signals that influence GLP‐1‐containing cells in the chicken small intestine.
Plasma thiobarbituric acid reactive substances, vitamin A and vitamin E levels and resumption of postpartum ovarian activity in dairy cows
Authors: Aoki Mari , Ohshita Tomoko , Aoki Yasuhiro , Sakaguchi Minoru
Published: February 2014

Vitamins with antioxidative functions are commonly used as supplements to improve fertility in dairy cows. However, according to field test results uncertainty exists about the effect of these vitamins, especially in vitamin A and vitamin E, on ovarian functional activity. This study was performed to reveal the physiological characteristics of cows receiving enough feed and the ovaries of which were activated in the early postpartum period. Six of 12 primiparous cows showing the corpus luteum on 25 to 27 days after parturition were classified as early responders (PER); the remaining six were classified as late responders (PLR). Among 11 multiparous cows, nine were early responders (MER), and the remaining two were late responders (MLR). Plasma concentration of thiobarbituric acid reactive substances (TBARS) in the PER were lower than those in the PLR (P < 0.01). The ratio of plasma all‐trans‐retinol to intake α‐tocopherol or β‐carotene were increased in the following order: MER < PER < PLR (P < 0.01). The milk lactose (P < 0.025) and plasma glucose (P < 0.01) of the early responders tended to be lower than those of the late responders. These may have been associated with the availability of vitamins or energy balance. Thus, we suggest the possibility that the cows which were able to utilize antioxidants and energy from the feed efficiently may have earlier resumption of ovaries postpartum.
Impacts of genotyping strategies on long‐term genetic response in genomic selection
Authors: Nishio Motohide , Satoh Masahiro
Published: February 2014

The present study investigated the effects of the choices of animals of reference populations on long‐term responses to genomic selection. Simulated populations comprised 300 individuals and 10 generations of selection practiced for a trait with heritability of 0.1, 0.3 or 0.5. Thirty individuals were randomly selected in the first five generations and selected by estimated breeding values from best linear unbiased prediction (BLUP) and genomic BLUP in the subsequent five generations. The reference populations comprise all animals for all generations (scenario 1), all animals for 6‐10 generations (scenario 2) and 2‐6 generations (scenario 3), and half of the animals for all generations (scenario 4). For all heritability levels, the genetic gains in generation 10 were similar in scenarios 1 and 2. Among scenarios 2 to 4, the highest genetic gains were obtained in scenario 2, with heritabilities of 0.1 and 0.3 as well as scenario 4 with heritability of 0.5. The inbreeding coefficients in scenarios 1, 2 and 4 were lower than those in BLUP, especially within cases with low heritability. These results indicate an appropriate choice of reference population can improve genetic gain and restrict inbreeding even when the reference population size is limited.
MYC and BCL2 protein expression predicts survival in patients with diffuse large B‐cell lymphoma treated with rituximab
Authors: Perry Anamarija M. , Alvarado‐Bernal Yuridia , Laurini Javier A. , Smith Lynette M. , Slack Graham W. , Tan King L. , Sehn Laurie H. , Fu Kai , Aoun Patricia , Greiner Timothy C. , Chan Wing C. , Bierman Philip J. , Bociek Robert G. , Armitage James O. , Vose Julie M. , Gascoyne Randy D. , Weisenburger Dennis D.
Published: February 2014

Diffuse large B‐cell lymphoma (DLBCL) is a heterogeneous disease and “double‐hit” DLBCL, with both MYC and BCL2 translocations has a poor prognosis. In this study, we investigated whether MYC and BCL2 protein expression in tissue would predict survival in DLBCL. The study included 106 cases of de novo DLBCL treated with rituximab and cyclophosphamide, doxorubicin, vincristine and prednisone (R‐CHOP) or CHOP‐like regimens. The results were validated on an independent cohort of 205 DLBCL patients. Patients with low expression of BCL2 (≤30%) and MYC (≤50%) had the best prognosis, whereas those with high BCL2 (>30%) and MYC (>50%) had the worst outcome. In multivariate analysis, the combination of the BCL2 and MYC was an independent predictor of overall survival (OS) and event‐free survival (EFS) (P = 0·015 and P = 0·005, respectively). The risk of death was nine times greater for patients with high BCL2 and MYC compared to those with low expression. High BCL2 and MYC was a strong predictor of poor OS (P < 0·001) and EFS (P = 0·0017) in patients with the germinal centre B‐cell (GCB) type, but not in the non‐GCB type. In DLBCL, high co‐expression of MYC and BCL2 was an independent predictor of poor survival, and could be used to stratify patients for risk‐adapted therapies.
Proteinase‐activated receptors 1 and 2 and the regulation of porcine coronary artery contractility: a role for distinct tyrosine kinase pathways
Authors: El‐Daly Mahmoud , Saifeddine Mahmoud , Mihara Koichiro , Ramachandran Rithwik , Triggle Christopher R , Hollenberg Morley D
Published: February 2014

Background and Purpose

Because angiotensin‐II‐mediated porcine coronary artery (PCA) vasoconstriction is blocked by protein tyrosine kinase (PYK) inhibitors, we hypothesized that proteinase‐activated receptors (PARs), known to regulate vascular tension, like angiotensin‐II, would also cause PCA contractions via PYK‐dependent signalling pathways.

Experimental Approach

Contractions of intact and endothelium‐free isolated PCA rings, stimulated by PAR1/PAR2‐activating peptides, angiotensin‐II, PGF2α, EGF, PDGF and KCl, were monitored with/without multiple signalling pathway inhibitors, including AG‐tyrphostins AG18 (non‐specific PYKs), AG1478 (EGF‐receptor kinase), AG1296 (PDGF receptor kinase), PP1 (Src kinase), U0126 and PD98059 (MEK/MAPKinase kinase), indomethacin/SC‐560/NS‐398 (COX‐1/2) and L‐NAME (NOS).

Key Results

AG18 inhibited the contractions induced by all the agonists except KCl, whereas U0126 attenuated contractions induced by PAR1/PAR2 agonists, EGF and angiotensin‐II, but not by PGF2α, the COX‐produced metabolites of arachidonate and KCl. PP1 only affected the responses to PAR1/PAR2‐activating peptides and angiotensin‐II. The EGF‐kinase inhibitor, AG1478, attenuated contractions initiated by the PARs (PAR2 >> PAR1) and EGF itself, but not by angiotensin‐II, PGF2α or KCl. COX‐1/2 inhibitors blocked the contractions induced by all the agonists, except KCl and PGF2α.

Conclusion and Implications

PAR1/2‐mediated contractions of the PCA are dependent on Src and MAPKinase and, in part, involve EGF‐receptor‐kinase transactivation and the generation of a COX‐derived contractile agonist. However, the PYK signalling pathways used by PARs are distinct from each other and from those triggered by angiotensin‐II and EGF. These signalling pathways may be therapeutic targets for managing coagulation‐proteinase‐induced coronary vasospasm.