bluuebunny/crossref_metadata_2025 huggingface dataset:
Utilizing a Human Factors Nursing Worksystem Improvement Framework to Increase Nurses’ Time at the Bedside and Enhance Safety
Authors: Probst C. Adam , Carter Megan , Cadigan Caton , Dalcour Cortney , Cassity Cindy , Quinn Penny , Williams Tiana , Montgomery Donna Cook , Wilder Claudia , Xiao Yan
Published: February 2017

OBJECTIVE

The aim of this study is to increase nurses’ time for direct patient care and improve safety via a novel human factors framework for nursing worksystem improvement.

BACKGROUND

Time available for direct patient care influences outcomes, yet worksystem barriers prevent nurses adequate time at the bedside.

METHODS

A novel human factors framework was developed for worksystem improvement in 3 units at 2 facilities. Objectives included improving nurse efficiency as measured by time-and-motion studies, reducing missing medications and subsequent trips to medication rooms and improving medication safety.

RESULTS

Worksystem improvement resulted in time savings of 16% to 32% per nurse per 12-hour shift. Requests for missing medications dropped from 3.2 to 1.3 per day. Nurse medication room trips were reduced by 30% and nurse-reported medication errors fell from a range of 1.2 to 0.8 and 6.3 to 4.0 per month.

CONCLUSIONS

An innovative human factors framework for nursing worksystem improvement provided practical and high priority targets for interventions that significantly improved the nursing worksystem.
IgG4 Expression in Primary Cutaneous Marginal Zone Lymphoma: A Multicenter Study
Authors: De Souza Aieska , Ferry Judith A. , Burghart Daniel R. , Tinguely Marianne , Goyal Amrita , Duncan Lyn M. , Kutzner Heinz , Kempf Werner
Published: February 2017

Background:

Primary cutaneous marginal zone lymphoma (PCMZL) is the second most common B-cell lymphoma of the skin. A recent study has demonstrated a strikingly high prevalence of immunoglobulin (Ig)G4 expression in PCMZL with plasmacytic differentiation.

Objective:

The objective was to investigate the incidence of IgG4 expression in PCMZL, and its correlation with clinical and immunophenotypic features.

Materials and Methods:

Multicenter study that utilized immunohistochemistry and in-situ hybridization to evaluate the expression of IgG4, Ig light (κ and λ), and heavy chains (IgM, IgG), and the ratio of T (CD3+) and B (CD20+) cells in biopsy specimens from 30 patients with PCMZL and to correlate these findings with the clinical features.

Results:

IgG4 expression was observed in 4 out of 30 patients (13%) with PCMZL. Patients with IgG4-positive lymphomas were 57 to 77 years of age (mean, 69) at biopsy. The lesions were solitary in 2 patients with IgG4-positive lymphomas, and were most commonly located on the trunk. Patients with IgG4-negative lymphomas experienced earlier disease onset at an average age of 53 years. The majority of the IgG4-negative cases presented with localized disease, on the trunk and upper extremities. There was no significant difference in the IgG4-positive versus negative cases for the following parameters: Ig κ or λ restriction, B-cell or T-cell predominance, and site of the lesions.

Conclusions:

IgG4 expression was observed in a minority of PCMZL patients. We did not identify significant clinical or immunophenotypic differences between IgG4 positive and negative cases.
Prognostic Significance of Stromal Versus Intratumoral Infiltrating Lymphocytes in Different Subtypes of Breast Cancer Treated With Cytotoxic Neoadjuvant Chemotherapy
Authors: Khoury Thaer , Nagrale Vidya , Opyrchal Mateusz , Peng Xuan , Wang Dan , Yao Song
Published: February 2017

Background:

The aim of the study was to investigate if there were differences in associations of stromal versus intratumoral tumor infiltrating lymphocytes (TILs) with pathology complete response (pCR) among breast cancer (BC) subtypes treated with neoadjuvant therapy.

Materials and Methods:

The hematoxylin and eosin slides of BC-core biopsy consecutive cases (n=331) were reviewed from a single institution between 2000 and 2014. TIL-stroma (TIL-str) was scored from 0% to 100%. Intratumoral lymphocytes (iTu-Ly) were scored semiquantitatively incorporating the infiltrate grade (0 to 3) and the corresponding percentage resulting in a score ranging from 0 to 300. pCR was defined as no residual infiltrating tumor in the tumor bed and the lymph nodes.

Results:

pCR was achieved in 29 of 95 (30.9%) triple negative cases, 25 of 77 (32.5%) HER2+, and 9 of 159 (5.6%) luminal tumors. In univariate analysis, invasive nonlobular carcinoma, higher Nottingham grade, nonluminal subtypes, trastuzumab therapy, nonadvanced clinical T stage (T1 and T2), TIL-str, and iTu-Ly-predicted pCR. In luminal subtype, iTu-Ly but not TIL-str was an independent predictor for pCR [odds ratio (OR)=1.44, 95% confidence interval (CI), 1.08-1.9, P=0.013]. In triple negative subtype, both TIL-str and iTu-Ly were independent predictors for pCR (OR=1.68, 95% CI, 1.29-2.18, P=0.001; OR=1.31, 95% CI, 1.05-1.63, P=0.017, respectively). In HER2+ subtype, neither TIL-str nor iTu-Ly predicted pCR.

Conclusions:

TILs are variably correlated with better neoadjuvant chemotherapy response depending on their location and clinical subtype of BC. It could indicate that TILs might be functionally heterogeneous with regard to their role in mediating antitumor immune response, depending on their location and BC subtypes.
The Relationship Between Safety Culture and Voluntary Event Reporting in a Large Regional Ambulatory Care Group
Authors: Miller Nina , Bhowmik Shelly , Ezinwa Margarete , Yang Ting , Schrock Susan , Bitzel Daniel , McGuire Maura Joyce
Published: February 2017

Objectives

The safety culture in the workplace may affect event reporting. We evaluated the relationship of safety culture and voluntary event reporting within a large network of ambulatory practices, most of which provided primary care.

Methods

This study was an observational, retrospective cohort study. Patient safety event reporting rates for 35 ambulatory practices were collected using a standard tool (UHC Patient Safety Net [PSN]) and normalized based on the number of patient visits in each practice. The overall and domain-specific safety culture of each practice was measured with a validated instrument (Safety Attitudes Questionnaire [SAQ]), distributed to 828 employees in 2013. We compared safety culture scores and the average event reporting rates during a 4-month window before and after the survey distribution. Poisson regression analyses were performed to determine the relationship between PSN reporting rates and SAQ results.

Results

The SAQ response rate was 87%. Practices varied widely in rates of reporting events, from 0.00 to 6.99 reports per 1000 total patient visits per month. Regression analyses indicated a positive association between PSN reporting rates and SAQ scores for the domains of overall culture (incidence rate ratio [IRR], 1.019; P = 0.004) and 4 safety culture domains: teamwork climate (IRR, 1.016; P = 0.019), safety climate (IRR, 1.018; P = 0.004), working conditions (IRR, 1.017; P = 0.006), and perceptions of local management (IRR, 1.016; P = 0.040).

Conclusions

Our work provides new evidence to show that in the ambulatory setting more events and near misses are reported when there is a strong culture of safety.
Making Residents Part of the Safety Culture: Improving Error Reporting and Reducing Harms
Authors: Fox Michael D. , Bump Gregory M. , Butler Gabriella A. , Chen Ling-Wan , Buchert Andrew R.
Published: February 2017

Objectives

Reporting medical errors is a focus of the patient safety movement. As frontline physicians, residents are optimally positioned to recognize errors and flaws in systems of care. Previous work highlights the difficulty of engaging residents in identification and/or reduction of medical errors and in integrating these trainees into their institutions’ cultures of safety.

Methods

The authors describe the implementation of a longitudinal, discipline-based, multifaceted curriculum to enhance the reporting of errors by pediatric residents at Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center. The key elements of this curriculum included providing the necessary education to identify medical errors with an emphasis on systems-based causes, modeling of error reporting by faculty, and integrating error reporting and discussion into the residents’ daily activities. The authors tracked monthly error reporting rates by residents and other health care professionals, in addition to serious harm event rates at the institution.

Results

The interventions resulted in significant increases in error reports filed by residents, from 3.6 to 37.8 per month over 4 years (P < 0.0001). This increase in resident error reporting correlated with a decline in serious harm events, from 15.0 to 8.1 per month over 4 years (P = 0.01).

Conclusions

Integrating patient safety into the everyday resident responsibilities encourages frequent reporting and discussion of medical errors and leads to improvements in patient care. Multiple simultaneous interventions are essential to making residents part of the safety culture of their training hospitals.
Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa
Authors: Goeieman Bridgette J. , Firnhaber Cynthia S. , Jong Eefje , Michelow Pam , Kegorilwe Patricia , Swarts Avril , Williamson Anna-Lise , Allan Bruce , Smith Jennifer S. , Wilkin Timothy J.
Published: February 2017

Background:

Anal cancer is a relatively common cancer among HIV-infected populations. There are limited data on the prevalence of anal high-risk human papillomavirus (HR-HPV) infection and anal dysplasia in HIV-infected women from resource-constrained settings.

Methods:

A cross-sectional study of HIV-infected women aged 25–65 years recruited from an HIV clinic in Johannesburg, South Africa. Cervical and anal swabs were taken for conventional cytology and HR-HPV testing. Women with abnormal anal cytology and 20% of women with negative cytology were seen for high-resolution anoscopy with biopsy of visible lesions.

Results:

Two hundred women were enrolled. Anal HR-HPV was found in 43%. The anal cytology results were negative in 51 (26%); 97 (49%) had low-grade squamous intraepithelial lesions (SIL), 32 (16%) had atypical squamous cells of unknown significance, and 19 (9.5%) had high-grade SIL or atypical squamous cells suggestive of high-grade SIL. On high-resolution anoscopy, 71 (36%) had atypia or low-grade SIL on anal histology and 17 (8.5%) had high-grade SIL. Overall, 31 (17.5%) had high-grade SIL present on anal cytology or histology. Abnormal cervical cytology was found in 70% and cervical HR-HPV in 41%.

Conclusions:

We found a significant burden of anal HR-HPV infection, abnormal anal cytology, and high-grade SIL in our cohort. This is the first study of the prevalence of anal dysplasia in HIV-infected women from sub-Saharan Africa. Additional studies are needed to define the epidemiology of these conditions, as well as the incidence of anal cancer, in this population.
Quantitative characterization of CTLA4 trafficking and turnover using a combinedin vitroandin silicoapproach
Authors: Khailaie Sahamoddin , Rowshanravan Behzad , Robert Philippe A. , Walker Lucy S. K. , Sansom David M. , Meyer-Hermann Michael
Published: February 2017

CTLA4 is an essential negative regulator of T cell immune responses and is a key checkpoint regulating autoimmunity and anti-tumour immunity. Genetic mutations resulting in a quantitative defect in CTLA4 are associated with the development of an immune dysregulation syndrome. Endocytosis of CTLA4 is rapid and continuous with subsequent degradation or recycling. CTLA4 has two natural ligands, the surface transmembrane proteins CD80 and CD86 that are shared with the T cell co-stimulatory receptor CD28. Upon ligation with CD80/CD86, CTLA4 can remove these ligands from the opposing cells by transendocytosis. The efficiency of ligand removal is thought to be highly dependent on the processes involved in CTLA4 trafficking. With a combinedin vitro-in silicostudy, we quantify the rates of CTLA4 internalization, recycling and degradation. We incorporate experimental data from cell lines and primary human T cells. Our model provides a framework for exploring the impact of altered affinity of natural ligands or therapeutic anti-CTLA4 antibodies and for predicting the effect of clinically relevant CTLA4 pathway mutations. The presented methodology for extracting trafficking rates can be transferred to the study of other transmembrane proteins.
The Evaluative Role of Rostrolateral Prefrontal Cortex in Rule-Based Category Learning
Authors: Paniukov Dmitrii , Davis Tyler
Published: February 2017

Category learning is a critical neurobiological function that allows organisms to simplify a complex world. Rostrolateral prefrontal cortex (rlPFC) is often active in neurobiological studies of category learning; however, the specific role this region serves in category learning remains uncertain. Previous category learning studies have hypothesized that the rlPFC is involved in switching between rules, whereas others have emphasized rule abstraction and evaluation. We aimed to clarify the role of rlPFC in category learning and dissociate switching and evaluation accounts using two common types of category learning tasks: matching and classification. The matching task involved matching a reference stimulus to one of four target stimuli. In the classification task, participants were shown a single stimulus and learned to classify it into one of two categories. Matching and classification are similar but place different demands on switching and evaluation. In matching, a rule can be known with certainty after a single correct answer. In classification, participants may need to evaluate evidence for a rule even after an initial correct response. This critical difference allows isolation of evaluative functions from switching functions. If the rlPFC is primarily involved in switching between representations, it should cease to be active once participants settle on a given rule in both tasks. If the rlPFC is involved in rule evaluation, its activation should persist in the classification task, but not matching. The results revealed that rlPFC activation persisted into correct trials in classification, but not matching, suggesting that it continues to be involved in the evaluations of evidence for a rule even after participants have arrived at the correct rule.

Highlights

Differences between rule-based matching and classification tasks were highlighted.

Rostrolateral prefrontal cortex is involved in evaluation of evidence for a rule in rule-based category learning tasks.
A machine-learning heuristic to improve gene score prediction of polygenic traits
Authors: Paré Guillaume , Mao Shihong , Deng Wei Q.
Published: February 2017

Machine-learning techniques have helped solve a broad range of prediction problems, yet are not widely used to build polygenic risk scores for the prediction of complex traits. We propose a novel heuristic based on machine-learning techniques (GraBLD) to boost the predictive performance of polygenic risk scores. Gradient boosted regression trees were first used to optimize the weights of SNPs included in the score, followed by a novel regional adjustment for linkage disequilibrium. A calibration set with sample size of ~200 individuals was sufficient for optimal performance. GraBLD yielded predictionR2of 0.239 and 0.082 using GIANT summary association statistics for height and BMI in the UK Biobank study (N=130K; 1.98M SNPs), explaining 46.9% and 32.7% of the overall polygenic variance, respectively. For diabetes status, the area under the receiver operating characteristic curve was 0.602 in the UK Biobank study using summary-level association statistics from the DIAGRAM consortium. GraBLD outperformed other polygenic score heuristics for the prediction of height (p<2.2x10−16) and BMI (p<1.57x10−4), and was equivalent to LDpred for diabetes. Results were independently validated in the Health and Retirement Study (N=8,292; 688,398 SNPs). Our report demonstrates the use of machine-learning techniques, coupled with summary-level data from large genome-wide meta-analyses to improve the prediction of polygenic traits.
Synthesis and structure of the mercury chloride complex of 2,2′-(2-bromo-5-tert-butyl-1,3-phenylene)bis(1-methyl-1H-benzimidazole)
Authors: Rani Varsha , Singh Harkesh B. , Butcher Ray J.
Published: February 2017

In the title mercury complex,catena-poly[[dichloridomercury(II)]-μ-2,2′-(2-bromo-5-tert-butyl-1,3-phenylene)bis(1-methyl-1H-benzimidazole)-κ2N3:N3′], [HgCl2(C26H25BrN4)]n, the HgIIatom is coordinated by two Cl atoms and by two N atoms from two 2,2′-(2-bromo-5-tert-butyl-1,3-phenylene)bis(1-methyl-1H-benzimidazole) ligands. The metal cation adopts a distorted tetrahedral coordination geometry with with bond angles around mercury of 100.59 (15)° [N—Hg—N] and 126.35 (7)° [Cl—Hg—Cl]. This arrangement gives rise to a zigzag helical 1-D polymer propagating along theb-axis direction.
Patchouli alcohol: 4α,8aβ,9,9-tetramethyl-3,4,4aβ,5,6β,7,8,8a-octahydro-1,6-methanonaphthalen-1β(2H)-ol
Authors: Inoue Yutaka
Published: February 2017

The title compound, C15H26O, commonly known as Patchouli alcohol or Patchoulol, is a tricyclo[5.3.1.03,8]undecane. It crystallized in the enantiomer-defining hexagonal space groupP63. However, the absolute structure could not be determined [absolute structure parameter = 0.4 (10)]. In the crystal, three molecules are linked by O—H...O hydrogen bonds, forming a trimer with anR33(6) ring motif. The crystal structure of patchouli alcohol determined by the crystalline inclusion method, using 1,1,6,6-tetraphenylhexa-2,4-diyne-1,6-diol as host, has been reported [Tonget al., (2013).Nat. Prod. Res.27, 32–36].
2-(5-Methyl-1-benzofuran-3-yl)-N-(2-phenylethyl)acetamide
Authors: Ramprasad N. , Gowda K. V. Arjuna , Gowda Ramakrishna , Basanagouda Mahantesha , Kantharaj K. S. , Gowda G. V. Jagadeesha
Published: February 2017

The title compound, C19H19NO2, is non-planar with the phenyl ring of the phenethylacetamide residue inclined to the benzofuran ring system by 84.8 (3)°. The methyl group lies in the plane of the fused ring system [C—C—C—C torsion angle = −179.6 (3)°]. In the crystal, N—H...O hydrogen bonds link the molecules into chains along thea-axis direction. π–π stacking interactions with a centroid-to-centroid distances of 3.497 (3) Å further stabilize the structure, stacking the molecules alonga.
Heat transfer enhancement via Görtler flow with spatial numerical simulation
Authors: Malatesta Vinicius , Rogenski Josuel Kruppa , Souza Leandro Franco de
Published: February 2017

Purpose

The centrifugal instability mechanism of boundary layers over concave surfaces is responsible for the development of quasi-periodic, counter-rotating vortices aligned in a streamwise direction known as Görtler vortices. By distorting the boundary layer structure in both the spanwise and the wall-normal directions, Görtler vortices may modify heat transfer rates. The purpose of this study is to conduct spatial numerical simulation experiments based on a vorticity–velocity formulation of the incompressible Navier–Stokes system of equations to quantify the role of the transition in the heat transfer process.

Design/methodology/approach

Experiments are conducted using an in-house, parallel, message-passing code. Compact finite difference approximations and a spectral method are used to approximate spatial derivatives. A fourth-order Runge–Kutta method is adopted for time integration. The Poisson equation is solved using a geometric multigrid method.

Findings

Results show that the numerical method can capture the physics of transitional flows over concave geometries. They also show that the heat transfer rates in the late stages of the transition may be greater than those for either laminar or turbulent ones.

Originality/value

The numerical method can be considered as a robust alternative to investigate heat transfer properties in transitional boundary layer flows over concave surfaces.
Dual solutions for nonlinear boundary value problems by the variational iteration method
Authors: Wazwaz Abdul-Majid
Published: February 2017

Purpose

The purpose of this paper is to use the variational iteration method (VIM) for studying boundary value problems (BVPs) characterized with dual solutions.

Design/methodology/approach

The VIM proved to be practical for solving linear and nonlinear problems arising in scientific and engineering applications. In this work, the aim is to use the VIM for a reliable treatment of nonlinear boundary value problems characterized with dual solutions.

Findings

The VIM is shown to solve nonlinear BVPs, either linear or nonlinear. It is shown that the VIM solves these models without requiring restrictive assumptions and in a straightforward manner. The conclusions are justified by investigating many scientific models.

Research limitations/implications

The VIM provides convergent series solutions for linear and nonlinear equations in the same manner.

Practical implications

The VIM is practical and shows more power compared to existing techniques.

Social implications

The VIM handles linear and nonlinear models in the same manner.

Originality/value

This work highlights a reliable technique for solving nonlinear BVPs that possess dual solutions. This paper has shown the power of the VIM for handling BVPs.
Wheels of change in higher education
Authors: Warr Pedersen Kristin , Pharo Emma , Peterson Corey , Clark Geoffrey Andrew
Published: February 2017

Purpose

The purpose of this paper is to profile the development of a bicycle parking hub at the University of Tasmania to illustrate how the Academic Operations Sustainability Integration Program promotes real change through the engagement of stakeholders from across an institution to deliver campus sustainability. This case study outlines one example of how place-based learning initiatives focused on campus sustainability challenges have delivered authentic education for sustainability in the Australasian higher education setting.

Design/methodology/approach

This case study outlines the process through which a cross-disciplinary place-based learning initiative was designed, implemented and evaluated over a three-year period. The evaluation of the project was designed to assess the impact of this education for sustainability approach on both operational and student learning outcomes, and to make recommendations on the continuation of place-based learning initiatives through the Academic Operations Sustainability Integration Program.

Findings

This case study illustrates how learning can be focused around finding solutions to real world problems through the active participation of staff and students as members of a learning community. This experience helped the authors to better understand how place-based learning initiatives can help deliver authentic education for sustainability and the success factors required for engaging staff and students in such efforts.

Originality/value

The case study highlights an example of an education for sustainability initiative that was mutually driven by the operational and learning objectives of an institution, and specifically the ways in which the engagement of staff and students from across an institution can lead to the successful integration of these two often disparate institutional goals.
Accountability and narrative disclosure by Muslim charity organisations in the UK
Authors: Yasmin Sofia , Haniffa Roszaini
Published: February 2017

Purpose

This paper aims to explore a narrative disclosure by Muslim charity organisations (MCOs) in the UK.

Design/methodology/approach

Using content analysis, this study assesses disclosure in MCOs’ trustee annual reports against the Statement of Recommended Reporting Practices (SORP) for charities using perspectives from accountability including the Islamic concept of accountability.

Findings

The findings suggest disclosure to be limited in showing how transactions and activities comply with the mandatory reporting requirements. Hence, MCOs need to increase their awareness of regulatory and sector challenges, as well as self-scrutiny of their current narrative reporting practices, especially in showing their mandatory reporting and hence religious accountability.

Originality/value

The paper provides important empirical data on the status quo of reporting practice by this important sub-sector. The paper provides a systematic analysis of the way trustee annual reports (TARs) are presented by MCOs and also provides a comprehensive framework for a better understanding of the minimum accountability requirements incumbent upon all charity organisations.
An international analysis of time varying beta risk in listed real estate securities
Authors: Morri Giacomo , Romito Federico
Published: February 2017

Purpose

Listed real estate securities have historically been used to achieve an exposure to the real estate asset class and to obtain a broad spectrum of other specific features such as return enhancement, but whether they must be associated to the direct property or to the broad stock market is deceptive on a merely theoretical basis. Moreover, the global financial crisis (GFC) has questioned their risk/return characteristics. The purpose of this paper is to asses if listed real estate securities are still enough dissimilar from the broad stock market to provide remarkable diversification benefits for a long term investor.

Design/methodology/approach

The analysis has been developed on the FTSE EPRA/NAREIT Developed Index and at country level (USA, UK, France, Japan, Singapore, Hong Kong and Australia) from November 2001 to October 2013. The authors analysed the real estate index over a broad market index and adjusted for a possible bias related to heteroskedasticity and autocorrelation, using a least squared regression with Newey-West HAC Correction. A Recursive Least Squares (RLS) was also used to test the stability of the parameters with the CUSUM squared test and the Chow test. Finally the authors tested for cointegration with the Augmented Dickey Fuller and the Engle Granger tests.

Findings

The authors found that after the GFC the Beta-risk related to the stock market has witnessed a sharp increase, but with differences among country. While the USA, the UK and France have experienced a trend similar to the one described for the FTSE EPRA/NAREIT Developed Index, Asian Markets depict a quite stable Beta over the full sample (gradual increase for the Australian market). Evidence of a structural break in conjunction with 2008 crisis has been found only in USA, UK and France.

Practical implications

Listed real estate securities, even if characterised by time varying Beta-risk and partially reduced diversification benefits, are still worth to be included in long term horizon portfolios. However, more wary considerations should be drafted before investing in the Asian markets where evidence of cointegration was found only for the Japanese market.

Originality/value

Analysis of post GFC effect on direct property investment vs indirect listed investment worldwide.
Service recommender system based on emotional features and social interactions
Authors: Yuan Soe Tsyr , Yang Chun-Ya
Published: February 2017

Purpose

Most existing recommendation systems or technologies are functional-oriented. Recommending services, nevertheless, requires the consideration of service experiences perceived by customers being individually unique and emphasizing the emotional experiences and the co-created value-in-use. This paper aims to present a new recommender system to capture customer emotional needs and address social interactions among service stakeholders.

Design/methodology/approach

This paper presents a color imagery-based recommender system (CIRS) capable of capturing customer emotional needs and addressing social interactions among service stakeholders that can collectively co-create the individual value-in-use and beneficial outcomes for customers. Based on the Color Image Scale, the recommender system uses the color imagery format as the uniform representation of customers’ psychological expectations, service providers and the service system, to facilitate the scoring and ranking of recommendations.

Findings

This study uses an application context of destination tourism to demonstrate and justify the recommender system’s attempted contributions preliminarily. That is, CIRS can recommend destinations and tour services that meet tourists’ emotional needs with a satisfactory precision of 70 per cent. CIRS can also make stakeholders’ image models evolve over time considering the dynamic interactions among stakeholders. CIRS can also help lesser-known tourism destinations be discovered by tourists who can be emotionally satisfied.

Originality/value

CIRS uses the color imagery as the uniform representation for customers’ expectations, service providers (e.g. small and medium enterprises) and service system (e.g. tourism destinations), considering the continued interactions among the service stakeholders that collectively co-create the individual value-in-use and beneficial outcomes for each customer.
Hybrid supervised clustering based ensemble scheme for text classification
Authors: Onan Aytug
Published: February 2017

Purpose

The immense quantity of available unstructured text documents serve as one of the largest source of information. Text classification can be an essential task for many purposes in information retrieval, such as document organization, text filtering and sentiment analysis. Ensemble learning has been extensively studied to construct efficient text classification schemes with higher predictive performance and generalization ability. The purpose of this paper is to provide diversity among the classification algorithms of ensemble, which is a key issue in the ensemble design.

Design/methodology/approach

An ensemble scheme based on hybrid supervised clustering is presented for text classification. In the presented scheme, supervised hybrid clustering, which is based on cuckoo search algorithm and k-means, is introduced to partition the data samples of each class into clusters so that training subsets with higher diversities can be provided. Each classifier is trained on the diversified training subsets and the predictions of individual classifiers are combined by the majority voting rule. The predictive performance of the proposed classifier ensemble is compared to conventional classification algorithms (such as Naïve Bayes, logistic regression, support vector machines and C4.5 algorithm) and ensemble learning methods (such as AdaBoost, bagging and random subspace) using 11 text benchmarks.

Findings

The experimental results indicate that the presented classifier ensemble outperforms the conventional classification algorithms and ensemble learning methods for text classification.

Originality/value

The presented ensemble scheme is the first to use supervised clustering to obtain diverse ensemble for text classification
1867 and the Rule of Wealth
Authors: Parry Jonathan
Published: February 2017

This essay examines the widespread concern in the 1860s and 1870s with ‘plutocracy’ – the political and social power of commercial wealth. It argues that we should not interpret either the pressure for parliamentary reform in the 1860s, or the consequences of the 1867 act, simply in terms of a contest between aristocracy and democracy. A third element, the growing influence of commercial men, was very widely noted before and after 1867, with differences of opinion about whether this would more favour the aristocracy or the democracy. Anxiety about plutocracy fuelled much of the pressure for reform, from both Cobdenite radicals and academic Liberals; this last group in particular was preoccupied with the possible parliamentary dominance of unimaginative and materialistic money men. On the other hand, opponents of reform were sceptical that a new electoral settlement would halt the rising influence of money. They were proved right, not least because the 1867 reforms increased the cost of winning a seat. The three parliaments elected in 1868, 1874, and 1880 were dominated by commercial men, and there was even more alarm about plutocracy than before 1867. While this was interpreted in different ways by different groups, on the whole it benefited the Conservative Party and Conservative argument significantly more than it helped the Liberals. The Liberal Party found it difficult to agree on whether the political influence of commercial elites – a group with which it had once been identified – was now excessive, and what, if anything, could be done about it. This was to become a major problem for the left.
Effect of Extraction Method on the Oxidative Stability of Camelina Seed Oil Studied by Differential Scanning Calorimetry
Authors: Belayneh Henok D. , Wehling Randy L. , Cahoon Edgar B. , Ciftci Ozan N.
Published: February 2017

Camelina seed is a new alternative omega‐3 source attracting growing interest. However, it is susceptible to oxidation due to its high omega‐3 content. The objective of this study was to improve the oxidative stability of the camelina seed oil at the extraction stage in order to eliminate or minimize the use of additive antioxidants. Camelina seed oil extracts were enriched in terms of natural antioxidants using ethanol‐modified supercritical carbon dioxide (SC‐CO2) extraction. Oxidative stability of the camelina seed oils extracted by ethanol modified SC‐CO2 was studied by differential scanning calorimeter (DSC), and compared with cold press, hexane, and SC‐CO2 methods. Nonisothermal oxidation kinetics of the oils obtained by different extraction methods were studied by DSC at varying heating rates (2.5, 5, 10, and 15 °C/min). Increasing ethanol level in the ethanol‐modified SC‐CO2 increased the oxidative stability. Based on oxidation onset temperatures (Ton), SC‐CO2 containing 10% ethanol yielded the most stable oil. Oxidative stability depended on the type and content of the polar fractions, namely, phenolic compounds and phospholipids. Phenolic compounds acted as natural antioxidants, whereas increased phospholipid contents decreased the stability. Study has shown that the oxidative stability of the oils can be improved at the extraction stage and this may eliminate the need for additive antioxidants.
Enhanced mRNA expression of plasminogen activator inhibitor‐1 in livedoid vasculopathy lesions
Authors: Agirbasli Mehmet , Göktay Fatih , Peker Irem , Gunes Pembegul , Aker Fugen Vardar , Akkiprik Mustafa
Published: February 2017

Aim

Thrombosis and inflammation play an important role in pathophysiology of livedoid vasculopathy (LV). Plasminogen activator inhibitor‐1 (PAI‐1) is the main physiological inhibitor of fibrinolysis and is a pivotal modulator in a broad range of biological processes.

Method

The study specimens were retrospectively selected from archives of pathology department. We investigated PAI‐1 mRNA expression in the paraffin blocks of patients with biopsy‐proven LV and controls. We analyzed the presence of thrombus, fibrinoid necrosis, ulcer, and epidermal atrophy in study samples. The correlation between histologic findings and PAI‐1 expression was investigated.

Results

Analyses were performed in 14 LV patients (mean age 31±20, 79% female) and 4 controls (mean age 64±19, 50% female). PAI‐1 gene expression was significantly higher in LV compared to the control group (median 7.74 (Iqr:13.94) vs 1.0 (0.31)), P=.011. Histological analysis displayed that fibrinoid necrosis was present on all patients with LV, 61.5% displayed thrombus, 46.2% displayed ulcer, and 15.4% displayed epidermal atrophy. Overall, we did not observe any discerning difference in PAI‐1 expression between the LV blocks with or without thrombus, fibrinoid necrosis, or epidermal atrophy, yet the LV specimens that displayed ulcer histologically had higher PAI‐1 mRNA expression compared to those without ulcer (median 13.98 (Iqr:19.21) vs 2.86 (5.59)), (P=.046).

Conclusion

PAI‐1 mRNA expression is significantly increased in cutaneous lesions of patients with LV. Histological finding of ulcer is associated with increased PAI‐1 expression in LV specimen. In the current era of PAI‐1 inhibitors, enhanced local PAI‐1 expression can form a novel and local therapeutic target in LV.
NLRP3 p.Q705K and CARD8 p.C10X single nucleotide polymorphisms are not associated with susceptibility to rheumatoid arthritis: a meta‐analysis
Authors: Yang Zhaowen , Cao Jin , Yang Qingrui , Zhang Yuanchao , Han Lihui
Published: February 2017

Aim

Genetic factors have a substantial contribution to the pathogenesis of rheumatoid arthritis (RA). Single nucleotide polymorphisms of NLRP3 p.Q705K and CARD8 p.C10X are two gene mutations that have been linked to many diseases. Here we carried out a meta‐analysis to identify their association with susceptibility to RA.

Method

Relevant studies were identified from databases, including PubMed, Cochrane Library, EMBase, Elsevier Science Direct, Web of Science, SpringerLink, and so on. Data extracted from selected studies were analyzed using the Version 12.0 STATA software. Pooled odds ratios (ORs) were calculated as the effect sizes for comparisons.

Results

In total, six case–control studies from five articles that contained 2705 RA patients and 2711 healthy controls were included. (i) The NLRP3 p.Q705K polymorphism in allelic model (OR = 0.908), genotypic models (OR1 = 0.786; OR2 = 0.916; OR3 = 0.729), dominant (OR = 0.909) and recessive models (OR = 0.778) were not associated with the risk of RA (all P > 0.05). (ii) The CARD8 p.C10X polymorphism in allelic model (OR = 0.995,), genotypic models (OR1 = 0.997; OR2 = 1.052; OR3 = 0.950), dominant (OR = 1.033) and recessive models (OR = 0.963) were not associated with the risk of RA (all P > 0.05). (iii) When compared with combined genotype CARD8/NLRP3 AA/CC, none of the other combined genotypes had significant pooled ORs (all P > 0.05). (iv) Individuals carrying at least one variant allele at each of the two loci showed no more susceptibility to RA than those carrying only wild‐type alleles at both the NLRP3 p.Q705K and CARD8 p.C10X loci (OR = 1.056, P > 0.05).

Conclusion

NLRP3 p.Q705K and CARD8 p.C10X polymorphisms were not associated with the susceptibility to RA, separately or in combined forms.
Pre‐exposure prophylaxis (PrEP) for people who inject drugs: reconciling community views and biomedical advances
Authors: Guise Andy , Albers Eliot Ross , Strathdee Steffanie A.
Published: February 2017

Commentary to: ‘PrEP is not ready for our community, and our community is not ready for PrEP’: pre‐exposure prophylaxis for HIV for people who inject drugs and limits to the HIV prevention response
Ultrasound‐guided approach to nerves (direct vs. tangential) and the incidence of intraneural injection: a cadaveric study
Authors: Sermeus L. A. , Sala‐Blanch X. , McDonnell J. G. , Lobo C. A. , Nicholls B. J. , van Geffen G. J. , Choquet O. , Iohom G. , de Jose Maria Galve B. , Hermans C. , Lammens M.
Published: February 2017

This study evaluated the incidence of nerve puncture and intraneural injection based on the needle approach to the nerve (direct vs. tangential). Two expert operators in regional anaesthesia performed in‐plane ultrasound‐guided nerve blocks (n = 158) at different levels of the brachial plexus in cadavers, aiming either directly for the nerve (n = 77) or tangentially inferior to the nerve (n = 81). After reaching the outer limit of the nerve, the needle was intentionally advanced approximately 1 mm in both approaches, and 0.2–0.5 ml of saline was injected. Each operator classified (in real time) the needle tip and injectate as intraneural or not. Video clips showing the final position of the needle and the injection were evaluated in the same manner by seven independent expert observers who were blinded to the aims of this study. In addition, 20 injections were performed with ink for histological evaluation. Intraneural injections of saline were observed by the operator in 58% (45/77) of cases using the direct approach and 12% (10/81) of cases using the tangential approach (p < 0.001). The independent observers agreed with the operator in a substantial number of cases (Cohen's kappa index 0.65). Histological studies showed intraneural spread in 83% (5/6) of cases using the direct approach and in 14% (2/14) of cases using the tangential approach (p = 0.007). No intrafascicular injections were observed. There was good agreement between the operators’ assessment and subsequent histological evaluation (Cohen's kappa = 0.89). Simulation of an unintentional/accidental advancement of the needle ‘beyond the edge’ of the nerve suggests significantly increased risk of epineural perforation and intraneural injection when a direct approach to the nerve is used, compared with a tangential approach.
Penalized Nonlinear Mixed Effects Model to Identify Biomarkers That Predict Disease Progression
Authors: Chen Huaihou , Zeng Donglin , Wang Yuanjia
Published: February 2017

Precise modeling of disease progression in neurodegenerative disorders may enable early intervention before clinical manifestation of a disease, which is crucial since early intervention at the premanifest stage is expected to be more effective. Neuroimaging biomarkers are indicative of the underlying disease pathology and may be used to predict future disease occurrence at the premanifest stage. As observed in many pivotal studies, longitudinal measurements of clinical outcomes, such as motor or cognitive symptoms, often present nonlinear sigmoid shapes over time, where the inflection points of the trajectories mark a meaningful time in disease progression. Therefore, to identify neuroimaging biomarkers predicting disease progression, we propose a nonlinear mixed effects model based on a sigmoid function to predict longitudinal clinical outcomes, and associate a linear combination of neuroimaging biomarkers with subject-specific inflection points. Based on an expectation-maximization (EM) algorithm, we propose a method that can fit a nonlinear model with many potentially correlated biomarkers for random inflection points while achieving computational stability. Variable selection is introduced in the algorithm in order to identify important biomarkers of disease progression and to reduce prediction variability. We apply the proposed method to the data from the Predictors of Huntington's Disease study to select brain subcortical regional volumes predictive of the inflection points of the motor and cognitive function trajectories. Our results reveal that brain atrophy in the striatum and expansion of the ventricular system are highly predictive of the inflection points. Furthermore, these inflection points may precede clinically defined disease onset by as early as a decade and thus may be useful biomarkers as early signs of Huntington's Disease onset.
The Arp2/3 inhibitory protein Arpin is dispensable for chemotaxis
Authors: Dang Irène , Linkner Joern , Yan Jun , Irimia Daniel , Faix Jan , Gautreau Alexis
Published: February 2017

Arpin is an Arp2/3 inhibitory protein, which decreases the protrusion lifetime and hence directional persistence in the migration of diverse cells. Arpin is activated by the small GTPase Rac, which controls cell protrusion, thus closing a negative feedback loop that renders the protrusion intrinsically unstable. Because of these properties, it was proposed that Arpin might play a role in directed migration, where directional persistence has to be fine‐tuned. We report here, however, that Arpin‐depleted tumour cells and Arpin knock‐out Dictyostelium amoeba display no obvious defect in chemotaxis. These results do not rule out a potential role of Arpin in other systems, but argue against a general role of Arpin in chemotaxis.
Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services
Authors: Smith Joanna , Kyle Richard G. , Daniel Brigid , Hubbard Gill
Published: February 2017

Background

During 12‐month period (2012/13) around 21,480 children and young people (CYP) were referred to Child and Adolescent Mental Health Service (CAMHS) in Scotland (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). At the end of September 2012, there were 3,602 CYP still waiting for ‘start of treatment’ or ‘removal from the waiting list’, 375 (10%) CYP had waited over 26 weeks and 1,204 (33%) CYP had waited over 18 weeks (NHS Scotland, 2013, Child and Adolescent Mental Health Services waiting times in Scotland). Referral source, referral reason and the sociodemographic characteristics of CYP are not routinely collected, and therefore, associations between these factors and wait times for ‘start of treatment’ or ‘removal from the waiting list’ (i.e. the referral outcome) are unknown.

Method

In this exploratory study, a retrospective analysis of referral data was conducted in one CAMHS. Data for 476 referrals between 1st May 2013 and 31st May 2014 were initially analysed to define categories for each of the following key variables: referral source, referral reason and referral outcome. Data on CYP sociodemographic characteristics were extracted from referral records, including age, gender and postcode, from which Scottish Index of Multiple Deprivation quintile of residence was derived. Descriptive statistics were calculated for referral source, referral reason and CYP sociodemographic characteristics. Regression models were then built to determine predictors of a referral being rejected by CAMHS and waiting time for referrals accepted by CAMHS. Data were analysed in SPSS (Version 20).

Results

Of the 476 referrals, 72% (n = 342) were accepted and 12% (n = 59) were rejected. Most referrals were made by general practitioners. Just under a third of referrals to CAMHS (31%) were for CYP with emotional and behavioural difficulties. The odds of being rejected by CAMHS were significantly higher if referred by teachers and for CYP with emotional and behavioural difficulties. Age and referral reason were significant independent predictors of waiting time after referral to CAMHS, with CYP referred for hyperactivity/inattention waiting significantly longer.

Conclusions

Policymakers should consider ways to foster dialogue and collaboration between different groups of professionals making and accepting referrals to CAMHS in order to improve timely access to appropriate mental health support services for CYP. Research is urgently needed to investigate the experiences of CYP who are either rejected by CAMHS or wait lengthy periods of time before starting their treatment with CAMHS.