bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of care and health professional burnout: narrative literature review
Authors: Humphries Niamh , Morgan Karen , Catherine Conry Mary , McGowan Yvonne , Montgomery Anthony , McGee Hannah
Published: June 2014

Purpose

– Quality of care and health professional burnout are important issues in their own right, however, relatively few studies have examined both. The purpose of this paper is to explore quality of care and health professional burnout in hospital settings.

Design/methodology/approach

– The paper is a narrative literature review of quality of care and health professional burnout in hospital settings published in peer-reviewed journals between January 2000 and March 2013. Papers were identified via a search of PsychInfo, PubMed, Embase and CINNAHL electronic databases. In total, 30 papers which measured and/or discussed both quality of care and health professional burnout were identified.

Findings

– The paper provides insight into the key health workforce-planning issues, specifically staffing levels and workloads, which impact upon health professional burnout and quality of care. The evidence from the review literature suggests that health professionals face heavier and increasingly complex workloads, even when staffing levels and/or patient-staff ratios remain unchanged.

Originality/value

– The narrative literature review suggests that weak retention rates, high turnover, heavy workloads, low staffing levels and/or staffing shortages conspire to create a difficult working environment for health professionals, one in which they may struggle to provide high-quality care and which may also contribute to health professional burnout. The review demonstrates that health workforce planning concerns, such as these, impact on health professional burnout and on the ability of health professionals to deliver quality care. The review also demonstrates that most of the published papers published between 2000 and 2013 addressing health professional burnout and quality of care were nursing focused.
Improving process quality for pediatric emergency department
Authors: B.J. Kim Byungjoon , R. Delbridge Theodore , B. Kendrick Dawn
Published: June 2014

Purpose

– Overcrowding in emergency departments (EDs) leads to longer waiting times and results in higher number of patients leaving the ED without being seen by a physician. EDs need to improve quality for patients’ waiting time and length of stay (LoS) from the perspective of process and flow control management. The paper aims to discuss these issues.

Design/methodology/approach

– The retrospective case study was performed using the computerized ED patient time logs from arrival to discharge between July 1, 2009 and June 30, 2010. Patients were divided into two groups either adult or pediatric with a cutoff age of 18. Patients’ characteristics were measured by arrival time periods, waiting times before being seen by a physician, total LoS and acuity levels. A discrete event simulation was applied to the comparison of quality performance measures.

Findings

– Statistically significant differences were found between the two groups in terms of arrival times, acuity levels, waiting time stratified for various arrival times and acuity levels. The process quality for pediatric patients could be improved by redesign of patient flow management and medical resource.

Research limitations/implications

– The results are limited to a case of one community and ED. This study did not analyze the characteristic of leaving the ED without being seen by a physician.

Practical implications

– Separation of pediatric patients from adult patients in an ED can reduce the waiting time before being seen by a physician and the total staying time in the ED for pediatric patients. It can also lessen the chances for pediatric patients to leave the ED without being seen by a physician.

Originality/value

– A process and flow control management scheme based on patient group characteristics may improve service quality and lead to a better patient satisfaction in ED.
Lean Six Sigma and marketing: a missed opportunity
Authors: Chaplin Lara , T.J. O’Rourke Simon
Published: June 2014

Purpose

– The purpose of this paper is to assess the current use being made of the sustainability message within business improvement activity and project justification within individual businesses.

Design/methodology/approach

– This is a reflective paper that looks at an illustrative case study against the wider perspectives of Lean Six Sigma (LSS) implementation, market orientation and business improvement initiatives in general.

Findings

– The piece discusses the gains derived from the LSS projects and identifies gaps in potential benefits in particular the paper questions how well any potential marketing messages were exploited by the organisation. The findings critically evaluates the impact that marketing function involvement could have in helping to promote the wider productivity message and its contribution to the wider corporate social responsibility (CSR) strategy for the organisation. The document also suggests how the company could leverage internally focused projects to adopt a companywide marketing orientation and use such leverage to support future LSS project selection and justification.

Research limitations/implications

– The observations are limited to a single case study, although tempered by the authors’ wider experience. Further empirical research is required to validate the observations and conclusions.

Practical implications

– The proposed approach to future improvement initiatives can help to increase the wider productivity message and assist organisations to exploit their internal projects in external communications and wider CSR strategy.

Originality/value

– The paper proposes an approach that can be used to widen organisational involvement in improvement initiatives allowing future project justification to be less internally cost focused, more holistic with a focus on customer voice.
The tragedy of the private: transaction cost considerations
Authors: Peneva Todorova Tamara
Published: June 2014

Purpose

– The purpose of this paper is to weigh the benefits and costs of public property, as opposed to private, from the transaction cost perspective. In the absence of transaction costs, private property has clear advantages over public. However, when the true costs of running an economic system are taken into account, the advantages of private property are not so evident and public property may turn out to be the preferred form of ownership. The paper shows that in high-transaction cost sectors and economies such as the newly emerging markets in Eastern Europe, public property is a cheaper way of organizing economic activities, as it can save on transaction costs. The paper demonstrates these virtues of public ownership in relation to market failure, the provision of public goods, natural monopolies and competitive industries with a high degree of market uncertainty, opportunism and asset specificity.

Design/methodology/approach

– A qualitative paper discussing the advantages of public over private property in the presence of high-transaction costs.

Findings

– Studying different types of market failure the paper finds that public property is advantageous to private in high-transaction cost systems.

Originality/value

– Since most of the standard literature emphasizes the advantages of private property, the paper gives an economic explanation to those of public property taking on a new institutional approach and conducting a transaction cost analysis.
Income inequality in the EU: how do member states contribute?
Authors: Papatheodorou Christos , Pavlopoulos Dimitris
Published: June 2014

Purpose

– The purpose of this paper is to analyse the structure of overall inequality in the EU-15 by investigating the extent to which total inequality is attributed to inequality between or within the individual countries. Also, the paper examines whether the contribution of between-country and within-country components changed in the period between 1996 to 2008, before the outbreak of the economic crisis.

Design/methodology/approach

– The paper applies a decomposition analysis by population subgroup utilizing micro-data from the ECHP and EU-SILC surveys. A number of inequality indices are employed to capture the different aspects of inequality and test the robustness of the results.

Findings

– The analysis shows that the between-countries differences account only for a small part of overall inequality in the EU-15. Furthermore, the contribution of the between county component to total inequality has shrunk dramatically during the examined period. The overall EU inequality has been affected disproportionally by income disparities at the various parts of the income distribution in different countries.

Practical implications

– Policies aiming to reduce inequality within each country would be far more effective in reducing overall inequality in the EU than policies targeting to reduce only disparities between member states.

Originality/value

– The findings question the effectiveness of EU policy priorities to decrease inequality that have mainly focused on reducing cross-country and/or regions differences regarding certain macroeconomic indicators such as per-capita income (or GDP). The evidence suggests that the social protection system provides a useful tool in explaining the differences in inequality between countries and their contribution to overall EU inequality.
Financial development and economic growth in GCC countries
Authors: Grassa Rihab , Gazdar Kaouthar
Published: June 2014

Purpose

– The purpose of this paper is to compare the effects of Islamic financial development and conventional financial development on the economic growth for five GCC countries (Bahrain, Kuwait, Qatar Saudi Arabia and UAE).

Design/methodology/approach

– Using generalized least squares, OLS and panel data frameworks, this paper employs different measures of financial development for the period (1996-2011).

Findings

– Empirical results strongly support the hypothesis that Islamic finance leads to growth in the five GCC countries, however, no significant relationship observed between conventional financial development and growth.

Practical implications

– The findings of this paper suggest the need to accelerate the financial reforms for Islamic finance that have been launched in the region since the last decade and to improve the efficiency of these countries’ Islamic financial systems to stimulate saving/investment and, consequently, long-term economic growth.

Originality/value

– This study has several contributions to the existing literature. To the best of the authors’ knowledge, this paper is the first study that examines empirically the effect of Islamic finance on economic growth in GCC countries. As well, this paper is the first to compare the different effects of Islamic finance and conventional finance on economic growth on a context of countries having the most developed Islamic financial system in the world operating side-by-side with a conventional financial system.
Customer relationship mining system for effective strategies formulation
Authors: Lam H.Y. , Ho G.T.S. , Wu C.H. , Choy K.L.
Published: June 2014

Purpose

– The purpose of this paper is to propose a customer relationship mining system (CRMS) to analyze the data collected from franchisees and formulates a marketing strategy based on customer demand and behavior.

Design/methodology/approach

– The system makes use of cloud technology to collect and manage data among the franchisees. An integrated approach of association rule mining and the neural network technique is adopted to investigate customer behavioral patterns and to forecast sales demand, respectively.

Findings

– The significance and contribution of this paper are demonstrated by adopting the CRMS in the education industry in Hong Kong. The findings led to the identification of student learning intentions such as course preferences, and the forecasting of enrolment demand in terms of demand forecast. It is believed that better resources allocation can be achieved and an increase in customer satisfaction is foreseeable.

Research limitations/implications

– The proposed CRMS could be applied to various franchising industries for effective marketing strategy formulation. However, since the data in this study are extracted from a specific industry, modifications may be required before the CRMS can be applied to other franchising industries.

Originality/value

– This study presents a new application to convert data into useful knowledge, and provides useful insights for delivering strategic promotional plans under a franchising business model. Through the pilot study conducted in a franchising education center, the results demonstrate that the proposed CRMS is valuable in providing effective promotion to attract more customers, better preparation in resources allocation and more standardized methods to formulate marketing strategies in the franchising industry.
Supply chain design through QFD-based optimization
Authors: Durga Prasad K.G. , Venkata Subbaiah K. , Narayana Rao K.
Published: June 2014

Purpose

– The purpose of this paper is to demonstrate a methodology to design a supply chain with a view to achieve a strategic fit between competitive and supply chain strategies.

Design/methodology/approach

– Quality function deployment (QFD)-based optimization methodology is employed to design a supply chain for a product through aligning the competitive and supply chain strategies. Normal boundary intersection (NBI) method is adopted to obtain optimal weights of the supply chain design objectives. Weighted additive model is developed for multi-objective optimization. Utility-based attribute function, which structure the relationship between the elements of competitive and supply chain strategies is established. The utility functions and the information contained in the House of Quality (HOQ) of QFD are used to define the supply chain performance (SCP).

Findings

– SCP index is computed using the set of supply chain design objectives obtained by solving the weighted additive model. On the basis of SCP index, the supply chain activities are planned accordingly. An illustrative example is presented in this paper to describe the QFD-based optimization methodology for designing a supply chain.

Originality/value

– QFD-based optimization is a novel approach to design a supply chain with a focus on aligning competitive and supply chain strategies.
The Six Sigma program: an empirical study of Brazilian companies
Authors: Monteiro de Carvalho Marly , Lee Ho Linda , Helena Boarin Pinto Silvia
Published: June 2014

Purpose

– The purpose of this paper is to assess the status of Six Sigma's status in Brazilian companies and understand the integration of this program with other quality management approaches. Additionally, the critical success factors (CSFs) for Six Sigma implementation and primary Six Sigma program characteristics were identified. Finally, the results of the used of Six Sigma were analysed.

Design/methodology/approach

– An extensive literature review illustrates the primary Six Sigma characteristics and its relationship with other quality approaches. The research methodology encompasses survey development and statistical analyses. Questionnaires are distributed to 1,000 large firms in the manufacturing and service industries in Brazil. Altogether, a total of 198 firms, of which 46 companies adopted the Six Sigma program, participated in this study.

Findings

– The results suggest a synergic and incremental pattern of quality model implementation. The study reveals that companies that have adopted Six Sigma have a long history of implementing quality programs, which suggests a certain level of quality maturity. The studied companies perceive in Six Sigma an incremental evolution, which can be combined with earlier initiatives and provides strong synergy with ISO 9000. The findings of this study confirm the distinctive Six Sigma role structure suggested by several authors. However, three possible configurations of the role structure were found that differ in terms of training and the dedication of human resources involved in the Six Sigma program.

Research limitations/implications

– This study demonstrates the inherent limits of the research method adopted, the use of a non-probabilistic sample and a reliance on self-reported perceptions, which introduces bias to the analysis.

Practical implications

– Important managerial implications of this study are related to the Six Sigma structure adopted. The capillarity of the program in the organisation as a whole can be related to the type of role structure configuration adopted. This structure can have an impact in terms of both numbers and employees’ and managers’ degree of involvement, as well as the type of training and resources provided.

Originality/value

– The diffusion of Six Sigma in Brazilian companies is less widespread than in other countries. Three possible configurations of the role structure were found that differ in terms of the training and dedication of human resources entailed by the Six Sigma program. Three CSFs factors were identified: organisation, infrastructure and human resources.
Status of lean manufacturing practices in Indian industries and government initiatives
Authors: Thanki S.J. , Thakkar Jitesh
Published: June 2014

Purpose

– The purpose of this paper is to report a pilot study on lean awareness and implementation using the survey data collected from about 32 industries situated in western and eastern region of India.

Design/methodology/approach

– A survey instrument containing 45 statements was designed to assess respondents’ attitude and awareness toward lean practices and to explore the level of lean implementation in the organization. The instrument was distributed personally or through mail to the employees of 32 industries and they were supported for any query about the questions. Descriptive statistical analysis, hierarchical cluster analysis and ANOVA were used to analyze the data with SPSS statistical software.

Findings

– The research uncovers the fact that the current status of lean implementation and awareness in Indian industries is not so encouraging and the reason for that is, the human-related issues are not tackled properly. Quality and process technology, are the two key areas where industries are indicating inadequate efforts and poor insight.

Research limitations/implications

– The study conducted was limited to 32 industries situated in the eastern and western region of India. The data collected for few industries rely on only one respondent.

Practical implications

– The study identifies the lean implementation status based on nine lean assessment key areas and uncovers the major roadblocks for lean practices in Indian industries. It provides key insights to lean practicing industries and lean practitioner about the major barriers and key areas for the improvement.

Originality/value

– The paper reports comprehensive insights on current awareness and implementation of lean manufacturing (LM) in India. It also highlights the initiatives taken by Government of India to increase the competitiveness of the Indian industries, specifically of manufacturing sector, through the adoption of LM techniques. This would provide a platform for carrying out a detailed research in LM in Indian context.
Lean “Leadership People Process Outcome” (LPPO) implementation model
Authors: K. Dibia Ifechukwude , Nath Dhakal Hom , Onuh Spencer
Published: June 2014

Purpose

– The purpose of this paper is to present the Lean “Leadership People Process Outcome” (LPPO) implementation model.

Design/methodology/approach

– The model is developed from existing models through literature review and its success from use in lean implementation is reported in case studies.

Findings

– The LPPO model is a Lean implementation model that is flexible and easily adaptable. It is system based, people driven, customer centred, with measurable outcome and a drive for continuous improvement.

Research limitations/implications

– This work is based on existing literature and case studies.

Practical implications

– The paper would be of interest to Lean practitioners as the model developed is system generic and easily adaptable.

Originality/value

– The LPPO model presented in this paper has been newly developed and the successful application is seen in the case studies.
Quantitative modeling and analysis of supply chain risks using Bayesian theory
Authors: Badurdeen Fazleena , Shuaib Mohannad , Wijekoon Ken , Brown Adam , Faulkner William , Amundson Joseph , Jawahir I.S. , J. Goldsby Thomas , Iyengar Deepak , Boden Brench
Published: June 2014

Purpose

– Globally expanding supply chains (SCs) have grown in complexity increasing the nature and magnitude of risks companies are exposed to. Effective methods to identify, model and analyze these risks are needed. Risk events often influence each other and rarely act independently. The SC risk management practices currently used are mostly qualitative in nature and are unable to fully capture this interdependent influence of risks. The purpose of this paper is to present a methodology and tool developed for multi-tier SC risk modeling and analysis.

Design/methodology/approach

– SC risk taxonomy is developed to identify and document all potential risks in SCs and a risk network map that captures the interdependencies between risks is presented. A Bayesian Theory-based approach, that is capable of analyzing the conditional relationships between events, is used to develop the methodology to assess the influence of risks on SC performance

Findings

– Application of the methodology to an industry case study for validation reveals the usefulness of the Bayesian Theory-based approach and the tool developed. Back propagation to identify root causes and sensitivity of risk events in multi-tier SCs is discussed.

Practical implications

– SC risk management has grown in significance over the past decade. However, the methods used to model and analyze these risks by practitioners is still limited to basic qualitative approaches that cannot account for the interdependent effect of risk events. The method presented in this paper and the tool developed demonstrates the potential of using Bayesian Belief Networks to comprehensively model and study the effects or SC risks. The taxonomy presented will also be very useful for managers as a reference guide to begin risk identification.

Originality/value

– The taxonomy developed presents a comprehensive compilation of SC risks at organizational, industry, and external levels. A generic, customizable software tool developed to apply the Bayesian approach permits capturing risks and the influence of their interdependence to quantitatively model and analyze SC risks, which is lacking.
Interview with Dr Rosalie Tung: a cross-cultural studies researcher and published author
Authors: Murillo Rocio
Published: June 2014

Purpose

– This interview was conducted with Dr Rosalie Tung. Dr Tung gives her insight about her career.

Design/methodology/approach

– Interview was conducted via Skype. There was a somewhat systematical approach to the Q&A interview.

Findings

– Dr Tung briefly goes through her academic career regarding cross-cultural studies and how her life experiences shaped her passion for the subject.

Originality/value

– This was a one-on-one interview via Skype.
Defining perceived employability: a psychological approach
Authors: Vanhercke Dorien , De Cuyper Nele , Peeters Ellen , De Witte Hans
Published: June 2014

Purpose

– The purpose of this paper is to define employability within the psychological literature with a focus upon perceived employability.

Design/methodology/approach

– To achieve the aim, the paper defines five objectives as follows. First, the paper discusses how employability is interpreted in the psychological literature. Second, the paper defines perceived employability within this literature. Third, the paper goes one step further by comparing the perceived employability approach to other approaches in the psychological field, namely, approaches based on competences and dispositions. The paper concludes with an integration of the three approaches into a process model to demonstrate their interrelationships, which the authors see as the fourth objective. With approach, the paper refers to a specific view on employability, including both definitions and measures, which share significant common ground. Finally, the paper highlights some implications.

Findings

– The paper concludes that each approach comes with specific advantages and disadvantages. Researchers and practitioners should use an approach according to the general research question one aims to address.

Originality value

– The authors believe to contribute to the employability literature in the following ways. First, the paper raises awareness that not all psychological notions of employability are equal, though they are often treated as such in the literature. Second, the paper highlights how perceived employability is tied to competences and dispositions. That is, though all notions are clearly different, they are also related.
2.5 million hectares and one sustainable goal
Authors: A. Moscovici Daniel
Published: June 2014

Purpose

– The purpose of this paper is to investigate historical environmental destruction and subsequent land use policies enacted over the last 400 years in the Adirondacks Park & Preserve – America's largest park and preserve in the lower 48 states.

Design/methodology/approach

– The paper includes a historical analysis using an extensive literature review. The historical analysis is divided into four distinct waves of time analyzing the specific environmental destruction and the policies enacted. They closely mimic century waves: 1700s, 1800s, 1900s, and the present 2000s.

Findings

– Findings indicate that each of the major policy or land use instruments applied to the Adirondack region were appropriate at the time, however, were retroactive approaches to stem widespread environmental devastation. These strong measures still impact the region today, impairing the 2.5 million ha and the ability to ensure a sustainable future of environmental protection, economic prosperity, and societal well-being. The conservation easement as a tool can proactively return the region to a sustainable balance.

Originality/value

– While there have been studies analyzing the historical importance and others highlighting the political uniqueness of the Adirondacks, this paper fills the gap in reframing the history and policies in a sustainable planning paradigm. Exposing retroactive responses when the environment was on the brink of destruction, the paper suggests a proactive approach using the conservation easement. Here, sustainability can be achieved through partnership between government, non-profit, and private business. This collaboration can build on one of the best regional planning models in the nation and ensure a balance between environment, economy, and society for more than one century wave.
Who will care for older people in China? Exploring the implications of gender imbalance at birth
Authors: Kadoya Yoshihiko , Yin Ting
Published: June 2014

Purpose

– The purpose of this paper is to provide evidence about the possible cause and effect of the problematic gender imbalance at birth in China. Much of the literature on this issue presents discussions based on the traditional assumption that Chinese sons are more involved in taking care of parents than Chinese daughters are, and thus, that Chinese parents prefer sons. Yet, empirical evidence is lacking.

Design/methodology/approach

– This paper verifies the assumption by using the “Preference Parameters Study in China 2011,” which conducted 652 face-to-face interviews with randomly selected individuals in six major Chinese cities.

Findings

– This paper first presents empirical evidence that Chinese sons (and their wives) are more likely, compared to daughters (and their husbands), to be primary caregivers for parents. The paper also reports the finding that Chinese parents’ dependencies on their children would not necessarily decrease with the development of social security, although that may be the case when a child has a highly educated spouse.

Practical implications

– The Chinese government needs to increase long-term care services for older people, especially since more women are being educated.

Originality/value

– Although this study has data collection limitations, with data collected in only six major cities, the problematic nature of gender imbalance at birth and the lack of available empirical evidence demand that researchers begin to construct a better understanding of the causes of, and possible solutions to, this phenomenon. With that in mind, this paper contributes to that construction of knowledge and insight.
Progress towards Healthy Ageing in Europe: to promote active healthy lifestyles in 45-68 year olds through workplace, rather than traditional health-related settings
Authors: Anne Gibson Elspeth
Published: June 2014

Purpose

– Progress towards Healthy Ageing in Europe has been a two-year European funded project led by Suffolk County Council Public Health and involving five European Union (EU) member nations. The purpose of this paper is to share the learning from the project as it relates to early preventative activity to promote healthy active ageing. The population of interest are those people in the mid-life age group of 45-68 years accessed via the workplace.

Design/methodology/approach

– Qualitative research applying an online Health Manager tool and focus group discussions. Transnational work to learn from other EU countries about approaches to promote healthy active ageing.

Findings

– A comprehensive account of all project findings is available via the following web site: www.progresshealthyageing.eu This paper outlines the findings from the UK regional activity of the application of an online Health Manager™ tool to employees from Suffolk in the 45-68 year age group.

Research limitations/implications

– The research limitations related to smaller cohorts (ca. 1,000 participants) as opposed to large-scale surveys. The phenomenon of the “healthy worker effect” (Shah, 2009), may be a limitation as the population of interest in this age group were mainly employed and in paid employment. The healthy worker effect implies that those who are employed are already “healthier” due to being employed. The further limitation of the timescale for the intervention and project funding as a resource limitation precludes longer term follow-up and evidence collection to find out if behaviour change in participants has been sustained over time.

Social implications

– The findings of the EU Project have contributed towards the Europe 2020 Strategy. Locally the findings from the project have supported Suffolk County Council's ambition to be the most active county in England. The findings have added momentum to local workplace health initiatives by providing a focus for the needs of the older workforce. Learning from the Project has also informed development of the Suffolk Workplace Challenge.

Originality/value

– This paper provides a review on a European project, Progress towards Healthy Ageing in Europe.
Coadministration of β‐asarone and levodopa increases dopamine in rat brain by accelerating transformation of levodopa: A different mechanism from Madopar
Authors: Huang Liping , Deng Minzhen , Zhang Sheng , Fang Yongqi , Li Ling
Published: June 2014

The aim of the present study was to investigate the effect of coadministration of β‐asarone and levodopa (l‐dopa) on increasing dopamine (DA) in the striatum of healthy rats. Rats were randomly divided into four groups: (i) a normal group, administered normal saline; (ii) a Madopar group, administered 75 mg/kg Madopar (l‐dopa : benserazide, 4 : 1); (iii) an l‐dopa group, administered 60 mg/kg l‐dopa; and (iv) a group coadministered 15 mg/kg β‐asarone and 60 mg/kg l‐dopa. All drugs (or normal saline) were administered intragastrically twice a day for 7 days. Then, plasma and striatum concentrations of DA, l‐dopa, 5‐hydroxytryptamine (5‐HT), homovanillic acid (HVA), 3,4‐dihydroxyphenylacetic acid (DOPAC), tyrosine hydroxylase (TH), catechol‐O‐methyltransferase (COMT) and monoamine oxidase B (MAO‐B) were determined. In the group coadministered β‐asarone and l‐dopa, there was a decline in plasma and striatal concentrations of l‐dopa; however, DA and DOPAC concentrations increased in the striatum and plasma and plasma HVA concentrations increased, whereas there was no significant change in striatal levels. Concentrations of 5‐HT in the striatum and plasma were similar in the coadministered and Madopar‐treated groups. In addition, plasma and striatal COMT levels decreased after coadministration of β‐asarone and l‐dopa, whereas there were no significant differences in MAO‐B concentrations among groups. Furthermore, coadministration of β‐asarone and l‐dopa increased plasma TH concentrations. Altogether, β‐asarone affects the conversion of l‐dopa to DA by modulating COMT activity and DA metabolism. The mechanism of coadministration is different from that of Madopar in Parkinson's disease (PD) treatment. Thus, the coadministration of β‐asarone and l‐dopa may be beneficial in the treatment of PD.
Emerging role of cystic fibrosis transmembrane conductance regulator as an epigenetic regulator: linking environmental cues to microRNAs
Authors: Chan Hsiao Chang , Jiang Xiaohua , Ruan Ye Chun
Published: June 2014

Although microRNAs (miRNAs) have been recognized as one of the important epigenetic mechanisms that regulate gene expression in response to changes in the environment, the links between environmental cues and changes in miRNAs remain largely unknown. Localized to the cell membrane and recognized as an anion channel, the cystic fibrosis transmembrane conductance regulator (CFTR) has recently been shown to mediate important signalling pathways leading to activation of miRNAs. This brief review summarizes the related findings and discusses the emerging role of CFTR as an epigenetic regulator, possibly involved in a wide spectrum of physiological and pathological processes.
Inhibitory action of naphtho[1,2‐b]furan‐4,5‐dione on hepatocyte growth factor‐induced migration and invasion of MDA‐MB‐231 cells: Mechanisms of action
Authors: Tsai Pei‐Chien , Chu Chiao‐Lun , Tseng Chih‐Hua , Chen Yeh‐long , Chang Long‐Sen , Lin Shinne‐Ren
Published: June 2014

Naphtho[1,2‐b]furan‐4,5‐dione (NFD), a bioactive component of Avicennia marina, has been shown to exhibit anticancer activity. The aim of the present study was to explore the effect of NFD on hepatocyte growth factor (HGF)‐induced cell migration and invasion of MDA‐MB‐231 human breast cancer cells, as well as the underlying mechanism of action. Cell viability was determined using the 3‐(4,5‐dimethyl‐2 thiazoyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide assay, western blot analysis was used to measure protein expression and cell migration and invasion were evaluated by the cell wound healing assay, Boyden chamber assay and gelatin zymography. When cells were treated with non‐toxic concentrations of NFD (1–3 μmol/L, 24 h), NFD concentration‐dependently inhibited HGF‐promoted cell migration and invasion. Simultaneously, NFD efficiently suppressed c‐Met phosphorylation and downstream activation of phosphatidylinositol 3‐kinase (PI3K) and Akt. In addition, NFD inhibited the phosphorylation of IκB kinases and IκBα and nuclear translocation of nuclear factor (NF)‐κB, as well as matrix metalloproteinase (MMP)‐9 activity. Furthermore, the c‐Met inhibitor PHA665752 (10 μmol/L) inhibited HGF‐induced MMP‐9 expression, cell migration and invasion, as well as the activation of PI3K/Akt, suggesting that PI3K/Akt activation occur downstream of c‐Met activation. In conclusion, the results of the present study suggest that NFD inhibits HGF‐induced invasion and migration of MDA‐MB‐231 cells via HGF‐ and/or c‐Met‐mediated PI3K/Akt and NF‐κB signalling pathways, leading to downregulation of MMP‐9 expression and cell migration.
Stimulation of electroporation‐induced inward currents in glioblastoma cell lines by the heat shock protein inhibitor AUY922
Authors: Chiang Nai‐Jung , Wu Sheng‐Nan , Kao Ching‐An , Huang Yan‐Ming , Chen Li‐Tzong
Published: June 2014

Membrane electroporation (MEP) increases the electrical conductivity of the plasma membrane by addition of an external electrical field. Combining MEP‐induced current (IMEP) with antineoplastic agents has been increasingly considered as a new therapeutic manoeuvre, especially in the treatment of malignant gliomas. Thus, the aim of the present study was to evaluate the effect of AUY922 (AUY), a potent inhibitor of heat‐shock protein 90 (HSP90), on IMEP in glioblastoma cells. The IMEP in glioblastoma cells (U373) was generated by repetitive hyperpolarization from −80 to −200 mV. The amplitude of IMEP was increased by AUY in a concentration‐dependent manner, with an EC50 of 0.32 μmol/L. In addition AUY shortened the latency to IMEP generation. Before depolarization to +50 mV, hyperpolarization to −200 mV for 50 msec produced Ca2+ influx and subsequently increased the amplitude of the Ca2+‐activated K+ current (IK(Ca)). The amplitude of IK(Ca) and Ca2+ influx was further increased by AUY through its ability to activate IMEP. Other HSP90 inhibitors, namely 17‐(allylamino)‐17‐demethoxygeldanamycin (17‐AAG; 1 μmol/L) and 6‐chloro‐9‐[(4‐methoxy‐3,5‐dimethylpyridin‐2‐yl)methyl]‐9H‐purin‐2‐amine (BIIB021; 1 μmol/L), only slightly (albeit significantly) increased the amplitude of IMEP in glioblastoma cells. A 50 msec depolarizing step elevated Ca2+ influx and subsequently increased the amplitude of IK(Ca) in the presence of these three inhibitors. These data indicate that the AUY‐mediated stimulation of IMEP and IK(Ca) in glioblastoma cells is independent of HSP90 inhibition. Moreover, these results indicate that AUY‐stimulated IMEP and the subsequent activation of IK(Ca) may create important signalling events in glioblastoma cells. Thus, AUY is a drug that could potentially be used to augment the effectiveness of electrochemotherapy.
Outcome of Patients with Severe PH due to Lung Disease with and without Targeted Therapy
Authors: Lange Tobias J. , Baron Miriam , Seiler Isabella , Arzt Michael , Pfeifer Michael
Published: June 2014

Introduction

Pulmonary hypertension (PH) can occur in patients with lung disease and worsen prognosis. Endothelin receptor antagonists, phosphodiesterase 5‐inhibitors, and prostacyclin analogs, referred to as targeted therapy, have not been shown in a limited number of controlled clinical studies to improve exercise capacity in these patients. Possibly targeted therapy could be of benefit in patients with severe PH due to lung disease, but this subgroup is not well studied.

Aims

To analyze influence of PH severity and use of targeted therapy on exercise capacity and survival in patients with PH due to lung disease.

Methods

Consecutive patients with PH (mean pulmonary artery pressure ≥25 mmHg at rest) due to lung disease diagnosed by right heart catheterization between 1/2005 and 9/2011 were retrospectively included. Severe PH was defined as mean pulmonary artery pressure ≥35 mmHg. Patients were followed until 4/2012 for exercise capacity, survival, and targeted therapy use.

Results

Patients with severe PH (n = 40) received significantly more often targeted therapy compared to the 32 patients with less severe PH (65% vs. 25%, P = 0.001). Survival was not significantly different between these groups (P = 0.310). Patients on targeted therapy were older, more often female, and had worse hemodynamic impairment, but significantly higher estimated 1‐, 3‐, and 5‐year survival rates compared to untreated patients (97%, 81%, and 75% vs. 83%, 54%, and 19%, respectively; P = 0.002). This effect was mainly driven by the patients with severe PH, in whom the survival advantage was statistically significant on subgroup analysis (HR 0.182, P = 0.002). Exercise capacity was not significantly altered in any patient group.

Conclusion

Patients with severe PH due to lung disease may have a survival benefit from targeted therapy compared to untreated patients with less severe PH. Prospective clinical trials utilizing targeted therapy and long‐term endpoints are justified in this patient group.
Prescribers' Practice of Assessing Arrhythmia Risk with QT‐Prolonging Medications
Authors: Choo Wai Kah , Turpie David , Milne Kim , Davidson Lynne , Elofuke Petrus , Whitfield Jonathan , Broadhurst Paul
Published: June 2014

Aims

This study aimed to assess prescribers' monitoring for arrhythmic risk with QT‐prolonging medications (LQT drugs).

Methods

Over a 6‐month period, all inpatients under the care of Cardiologists (Cohort A) and General Physicians (Cohort B) at Aberdeen Royal Infirmary who were prescribed drugs with known risk of Torsades de Pointes (TdP) were identified. Admission and repeat electrocardiograms (ECG) after 48 h of commencing a LQT drug were examined. Actions taken if QTc was prolonged and drug–drug interactions were examined. A risk estimate on the UK hospital population was calculated.

Results

Of the 4133 patients admitted during the study period, 234 (6%) patients were prescribed a LQT drug. There were 100 (43%) patients in Cohort A and 134 (57%) patients in Cohort B. Of those admitted with a pre‐existing LQT drug prescription, an ECG was performed in 167 (96%) of patients and QTc prolongation was identified in 59 (34%). Of those who received a new prescription of LQT drug, 23 (38%) had QTc prolongation and more patients in Cohort A than Cohort B had a repeat ECG within 48 h (84% vs. 11%, P < 0.0001). QTc prolongation was only recognized in 6 (14%) and 2 (5%) patients in cohorts A and B, respectively. Only one patient at risk of drug interaction had QTc prolongation. None of our patients had documented TdP in hospital. Extrapolating these findings to the UK hospital population, at least 204 and <17–175 patients on cardiac and noncardiac LQT drugs, respectively, might be expected to have TdP each year.

Conclusion

Recognition of acquired QTc prolongation is poor. Clinician education and an electronic prescribing system may improve this situation.
Incidental renal neoplasms: is there a need for routine screening? A Danish single‐center epidemiological study
Authors: Rabjerg Maj , Mikkelsen Minne Nedergaard , Walter Steen , Marcussen Niels
Published: June 2014

On the basis of associations between tumor size, pathological stage, histological subtype and tumor grade in incidentally detected renal cell carcinoma vs symptomatic renal cell carcinoma, we discussed the need for a screening program of renal cell carcinoma in Denmark. We analyzed a consecutive series of 204 patients with renal tumors in 2011 and 2012. The tumors were classified according to detection mode: symptomatic and incidental and compared to pathological parameters. Eighty‐nine patients (44%) were symptomatic, 113 (55%) were incidental. Information was not available in two patients. In the incidental group, the size (p < 0.05), pathological stage (p < 0.001), Fuhrman grading (p < 0.0001) and Leibovich score (p < 0.0001) were lower than in those causing symptoms. Significantly less in the incidental group had metastasis at follow‐up (p < 0.0001). Incidentally discovered RCC constitute a major part of kidney tumors. They have a more favorable prognosis than symptomatic tumors and seem to be discovered in an earlier phase. Needle core biopsy is an accurate technique for distinguishing between malignant and benign tumors and is recommendable for smaller incidental tumors. Screening may help detect RCC at an earlier stage.
Dysplasia and cancer screening in 21st century
Authors: Khunger Monica , Kumar Ujjwal , Roy Hemant K. , Tiwari Ashish K.
Published: June 2014

Cancer is the second leading cause of death in the United States, and is projected to overtake cardiovascular diseases as the number one cause of mortality in adults within a decade. Cancer screening offers an opportunity to detect cancer precursor lesions at early stages, and hence preemptively manage and prevent development of frank cancers. Despite tremendous technological advances over last decade, which allow us to study genomic/epigenomic and proteomic profile of cells with unprecedented details, it has been difficult to develop non‐invasive biomarkers with high sensitivity and specificity that can have clinical applications. Dysplasia, which requires histopathological examination of the tissue, remains the best marker of propensity to develop cancer, and hence the best available surrogate biomarker. However, procuring tissues for detection of dysplasia is highly invasive and economically unviable for most visceral malignancies. Therefore, there is emphasis on developing circulating biomarkers through a consortium approach where high‐performing biomarkers in basic research are tested in large collaborative clinical settings to assess their clinical efficacy. In this review, we have discussed fundamental principles of cancer screening, difficulties in developing novel and effective biomarkers, continuing reliance on dysplasia as best available surrogate marker for cancer screening, as well as briefly highlighted newer screening modalities.