bluuebunny/crossref_metadata_2025 huggingface dataset:
Partners or Managers? A Case Study of Public–Private Partnerships in New York City
Authors: DiMartino Catherine , Thompson Eustace
Published: November 2016

This case tells the story of a failed public–private partnership. It illustrates how stakeholders, encouraged by the current political context, rushed into a partnership without establishing a basis for mutual understanding and expectations. As a result of this hasty arrangement, questions emerged over who ultimately controlled decisions related to curriculum and personnel issues. This case speaks to educational school and district leaders as well as private sector actors interested in becoming involved in public education. Students studying this case should examine the power and potential of memos of understanding and contracts, the importance of a unified educational vision and the successes and pitfalls of public–private partnerships.
Sensitivity and Specificity of Skyline and Carpal Shoot-Through Fluoroscopic Views of Volar Plate Fixation of the Distal Radius: A Cadaveric Investigation of Dorsal Cortex Screw Penetration
Authors: Stoops T. Kyle , Santoni Brandon G. , Clark Nicolette M. , Bauer Amy A. , Shoji Christopher , Schwartz-Fernandes Francisco
Published: November 2016

Background: Volar plate fixation of distal radius fractures can result in soft tissue injuries. Abnormal contour of the dorsal cortex of the distal radius provides difficulties in discerning screw penetration on standard radiographs. The skyline and carpal shoot-through views are additional views to improve dorsal cortex visibility. We report on the sensitivity and specificity of determining screw protrusion with these views. Methods: Seven fresh frozen cadavers were instrumented with a distal radius volar locking plate. Initial screw length was determined by depth gauge measurement. A dorsal dissection of the wrist was performed to detect screw penetration. Protruding screws were documented and replaced with screws of the appropriate length and deemed as baseline. Screws were then sequentially lengthened by 2 and 4 mm. Skyline and carpal shoot-through views were obtained at baseline, 2 mm, and 4 mm. The images were randomized and compiled into an untimed survey asking orthopedic surgeons to determine whether screws were penetrating through the dorsal cortex. Results: Based on depth gauge measurements, 4 out of 44 (9.1%) volar plate locking screws penetrated the dorsal cortex, as confirmed with dorsal dissection. Sensitivities for the skyline and carpal shoot-through views were 75% and 86% ( P ≤ .001), respectively, for 2-mm protrusions, and 76% and 89% ( P ≤ .001), respectively, for 4-mm screw protrusions. Specificities were 85% and 84% for the skyline and shoot-through views, respectively. Conclusions: We believe that the carpal shoot-through view has utility and can be implemented to augment standard intraoperative views, and may decrease the incidence of screw protrusion resulting in soft tissue injuries.
Coping with increased managerial tasks: tensions and dilemmas in nursing leadership
Authors: Kristiansen Margrethe , Westeren Knut Ingar , Obstfelder Aud , Lotherington Ann Therese
Published: November 2016

The present study explores how increased managerial tasks affect nursing leadership in Norwegian nursing homes. Responding to New Public Management reforms, increased managerial tasks have been implemented by Norwegian central government into public nursing homes. Even though nursing leadership plays a key role in implementing managerial tasks, it is still unclear how nurses describe the influence of increased managerial tasks in nursing leadership. This was a qualitative study, including 100 hours of observations and 18 semi-structured interviews of nurses holding various positions in three public nursing homes. Thematic analysis was used in analysing data. Three changes were identified in the exercise of nursing leadership: (1) leading daily care from a distance; (2) lack of support in problem-solving; and (3) difficulties in adopting new managerial language. The study demonstrates that managers take on a more administrative role that, in turn, weakens their ability to supervise and motivate nurses in daily care. Lack of a reciprocal relationship between managers and nurses in goal achievement has significantly weakened nursing leadership in nursing homes. The study contributes knowledge on how nursing leadership weakens as a response to changes in nurses’ roles with increased managerial tasks.
Fostering self-care behaviours through symptom diary use? An exploratory, cross-sectional study about the use of and attitude towards a symptom diary of patients with heart failure
Authors: Köberich Stefan
Published: November 2016

Using health diaries is associated with improved outcomes in patients with heart failure. However, heart failure patients’ attitudes towards using a diary have not been investigated so far. The aim of this study was to investigate heart failure patients’ attitudes towards and the factors influencing diary use. Patients who took part in an educational session to foster self-care behaviours, during which they were given a diary, were asked to participate in this explorative, cross-sectional survey study. The survey took place at least six months after the educational session. Over half of the 53 participants (52.8%) were still using the diary. Reasons for not using it were no perceived need to use it, stable vital signs, and being able to recognise symptoms of exacerbation without the diary. Users and non-users did not differ in their general attitudes towards diary use except regarding the statements ‘Keeping a diary makes no sense’ and ‘Keeping a diary helps to control the disease and the occurrence of symptoms’. Therefore, diary users may be prone to better self-care activities. Age and living situation are influencing diary use. To improve diary adherence, health care providers should stress the advantage of using a diary and the importance of diary adherence.
Does prior antiplatelet treatment improve functional outcome after intra-arterial treatment for acute ischemic stroke?
Authors: Mulder Maxim JHL , Berkhemer Olvert A , Fransen Puck SS , van den Berg Lucie A , Lingsma Hester F , den Hertog Heleen M , Staals Julie , Jenniskens Sjoerd FM , van Oostenbrugge Robert J , van Zwam Wim H , Majoie Charles BLM , van der Lugt Aad , Dippel Diederik WJ ,   on behalf of the MR CLEAN investigators
Published: November 2016

Background and purpose

In patients with acute ischemic stroke who receive antiplatelet treatment, uncertainty exists about the effect and safety of intra-arterial treatment. Our aim was to study whether intra-arterial treatment in patients with prior antiplatelet treatment is safe and whether prior antiplatelet treatment modifies treatment effect.

Methods

All 500 MR CLEAN patients were included. We estimated the effect of intra-arterial treatment with ordinal logistic regression analysis, and tested for interaction of antiplatelet treatment with intra-arterial treatment on outcome. Furthermore, safety parameters and serious adverse events were analyzed.

Results

The 144 patients (29%) on antiplatelet treatment were older, more often male, and had more vascular comorbidity. Intra-arterial treatment effect size after adjustments in antiplatelet treatment patients was 1.7 (95% confidence interval 0.9–3.2), and in no antiplatelet treatment patients 1.8 (95% confidence interval: 1.2–2.6). There was no statistically or clinically significant interaction between prior antiplatelet treatment and the relative effect of intra-arterial treatment ( p = 0.78). However, in patients on antiplatelet treatment, the effect of successful reperfusion on functional outcome in the intervention arm of the trial was doubled: the absolute risk difference for favorable outcome after successful reperfusion in patients on prior antiplatelet treatment was 39% versus 18% in patients not on prior antiplatelet treatment (Pinteraction = 0.025). Patients on antiplatelet treatment more frequently had a symptomatic intracranial hemorrhage (15%) compared to patients without antiplatelet treatment (4%), without differences between the control and intervention arm.

Conclusions

Prior treatment with antiplatelet agents did not modify the effect of intra-arterial treatment in patients with acute ischemic stroke presenting with an intracranial large vessel occlusion. There were no safety concerns. In patients with reperfusion, antiplatelet agents may improve functional outcome.
Blood biomarkers associated with neurological deterioration in patients with acute penetrating artery territory infarction: A multicenter prospective observational study
Authors: Kawano Tomohiro , Miyashita Kotaro , Takeuchi Mariko , Nagakane Yoshinari , Yamamoto Yasumasa , Kamiyama Kenji , Manabe Yasuhiro , Todo Kenichi , Metoki Norifumi , Akaiwa Yasuhisa , Toyoda Kazunori , Nagatsuka Kazuyuki
Published: November 2016

Background and purpose

Neurological deterioration in acute penetrating artery territory infarction is unpredictable and associated with unfavorable clinical outcomes. The aim of this prospective study was to clarify the cause of neurological worsening and predict clinical outcomes using blood biomarkers.

Methods

Eight Japanese stroke centers participated. Blood samples were obtained within 24 h (the first sampling) and on day 7 in hospital (the second sampling) in patients with penetrating artery territory infarction, arriving within two days of stroke onset. Symptomatic worsening was defined as a minimum increase of one point on the National Institutes of Health Stroke Scale. Poor outcome was defined as a modified Rankin Scale score of ≥3 at 90 days after ictus.

Results

Of the 89 patients, 25 (28%) had symptomatic worsening, and 25 (28%) had a poor outcome. Although tumor necrosis factor-alpha, high-sensitivity C-reactive protein levels were significantly increased in both groups at the second sampling, soluble lectin-like oxidized low-density lipoprotein receptor-1, CD40 ligand, and pro-adrenomedullin levels were significantly increased and ADAMTS13 activity was decreased in symptomatic worsening patients ( p < 0.05 for all). After multivariate adjustment, a low number of CD34+ cells at the first sampling was an independent predictor of poor outcome (odds ratio, 0.20; 95% confidence interval, 0.04–0.74, p = 0.011, per 1 cell/µl increase).

Conclusions

Blood biomarkers associated with atherosclerotic processes seem to be an indication for symptomatic worsening, and the number of CD34+ cells may help to predict three-month functional outcome in patients with penetrating artery territory infarction.
Multi-institutional prospective study of nedaplatin plus S-1 chemotherapy in recurrent and metastatic nasopharyngeal carcinoma patients after failure of platinum-containing regimens
Authors: Peng Pei-Jian , Lv Bao-Jun , Wang Zhi-Hui , Liao Hai , Liu Yu-Meng , Lin Zhong , Con Yun-Yan , Huang Pei-Yu
Published: November 2016

Background:

In this multi-institutional prospective study, we aimed to assess the safety and efficacy of nedaplatin plus S-1 (NS) chemotherapy for patients with recurrent and metastatic nasopharyngeal carcinoma (NPC) when platinum-containing regimens failed.

Methods:

A total of 52 recurrent and metastatic NPC patients who previously received, but failed with platinum-containing chemotherapy, had oral S-1 chemotherapy (twice daily from the first day to the fourteenth day) and nedaplatin (80 mg/ m2, day 1) every 3 weeks. The body surface area (BSA) decided the dose of S-1: 40 mg twice a day when BSA < 1.25 m2; 50 mg twice daily when 1.25 m2 ⩽ BSA < 1.5 m2; and 60 mg twice daily when BSA ⩾ 1.5 m2.

Results:

Treatment was well tolerated. The main hematological adverse event was neutropenia. Five patients (9.6%) had grade 3 neutropenia. Three patients were found with grade 3 anemia (5.8%). One patient was found with grade 3 thrombocytopenia (1.9%). No patient was found with grade 3 or 4 nonhematological toxicity. The rates of complete response, partial response and overall response were 3.8%, 38.5% and 42.3%, respectively. Median time to progression was 6.2 months and median survival was 14.6 months. The rates of 1-year survival and 2-year survival were 63% and 27%, respectively.

Conclusions:

NS chemotherapy provides a satisfactory and safe clinical activity for patients with recurrent and metastatic NPC after platinum-containing chemotherapy failed.
Refractory carcinoid syndrome: a review of treatment options
Authors: Riechelmann Rachel P. , Pereira Allan A. , Rego Juliana F. M. , Costa Frederico P.
Published: November 2016

Carcinoid syndrome (CSy) is a constellation of symptoms that may commonly present in patients with well differentiated neuroendocrine tumors (NETs), with somatostatin analogs (SSAs) being the first-line option for symptom management. However, symptomatic progression eventually occurs and in this scenario of a refractory CSy; several treatment options have been studied such as dose escalation of SSA, interferon and liver-directed therapies. Nevertheless, recent phase III trials have contributed to the understanding and management of this condition. We performed a comprehensive review of interventional studies examining refractory CSy to provide the evidence for current treatment options and propose a treatment sequence.
A modified regimen of biweekly gemcitabine and nab-paclitaxel in patients with metastatic pancreatic cancer is both tolerable and effective: a retrospective analysis
Authors: Ahn Daniel H. , Krishna Kavya , Blazer Marlo , Reardon Joshua , Wei Lai , Wu Christina , Ciombor Kristen K. , Noonan Anne M. , Mikhail Sameh , Bekaii-Saab Tanios
Published: November 2016

Background:

Treatment with nab-paclitaxel with gemcitabine demonstrates a survival advantage when compared with single-agent gemcitabine. However, the combination is associated with significant toxicities, leading to a high rate of drug discontinuation. We implemented a modified regimen of gemcitabine and nab-paclitaxel (mGNabP) in an attempt to minimize toxicities while maintaining efficacy.

Methods:

A total of 79 evaluable patients with metastatic pancreatic adenocarcinoma (mPC) treated with a modified regimen of gemcitabine (1000 mg/m2) and nab-paclitaxel (125 mg/m2) on days 1, 15 of every 28-day cycle were identified from our prospective database. A total of 57 patients received this regimen as first-line treatment and were evaluated for toxicities, progression-free survival (PFS), and overall survival (OS). Overall, 22 patients with advanced or metastatic PC treated with the modified regimen outside the first-line setting were only evaluated for toxicities.

Results:

The median OS and PFS were 10 months [95% confidence interval (CI) 5.9–13 months] and 5.4 months (95% CI 4.1–7.4 months) for patients that received the modified regimen as first-line therapy. Neurotoxicity occurred in 27% with only 1.6% of patients experiencing grade ⩾3 toxicity. The incidence of grade ⩾3 neutropenia was 19%, resulting in growth factor support in 12% of patients. This rate was similar in patients who received the modified regimen for first-line treatment of mPC versus the overall group.

Conclusions:

A modified regimen of biweekly nab-paclitaxel with gemcitabine is associated with a lower cost, acceptable toxicity profile and appears to be relatively effective in pancreatic cancer. Prospective randomized studies confirming its potential benefits compared with standard weekly mGNabP are warranted.
Examining the Potential Use of a Novel Radiographic Scoring System for Determining Surgical Intervention in Diabetic Charcot Arthropathy
Authors: Bijlani Rahul , Lomasney Laurie M. , Pinzur Michael , Dux Katherine
Published: November 2016

Introduction. Although Eichenholtz and the Schon systems are commonly used to evaluate foot Charcot arthropathy on radiographs, a novel system with expanded characterization may have added benefit. Methods. Patients with Charcot arthropathy and foot radiographs were grouped in nonsurgical group 1 (imaging sets at minimum 2-year interval) and surgical group 2 (imaging preceding fusion and/or amputation). Radiographs were scored with Eichenholtz and Schon systems, and a novel scoring system (summation of 0-3 rank for bone density, distention/swelling, debris, disorganization, and dislocation/subluxation). Summative scores of the 2 groups were compared. Differences in scores of each system from serial images of group 1 were compared and average scores from each of the systems for preoperative imaging sets of group 2 were compared. Results. A total of 111 patients were included (group 1, 19 patients; group 2, 92 patients). The novel system provided a broad numerical characterization of the radiographs (range 1-15). Summative scores of the novel system for groups 1 and 2 were statistically different with lower median score in the nonsurgical group (nonsurgical median score 6 vs surgical median score 9). Individual characteristic scores from 4 (distention, debris, disorganization, and dislocation) of 5 categories for the novel system were statistically different, with lower scores for the nonoperative group. The narrower numerical scores from the Eichenholtz and Schon systems did not yield statistically significant results. Conclusion. The novel scoring system provides a broad numerical description of radiographic findings in Charcot arthropathy of the foot and has potential advantage for surgical predictive value.

Levels of Evidence: Level IV: Retrospective
High School Sport Specialization Patterns of Current Division I Athletes
Authors: Post Eric G. , Thein-Nissenbaum Jill M. , Stiffler Mikel R. , Brooks M. Alison , Bell David R. , Sanfilippo Jennifer L. , Trigsted Stephanie M. , Heiderscheit Bryan C. , McGuine Timothy A.
Published: November 2016

Background:

Sport specialization is a strategy to acquire superior sport performance in 1 sport but is associated with increased injury risk. Currently, the degree of high school specialization among Division I athletes is unknown.

Hypothesis:

College athletes will display increased rates of specialization as they progress through their high school careers.

Study Design:

Descriptive epidemiological study.

Level of Evidence:

Level 4.

Methods:

Three hundred forty-three athletes (115 female) representing 9 sports from a Midwest Division I University completed a previously utilized sport specialization questionnaire regarding sport participation patterns for each grade of high school. McNemar and chi-square tests were used to investigate associations of grade, sport, and sex with prevalence of sport specialization category (low, moderate, high) (a priori P ≤ 0.05).

Results:

Specialization increased throughout high school, with 16.9% (n = 58) and 41.1% (n = 141) of athletes highly specialized in 9th and 12th grades, respectively. Football athletes were less likely to be highly specialized than nonfootball athletes for each year of high school ( P < 0.001). There was no difference in degree of specialization between sexes at any grade level ( P > 0.23).

Conclusion:

The majority of Division I athletes were not classified as highly specialized throughout high school, but the prevalence of high specialization increased as athletes progressed through high school. Nonfootball athletes were more likely to be highly specialized than football athletes at each grade level.

Clinical Relevance:

Most athletes who are recruited to participate in collegiate athletics will eventually specialize in their sport, but it does not appear that early specialization is necessary to become a Division I athlete. Athletes should be counseled regarding safe participation in sport during high school to minimize injury and maximize performance.
Patients Undergoing Shoulder Stabilization Surgery Have Elevated Shoulder Activity Compared With Sex- and Age-Matched Healthy Controls
Authors: Brophy Robert H. , Hettrich Carolyn M. , Ortiz Shannon ,   MOON Shoulder Instability Group, Wolf Brian R. , Baumgarten Keith M. , Bedi Asheesh , Bishop Julie Y. , Bollier Matthew J. , Bravman Jonathan T. , Carey James L. , Cox Charlie L. , Dunn Warren , Feeley Brian T. , Jones Grant L. , Kelly John D. , Kuhn John E. , Benjamin Ma C. , Marx Robert G. , Miller Bruce S. , Sennett Brian J. , Smith Matthew V. , Wright Rick W. , Zhang Alan
Published: November 2016

Background:

Shoulder activity level may be a risk factor for shoulder instability, an indication for surgical intervention, and a risk factor for failure of operative stabilization.

Hypothesis:

Patients undergoing shoulder stabilization surgery have a higher activity level compared with sex- and age-matched healthy controls.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 2.

Methods:

Patients undergoing shoulder stabilization surgery aged 18 to 50 years were prospectively enrolled. As part of data collection, patients completed a previously validated shoulder activity scale, which generates a score reporting frequency of activity ranging from 0 (least active) to 20 (most active). The activity level of these patients was compared with sex- and age-matched norms for a healthy population with no history of shoulder disorders.

Results:

A total of 409 subjects (343 male, 66 female) undergoing shoulder instability surgery completed the activity scale. Seventy-seven percent of patients had higher shoulder activity level than sex- and age-matched controls. Seventy-nine percent aged 18 to 30 years had a higher shoulder activity level than controls, with an identical distribution for men (79%) and women (79%). Among patients aged 31 to 50 years, 70% had higher activity than controls. However, men were more likely to have a higher activity level than controls (72%) versus women (59%). In patients aged 18 to 30 years, median activity level for instability patients was 14 in men compared with 10 in controls, and 13 in women compared with 8 in controls. In patients aged 31 to 50 years, median activity level was 13 in men compared with 10 in controls and 10 in women compared with 8 in controls.

Conclusion:

Patients undergoing shoulder stabilization surgery have a higher activity level than sex- and age-matched healthy controls.

Clinical Relevance:

Shoulder activity is especially elevated in younger, male instability patients.
Belatacept conversion in African American kidney transplant recipients with severe renal dysfunction
Authors: Snyder Heather S , Duhart Benjamin T , Krauss Amy G , Rao Vinaya
Published: November 2016

Objectives:

Conversion from calcineurin inhibitor–based maintenance immunosuppression to belatacept in kidney transplant recipients has been demonstrated to improve renal function while maintaining efficacy against rejection. However, conversion studies to date have excluded patients with an estimated glomerular filtration rate < 35 mL/min/1.73 m2.

Methods:

We describe two patients with an estimated glomerular filtration rate < 30 mL/min/1.73 m2 who underwent conversion from maintenance calcineurin inhibitor to belatacept.

Results:

Both patients experienced improvement in renal function following conversion.

Conclusions:

These results suggest that patients with more severe degrees of allograft impairment may benefit from conversion of maintenance calcineurin inhibitor to belatacept-based immunosuppression. Larger, randomized studies are warranted to evaluate the impact of such an approach.
Truck Drivers’ Use of the Internet: A Mobile Health Lifeline
Authors: Heaton Karen , Combs Bryan , Griffin Russell
Published: November 2016

Because of their social isolation, irregular and unpredictable schedules, limited access to health care, and long periods of travel, long-haul truckers may benefit from the use of mobile health applications on Internet-capable devices. The purpose of this study was to determine Internet access and usage among a sample of long-haul truck drivers. In this cross-sectional study, truck drivers completed a pencil and paper survey with questions on demographics, work and health histories, and Internet access and usage for both personal and job reasons. A total of 106 truck drivers were recruited from trucking industry trade shows, by word of mouth, and directly from trucking companies. Overall, the truck drivers’ use of the Internet was limited. Their usage for personal and job-related reasons differed. Social connectivity and access to health and wellness information were important during personal usage time. Job-related Internet use was highly practical, and applied to seeking information for directions and maps, fuel stops and pricing, and communicating with employers or transmitting documents. Age and experience were associated with Internet use. Younger, less-experienced drivers used the Internet more than older, experienced drivers. Targeted mobile health messaging may be a useful tool to inform truck drivers of health conditions and plans, and may provide links to primary care providers needing to monitor or notify drivers of diagnostic results or treatment plans.
Matching for the MICA-129 polymorphism is beneficial in unrelated hematopoietic stem cell transplantation
Authors: Fuerst Daniel , Neuchel Christine , Niederwieser Dietger , Bunjes Donald , Gramatzki Martin , Wagner Eva , Wulf Gerald , Glass Bertram , Pfreundschuh Michael , Einsele Hermann , Arnold Renate , Stuhler Gernot , Schaefer-Eckart Kerstin , Freitag Sebastian , Casper Jochen , Kaufmann Martin , Wattad Mohammed , Hertenstein Bernd , Klein Stefan , Ringhoffer Mark , Mytilineos Daphne , Tsamadou Chrysanthi , Mueller Carlheinz , Schrezenmeier Hubert , Mytilineos Joannis
Published: November 2016

Key Points

MICA-129 matching improves survival in uHSCT. MICA-129 mismatches were observed in 6.7% of all transplant patients.
Memorial
Authors: Ziolkowski Anton , Treitel Sven
Published: November 2016

Clint W. Frasier passed away after a long illness on 29 August 2016. He is mourned by his wife, Ann; his two children, Shelly and Colin; and his grandsons, Rex and Felix; along with countless friends and relatives far and wide.
Loss of Functional Osteoprotegerin: More Than a Skeletal Problem
Authors: Grasemann Corinna , Unger Nicole , Hövel Matthias , Arweiler-Harbeck Diana , Herrmann Ralf , Schündeln Michael M. , Müller Oliver , Schweiger Bernd , Lausch Ekkehart , Meissner Thomas , Kiewert Cordula , Hauffa Berthold P. , Shaw Nick J.
Published: November 2016

Introduction:

Juvenile Paget’s disease (JPD), an ultra-rare, debilitating bone disease due to loss of functional osteoprotegerin (OPG), is caused by recessive mutations in TNFRFSF11B. A genotype–phenotype correlation spanning from mild to very severe forms is described.

Aim:

This study aimed to describe the complexity of the human phenotype of OPG deficiency in more detail and to investigate heterozygous mutation carriers for clinical signs of JPD.

Patients:

We investigated 3 children with JPD from families of Turkish, German, and Pakistani descent and 19 family members (14 heterozygous).

Results:

A new disease-causing 4 bp-duplication in exon 1 was detected in the German patient, and a microdeletion including TNFRFSF11B in the Pakistani patient. Skeletal abnormalities in all affected children included bowing deformities and fractures, contractures, short stature and skull involvement. Complex malformation of the inner ear and vestibular structures (2 patients) resulted in early deafness. Patients were found to be growth hormone deficient (2), displayed nephrocalcinosis (1), and gross motor (3) and mental (1) retardation. Heterozygous family members displayed low OPG levels (12), elevated bone turnover markers (7), and osteopenia (6). Short stature (1), visual impairment (2), and hearing impairment (1) were also present.

Conclusion:

Diminished OPG levels cause complex changes affecting multiple organ systems, including pituitary function, in children with JPD and may cause osteopenia in heterozygous family members. Diagnostic and therapeutic measures should aim to address the complex phenotype.
Inappropriate expression of the translation elongation factor 1A disrupts genome stability and metabolism
Authors: Tarrant Daniel J. , Stirpe Mariarita , Rowe Michelle , Howard Mark J. , von der Haar Tobias , Gourlay Campbell W.
Published: November 2016

The translation elongation factor eEF1A is one of the most abundant proteins found within cells, and its role within protein synthesis is well documented. Levels of eEF1A are tightly controlled, with inappropriate expression linked to oncogenesis. However, the mechanisms by which increased eEF1A expression alters cell behaviour are unknown. Our analyses in yeast suggest that elevation of eEF1A levels leads to stabilisation of the spindle pole body and changes in nuclear organisation. Elevation of the eEF1A2 isoform also leads to altered nuclear morphology in cultured human cells, suggesting a conserved role in maintaining genome stability. Gene expression and metabolomic analyses reveal that the level of eEF1A is crucial for the maintenance of metabolism and amino acid levels in yeast, most likely because of its role in the control of vacuole function. Increased eEF1A2 levels trigger lysosome biogenesis in cultured human cells, also suggesting a conserved role within metabolic control mechanisms. Taken together, our data suggest that the control of eEF1A levels is important for the maintenance of a number of cell functions beyond translation and that its de-regulation might contribute to its oncogenic properties.
RHO binding to FAM65A regulates Golgi reorientation during cell migration
Authors: Mardakheh Faraz K. , Self Annette , Marshall Christopher J.
Published: November 2016

Directional cell migration involves reorientation of the secretory machinery. However, the molecular mechanisms that control this reorientation are not well characterised. Here, we identify a new Rho effector protein, named FAM65A, which binds to active RHOA, RHOB and RHOC. FAM65A links RHO proteins to Golgi-localising cerebral cavernous malformation-3 protein (CCM3; also known as PDCD10) and its interacting proteins mammalian STE20-like protein kinases 3 and 4 (MST3 and MST4; also known as STK24 and STK26, respectively). Binding of active RHO proteins to FAM65A does not affect the kinase activity of MSTs but results in their relocation from the Golgi in a CCM3-dependent manner. This relocation is crucial for reorientation of the Golgi towards the leading edge and subsequent directional cell migration. Our results reveal a previously unidentified pathway downstream of RHO that regulates the polarity of migrating cells through Golgi reorientation in a FAM65A-, CCM3- and MST3- and MST4-dependent manner.
Genome-scale characterization of RNA tertiary structures and their functional impact by RNA solvent accessibility prediction
Authors: Yang Yuedong , Li Xiaomei , Zhao Huiying , Zhan Jian , Wang Jihua , Zhou Yaoqi
Published: November 2016

As most RNA structures are elusive to structure determination, obtaining solvent accessible surface areas (ASAs) of nucleotides in an RNA structure is an important first step to characterize potential functional sites and core structural regions. Here, we developed RNAsnap, the first machine-learning method trained on protein-bound RNA structures for solvent accessibility prediction. Built on sequence profiles from multiple sequence alignment (RNAsnap-prof), the method provided robust prediction in fivefold cross-validation and an independent test (Pearson correlation coefficients,r, between predicted and actual ASA values are 0.66 and 0.63, respectively). Application of the method to 6178 mRNAs revealed its positive correlation to mRNA accessibility by dimethyl sulphate (DMS) experimentally measured in vivo (r= 0.37) but not in vitro (r= 0.07), despite the lack of training on mRNAs and the fact that DMS accessibility is only an approximation to solvent accessibility. We further found strong association across coding and noncoding regions between predicted solvent accessibility of the mutation site of a single nucleotide variant (SNV) and the frequency of that variant in the population for 2.2 million SNVs obtained in the 1000 Genomes Project. Moreover, mapping solvent accessibility of RNAs to the human genome indicated that introns, 5′ cap of 5′ and 3′ cap of 3′ untranslated regions, are more solvent accessible, consistent with their respective functional roles. These results support conformational selections as the mechanism for the formation of RNA–protein complexes and highlight the utility of genome-scale characterization of RNA tertiary structures by RNAsnap. The server and its stand-alone downloadable version are available athttp://sparks-lab.org.
Reforming environmental law: the democratic case for market incentives
Authors: Ackerman Bruce A. , Stewart Richard B.
Published: November 2016

In this article, the environmental law is discussed under the democratic and market perspectives, in order to present to the reader that it is possible to have more efficiency to the administrative processes of this scenario, and that the market incentives, when properly used, can save billions of dollars each year, helping to balance the budget and the system of pollution regulation. Neste artigo, a reforma do direito ambiental é discutida à luz dos valores democráticos e de mercado, no intuito de mostrar ao leitor que é possível trazer mais eficiência aos processos administrativos presentes neste cenário, e que os incentivos de mercado, quando usados de forma criativa, podem economizar bilhões de dólares por ano, auxiliando no controle do orçamento e no sistema de regulação da poluição.
Empresas estatais e parcerias institucionais
Authors: Marques Neto Floriano de Azevedo , De Palma Juliana Bonacorsi
Published: November 2016

O presente artigo aborda o tema das parcerias nas empresas estatais considerando o regime jurídico das estatais e o potencial desses instrumentos de desenvolver a governança nas estatais, bem como propiciar a inovação tecnológica a partir da associação público-privada. Para tanto, o artigo parte da análise do regime jurídico-constitucional das empresas estatais, cujas recentes emendas constitucionais terminaram por viabilizar parcerias estratégicas das empresas estatais sem importar em burla ao dever de licitar. Na sequência, analisa a formalização fundamental das parcerias envolvendo as empresas estatais e os tipos de parcerias de que elas podem se valer para satisfazer suas finalidades públicas. Casos concretos exemplificam as nossas análises. Ao final, apresentamos considerações sobre o cenário de mudança do direito público e seu impacto sobre as empresas estatais. This paper tackles the issue of state-owned companies’ partnerships considering their regulation, the potential of governance increment, as well as how public-private associations can foster innovation. First, we analyze the constitutional norms applicable to state-owned companies and the recent amendments, which enabled strategic partnerships. This constitutional change does not imply bid rigging. Second, we study how the different types of the state-owned companies’ partnerships and their correspondent formalization. Cases exemplify the analysis hereby developed. In the end, we discuss hoe the current changes in Brazilian public law may impact the regulation of the state-owned companies.
Possibilities and limitations of spatial development
Authors: Швец Ирина , Shvets Irina
Published: November 2016

Features of territorial development of Russia in determining the opportunities and limitations of spatial development suggest that the same parameter characteristics of the area can be a factor of development, and a mechanism that limits the realization of the potential of the individual regions of the country. Of course, the development of conceptual frameworks of spatial development should take into account these features. The aim of the article is to consider basic definitions of the factors that shape the opportunities and limitations of spatial development of the Russian Federation. The article defines the basic factors shaping the capabilities and limitations of spatial development of the Russian Federation. By the possibilities of spatial development of Russia include: cost-effective transit situation in the country; considerable industrial potential of the country, implemented not only by the mineral resource base; availability of rail and highways included in the international transport corridors; high scientific, innovative and educational potential; created conditions for the development of regional innovation clusters and increase their role, both in the national and regional economy, etc. Limitations of the spatial development of Russia are: narrow, primarily raw materials specialization of the country in global and regional division of labor; single-industry economy of most regions, improperly formed structure and the continued disintegration of the economy; the presence of factors that significantly reduce productivity and increase the riskiness of agricultural production; the state of the transport network, does not meet current transit capacity of the country´s economy, competition from neighboring countries in the development of trans-Eurasian latitude of international transport corridors; significant regional disparities, etc.
Food security of a region: essence, factors, criteria
Authors: Кугушева Т , Kugusheva T , Кармазин С , Karmazin S
Published: November 2016

Now food security of the region is a priority task the solution of which promotes stable development of national economy. Indeed, food security is one of criteria reflecting the level of social and economic development of society. At the same time there is an objective necessity of doing researches of the factors influencing it, and also descriptions of its assessment criteria.
The integrated structure as the spatial organization of regional industrial complex
Authors: Иваненко Лариса , Ivanenko Larisa
Published: November 2016

The paper studies an enterprise as the element of industrial branch. The reasons of production decrease were shown and the necessity of sustainable development was proved. The forms of regional economy organization were analyzed such as aglomeration, industrial junction, territory and industrial sector, holding, financial and industrial groups, clusters and others. The application of cluster approach as up-to-date innovative form of regional economy organization was justified.
State support of small entrepreneurship in the Republic of Crimea
Authors: Глушко Юлия , Glushko Yuliya
Published: November 2016

STATE SUPPORT FOR SMALL BUSINESS IN THE REPUBLIC OF CRIMEA
INFORMATION INFRASTRUCTURE SYSTEM OF INDUSTRIAL POLICY IMPLEMENTATION
Authors: Бунчиков О , Bunchikov O , Гайдук Владмир , Gayduk Vladmir , Мирошников Д , Miroshnikov D
Published: November 2016

Information of interaction of subjects of industrial activities is one of the most important priorities of the industry management system and suggests structural and functional reorganization of the infrastructural support system both at the micro and macro levels. Tools using information infrastructure can be differentiated according to the type of industry. A segmentation of channels use the information infrastructure of industrial enterprises in the framework of a process-oriented approach that allows you to define the role of the information infrastructure, which improves the efficiency of each of these business process. A model of infrastructural support implementation of industrial policy, which covers both the level of districts and industrial districts, and the federal district level. Based approaches to reduce the fixed costs due to the active use of the idea of information-analytical outsourcing, implemented on the basis of the proposed system of information and infrastructural support industrial policy, purposeful on increasing the volume of core business, increasing business activity and the development of information exchange channels
Electronic Commerce, Spatial Arbitrage, and Market Efficiency
Authors: Subramanian Hemang , Overby Eric
Published: November 2016

Electronic commerce can improve market efficiency by helping buyers and sellers find and transact with each other across geographic distance. We study the effect of two distinct forms of electronic commerce on market efficiency, which we measure via the existence and exploitation of spatial arbitrage opportunities. Spatial arbitrage represents a more precise measure of market efficiency than does price dispersion, which is typically used, because it accounts for the transaction costs of trading across distance and for unobserved product heterogeneity. One of the forms of electronic commerce that we study is a webcast channel that allows electronic access to the traditional physical market, while the other is a standalone electronic market. Both forms provide traders with expanded reach to find and transact with each other across geographic distance, but only one allows traders to conduct transactions immediately, at any time. This variance helps us isolate the effect of these mechanisms (reach and transaction immediacy) on efficiency. We find that electronic commerce reduces the number of arbitrage opportunities (likely by expanding traders’ geographic reach) but improves arbitrageurs’ ability to identify and exploit those that remain (likely by expanding arbitrageurs’ reach and providing them with the immediacy to exploit opportunities quickly). Overall, our results suggest that electronic commerce improves market efficiency not only by helping buyers and sellers transact across distance (thereby balancing supply and demand across geographic locations) but also by helping arbitrageurs quickly exploit any remaining arbitrage opportunities (thereby rebalancing supply and demand across geographic locations).
Resource Allocation Under Demand Uncertainty and Private Information
Authors: Belloni Alexandre , Lopomo Giuseppe , Wang Shouqiang
Published: November 2016

We study the effect of multilateral private information on the efficiency of markets where capacity-constrained upstream agents supply a resource to downstream entities facing uncertain end-demands. We analyze two models: a “pooling system,” in which a single downstream principal pools a resource from multiple upstream agents; and a “distribution system,” in which one upstream principal allocates a resource across multiple downstream agents. We show that the presence of multilateral private information does not hinder efficiency in the pooling system. In contrast, in the distribution system, the quantities allocated to downstream agents can exceed, as well as fall short of, their first-best levels. These results shed light on the recently improved performance of U.S. agricultural produce market, and the observed episodes of shortages/oversupplies in flu vaccine and other seasonal markets.

This paper was accepted by Manel Baucells, decision analysis.
Robust Product Line Design
Authors: Bertsimas Dimitris , Mišić Velibor V.
Published: November 2016

The majority of approaches to product line design that have been proposed by marketing scientists assume that the underlying choice model that describes how the customer population will respond to a new product line is known precisely. In reality, however, marketers do not precisely know how the customer population will respond and can only obtain an estimate of the choice model from limited conjoint data. In this paper, we propose a new type of optimization approach for product line design under uncertainty. Our approach is based on the paradigm of robust optimization where, rather than optimizing the expected revenue with respect to a single model, one optimizes the worst-case expected revenue with respect to an uncertainty set of models. This framework allows us to account for parameter uncertainty, when we may be confident about the type of model structure but not about the values of the parameters, and structural uncertainty, when we may not even be confident about the right model structure to use to describe the customer population. Through computational experiments with a real conjoint data set, we demonstrate the benefits of our approach in addressing parameter and structural uncertainty. With regard to parameter uncertainty, we show that product lines designed without accounting for parameter uncertainty are fragile and can experience worst-case revenue losses as high as 23%, and that the robust product line can significantly outperform the nominal product line in the worst case, with relative improvements of up to 14%. With regard to structural uncertainty, we similarly show that product lines that are designed for a single model structure can be highly suboptimal under other structures (worst-case losses of up to 37%), while a product line that optimizes against the worst of a set of structurally distinct models can outperform single model product lines by as much as 55% in the worst case and can guarantee good aggregate performance over structurally distinct models.
Discharge planning: best practice in transitions of care
Authors: Pellett Candice
Published: November 2016

This article provides an overview of a project undertaken by the Queen's Nursing Institute (QNI) and funded by The Department of Health, to identify the barriers and challenges that prevent effective discharge from hospital to home. Unnecessary delays in discharging patients from hospital to home is an ongoing problem and for older people this can lead to worse health outcomes, which can increase their long-term care needs. Findings from the project illustrates that while there are challenges in achieving excellent practice in the transfer of a patient's care from hospital to home, there is a significant willingness and commitment from nurses based both in the community and hospital to improve the patient experience. Key recommendations are cited in the article that will enhance an improved discharge experience for patients, carers and their families.
Integrating nutrition into pathways for patients with COPD
Authors: Hodson Matthew
Published: November 2016

This article looks at the role of the community nurse in assessing the nutritional status of patients with COPD and in integrating nutrition into the COPD care pathway.
Treating malnutrition in the community
Authors: Dera Merceline , Woodham Diane
Published: November 2016

Malnutrition is a clinical and public health problem. It has adverse effects on the physical and psycho-social wellbeing of individuals by predisposing to disease, negatively affecting its outcome and reducing the likelihood of independence. An estimated 3 million people in the UK are affected by malnutrition, most of whom live in the community ( BAPEN, 2011 ). Despite the scale of this problem, it remains under-detected, under-treated, underresourced and often overlooked by those involved in the care of at risks individuals such as the elderly. In most cases malnutrition is a treatable condition that can be managed by optimising food intake and using oral nutritional supplements (ONS) where necessary. The main focus of this article is on the dangers of malnutrition for older people in the community and the use of ONS in the treatment and management of malnutrition.
Research Roundup
Authors: Clabburn Oliver
Published: November 2016

Oliver Clabburn provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Preventing venous thromboembolism in acute stroke: guideline review
Authors: Doyle Cara
Published: November 2016

Following a diagnosis of stroke, patients are at risk of developing venous thromboembolism (VTE). Standard preventative measures cannot be routinely undertaken due to the risk of bleeding following an acute stroke. In 2010, VTE prevention was named a national priority for patient safety in England. Since then, hospitals have strived to provide the highest quality of VTE prevention care for patients, using evidence-based guidelines and standards. Following acute stroke, the guidelines available to clinicians vary widely and there is debate over how safe thromboprophylaxis is. The aim here is to review the most commonly adhered to guidelines and the research used to create them.