bluuebunny/crossref_metadata_2025 huggingface dataset:
Socioeconomic development and fertility trends among the states of India
Authors: Brinker Gary , Amonker Robin
Published: April 2013

Purpose

The purpose of this paper is to investigate the relationship between levels of socioeconomic development and subsequent trends in fertility among the states of India. Based on the Theory of Demographic Transition, this study tests the hypothesis: The higher the level of socioeconomic development in 1993, the greater the subsequent percentage of decrease in fertility rates between 1999 and 2006 among the states of India.

Design/methodology/approach

The study utilizes Pearson'srcorrelation and linear multiple regression analysis on three National Family Health Surveys data to predict two measures of decline in fertility from socioeconomic indicators.

Findings

The findings support the theory of demographic transition in large measure revealing that the overall level of socioeconomic development is directly related to subsequent declines in fertility among the states of India.

Research limitations/implications

Correlations between state‐wide indicators are based on sample data of which margins of error and response rates are unknown.

Practical implications

The study suggests that the empowerment of women through education, employment opportunities and exposure to the mass media reduces fertility.

Social implications

Population control in India is extremely important for the future welfare of all of its society members.

Originality/value

Although previous research has shown cross‐sectional correlations between fertility and socioeconomic development, this is the first time correlations between socioeconomic development and subsequent trends in fertility have been measured. This is methodologically important because Demographic Transition Theory hypothesizes a lag between modernization and fertility decline. Rather than correlating level of economic development with current fertility, this study correlates level of economic development with the subsequent dynamic changes in fertility.
Habits for a highly‐effective organization
Authors: by Gareth Bell Interview
Published: April 2013

Purpose

The purpose of this article is to provide an interview with FranklinCovey consultant Tomasin Magwood.

Design/methodology/approach

The article takes the form of an interview.

Findings

The article discusses the various challenges HR managers are currently faced with, and how they can be overcome.

Originality/value

The interview offers insight for HR professionals on how to succeed in a challenging and changing environment.
Partnerships for health and wellbeing
Authors: Kingsnorth Rebecca
Published: April 2013

Purpose

This article aims to consider the transfer of public health responsibilities to Local Authorities, and implications for promotion of health and wellbeing through partnership. The article describes findings of interviews with stakeholders in one London borough.

Design/methodology/approach

Elements of the Partnership Assessment Tool (PAT) provided a framework for semi‐structured interviews.

Findings

A limited history of successful partnership between health and social care was attributed to a focus on partnership structures over behaviours. Transfer of public health responsibilities to the Local Authority was seen as an opportunity to address the wider determinants of health, but a shared vision for health and wellbeing had not been articulated. There appeared to be an expectation that the public health team would operate in a network partnership model.

Research limitations/implications

While the PAT is presented as a complete tool, this project isolated elements of the tool to support development of the interview structure. The project did not include interviews with clinical members of the developing Clinical Commissioning Group, who may have different requirements of the public health function; this is an area for future research.

Practical implications

Recommendations are made to support effective integration of public health responsibilities into Local Authority functions.

Originality/value

This project provides a snapshot of preparations for the transfer of public health responsibilities to the Local Authority in one area. Relevant literature suggests that experiences in this area are not unique and findings and recommendations are likely to be applicable elsewhere.
Care management in the twenty‐first century
Authors: Stewart Ailsa , MacIntyre Gillian
Published: April 2013

Purpose

The purpose of this paper is to examine the persistent challenges in implementing care management within the context of integration. In addition the appropriateness of the care management model will be considered within the current, personalization focused, health and social care policy landscape. The paper draws upon a recent evaluation of a care management and assessment pilot project within a health and social care partnership in Scotland.

Design/methodology/approach

A multi‐method approach was adopted, including interviews, vignettes and focus groups, in order to capture data around expectations in relation to the pilot as well as exploring processes and outcomes for those involved.

Findings

This paper argues that whilst progress has been made with regard to care management, specific and persistent challenges remain. Professional and organizational boundaries, communication and information sharing remain key challenges. Policy imperatives have shifted the emphasis in community care services towards self‐care, co‐production and personalization contributing to a lack of clarity over the place of care management within the broader integration agenda.

Research limitations/implications

This research was undertaken in one partnership locality in Scotland and as such the findings are related to that particular area. However, the key messages arising from this paper resonate with the broader academic literature on care management and as such are likely to be of interest to a broader audience.

Originality/value

This paper brings together integrated working, care management and the developing policy framework of self‐care to consider the challenges for care management in this context.
Rotational vegetation burning effects on peatland stream ecosystems
Authors: Ramchunder Sorain J. , Brown Lee E. , Holden Joseph
Published: April 2013

Rotational vegetation burning in peatlands is undertaken predominantly to increase habitat suitability and food availability for red grouse Lagopus lagopus (Linnaeus). Red grouse shooting contributes to the upland economy and is seen as a traditional leisure activity. However, there is concern that burning can have detrimental effects on peatland terrestrial and freshwater ecosystems.

This study examined spatial and seasonal dynamics of stream physicochemistry and benthic macroinvertebrates from peatland sites that are managed via rotational vegetation burning and compared these with intact sites with no recent history of burning.

Streams draining burned catchments were characterized by higher fine benthic particulate organic matter (FPOM), suspended sediment concentration (SSC), aluminium, iron and dissolved organic carbon than unburnt intact catchments. Anion concentrations were higher in intact catchments.

There were significant differences in benthic macroinvertebrate richness, diversity and dominance, and community composition and functional feeding groups between burned and intact catchments, suggesting that land management had an effect on aquatic ecosystems.

Higher SSC and FPOM in burned catchments were associated with lower abundance of some mayflies, stoneflies and caddis‐flies and elevated abundance of some Diptera (Chironomidae and Simuliidae) larvae.

Synthesis and applications. This study suggests that some aspects of peatland stream ecosystems are altered in catchments with rotational vegetation burning. Currently, there is much emphasis on the effects of rotational burning on peat carbon stores, but this study is the first to document the impacts on stream biota. Agencies with a remit covering upland freshwater ecosystem management might need to consider ways of reducing the extent of rotational vegetation burning to prevent effects on lotic ecosystems, and monitor whether macroinvertebrate assemblages subsequently shift back to a status similar to those in intact peatland streams. Fire occurs commonly on peatlands throughout the world, and our results suggest that trade‐offs are needed to satisfy both economic and ecological facets of the combined social–ecological systems in such areas, especially where fire is implemented as a management tool.
How many signal peptides are there in bacteria?
Authors: Ivankov Dmitry N. , Payne Samuel H. , Galperin Michael Y. , Bonissone Stefano , Pevzner Pavel A. , Frishman Dmitrij
Published: April 2013

Over the last 5 years proteogenomics (using mass spectroscopy to identify proteins predicted from genomic sequences) has emerged as a promising approach to the high‐throughput identification of protein N‐termini, which remains a problem in genome annotation. Comparison of the experimentally determined N‐termini with those predicted by sequence analysis tools allows identification of the signal peptides and therefore conclusions on the cytoplasmic or extracytoplasmic (periplasmic or extracellular) localization of the respective proteins. We present here the results of a proteogenomic study of the signal peptides in Escherichia coli K‐12 and compare its results with the available experimental data and predictions by such software tools as SignalP and Phobius. A single proteogenomics experiment recovered more than a third of all signal peptides that had been experimentally determined during the past three decades and confirmed at least 31 additional signal peptides, mostly in the known exported proteins, which had been previously predicted but not validated. The filtering of putative signal peptides for the peptide length and the presence of an eight‐residue hydrophobic patch and a typical signal peptidase cleavage site proved sufficient to eliminate the false‐positive hits. Surprisingly, the results of this proteogenomics study, as well as a re‐analysis of the E. coli genome with the latest version of SignalP program, show that the fraction of proteins containing signal peptides is only about 10%, or half of previous estimates.
The Effect of Parity on Expenditures for Individuals with Severe Mental Illness
Authors: McConnell K. John
Published: April 2013

Objective

To determine whether comprehensive behavioral health parity leads to changes in expenditures for individuals with severe mental illness (SMI), who are likely to be in greatest need for services that could be outside of health plans' traditional limitations on behavioral health care.

Data Sources/Study Setting

We studied the effects of a comprehensive parity law enacted by Oregon in 2007. Using claims data, we compared expenditures for individuals in four Oregon commercial plans from 2005 through 2008 to a group of commercially insured individuals in Oregon who were exempt from parity.

Study Design

We used difference‐in‐differences and difference‐in‐difference‐in‐differences analyses to estimate changes in spending, and quantile regression methods to assess changes in the distribution of expenditures associated with parity.

Principal Findings

Among 2,195 individuals with SMI, parity was associated with increased expenditures for behavioral health services of $333 (95 percent CI $67, $615), without corresponding increases in out‐of‐pocket spending. The increase in expenditures was primarily attributable to shifts in the right tail of the distribution.

Conclusions

Oregon's parity law led to higher average expenditures for individuals with SMI. Parity may allow individuals with high mental health needs to receive services that may have been limited without parity regulations.
Telephone Care Management's Effectiveness in Coordinating Care for Medicaid Beneficiaries in Managed Care: A Randomized Controlled Study
Authors: Kim Sue E. , Michalopoulos Charles , Kwong Richard M. , Warren Anne , Manno Michelle S.
Published: April 2013

Objective

To test the effectiveness of a telephone care management intervention to increase the use of primary and preventive care, reduce hospital admissions, and reduce emergency department visits for Medicaid beneficiaries with disabilities in a managed care setting.

Data Source

Four years (2007–2011) of Medicaid claims data on blind and/or disabled beneficiaries, aged 20–64.

Study Design

Randomized control trial with an intervention group (n = 3,540) that was enrolled in managed care with telephone care management and a control group (n = 1,524) who remained in fee‐for‐service system without care management services. Multi‐disciplinary care coordination teams provided telephone services to the intervention group to address patients' medical and social needs.

Data Collection/Extraction

Medicaid claims and encounter data for all participants were obtained from the state and the managed care organization.

Principal Findings

There was no significant difference in use of primary care, specialist visits, hospital admissions, and emergency department between the intervention and the control group. Care managers experienced challenges in keeping members engaged in the intervention and maintaining contact by telephone.

Conclusions

The lack of success for Medicaid beneficiaries, along with other recent studies, suggests that more intensive and more targeted interventions may be more effective for the high‐needs population.
Enzymatic Properties of β‐1,3‐Glucanase from Streptomyces sp Mo.
Authors: Kurakake Masahiro , Yamanouchi Yuuki , Kinohara Kouta , Moriyama Shingo
Published: April 2013

Streptomyces sp Mo endo‐β‐1,3‐glucanase was found to have hydrolyzing activity toward curdlan and released laminarioligosaccharides selectively. The molecular weight was estimated to be 36000 Da and its N‐terminal amino acid sequence was VTPPDISVTN. The optimal pH was 6 and the enzyme was found to be stable from pH 5 to 8. The optimal temperature was 60 °C and the activity was stable below 50 °C. The enzyme hydrolyzed selectively curdlan containing only β‐1,3 linkages. The enzyme had 89% relative activity toward Laminaria digitata laminarin, which contains a small amount of β‐1,6 linkages compared with curdlan, while Eisenia bicyclis laminarin with a higher amount of β‐1,6‐linkages, was not hydrolyzed. Mo enzyme adsorbed completely on curdlan powder. The enzymatic hydrolysis of curdlan powder resulted in the accumulation of laminaribiose (yield 81.7%). Trisaccharide was inevitably released from the hydrolysis of laminarioligosaccharides with 5 to 7 degrees of polymerization (DP). Although the enzyme cleaved off disaccharide (DP 2) from tetrasaccharide (DP 4), the reaction rate was lower than those of DP 5 to 7. The results indicated that the active site of Mo endo‐β‐1,3‐glucanase can efficiently recognize glucosyl residue chain of greater than DP 5 and hydrolyzes the β‐1,3 linkage between the 3rd and 4th glucosyl residue.
Impact of the spinal cord position uncertainty on the dose received during head and neck helical tomotherapy
Authors: Piotrowski Tomasz , Kaźmierska Joanna , Sokołowski Adam , Skórska Małgorzata , Jodda Agata , Ryczkowski Adam , Cholewiński Witold , Bąk Bartosz
Published: April 2013

Introduction

The study aims to establish the optimal planning risk volume (PRV) to the spinal cord (SC) for oropharyngeal cancer patients during adaptive radiation therapy with concurrent chemotherapy.

Methods

Geometrical uncertainties of the SC were evaluated. Differences between planned and delivered maximum doses to each part of the SC were established for every fraction dose and for cumulative dose. Maximum doses were evaluated as a dose received in 0.5 and 1 cm3 of the analysed part of the SC defined as C1–C2, C3–C4, C5–C6 and C7–Th1 where Cn was a n‐th cervical vertebra (n = 1, … , 7) and Th1 was the first thoracic vertebra. Finally, relations between dose differences and geometrical uncertainties were analysed using a relative risk (RR) and the importance of the PRV dose gradient to establish an optimal PRV for the SC.

Results

Prospective study based on the 875 observations from 25 oropharyngeal cancer patients was performed. The C1‐C2 part of the SC is most exposed to risk of overdosage during chemoradiation for patients with oropharyngeal cancer due to its proximity to the clinical target volume (CTV). Doses received by other parts of the SC are smaller, with the lowest dose delivered to C7–Th1. For the C1–C2, delivered dose was higher than planned dose by 11%, while for the C7–Th1, this difference was smaller than 7%. The lowest movement of individual parts of the SC were detected for the C1–C2 and the highest for the C7–Th1. The standard deviations of the mean shift ranged respectively from 0.9 to 1.4 mm and from 1.3 to 2.9 mm. For each part of the SC delivered dose was smaller than planned dose to the PRV (RR < 1).

Conclusion

Our study showed that for chemoradiation of oropharyngeal cancer, using daily image guidance and proper plan adaptation scheme, the current PRV margin for the SC could be reduced to 4 mm.
Search, bargaining, and signalling in the market for legal services
Authors: Daughety Andrew F. , Reinganum Jennifer F.
Published: April 2013

Over the last eight centuries, lawyers in common law countries have generally been precluded from buying their clients’ cases. Recently, a number of economists and lawyers have argued that sale should be allowed so as to eliminate moral hazard, particularly when contingent fees are used; this argument is based on full‐information reasoning. However, if the lawyer has private information about the case value, then compensation demands potentially signal this value when the client can search over lawyers. We provide a formal model and a family of computational examples that show that allowing (possibly partial) purchase can reduce expected social efficiency.
Stairway to heaven or highway to hell: Liquidity, sweat equity, and the uncertain path to ownership
Authors: Krishna R. Vijay , Lopomo Giuseppe , Taylor Curtis R.
Published: April 2013

We study a setting in which a principal contracts with an agent to operate a firm over an infinite time horizon when the agent is liquidity constrained and privately observes the sequence of cost realizations. We formulate the principal’s problem as a dynamic program in which the state variable is the agent’s continuation utility, which is naturally interpreted as his equity in the firm. The optimal incentive scheme resembles what is commonly regarded as a sweat equity contract, with all rents back loaded. Payments begin when the agent effectively becomes the owner, and from this point on, all production is efficient. These features are shown to be similar to features common in real‐world work‐to‐own franchising agreements and venture capital contracts.
Internal control system, earnings quality, and the dynamics of financial reporting
Authors: Marinovic Iván
Published: April 2013

Using an earnings management model in which managers manipulate information when the firm’s control system fails, I introduce a measure of earnings quality, based on the notion of integral precision, that has solid theoretical foundations. A trade‐off between the frequency and the magnitude of overstatements is shown: overstatements are larger when misreporting is less likely. Overall, the model generates a distribution of earnings announcements similar to its empirical analogue and provides a structural method to identify the likelihood and magnitude of misreporting by exploiting information from the moments of the distribution of reported earnings.
Assessment of intraoperative microaspiration: does a modified cuff shape improve sealing?
Authors: D'HAESE J. , DE KEUKELEIRE T. , REMORY I. , VAN ROMPAEY K. , UMBRAIN V. , POELAERT J.
Published: April 2013

Background

Intra‐operative aspiration of oropharyngeal secretions is associated with post‐operative pneumonia. The use of endotracheal tubes (ETTs) with a modified cuff shape could be one preventive action. In this clinical, prospective, randomised controlled trial, we hypothesised that altering the cuff shape to a tapered shape could reduce the aspiration incidence. The primary outcome was aspiration of dye solution into the trachea.

Methods

Patients scheduled for lumbar surgery were intubated with either an ETT with a barrel‐shaped polyvinylchloride cuff (control group, n = 30) or tapered‐shaped polyvinylchloride cuff (intervention group, n = 30). Subsequently, instillation with methylthioninium chloride was performed. At 10, 30, 60, 90, and 120 min after intubation, bronchoscopy was performed assessing the degree of dye descent along the cuff and digitally stored. Single blind review of the videoclips provided data on incidence of dye aspiration and depth of penetration along the cuff.

Results

The traditional cuff showed descent of dye into the trachea in 20% of the patients. Although a tapered‐shaped polyvinylchloride cuff leaked up to the second third of the cuff, no dye leakage into the trachea was observed. The use of a tapered‐shaped cuff had a protective role against aspiration (T30: OR 3.0, CI 1.57‐5.75; P = 0.001).

Conclusions

Short‐term use of tapered‐shaped polyvinylchloride cuffs in surgical patients results in more effective sealing of the tracheal lumen in comparison with a traditional barrel‐shaped polyvinylchloride cuffs. Further evaluation is needed to determine whether a reduction in post‐operative pneumonia can be demonstrated when these cuffs are used.
Refining the ‘pulse‐reserve’ model for arid central Australia: Seasonal rainfall, soil moisture and plant productivity in sand ridge and stony plain habitats of the Simpson Desert
Authors: Nano Catherine E. M. , Pavey Chris R.
Published: April 2013

In dry ecosystems, water supply is highly variable in time and space, occurring either as short pulses of shallow soil water or long phases of deep soil water. There may be correspondence between hierarchical soil water pulses and hierarchical biological responses, but this has not been directly tested for arid Australia. We compared plant community responses to an isolated short rain pulse (about 130 mm, November 2008) versus the start, mid and later stages of an extended high rainfall phase (about 540 mm, February 2010 to March 2011) at a site on the western edge of the Simpson Desert. We sampled across contrasting habitats: tall longitudinal sand ridges and adjacent stony clay plains (gibber). Thus, we compared responses to spatially variable soil moisture availability (sand vs. clay soil; run‐off/on relief) and temporally variable rainfall supply. Our results supported the hierarchical resource pulse‐biological response concept for dry ecosystems, with the short and long rainfall phases modulating distinct responses among functional types. Shallow‐rooted annual grasses showed an equivalent positive response to the isolated pulse as to the first pulse of the high rain phase; whereas short‐lived forbs, longer‐lived (2–3 years) grasses and persistent forbs had peak abundance during the high rainfall phase. Perennial grass and shrub productivity did not change over time, though there was a distinct trend towards heightened sexual reproduction at the mid‐late stages of the high rain phase. We also found that species seasonal growth tendencies were pronounced, and that spatial aspects of moisture availability resulted in different composition patterns at the habitat scale with the gibber and sand ridge sites showing strong and weak correspondence with temporal rainfall patterning respectively. Thus, we confirm that plant productivity models for this region should include the effects of rainfall connectivity and soil texture as well as species seasonal growth constraints and rooting attributes.
Restoration of retinal morphology and residual scarring after photocoagulation
Authors: Lavinsky Daniel , Cardillo Jose A. , Mandel Yossi , Huie Philip , Melo Luiz A. , Farah Michel E. , Belfort Rubens , Palanker Daniel
Published: April 2013

Purpose:  To study healing of retinal laser lesions in patients undergoing PRP using SD‐OCT.

Methods:  Moderate, light and barely visible retinal burns were produced in patients with proliferative diabetic retinopathy scheduled for PRP using 100‐, 20‐ and 10‐ms pulses of 532‐nm laser, with retinal spot sizes of 100, 200 and 400 μm. Lesions were measured with OCT at 1 hr, 1 week, 1, 2, 4, 6, 9 and 12 months. OCT imaging was correlated with histology in a separate study in rabbits.

Results:  Lesions produced by the standard 100‐ms exposures exhibited steady scarring, with the damage zone stabilized after 2 months. For 400‐ and 200‐μm spots and 100‐ms pulses, the residual scar area at 12 months was approximately 50% of the initial lesion size for moderate, light and barely visible burns. In contrast, lesions produced by shorter exposures demonstrated enhanced restoration of the photoreceptor layer, especially in smaller burns. With 20‐ms pulses, the damage zone decreased to 32%, 24% and 20% for moderate, light and barely visible burns of 400 μm, respectively, and down to 12% for barely visible burns of 200 μm. In the 100‐μm spots, the residual scar area of the moderate 100‐ms burns was 41% of the initial lesion, while barely visible 10‐ms burns contracted to 6% of the initial size. Histological observations in rabbits were useful for proper interpretation of the damage zone boundaries in OCT.

Conclusions:  Traditional photocoagulation parameters (400 μm, 100 ms and moderate burn) result in a stable scar similar in size to the beam diameter. Restoration of the damaged photoreceptor layer in lighter lesions produced by shorter pulses should allow reducing the common side‐effects of photocoagulation such as scotomata and scarring.
Biomechanical diagnosis of keratoconus: evaluation of the keratoconus match index and the keratoconus match probability
Authors: Labiris Georgios , Gatzioufas Zisis , Sideroudi Haris , Giarmoukakis Athanassios , Kozobolis Vassilios , Seitz Berthold
Published: April 2013

Purpose:   To evaluate the diagnostic capacity of the Ocular Response Analyser’s keratoconus match index (KMI) and keratoconus match probability (KMP) classification in a sample of keratoconus (KC) patients.

Methods:  Keratoconus match index and KMP from 114 KC eyes, randomly selected from 114 patients with bilateral keratoconus (KCG), were compared with the corresponding ones from 109 normal eyes (CG). Keratoconus match index’s predictive accuracy was assessed by receiver operating curves (ROC). Keratoconus match probability level of agreement was evaluated at the different KC stages of the Amsler–Krumeich classification. Correlations were estimated with topographic keratoconus classification (TKC), keratoconus index (KI), index of surface variance (ISV), vertical asymmetry (IVA), height asymmetry (IHA), height decentration (IHD), minimal radius (Rmin), central corneal thickness (CCT), thinnest corneal thickness (TCT) mean keratometry (Km) and intraocular pressure (IOPg).

Results:  Mean KMI in KCG and CG was 0.20 ± 0.38 and 0.98 ± 0.25, respectively (p < 0.01). Significant KMI differences (p < 0.01) were detected in different KC groups [range: 0.62 ± 0.38 (KC 1), −0.62 ± 0.04 (KC 4)]. Significant correlation was detected between KC staging and KMI (r = −0.56, p < 0.0001). Keratoconus match probability identified 22.03% of the CG eyes as suspect. Moreover, KMP identified 7.01% and 23.68% of the KCG eyes as normal and suspect, respectively. Receiver operating curves analysis for KMI parameter indicated a predictive accuracy of 97.7% (cut‐off point: 0.512, sensitivity: 91.18%, specificity: 94.34%).

Conclusions:  Keratoconus match index seems to be a reliable index in keratoconus diagnosis and staging. Keratoconus match probability identifies a significant percentage of topographically defined KC and CG eyes as suspect. Diagnostic capacity of these novel indexes needs to be further explored.
Transition to noncurative end‐of‐life care in paediatric oncology – a nationwide follow‐up in Sweden
Authors: Jalmsell Li , Forslund Martin , Hansson Mats G , Henter Jan‐Inge , Kreicbergs Ulrika , Frost Britt‐Marie
Published: April 2013

Aim

To estimate whether and when children dying from a malignancy are recognized as being beyond cure and to study patterns of care the last weeks of life.

Methods

A nationwide retrospective medical record review was conducted. Medical records of 95 children (60% of eligible children) who died from a malignancy 2007–2009 in Sweden were studied.

Results

Eighty‐three children (87%) were treated without curative intent at the time of death. Children with haematological malignancies were less likely to be recognized as being beyond cure than children with brain tumours [relative risks (RR) 0.7; 95% confidence interval (CI) 0.6–0.9] or solid tumours (RR 0.8; 0.6–1.0). The transition to noncurative care varied from the last day of life to over four years prior to death (median 60 days). Children with haematological malignancies were treated with a curative intent closer to death and were also given chemotherapy (RR 5.5; 1.3–22.9), transfusions (RR 2.0; 1.0–4.0) and antibiotics (RR 5.3; 1.8–15.5) more frequently than children with brain tumours the last weeks of life.

Conclusion

The majority of children dying from a malignancy were treated with noncurative intent at the time of death. The timing of a transition in care varied with the diagnoses, being closer to death in children with haematological malignancies.
Detection of medication‐related problems in hospital practice: a review
Authors: Manias Elizabeth
Published: April 2013

This review examines the effectiveness of detection methods in terms of their ability to identify and accurately determine medication‐related problems in hospitals. A search was conducted of databases from inception to June 2012. The following keywords were used in combination: medication error or adverse drug event or adverse drug reaction, comparison, detection, hospital and method. Seven detection methods were considered: chart review, claims data review, computer monitoring, direct care observation, interviews, prospective data collection and incident reporting. Forty relevant studies were located. Detection methods that were better able to identify medication‐related problems compared with other methods tested in the same study included chart review, computer monitoring, direct care observation and prospective data collection. However, only small numbers of studies were involved in comparisons with direct care observation (n = 5) and prospective data collection (n = 6). There was little focus on detecting medication‐related problems during various stages of the medication process, and comparisons associated with the seriousness of medication‐related problems were examined in 19 studies. Only 17 studies involved appropriate comparisons with a gold standard, which provided details about sensitivities and specificities. In view of the relatively low identification of medication‐related problems with incident reporting, use of this method in tracking trends over time should be met with some scepticism. Greater attention should be placed on combining methods, such as chart review and computer monitoring in examining trends. More research is needed on the use of claims data, direct care observation, interviews and prospective data collection as detection methods.
Pan‐BH3 Mimetic S1 Exhibits Broad‐Spectrum Antitumour Effects by Cooperation between Bax and Bak
Authors: Song Ting , Xue Zuguang , Zhang Zhichao , Shen Xiaoyun , Li Xiangqian
Published: April 2013

Small molecule S1 is a pan‐BH3 mimetic that can bind antiapoptotic Bcl‐2, Bcl‐xL and Mcl‐1 proteins. Herein, different Bcl‐2 member expression cancer cell lines (NCI‐H345, MCF‐7, SMMC‐7721 and Hela) and cells deficient in Bax and/or Bak by shRNA were used to unravel the cascade of events by which S1 promotes apoptosis compared with Bcl‐2/Bcl‐xL inhibitor ABT‐737. We identified that S1 exhibited broader antitumour spectrum than ABT‐737 through disruption of more Bcl‐2 interactions including Mcl‐1/Bak interaction. Moreover, the individual and combined roles of Bax and Bak in S1‐induced apoptosis were revealed. Our results showed that S1 induced a Bak‐mediated apoptosis. Bak played a predominant role in either S1 or ABT‐737‐induced apoptosis through the cooperation with Bax on the formation of large oligomers on mitochondrial membrane.
The effect of targeted rheumatoid arthritis therapies on anti-citrullinated protein autoantibody levels and B cell responses
Authors: Modi S , Soejima M , Levesque M C
Published: April 2013

Rheumatoid arthritis (RA) is a complex inflammatory disorder associated with synovitis and joint destruction that affects an estimated 1·3 million Americans and causes significant morbidity, a reduced life-span and lost work productivity. The use of biological therapies for the treatment of RA is costly, and the selection of therapies is still largely empirical and not guided by the underlying biological features of the disease in individual patients. The synovitis associated with RA is characterized by an influx of B and T cells, macrophages and neutrophils and the expansion of fibroblast-like synoviocytes, which form pannus and lead to cartilage and bone destruction. RA is associated with synovial production of rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPA) and with the production of inflammatory cytokines, including interleukin (IL)-1, IL-6, IL-17 and tumour necrosis factor (TNF)-α, which are targets for RA therapeutics. Recent ideas about the pathogenesis of RA emphasize a genetic predisposition to develop RA, a preclinical phase of disease that is associated with the production of ACPA and the development of symptomatic disease following inflammatory initiating events that are associated with expression of citrullinated epitopes in the joints of patients. However, we still have a limited understanding of the cytokine and intracellular pathways that regulate ACPA levels. In humans, therapy with biological agents affords a unique opportunity to better understand the cytokine and signalling pathways regulating ACPA levels and the impact of ACPA level changes on disease activity. In this study we summarize the effect of RA therapies on ACPA levels and B cell responses.
The use of ultrasound elastography in the assessment of malignancy risk in thyroid nodules and multinodular goitres
Authors: Rivo‐Vázquez Ángel , Rodríguez‐Lorenzo Ángel , Rivo‐Vázquez José E. , Páramo‐Fernández Concepción , García‐Lorenzo Francisco , Pardellas‐Rivera Hermelinda , Casal‐Núñez José E. , Gil‐Gil Pedro
Published: April 2013

Objective

The objective of our work is to use a surgical series to analyse the validity of elastography in evaluating the malignancy of thyroid nodules and multinodular goitres.

Patients and methods

The study examined 156 patients, 134 women (85·9%) and 22 men (14·1%), who underwent surgery for nodular thyroid disease between October 2008, and November 2010. The average age of the patients was 52 years (±14·42). Thirty‐six patients (23·1%) presented with a single nodule, and 120 (76·9%) exhibited multinodular goitres. Prior to surgical intervention, all patients underwent colour eco‐elastography using a qualitative five‐point ordinal scale for nodule classifications. Test results were analysed using a receiver operating characteristic (ROC) curve, and an anatomical pathologic examination of surgical specimens was used as a gold standard diagnostic tool for comparison.

Results

Of the 192 nodules analysed, 28 (14·6%) were malignant. Using elastography data, an ROC curve was obtained with an area under the curve of 0·662 (±0·060) and a 95% confidence interval (CI 95%) between 0·545 and 0·779 (P = 0·006). By establishing a cut‐off point that classified thyroid nodules with an elastographic value greater than or equal to 3 as malignant, we achieved a sensitivity of 75%, specificity of 45·73%, positive predictive value of 19·1% and negative predictive value of 91%. The positive and negative likelihood ratios were 1·38 and 0·55, respectively.

Conclusions

Ultrasound elastography can provide information regarding malignancy risk in thyroid nodules and multinodular goitres. However, the sensitivity and specificity values obtained in our study are below those reported by other groups, a finding that calls into question the current clinical utility of ultrasound elastography.
The All‐on‐Four Treatment Concept: A Systematic Review
Authors: Patzelt Sebastian B. M. , Bahat Oded , Reynolds Mark A. , Strub Joerg R.
Published: April 2013

Purpose

The study aims to evaluate the all‐on‐four treatment concept with regard to survival rates (SRs) of oral implants, applied fixed dental prostheses (FDPs) and temporal changes in proximal bone levels.

Materials and Methods

A systematic review of publications in English and German was performed using the electronic bibliographic database MEDLINE, the Cochrane Library, and Google. Hand searches were conducted of the bibliographies of related journals and systematic reviews. The authors performed evaluations of articles independently, as well as data extraction and quality assessment. Data were submitted the weighted least‐squared analysis.

Results

Thirteen (487 initially identified) papers met inclusion criteria. A number of 4,804 implants were initially placed, of which 74 failed, with a majority of failures (74%) within the first 12 months. A total of 1,201 prostheses were incorporated within 48 hours after the surgery. The major prosthetic complication was the fracture of the all‐acrylic FDP. The mean cumulative SR/SR ± (standard deviation) (36 months) of implants and prostheses were 99.0 ± 1.0% and 99.9 ± 0.3%, respectively. The averaged bone loss was 1.3 ± 0.4 mm (36 months). No statistically significant differences were found in outcome measures, when comparing maxillary versus mandibular arches and axially versus tilted placed implants.

Conclusion

The available data provide promising short‐term results for the all‐on‐four treatment approach; however, current evidence is limited by the quality of available studies and the paucity of data on long‐term clinical outcomes of 5 years or greater. In terms of an evidence‐based dentistry, the authors recommend further studies designed as randomized controlled clinical trials and reported according to the CONSORT statement.
Ridge preservation with the use of deproteinized bovine bone mineral
Authors: Lindhe Jan , Cecchinato Denis , Donati Mauro , Tomasi Cristiano , Liljenberg Birgitta
Published: April 2013

Objective

The aim was to examine the tissue composition of extraction sockets that had been grafted with deproteinized bovine bone mineral and allowed to heal for 6 months.

Material and methods

Twenty‐five subjects with one tooth each scheduled for extraction and replacement with dental implants were recruited. The assigned teeth were carefully removed. The site/patient was thereafter allocated to a test or a control group. In the test group patients, Bio‐Oss® Collagen was placed to fill the fresh extraction socket while in the controls no grafting was performed. After about 6 months of healing, a biopsy was sampled from the center of the extraction site. The specimens were decalcified, embedded in paraffin, sectioned, and stained in HTX. The proportions occupied by mineralized bone, osteoid, bone marrow, fibrous tissue, and Bio‐Oss® particles were determined by morphometric point counting.

Results

Mineralized bone made up 57.4 ± 12.4% of the control sites (C) and 48.9 ± 8.5% of the T1 sites (graft material not included). The amount of bone marrow (C: 7.1 ± 6.1%, T1: 2.1 ± 3.1%) and osteoid (C: 7.3 ± 4.9%, T1: 1.9 ± 2.1%) was about five times greater in the control than in the test sites. Fibrous tissue comprised 23.1 ± 16.3% (C) and 40.0 ± 11.9% (T1). I n the T2 sites (graft material included), the percentage mineralized bone was 39.9 ± 8.6 while the proportions of bone marrow and osteoid were 1.8 ± 2.5% and 1.6 ± 1.8%. Fibrous tissue occupied 32.4 ± 9.2% and Bio‐Oss® particles 19.0 ± 6.5% of the T2 sites.

Conclusion

Placement of the biomaterial in the fresh extraction socket retarded healing. The Bio‐Oss® particles were not resorbed but became surrounded by new bone. This may explain why grafted extraction sites may fail to undergo dimensional change.
Timelines in Exhibitions
Authors: Lubar Steven
Published: April 2013

Timelines serve as the organizing structure for many exhibitions. This essay explores the use of the timeline in museums in an attempt to understand its appeal and its meaning. The article considers the nature of narrative, and of chronology specifically, as well as the history of the timeline and of its use in museum exhibitions. Raising questions about the message sent by chronological ordering, the essay encourages exhibition developers to consider how exhibits might move beyond the timeline to provide visitors with a more nuanced historical understanding and a more active relationship to the past. If we stop taking the timeline for granted, we might find ways to complicate chronology while still taking advantage of its power.
One Hundred Strong: A Colloquium on Transforming Natural History Museums in the Twenty‐first Century
Authors: Watson Bill , Werb Shari Rosenstein
Published: April 2013

In February 2012, the Smithsonian's National Museum of Natural History (NMNH) convened 100 colleagues from 43 organizations to initiate a collaborative learning research agenda focused on examining important areas for innovation to better serve twenty‐first‐century audiences. The conference organizers anticipated that scientists, educators, exhibit professionals, and other members of the natural history community would identify and prioritize research questions about what, how, why, when, and where people learn about natural history. We prepared to engage in a conversation about how natural history museums could change what they do. The participants' overwhelming passion for their work, and for natural history museums and their transformative potential for society, quickly turned the conversation toward how natural history museums should change what they are. The result was an emergent learning research agenda situated within a broader vision for natural history museums.
How can we help children after mild traumatic brain injury?
Authors: Mack Kenneth J
Published: April 2013

This commentary is on the original article by Kuczynski et al. on pages 636–641 of this issue.
EXCHANGE RATE REGIMES AND FISCAL DISCIPLINE: THE ROLE OF CAPITAL CONTROLS
Authors: VULETIN GUILLERMO
Published: April 2013

How do exchange rate regimes influence fiscal discipline? This important question has typically been addressed exploiting the classic dichotomy of fixed versus flexible exchange rate regimes assuming perfect capital mobility. However, the role of capital controls cannot be neglected, particularly in developing countries. This paper analyzes the effects of capital controls on fiscal performance by focusing on dual exchange rate regimes. In a model in which the fiscal policy is endogenously determined by a nonbenevolent fiscal authority, dual regimes induce politicians to have higher fiscal deficits than under fixed and flexible regimes operating under perfect capital mobility. The model also shows this effect increases as fiscal authorities become more impatient. Dynamic panel regressions confirm that dual regimes lead to higher fiscal deficits than fixed and flexible regimes operating under unified rates. Using a dummy for pre‐electoral year as an indicator of fiscal authorities' shortsightedness, we also confirm that dual exchange rate has a more adverse effect on fiscal deficits as the authorities become more impatient. (JEL E50, E60, F31, F41)
Efficacy of the pheromone (3Z)‐lactone and the host kairomone (3Z)‐hexenol at detecting early infestation of the emerald ash borer, Agrilus planipennis
Authors: Ryall Krista L. , Fidgen Jeffrey G. , Silk Peter J. , Scarr Taylor A.
Published: April 2013

The invasive emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), is a major pest of ash trees, Fraxinus spp., in its introduced range in North America. Field studies were conducted to quantify the efficacy of traps baited with kairomone and pheromone lures for early detection of A. planipennis infestation. A trapping experiment demonstrated that green traps baited with the kairomone (3Z)‐hexenol detected at least one adult A. planipennis in 55.3% of plots with ‘nil to low’‐density infestations and in 100% of plots with ‘moderate to high’‐density A. planipennis infestations. Mean trap captures increased significantly with increasing infestation density. In terms of the optimal number of traps per plot, when one (3Z)‐hexenol‐baited trap was placed per plot, the trap detected populations in 62% of the plots with ‘low to moderate’‐density infestations through branch sampling. Detectability was increased to 82% when two traps were placed per plot. Finally, addition of female‐produced (3Z)‐lactone pheromone to traps significantly increased detection rates at both the trap and plot level, as compared with traps baited with the host volatile, (3Z)‐hexenol, alone (88 vs. 60%, respectively). Our results are the first to demonstrate the efficacy of baited green sticky traps for detecting low‐density A. planipennis infestations, particularly when the (3Z)‐lactone pheromone is used. This combination is therefore recommended for development of early‐detection protocols against A. planipennis.
Prediction of on‐road driving ability after traumatic brain injury and stroke
Authors: Aslaksen P. M. , Ørbo M. , Elvestad R. , Schäfer C. , Anke A.
Published: April 2013

Background and purpose

The aim of the study was to examine the predictive value of widely used standardized neuropsychological tests in a clinical setting for on‐road driving performance in patients with cerebral stroke or traumatic brain injury (TBI), and to provide cut‐off values for neuropsychological test results under which driving should not be recommended.

Methods

Data from 78 patients who had undergone comprehensive driving assessment after stroke or TBI were retrospectively included in the analysis. Patients underwent medical examination, neuropsychological testing and on‐road assessment. Medical data, demographic variables and neuropsychological performance were used as predictors in a stepwise logistic regression analysis with pass/fail after the on‐road test as the dependent variable. Receiver operating characteristic curve analysis was employed to select cut‐off values for the tests that were significant predictors for on‐road performance.

Results

Forty‐three patients passed and 35 failed the on‐road driving task. Logistic regression analysis revealed three significant neuropsychological tests (CalCap simple reaction time, Trail Making Test A, Grooved Pegboard) as predictors for on‐road performance explaining 46% of the variance with an overall classification accuracy of 82.1%. Receiver operating characteristic curve analysis showed the following cut‐off values: CalCap, 395 ms; Trail Making Test A, 46 s; Grooved Pegboard, 97.5 s.

Conclusion

The results suggest that driving ability after brain damage and cerebral disease with no severe neurological deficits can be measured with a few distinctive neuropsychological tests together with medical examination and on‐road assessment. Cut‐off scores are a useful supplement to normative data/scaled scores.