bluuebunny/crossref_metadata_2025 huggingface dataset:
AML compliance for foreign correspondent accounts: a primer on beneficial ownership requirements and other challenges
Authors: N. Davilas Christina
Published: April 2014

Purpose

– To educate on AML legal requirements and issues relative to foreign correspondent accounts, and give practical advice on relatively low-burdensome measures firms can take to help them achieve compliance in this challenging area.

Design/methodology/approach

– Summarizes AML requirements relevant to foreign correspondent accounts, discusses two related FINRA settlements involving the alleged failure to obtain and verify beneficial ownership information, reviews ongoing regulatory and legislative initiatives (including a FinCEN initiative to require firms to identify beneficial owners and verify their identities), and suggests certain due diligence procedures firms can use to screen foreign correspondent accounts.

Findings

– One of the fundamental risks that firms face when dealing with foreign correspondent accounts is not knowing their customers' customers. While the current regulatory framework does not, in most cases, explicitly require firms to obtain beneficial ownership information, the practical reality seems to be that obtaining and verifying such information, where possible, could pay substantial dividends in terms of risk assessment and avoidance.

Practical implications

– In some cases, a variety of cost-effective screening measures can be sufficient for a firm to identify concrete risks so that it may take steps to reduce its own regulatory exposure. Firms should not discount the simple for the elaborate, and should take advantage of the several, cost-effective AML tools and resources that are readily available.

Originality/value

– Practical guidance for AML officers and other compliance and legal professionals by an experienced financial institutions lawyer.
Archival information services based on social networking services in a mobile environment
Authors: Kim Yong , Kyung Kang Hye , Kim Ee-gyeong , Kim Geon
Published: April 2014

Purpose

– Social networking services (SNS) sites such as Facebook and Twitter have increasingly established themselves as a new paradigm of communication. Due to the rapid popularization of mobile devices, mobile SNS are creating a particularly significant change in the way in which information is distributed. The purpose of this paper is to propose a mobile SNS system tailored for archival information services (AIS) in South Korea.

Design/methodology/approach

– In order to find an appropriate service structure for the proposed AIS system, the authors conduct a case study of the existing mobile SNS sites. In addition to this, the authors investigate how mobile SNS are currently used in libraries and archives. Based on the results, they propose a mobile SNS structure suitable for the AIS system, for which a user interface and database is designed and implemented.

Findings

– The proposed system can leverage mobile SNS to expand the accessibility of AIS and encourage active participation and cooperation from users.

Originality/value

– The proposed system can improve the security vulnerabilities inherent in Facebook and Twitter; further, it can induce active user participation through two-way communication channels with users and also produce high-quality information by providing a communication space between the archiving experts.
Comparing digital libraries with virtual communities from the perspective of e-quality
Authors: Yan Yalan , Zha Xianjin , Zhang Jinchao , Hou Xiaorong
Published: April 2014

Purpose

– In this study, the authors use the term “e-quality” to refer to information quality, system quality and service quality. This study aims to focus on e-quality, exploring and comparing users' perceptions of digital libraries and virtual communities in the hope that the results of this study can help lead to better understanding of the exact nature of e-quality as perceived by users.

Design/methodology/approach

– A large-scale survey was conducted for data collection. Data collected from 334 users of digital libraries and virtual communities were used for data analysis.

Findings

– The study finds that users are likely to perceive a higher level of information quality, system quality and service quality of digital libraries than of virtual communities.

Practical implications

– The authors suggest that librarians do not need to have concerns over the challenge brought by virtual communities, which indeed have an increasing impact on the way a lot of people seek and gather information. Instead, they should encourage their users to use both digital libraries and virtual communities. The authors believe that the usage of these two types of information sources by users can efficiently inform each other, thus facilitating the e-quality of both digital libraries and virtual communities to reach excellence.

Originality/value

– Building on the information systems (IS) success model, this study explores and compares users' perceptions of digital libraries and virtual communities in terms of e-quality, which the authors think presents a new view for digital library research and practice alike.
Study expectations of 1st/2nd generation STEM postgraduate taught students
Authors: Morgan Michelle
Published: April 2014

Purpose

– Although there is an increasing body of literature looking at the postgraduate student experience, there is a lack of research and knowledge in understanding the impact of postgraduate (taught) PGT students' learning experiences prior to their postgraduate study, and their expectations of studying at PGT level. The research undertaken in the Faculty of Science, Engineering and Computing at a post-1992 institution, which focuses on STEM disciplines (science, technology, engineering and mathematics), aims to correct this deficiency by providing valuable data and insights into this nationally and internationally largely neglected area. This paper seeks to report the notable findings of first and second-generation respondents.

Design/methodology/approach

– Data were collected via a hard copy questionnaire that had been developed through previous research and with staff and PGT course representative input. It was distributed and completed by new taught postgraduate students during the orientation period in September 2012. It was entered into the Statistical Package for the Social Sciences (SPSS) and a range of tests were run on the data.

Findings

– This original research highlights the similarities and differences between first and second-generation respondents' prior learning experiences and their expectations of studying at postgraduate taught level.

Research limitations/implications

– The findings from the research presented was conducted over a one-year period and the findings are based on the limitations that such a time and financially limited project can offer. The university concerned is a post-1992 institution and has a high concentration towards teaching functions. What is observed at this UK HEI could be replicable in other teaching oriented organisations thus merits further research.

Originality/value

– The findings from this original piece of research offer potentially important contributions to the current PGT debate looking at developing and expanding PGT provision and ensuring its sustainability.
Quality improvement of technical education in Saudi Arabia: self-evaluation perspective
Authors: A. Alzamil Zakarya
Published: April 2014

Purpose

– In Saudi Arabia, technical education is managed by Technical and Vocational Training Corporation. However, there is no independent accrediting body to accredit the technical institutes and assure its quality, which causes the lack of unified quality assurance standards and manageable quality improvement processes. The purpose of this paper is to propose self-evaluation standards to help the technical institutes to evaluate their performance.

Design/methodology/approach

– The author has used a brainstorming technique of local practitioners in quality assurance. Such technique was performed by adopting DACUM that stands for “Developing A CurriculUM”. The author has used a heuristic educational and training process as the foundation of the standards and processes development, namely; curriculum, environment, training managements, and instructors. A team has been established that has been trained locally and abroad on the quality assurance standards and processes. The team studied several quality frameworks of the different countries to come up with guidelines for quality self-evaluation and standards.

Findings

– The author has found that such an approach is a very effective tool for improving the institutes' performance and gives them the flexibility to decide about their missions. Most of institutes' staff is reluctant to participate in the self-evaluation process because of the fear it may reveal their weaknesses, but with encouragement and motivation especially from the top management they tend to participate in such a process. Self-evaluation helps the educational institutes to be benchmarked with other international institutions, in which good practices may be adopted by the institutes' managements to achieve their vision.

Research limitations/implications

– The proposed approach can help the technical education institutes to manage their quality system. In addition, the implementation of such an approach might be the starting point to develop a quality system framework for the technical education in Saudi Arabia. However, further investigation is needed to measure whether applying such standards may help the technical education institutes to meet the required quality standards to attain an accreditation from the international quality agencies.

Originality/value

– The proposed guidelines for quality standards and processes is a contribution in the accreditation and quality assurance processes for many public and private institutions in Saudi Arabia. In addition, it is an important step to standardize the quality processes.
Risk management and cultural virtue in HE co-delivery arrangements
Authors: Talbot Jonathan , Perrin David , Meakin Denise
Published: April 2014

Purpose

– The purpose of the paper is to contribute to the debate on the maintenance and enhancement of quality in the emerging landscape of higher education practice and delivery where new kinds of institutional relationships are emerging. Much of the literature describes situations where the risk to quality assurance is relatively low. The example discussed here details how principles of risk management can be used to assure quality where the risk of reputational damage is far greater.

Design/methodology/approach

– The paper uses a single case study approach.

Findings

– New and flexible forms of delivery in higher education present opportunities but also the potential for reputational damage so innovative delivery must be matched by a corresponding commitment to quality. This must be embedded at all levels, including tutors. Much of the literature from the perspective of tutors emphasises their experience of quality as a matter of bureaucratic compliance. The case study illustrates that in circumstances where there is a risk of compromise academic tutors can actively engage with a quality enhancement process.

Research limitations/implications

– Although a case study of specialised practice there is evidence that increasing numbers of universities are seeking to engage in similar methods. The literature on the implications of these initiatives is comprised of case studies so there is a need for more systematic research which examines practices more broadly. The case study also suggests that the search for quality cultures in HE may fruitfully investigate circumstances where quality has to be fought for rather than assumed.

Practical implications

– The paper demonstrates that universities can deliver in flexible and innovative ways which do not compromise their reputation provided they risk assess the implications of each arrangement and develop appropriate procedures and practices at all levels of operation.

Originality/value

– The case study is not the first of its kind to be published but it is the first to be published in the context of the quality assurance literature rather than the more specialist work based learning literature. It links developments within that specialist field to more mainstream discourses in the quality assurance literature. It also draws attention of a wider audience to some of the more innovative developments in British HE practice.
Avoidable Euler Errors – the use and abuse of Euler deconvolution applied to potential fields
Authors: Reid Alan B. , Ebbing Jörg , Webb Susan J.
Published: April 2014

Window‐based Euler deconvolution is commonly applied to magnetic and sometimes to gravity interpretation problems. For the deconvolution to be geologically meaningful, care must be taken to choose parameters properly. The following proposed process design rules are based partly on mathematical analysis and partly on experience.

The interpretation problem must be expressible in terms of simple structures with integer Structural Index (SI) and appropriate to the expected geology and geophysical source.

The field must be sampled adequately, with no significant aliasing.

The grid interval must fit the data and the problem, neither meaninglessly over‐gridded nor so sparsely gridded as to misrepresent relevant detail.

The required gradient data (measured or calculated) must be valid, with sufficiently low noise, adequate representation of necessary wavelengths and no edge‐related ringing.

The deconvolution window size must be at least twice the original data spacing (line spacing or observed grid spacing) and more than half the desired depth of investigation.

The ubiquitous sprays of spurious solutions must be reduced or eliminated by judicious use of clustering and reliability criteria, or else recognized and ignored during interpretation.

The process should be carried out using Cartesian coordinates if the software is a Cartesian implementation of the Euler deconvolution algorithm (most accessible implementations are Cartesian).

If these rules are not adhered to, the process is likely to yield grossly misleading results. An example from southern Africa demonstrates the effects of poor parameter choices.
The outcome of shared pollination services is affected by the density and spatial pattern of an attractive neighbour
Authors: Seifan Merav , Hoch Eva‐Maria , Hanoteaux Sven , Tielbörger Katja
Published: April 2014

Interactions among neighbouring plants are often mediated by foraging choices of pollinators. For example, the presence of a conspicuous species may increase the number of pollinators attracted to its vicinity, indirectly increasing visitation rates also to neighbouring plants. Because pollinator choices are frequently density‐dependent, the presence of a conspicuous species at high densities may also increase competition for pollination services. Additionally, models predict that plant density will interact with spatial distribution in manipulating the pollinator behaviour, yet experimental evidence for this effect is missing.

We performed a field experiment in which we introduced a highly conspicuous species in different densities and spatial configurations in a full‐factorial manner into a species‐rich meadow and studied its effect on neighbouring plants.

We showed that the highly conspicuous species strongly contributed to the attractiveness of its local patch and thus benefited its neighbours. However, because of the strong density effect, the conspicuous species changed its role and became a competitor for pollinators when its density increased.

We supported our theoretical assumptions and showed that when the introduced conspicuous species was regularly distributed among other plants in the patch, it increased visitation rate, and in some cases also seed set, to conspicuous neighbours relative to when it was aggregated, at least at low densities.

Synthesis. We suggest that complex interactions between density and spatial distribution of plant species at the patch scale are highly relevant for the interpretation of pollinator behaviour and therefore should be treated as factors of floral attractiveness in future studies.
Predictive accuracy of Edinburgh Postnatal Depression Scale assessment during pregnancy for the risk of developing postpartum depressive symptoms: a prospective cohort study
Authors: Meijer JL , Beijers C , van Pampus MG , Verbeek T , Stolk RP , Milgrom J , Bockting CLH , Burger H
Published: April 2014

Objective

To investigate whether the 10‐item Edinburgh Postnatal Depression Scale (EPDS) administered antenatally is accurate in predicting postpartum depressive symptoms, and whether a two‐item EPDS has similar predictive accuracy.

Design

Prospective cohort study.

Setting

Obstetric care in the Netherlands.

Population

One thousand six hundred and twenty women from the general population.

Methods

Mean values, area under the receiver operating characteristics curve (AUC), sensitivity, specificity and predictive values of antenatal EPDS for the likelihood of developing postpartum depressive symptoms were calculated. Analyses were repeated for each trimester, several cut‐off values and a two‐item EPDS (low mood and anhedonia).

Main outcome measures

Postpartum depressive symptoms, defined as EPDS score ≥10.

Results

Mean EPDS scores were significantly higher during each trimester in women with postpartum depressive symptoms than in those without the symptoms (P < 0.001). Using the prevailing cut‐off (≥13), the AUC was reasonable (0.74), sensitivity was 16.8% (95% CI 11.0–24.1), positive predictive value was 41.8% (95% CI 28.7–55.9), specificity was 97.8% (95% CI 97.0–98.5) and negative predictive value was 92.7% (95% CI 91.3–94.0). Using a lower cut‐off value (≥5), sensitivity was 70.8% (95% CI 62.4–78.3) and specificity was 65.4% 4 (95% CI 62.9–67.8), but positive predictive value was low (15.9%, 95% CI 13.1–19.0). Negative predictive value was exceedingly high at 96.0% (95% CI 94.6–97.2). Results were similar during the second and third trimester. The predictive accuracy of the two‐item EPDS appeared inferior.

Conclusions

The EPDS was not sufficiently accurate in predicting risk of postpartum depressive symptoms. Nevertheless, when using the ≥5 cut‐off value, it may be adequate for initial screening, followed by further assessments and possibly antenatal intervention when positive. Furthermore, when negative, women may be reassured that postpartum depressive symptoms are unlikely. A two‐item version showed poor predictive accuracy.
A Note on the Effects of the Income Stabilisation Tool on Income Inequality in Agriculture
Authors: Finger Robert , El Benni Nadja
Published: April 2014

Increasing concerns with income risks in agriculture have led to discussions on the introduction of an Income Stabilisation Tool (IST) in Europe. In this note, we extend existing evaluations of the IST by investigating the potential effect of the IST on inequality in farm incomes using Swiss agriculture as a case study. We find that the IST will significantly reduce income inequality, in particular by increasing lower quantiles of the income distribution. This property constitutes a value‐added of the IST that is not yet considered in the current policy debate.
The Politics of Austerity and Public Policy Reform in the EU
Authors: Ladi Stella , Tsarouhas Dimitris
Published: April 2014

The European Union (EU) is at a critical juncture that will either trigger further integration or reinforce a mode of intergovernmental cooperation. The spread of market pressure to a growing number of states demonstrates that the crisis needs to be dealt with at the European and not just the national level. Up to now the ‘politics of extreme austerity’ has been the mainstream recipe promoted to and adopted by member states. The measures are tougher in those countries where there has been external financial assistance (i.e. Greece, Portugal and Ireland) but the rest of Europe is following suit (e.g. Italy and the UK). This introduction outlines the key directions of EU reforms to put into context the more specific cases discussed elsewhere in this symposium. The strengths and weaknesses of the theoretical frameworks employed in the articles are discussed to demonstrate the lessons that the crisis offers for our well-established public policy models and to highlight avenues for further research. Two main arguments are advanced: first, the crisis calls for an interdisciplinary approach to comprehend its full extent and deal with it efficiently; and second, the current political trajectory of the EU calls for urgent changes to strengthen its cohesion and long-term viability.
Internal Validation of Human Mitochondrial DNA Quantification Using Real‐Time PCR
Authors: Sprouse Marc L. , Phillips Nicole R. , Kavlick Mark F. , Roby Rhonda K.
Published: April 2014

The quantity of mitochondrial DNA (mtDNA) template added for amplification and subsequent dye terminator reactions is critical for obtaining quality sequence data. Validation of a human mtDNA real‐time quantitative PCR (qPCR) assay demonstrated its high degree of reproducibility and precision as well as an extremely sensitive threshold of detection (0.0001 pg/μL or approximately six human mtDNA copies/μL). A study of 35 nonprobative bone and teeth evidence samples revealed that 20 pg of mtDNA template is recommended for successful HV1 and HV2 sequence analysis; however, as little as 0.013 pg can generate a full mtDNA profile when using enhanced amplification reactions. The assay can also detect PCR inhibition and is useful for identifying samples that may benefit from re‐purification. Overall, the assay is an excellent method to quantify mtDNA and is useful for determining the best analytical approach for successful sequencing.
Tranexamic acid for trauma: Filling the ‘GAP’ in evidence
Authors: Mitra Biswadev , Mazur Stefan , Cameron Peter A , Bernard Stephen , Burns Brian , Smith Anthony , Rashford Stephen , Fitzgerald Mark , Smith Karen , Gruen Russell L ,   PATCH‐Trauma Study Investigators
Published: April 2014

Following findings of the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH‐2) trial, tranexamic acid (TxA) use post trauma is becoming widespread. However, issues of generalisability, applicability and predictability beyond the context of study sites remain unresolved. Internal and external validity of the CRASH‐2 trial are currently lacking and therefore incorporation of TxA into routine trauma resuscitation guidelines appears premature. The Pre‐hospital Antifibrinolytics for Traumatic Coagulopathy and Haemorrhage (PATCH)‐Trauma study is a National Health and Medical Research Council‐funded randomised controlled trial of early administration of TxA in severely injured patients likely to have acute traumatic coagulopathy. The study population chosen has high mortality and morbidity and is potentially most likely to benefit from TxA's known mechanisms of action. This and further trials involving appropriate sample populations are required before evidence based guidelines on TxA use during trauma resuscitation can be developed.
Bottom‐up manipulations alter the community structures of galling insects and gall morphs on Neoboutonia macrocalyx trees in a moist tropical rainforest
Authors: Malinga Geoffrey M. , Valtonen Anu , Nyeko Philip , Roininen Heikki
Published: April 2014

The effects of bottom‐up forces on the community structure of tropical insect gallers and within species variation in gall morphotype assemblages are not well understood.

We tested the roles of increased nutritional quality and density of host plants with respect to structuring the galling insect communities and gall morphotype assemblages on Neoboutonia macrocalyx trees in Uganda.

Plant nutritional quality and resource concentration were manipulated with four levels of fertilization and the group size of trees, respectively. After applying these treatments in May 2011, gallers established naturally on experimental replicates. Five months later, we sampled gallers and recorded their numbers and the different morphotypes. We analyzed the effects of treatments on the structures of galler communities and gall morphotype assemblages.

We recorded 5237 individuals, representing four galler species. One species, Cecidomyiid leaf galler, was represented by three morphologically distinct galls. Fertilization, host tree density and their interactions significantly changed the structures of galler species communities and gall morphotype assemblages.

The results of the present study demonstrate the important role of bottom‐up factors in structuring galler communities and the gall morphotype assemblages. These changes are likely caused by differential responses of different galler species and gall morphs to plant quality or quantity changes.
Harmonic dissection versus electrocautery in breast surgery in regional Victoria
Authors: Kiyingi Andrew K. , Macdonald Leigh J. , Shugg Sarah A. , Bollard Ruth C.
Published: April 2014

Background

Harmonic instruments are an alternative tool for surgical dissection. The aim of this study is to evaluate differences in clinical outcomes relating to harmonic dissection when compared with electrocautery in patients undergoing major breast surgery in a regional centre over a 3‐year period.

Methods

Retrospective chart analysis was conducted of 52 patients undergoing major breast surgery for carcinoma or ductal carcinoma in situ by a single surgeon in a regional centre from May 2008 to January 2011. Analysis involved the extraction of qualitative data relating to patient demographics, surgery type and specimen histopathology. Quantitative data were extracted relating to duration of surgery, duration of patient‐controlled analgesia (PCA) use, length of hospital admission, drainage output and presence of infection, haematoma or seroma.

Results

Fifty‐two patients underwent major breast surgery; harmonic dissection n = 32 and electrocautery n = 20. The two groups were comparable. There was no significant difference identified relating the outcome measures. The median operative duration was shorter in the harmonic dissection group, however, was not of statistical significance. No significant difference was identified between groups relating to length of inpatient stay, duration of PCA use and total volume wound drainage and total days of drainage. Incidence of seroma and infection in the groups was not significantly different.

Conclusion

The harmonic dissection is safe and effective in major breast surgery. The study did not demonstrate any clinical advantage from the use of harmonic dissection in major breast surgery compared with electrocautery, nor was there any difference in the complication rates measured.
Abnormal uterine bleeding: advantages of formal classification to patients, clinicians and researchers
Authors: Madhra Mayank , Fraser Ian S. , Munro Malcolm G. , Critchley Hilary O. D.
Published: April 2014

Objective

To highlight the advantages of formal classification of causes of abnormal uterine bleeding from a clinical and scientific perspective.

Design

Review and recommendations for local implementation.

Setting

In the past, research in the field of menstrual disorders has not been funded adequately with respect to the impact of symptoms on individuals, healthcare systems and society. This was confounded by a diverse terminology, which lead to confusion between clinical and scientific groups, ultimately harming the underlying evidence base. To address this, a formal classification system (PALM‐COEIN) for the causes of abnormal uterine bleeding has been published for worldwide use by FIGO (International Federation of Gynecology and Obstetrics).

Population and main outcome measures

This commentary explains problems created by the prior absence of such a system, the potential advantages stemming from its use, and practical suggestions for local implementation.

Results and conclusions

The PALM‐COEIN classification is applicable globally and, as momentum gathers, will ameliorate recurrence of historic problems, and harmonise reporting of clinical and scientific research to facilitate future progress in women's health.
Identification of functional visual field loss by automated static perimetry
Authors: Frisén Lars
Published: April 2014

Purpose

Diagnosis of functional visual field loss, that is, field loss lacking objective corollaries, has long relied on kinetic visual field examinations using tangent screens or manual perimeters. The modern dominance of automated static perimeters requires the formulation of new diagnostic criteria.

Methods

Retrospective review of automated perimetry records from 36 subjects meeting clinical and tangent screen criteria for functional visual field loss. Thirty‐three normal eyes and 57 eyes with true lesions, including optic nerve compression, glaucoma, anterior ischaemic optic neuropathy and vigabatrin toxicity, served as controls.

Results

Standard automated perimetry statistics were unable to reliably discriminate organic versus non‐organic visual field loss. Subjective evaluation of perimetric maps indicated that functional fields generally could be identified by the presence of severe and irregular contractions and depressions that did not conform to the visual system's neuro‐architecture. Further, functional fields generally presented one or more isolated threshold ‘spikes’, that is, isolated locations showing much better than average sensitivity. On repeated examinations, threshold spikes always changed locations. Visual evaluation for spikes proved superior to an objective computational algorithm. Fairly reliable objective discrimination of functional fields could be achieved by point‐wise correlations of repeated examinations: median intertest correlation coefficients equalled 0.47 compared with 0.81 for true lesions.

Conclusion

Functional visual loss can be identified by automated static perimetry. Useful criteria include severe and irregular contractions and depressions, the presence of isolated threshold spikes and poor intertest correlations.
Ca2+ signals, NAADP and two‐pore channels: role in cellular differentiation
Authors: Parrington J. , Tunn R.
Published: April 2014

Ca2+ signals regulate a wide range of physiological processes. Intracellular Ca2+ stores can be mobilized in response to extracellular stimuli via a range of signal transduction mechanisms, often involving recruitment of diffusible second messenger molecules. The Ca2+‐mobilizing messengers InsP3 and cADPR release Ca2+ from the endoplasmic reticulum via the InsP3 and ryanodine receptors, respectively, while a third messenger, NAADP, releases Ca2+ from acidic endosomes and lysosomes. Bidirectional communication between the endoplasmic reticulum (ER) and acidic organelles may have functional relevance for endolysosomal function as well as for the generation of Ca2+ signals. The two‐pore channels (TPCs) are currently strong candidates for being key components of NAADP‐regulated Ca2+ channels. Ca2+ signals have been shown to play important roles in differentiation; however, much remains to be established about the exact signalling mechanisms involved. The investigation of the role of NAADP and TPCs in differentiation is still at an early stage, but recent studies have suggested that they are important mediators of differentiation of neurones, skeletal muscle cells and osteoclasts. NAADP signals and TPCs have also been implicated in autophagy, an important process in differentiation. Further studies will be required to identify the precise mechanism of TPC action and their link with NAADP signalling, as well as relating this to their roles in differentiation and other key processes in the cell and organism.
Real‐world assessment of therapy changes, suboptimal treatment and associated costs in patients with ulcerative colitis or Crohn's disease
Authors: Rubin D. T. , Mody R. , Davis K. L. , Wang C.‐C.
Published: April 2014

Background

Treatments for Crohn's disease (CD) and ulcerative colitis (UC) are not uniformly effective, thus necessitating dose changes, switching, and augmentation and carry adverse event risk, often requiring discontinuation, which reduces treatment benefits.

Aim

To assess continuity of and changes to initial CD and UC treatments, as well as costs associated with specific parameters defining suboptimal therapy.

Methods

Commercial US insurance claims (2006–2010) were retrospectively analysed. CD and UC patients receiving monotherapy with 5‐aminosalicylates (5‐ASAs), corticosteroids (CS), immunomodulators (IM) or biologics were included. Continuity of and changes to initial (index) therapy and associated costs (2011 US$) were assessed over 12 months following therapy initiation. Suboptimal therapy included discontinuation or switch (except for CS), dose escalation, augmentation, inadequate loading (biologics only), prolonged CS use (>3 months), surgery or hospitalisation.

Results

The study included 13 005 CD and 19 878 UC patients. Augmentation was a common index therapy change (~20% of 5‐ASA initiators, ~40% of CS initiators, ≥40% of IM initiators and 26–55% of biologic initiators) in both CD and UC patients. Approximately 50% of CD and UC 5‐ASA initiators discontinued/interrupted treatment. Approximately 80% of CD and UC patients had ≥1 suboptimal therapy marker. Mean all‐cause total costs per CD patient were significantly higher in those with vs. without suboptimal therapy ($18 736 vs. $10 878; P < 0.001); in UC, the disparity was smaller ($12 679 vs. $9653; P < 0.001).

Conclusions

Frequent dose and treatment changes were observed in all classes of initial UC and CD treatments. The economic impact of suboptimal therapy among UC and CD patients is substantial.
State Dissatisfaction: Predicting the Occurrence of Interstate War
Authors: Liao Hsiao‐chuan
Published: April 2014

Dissatisfaction is the trigger for states to initiate war according to power transition theory. The more a state is dissatisfied, the more likely it will initiate war. Traditionally, scholars use military buildups and alliance portfolios to measure states' dissatisfaction. Those measures do not express state dissatisfaction directly but provide, at best, circumstantial evidence. This paper introduces a direct measure of state dissatisfaction by counting requests and threats made by one state to another state. Four types of cases are selected from combinations of state dissatisfaction and initiation of war. The analyses are based on a selected‐focus‐dyad unit and quantified data sets. Using Boolean algebra, this article demonstrates that military parity and dissatisfaction expressed by territorial threats are more likely to trigger war. The results also show what elements of power parity and state dissatisfaction contribute to noninitiation of war. Last, the case studies highlight the nuances in the decision to initiate war among various states.
Moving Toward Patient‐Centered Care: Women's Decisions, Perceptions, and Experiences of the Induction of Labor Process
Authors: Moore Jennifer E. , Low Lisa Kane , Titler Marita G. , Dalton Vanessa K. , Sampselle Carolyn M.
Published: April 2014

Background

Patient preferences and clinician practices are possible causative factors to explain the increase in induction of labor, but scientific studies that demonstrate this link are limited. The purpose of this study is to identify factors that influence inductions from the perspective of women.

Methods

A qualitative investigation using grounded theory methodology was conducted. Women were interviewed preinduction and postinduction. Analysis of the interviews was conducted using constant comparison to identify codes, categories, and themes. Through this process the complex intersection between women, their clinician, and the application of evidence‐based care in clinical practice was explored.

Results

Five major themes from the preinduction interview were identified; safety of baby, women's trust in their clinician, relief of discomfort and/or anxiety, diminish potential or actual risk, and lack of informed decision making. Five major themes were identified from the postinduction interview; lack of informed decision making, induction as part of a checklist, women's trust in their clinician, happy with induction, and opportunities to improve the experience.

Conclusions

Lack of informed decision making was cited as a barrier to optimal care. This study has important implications for patient‐centered research and clinical care, requiring the inclusion of women and the salient concepts of care that they identify.
Does a Large Infant Head or a Short Perineal Body Increase the Risk of Obstetrical Perineal Trauma?
Authors: Komorowski Leanne K. , Leeman Lawrence M. , Fullilove Anne M. , Bedrick Edward J. , Migliaccio Laura D. , Rogers Rebecca G.
Published: April 2014

Background

Perineal trauma after vaginal delivery can have significant long‐term consequences. It is unknown if a larger infant head circumference or smaller maternal perineal anatomy are risk factors for perineal trauma after vaginal delivery.

Methods

We conducted a prospective cohort study of low‐risk nulliparous women. Data collected included maternal characteristics, antepartum Pelvic Organ Prolapse Quantification measurements of the perineal body and genital hiatus, labor characteristics, perineal trauma, and infant head circumference. Perineal trauma was defined as trauma that extended into the muscles of the perineum (second‐degree or deeper). Univariate and multivariate logistic models were created to calculate odds ratios (OR) and 95 percent confidence intervals (CI).

Results

We observed 448 vaginal births. Multivariate analysis demonstrated a significant association between infant head circumference at birth and perineal trauma: OR 1.22 for each increase of 1 cm in head circumference (95% CI 1.05–1.43). There was no association between perineal body or genital hiatus length and perineal trauma.

Conclusions

In nulliparous low‐risk women a larger infant head circumference at birth increases the likelihood of perineal trauma, although the effect is modest. Antenatal perineal body and genital hiatus measurements do not predict perineal trauma. These results do not support alteration in mode of delivery or other obstetric practices.
Parent and child distress after war exposure
Authors: Lai Betty S. , Hadi Fawzyiah , Llabre Maria M.
Published: April 2014

Objectives

The purpose of this study was to examine multiple distress symptoms (i.e., post‐traumatic stress [PTS], anxiety, depression) among parents and children exposed to the Gulf Crisis in 1990–1991. Profiles of parent distress were identified, and the relationship between parent distress and specific child distress symptoms was examined.

Design

Parents and children were assessed at one time point.

Methods

Participants included 151 children (Mage = 10.62 years; 51% female) and 140 parents (Mage = 40 years; 81% female).

Results

Utilizing latent profile analysis, three parallel profiles of parent distress were identified: low distress, moderate distress, and high distress. Parent distress was a risk factor for child depression, but it was not a risk factor for child PTS or anxiety.

Conclusions

Findings support the importance of broadening the scope of research conducted after exposure to traumatic events to include the assessment of anxiety and depression, as well as PTS, among both parents and children. Additional implications for research and clinical work are discussed.

Practitioner points

Findings support the importance of screening for multiple distress symptoms among both children and parents after war exposure.

Based on our findings, clinicians may want to consider including parents in therapy for children reporting psychological distress, especially depression symptoms, after exposure to traumatic events.

This study was cross‐sectional. Thus, we are not able to infer direction or causality.

The generalizability of our study should be interpreted with caution, as findings will need to be replicated across other populations and other cultures.
Technological utopia, dystopia and ambivalence: Teaching with social media at aSouthAfrican university
Authors: Rambe Patient , Nel Liezel
Published: April 2014

The discourse of social media adoption in higher education has often been funnelled through utopian and dystopian perspectives, which are polarised but determinist theorisations of human engagement with educational technologies. Consequently, these determinist approaches have obscured a broadened grasp of the situated, socially constructed nature of human interaction with educational technologies and failed to explain ambivalent positions of technology adoption. To contest the innate determinism embodied in the aforementioned technological views, this paper draws on technological ambivalence to unravel the complex, multiple possibilities in pragmatic use of technology—including the double‐bound relationship between human agency and educational technology. A phenomenological approach that draws on self‐narratives of the use of social media byComputerScience andInformatics educators at aSouthAfrican university is employed to unravel how their perceptions of social media shaped and informed their pragmatic instructional uses of these technologies. Findings suggest that the sharp contrasting experiences of collaborative engagement, enactment of decentralised power and democratic expression in social media coexist recursively with the disempowering, dependence‐ridden and distractive effects of these technologies. This technological divergence is further compounded by ambivalent views that neither celebrate the unrealistic hopes of social media nor grossly protest against the debilitating effects of these technologies. This view foregrounds the social embeddedness of technology and its potentially multiple, contradictory effects. The implications of these findings include the need for educators to consider social conditions of technology use, the alignment of such conditions with innovative social media‐enhanced pedagogical models and the use of proven models to demonstrate the educational potential of social media technologies.
Lymphoma diagnosis at an academic centre: rate of revision and impact on patient care
Authors: Bowen Joslin M. , Perry Anamarija M. , Laurini Javier A. , Smith Lynette M. , Klinetobe Kimberly , Bast Martin , Vose Julie M. , Aoun Patricia , Fu Kai , Greiner Timothy C. , Chan Wing C. , Armitage James O. , Weisenburger Dennis D.
Published: April 2014

Few studies have examined the value of a mandatory second review of outside pathology material for haematological malignancies. Therefore, we compared diagnoses on biopsies referred to an academic medical centre to determine the rate and therapeutic impact of revised diagnoses resulting from a second review. We reviewed 1010 cases referred for lymphoma during 2009–2010. For each case, referral diagnosis and second review diagnosis were compared. Revised diagnoses were grouped into major and minor discrepancies and all major discrepancies were reviewed by a haematologist to determine the effect the diagnostic change would have on therapy. There was no change in diagnosis in 861 (85·2%) cases. In 149 (14·8%) cases, second review resulted in major diagnostic change, of which 131 (12·9%) would have resulted in a therapeutic change. The highest rates of revision were for follicular, high‐grade B‐cell, and T‐cell lymphomas. We found higher rates of major discrepancy in diagnoses from non‐academic centres (15·8%) compared to academic centres (8·5%; P = 0·022), and in excisional biopsies (17·9%) compared to smaller biopsies (9·6%; P = 0·0003). Mandatory review of outside pathology material prior to treatment of patients for lymphoma will identify a significant number of misclassified cases with a major change in therapy.
Disturbed CXCR4/CXCL12 axis in paediatric precursor B‐cell acute lymphoblastic leukaemia
Authors: van den Berk Lieke C. J. , van der Veer Arian , Willemse Marieke E. , Theeuwes Myrte J. G. A. , Luijendijk Mirjam W. , Tong Wing H. , van der Sluis Inge M. , Pieters Rob , den Boer Monique L.
Published: April 2014

Malignant cells infiltrating the bone marrow (BM) interfere with normal cellular behaviour of supporting cells, thereby creating a malignant niche. We found that CXCR4‐receptor expression was increased in paediatric precursor B‐cell acute lymphoblastic leukaemia (BCP‐ALL) cells compared with normal mononuclear haematopoietic cells (P < 0·0001). Furthermore, high CXCR4‐expression correlated with an unfavourable outcome in BCP‐ALL (5‐year cumulative incidence of relapse ± standard error: 38·4% ± 6·9% in CXCR4‐high versus 12% ± 4·6% in CXCR4‐low expressing cases, P < 0·0001). Interestingly, BM levels of the CXCR4‐ligand (CXCL12) were 2·7‐fold lower (P = 0·005) in diagnostic BCP‐ALL samples compared with non‐leukaemic controls. Induction chemotherapy restored CXCL12 levels to normal. Blocking the CXCR4‐receptor with Plerixafor showed that the lower CXCL12 serum levels at diagnosis could not be explained by consumption by the leukaemic cells, nor did we observe an altered CXCL12‐production capacity of BM‐mesenchymal stromal cells (BM‐MSC) at this time‐point. We rather observed that a very high density of leukaemic cells negatively affected CXCL12‐production by the BM‐MSC while stimulating the secretion levels of granulocyte colony‐stimulating factor (G‐CSF). These results suggest that highly proliferative leukaemic cells are able to down‐regulate secretion of cytokines involved in homing (CXCL12), while simultaneously up‐regulating those involved in haematopoietic mobilization (G‐CSF). Therefore, interference with the CXCR4/CXCL12 axis may be an effective way to mobilize BCP‐ALL cells.
YC‐1 inhibits proliferation of breast cancer cells by down‐regulating EZH2 expression via activation of c‐Cbl and ERK
Authors: Chang Ling‐Chu , Lin Hui‐Yi , Tsai Meng‐Tung , Chou Ruey‐Hwang , Lee Fang‐Yu , Teng Che‐Ming , Hsieh Min‐Tsang , Hung Hsin‐Yi , Huang Li‐Jiau , Yu Yung‐Luen , Kuo Sheng‐Chu
Published: April 2014

Background and Purpose

YC‐1 exhibits potent anticancer activity via numerous actions in many cancer cell lines. Hence, we investigated the in vivo antitumour efficacy of YC‐1 in an MDA‐MB‐468 xenograft model and elucidated the mechanism of down‐regulation of enhancer of zeste homology 2 (EZH2) by YC‐1 in breast cancer cells.

Experimental Approach

In YC–1‐treated breast cancer cells and tumour specimens from YC–1‐treated MDA‐MB‐468 xenografts, EZH2 expression was analysed by Western blotting. Pharmacological inhibitors and short hairpin RNA‐mediated knockdown were applied to identify possible signalling pathways involved in EZH2 down‐regulation by YC‐1.

Key Results

YC‐1 reduced the viability of breast cancer cells and tumour growth in MDA‐MB‐468 xenografts. In breast cancer cells, YC‐1 down‐regulated EZH2 expression in a concentration‐ and time‐dependent manner. Depletion of EZH2 reduced the proliferation and susceptibility of breast cancer cells to YC–1‐induced apoptosis. EZH2 expression was suppressed in tumour specimens from YC–1‐treated MDA‐MB‐468 xenograft mice. YC‐1 enhanced both the degradation rate and ubiquitination of EZH2. The down‐regulation of EZH2 by YC‐1 was associated with activation of PKA and Src–Raf–ERK‐mediated signalling pathways. Furthermore, depletion of Casitas B‐lineage lymphoma (c‐Cbl), an E3 ubiquitin ligase, abolished YC–1‐induced apoptosis and suppression of EZH2. YC‐1 rapidly activated c‐Cbl to induce signalling associated with ERK and EZH2.

Conclusion and Implications

We discovered that YC‐1 induces apoptosis and inhibits tumour growth of breast cancer cells via down‐regulation of EZH2 by activating c‐Cbl and ERK. These data suggest that YC‐1 is a potential anticancer drug candidate for triple‐negative breast cancer.