Regulatory regionalism and anti-money-laundering governance in Asia

With the intensification of the Financial Action Task Force's (FATF's) worldwide campaign to promote anti-money-laundering regulation since the late 1990s, all Asian states except North Korea have signed up to its rules and have established a regional institution—the Asia/Pacific Group on Money Laundering—to promote and oversee the implementation of FATF's 40 Recommendations in the region. This article analyses the FATF regime, making two key claims. First, anti-money-laundering governance in Asia reflects a broader shift to regulatory regionalism, particularly in economic matters, in that its implementation and functioning depend upon the rescaling of ostensibly domestic agencies to function within a regional governance regime. Second, although this form of regulatory regionalism is established in order to bypass the perceived constraints of national sovereignty and political will, it nevertheless inevitably becomes entangled within the socio-political conflicts that shape the exercise of state power more broadly. Consequently, understanding the outcomes of regulatory regionalism involves identifying how these conflicts shape how far and in what manner global regulations are adopted and implemented within specific territories. This argument is demonstrated by a case study of Myanmar

The James Webb Space Telescope Mission: Optical Telescope Element Design, Development, and Performance

The James Webb Space Telescope (JWST) is a large, infrared space telescope that has recently started its science program which will enable breakthroughs in astrophysics and planetary science. Notably, JWST will provide the very first observations of the earliest luminous objects in the Universe and start a new era of exoplanet atmospheric characterization. This transformative science is enabled by a 6.6 m telescope that is passively cooled with a 5-layer sunshield. The primary mirror is comprised of 18 controllable, low areal density hexagonal segments, that were aligned and phased relative to each other in orbit using innovative image-based wavefront sensing and control algorithms. This revolutionary telescope took more than two decades to develop with a widely distributed team across engineering disciplines. We present an overview of the telescope requirements, architecture, development, superb on-orbit performance, and lessons learned. JWST successfully demonstrates a segmented aperture space telescope and establishes a path to building even larger space telescopes.Comment: accepted by PASP for JWST Overview Special Issue; 34 pages, 25 figure

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease

The recommendations listed in this document are, whenever possible, evidence based. An extensive evidence review was conducted as the document was compiled through December 2008. Repeated literature searches were performed by the guideline development staff and writing committee members as new issues were considered. New clinical trials published in peer-reviewed journals and articles through December 2011 were also reviewed and incorporated when relevant. Furthermore, because of the extended development time period for this guideline, peer review comments indicated that the sections focused on imaging technologies required additional updating, which occurred during 2011. Therefore, the evidence review for the imaging sections includes published literature through December 2011

A Mechanical Switch Couples T Cell Receptor Triggering to the Cytoplasmic Juxtamembrane Regions of CD3ζζ

The eight-subunit T cell receptor (TCR)-CD3 complex is the primary determinant for T cell fate decisions. Yet how it relays ligand-specific information across the cell membrane for conversion to chemical signals remains unresolved. We hypothesized that TCR engagement triggers a change in the spatial relationship between the associated CD3ζζ subunits at the junction where they emerge from the membrane into the cytoplasm. Using three in situ proximity assays based on ID-PRIME, FRET, and EPOR activity, we determined that the cytosolic juxtamembrane regions of the CD3ζζ subunits are spread apart upon assembly into the TCR-CD3 complex. TCR engagement then triggered their apposition. This mechanical switch resides upstream of the CD3ζζ intracellular motifs that initiate chemical signaling, as well as the polybasic stretches that regulate signal potentiation. These findings provide a framework from which to examine triggering events for activating immune receptors and other complex molecular machines.National Institutes of Health (U.S.) (5R01CA186568

168 Decompression versus Fusion for Grade 1 Lumbar Spondylolisthesis A Multicenter Assessment of 12-Month Patient-Reported Outcomes Using the Quality Outcomes Database

Abstract INTRODUCTION The ideal treatment strategy for patients with degenerative lumbar spondylolisthesis remains a topic of debate. The authors compared patient-reported outcomes for patients undergoing 1- or 2-level decompression with those undergoing 1-level fusion for grade 1 lumbar spondylolisthesis. METHODS A retrospective analysis of prospectively collected Quality Outcomes Database (QoD) data was performed at 12 participating centers. Patients were included who underwent either 1- to 2-level lumbar decompression or 1-level lumbar fusion for a diagnosis of degenerative grade 1 spondylolisthesis between July 1, 2014 and June 30, 2016. A variety of demographic, comorbidity, and patient reported outcome measures were collected and analyzed. RESULTS A total of 599 patients met criteria for analysis, with 462 undergoing fusion and 137 undergoing decompression. On univariate analysis, older patients, patients with lower body mass index, men, Medicare enrollees, diabetics, patients without depression, patients with predominantly back pain, individuals with preoperative motor or ambulation deficits, patients with symptom duration less than 3 mo, patients with more formal education, and the unemployed were more likely to receive decompression compared to fusion (all P values < .05). Patients undergoing fusion had significantly higher intraoperative blood loss, surgical length, and length of stay compared to decompression (all P values < .001). At 12 mo postoperatively, patients undergoing fusion had greater improvements in Numerical Rating Scale (NRS) back pain (–4.1 ± 3.0 vs –2.7 ± 3.4, P = .007), Oswestry Disability Index (ODI, –26.3 ± 18.8 vs –18.5 ± 20.1, P = .001), and EQ5D (0.25 ± 0.2 vs 0.17 ± 0.2, P = .004) compared to decompression. In our multivariate regression models, fusion remained associated with greater 12-mo improvement in NRS back pain (P = .042) and ODI (P = .004) compared to decompression alone. CONCLUSION Based on data derived from a large, multi-institutional cohort of QoD patients, single-level fusion provides greater improvements in NRS back pain and ODI at 12 mo than 1- or 2-level decompression in patients with grade 1 degenerative spondylolisthesis

Regional Variance in Disability and Quality-of-Life Outcomes After Surgery for Grade I Degenerative Lumbar Spondylolisthesis: A Quality Outcomes Database Analysis

Regional differences in outcomes after spine surgery are poorly understood. We assessed disability and quality-of-life outcomes by geographic region in the United States using the NeuroPoint Alliance Quality Outcomes Database. We queried the prospective Quality Outcomes Database patient registry to identify patients who underwent elective 1- or 2-level lumbar surgery for grade I degenerative spondylolisthesis from July 2014 through June 2016. Primary outcome measures included Oswestry Disability Index (ODI) and EuroQOL-5D (EQ-5D) reported at 24 months postoperatively. Differences in EQ-5D and ODI were compared across geographic regions of the United States (Northeast, Midwest, South, West). We identified 608 patients from 12 centers who underwent surgery. Of these, 517 (85.0%) had ODI data and 492 (80.9%) had EQ-5D data at 24 months. Southern states had the largest representation (304 patients; 5 centers), followed by Northeastern (114 patients; 3 centers), Midwestern (96 patients; 2 centers), and Western (94 patients; 2 centers) states. Baseline ODI scores were significantly different among regions, with the South having the greatest baseline disability burden (Northeast: 40.9 ± 16.9, South: 51.2 ± 15.8, Midwest: 40.9 ± 17.8, West: 45.0 ± 17.1, P < 0.001). The change in ODI at 24 months postoperatively was significantly different among regions, with the South showing the greatest ODI improvement (Northeast: −21.1 ± 18.2, South: −26.5 ± 20.2, Midwest: −18.2 ± 22.9, West: −21.7 ± 19.6, P < 0.001). All regions had ≥60% achievement of the minimum clinically important difference in ODI at 24 months postoperatively. No regional differences were observed for EQ-5D. Significant regional variation exists for disability outcomes, but not quality of life, at 24 months after spinal surgery for grade I degenerative spondylolisthesis