bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigação e análise dos processos de gestão da informação em uma empresa do setor de call centers
Authors: Andrade Eduardo Augusto , Alvarenga Neto Rivadávia Correia Drummond
Published: November 2009

Este trabalho investiga e analisa as práticas e os processos de gestão estratégica informacional implementados em um call center, embasando-se em quatro categorias analíticas: determinação de exigências informacionais, obtenção, disseminação e uso de informações. Múltiplas fontes de evidências foram utilizadas, como quatorze entrevistas semi-estruturadas, pesquisa documental e observação direta. Os resultados apontaram para a inexistência de uma estrutura legítima de gestão estratégica da informação, e evidenciaram a distância entre o discurso e a prática vigente.
Criação e disseminação do conhecimento na fundação Hemominas
Authors: Vargas Diana Alexandra Cubillos , Coelho Kátia , Magnani Maria Cristina
Published: November 2009

Apresentam-se diferentes conceitos sobre sociedade da informação, governança e política da informação, relacionando-os com os processos de criação e disseminação do conhecimento. Por meio de entrevistas e sob a abordagem do modelo SESI, esses processos são identificados e analisados em diversas áreas da Fundação Hemominas. Nas ações e práticas da instituição, procura-se encontrar elementos de uma política de informação, estabelecida implícita ou explicitamente, que seja catalisadora das diversas formas de criação e conversão do conhecimento. Conclui-se que, embora exista uma prática comum de registro e compartilhamento do conhecimento, esta prática nem sempre ultrapassa os domínios e limites das áreas onde ela acontece. Constata-se que as ações acontecem como resultado da busca pela melhoria dos processos produtivos ou de gestão, e não como resultado de uma política de informação direcionada para a criação e o compartilhamento do conhecimento como agente de inovação.
Egressos dos programas de pós-graduação em ciência da informação: por onde andam os doutores?
Authors: Noronha Daisy Pires , Población Dinah Aguiar , Assis Leonardo da Silva de , Hyodo Tatiana
Published: November 2009

Apresenta a formação dos doutores egressos dos programas brasileiros de Pós-graduação em Ciência da Informação, no período de 2000-2005, e sua inserção no mercado acadêmico após a sua titulação. Os dados foram coletados dos currículos disponíveis na Plataforma Lattes (CNPq), identificando-se o atual vínculo desses nos cursos de graduação, especialização e pós-graduação. Constatou-se um crescimento do envolvimento dos doutores em atividades de ensino, com destaque à graduação.
Segurança e eficácia do treinamento físico na insuficiência renal crônica
Authors: Najas Cláudio Spínola , Pissulin Flávio Danilo Mungo , Pacagnelli Francis Lopes , Betônico Gustavo Navarro , Almeida Igor Costa , Neder José Alberto
Published: November 2009

A doença renal crônica acarreta alterações em todos os sistemas corporais. Os pacientes cursam com marcada redução do condicionamento cardiorrespiratório, alterações musculares, reduzida performance física e pior qualidade de vida. A atividade física tem sido cada vez mais utilizada como forma de tratamento para essa população. Programas de treinamento físico aeróbio e/ou resistidos de moderada ou baixa intensidade no período interdialítico e durante a hemodiálise têm sido utilizados. Entretanto, os benefícios dessas intervenções no doente renal crônico, a escolha mais apropriada do tipo de treinamento e a segurança da aplicabilidade de atividades específicas não estão bem esclarecidos. Esta revisão tem como objetivo abordar os aspectos relacionados com o tipo de treinamento, período em que este é realizado, assim como os possíveis benefícios que o treinamento físico pode induzir nessa população.
Fish larvae assemblages in two floodplain lakes with different degrees of connection to the Paraná River, Brazil
Authors: Daga Vanessa Salete , Gogola Tatiane Mary , Sanches Paulo Vanderlei , Baumgartner Gilmar , Baumgartner Dirceu , Piana Pitágoras Augusto , Gubiani Éder André , Delariva Rosilene Luciana
Published: November 2009

The objective of this study was to assess the abundance, attributes of assemblages, and spatial and temporal distributions of fish larvae and their relationships with some abiotic variables in two floodplain lakes with different degrees of connection to the Paraná River in Ilha Grande National Park, PR, Brazil. Four sampling sites were chosen, two in each floodplain lake. Night samples were taken with plankton nets during three spawning seasons (monthly, from October to March) from 2001 to 2005. The highest diversity and abundance were recorded at Saraiva Lake, with 25 taxa being identified. In Xambrê Lake, only sedentary species were captured, and the most abundant species were Plagioscion squamosissimus and Hypophthalmus edentatus. The greatest abundance of larvae was found in the second spawning season. In the Saraiva Lake, the most abundant species were Moenkhausia aff. intermedia, Hyphessobrycon sp., and Bryconamericus stramineus, but larvae of known migratory species were also documented. In this lake, the greatest abundance of larvae was found in the third spawning. Larvae abundance was influenced by water temperature and conductivity. The high diversity and abundance recorded in Saraiva Lake may be a result of its connectivity with the Paraná River, and the low diversity and abundance observed at Xambrê Lake are likely due to its isolation from the river. This work shows the importance of these lagoons for fish development, for both sedentary and migratory species. Both lagoons may be considered to have extreme ecological importance and they are also extremely susceptible to impacts, so any careless disturbance may cause irreversible damage.
Response of mucous cells of the gills of traíra (Hoplias malabaricus) and jeju (Hoplerythrinus unitaeniatus) (Teleostei: Erythrinidae) to hypo- and hyper-osmotic ion stress
Authors: Moron Sandro Estevan , Andrade Cássio Arilson de , Fernandes Marisa Narciso
Published: November 2009

The mucous cells (MC) of traíra, Hoplias malabaricus, and jeju, Hoplerythrinus unitaeniatus, two ecologically distinct erythrinid species, were analyzed in fish exposed to deionized (DW) and high ion concentration (NaCl and Ca2+) water (HIW) during 15 days to evaluate the MC responses to ion challenge. MCs are localized in the leading and trailing edge and, interlamellar region of the gill filament epithelium but, in H. unitaeniatus, they are also found in the breathing or lamellar epithelium. MC density is lower in H. malabaricus, the exclusively water-breathing fish, than in H. unitaeniatus, a facultative air-breathing fish. The transference to DW or HIW did not change the MC density and surface area, excepting in H. malabaricus, in the first day of exposure to DW. A single MC containing three types of glycoproteins (neutral, acidic and sulphated) was identified in the gill epithelium of both, H. malabaricus and H. unitaeniatus. The amount (based on the intensity of histochemistry reaction) of these glycoproteins differed between the species and were altered after exposure to DW and HIW showing little adjustments in the amount of mucosubstances in the MC of H. malabaricus and reduction of acidic and sulphated glycoproteins in H. unitaeniatus. The decreasing of these glycoproteins in H. unitaeniatus reduced the mucus protection against desiccation of gill tissue when change the ion concentration in water.
Temporal and ontogenetic variations in feeding habits of Hollandichthys multifasciatus (Teleostei: Characidae) in coastal Atlantic rainforest streams, southern Brazil
Authors: Abilhoa Vinícius , Bornatowski Hugo , Otto Gislaine
Published: November 2009

Feeding habits of the characin Hollandichthys multifasciatus were investigated. Samplings were made between March 2004 and February 2005 in two black water streams of the coastal Atlantic rainforest in southern Brazil. The diet, evaluated by qualitative and quantitative methods, included aquatic and terrestrial insects, decapods, oligochaetes, plants and spiders. Large individuals feed mainly on plants, terrestrial insects, and spiders, whereas small fish feed basically on plants and oligochaetes. The species showed an omnivorous feeding habit, and its diet was composed of autochthonous (mainly oligochaetes) and allochthonous (plants and terrestrial insects) material.
The Role for Community-Based Participatory Research in Formulating Policy Initiatives: Promoting Safety and Health for In-Home Care Workers and Their Consumers
Authors: Gong Fang , Baron Sherry , Ayala Linda , Stock Laura , McDevitt Susannah , Heaney Cathy
Published: November 2009

Although community-based participatory research (CBPR) can be effective in influencing policy, the process of formulating policy initiatives through CBPR is understudied. We describe a case study to illustrate how alliances among various community partners could be united to formulate policy directions.

In collaboration with partners, the National Institute for Occupational Safety and Health initiated a project aimed at improving health and safety for low-income elderly and disabled persons and their in-home care workers. Community partners and stakeholders participated in focus groups, stakeholder interviews, and meetings; they played multiple roles including identifying organizational policy changes the partners could initiate immediately, as well as broader public policy goals.

Results indicated that a strong community partnership, participation, and shared values contributed to successful formulation of policy initiatives.
Partnerships for Environmental and Occupational Justice: Contributions to Research, Capacity and Public Health
Authors: Baron Sherry , Sinclair Raymond , Payne-Sturges Devon , Phelps Jerry , Zenick Harold , Collman Gwen W. , O'Fallon Liam R.
Published: November 2009

In 1994, the National Institute of Environmental Health Sciences (NIEHS) initiated a program to address communication gaps between community residents, researchers and health care providers in the context of disproportionate environmental exposures. Over 13 years, together with the Environmental Protection Agency and National Institute for Occupational Health and Safety, NIEHS funded 54 environmental justice projects. Here we examine the methods used and outcomes produced based on data gathered from summaries submitted for annual grantees' meetings. Data highlight how projects fulfilled program objectives of improving community awareness and capacity and the positive public health and public policy outcomes achieved. Our findings underscore the importance of community participation in developing effective, culturally sensitive interventions and emphasize the importance of systematic program planning and evaluation.
`Me-Too' Innovation in Pharmaceutical Markets
Authors: Jena Anupam B , Calfee John E. , Mansley Edward C , Philipson Tomas J
Published: November 2009

Critics of me-too innovation often argue that follow-on drugs offer little incremental clinical value over existing pioneer products, while at the same time increasing health care costs. We examine whether consumers view follow-on and pioneer drugs as close substitutes or distinct clinical therapies. For five major classes of drugs, we find that large reductions in the price of pioneer molecules after patent expirationwhich would typically lead to decreased consumption of strong substituteshave no effect on the trend in demand for follow-on drugs. Our findings are likely unaffected by health insurance, competitive pricing of me-toos, marketing, and switching costs.
Stocking density: Factor of production performance, quality and broiler welfare
Authors: Skrbic Z. , Pavlovski Z. , Lukic M.
Published: November 2009

Significance of stocking density in broiler production i.e. production performance, vitality and health condition of chickens, was established at the beginning of development of industrial poultry production. However, considering intensive development of selection work and creation of more productive genotypes which, at the same time, were more demanding in regard to rearing conditions, the current importance of this research is not diminished. In favour of this statement is also the complexity of the effect of stocking density which is direct, indirect, and interacted with other factors of rearing, which eventually reflects on all aspects of broiler production: economical efficiency, quality of products and broiler welfare aspects. In the paper a review of research results is presented with general objective to define optimal stocking density in broiler production based on comparison of effects on production performances, parameters of carcass quality and indicators of broiler welfare.
Autochthonous Balkan goat breed: Composition and traits of kid carcass
Authors: Zujovic M. , Stanisic N. , Memisi N.
Published: November 2009

Investigations were realized within the program of protection of genetic resources of autochthonous goat breeds - Balkan goat breed. Trial was carried out on farms of individual producers, breeders on the territory of Svrljig region, on 12 male kids of average age of 63 days and average body mass prior to slaughtering of 10,54 kg. Objective of the research was to determine the meat yield (dressing percentage), share of by products of in body mass prior to slaughtering and in processed carcass, commercial value of carcass (by evaluation of conformation, covering of carcass and kidneys with fat tissue, colour of meat and tallow) and share of main carcass parts. Results of the research indicated that kids of Balkan goat breed at stated age have average body mass of 10,54 kg and yield of warm carcass with head and giblets of 58,89%, which is high value and is within the limits for yield realized by kids of approximate age of pure goat breeds. Shares of slaughter by products (rumen, small intestines, skin, abomasus), giblets (liver, lungs, heart, spleen, kidneys), fat tissue (peritoneum, kidney, mesentherium) and head in cooled carcass are also within the limits realized by kids of pure goat breeds. Commercial value of carcass, established based on assessment of conformation (scored as good), covering of carcass and kidneys with fat tissue (scored as medium), colour of meat and tallow (scored as very good) is good and within the values realized by kids of pure goat breeds. Quality of carcass evaluated based on share of main carcass parts of category I (thigh, loin part) of 33,41%, category II (back, shoulder, neck) of 38,68% and category III (breast, second fore thigh, second thigh) of 26,91%, was very good. Muscle, fat and binding tissue (meat in narrow sense) made 2/3, whereas bones made 1/3 of the mass of three rib cut, which is also very good. Ratio of muscle and fat tissue was also very favourable - 5,08.
The effect of beef tallow in lamb nutrition on fattening and carcass characteristics
Authors: Ruzic-Muslic D. , Petrovic M.P. , Bijelic Z.
Published: November 2009

Trial was carried out on 60 suckling lambs of Mis sheep population, divided into three groups. Beside milk, lambs consumed alfalfa hay and iso-protein concentrate mixtures (15% CP) ad libitum. Forage mixture I was of standard composition, whereas mixtures II and III contained 4 and 6% of beef tallow, respectively. Energy value of used mixtures I, II and III was 7,29, 7,71 and 7,94 MJ, respectively. Fattening duration was 60 days. Statistical processing of obtained data was performed using standard mathematical-statistical methods. Lambs on treatments I:II:III realized average daily gain of: 0,280 : 0,303 : 0,277 kg. Conversion of dry matter of diet was: 2,68: 2,58: 2,93 kg; of energy: 19,08 : 18,37 : 20,71 MJ NEM; of protein: 481 : 451: 514 g. Values of the meat yield of warm carcass were: 57,89 : 58,63 : 58,46%. The best production results in regard to gain, and feed conversion were realized by lambs on treatment with 4% of beef tallow in the mixtures.
Effect of the spirulina platensis included in the main diet on the boar sperm quality
Authors: Kistanova E. , Marchev Y. , Nedeva R. , Kacheva D. , Shumkov K. , Georgiev B. , Shimkus A.
Published: November 2009

Microalgae Spirulina platensis accumulates many chemical components which are suitable for all higher organisms as food and forage raw material. There are a lot of vitally important for the organisms minerals and macroelements such as iron, calcium, sodium, potassium, copper, magnesium, phosphorus, selenium, vitamins, carotin, nucleic acids, enzymes and other active substances. That should explain the value of Spirulina as a feed additive for the agricultural animals. In the present work the influence of the microalgae Spirulina platensis on the quantitative and qualitative characteristics of boars' sperm was studied. The experiment was carried out with 6 boars from Danube white breed in the experimental animal base of the Agricultural Institute - Shumen. The time of the experiment was divided in the control and experimental periods. During the control period the animals received the main diet in accordance with Bulgarian state standard BDS- 1642-96. In the experimental period to the main diet was added 7 ml/ per head the fresh biomass of microalgae preserved by melasa (final quantity - 1,4 mg Spirulina platensis). The obtained results shown that the addition of Spirulina improves the sperm parameters in boars: the volume of the ejaculates increased with 30 ml in experimental period (306 ml against 276 in control, P<0,05) as well as the spermatozoa concentration enhanced with 27 mln/ml. The total dehydrogenases activities estimated by reaction with methylene blue as well as LDH activity were higher in the experimental period. Also the survivability of the spermatozoids at 24, 48 and 72 hour in the experimental period was more than in control.
Zeta-potential and flotability of the scheelite mineral in different type of waters, Part 1: Zeta-potential
Authors: Milanovic Dragan , Markovic Zoran
Published: November 2009

The aim of this work is the investigation of zeta-potential of the mineral scheelite from mine 'Rudnik', located in central Serbia. Electrophoresis measurements using zeta-meter were carried out on four different types of water, namely: tap water, distilled water, rain water and spring water. All types of water had different hardness and conductivity as well as natural pH values. It was found that the zeta-potential of mineral scheelite depends on the hardness and electro-conductivity of the chosen type of water as well as on Ca2+ content. The results obtained reveal the importance of proper choice of water as well as the type of reagents for flotation processes.
Zeta-potential and flotability of the scheelite mineral in different type of waters, Part 2: Flotability
Authors: Milanovic Dragan , Markovic Zoran
Published: November 2009

The aim of this work was to study floatability of the mineral sheelite from mine 'Rudnik', central Serbia. Flotation tests of the mineral in a Hallimond tube cell were carried out in four different types of water, namely: tap water, distilled water, rain water and spring water. All types of water had different hardness and conductivity as well as natural pH values. It was found that the flotability of mineral scheelite depends on the hardness and electro-conductivity of the chosen type of water as well as on Ca2+ content. Also, it was found the floatability of mineral depends on the scheelite particle size fraction used in microflotation experiments. Presented results may be useful for proper selection of type of water, as well of the type of reagents used in flotation processes.
The Ontology and Epistemology of Social Reality in Accounting According to Mattessich
Authors: Lee Thomas A.
Published: November 2009

ABSTRACT: Mattessich (2009) is a response to a previous discussion on the ontology and epistemology of social reality in accounting by Lee (2006a, 2006b), Macintosh (2006), and Williams (2006). The original discussion was motivated by the Financial Accounting Standards Board's (FASB) (2002a) commitment to introduce principles-based accounting standards (PBAS) based on its conceptual framework (CF). Lee (2006a, 2006b) argues that PBAS requires the FASB to recognize social reality in its CF. While agreeing with this argument generally, Mattessich (2009) states that, compared to the social reality construction model (SRCM) of Searle (1995) adopted by Lee (2006a), the onion model of reality (OMR) is more relevant to standard setters such as the FASB when they consider social reality in accounting. The purpose of this response to Mattessich (2009) is to contrast the SRCM and the OMR in the context of accounting for social reality, the FASB's ongoing revision of its CF, and recent accounting events in the global financial crisis. The overall conclusions are that the SRCM and the OMR are capable of introducing social reality to accounting thought; the SRCM has features that are particularly useful in emphasizing the subjective nature of the subject matter of accounting practice; the FASB continues to ignore social reality in its CF; and recent accounting events support arguments such as Lee (2006a, 2006b) and Mattessich (2009) that the FASB and other standard setters address social reality in their CF and PBAS. However, for social reality to be successfully incorporated into accounting thought, the ontology and epistemology of reality generally need to be part of the accounting curriculum.
Inhibitory effect of Torilis anthriscus on growth of microorganisms
Authors: Stefanovic Olgica , Stanojevic Dragana , Comic Ljiljana
Published: November 2009

Antibacterial and antifungal activities of aqueous, ethanol and ethyl acetate extract of Torilis anthriscus (L.) Gmel. (Apiaceae) were tested in vitro against ten species of bacteria and five of fungi. Antimicrobial properties were determined by disk diffusion and broth tube dilution method. In the minimum inhibitory concentrations (MICs), the ethanol extract showed the highest activity, followed by the ethyl acetate extract and the aqueous extract against bacterial species, while the extracts were inactive against the tested fungi species. The most active extract was chosen to examine the effects of its combinations with commercial antibiotics by checkerboard method. The obtained results showed that the interactions between ethanol extract/streptomycin and ethanol extract/chloramphenicol were additive and indifferent against the tested human-pathogenic bacteria. Synergism and antagonism were not observed.
Key Performance Indicators to Benchmark Hospital Information Systems – A Delphi Study
Authors: Hübner-Bloder G. , Ammenwerth E.
Published: November 2009

Objectives: To identify the key performance indicators for hospital information systems (HIS) that can be used for HIS benchmarking.

Methods: A Delphi survey with one qualitative and two quantitative rounds. Forty-four HIS experts from health care IT practice and academia participated in all three rounds.

Results: Seventy-seven performance indicators were identified and organized into eight categories: technical quality, software quality, architecture and interface quality, IT vendor quality, IT support and IT department quality, workflow support quality, IT outcome quality, and IT costs. The highest ranked indicators are related to clinical workflow support and user satisfaction. Isolated technical indicators or cost indicators were not seen as useful. The experts favored an interdisciplinary group of all the stakeholders, led by hospital management, to conduct the HIS benchmarking. They proposed benchmarking activities both in regular (annual) intervals as well as at defined events (for example after IT introduction). Most of the experts stated that in their institutions no HIS benchmarking activities are being performed at the moment.

Conclusion: In the context of IT governance, IT benchmarking is gaining importance in the healthcare area. The found indicators reflect the view of health care IT professionals and researchers. Research is needed to further validate and operationalize key performance indicators, to provide an IT benchmarking framework, and to provide open repositories for a comparison of the HIS benchmarks of different hospitals.
NOD2 Ligation Subverts IFN-α Production by Liver Plasmacytoid Dendritic Cells and Inhibits Their T Cell Allostimulatory Activity via B7-H1 Up-Regulation
Authors: Castellaneta Antonino , Sumpter Tina L. , Chen Lieping , Tokita Daisuke , Thomson Angus W.
Published: November 2009

The nucleotide-binding oligomerization domain (NOD)2/CARD15 protein, which senses muramyl dipeptide (MDP), a product of bacterial peptidoglycan, appears to play an important role in regulating intestinal immunity. Although the liver is exposed to gut-derived MDP, the influence of NOD2 ligation on hepatic APC, in particular dendritic cells (DC), is unknown. Freshly isolated mouse liver and spleen plasmacytoid (p)DC expressed higher levels of NOD2 message than conventional myeloid (m)DC. Following MDP stimulation in vivo, liver pDC, but not mDC, up-regulated expression of IFN regulatory factor 4 (IRF-4), a negative regulator of TLR signaling, and induced less allogeneic T cell proliferation and IFN-γ production. The adoptive transfer of liver pDC from MDP-treated mice failed to prime allogeneic T cells in vivo. By contrast, splenic DC IRF-4 levels and T cell stimulatory activity remained unchanged. Liver pDC from MDP-stimulated mice also displayed greater IκBα, cell surface B7-H1, and B7-H1 relative to CD86 than control liver pDC. No similar effects were observed for liver mDC or spleen DC. Absence of B7-H1 on liver pDC reversed the inhibitory effect of MDP. After ex vivo stimulation with LPS or CpG, liver pDC but not mDC from MDP-treated animals secreted less IL-12p70, IL-6, and TNF-α and induced weaker allogeneic T cell proliferation than those from controls. Moreover, CpG-stimulated liver pDC from MDP-treated mice secreted less IFN-α than their splenic counterparts, and systemic levels of IFN-α were reduced in MDP-treated animals after CpG administration. These findings suggest that differential effects of NOD2 ligation on liver pDC may play a role in regulating hepatic innate and adaptive immunity.
Processing in the Endoplasmic Reticulum Generates an Epitope on the Insulin A Chain that Stimulates Diabetogenic CD8 T Cell Responses
Authors: Brosi Helen , Reiser Michael , Rajasalu Tarvo , Spyrantis Andreas , Oswald Franz , Boehm Bernhard Otto , Schirmbeck Reinhold
Published: November 2009

RIP-B7.1 mice express the costimulator molecule B7.1 (CD80) on pancreatic β cells and are a well-established model for studying de novo induction of diabetogenic CD8 T cells. Immunization of RIP-B7.1 mice with preproinsulin (ppins)-encoding plasmid DNA efficiently induces experimental autoimmune diabetes (EAD). EAD is associated with an influx of CD8 T cells specific for the Kb/A12–21 epitope into the pancreatic islets and the subsequent destruction of β cells. In this study, we used this model to investigate how ppins-derived Ags are expressed and processed to prime diabetogenic, Kb/A12–21-specific CD8 T cells. Targeting the Kb/A12–21 epitope, the insulin A chain, or the ppins to the endoplasmic reticulum (ER) (but not to the cytosol and/or nucleus) efficiently elicited Kb/A12–21-specific CD8 T cell responses. The Kb/A12–21 epitope represents the COOH terminus of the ppins molecule and, hence, did not require COOH-terminal processing before binding its restriction element in the ER. However, Kb/A12–21-specific CD8 T cells were also induced by COOH-terminally extended ppins-specific polypeptides expressed in the ER, indicating that the epitope position at the COOH terminus is less important for its diabetogenicity than is targeting the Ag to the ER. The Kb/A12–21 epitope had a low avidity for Kb molecules. When epitopes of unrelated Ags were coprimed at the same site of Ag delivery, “strong” Kb-restricted (but not Db-restricted) CD8 T cell responses led to the suppression of Kb/A12–21-specific CD8 T cell priming and reduced EAD. Thus, direct expression and processing of the “weak” Kb/A12–21 epitope in the ER favor priming of autoreactive CD8 T cells.
Race and Ethnicity of Reproductive-Age Females Affected by US State Abortion Bans
Authors: Goutos Demetri , Cesare Nina , Vu Cecilia , Lim Kenneth , Green Tiffany , Rodriguez Kate , Raifman Julia
Published: May 2024

This study compares the race and ethnicity of reproductive-age females between states that implemented restrictive abortion policies after the Dobbs v Jackson Women’s Health Organization decision and states that did not.
The Women’s Health Initiative Randomized Trials and Clinical Practice
Authors: Manson JoAnn E. , Crandall Carolyn J. , Rossouw Jacques E. , Chlebowski Rowan T. , Anderson Garnet L. , Stefanick Marcia L. , Aragaki Aaron K. , Cauley Jane A. , Wells Gretchen L. , LaCroix Andrea Z. , Thomson Cynthia A. , Neuhouser Marian L. , Van Horn Linda , Kooperberg Charles , Howard Barbara V. , Tinker Lesley F. , Wactawski-Wende Jean , Shumaker Sally A. , Prentice Ross L.
Published: May 2024

Importance

Approximately 55 million people in the US and approximately 1.1 billion people worldwide are postmenopausal women. To inform clinical practice about the health effects of menopausal hormone therapy, calcium plus vitamin D supplementation, and a low-fat dietary pattern, the Women’s Health Initiative (WHI) enrolled 161 808 postmenopausal US women (N = 68 132 in the clinical trials) aged 50 to 79 years at baseline from 1993 to 1998, and followed them up for up to 20 years.

Observations

The WHI clinical trial results do not support hormone therapy with oral conjugated equine estrogens plus medroxyprogesterone acetate for postmenopausal women or conjugated equine estrogens alone for those with prior hysterectomy to prevent cardiovascular disease, dementia, or other chronic diseases. However, hormone therapy is effective for treating moderate to severe vasomotor and other menopausal symptoms. These benefits of hormone therapy in early menopause, combined with lower rates of adverse effects of hormone therapy in early compared with later menopause, support initiation of hormone therapy before age 60 years for women without contraindications to hormone therapy who have bothersome menopausal symptoms. The WHI results do not support routinely recommending calcium plus vitamin D supplementation for fracture prevention in all postmenopausal women. However, calcium and vitamin D are appropriate for women who do not meet national guidelines for recommended intakes of these nutrients through diet. A low-fat dietary pattern with increased fruit, vegetable, and grain consumption did not prevent the primary outcomes of breast or colorectal cancer but was associated with lower rates of the secondary outcome of breast cancer mortality during long-term follow-up.

Conclusions and Relevance

For postmenopausal women, the WHI randomized clinical trials do not support menopausal hormone therapy to prevent cardiovascular disease or other chronic diseases. Menopausal hormone therapy is appropriate to treat bothersome vasomotor symptoms among women in early menopause, without contraindications, who are interested in taking hormone therapy. The WHI evidence does not support routine supplementation with calcium plus vitamin D for menopausal women to prevent fractures or a low-fat diet with increased fruits, vegetables, and grains to prevent breast or colorectal cancer. A potential role of a low-fat dietary pattern in reducing breast cancer mortality, a secondary outcome, warrants further study.
Wide Complex Tachycardia in a Middle-Aged Woman With Diarrhea
Authors: Peters Matthew G. , Apte Nachiket , Kalra Dinesh K.
Published: May 2024

A woman in her mid-60s with a history of paroxysmal atrial fibrillation and hypertension presents with 3 days of nausea, vomiting, and diarrhea. What would you do next?
Label Accuracy of Weight Loss Dietary Supplements Marketed Online With Military Discounts
Authors: Crawford Cindy , Avula Bharathi , Lindsey Andrea T. , Katragunta Kumar , Khan Ikhlas A. , Deuster Patricia A.
Published: May 2024

Importance

Dietary supplements for weight loss, among the most popular supplement products on the market, are promoted not only for losing weight and shedding fat, but also for added benefits of energy and performance, all packed into 1 capsule with multiple combinations of ingredients. Fraudulent marketing of weight loss supplements, some with exaggerated claims, some that are potentially dangerous, and some that contain illegal ingredients, is ever present, especially through online sources, where multiple manufacturers target service members by offering military discounts.

Objectives

To examine whether select dietary supplements marketed online for weight loss from companies advertising military discounts are accurately labeled according to the Supplement Facts listed ingredients, whether they contain any ingredients prohibited for use in the military, and to qualitatively describe the products’ label claims.

Design, Setting, and Participants

In this case series, 30 dietary supplement products marketed for weight loss were selected and purchased in June 2023 from 12 online companies advertising military discounts. Data were analyzed from July to August 2023.

Main Outcomes and Measures

Liquid chromatography-mass spectrometry was used to verify whether products were accurately labeled according to the Supplement Facts listed ingredients and whether they contained any substances on the DoD Prohibited Dietary Supplement Ingredients List. A separate analysis was conducted to describe product label claims by using the Operation Supplement Safety (OPSS) Risk Assessment Scorecard.

Results

Of the 30 products tested, analysis showed that 25 had inaccurate labels. Of these, 24 had ingredients listed on the label that were not detected (misbranded); 7 had hidden components not present on the label, some of which would be considered adulterated; and 10 had substances on the DoD Prohibited Dietary Supplement Ingredients List either on or hidden from the label. All products were rated as risky when applying the OPSS Scorecard.

Conclusions and Relevance

In this case series study, the majority of products had inaccurate labels. Some were misbranded, others would be considered adulterated with ingredients not allowed in dietary supplements, and some contained ingredients prohibited for use in the military.
Geographic Penetration of Private Equity Ownership in Outpatient and Residential Behavioral Health
Authors: Zhu Jane M. , Greenberg Emmanuel , King Marissa , Busch Susan
Published: May 2024

This cross-sectional study estimates the geographic penetration of private equity–owned outpatient mental health and substance use disorder practices across the US.
Serratus Anterior Plane Blocks for Early Rib Fracture Pain Management
Authors: Partyka Christopher , Asha Stephen , Berry Melanie , Ferguson Ian , Burns Brian , Tsacalos Katerina , Gaetani Daniel , Oliver Matthew , Luscombe Georgina , Delaney Anthony , Curtis Kate
Published: May 2024

Importance

Rib fractures secondary to blunt thoracic trauma typically result in severe pain that is notoriously difficult to manage. The serratus anterior plane block (SAPB) is a regional anesthesia technique that provides analgesia to most of the hemithorax; however, SAPB has limited evidence for analgesic benefits in rib fractures.

Objective

To determine whether the addition of an SAPB to protocolized care bundles increases the likelihood of early favorable analgesic outcomes and reduces opioid requirements in patients with rib fractures.

Design, Setting, and Participants

This multicenter, open-label, pragmatic randomized clinical trial was conducted at 8 emergency departments across metropolitan and regional New South Wales, Australia, between April 12, 2021, and January 22, 2022. Patients aged 16 years or older with clinically suspected or radiologically proven rib fractures were included in the study. Participants were excluded if they were intubated, transferred for urgent surgical intervention, or had a major concomitant nonthoracic injury. Data were analyzed from September 2022 to July 2023.

Interventions

Patients were randomly assigned (1:1) to receive an SAPB in addition to usual rib fracture management or standard care alone.

Main Outcomes and Measures

The primary outcome was a composite pain score measured 4 hours after enrollment. Patients met the primary outcome if they had a pain score reduction of 2 or more points and an absolute pain score of less than 4 out of 10 points.

Results

A total of 588 patients were screened, of whom 210 patients (median [IQR] age, 71 [55-84] years; 131 [62%] male) were enrolled, with 105 patients randomized to receive an SAPB plus standard care and 105 patients randomized to standard care alone. In the complete-case intention-to-treat primary outcome analysis, the composite pain score outcome was reached in 38 of 92 patients (41%) in the SAPB group and 18 of 92 patients (19.6%) in the control group (relative risk [RR], 0.73; 95% CI, 0.60-0.89; P = .001). There was a clinically significant reduction in overall opioid consumption in the SAPB group compared with the control group (eg, median [IQR] total opioid requirement at 24 hours: 45 [19-118] vs 91 [34-155] milligram morphine equivalents). Rates of pneumonia (6 patients [10%] vs 7 patients [11%]), length of stay (eg, median [IQR] hospital stay, 4.2 [2.2-7.7] vs 5 [3-7.3] days), and 30-day mortality (1 patient [1%] vs 3 patients [4%]) were similar between the SAPB and control groups.

Conclusions and Relevance

This randomized clinical trial found that the addition of an SAPB to standard rib fracture care significantly increased the proportion of patients who experienced a meaningful reduction in their pain score while also reducing in-hospital opioid requirements.

Trial Registration

http://anzctr.org.au Identifier: ACTRN12621000040864
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Authors: Rindal Eric J. , Zaragoza Maria S.
Published: May 2024

When providing eyewitness testimony, people sometimes fabricate lies that supplement the truth by embellishing or adding new information. This study investigated whether participants confuse their fabricated lies for actually witnessed events over time. In two experiments employing different eyewitness events, participants viewed an event and were then asked to lie about unseen details and events. Memory was assessed after either a 1‐week (E1a & E2) or a 4‐week (E1b & E2) retention interval. In both experiments, participants falsely reported witnessing their lies after a 4‐week retention interval, but only one experiment (E2) obtained evidence for these memory errors at the shorter retention interval of 1‐week. In addition, when assessed repeatedly, lies that participants correctly rejected as not witnessed at the 1‐week retention interval were later incorrectly endorsed as witnessed when tested again at the 4‐week retention interval, thus showing that distinguishing lies from truth became more difficult over time.
An A(i)lien Embassy: AI and Interspecies Communication
Authors: Witt Andrew
Published: May 2024

There is more than just human intelligence out there, and we must now get to grips with the end of human uniqueness. Our accelerating dexterity with biology of all sorts, digital software and hardware, pharmacology and a myriad other interventionist or evolutionary technologies is leading to the design of architectures/bodies/ systems that are fundamentally intelligently entangled. Harvard Graduate School of Design's Andrew Witt explains this ongoing synthesis and its cultural and social ramifications for today and deeper into tomorrow.
Signs, Signals and Signifiers: The Doghouse and the Semiotics of AI
Authors: Manninger Sandra
Published: May 2024

Architecture is a complex web of semiotics – signs, signals and signifiers. The creation of these codes, and their dynamic manipulation and interaction over time, is the lifeblood of experimental architecture practice SPAN's Doghouse project. Co‐founder Sandra Manninger explains how the project's articulation, robotic inhabitants and fluctuating symbolic meanings and languages create a complex multi‐readable architectural structure and text.
Chlorin e6 and BLZ945 Based Self‐Assembly for Photodynamic Immunotherapy Through Immunogenic Tumor Induction and Tumor‐Associated Macrophage Depletion
Authors: Huang Chu‐Yu , Zhao Lin‐Ping , Rao Xiao‐Na , Zheng Rong‐Rong , Liu Zhi‐Shan , Cai Hua , Zhang Wei , Chen A‐Li , Xu Lin , Li Shiying
Published: May 2024

Immunotherapeutic effect is restricted by the nonimmunogenic tumor phenotype and immunosuppression behaviors of tumor‐associated macrophages (TAMs). In this work, a drug self‐assembly (designated as CeBLZ) is fabricated based on chlorin e6 (Ce6) and BLZ945 to activate photodynamic immunotherapy through tumor immunogenic induction and tumor‐associated macrophage depletion. It is found that Ce6 tends to assemble with BLZ945 without any drug excipients, which can enhance the cellular uptake, tumor penetration, and blood circulation behaviors. The robust photodynamic therapy effect of CeBLZ efficiently suppresses the primary tumor growth and also triggers immunogenic cell death to reverse the nonimmunogenic tumor phenotype. Moreover, CeBLZ can deplete TAMs in tumor tissues to reverse the immunosuppression microenvironment, activating abscopal effect for distant tumor inhibition. In vitro and in vivo results confirm the superior antitumor effect of CeBLZ with negligible side effect, which might promote the development of sophisticated drug combinations for systematic tumor management.
Erythrocyte‐Membrane‐Camouflaged Magnetic Nanocapsules With Photothermal/Magnetothermal Effects for Thrombolysis
Authors: Zhu Liqiong , Lian Weishuai , Yu Nuo , Meng Jialan , Zeng Hongchun , Wang Yue , Wang Xiao , Wen Mei , Chen Zhigang
Published: May 2024

Venous/arterial thrombosis poses significant threats to human health. However, drug‐enabled thrombolysis treatment often encounters challenges such as short half‐life and low bioavailability. To address these issues, the design of erythrocyte‐membrane (EM) camouflaged nanocapsules (USIO/UK@EM) incorporating ultra‐small iron oxide (USIO) and urokinase (UK) drug, which exhibits remarkable photothermal/magnetothermal effects and drug delivery ability for venous/arterial thrombolysis, is reported. USIO, UK, and EM are coextruded to fabricate USIO/UK@EM with average sizes of 103.7 nm. As USIO/UK@EM possesses wide photoabsorption and good magnetic properties, its solution demonstrates a temperature increase to 41.8–42.9 °C within 5 min when exposed to an 808 nm laser (0.33 mW cm−2) or alternating magnetic field (AMF). Such photothermal/magnetothermal effect along with UK confers impressive thrombolytic rates of 82.4% and 74.2%, higher than that (≈15%) achieved by UK alone. Further, the EM coating extends the circulating half‐life (t1/2 = 3.28 h). When USIO/UK@EM is administered to mice and rabbits, tail vein thrombus in mice and femoral artery thrombus in rabbits can be dissolved by the synergetic effect of thermothrombolysis and UK. Therefore, this study not only offers insights into the rational design of multifunctional biomimetic nanocapsules but also showcases a promising thrombolysis strategy utilizing nanomedicine.
ROS‐Responsive Injectable Hydrogel Loaded with SLC7A11‐modRNA Inhibits Ferroptosis and Mitigates Intervertebral Disc Degeneration in Rats
Authors: Gao Tian , Xu Guangyu , Ma Tiancong , Lu Xiao , Chen Kaiwen , Luo Huanhuan , Chen Gang , Song Jian , Ma Xiaosheng , Fu Wei , Zheng Chaojun , Xia Xinlei , Jiang Jianyuan
Published: May 2024

Intervertebral disc degeneration (IVDD) is the primary cause of low back pain, with oxidative stress being a recognized factor that causes its development. Presently, low back pain imposes a significant global economic burden. However, the effectiveness of treatments for IVDD remains extremely limited. Therefore, this study aims to explore innovative and effective IVDD treatments by focusing on oxidative stress as a starting point. In this study, an injectable reactive oxygen species‐responsive hydrogel (PVA‐tsPBA@SLC7A11 modRNA) is developed, designed to achieve rapid loading and selective release of chemically synthesized modified mRNA (modRNA). SLC7A11 modRNA is specifically used to upregulate the expression of the ferroptosis marker SLC7A11. The local injection of PVA‐tsPBA@SLC7A11 modRNA into the degenerated intervertebral disc (IVD) results in the cleavage of PVA‐tsPBA, leading to the release of enclosed SLC7A11 modRNA. The extent of SLC7A11 modRNA release is directly proportional to the severity of IVDD, ultimately ameliorating IVDD by inhibiting ferroptosis in nucleus pulposus cells (NPCs). This study proposes an innovative system of PVA‐tsPBA hydrogel‐encapsulated modRNA, representing a potential novel treatment strategy for patients with early‐stage IVDD.
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Authors: Xie Jing , Lu Yi‐Chun
Published: May 2024

Li‐ion batteries are essential technologies for electronic products in the daily life. However, serious fire safety concerns that are closely associated with the flammable liquid electrolyte remains a key challenge. Tremendous effort has been devoted to designing nonflammable liquid electrolytes. It is critical to gain comprehensive insights into nonflammability design and inspire more efficient approaches for building safer Li‐ion batteries. This review presents current mechanistic understanding of safety issues and discusses state‐of‐the‐art nonflammable liquid electrolytes design for Li‐ion batteries based on molecule, solvation, and battery compatibility level. Various safety test methods are discussed for reliable safety risk evaluation. Finally, the challenges and perspectives of the nonflammability design for Li‐ion electrolytes are summarized.
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Published: May 2024

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