bluuebunny/crossref_metadata_2025 huggingface dataset:
Conivaptan for Treatment of Hyponatremia in Neurologic and Neurosurgical Adults
Authors: Buckley Mitchell S. , Patel Shardool A. , Hattrup Allison E. , Kazem Nadine H. , Jacobs Sara C. , Culver Mark A.
Published: July 2014

Objective: To review the literature evaluating the clinical safety and efficacy of conivaptan in the management of hyponatremia in a neurologic and neuro-surgical adult patient population. Data Sources: A literature search was conducted using MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials (1966-May 2013). Search limits were English, human, and adult using the terms vasopressin receptor antagonist, conivaptan, tolvaptan, lixivaptan, neurology, neurological disorder, neurosurgery, neurointensive care, and neurocritical care. Study Selection and Data Extraction: All case reports, case series, and clinical trials investigating the use of conivaptan in neurosurgical patients were included. Data Synthesis: Seven reports were identified using conivaptan as monotherapy or adjunctive treatment for hyponatremia in a neurosurgical patient population. One study was a prospective, randomized, controlled trial, while 6 reports were case reports or case series. The prospective randomized trial found a significant increase in serum sodium concentration over baseline with a conivaptan 20-mg intravenous bolus dose followed by a 20-mg/day continuous infusion for 24 hours compared to “usual care” at 6 hours (7.0 ± 1.7 vs −0.6 ± 2.1 mEq/L, respectively; p = 0.008) and 36 hours (8.0 ± 5.6 vs −1.7 ± 2.1 mEq/L, respectively; p = 0.05) after treatment. One case series found that the mean serum sodium remained significantly increased from baseline up to 72 hours (5.12 ± 4.0 mEq/L; p < 0.001) after a single conivaptan 20-mg intravenous bolus dose. All reports demonstrated clinical effectiveness of conivaptan in significantly increasing serum sodium concentrations following administration compared to baseline. However, the clinical significance of this finding remains debatable since some of these patients remained hyponatremic. Conclusions: Overall, conivaptan is a promising and well-tolerated agent for the management of hyponatremia in neurologic and neurosurgical patients. However, its use should be limited to patients in whom conventional therapies fail or as adjunctive therapy.
Quality Improvement in Health Care
Authors: Ross Leigh Ann
Published: July 2014

Quality in health care has never been more important than today. As health care providers, pharmacists have an obligation to serve as leaders and visionaries and actively demonstrate and document the advances that patient-centered pharmacy services can provide. Many agencies and organizations have developed initiatives to advance patient care through quality improvement measures and patient safety programs. Pharmacists, both individually and collectively, must actively engage in quality improvement and patient safety programs that elevate care and support the evidence base for clinical pharmacy services.
Inaccuracy of Point-of-Care International Normalized Ratio in Rivaroxaban-Treated Patients
Authors: Baruch Lawrence , Sherman Olga
Published: July 2014

Objective: To report 2 cases in which point-of-care international normalized ratios (POC-INRs) measured using a Hemochron Jr. Signature Elite device (International Technidyne Corporation) were inaccurate in rivaroxaban-treated patients. Case Summaries: Therapy in an 86-year-old man with atrial fibrillation was converted from warfarin to rivaroxaban 15 mg twice daily because of a deep venous thrombotic event despite an INR of 2.4, which was within the therapeutic range. One week later a POC-INR was inadvertently measured, which was 6.3. In light of the POC-INR being markedly elevated, a laboratory test for INR was performed, which gave a result of 2.74. Therapy in a 66-year-old man was converted from war-farin to rivaroxaban 15 mg twice daily because of unstable INRs and a pulmonary embolism despite a therapeutic INR. Seven days after rivaroxaban was started, the patient’s POC-INR was 9.2; simultaneously measured laboratory-determined INR was 2.0. For both patients, coagulation tests performed on follow-up visits revealed continued discordance between the POC and laboratory assays. Discussion: Rivaroxaban is an oral factor Xa inhibitor with a predictable pharmacokinetic profile, allowing for a fixed-dose regimen without the need for coagulation monitoring. When patients’ therapy is switched from rivaroxaban to warfarin, it is recommended that the drugs be given concurrently until the INR is 2.0 or higher, to ensure adequate anticoagulation during this well-recognized vulnerable period for stroke. POC testing is a common method of INR assessment in clinical practice. During ROCKET-AF (Rivaroxaban Once-Daily, Oral, Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation), POC-INRs were measured exclusively with the INRatio device (Hemosense), and values above 4 were seen very rarely (0.25%), which indicates that the values determined in our patients were highly unusual. Conclusions: Our 2 patients receiving rivaroxaban had POC-INRs elevated beyond what was expected; these measurements were discordant from INRs simultaneously measured via the laboratory. A prospective evaluation assessing the accuracy of other commonly used POC-INR devices in patients receiving rivaroxaban would determine whether our findings extend to other devices. Until that time, laboratory measurement of INR or POC-INR using an INRatio device is recommended when patients’ therapy is transitioned from rivaroxaban to warfarin.
Association of Age With Polypharmacy and Risk of Drug Interactions With Antiretroviral Medications in HIV-Positive Patients
Authors: Tseng Alice , Szadkowski Leah , Walmsley Sharon , Salit Irving , Raboud Janet
Published: July 2014

Background: Interactions between antiretroviral (ARV) therapy and medications to treat age-related comorbidities are a growing concern in the aging HIV population. Objective: To investigate the association of age with potential drug-drug interactions (PDDIs) involving ARVs. Methods: We studied ARV-treated patients attending a tertiary care center. PDDIs were classified as “red flag” (contraindicated) or “orange flag” (use with caution or dose adjustment). Logistic regression was used to determine the association of age with the occurrence of ≥1 PDDI. Results: Of 914 patients (78% male, median age 49 years), older patients (age ≥50 years) were on more drugs than younger patients (total 9 vs 7; P < .0001) and were more likely to be on ritonavir-boosted protease inhibitors (PIs), integrase inhibitors, and non-ARV medications. Older patients were more likely to have ≥1 orange flag PDDI (71% vs 55%, P < .0001) and to have a red flag PDDI (5% vs 2%, P = .07), although the latter did not reach statistical significance. A 10-year increase in age was associated with an increased likelihood of ≥1 PDDI (odds ratio [OR] = 1.72; P < .0001) after adjusting for gender, race and number and class of ARVs. The effect of age was diminished after adjusting further for the number of non-ARV medications (OR = 1.28; P = .02) and use of cardiovascular drugs (OR = 1.16; P = .21). Conclusions: In our clinic population, older patients were more likely to have a PDDI because of the greater number of non-ARV medications, particularly cardiovascular agents.
Implementation of a Dexmedetomidine Stewardship Program at a Tertiary Academic Medical Center
Authors: Blum Rachel M. , Stevens Craig A. , Carter Danielle M. , Hussey Aaron P. , Marquis Kathleen A. , Torbic Heather , Southard Robert A. , Szumita Paul M.
Published: July 2014

Background: Brigham and Women’s Hospital implemented a dexmedetomidine stewardship program in October 2010 beginning with an institution-specific prescribing guideline. To ensure continued adherence to the prescribing guideline, a pharmacist-driven quality assurance program was implemented in November 2011. Objective: The primary objective of this study is to describe the role and impact of a dexmedetomidine stewardship program on dexmedetomidine use at a tertiary academic medical center. Methods: This is a prospective descriptive analysis of a dexmedetomidine stewardship program. Dexmedetomidine stewardship data were collected prospectively from January 2012 through June 2012, in all intensive care units (ICUs) at a single academic medical center. Adult patients (>18 years old) receiving dexmedetomidine therapy continuously for sedation and in the ICU were included in the analysis. Results: A total of 99 patients were identified during the study time frame, during which 71 (71.7%) were identified as compliant with the institutional guideline. The total number of patients receiving dexmedetomidine for greater than 24 hours was 13 (13.1%), of whom 10 (76.9%) received targeted interventions; 15 (15.2%) targeted interventions were made on all patients receiving dexmedetomidine during the study time frame. The total use of dexmedetomidine during the study period was 1310 vials, compared with 5404 vials during the equivalent time frame in 2010—a 76% reduction. Conclusions: A dexmedetomidine stewardship program, including an institution-specific prescribing guideline and a pharmacist-driven quality assurance program may ensure guideline compliance and decreased use of dexmedetomidine at an academic medical center.
Efficacy of Alvimopan Following Bowel Resection
Authors: Winegar Bradley , Cox Mark , Truelove Daniel , Brock Guy , Scherrer Noah , Pass Leigh Ann
Published: July 2014

Background: Alvimopan is indicated to accelerate the time to gastrointestinal recovery following partial bowel resection with primary anastomosis. The approved dosing regimen includes an initial dose prior to surgery and 12 mg twice daily after surgery for up to 7 days; however, there are no human studies evaluating the need for the preoperative dose. We report our experience with gastrointestinal recovery when the preoperative dose is omitted. Objective: To evaluate the efficacy of alvimopan therapy when the preoperative dose is not administered. Methods: This retrospective study included elective surgery patients who underwent bowel resection with primary anastomosis without colostomy or ileostomy. The study compared ( a) patients who received alvimopan and received a dose preoperatively, ( b) patients who received alvimopan but did not receive a dose preoperatively, and ( c) matched control patients who did not receive alvimopan. Length of stay following bowel resection, direct hospital costs, time to first bowel movement, and time to oral diet were evaluated. Results: Of 50 patients who received alvimopan, 27 received the preoperative dose and 23 did not. These 50 patients were matched to similar control patients who received no alvimopan during their admission for resection. Compared with controls, time to discharge was significantly shorter in patients who received alvimopan, regardless of whether the preoperative dose was administered ( P < .001) or omitted ( P = .03). Patients who did not receive the preoperative dose still experienced faster time to first bowel movement (71 vs 97 hours; P = .006) and faster time to first diet (17 vs 54 hours; P < .001) than non–alvimopan users. Conclusion: Patients receiving the approved alvimopan dosing regimen experienced the most rapid recovery of gastrointestinal function. However, administering alvimopan only postoperatively (if the preoperative dose is omitted) may still reduce the severity of postoperative ileus.
Pharmacist-Physician Collaboration for Diabetes Care
Authors: Howard-Thompson Amanda , Farland Michelle Z. , Byrd Debbie C. , Airee Anita , Thomas Jeremy , Campbell Jennifer , Cassidy Regina , Morgan Timothy , Suda Katie J.
Published: July 2014

Background: Only 23% of patients are meeting all goals for cardiovascular complications of diabetes. Objective: The purpose of our study is to evaluate the effect of a pharmacist-physician collaboration on attainment of cardiovascular-related goals in patients with type 2 diabetes. Methods: This prospective, multicenter cohort enrolled patients from 7 practice sites that were members of the University of Tennessee Pharmacist Practice Based Research Network (UT Pharm Net). Patients were included if they were diagnosed with type 2 diabetes, at least 18 years of age and English speaking. Pregnant patients were excluded. Patients were followed for 12 months after enrollment. Primary cardiovascular outcomes included reduction in systolic blood pressure, diastolic blood pressure, and low-density lipoprotein (LDL) as well as the proportion of patients achieving a blood pressure goal of <130/80 mm Hg and proportion of patients achieving an LDL goal of <100 mg/dL. Results: For the 206 patients enrolled, the average age was 59.7 years; the majority were male (59.7%) and white (66%). When compared with baseline, the postintervention mean systolic ( P < .0001), diastolic blood pressure ( P = .0003), and LDL ( P < .0001) decreased significantly. The proportion of patients achieving a blood pressure of <130/80 mm Hg increased 21.8% ( P < .0001), and the proportion of patients achieving an LDL of <100 mg/dL increased 12% ( P = .0023). Conclusions: The results of our study indicate that collaborative management has a positive impact on decreasing cardiovascular risk and assists patients in attaining national goals for blood pressure and cholesterol.
Safety and Efficacy of Allopurinol in Chronic Kidney Disease
Authors: Thurston Maria Miller , Phillips Beth Bryles , Bourg Catherine A.
Published: July 2014

Objective: To review the evidence surrounding the use of allopurinol in chronic kidney disease (CKD) and discuss safety and efficacy considerations of such use. Data Sources: A literature search was conducted through MEDLINE (1950-July 2013), PubMed (1965-July 2013), and International Pharmaceutical Abstracts (1970-July 2013) using the search terms allopurinol and kidney or renal. In addition, reference citations from publications identified were reviewed. Study Selection and Data Extraction: All articles in English identified from the data sources were evaluated for inclusion. Data Synthesis: Gout management with allopurinol in patients with CKD can be challenging because of the risk of adverse events and uncertain efficacy. Not all gout treatment guidelines provide recommendations for allopurinol use specifically in patients with CKD. Literature regarding the safety and efficacy of dosing allopurinol in CKD has shown inconsistent results and is based primarily on retrospective, case cohort or observational data. Some trials have demonstrated an increased risk of allopurinol-induced adverse reactions in patients with CKD, whereas others have not confirmed renal insufficiency as a risk factor. More CKD patients achieved a target uric acid level in studies where the allopurinol dose was titrated to effect as compared with those studies in which patients were given renally adjusted or untitrated allopurinol doses. Conclusions: Studies evaluating allopurinol use in patients with CKD have reported inconsistent findings relative to safety and efficacy. Providers should be aware of the potential risk of allopurinol hypersensitivity syndrome as well as the need for reducing the initiation dose and gradual titration of allopurinol to safely achieve a target serum urate level in this population.
Azithromycin-Induced Proarrhythmia and Cardiovascular Death
Authors: Howard Patricia A.
Published: July 2014

Objective: To review the possible association between azithromycin and increased cardiovascular risk. Data sources: A literature search of MEDLINE (1946-August 2013) was performed using the search terms macrolide, azithromycin, QT prolongation, cardiovascular, and torsade de pointes. Additional references were identified from a review of literature citations. Study selection and data extraction: All English-language observational studies assessing the association between azithromycin and QT prolongation or cardiovascular risk were evaluated. Case reports describing this potential association were also reviewed. Data synthesis: A total of 6 case reports have shown a possible association between azithromycin and QT prolongation. In 3 of these cases, proarrhythmic events were reported. In a prospective observational study of 47 individuals with low cardiovascular risk, electrocardiograms were compared before and after 5 days of azithromycin treatment. Mild prolongation of the QTc was noted, but it was statistically insignificant compared with baseline. No arrhythmias were observed. A large observational cohort study found a small increase in cardiovascular deaths after azithromycin therapy, primarily among patients with high baseline cardiovascular risk. Conversely, a second cohort study involving a population of young to middle-aged adults failed to find an association. Conclusions: An emerging body of evidence suggests that azithromycin therapy may prolong the QT interval and, in rare cases, precipitate the potentially fatal arrhythmia torsade de pointes. Patients with additional risk factors for QT prolongation appear to be at highest risk, including women, elderly individuals; those with existing or prior history of cardiovascular disease, QT interval prolongation, hypokalemia, hypomagnesium, or bradycardia; and those using concomitant drugs associated with QT prolongation. For patients without these additional risk factors, azithromycin appears to be relatively safe.
Unleash Metformin
Authors: Lu Wenya R. , Defilippi Jennifer , Braun Amy
Published: July 2014

Objective: To evaluate the expanded use of metformin in renal impairment. Data Sources: The MEDLINE database via PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health were searched in August 2013 and included studies from 1950 onward. Study Selection and Data Extraction: The search included comparative trials, observational cohort studies, and meta-analyses using the terms diabetes mellitus, metformin, renal insufficiency, and acidosis, lactic. Data Synthesis: One randomized controlled trial, 1 meta-analysis, 1 case-control, and 3 prospective-cohort studies, representing about 150 000 patients, revealed that metformin is safe in patients with stable mild-moderate renal impairment. The incidence of lactic acidosis is low and similar to sulfonylureas. In addition, reduced risks of cardiovascular disease, all-cause mortality, or any acidosis/serious infection were seen with metformin use in mild-to-moderate renal impairment. Conclusions: Data over the past decade refute the historical contraindication in patients with renal impairment and suggest that the risk of metformin-associated lactic acidosis is low in stable mild-to-moderate renal impairment and similar to the risk with other type 2 diabetes mellitus (DM2) medications with no renal impairment restrictions. Because of its unique impact on microvascular and macrovascular complications, it is advantageous to utilize metformin as the cornerstone in DM2 treatment for as long as possible, including in those patients with mild to moderate stages of renal impairment with no additional contraindications. A dosage reduction is recommended if estimated glomerular filtration rate (eGFR) is between 30 and 45 mL/min/1.73 m2 and discontinuation if eGFR is <30 mL/min/1.73 m2.
Association of Copayment and Statin Adherence Stratified by Socioeconomic Status
Authors: Kazerooni Rashid , Bounthavong Mark , Watanabe Jonathan H.
Published: July 2014

Background: There is a growing body of evidence supporting means testing out of copayment for high-value therapies such as statins. Objective: To investigate association between statin adherence and copayment when stratified by socioeconomic status. Methods: This was a retrospective cohort study set in a network of VA facilities that includes Southern California and Nevada, with an enrollment of 1.4 million veterans. Socioeconomic status was estimated using zip code median household income. Differences in medication possession ratio (MPR) associated with copayment was the primary outcome measure. Odds of attaining low-density lipoprotein cholesterol (LDL) <100 mg/dL was the secondary outcome measure. Separate regression models for each income quintile were performed for each outcome measure, respectively. Results: A total of 4748 patients were included in the analysis. Patients in quintiles two (−0.057, 95% confidence interval [CI] = −0.095 to −0.020) and three (−0.044, CI = −0.081 to −0.007) had statistically significant decreases in MPR associated with having a copayment versus not having a copayment. Quintiles two (odds ratio [OR] = 0.68; 95% CI = 0.47 to 0.98) and three (OR = 0.66; 95% CI = 0.45 to 0.96) also had lower odds of attaining LDL <100 mg/dL when having a copayment. Patients in higher earning quintiles (four and five) did not show any associations with copayment. Conclusion: In the veteran population studied, the association of statin copayment status with adherence varied by socioeconomic status. Middle-income and lower-middle-income patients were more likely to have adherence negatively influenced by having a copayment for statin therapy.
Rational Prescribing of Extended-Spectrum Penicillin β-Lactamase Inhibitor Combinations: Focus on Ticarcillin/Clavulanic Acid
Authors: Reed Michael D
Published: July 2014

OBJECTIVE

To provide an overview of the clinical pharmacokinetics and pharmacodynamics of ticarcillin/clavulanic acid and to reassess traditional dosage recommendations based on contemporary pharmacokinetic and pharmacodynamic principles.

DATA SOURCES

Published ticarcillin and clavulanic acid pharmacokinetic data derived from infants and children combined with data obtained from a rigorous, dose-escalation study performed in 12 healthy adults. Pharmacodynamic correlates were derived from published in vitro susceptibility data for the combination drug ticarcillin/clavulanic acid.

DATA SYNTHESIS:

Limited differences were observed in the pharmacokinetic disposition profiles between ticarcillin and clavulanic acid and relative to subject age. Integration of these data with defined pathogen minimum inhibitory concentrations underscores the appropriateness of an extended dosing interval (e.g., q8h to q12h) for many infections and demonstrates the probable therapeutic interchangeability of the following three intravenous dosing regimens: 3.1 g every 6 hours, 75 mg/kg every 8 hours, and 100 mg/kg every 12 hours of a 30:1 ticarcillin/clavulanic acid combination.

CONCLUSIONS

Integration of pharmacokinetic and pharmacodynamic data is an appropriate means to assess/reassess dosing recommendations for antimicrobial agents. Initial ticarcillin/ clavulanic acid dose recommendations did not account for known dynamic interactions for this combination antibiotic. Pharmacokinetic data in infants, children, and adults support a less frequent dosing interval (q8h to q12h) for the treatment of infections arising outside the central nervous system.
Switch Therapy with β-Lactam/β-Lactamase Inhibitors in Patients with Community-Acquired Pneumonia
Authors: Ramirez Julio A
Published: July 2014

BACKGROUND:

Antimicrobial drugs are prescribed inappropriately nearly 50% of the time. To address this problem, a hospital antimicrobial team was formed integrating the talents of infectious disease physicians, pharmacists, microbiologists, infectious control practitioners, and nurses. The primary goal of the team is to provide optimal, cost-effective antimicrobial therapy.

OBJECTIVE

To review the principles of streamlining antimicrobial therapy, with an emphasis on antibiotic switch therapy.

DISCUSSION:

With appropriate guidelines, switch therapy appears to be an important means to provide optimal antimicrobial therapy complementing the many social pressures placed on patients, while positively impacting on the overall cost of treatment. The use of β-lactam/β-lactamase inhibitor combinations as the antibiotics for initial intravenous medication to oral combination switch therapy is a viable approach to the treatment of hospitalized patients with community-acquired pneumonia. Preliminary data from our institution were obtained with such a therapeutic approach to assess the clinical efficacy, patient satisfaction with their care, and calculated dollar savings in the overall cost of care. The results of this evaluation strongly support the validity and desirability of such an approach.

CONCLUSIONS

The prospective use of a program that incorporates the use of β-lactam/β-lactamase inhibitor combinations for intravenous and switch-to-oral drug administration is a cost-effective means of providing optimal antimicrobial therapy for patients with community-acquired pneumonia.
Novel Cost-Effective Approaches to the Treatment of Community-Acquired Infections
Authors: Schwarzmann Stephen W
Published: July 2014

OBJECTIVE

To review approaches to the diagnosis and treatment of patients with community-acquired infections.

INTRODUCTION:

Dramatic changes in the antibiotic susceptibility of pathogens commonly associated with community-acquired infections have occurred during the past decade.

DISCUSSION:

Changes in the antibiotic sensitivity profile of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis that have occurred over the past several years have required modifications in empiric antibiotic selections for infections due to these pathogens. The most profound changes have occurred with S. pneumoniae, which has shown significant resistance to β-lactams by means of alteration of one or more of the five important penicillin-binding proteins. Many of these organisms have become resistant to other classes of antibiotics; some are sensitive only to vancomycin. H. influenzae and M. catarrhalis have developed resistance primarily by production of β-lactamase.

CONCLUSIONS

The antibiotic selection process for the treatment of community-acquired pneumonia relates to the site of infection and, in many cases, the in vitro sensitivity testing results or known patterns in a given geographic area.
Oil Wealth, Colonial Legacies, and the Challenges of Economic Liberalization
Authors: Mazaheri Nimah
Published: July 2014

This article examines the relationship between oil wealth and the adoption of economic liberalization, specifically financial and investment reforms. It argues that volatility in the international oil market renders oil-producing countries less likely to adopt financial and investment liberalization. This is particularly the case for long-term oil producers in the developing world who had firsthand experience with colonialism. A statistical analysis confirms these hypotheses after controlling for rival factors. Despite pressures for countries to work toward greater economic liberalization, oil wealth and the legacy of colonialism can lead countries away from reform in certain policy areas.
Mediatised affective activism
Authors: Reestorff Camilla M
Published: July 2014

Focusing on the Tunisian Femen-activist Amina Tyler/Sboui and the topless ‘Free Amina protest’ carried out in Tunis, this article investigates the participatory practices and activist imaginary (Marcus, 2006: 6) of the Femen movement. Femen is conceptualized as an assemblage (Delanda, 2006; Latour, 2005) of protesting women and various human and non-human, mediatised (Hepp, 2013; Hjarvard, 2008; Lundby 2009) and localized actors. The article suggests that Femen’s protests undergo a dual process of mediatisation that aims to both generate a spreadable imaginary and enable communication between bodies by addressing affective registers. The mediatised ‘affective environment’ (Massumi, 2009) cues bodies and generates spreadability, yet it also produces disconnections. These disconnections might redistribute the ‘economy of recognizability’ (Butler and Athanasiou, 2013); however, the Femen headquarters in Kiev and Paris increasingly provide centralized interpretations of the movement and the localized actions causing the perception of Femen’s activist imaginary to be unfolded between the unrecognizable and the too recognizable body.
Intimate internationalisms: 1970s ‘Third World’ queer feminist solidarity with Chile
Authors: Lea Spira Tamara
Published: July 2014

This article theorises the relationship between 1970s US Third World queer and feminist movements and Latin American anti-imperialist revolutions of the late twentieth century. I focus upon the historically occluded relationships between Third World feminists and queers in Chile and the United States throughout the transition to neoliberalism. My archive includes June Jordan’s little-known writings on Chile, the writings of Audre Lorde, and, primarily, a 1973 Third World feminist poetry reading staged in San Francisco shortly after the Pinochet coup. By assembling this unconventional archive, I intervene into the domestication of US anti-racist queer, black and feminist of colour politics. I argue for the profoundly internationalist foundation of these formations. I work to re-animate a moment when the affective economies of anti-colonial ‘global revolution’ opened up space for the imagination of joint struggle – allowing a visceral sense of struggle’s urgency and vitality in ways that have since been partially eclipsed.
Feminist asylums and acts of dreaming
Authors: Turcotte Heather M.
Published: July 2014

This article explores how US legal expansions narrow justice possibilities. Drawing from Joan Scott's work on experience, echo and reverberation, the article puts forth a method for reading the convergence of historical absences within legal subjectivity. In particular, it traces the denial of one Nigerian woman's US political asylum claim within the context of US handlings of Nigerian human rights cases focused on petroleum violence alongside the expansion of political asylum to include gender and sexual violence. The article accounts for the production of gender within a larger context of colonial state violence and questions how gender becomes a viable legal category through a variety of violent histories that implicate the US. By reframing questions of feminist justice within the site of law, the article argues for a deeper engagement with discontinuous narratives, which read against our common sense understandings, as a first step in divesting in US legal privilege.
Politics, historicity, and persuasion: A feminist materialist engagement with Linda Zerilli's politics of freedom
Authors: Tillman Rachel
Published: July 2014

Following in Joan Scott's anti-foundationalist footsteps, Linda Zerilli argues for a theory of feminist political judgement not framed in terms of epistemological certainty but assimilated to aesthetic judgement. Tani Barlow criticises Zerilli for not taking adequate account of history in her theory. I analyse the implications of Zerilli's ‘abyssal’ approach to political judgement and Barlow's critique of it. Despite their shared concerns, Zerilli's, Barlow's, and Scott's abyssal approaches struggle to effectively ground the validity of historical analysis and political judgement within a context of plurality and historical difference. All three thinkers focus extensively on discursive and imaginative potential for change while marginalising the role of materiality in the creation of new horizons for women. Incorporating a dynamic account of the materiality of human life into their work would allow them to tie politics and history to an explanation of the role material life plays in constituting plurality, factuality, and historicity.
The Critical Power of Virtual Dystopias
Authors: Schulzke Marcus
Published: July 2014

This article explores the capacity of video games and virtual worlds to function as critical utopias or dystopias. A theme of utopian thinking over the past century has been that utopian fantasies offer a critical perspective on the real world. I argue that video games and virtual worlds have generally failed to offer utopian fantasies that can perform a critical function because of their tendency of mirroring the real world, but I show that dystopian video games tend to be very effective in presenting critical themes. Moreover, I argue that video games create critical dystopias in ways that display the unique strengths of the medium. Virtual dystopias rely on a combination of engaging narrative elements and gameplay mechanics, which come together to create dynamic worlds in which players are active participants.
A trial of in-hospital, electronic alerts for acute kidney injury: Design and rationale
Authors: Wilson Francis Perry , Reese Peter P , Shashaty Michael GS , Ellenberg Susan S , Gitelman Yevgeniy , Bansal Amar D , Urbani Richard , Feldman Harold I , Fuchs Barry
Published: July 2014

Background:

Acute kidney injury is common in hospitalized patients, increases morbidity and mortality, and is under-recognized. To improve provider recognition, we previously developed an electronic alert system for acute kidney injury. To test the hypothesis that this electronic acute kidney injury alert could improve patient outcome, we designed a randomized controlled trial to test the effectiveness of this alert in hospitalized patients. The study design presented several methodologic, ethical, and statistical challenges.

Purpose:

To highlight the challenges faced and the solutions employed in the design and implementation of a clinical trial to determine whether the provision of an early electronic alert for acute kidney injury would improve outcomes in hospitalized patients. Challenges included how to randomize the delivery of the alert system and the ethical framework for waiving informed consent. Other methodologic challenges included the selection and statistical evaluation of our study outcome, a ranked-composite of a continuous covariate (creatinine) and two dichotomous outcomes (dialysis and death), and the use of the medical record as a source of trial data.

Methods:

We have designed a randomized trial to assess the effectiveness of an electronic alert system for acute kidney injury. With broad inclusion criteria, and a waiver of informed consent, we enroll and randomize virtually every patient with acute kidney injury in our hospital.

Results:

As of 31 March 2014, we have enrolled 2373 patients of 2400 targeted. Pre-alert data demonstrated a strong association between severity of acute kidney injury and inpatient mortality with a range of 6.4% in those with mild, stage 1 acute kidney injury, to 29% among those with stage 3 acute kidney injury (p < 0.001). We judged that informed consent would undermine the scientific validity of the study and present harms that are out of proportion to the very low risk intervention.

Conclusion:

Our study demonstrates the feasibility of designing an ethical randomized controlled trial of an early electronic alert for acute kidney injury without obtaining informed consent from individual participants. Our study outcome may serve as a model for other studies of acute kidney injury, insofar as our paradigm accounts for the effect that early death and dialysis have on assessment of acute kidney injury severity as defined by maximum achieved serum creatinine.
Good intentions and ICH-GCP: Trial conduct training needs to go beyond the ICH-GCP document and include the intention-to-treat principle
Authors: Browne Lois H , Graham Peter H
Published: July 2014

Background:

It is assumed investigators and statisticians fully understand the importance of avoiding missing outcomes and the intention-to-treat principle during design and analysis phases of a randomised controlled trial in order to obtain the most valuable and reliable results. However, many personnel undertaking day-to-day trial conduct and data collection commonly rely exclusively for guidance on the widely implemented, indeed regulated, International Conference on Harmonisation–Good Clinical Practice document as the guideline and standard for trial conduct.

Purpose:

This article describes adverse consequences of omission of intention-to-treat principles from training for trial personnel and explores the need for training in addition to the International Conference on Harmonisation–Good Clinical Practice guideline document.

Methods:

Data from the Breast Boost Study were used to illustrate a comparison of actual results, where vigilant senior investigators re-enforced intention-to-treat requirements throughout all aspects of trial conduct with results that could easily have occurred if study personnel did not understand the importance of intention-to-treat principles. Experience as a co-ordinating centre for an international trial (Trans-Tasman Radiation Oncology Group 08.06 Breast STARS) acted as an audit of data-management culture regarding intention-to-treat in Australia and New Zealand.

Results:

Despite the Breast Boost Study exceeding planned accrual, it was demonstrated that the study, which found a statistically significant result, could have reported a negative or inconclusive result under the scenario of trial conduct personnel having lack of understanding of the importance of avoiding losses to follow-up. Trans-Tasman Radiation Oncology 08.06 co-ordination experience verified that data-management culture in Australia and New Zealand does not adequately recognise intention-to-treat principles, and this is reflected in trial conduct.

Limitations:

Trial data described are limited to two trials and in the Australian and New Zealand setting.

Conclusion:

To be both scientifically and ethically valid, guidelines for trial conduct should include and stress the importance of the intention-to-treat principle and in particular avoiding missing outcomes. Our discussion highlights the vitally important role played by personnel involved in day-to-day trial conduct. Inclusion of scientific principles in guideline documents and/or training which goes beyond International Conference on Harmonisation–Good Clinical Practice to include intention-to-treat is essential to achieve robust research results. Related aspects of randomised trial consent and ethics are discussed.
Reliability of warm-standby systems subject to imperfect fault coverage
Authors: Tannous Ola , Xing Liudong , Peng Rui , Xie Min
Published: July 2014

This article models and analyzes the reliability of warm-standby systems subject to imperfect fault coverage based on sequential multistate decision diagrams. For warm-standby systems, the standby units have different failure rates before and after they are used to replace the online faulty unit. Furthermore, a component fault may propagate through the system and cause the entire system to fail if the fault is uncovered or undetected due to the imperfect system recovery mechanism. Existing works on warm-standby systems with imperfect fault coverage are restricted to some special cases, such as cases assuming an exponential time-to-failure distribution for all the system components or cases considering only one warm spare unit. The proposed sequential multistate decision diagram–based approach can overcome the limitations of the existing approaches. Examples are given to illustrate its advantages and applications.
Re-artification in a World of De-artification: Materiality and Intellectualization in Fashion Media Discourse (1949–2010)
Authors: Van de Peer Aurélie
Published: July 2014

Through a grounded theory analysis of 1301 collection reviews from The New York Times and The International Herald Tribune, issued between 1949 and 2010, the article discusses the shift in the themes that journalists employ to make sense of the latest collections. Contemporary journalists pay far less attention to the materiality of fashion than their earlier colleagues did. In the late 20th century they construed designer fashion as an intellectual practice. The article traces this shift to developments in the structural organization of the field of high-end fashion production, which today is involved in a process of de-artification, as the commercial aspects of the fashion system became more apparent in the later 20th century. In the 1990s leading fashion journalists drew on the new intellectual conception of designer fashion to engage in a process of re-artification. Hereby they seek to create an image of cultural worth for their object of criticism and for themselves, while they also seek to reinforce the long-standing but challenged division between mass market and high-end fashion.
On manhood and Movember…or why the moustache works
Authors: Wassersug Richard , Oliffe John , Han Christina
Published: July 2014

The unprecedented success of the Movember campaign in raising money for, and awareness of, prostate cancer (PCa) brings with it a novel opportunity to consider how masculinity and men’s health can connect. In this essay we first detail the history of some less fruitful endeavors for advancing PCa awareness that played on masculine stereotypes. We then consider how Movember’s moustache motif has succeeded. Included are commentaries about why the strongly masculine motifs of combat, loyalty, and aggression couched in military language were not successful when used to promote concern about men’s health. Movember in contrast succeeds by focusing on a way that men can express their individuality without resorting to overt acts or signs of aggression or militarism.
Do partial thickness, bursal side cuff tears affect outcome following arthroscopic subacromial decompression? A prospective comparative cohort study
Authors: Lawson-Smith Matthew , Al-Maiyah Mohammed , Goodchild Lorna , Fourie J M Brendan , Finn Paul , Rangan Amar
Published: July 2014

Background:

The present study aimed to compare medium-term clinical outcomes of patients following arthroscopic subacromial decompression (ASAD): those with intact rotator cuff with two groups of increasing size of partial thickness bursal-side tears.

Methods:

Patients undergoing shoulder arthroscopy by a single surgeon had pre- and postoperative Constant scores prospectively recorded. Arthroscopic surgery included the assessment of any supraspinatus tears using the Ellman criteria, as well as ASAD and cuff debridement. Groups were created based on the status of rotator cuff and size of bursal tear. Outcome in these patient groups was then compared and analyzed

Results:

Seventy-four patients were suitable for inclusion in the study: 32 patients without a cuff tear; 21 patients with a cuff tear of 9 mm or less in length; and 21 patients with a cuff tear of 10 mm or more in length. Baseline characteristics of the three groups were similar. All three groups showed a significant improvement in their Constant scores following surgery. There was, however, no significant difference in Constant scores between the three groups.

Conclusions:

The results of the present study show that patients with varying sizes of bursal-side tears respond to ASAD as well as those with no rotator cuff tear.
Static Versus Dynamic Musculoskeletal Ultrasound for Detection of Plantar Plate Pathology
Authors: Feuerstein Catherine A. , Weil Lowell , Weil Lowell Scott , Klein Erin E. , Fleischer Adam , Argerakis Nicholas G.
Published: July 2014

Musculoskeletal ultrasound (US) is a common modality used to examine plantar plate pathology. Comparison of the diagnostic accuracy of static versus dynamic ultrasound has not been previously published. The objective of this study was to prospectively compare the value of using preoperative static and dynamic ultrasound findings to diagnose plantar plate pathology using intraoperative inspection as the standard of reference. Patients attending a single foot and ankle specialty clinic from August 2012 to June 2013 with clinically suspected plantar plate pathology that was unresponsive to conservative care served as the study population. Static and dynamic ultrasound exams were performed by a single experienced rater and compared to intraoperative findings. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were determined for static and dynamic ultrasound exams. Thirty-six patients (45 lesser metatarsophalangeal joints) were included in this analysis. Of the 36 patients, 29 were females and 7 were males with average age of 57.9 ± 7.8 years (range, 38-73). There were 38 plantar plate tears (84.4%) noted on intraoperative examination. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for the static US exam were 80.0%, 81.6%, 71.4%, 93.9%, and 41.7%, respectively. The same values for the dynamic US exam were 88.9%, 100%, 28.6%, 88.3%, and 100%, respectively. Static and dynamic ultrasound techniques are each highly sensitive methods for assessing plantar plate pathology. However, the sensitivity and accuracy of the exam is best when dynamic assessment of the plantar plate is employed. Caution should be used when relying solely on static images to diagnose subtle injuries in this area of the foot.

Levels of Evidence: Diagnostic Level II, Prospective
Composite film of magnesium alloy chemical conversion microarc oxidation
Authors: Shao Z. , Kong B. , Zhao Y. , Cai Z.
Published: July 2014

The dark composite ceramic film was prepared on AZ91D magnesium alloy with a new method which combined chemical conversion with microarc oxidation. Using L16 (45) orthogonal test to optimise the optimum technological conditions of the chemical conversion treatment fluid. The surface morphologies, chemical composition and structure of the film were examined by SEM and XRD. The corrosion resistance performances of the films were investigated by electrochemical measurements (in 3·5 wt-%NaCl aqueous solution). The results showed Zn element was introduced into the microarc oxide ceramic films by chemical conversion pretreatment. The main composition of composite ceramic film was ZnO, ZnO2 and Mg3 (PO4)2 and the surface of the composite ceramic film was smooth, compact and even dark. The saline soaks experiment (72 h) and electrochemical analysis showed corrosion resistance of ceramic film was improved obviously. Adding glycerin can make microarc oxidation reaction more stable and ceramic film of the discharge apertures was smaller. This further increased the density of the film layer and improved the corrosion resistance of the film.
A prospective study of mediastinal gray-zone lymphoma
Authors: Wilson Wyndham H. , Pittaluga Stefania , Nicolae Alina , Camphausen Kevin , Shovlin Margaret , Steinberg Seth M. , Roschewski Mark , Staudt Louis M. , Jaffe Elaine S. , Dunleavy Kieron
Published: July 2014

Key Points

MGZL with pathologic features in between NSHL and PMBL is very rare and most frequently occurs in young patients. A prospective study of DA-EPOCH-R without mediastinal radiation in MGZL demonstrated an inferior outcome compared to patients with PMBL.