bluuebunny/crossref_metadata_2025 huggingface dataset:
Possible Implications for Bundled Payment Models of Comorbidities and Complications as Drivers of Cost in Total Ankle Arthroplasty
Authors: Cunningham Daniel , Karas Vasili , DeOrio James K. , Nunley James A. , Easley Mark E. , Adams Samuel B.
Published: October 2018

Background:

The Comprehensive Care for Joint Replacement (CJR) model provides bundled payments for in-hospital and 90-day postdischarge care of patients undergoing total ankle arthroplasty (TAA). Defining patient factors associated with increased costs during TAA could help identify modifiable preoperative patient factors that could be addressed prior to the patient entering the bundle, as well as determine targets for cost reduction in postoperative care.

Methods:

This study is part of an institutional review board–approved single-center observational study of patients undergoing TAA from January 1, 2012, to December 15, 2016. Patients were included if they met CJR criteria for inclusion into the bundled payment model. All Medicare payments beginning at the index procedure through 90 days postoperatively were identified. Patient, operative, and postoperative characteristics were associated with costs in adjusted, multivariable analyses. One hundred thirty-seven patients met inclusion criteria for the study.

Results:

Cerebrovascular disease (intracranial hemorrhages, strokes, or transient ischemic attacks) was initially associated with increased costs (mean, $5595.25; 95% CI, $1710.22-$9480.28) in adjusted analyses ( P = .005), though this variable did not meet a significance threshold adjusted for multiple comparisons. Increased length of stay, discharge to a skilled nursing facility (SNF), admissions, emergency department (ED) visits, and wound complications were significant postoperative drivers of payment.

Conclusion:

Common comorbidities did not reliably predict increased costs. Increased length of stay, discharge to an SNF, readmission, ED visits, and wound complications were postoperative factors that considerably increased costs. Lastly, reducing the rates of SNF placement, readmission, ED visitation, and wound complications are targets for reducing costs for patients undergoing TAA.

Level of Evidence:

Level II, prognostic prospective cohort study.
Relationship of Duration of Wait for Surgery and Postoperative Patient-Reported Outcomes for Hallux Valgus Surgery
Authors: Sutherland Jason M. , Wing Kevin , Younger Alastair , Penner Murray , Veljkovic Andrea , Liu Guiping , Crump Trafford
Published: October 2018

Background:

Little is known about the effect of delayed access to bunion correction (hallux valgus) surgery on patient-reported outcomes. The objective of this study was to measure the association between preoperative wait time for bunion correction surgery and postoperative patient-reported outcomes.

Methods:

This study prospectively recruited patients to complete preoperative patient-reported outcomes measuring depression, pain, and foot and ankle health, including the Patient Health Questionnaire–9 (PHQ-9); the pain intensity (P), interference with enjoyment (E) of life and general (G) instrument (ie, PEG); and the Foot and Ankle Outcome Score (FAOS), a condition-specific instrument. Patients complete the same patient-reported outcomes 6 months postoperatively. Regression models measured patient-reported outcomes as a function of wait time, adjusting for baseline health, age category, sex, comorbidities, and socioeconomic status. This study included 87 participants, a response rate of 53% among eligible patients.

Results:

Longer waits for bunion correction surgery, adjusting for other factors, were associated with smaller gains in health in 4 of the 5 domains of the FAOS. There was no relationship between postoperative depression and pain scores with duration of wait time, adjusting for patient characteristics.

Conclusion:

At the 6-month postoperative time point, prolonged preoperative wait times were detrimental to foot and ankle outcomes in 4 of the 5 domains of the foot and ankle–specific PRO. Policies for expediting access for symptomatic hallux valgus are warranted to mitigate poorer postoperative outcomes. Further study is required to understand if failure to improve is a permanent finding in the postoperative period.

Level of Evidence:

Level II, prospective comparative study.
Good long-term patency: 10-year follow-up using the mid-thigh adductor loop arteriovenous graft
Authors: McEwan Samantha J , Maple Hannah , Gibbs Paul J
Published: October 2018

Introduction:

Definitive access in patients requiring renal replacement therapy is an ever-increasing challenge. For those where autogenous venous access is no longer a viable option, arteriovenous grafts can be considered. This article describes long-term follow-up, complications and patency rates of the mid-thigh ‘adductor loop’ arteriovenous graft.

Methods:

50 mid-thigh loop arteriovenous grafts have been inserted into 48 patients in our unit over the past 11 years. A prospective database was collected on patients receiving an arteriovenous graft at our unit by the senior author. All remained under the care of our unit ensuring accurate follow-up data collection and database was updated at regular intervals.

Results:

Death-only censored primary patency at 1, 3 and 5 years was 76%, 44% and 23%, respectively. Patients receiving transplants were not censored as follow-up of the arteriovenous grafts was possible. Secondary patency at 1, 3 and 5 years was 95%, 63% and 45%. These rates are higher than previous studies looking at lower limb arteriovenous grafts. Graft thrombosis occurred in 14 patients (28%). Six patients were treated for an infection (12%) but only four grafts were excised; much lower than documented in previous studies.

Conclusion:

Autogenous venous access remains the perceived gold standard for patients requiring dialysis for end stage renal failure, despite some published data reporting poor outcomes. We have shown that adductor loop arteriovenous grafts can be a reliable, safe and long-term alternative in those whom fistula formation is not possible and may have a role earlier in the patient journey than previously thought, as a result of good patency and lower complications.
Perceptions of parties’ left-right positions: The impact of salience strategies
Authors: Meyer Thomas M , Wagner Markus
Published: October 2018

The left-right dimension is widely used by voters and parties as a ‘super-issue’ with flexible, varying meaning. Hence, it is important to know how voters place parties on the left-right dimension. We argue that voters infer left-right party positions from their positions on two key ideological subdimensions: economic and cultural issues. However, a subdimension should influence party placements on the left-right dimension more if the subdimension is important (1) to the party and (2) in the party system as a whole. In aggregate-level models using voter data from the 2014 European Election Study and party data from the 2014 Chapel Hill Expert Survey, we show that perceived left-right position of a party reflects in particular party positions on issue dimensions that are (1) more important to the party and (2) more salient in the party system. This finding provides insight into the sources of voter perceptions and has wider implications for our understanding of party competition, as we show how parties’ salience strategies can have consequences for position-based ideological perceptions and voting decisions.
The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis
Authors: Nair Uthara , Armfield Nigel R , Chatfield Mark D , Edirippulige Sisira
Published: October 2018

Introduction

Maternal depression (MD), is an overarching term for depression affecting pregnant women and mothers for up to 12 months postpartum. Because MD may have chronic and long-lasting effects, it is an important public health concern. The extent to which telemedicine may be an effective way to provide services to sufferers of MD is unknown, therefore, this review aimed to assess the available evidence.

Methods

We conducted a search of The Cochrane Library, PubMed/MEDLINE, PsycINFO, and EMBASE for relevant randomised controlled trials published between 2000 and 2018; we then conducted a systematic review and meta-analysis.

Results

We identified 10 studies for inclusion. Therapeutic strategies involved cognitive behavioural therapy (CBT), behavioural activation and other psychoeducation. Eight trials reported significant improvement in depression scores post-intervention; four studies that conducted post-intervention follow-up found that these improvements continued. However, high attrition rates and lack of blinding were common problems.

Discussion

This review found limited evidence supporting the delivery of CBT for the treatment of MD and anxiety using telemedicine. However, most of the evidence only studied improvements in postpartum depression, indicating that use of telemedicine to provide MD intervention is still small and an under-researched area.
Direct-to-consumer mobile teledermoscopy for skin cancer screening: Preliminary results demonstrating willingness-to-pay in Australia
Authors: Snoswell Centaine L , Whitty Jennifer A , Caffery Liam J , Loescher Lois J , Gillespie Nicole , Janda Monika
Published: October 2018

Introduction

Internationally, teledermoscopy has been found to have clinical and economic efficacy. This study aims to identify the attributes of a mobile teledermoscopy service that consumers prefer. This preliminary study was set within a broader randomised control trial (RCT) investigating the effectiveness of direct to consumer mobile teledermoscopy.

Methods

We undertook a discrete choice experiment (DCE). The DCE comprised 24 choice sets, divided into in two blocks of 12. For each choice set, respondents were asked to make discrete choices between two opt-out choices and two skin cancer screening service options described by seven attributes. A mixed logit model was used to estimate preferences for skin cancer screening services. Consumer preferences weights were used to calculate marginal willingness-to-pay (WTP) for skin cancer screening services.

Results

The DCE was completed by 113 consumer respondents. Consumers’ preference for dermatologist involvement in their diagnosis, increased accuracy, and reduced excisions were all statistically significant in driving choice between service models. Consumers preferred having a professional involved in their skin cancer screening, rather than performing a self-examination. Consumers were only WTP $1.18 to change from a GP visit to mobile teledermoscopy (diagnosis using a phone camera). However, they were WTP $43 to have their results reviewed by a dermatologist rather than a GP, and $117 to increase the chance of detecting a melanoma if it was present from 65-75% to 95%.

Conclusion

Skin cancer screening services which are delivered by health professionals, rather than skin self-examination, are preferred by consumers. Consumers were willing to pay for their preferred skin cancer screening method, especially if a dermatologist was involved.
Study of challenges to utilise mobile-based health care monitoring systems: A descriptive literature review
Authors: Baniasadi Tayebeh , Niakan Kalhori Sharareh R , Ayyoubzadeh Seyed Mohammad , Zakerabasali Somayyeh , Pourmohamadkhan Marjan
Published: October 2018

Mobile health encompasses remote and wireless applications to provide health services. Despite the advantages of applying mobile-based monitoring systems, there are challenges and limitations; understanding the challenges may assist in identifying available solutions and optimising decision-making to apply mHealth technologies more practically. This study aimed to investigate the main challenges related to mHealth-based systems for health monitoring purposes. This review was carried out through investigation of English evidence from four databases, including Scopus, PubMed, Embase, and Web of Science, using a defined search strategy from 2013 to 2017. Two independent researchers reviewed the results based on PRISMA guidelines, and data was categorised using a bottom-up approach to reach a framework for the most general challenges. Among the 105 papers obtained, eight works were selected. The revealed challenges were categorised into six main branches across a tree (with 55 nodes, four levels) including user-related, infrastructure, process, management, resource and training challenges. Identifying the resolvable and preventable challenges, such as those related to training, design might play a crucial role in preventing loss of resources and in growing the success rate of a project, particularly if considered in national level projects.
Cognitive, emotional, and behavioral profile in children and adolescents with chronic pain associated with rheumatic diseases: A case-control study
Authors: Pascali Maria , Matera Emilia , Craig Francesco , Torre Francesco La , Giordano Paola , Margari Francesco , Zagaria Giuseppina , Margari Mariella , Margari Lucia
Published: October 2018

Background:

The prevalence of chronic pain is about 30% in children and adolescents which suffer from severe emotional distress. The aim of this observational study is to investigate cognitive, emotional and behavioral consequences of benign chronic pain in children and adolescents suffering of reumathologic diseases.

Materials and Methods:

A total of 49 participants, chronic pain participants (CPPs) and controls (CGPs), affected by rheumatic diseases, were enrolled. Assessment included collection of sociodemographic data, pain characteristics, and administration of Visual Analog Scale (VAS), Depression Inventory for Children and Adolescents (CDI), Conners’ Parent Rating Scales–Revised (CPRS-R), Child Behavior Checklist (CBCL), and Screen for Child Anxiety–Related Disorders (SCARED). For the statistical analysis, Student’s t-test for independent samples and Pearson’s correlation were used. The significance value was set at p less than .05.

Results:

A significant difference of mean scores of CBCL items and of CPRS items between the two groups was found. In CPPs, a significant correlation between VAS and mean scores of several CBCL items and between VAS and mean scores of several CPRS items was found.

Conclusion:

Chronic pain is a real syndrome in which an interdisciplinary treatment should be applied, considering the psychopathological risk, especially in developmental age.
Geopower: On the states of nature of late capitalism
Authors: Luisetti Federico
Published: October 2018

The article argues that environmental planetary discourses have coalesced into the Anthropocene crisis narrative and reformulated the state of nature apparatus of Western political theory. The Anthropocene, as an ecological state of nature of late capitalism, casts light on the logics of geopower, which assembles species thinking, a fascination with nonlife and sovereignty, and the imaginary of extinction and mutation. Geopower shifts governmental technologies from human populations and their ‘milieu’ to nonhuman species, energy flows and ecosystems, from political economy and biopower to Earth science and systems ecology. This configuration of power suggests a shift in the neoliberal agenda and imposes the Earth as a political personage, generating threatening political myths and figures of chaos and sovereignty, such as Gaia, Chthulu and Climate Leviathans.
Gender empowerment, inequalities and the prevalence of adult female obesity: An empirical analysis using new data, 1990–2013
Authors: De Soysa Indra , Lewin Oda L.
Published: October 2018

Aims: Do gender inequality and gender discrimination explain female obesity? Discrimination denies access to choose and constrains agency. Scope: Using the Global Burden of Disease data on overweight and obesity share of the adult female population for almost 160 countries over a 24-year period, we find that female empowerment has no effect on the population share that is overweight, but it reduces the obese share of women. The substantive impact is, however, slight and the results are not robust to testing a sample of only developing countries. Political freedoms for women in general, however, show positive effects on the prevalence of obesity, results that are again substantively meagre. Higher levels of income inequality and a measure of health inequality predict lower levels of female obesity independently of the controls, which raises some doubt about large arguments linking generalized inequality to obesogenic environments. Results: In so far as our measures of female empowerment capture greater access to rights and agency, they are poor predictors of the prevalence of obesity. The results suggest that local-level idiosyncrasies matter a lot more than do macro-level factors. Conclusions: Any conclusion should be treated tentatively given the short temporal domain examined here and uncertainties in the data. While promoting rights and equity for women are still intrinsically valuable and moral, the task of reducing obesity per se may require more targeted public action promoting healthier lifestyles and consumption among vulnerable groups.
Musical Features and Affective Responses to Personalized Playlists in People With Probable Dementia
Authors: Garrido Sandra , Stevens Catherine J. , Chang Esther , Dunne Laura , Perz Janette
Published: October 2018

Objectives:

Personalized music playlists are increasingly being utilized in aged care settings. This study aims to investigate how musical features influence the affective response to music of people with probable dementia.

Methods:

A factorial experiment (2 × 2 × 3) was conducted to investigate the influence of tempo (fast, slow), mode (major, minor), and lyrics (none, negative, positive). Ninety-nine people with probable dementia were randomly assigned to 3 conditions, listening to 3 personalized playlists. Galvanic skin response and activation of facial action units were measured.

Results:

Music with fast tempos increased arousal and reduced enjoyment. Music in minor keys increased activation of the depressor anguli oris, suggesting increased sadness. Lyrics had no significant effect on response.

Discussion:

The findings demonstrate that both tempo and mode influenced the response of the listener. As well as accounting for personal preferences, music for people with dementia should be carefully targeted toward the affective outcome desired.
A sensitive information protection scheme in wearable devices based on quantum entanglement
Authors: Chen Yongzhi , Wen Xiaojun , Sun Zhiwei , Jiang Zoe L , Fang Junbin
Published: October 2018

At present, wearable devices are in the ascendant in the field of personal smart communication terminals across the globe, but their information security issues deserve attention. We hereby propose a secure transmission solution that addresses the special requirements of wearable devices in information security. It is based on the principle of quantum secure communication and works well to protect sensitive information on wearable devices. The solution utilizes the coherence properties of quantum entanglement and uses quantum information security techniques such as quantum key distribution and non-orthogonal base measurement to realize secure transmission of sensitive information on wearable devices. Unlike traditional encryption methods based on the complexity of the mathematical algorithm, the solution has unconditional security.
Socio-economic challenges to Tunisia’s democratic transition
Authors: Weilandt Ragnar
Published: October 2018

Among those countries that faced the so-called Arab Spring in 2011, Tunisia is the last one for which hope for a successful democratic transition remains justified. However, the country’s comparatively favourable institutional evolution has led to a dangerous complacency not only in Europe but across the West. While important reforms have been implemented, democracy has so far failed to fulfil the high expectations it has raised within the population. Tunisians’ discontent with their living conditions and the new system’s perceived inability to deliver are fundamental threats to the country’s transition. This article argues that the EU has a major interest in making Tunisia a democratic and socio-economic success story, as failure would not only constitute a lost opportunity to create a role model in the region but would also jeopardise European security interests. The EU should therefore provide more substantial support with the aim of realising socio-economic improvements in Tunisia.
Scoping Review of the National Surgical Quality Improvement Program in Plastic Surgery Research
Authors: Augustine Haley F. M. , Hu Jiayi , Najarali Zainab , McRae Matthew
Published: October 2018

Background:

The National Surgical Quality Improvement Program (NSQIP) is a robust, high-quality surgical outcomes database that measures risk-adjusted 30-day outcomes of surgical interventions. The purpose of this scoping review is to describe how the NSQIP is being used in plastic surgery research.

Methods:

A comprehensive electronic literature search was completed in PubMed, Embase, MEDLINE, and CINAHL. Two reviewers independently reviewed articles to determine their relevance using predefined inclusion criteria. Articles were included if they utilized NSQIP data to conduct research in a domain of plastic surgery or analyzed surgical procedures completed by plastic surgeons. Extracted information included the domain of plastic surgery, country of origin, journal, and year of publication.

Results:

A total of 106 articles met the inclusion criteria. The most common domain of plastic surgery was breast reconstruction representing 35% of the articles. Of the 106 articles, 95% were published within the last 5 years. The Plastic and Reconstructive Surgery journal published most of the (59%) NSQIP-related articles. All of the studies were retrospective. Of note, there were no articles on burns and only one study on trauma as the domain of plastic surgery.

Conclusion:

This scoping review describes how NSQIP data are being used to analyze plastic surgery interventions and outcomes in order to guide quality improvement in 106 articles. It demonstrates the utility of NSQIP in the literature, however also identifies some limitations of the program as it applies to plastic surgery.
The Making of Breasts: Navigating the Symbolism of Breasts in Women Facing Cancer
Authors: Webb Carmen , Jacox Natalie , Temple-Oberle Claire
Published: October 2018

In many cultures, the female breast is a potent symbol of beauty, motherhood, and vitality. When such breasts become diseased and a woman is faced with a mastectomy, multiple competing discourses converge to complicate the decision for or against breast reconstruction. This process can be fraught with tension and ambivalence. Women, along with surgeons working in the field of breast reconstruction, should be aware of the cultural history that shapes the understanding of breasts. When a woman considers her options, she is influenced by the personal and the evolving social and cultural discourse.
Clinical and Functional Outcomes of Anterior Cruciate Ligament Reconstruction at a Minimum of 2 Years Using Adjustable Suspensory Fixation in Both the Femur and Tibia: A Prospective Study
Authors: Colombet Philippe , Saffarini Mo , Bouguennec Nicolas
Published: October 2018

Background:

The success of anterior cruciate ligament (ACL) reconstruction requires reliable and rigid graft fixation. Cortical suspensory fixation (CSF) devices have become an acceptable alternative to interference screws for soft tissue ACL grafts. However, CSF devices have been reported to be associated with tunnel widening and increased postoperative anterior laxity compared with interference screw fixation. Adjustable CSF devices were introduced to avoid these problems but have been associated with graft lengthening and inconsistent outcomes.

Purpose:

To (1) report the side-to-side difference (SSD) in anterior laxity at 150 N, clinical scores, and failure rates 2 years after ACL reconstruction with 4-strand semitendinosus autografts using an adjustable CSF device and (2) determine the preoperative factors associated with clinical outcomes.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A total of 131 patients who had undergone primary ACL reconstruction, performed with 4-strand semitendinosus grafts that were secured using Pullup adjustable-length CSF devices with femoral and tibial fixation techniques, were prospectively enrolled in this study; 34 patients were excluded because of contralateral instability or ipsilateral knee injuries that required additional surgery. This left a cohort of 97 patients who were evaluated preoperatively and at 6, 12, and 24 months. The evaluation consisted of measuring the SSD in anterior laxity and patient-reported outcome scores (International Knee Documentation Committee [IKDC] and Lysholm scores). Regression analyses were performed to determine associations between these outcomes and 9 preoperative variables.

Results:

Only 2 patients could not be reached, 2 could not be evaluated because of contralateral ACL tears, and 2 had graft failure. At 2-year follow-up, the remaining 91 patients had a mean SSD in anterior laxity of 0.8 ± 1.8 mm (range, –4.2 to 5.3 mm), mean IKDC score of 87.6 ± 10.6 (range, 43.7-100.0), and mean Lysholm score of 90.8 ± 9.3 (range, 56.0-100.0). At final follow-up, compared with knees with partial ruptures, those with complete ruptures had equivalent laxity ( P = .266) and Lysholm scores ( P = .352) but lower IKDC scores ( P = .009). Multivariable regression revealed that the IKDC score decreased with increased preoperative laxity (β = –1.35 [95% CI, –2.48 to –0.23]; P = .019).

Conclusion:

The novel adjustable-length CSF device produced satisfactory anterior laxity and clinical outcomes, with a failure rate of 2.1%, which compare favorably with those reported for nonadjustable CSF devices.
Listening in Naturalistic Scenes: What Can Functional Near-Infrared Spectroscopy and Intersubject Correlation Analysis Tell Us About the Underlying Brain Activity?
Authors: Rowland Stephen C. , Hartley Douglas E. H. , Wiggins Ian M.
Published: October 2018

Listening to speech in the noisy conditions of everyday life can be effortful, reflecting the increased cognitive workload involved in extracting meaning from a degraded acoustic signal. Studying the underlying neural processes has the potential to provide mechanistic insight into why listening is effortful under certain conditions. In a move toward studying listening effort under ecologically relevant conditions, we used the silent and flexible neuroimaging technique functional near-infrared spectroscopy (fNIRS) to examine brain activity during attentive listening to speech in naturalistic scenes. Thirty normally hearing participants listened to a series of narratives continuously varying in acoustic difficulty while undergoing fNIRS imaging. Participants then listened to another set of closely matched narratives and rated perceived effort and intelligibility for each scene. As expected, self-reported effort generally increased with worsening signal-to-noise ratio. After controlling for better-ear signal-to-noise ratio, perceived effort was greater in scenes that contained competing speech than in those that did not, potentially reflecting an additional cognitive cost of overcoming informational masking. We analyzed the fNIRS data using intersubject correlation, a data-driven approach suitable for analyzing data collected under naturalistic conditions. Significant intersubject correlation was seen in the bilateral auditory cortices and in a range of channels across the prefrontal cortex. The involvement of prefrontal regions is consistent with the notion that higher order cognitive processes are engaged during attentive listening to speech in complex real-world conditions. However, further research is needed to elucidate the relationship between perceived listening effort and activity in these extended cortical networks.
What Does Strategic Partnerships with ASEAN Mean for Japan’s Foreign Aid?
Authors: Trinidad Dennis D.
Published: October 2018

This article examines the implications of Japan’s strategic partnerships with Association of Southeast Asian Nations (ASEAN) member-countries on its foreign aid policy. Although there were previous attempts at aligning the broad goals of Japan’s aid policy with security and defence objectives, it argues that these partnerships have increasingly led to the emergence of a securitized aid. This is because strategic partnership, as a new form of security practice in the Asia-Pacific, extends the scope of Japan’s regional cooperation to the fields of defence and security. The overall extent of Japan’s aid securitization is still minimal but prominent in terms of the aid discourse, pattern of allotments or choice of recipients and institutional structures. Despite the adoption of new development cooperation charter in 2015, the use of Japan’s ODA is still confined to non-military use which limits Tokyo’s desire to deepen its security cooperation with ASEAN partner-countries.
Mechanisms of receptor shedding in platelets
Authors: Montague Samantha J. , Andrews Robert K. , Gardiner Elizabeth E.
Published: October 2018

The ability to upregulate and downregulate surface-exposed proteins and receptors is a powerful process that allows a cell to instantly respond to its microenvironment. In particular, mobile cells in the bloodstream must rapidly react to conditions where infection or inflammation are detected, and become proadhesive, phagocytic, and/or procoagulant. Platelets are one such blood cell that must rapidly acquire and manage proadhesive and procoagulant properties in order to execute their primary function in hemostasis. The regulation of platelet membrane properties is achieved via several mechanisms, one of which involves the controlled metalloproteolytic release of adhesion receptors and other proteins from the platelet surface. Proteolysis effectively lowers receptor density and reduces the reactivity of platelets, and is a mechanism to control robust platelet activation. Recent research has also established clear links between levels of platelet receptors and platelet lifespan. In this review, we will discuss the current knowledge of metalloproteolytic receptor regulation in the vasculature with emphasis on the platelet receptor system to highlight how receptor density can influence both platelet function and platelet survival.
Unrelated donor vs HLA-haploidentical α/β T-cell– and B-cell–depleted HSCT in children with acute leukemia
Authors: Bertaina Alice , Zecca Marco , Buldini Barbara , Sacchi Nicoletta , Algeri Mattia , Saglio Francesco , Perotti Cesare , Gallina Anna Maria , Bertaina Valentina , Lanino Edoardo , Prete Arcangelo , Barberi Walter , Tumino Manuela , Favre Claudio , Cesaro Simone , Del Bufalo Francesca , Ripaldi Mimmo , Boghen Stella , Casazza Gabriella , Rabusin Marco , Balduzzi Adriana , Fagioli Franca , Pagliara Daria , Locatelli Franco
Published: October 2018

Traditionally, hematopoietic stem cell transplantation (HSCT) from both HLA-matched related and unrelated donors (UD) has been used for treating children with acute leukemia (AL) in need of an allograft. Recently, HLA-haploidentical HSCT after αβ T-cell/B-cell depletion (αβhaplo-HSCT) was shown to be effective in single-center studies. Here, we report the first multicenter retrospective analysis of 127 matched UD (MUD), 118 mismatched UD (MMUD), and 98 αβhaplo-HSCT recipients, transplanted between 2010 and 2015, in 13 Italian centers. All these AL children were transplanted in morphological remission after a myeloablative conditioning regimen. Graft failure occurred in 2% each of UD-HSCT and αβhaplo-HSCT groups. In MUD vs MMUD-HSCT recipients, the cumulative incidence of grade II to IV and grade III to IV acute graft-versus-host disease (GVHD) was 35% vs 44% and 6% vs 18%, respectively, compared with 16% and 0% in αβhaplo-HSCT recipients (P < .001). Children treated with αβhaplo-HSCT also had a significantly lower incidence of overall and extensive chronic GVHD (P < .01). Eight (6%) MUD, 32 (28%) MMUD, and 9 (9%) αβhaplo-HSCT patients died of transplant-related complications. With a median follow-up of 3.3 years, the 5-year probability of leukemia-free survival in the 3 groups was 67%, 55%, and 62%, respectively. In the 3 groups, chronic GVHD-free/relapse-free (GRFS) probability of survival was 61%, 34%, and 58%, respectively (P < .001). When compared with patients given MMUD-HSCT, αβhaplo-HSCT recipients had a lower cumulative incidence of nonrelapse mortality and a better GRFS (P < .001). These data indicate that αβhaplo-HSCT is a suitable therapeutic option for children with AL in need of transplantation, especially when an allele-matched UD is not available.
Longer Follow-Up Confirms Relapse-Free Survival Benefit With Adjuvant Dabrafenib Plus Trametinib in Patients With Resected BRAF V600–Mutant Stage III Melanoma
Authors: Hauschild Axel , Dummer Reinhard , Schadendorf Dirk , Santinami Mario , Atkinson Victoria , Mandalà Mario , Chiarion-Sileni Vanna , Larkin James , Nyakas Marta , Dutriaux Caroline , Haydon Andrew , Robert Caroline , Mortier Laurent , Schachter Jacob , Lesimple Thierry , Plummer Ruth , Dasgupta Kohinoor , Haas Tomas , Shilkrut Mark , Gasal Eduard , Kefford Richard , Kirkwood John M. , Long Georgina V.
Published: October 2018

Purpose

Dabrafenib plus trametinib improved relapse-free survival (RFS) versus placebo (hazard ratio [HR], 0.47; P < .001) in patients with resected BRAF V600–mutant stage III melanoma (BRF115532; COMBI-AD; ClinicalTrials.gov identifier: NCT01682083). We present an updated RFS analysis on the basis of extended study follow-up and a cure-rate model analysis to estimate the fraction of patients expected to remain relapse free long term.

Methods

In this phase III trial, patients with resected BRAF V600–mutant stage III melanoma were randomly assigned to 12 months of adjuvant dabrafenib plus trametinib versus placebo. We report updated RFS (primary end point) and distant metastasis–free survival. RFS was also analyzed by subgroups defined by baseline disease stage (American Joint Committee on Cancer 7th and 8th editions), nodal metastatic burden, and ulceration status. The fraction of patients who remained relapse free long term was estimated using a Weibull mixture cure-rate model.

Results

At median follow-up of 44 months (dabrafenib plus trametinib) and 42 months (placebo), 3- and 4-year RFS rates were 59% (95% CI, 55% to 64%) and 54% (95% CI, 49% to 59%) in the dabrafenib plus trametinib arm and 40% (95% CI, 35% to 45%) and 38% (95% CI, 34% to 44%) in the placebo arm, respectively (HR, 0.49; 95% CI, 0.40 to 0.59). Distant metastasis–free survival also favored dabrafenib plus trametinib (HR, 0.53; 95% CI, 0.42 to 0.67). The estimated cure rate was 54% (95% CI, 49% to 59%) in the dabrafenib plus trametinib arm compared with 37% (95% CI, 32% to 42%) in the placebo arm. Subgroup analysis of RFS demonstrated similar treatment benefit regardless of baseline factors, including disease stage, nodal metastatic burden, and ulceration.

Conclusion

Longer follow-up confirmed RFS benefit with dabrafenib plus trametinib. Subgroup analysis suggested that dabrafenib plus trametinib benefited patients regardless of baseline factors.
The right to aftercare: best endeavours
Authors: Griffith Richard
Published: October 2018

In this two-part article Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers a detained mental health patient's right to aftercare under the Mental Health Act 1983, section 117
Schools prepare for January consultation over Ofsted plans
Authors: Henshaw Pete
Published: October 2018

Proposed new ‘quality of education’ judgement marks a shift away from headline data towards curriculum breadth and quality
In vitro Antacid Screening of the Aqueous and Ethanolic Leaf Extracts of Ixora Coccinea (Linn). and Mimosa Pudica (Linn.)
Authors: Jesselyn Cua Sharmaine , Lirazan Marcelina , Russelle Alvarez Michael
Published: October 2018

Ixora coccinea L. (santan) and Mimosa pudica L. (makahiya) ethanolic and aqueous extracts were screened for their in vitro antacid potentials using the preliminary antacid test, determination of acid neutralization capacity, acid neutralizing effect, duration of consistent neutralization, and buffering capacity. Phytochemical screening and quantification of alkaloids were also done and the alkaloid content was correlated to the in vitro antacid potentials of the extracts. Among the extracts, the M. pudica aqueous extract gave the best preliminary antacid test result (1.0066±0.0083 pH) and acid neutralization capacity (0.0711±0.0038 mmol H+). Its aqueous extract showed comparable acid neutralizing effect (3.507% acid neutralized) on gastric juice with that of its ethanol extract (3.509% acid neutralized). On the other hand, the I. coccinea aqueous extract had the highest acid buffering capacity (0.0701±0.0020 mmol H+/pH). Both aqueous extracts gave the longest duration of neutralization with 9±1.732 minutes. All the extracts were tested positive for flavonoids, indoles, tannins, anthraquinones, anthrones, and alkaloids, with the I. coccinea aqueous extract having the highest alkaloid content (18.0282±1.2607% w alkaloid/w extract). This study provides the first reported proof of the antacid activities of I. coccinea and M. pudica. Further tests, including mouse model assays, are suggested to determine the efficacy of the extracts in vivo.
Comparison of Iron Reduction Methods on the Determination of Antioxidants Content in Vegetables Sample
Authors: Yefrida Yefrida , Suyani Hamzar , Aziz Hermansyah , Efdi Mai
Published: October 2018

Determination of antioxidant content in 14 vegetables has been done using Modified Phenanthroline (MPM), Phenanthroline (PM) and Ferric Reducing Antioxidant Power (FRAP) methods. The SDR values ​​obtained for the MPM and PM methods were (2.65 ± 1.26) % and (3.51 ± 0.88) %, while the recovery values ​​were (100.86 ± 4.45)% and (99.93 ± 3.50) %, respectively. The antioxidant content of vegetables obtained by MPM, PM and FRAP methods were (30.4 ± 1.46 - 515.9 ± 3.32), (25.9 ± 1.13 - 327.3 ± 2.57) and (21.4 ± 0.51 - 371.7 ± 1.10) μmol Fe / g DW, respectively. The antioxidant content obtained with the three methods showed no significant different. The correlation values ​​between MPM - PM, MPM - FRAP, and PM - FRAP methods are 0.9712, 0.9896 and 0.9611, respectively. These values indicate a very strong correlation among the three methods.
T.H. Marshall is (almost) dead and buried: a response to Filipe Duarte
Authors: Harris John
Published: October 2018

In a previous edition of Critical and Radical Social Work, Filipe Duarte provided a full account of Marshall’s model of citizenship and argued for the continuing relevance of social citizenship in public welfare provision. Questions are raised about the adequacy of this exposition of Marshall’s model and the significant absences that result from the failure to critique it. The need for an understanding of social citizenship that goes beyond Marshall’s model is explored.
O Recife de Chico Vulgo e Jorge dü Peixe nos passos do break
Authors: Do Nascimento Francisco Gerardo Cavalcante
Published: October 2018

Neste artigo o debate se centra no Recife da década de 1980, entendido não apenas como a urbe que serviu de palco e cenário para o MangueBit, mas como um espaço coletivo múltiplo que vivenciou a atmosfera política do pósditadura militar. No universo citadino recifense buscaremos captar a aventura da convivência e da produção cultural de certas parcelas dos jovens. Diante disso, encararemos dois desafi os. O primeiro consistirá em situar Chico Vulgo e Jorge dü Peixe imersos em uma grupalidade juvenil pautada no movimento hip hop. O segundo implicará a necessidade de traçar as trilhas básicas das cartografias culturais do Recife segundo as representações dos breakers.Palavras-chave: Recife: anos 1980: breakers; Chico Vulgo e Jorge dü Peixe.
Entrevista com Lucia Murat
Authors: Morettin. Eduardo. . , Kornis. Mônica. Almeida.
Published: October 2018

Lucia Murat (Rio de Janeiro, RJ, 1948) é cineasta. Militante estudantil nos anos 1960, entrou na clandestinidade após a promulgação do Ato Institucional nº 5 (AI-5). Presa em 1971, sofreu inúmeras torturas até ser posta em liberdade em 1974. O interesse pelo cinema, política e jornalismo a levou em 1978 à Nicarágua, que enfrentava uma guerra civil entre as forças governistas e a oposição, liderada pela Frente Sandinista de Libertação Nacional. Ao retornar ao Brasil, a partir dos registros feitos, edita o seu primeiro fi lme O pequeno exército louco (1984). Desde então havia o desejo de misturar documentário e fi cção, articulação presente em seu primeiro longa-metragem, Que bom te ver viva (1989). Nele, o monólogo da personagem interpretada por Irene Ravache dialoga com os depoimentos de expresas políticas, que relatam as suas experiências sofridas pela repressão militar a partir de 1964. O interesse pela história do país está presente em diversos fi lmes, tanto nos que se voltam ao contemporâneo, como Quase dois irmãos (2004), que mostra em três diferentes épocas e situações os confl itos entre a classe média e a favela no Rio de Janeiro, quanto os que se ocupam do passado, como Brava gente brasileira (2000), em que os confrontos dos colonos com os índios no século XVIII na região Centro-Oeste indicam um passado de luta e resistência. Em Uma longa viagem (2011) e A memória que me contam (2013) a dimensão autobiográfi ca se entrelaça com o retrato mais geral de uma época, traço que indica a força e a perenidade das questões levantadas pela sua obra.
Entre cakewalks, jongos e lundus: racismo e resistência negra nos palcos, no mercado editorial e na indústria fonográfi ca do Brasil e dos Estados Unidos, 1870-1930
Authors: Neto Luiz Costa-Lima
Published: October 2018

Escrito como um possível “registro da transformação de uma historiadora da festa e da cultura popular na historiadora do legado da canção escrava” o presente estudo de Martha Abreu investiga como canções de africanos escravizados e seus descendentes foram divulgadas e ganharam visibilidade fora do contexto da escravidão, entre 1870 e 1930, no Brasil e nos Estados Unidos. O livro é ilustrado com imagens de pôsteres de espetáculos teatrais, pinturas, cartões-postais e, principalmente, capas de partituras. São disponibilizados pelo formato e-book links para dezenas de fonogramas e vídeos, entre outros recursos como, por exemplo, marcadores, a procura por palavras-chave ou a leitura em voz alta – especialmente útil aos portadores de necessidades especiais de visão. A autora demonstra como as “danças de negros” ocuparam espaço crescente na produção de impressões musicais nas lojas de venda de pianos, partituras, fonógrafos e discos, ou no circuito de teatros, circos e casas de espetáculos. Abordando o racismo no campo cultural e musical e as formas encontradas pelos artistas para subvertê-lo Martha Abreu busca contribuir para o entendimento mais aprofundado das “formas de reprodução do racismo na sociedade brasileira, um problema a ser superado por negros e brancos”.
La escritura escéptica como clave de lectura: los prólogos de Wittgenstein
Authors: Reinoso Guadalupe
Published: October 2018

La preocupación por los modos de producción del discurso filosóficocomo inseparable de la práctica filosófica ha sido un rasgo distintivo del período helenístico, y desde nuestra perspectiva, adopta un rasgo novedoso en el escepticismo antiguo. El pirronismo incluye en su propuesta el tratamiento crítico sobre la tendencia aseverativa propia del lenguaje como fuente productora de dogmatismos. De esta manera, la terapéutica escéptica debe operar también sobre las propias expresiones y los tipos de escritura que adopta el pirrónico. Wittgenstein parece cercano a algunas de estas preocupaciones en la medida en que las formas de expresar y escribir deben reflejar el enfoque no-teórico en el que se practica la filosofía –asociado a una reflexión filosófica sobre el lenguaje. Atendiendo a ciertos aspectos de la orientación pirrónica como clave de lectura, estudiaremos lasreflexiones de Wittgenstein sobre sus propios escritos como quedan exhibidas en sus prólogos.
Principios y conclusiones en una axiomatización de la astronomía de Acerca del cielo I de Aristóteles
Authors: Berrón Manuel
Published: October 2018

En Acerca del cielo I se encuentran cuatro pruebas fundamentales de la cosmología aristotélica, a saber: la prueba de la existencia del éter, la prueba de la finitud del universo, la prueba de su unicidad y la prueba de su ingenerabilidad e incorruptibilidad. Ofrecemos una reconstrucción parcial del conjunto de estas cuatro pruebas para poner en evidencia que ellas utilizan un grupo semejante de premisas y definiciones. En efecto, nuestro propósito es mostrar que dicho conjunto de pruebas utiliza los mismos principios y, de este modo, que en una reconstrucción axiomática del total de pruebas podemos hallar un número semejante, o incluso mayor, de premisas que de conclusiones. Así, encontramos una forma alternativa para una axiomatización posible en Acerca del cielo de Aristóteles.
Psicología descriptiva y ‘mereología’ en Carl Stumpf
Authors: Niel Luis Ignacio
Published: October 2018

El artículo analiza la teoría de todos y partes (mereología) de CarlStumpf. Por un lado, se presentan los elementos básicos de su psicología descriptiva de la experiencia. Por otro lado, se analiza el desarrollo de la teoría de todos y partes sobre la base de dicha psicología descriptiva. El trabajo pretende probar dos tesis complementarias: primero, si bien la teoría mereológica de Stumpf es aún incipiente y no del todo explícita, constituye un auténtico punto de partida. Segundo, dicha mereología surge a partir de una atenta descripción de la experiencia dada y no es algo impuesto a ésta.
Epistemología de la administración: objeto, estatuto, desarrollo disciplinar y método
Authors: Mendoza Guerra José María
Published: October 2018

En este artículo se aborda el desarrollo discursivo de la administración, untema que es fundamental para entender el área y concebir la posibilidadde ampliar su horizonte. En primer lugar, se trabaja el objeto discipinar, elcual se considera que son los procesos de conducción de la gente hacia resultados en las organizaciones. Luego, se trata el punto de la naturaleza disciplinar de la admnistración y se ubica dentro de las disciplinas de acción, lo cual la conduce a la utilización de enunciados del tipo acción-resultados, en línea con la razón práctica. A continuación, se presentan los momentos cruciales de su evolución: primero, se expone la visión convencional, y luego se proponen formas alternativas de concebir la dinámica discursiva. Por último, se plantea la forma como se ajustan a esta dinámica los métodos de investigación.
Transforming cooperation practices into individual routines: an analysis of firms inserted in cooperation networks
Authors: Beltrame Gabriela , Diniz Pereira Breno Augusto
Published: October 2018

This research study aims to identify new organizational routines practiced by firms that are members of horizontal interorganizational networks as a result of knowledge acquired through cooperation. Based on the study by Provan, Fish and Sydow (2007), four different ways to share knowledge in a network are proposed. The method is an exploratory, qualitative approach through a multi-case study. The units of analysis are ten firms that are members of two supermarket networks. In-depth interviews with managers were performed and analyzed by content analysis. This research study brings empirical and theoretical contributions, shedding light on how shared knowledge in a network can transform and develop companies,allowing small details and simple information to contribute to companies’ growth and permanence in the market.