bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction of Vertebral Bone Defects using an Expandable Replacement Device and Bioactive Glass S53P4 in the Treatment of Vertebral Osteomyelitis: Three Patients and Three Pathogens
Authors: Kankare J. , Lindfors N. C.
Published: March 2016

Background and Aims:

Bioactive glass S53P4 is an antibacterial bone substitute with bone-bonding and osteostimulative properties. The bone substitute has been successfully used clinically in spine; trauma; orthopedic; ear, nose, and throat; and cranio-maxillofacial surgeries. Bioactive glass S53P4 significantly reduces the amount of bacteria in vitro and possesses the capacity to kill both planktonic bacteria and bacteria in biofilm. Three patients with severe spondylodiscitis caused by Mycobacterium tuberculosis, Candida tropicalis, or Staphylococcus aureus were operatively treated due to failed conservative treatment. The vertebral defects were reconstructed using bioactive glass S53P4 and an expandable replacement device.

Material and Methods:

Decompression and a posterolateral spondylodesis, using transpedicular fixation, were performed posteriorly in combination with an anterior decompression and reconstruction using an expandable vertebral body replacement device. For patients 1 and 2, the expander was covered with bioactive glass S53P4 only, and for patient 3, the glass was mixed with autograft bone.

Results:

The patients healed well with complete neurological recovery. Fusion was observed for all patients. The total follow-up was 4 years for patient 1, 1 year and 8 months for patient 2, and 2 years and 2 months for patient 3. No relapses or complications were observed.

Conclusion:

The antibacterial properties of bioactive glass S53P4 also make it a suitable bone substitute in the treatment of severe spondylodiscitis.
Ultrasound Screening of Men with Coronary Artery Disease for Abdominal Aortic Aneurysms: A Prospective Dual Center Study
Authors: Vänni V. , Hakala T. , Mustonen J. , Turtiainen J. , Rissanen T. T. , Kajander O. , Ilveskoski E. , Koivumäki J. , Eskola M. , Hernesniemi J.
Published: March 2016

Background and Aims:

According to the heterogeneous results of previous studies, the prevalence of abdominal aortic aneurysm seems high among men with coronary artery disease. The associating risk factors for abdominal aortic aneurysm in this population require clarification. Our objective was to assess the prevalence of non-diagnosed abdominal aortic aneurysms in men with angiographically verified coronary artery disease and to document the associated co-morbidities and risk factors.

Material and Methods:

Altogether, 407 men with coronary artery disease were screened after invasive coronary angiography in two series at independent centers. Risk factor data were recorded and analyzed.

Results and Conclusion:

The mean age of the study cohort was 70.0 years (standard deviation: 11.0). The prevalence of previously undiagnosed abdominal aortic aneurysms in the whole screened population of 407 men was 6.1% (n = 25/407). In a multivariate analysis of the whole study population, the only significant risk factors for abdominal aortic aneurysm were age (odds ratio: 1.04, 95% confidence interval: 1.00–1.09) and history of smoking (odds ratio: 3.13, 95% confidence interval: 1.26–7.80). Non-smokers with abdominal aortic aneurysm were significantly older than smokers (mean age: 80.7 (standard deviation: 8.0) vs 68.0 (standard deviation: 11.1), p = 0.003), and age was a significant risk factor only among non-smokers (p = 0.011; p = 0.018 for interaction). Among smokers, the prevalence of abdominal aortic aneurysm was 8.8%, and 72% (n = 18/25) of all diagnosed abdominal aortic aneurysm patients were smokers. Prevalence of undiagnosed abdominal aortic aneurysms among patients with coronary artery disease is high, and history of smoking is the most significant risk factor for abdominal aortic aneurysm. Effectiveness of selective screening of abdominal aortic aneurysm in male patients with coronary artery disease warrants further studies.
Comparison Between Minimally Invasive and Open Gastrectomy for Gastric Cancer in Europe: A Systematic Review and Meta-analysis
Authors: Kostakis I. D. , Alexandrou A. , Armeni E. , Damaskos C. , Kouraklis G. , Diamantis T. , Tsigris C.
Published: March 2016

Aims:

We compared laparoscopic and robotic gastrectomies with open gastrectomies and with each other that were held for gastric cancer in Europe.

Methods:

We searched for studies conducted in Europe and published up to 20 February 2015 in the PubMed database that compared laparoscopic or robotic with open gastrectomies for gastric cancer and with each other.

Results:

We found 18 original studies (laparoscopic vs open: 13; robotic vs open: 3; laparoscopic vs robotic: 2). Of these, 17 were non-randomized trials and only 1 was a randomized controlled trial. Only four studies had more than 50 patients in each arm. No significant differences were detected between minimally invasive and open approaches regarding the number of retrieved lymph nodes, anastomotic leakage, duodenal stump leakage, anastomotic stenosis, postoperative bleeding, reoperation rates, and intraoperative/postoperative mortality. Nevertheless, laparoscopic procedures provided higher overall morbidity rates when compared with open ones, but robotic approaches did not differ from open ones. On the contrary, blood loss was less and hospital stay was shorter in minimally invasive than in open approaches. However, the results were controversial concerning the duration of operations when comparing minimally invasive with open gastrectomies. Additionally, laparoscopic and robotic procedures provided equivalent results regarding resection margins, duodenal stump leakage, postoperative bleeding, intraoperative/postoperative mortality, and length of hospital stay. On the contrary, robotic operations had less blood loss, but lasted longer than laparoscopic ones. Finally, there were relatively low conversion rates in laparoscopic (0%–6.7%) and robotic gastrectomies (0%–5.6%) in most studies.

Conclusion:

Laparoscopic and robotic gastrectomies may be considered alternative approaches to open gastrectomies for treating gastric cancer. Minimally invasive operations are characterized by less blood loss and shorter hospital stay than open ones. In addition, robotic procedures have less blood loss, but last longer than laparoscopic ones.
Hemorrhage after Major Pancreatic Resection: Incidence, Risk Factors, Management, and Outcome
Authors: Ansari D. , Tingstedt B. , Lindell G. , Keussen I. , Ansari D. , Andersson R.
Published: March 2016

Background and Aims:

Hemorrhage is a rare but dreaded complication after pancreatic surgery. The aim of this study was to examine the incidence, risk factors, management, and outcome of postpancreatectomy hemorrhage in a tertiary care center.

Materials and Methods:

A retrospective observational study was conducted on 500 consecutive patients undergoing major pancreatic resections at our institution. Postpancreatectomy hemorrhage was defined according to the International Study Group of Pancreatic Surgery criteria.

Results:

A total of 68 patients (13.6%) developed postpancreatectomy hemorrhage. Thirty-four patients (6.8%) had a type A, 15 patients (3.0%) had a type B, and the remaining 19 patients (3.8%) had a type C bleed. Postoperative pancreatic fistula Grades B and C and bile leakage were significantly associated with severe postpancreatectomy hemorrhage on multivariable logistic regression. For patients with postpancreatectomy hemorrhage Grade C, the onset of bleeding was in median 13 days after the index operation, ranging from 1 to 85 days. Twelve patients (63.2%) had sentinel bleeds. Surgery lead to definitive hemostatic control in six of eight patients (75.0%). Angiography was able to localize the bleeding source in 8/10 (80.0%) cases. The success rate of angiographic hemostasis was 8/8. (100.0%). The mortality rate among patients with postpancreatectomy hemorrhage Grade C was 2/19 (10.5%), and both fatalities occurred late as a consequence of eroded vessels in association with pancreaticogastrostomy.

Conclusion:

Delayed hemorrhage is a serious complication after major pancreatic surgery.Sentinel bleed is an early warning sign. Postoperative pancreatic fistula and bile leakage are important risk factors for severe postpancreatectomy hemorrhage.
A discrete event simulation tool to support and predict hospital and clinic staffing
Authors: DeRienzo Christopher M , Shaw Ryan J , Meanor Phillip , Lada Emily , Ferranti Jeffrey , Tanaka David
Published: March 2016

We demonstrate how to develop a simulation tool to help healthcare managers and administrators predict and plan for staffing needs in a hospital neonatal intensive care unit using administrative data. We developed a discrete event simulation model of nursing staff needed in a neonatal intensive care unit and then validated the model against historical data. The process flow was translated into a discrete event simulation model. Results demonstrated that the model can be used to give a respectable estimate of annual admissions, transfers, and deaths based upon two different staffing levels. The discrete event simulation tool model can provide healthcare managers and administrators with (1) a valid method of modeling patient mix, patient acuity, staffing needs, and costs in the present state and (2) a forecast of how changes in a unit’s staffing, referral patterns, or patient mix would affect a unit in a future state.
Learning while (re)configuring: Business model innovation processes in established firms
Authors: Berends Hans , Smits Armand , Reymen Isabelle , Podoynitsyna Ksenia
Published: March 2016

This study addresses the question of how established organizations develop new business models over time, using a process research approach to trace how four business model innovation trajectories unfold. With organizational learning as analytical lens, we discern two process patterns: “drifting” starts with an emphasis on experiential learning and shifts later to cognitive search; “leaping,” in contrast, starts with an emphasis on cognitive search and shifts later to experiential learning. Both drifting and leaping can result in radical business model innovations, while their occurrence depends on whether a new business model takes off from an existing model and when it goes into operation. We discuss the implications of these findings for theory on business models and organizational learning.
Collecting Social Network Data from Mobile Phone SIM Cards
Authors: Peseckas Ryan
Published: February 2016

I used a subscriber identity module card reader to copy the lists of saved contacts from 170 mobile phones in Fiji. This approach has both advantages and disadvantages compared to other techniques for collecting telephone network data. Copying phone contacts avoids recall biases associated with survey-based name generators. It also obviates the need to obtain calling records from network service providers or to provide research subjects with specialized phones. In markets with multiple service providers, or in contexts in which mobile phones are shared extensively, the contents of contact lists may represent personal networks more accurately than actual calling records do. However, owners’ varying durations of phone ownership and varying tendencies to save and delete contacts are sources of error. Also, copying contacts from phones relies on self-reports of tie strength, which are frequently inaccurate. I analyze the data I collected in rural Fiji to evaluate these sources of error.
Estimating the Value of Medal Success in the Olympic Games
Authors: Humphreys Brad R. , Johnson Bruce K. , Mason Daniel S. , Whitehead John C.
Published: February 2016

We estimate Canadians’ willingness to pay (WTP) for medals won by Team Canada in the 2010 Winter Olympic Games using data from contingent valuation method (CVM) surveys of nationally representative samples conducted before and after the Games. The results permit an assessment of Own the Podium, a government program designed to increase Canada’s medal count. International prestige and national pride are important determinants of WTP. The results are sensitive to cost and scope, respondents’ beliefs about the effectiveness of the program, as measured by expected medal count. WTP estimates suggest that Own the Podium generated benefits above its cost to a degree unique in the growing literature of sport CVM studies.
Criminology, Gender, and Race
Authors: Chesney-Lind Meda , Chagnon Nicholas
Published: February 2016

Criminology has historically exhibited a significant gender bias. Yet, spurred by feminist efforts, criminology has become more gender-inclusive recently. Research has documented this bias, and gains made by women. However, much of this research examines only gender bias, ignoring other important factors such as race. In this article, we examine gender and racial bias in criminology, conceptualizing the discipline as a Bourdieusian field, characterized by hierarchically arranged positions. We find that though women are present in nearly equal numbers to men, non-White people have a more limited presence, and White men dominate in positions endowed with the highest amounts of prestige and power.
‘It’s a matter of your personality more than anything else’
Authors: Etheridge Leanne , Senior Hannah
Published: March 2016

The impact on full-time carers of children with intellectual disabilities who exhibit challenging behaviour has been well researched (e.g. Lach et al., 2009; Shah et al., 2010; Wodehouse and McGill, 2009), however, there is to date no published research into the impact of behaviour that challenges on seasonal carers. Five participants who had been employed in summer playschemes for children and young people (up to the age of 18) were interviewed about their experiences of behaviour that challenges. The transcripts were analysed using interpretative phenomenological analysis, which revealed six superordinate themes: the belief in and sanctuary of temporary work, emotional impact, personality and gender, strength through knowledge, communication difficulties and the belief in integration. Seasonal workers discussed suppressing their emotions in order to stay in control of a challenging situation, using coping styles developed through experience or based on personal skills; it is suggested that formalized training, particularly regarding non-verbal communication, would support playscheme workers in the management of and adaption to challenging behaviour.
Three-month risk-benefit profile of anticoagulation after stroke with atrial fibrillation: The SAMURAI-Nonvalvular Atrial Fibrillation (NVAF) study
Authors: Arihiro Shoji , Todo Kenichi , Koga Masatoshi , Furui Eisuke , Kinoshita Naoto , Kimura Kazumi , Yamagami Hiroshi , Terasaki Tadashi , Yoshimura Sohei , Shiokawa Yoshiaki , Kamiyama Kenji , Takizawa Shunya , Okuda Satoshi , Okada Yasushi , Nagakane Yoshinari , Kameda Tomoaki , Hasegawa Yasuhiro , Shibuya Satoshi , Ito Yasuhiro , Nakashima Takahiro , Takamatsu Kazuhiro , Nishiyama Kazutoshi , Matsuki Takayuki , Homma Kazunari , Takasugi Junji , Tokunaga Keisuke , Sato Shoichiro , Kario Kazuomi , Kitazono Takanari , Toyoda Kazunori ,   for the SAMURAI Study Investigators
Published: March 2016

Aims

This study was performed to determine the short-term risk-benefit profiles of patients treated with oral anticoagulation for acute ischemic stroke or transient ischemic attack using a multicenter, prospective registry.

Methods

A total of 1137 patients (645 men, 77 ± 10 years old) with acute ischemic stroke/transient ischemic attack taking warfarin (662 patients) or non-vitamin K antagonist oral anticoagulants (dabigatran in 205, rivaroxaban in 245, apixaban in 25 patients) for nonvalvular atrial fibrillation who completed a three-month follow-up survey were studied. Choice of anticoagulants was not randomized. Primary outcome measures were stroke/systemic embolism and major bleeding.

Results

Both warfarin and non-vitamin K antagonist oral anticoagulants were initiated within four days after stroke/transient ischemic attack onset in the majority of cases. Non-vitamin K antagonist oral anticoagulant users had lower ischemia- and bleeding-risk indices (CHADS2, CHA2DS2-VASc, HAS-BLED) and milder strokes than warfarin users. The three-month cumulative rate of stroke/systemic embolism was 3.06% (95% CI 1.96%–4.74%) in warfarin users and 2.84% (1.65%–4.83%) in non-vitamin K antagonist oral anticoagulant users (adjusted HR 0.96, 95% CI 0.44–2.04). The rate of major bleeding was 2.61% (1.60%–4.22%) and 1.11% (0.14%–1.08%), respectively (HR 0.63, 0.19–1.78); that for intracranial hemorrhage was marginally significantly lower in non-vitamin K antagonist oral anticoagulant users (HR 0.17, 0.01–1.15). Major bleeding did not occur in non-vitamin K antagonist oral anticoagulant users with a CHADS2 score <4 or those with a discharge modified Rankin Scale score ≤2.

Conclusions

Stroke or systemic embolism during the initial three-month anticoagulation period after stroke/transient ischemic attack was not frequent as compared to previous findings regardless of warfarin or non-vitamin K antagonist oral anticoagulants were used. Intracranial hemorrhage was relatively uncommon in non-vitamin K antagonist oral anticoagulant users, although treatment assignment was not randomized. Early initiation of non-vitamin K antagonist oral anticoagulants during the acute stage of stroke/transient ischemic attack in real-world clinical settings seems safe in bleeding-susceptible Japanese population.
A Welcomed Intrusion
Authors: Warne Russell T.
Published: February 2016

Card and Giuliano conducted a regression discontinuity study in a large Florida school district to investigate the magnitude of academic benefits of the district’s gifted program. They found that for children identified as gifted through an intelligence test, the program provided few or no benefits. But children who were admitted to the gifted program because of high achievement test scores received academic benefits in multiple school subjects. This study—performed by economists with no vested interest in educational theory or practice—is a welcomed contribution to the gifted education research because it touches upon issues of identification, diversity, program evaluation, and more. However, Card and Giuliano’s contributions to gifted education theory are more limited. Nevertheless, gifted education is better off because of their study, and I welcome other “intrusions” from non-educational scholars into gifted education research.
Universal Screening and the Representation of Historically Underrepresented Minority Students in Gifted Education
Authors: Lakin Joni M.
Published: February 2016

A research paper by Card and Giuliano took advantage of a natural experiment in a large school district to explore the impact that universal screening policies had on the identification of historically underrepresented minorities in gifted and talented programs. The authors concluded that the universal screening system was more effective than the previous teacher and parent referral system in addressing the underidentification of African American, Hispanic, female, low socioeconomic status, and English learner students. However, the present article identified gaps in the system that allowed new inequities to emerge. This review of their study concludes that districts must be advocates for gifted and talented students who come from culturally and linguistically diverse backgrounds. Implementing universal screening procedures can be an important tool in ensuring fair access to gifted and talented services, but districts must manage the increased resource demands of such programs.
Commentary Regarding Bui, Craig, and Imberman (2011)
Authors: Moon Tonya R.
Published: February 2016

Using data from a large southwestern school district, Bui, Craig, and Imberman investigated the effects of gifted and talented programming on middle school students’ achievement and behavior (attendance and discipline) through two avenues. Using a regression discontinuity design for the first set of analyses, the authors took advantage of a discontinuity in eligibility requirements at the cut-score; the second set of analyses used data from randomized lotteries of two oversubscribed Gifted and Talented (GT) magnet schools. Findings from both sets of analyses revealed no discernable impact on student outcomes, with the exception in the area of science for the students attending the GT magnet schools. This commentary highlights both the methodological and practical considerations of the study’s findings and the importance of policies and procedures being based on high-quality evidence sources.
What You Don’t Look For, You Won’t Find
Authors: McBee Matthew T.
Published: February 2016

Card and Giuliano’s National Bureau of Economic Research (NBER) working paper on universal screening is discussed. This commentary provides a brief summary and critique of the article, proposes an explanation of the results in light of the author’s research on the role of nominations or screening tests in the gifted identification process, and discusses the methodological implications of this work for the field.
Commentary—Sorting It Out
Authors: Coleman Mary Ruth Blackwell
Published: February 2016

One of the most challenging decisions made by school system administrators each year is how to assign students to teachers. This decision, usually guided by the administrator’s beliefs and values, has major implications for the teacher and the student. Collins and Gan undertook a complex study to examine the impact of grouping practices on student achievement within 135 schools in the Dallas independent school district. Their study addressed three issues: (a) how schools sort students into classes, (b) the effect of these sorting practices on student performance, and (c) differences in effects for different groups of students. They looked at the “tracking effect” on high- and low-achieving students, students who had been identified for special (SPED) and gifted (GT) education, and for students with limited English proficiency (LEP). This commentary explores the implications of this study for students with gifts and talents.
Egocentric publics and corrective action
Authors: Rojas Hernando , Barnidge Matthew , Abril Eulàlia P.
Published: March 2016

This study examines whether the emerging communication environment makes people perceive media as more or less biased. Do social media contribute to the perception of a hostile media environment? Or do they promote a “friendly” media phenomenon through processes of selective affiliation/exposure and/or user filtration of disagreeable content? Based on the idea of egocentric publics, that is, the emergence of socially networked publics that are key for our understanding of current communication processes and examining these questions in a politically polarized society—Colombia—results indicate that reliance on social media for news exacerbates the perceptions of media bias. These perceptions of bias in turn foster political action in both the “campaigning” and “complaining” dimensions of political engagement. Thus, egocentric publics can be sources of political mobilization, but part of their mobilizing influence works through perceptions of a biased communication environment. Implications of these findings are discussed.
Impact of social networks on healthy behaviors: An example of breastfeeding in western China
Authors: Zhao Yandong , Hu Qiaoxian
Published: March 2016

Most researchers agree that social networks have a positive impact on people’s health. However, more studies are needed to explore how social networks affect health. Some researchers argue that networks promote health by improving people’s healthy behaviors. However, this argument needs further empirical testing. Based on a large-scale survey in western China, this article studies the relationship between social networks and one particular form of healthy behavior, namely breastfeeding. Our results show that a new mother with a network consisting mainly of strong ties is more likely to obtain social support for breastfeeding her infant, especially in early infancy. Meanwhile, if there are any medical professionals in a mother’s social network, she will be more likely to breastfeed her baby. We conclude that social networks enhance people’s healthy behaviors by providing social support and information and thus can be helpful in improving people’s general health.
The 2014 Indonesian general election and beyond
Authors: Trihartono Agus , Patriadi Himawan Bayu
Published: March 2016

This study investigates Lipset-Rokkan’s “freezing hypothesis” based on the contemporary Indonesia cleavages by analyzing the 2014 election together with the previous elections. This study found the endured cleavages are ethnic and aliran (literally, “stream”), which consist of the competing abangan (nominal Muslim) and santri (devout Muslim) cleavages. Both had been “frozen,” or existed latantly, during the New Order, but they revived afterwards. However, the ethnic cleavage arguably has been “melted” faster than the aliran one as the former seems to be more vulnerable to other political appeals. The aliran, in contrast, is somewhat callous due to its complex basis. This paper also suggests that, because the strength of any individual cleavage may vary from one region to another, capturing the empirically existing cleavages better may require going to regional or district levels instead of being solely reliant on a national-level study. This study underscores that the cleavages in the form of ethnicity and aliran cannot simply be abandoned in the elections in Indonesia. It is even suggested that the aliran may be one of the dimensions of the endogeneity of voters’ religio-political identity.
A Traditional Mouthwash (Punica granatum var pleniflora) for Controlling Gingivitis of Diabetic Patients
Authors: Sedigh-Rahimabadi Massih , Fani Mohammadmehdi , Rostami-chijan Mahsa , Zarshenas Mohammad M. , Shams Mesbah
Published: February 2016

This study evaluates the safety and efficacy of Punica granatum var pleniflora mouthwash in treatment of diabetic gingivitis. In a double-blind randomized clinical trial 80 patients with diabetes mellitus and gingivitis were assigned to Golnaar and chlorhexidine 0.2% groups. After using mouthwashes for 2 weeks; participants underwent tooth scaling and the last visit was 2 weeks after scaling. The primary outcome measures were plaque, modified gingival and gingival bleeding indices, and pocket depth. Both interventions had significant improvement on all of the gingival and plaque indices ( P < .001 for all indices). There were no significant differences between Golnaar and chlorhexidine in primary outcome measures except for modified gingival index for which Golnaar mouthwash had a superiority after 2 weeks when comparing with chlorhexidine ( P = .039). Meanwhile, Golnaar mouthwash had no staining effect. Golnaar mouthwash is safe and effective in treatment of gingivitis in diabetic patients although further studies are recommended.
Framing the Future
Authors: Petersen Donna J.
Published: March 2016

The Framing the Future Task Force identified critical roles for community colleges in the spectrum of education in public health. The time for innovation is now.
False Start but High Hopes
Authors: Mulhorn Kristine A.
Published: March 2016

This article explains how a good idea to provide bachelor’s degree completion with great convenience to community college students needed much more planning and discussion among all stakeholders, before final implementation. It discusses the creation of a “network initiative” between a 4-year private, medium-sized urban research university in the northeastern United States and a suburban community college to offer several bachelor’s degree completions. More specifically, the article explains the process to articulate an associate degree in health services administration to the Bachelor of Science degree. While this network had a “false start,” there is hope that involving community colleges in the pipeline to prepare more health services managers is a prudent effort, given the rise in need for almost all health services occupations.
Instrumental Music Educators’ Experiences in a Professional Development Course
Authors: Draves Tami J.
Published: March 2016

The purpose of this research was to investigate the experiences of instrumental music teachers in Designing Arts Instruction, a 4-day professional development course in a large urban school district. Specifically, I was interested in which activities participants (a) found most relevant and applicable to their current teaching situation, (b) believed would most benefit student learning, and (c) believed would contribute most to their overall music teacher development. Multiple forms of data were collected including participants’ reflections, researcher-facilitator journal and field notes, and structured individual interviews. Curriculum development and rubric writing were relevant to participants’ teaching situations and also engaged teachers’ personal musicianship. Participants recognized creative activities as motivating for students. Collaboration emerged as the course feature that contributed most to participants’ overall development. Those who plan and facilitate professional development might consider including aspects that invite collaboration, deep thinking, engagement, and reflection, particularly within the context of teachers’ musicianship.
Short-course treatment for multidrug-resistant tuberculosis: the STREAM trials
Authors: Moodley Riya , Godec Thomas R.
Published: March 2016

Multidrug-resistant (MDR) tuberculosis (TB) is a threat to global TB control, as suboptimal and poorly tolerated treatment options have resulted in largely unfavourable outcomes for these patients. The last of six cohort studies conducted in Bangladesh which assessed a new shorter regimen using currently available TB drugs showed promising results and offered the possibility of a more acceptable and more effective regimen than the one recommended by the World Health Organization (WHO). The aims of stage 1 of the STREAM (Evaluation of a Standardised Treatment Regimen of Anti-tuberculosis Drugs for Patients with Multidrug-resistant Tuberculosis) trial are to evaluate the efficacy and safety of this regimen, compared to the current WHO-recommended standard of care. Stage 2 evaluates two new bedaquiline-containing regimens: one an all-oral regimen and the second a further shortened and simplified version of the stage 1 study regimen, comparing the efficacy and safety of each to that of the stage 1 study regimen and also to the WHO-recommended standard of care. Success of the stage 1 study regimen would in all probability provide a new standard of care for MDR-TB patients, while positive results from the bedaquiline-containing regimens in stage 2 may allow for even greater progress in the management of this difficult population.
The role of moxifloxacin in tuberculosis therapy
Authors: Gillespie Stephen H.
Published: March 2016

Tuberculosis (TB) remains a global threat with more than 9 million new infections. Treatment remains difficult and there has been no change in the duration of the standard regimen since the early 1980s. Moreover, many patients are unable to tolerate this treatment and discontinue therapy, increasing the risk of resistance. There is a growing tide of multidrug resistance and few effective antibiotics to tackle the problem. Since the turn of the millennium there has been a surge in interest in developing new therapies for TB and a number of new drugs have been developed. In this review the repurposing of moxifloxacin, an 8-methoxy-fluoroquinolone, for TB treatment is discussed. The evidence that underpins the development of this agent is reviewed. The results of the recently completed phase III trials are summarised and the reasons for the unexpected outcome are explored. Finally, the design of new trials that incorporate moxifloxacin, and that address both susceptible disease and multidrug resistance, is described.
Population physiologically-based pharmacokinetic model incorporating lymphatic uptake for a subcutaneously administered pegylated peptide
Authors: Offman Elliot , Phipps Colin , Edginton Andrea N.
Published: March 2016

Purpose

Physiologically-based pharmacokinetic (PBPK) models provide a rational mechanistic approach for predicting the time course of macromolecules in plasma. Population PBPK models for large molecules necessitate incorporation of lymphatic circulation to mechanistically account for biodistribution. Moreover, characterization of subcutaneous absorption requires consideration of the microvascular transit from the injection site to the systemic circulation. A PBPK model for a pegylated peptide conjugate, previously developed for primates, was modified to describe the lymphatic uptake in a population of humans by incorporation of interindividual variability in the lymphatic circulation and a unique lymphatic drainage compartment (LDC). The model was then used to simulate the time course of the drug in a population of humans and compared to the same drug administered to a group of human subjects participating in a first-in-human study.

Methods

Organ, blood and lymph masses for the population were sampled from either normal or log-normal distributions. Blood flows were calculated for each organ based on mean organ perfusion per gram of organ tissue and lymphatic flow was set as a fixed fraction of blood flow. Interindividual variability in lymphatic volume was assumed to be similar to that of blood volume. The volume of the LDC was parameterzed as a fraction of the injection volume. Sensitivity analysis was performed to study uncertain parameters and distribution assumptions.

Results

The population generator was capable of simulating a virtual population incorporating the lymphatic circulation. Incorporation of a LDC resulted in similar line shape relative to the observed data and incorporation of anthropometric variability accounted for individual differences in the absorption and elimination phases across all dose cohorts. Line shape was sensitive to the inclusion of LDC while peak and elimination portions of the time course were influenced by the magnitude of variance assumed for blood volume and renal clearance, respectively.

Conclusion

Lymphatic circulation can be incorporated into a population PBPK model assuming similar interindividual variability as observed for blood volume. Incorporation of an LDC, where the volume of this transit compartment is proportional to the SC injection volume may be an important mechanistic means of predicting the transit from the SC depot to the systemic circulation.
Clinical vignettes and global health considerations of infertility care in under-resourced patients
Authors: Chow Erika Tiffanie , Mahalingaiah Shruthi
Published: March 2016

The ability to receive standard of care for a diagnosis of infertility is a factor of one’s financial state and educational level, which are often correlated. Providing infertility care in an under-resourced tertiary care environment provides challenges but also opportunities for unique successes in creating a family. Among the under-represented populations are recent immigrants and refugees. Challenges arise when the infertility treatment is futile or when the standard of care is inaccessible due to cost and scheduling. Unique accomplishments are noted when families are built and hope is restored for couples fleeing from genocide and war-inflicted countries. This article will highlight two clinical vignettes from the Division of Reproductive Endocrinology and Infertility clinic at Boston University School of Medicine/Boston Medical Center. Thereafter, the article will summarize the barriers to care in the United States among those with low socioeconomic status, with non-dominant racial status (non-Caucasian), and with refugee status. All identifiers have been removed and names altered in the patient vignettes.
Alcohol misuse in older people
Authors: Rao Rahul , Crome Ilana
Published: March 2016

The clinical and public mental health aspects of alcohol misuse in older people (both men and women) have increasing relevance for both old age and addiction psychiatrists. Clinical presentations are often complex and involve a number of different psychiatric, physical and psychosocial factors. The assessment, treatment and aftercare of alcohol-related and comorbid other mental disorders will also involve a broad range of interventions from a wide range of practitioners. Given its growing clinical relevance, there are particular areas, such as alcohol-related brain damage and drug interactions with alcohol, that deserve special attention.
Iatrogenic harm from psychological therapies – time to move
on
Authors: Parry Glenys D. , Crawford Mike J. , Duggan Conor
Published: March 2016

The problem of adverse effects of psychotherapy has been recognised for
decades, yet research on causes and prevention of harm has failed to
progress. There is confusion between different definitions and a lack of
systematic recording and reporting. A new framework for moving this field
forward is proposed.
Psychotherapies should be assessed for both benefit and
harm
Authors: Scott Jan , Young Allan H.
Published: March 2016

The past four decades have witnessed a transformation in research on the
benefits of psychological therapies. However, even though therapists
highlight that negative and adverse effects are seen in day-to-day practice,
research on the negative effects of psychotherapy is insufficient. Given the
unrelenting popularity of therapies, the argument for examining the adverse
effects of psychotherapy would seem to be compelling. Such a strategy would
extend beyond supervision of individual therapists to the introduction of
monitoring systems that allow for a more systematic examination of failed
psychotherapy interventions (such as exist for medication prescribing). The
starting point could be the development of a consensus on how to define,
classify and assess psychotherapy side-effects, unwanted events, adverse
reactions, etc. This would provide a conceptual framework for communication,
monitoring and research. This approach should not be viewed as an attack on
therapies: every branch of medicine learns from mistakes, the same must
surely be true for psychological treatments.
Nucleophilic Attack of R-lithium at Tetrahedral Silicon in Alkoxysilanes. An Alternate Mechanism
Authors: Furgal Joseph C , Laine Richard M
Published: February 2016

The currently accepted mechanism for nucleophilic attack at silicon in tetraalkoxysilanes, e.g. Si(OEt)4 is suggested to involve formation of penta- and then hexacoordinated intermediates as supported by the apparent exclusive formation of R3SiOR′ and R4Si from nucleophilic attack by RLi and RMgX. Our recent discovery of a direct route from biogenic silica to tetraalkoxyspirosiloxanes prompted us to revisit this reaction as a potential route to diverse silicon-containing species with single Si–C bonds as early studies demonstrate that spirosiloxanes form quite stable pentacoordinated alkoxysilane compounds. As anticipated, Si(2-methyl-2,4-pentanediolato)2 (SP) reacts with RLi (R = Ph, anthracene, phenylacetylene, etc.) at −78 °C to form pentacoordinated Si, e.g. LiPhSP equilibrates with the starting reagents even at 3:1 ratios of PhLi:SP with no evidence for formation of hexacoordinated species by mass spectral, NMR and quenching studies. Thus, quenching with MeI or Me3SiCl allows isolation of monosubstituted products from RLi:SP; RSi(OR′)3 including some ring-opened oligomers. Comparative studies of reactions of PhLi with Si(OEt)4 allows isolation of mono- and disubstituted products again even at 1:1 ratios of PhLi:Si(OEt)4. However, on standing at −78 °C for long periods of time or on warming to 0 °C, the primary product for both reactions is Ph4Si even with 0.5 equivalents of PhLi. At reaction temperatures ≥0 °C the primary product is again Ph4Si. These results suggest that hexacoordinated intermediates are not part of the substitution mechanism and may suggest that the higher-substituted compounds arise from disproportionation processes. We also briefly describe the conversion of anthracenylSP and 9,9-dimethylfluoreneSP to silsesquioxanes.
Governador - Gastos pessoais - Responsabilidade civil
Authors: Pereira Milton Luiz
Published: March 2016

EMENTA: Civil e Processual Civil. Administrativo. Despesas Pessoais. Responsabilidade Civil do Administrador Público. Denúncia Penal Rejeitada. C.F. artigo 105, III. Código Civil, artigos 159, 160, I, 1.521 e 1.525, Código Penal, artigo 91, I. CPC, artigo 541, Parágrafo único. Súmulas211/STJ, 282 e 356/STF. 1. Vezes a basto tem-se dito que a menção ou referências gerais à padrão legal apontado como malferido, por si, não basta à configuração do prequestionamento. É necessária a interpretação e aplicação das disposições legais alçadas na articulação recursal. Deveras, temas não decididos substancialmente nas instâncias ordinárias não configuram a "causa decidida", pressusposto inafastável para o conhecimento na via processual do Recurso Especial (art. 105,III, C.F.). 2. A interposição de Embargos Declaratórios, prequestionando padrões legais sem enunciação material no julgado, não tem suficiência para abrir o pórtico da via Especial. Rejeitados os embargos demais, exige-se a específica argüição de contrariedade ou negativa de ofensa ao artigo 535, I e II, CPC (Súmula 211/STJ). 3. Divergência jurisprudencial sem o cumprimento de expressas exigências formais, não merece conhecimento (art. 541, Parágrafo único, CPC; art. 255, § 1ª, a, b, RISTJ). 4. Recurso não conhecido.
Loteria - Competência estadual - Bingo
Authors: Barroso Luis Roberto
Published: March 2016

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As alterações constitucionais e os limites do poder de reforma
Authors: Gama Guilherme Calmon Nogueira da
Published: March 2016

1. Classificação das Constituições - 2. Esferas ou momentos do poder normativo - 3. As alterações constitucionais - 4. A alteração constitucional formal: a reforma da Constituição - 5. Limites ao poder de reforma - 6. Pontos polêmicos atinentes às limitações materiais - 7.Controle de constitucionalidade da reforma da constituição - 8. Polêmica acerca da necessidade de limitações ao poder de reforma - 9. Conclusão.
Cargo em comissão - Aposentadoria - Função gratificada (TCU)
Authors: Bueno Wagner Pimenta
Published: March 2016

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O princípio da transparência e o aprofundamento dos caracteres fundamentais do direito administrativo
Authors: Taborda Maren Guimarães
Published: March 2016

Introdução. 1 - DEVERES DE TRANSPARÊNCIA E DIREITOS DE PARTICIPAÇÃO. 1.1 Naturez.a e conteúdo do Princípio da Transparência; 1.2 Participação pelo Procedimento Administrativo. II - CONCRETIZAÇÕES DA TRANSPARÊNCIA ADMINISTRATIVA NO BRASIL. 2.1 A lei de processo administrativo Brasileira; 2.1.1 Os princípios e regras fundamentais; 2.1.2 Participação dos interessados e motivação dos atos administrativos; 2.2 Direito de obter informações e certidões; 2.3 A lei de responsabilidade fiscal. Conclusão.
Neoconstitucionalismo e constitucionalização do Direito (O triunfo tardio do direito constitucional no Brasil)
Authors: Barroso Luis Roberto
Published: March 2016

Introdução - Parte I. Neoconstitucionalismo e transformações do direito constitucional contemporâneo - I. Marco histórico - II. Marco filosófico - III. Marco teórico - 1. A força  normativa da Constituição - 2. A expansão da jurisdição constitucional - 3. A nova interpretação constitucional - Parte II. A constitucionalização do Direito - I. Generalidades - II. Origem e evolução do fenômeno - III. A constitucionalização do Direito no Brasil - 1. O direito infraconstitucional na Constituição - 2. A constitucionalização do direito infraconstitucional - 3. Constitucionalização do Direito e seus mecanismos de atuação prática - IV. Alguns aspectos da constitucionalização do Direito - I. Direito civil - 2. Direito  administrativo - 3. Direito penal - 4. Direito processual e outros ramos - V. Constitucionalização e judicialização das relações sociais. Conclusão.
Agências reguladoras independentes e democracia no Brasil
Authors: Binenbojm Gustavo
Published: March 2016

NOTA PRÉVIA - I. Contextualizando as Agências Reguladoras nos Estados Unidos e no Brasil: mão e contramão. - II. O Governo Lula e as agências reguladoras independentes - III. Propostas de aprimoramento do arranjo institucional das agências reguladoras no Brasil. - III.1  Em relação ao princípio da legalidade: rejeição à tese da deslegalização - III.2. Em relação ao sistema de freios e contrapesos: controles ancilares do Executivo e do Legislativo - III.3. Em relação ao dito déficit democrático: controle social e legitimação pelo procedimento - IV. Conclusão.
Mast cell activation is enhanced by Tim1:Tim4 interaction but not by Tim-1 antibodies
Authors: Phong Binh , Kane Lawrence P.
Published: March 2016

Polymorphisms in theT cell (or transmembrane) immunoglobulin and mucin domain 1(TIM-1) gene, particularly in the mucin domain, have been associated with atopy and allergic diseases in mice and human. Genetic- and antibody-mediated studies revealed that Tim-1 functions as a positive regulator of Th2 responses, while certain antibodies to Tim-1 can exacerbate or reduce allergic lung inflammation. Tim-1 can also positively regulate the function of B cells, NKT cells, dendritic cells and mast cells. However, the precise molecular mechanisms by which Tim-1 modulates immune cell function are currently unknown. In this study, we have focused on defining Tim-1-mediated signaling pathways that enhance mast cell activation through the high affinity IgE receptor (FceRI). Using a Tim-1 mouse model lacking the mucin domain (Tim-1Dmucin), we show for the first time that the polymorphic Tim-1 mucin region is dispensable for normal mast cell activation. We further show that Tim-4 cross-linking of Tim-1 enhances select signaling pathways downstream of FceRI in mast cells, including mTOR-dependent signaling, leading to increased cytokine production but without affecting degranulation.
Providing Consistent Opinions from Online Reviews: A Heuristic Stepwise Optimization Approach
Authors: Zhang Zunqiang , Chen Guoqing , Zhang Jin , Guo Xunhua , Wei Qiang
Published: March 2016

The consistency between review summaries and review ranking lists is important for consumers so they can utilize online reviews effectively and efficiently in their purchase decisions. This paper examines this consistency issue and formulates it as an optimization problem. Based on consumers’ reading behaviors, all possible sets of reviews that consumers would read from ranking lists are considered; the objective is to maximize the expected consistency. Because of the NP-hardness of the problem, exact methods that search for the optimal ranking lists are generally not acceptable in practice. Hence, a heuristic approach (the enhanced stepwise optimization procedure) is proposed. This approach is an effective and efficient approximation that selects reviews iteratively to add to the ranking lists in light of expected consistency value, superiority, and execution time. Intensive experiments on both synthetic and real data are conducted, with various environments and settings, along with a relevant user study, revealing that the proposed approach outperforms other related methods.