bluuebunny/crossref_metadata_2025 huggingface dataset:
South Africa’s Foreign Policy and the BRICS Formation: Reflections on the Quest for the ‘Right’ Economic-diplomatic Strategy
Authors: Neethling Theo
Published: January 2017

South Africa’s foreign policy has recently been gravitating away from an appeal to Western powers towards the establishment of new friendships in the Global South, especially with Asia and Latin America. Moreover, the favouring of the Brazil, Russia, India, China and South Africa (BRICS) partnership and a rising tone of anti-Western sentiments have increasingly been evidenced in South Africa’s contemporary foreign policy, which are of major significance to the nature and direction of its economic-diplomatic strategy. Three broad perspectives or main arguments from this article are of special importance: First, most members of BRICS are troubled by slower economic growth, which should be of concern to South Africa’s current foreign policy stand. Second, anti-Western ideological concerns and related presumptions on the part of the South African government that the BRICS formation could potentially assume a counter-hegemonic character vis-à-vis the West are questionable and dubious. Third, South Africa stands to benefit from many networks and opportunities provided by BRICS membership. At the same time, because of its low economic growth, high levels of poverty and lack of employment opportunities, South Africa cannot afford to follow an approach of narrow interest concerning the BRICS formation and to constrain itself in its economic diplomacy. This article argues that the South African government will therefore have to consider the opportunities offered by a more nuanced and pragmatic foreign policy designed on multiple identities.
The Failure of the Third Way in Australia: Implications for Policy about Work
Authors: Buchanan John , Watson Ian
Published: January 2017

This paper assesses whether ‘third way’ style policies can effectively address the key working life issues of today. It does this by reflecting on the experiences of ‘third way’ style policies as they operated in Australia between 1983 and 1996. We show that not only have such style policies failed to effectively address a deteriorating labour market situation, many have in fact been counter productive. We also argue that policies based on the classical wage earner model of employment are equally ineffectual. Instead the paper proposes that key contemporary labour market problems can only be effectively addressed if social, educational and industrial relations policies are integrated around a coherent understanding of key transitions over the life cycle.
Internationalisation and Integration: A Comparison of Manufacturing and Service Firms
Authors: Thompson Paul , Nickson Dennis , Wallace Terry , Jones Carol
Published: January 2017

This paper reports on the results of a three year project examining the processes of internationalisation in two sectors: commercial vehicles and international hotel chains. Through case studies of leading firms it explores a relatively neglected feature of debate: the comparative analysis of manufacturing and services. It focuses on some of the distinct characteristics of internationalisation and corporate integration that have traditionally been argued to distinguish between the two, examining in particular the factors and mechanisms of integration and the consequences in terms of degrees of standardisation. In addition to reporting on the substantive processes of change in commercial vehicles and international hotels, the paper concludes by arguing, contrary to established wisdom, that in some respects internationalisation of services may be more straightforward than manufacturing. The latter is likely to have a more complex set of technical and social filters through which the “product” is assembled and be more embedded in its local environment.
Approaches to Analyzing the Outcomes of International Scholarship Programs for Higher Education
Authors: Mawer Matt
Published: January 2017

International scholarship programs for higher education attract a substantial body of funding each year from national governments, supranational bodies, large charitable foundations, higher education institutions, and many smaller organizations. With aims variously shaped by international development and public diplomacy considerations, international scholarships fund students at higher education institutions worldwide. As the investment in, and scope of, scholarship programs has expanded, concurrent commitment to analysis and evaluation of their outcomes—both to improve policy making and justify further funding—has increased. This article explores several of the key methodological and conceptual challenges in the evaluation of international scholarship outcomes, focusing on the relationship between aims and outcomes, difficulties with “attribution” and “contribution,” and scholarship programs in comparison with their alternatives. The relationship between evidence gathering and policy making is considered in context of international scholarship programs, and several potentially useful future developments in evaluation approaches are suggested.
High-throughput whole genome sequencing of Porcine reproductive and respiratory syndrome virus from cell culture materials and clinical specimens using next-generation sequencing technology
Authors: Zhang Jianqiang , Zheng Ying , Xia Xiao-Qin , Chen Qi , Bade Sarah A. , Yoon Kyoung-Jin , Harmon Karen M. , Gauger Phillip C. , Main Rodger G. , Li Ganwu
Published: January 2017

Next-generation sequencing (NGS) technologies have increasingly played crucial roles in biological and medical research, but are not yet in routine use in veterinary diagnostic laboratories. We developed and applied a procedure for high-throughput RNA sequencing of Porcine reproductive and respiratory syndrome virus (PRRSV) from cell culture–derived isolates and clinical specimens. Ten PRRSV isolates with known sequence information, 2 mixtures each with 2 different PRRSV isolates, and 51 clinical specimens (19 sera, 16 lungs, and 16 oral fluids) with various PCR threshold cycle (Ct) values were subjected to nucleic acid extraction, cDNA library preparation (24-plexed), and sequencing. Whole genome sequences were obtained from 10 reference isolates with expected sequences and from sera with a PRRSV real-time reverse transcription PCR Ct ≤ 23.6, lung tissues with Ct ≤ 21, and oral fluids with Ct ≤ 20.6. For mixtures with PRRSV-1 and -2 isolates (57.8% nucleotide identity), NGS was able to distinguish them as well as obtain their respective genome sequences. For mixtures with 2 PRRSV-2 isolates (92.4% nucleotide identity), sequence reads with nucleotide ambiguity at numerous sites were observed, indicating mixed infection; however, individual virus sequences could only be separated when 1 isolate identity and sequence in the mixture is known. The NGS approach described herein offers the prospect of high-throughput sequencing and could be adapted to routine workflows in veterinary diagnostic laboratories, although further improvement of sequencing outcomes from clinical specimens with higher Ct values remains to be investigated.
A serosurvey for ruminant pestivirus exposure conducted using cattle sera collected for brucellosis surveillance in the United States
Authors: Bauermann Fernando V. , Ridpath Julia F. , Dargatz David A.
Published: January 2017

Four species of ruminant pestivirus are currently circulating in the United States: Bovine viral diarrhea virus 1 and 2 (BVDV-1, -2; predominant host: cattle), Border disease virus (BDV; predominant host: sheep), and pronghorn virus (sporadically detected in wild ruminants). A third bovine pestivirus called HoBi-like virus has been detected in cattle and water buffalo in South America, Asia, and Europe. To date, no isolations of HoBi-like viruses from U.S. cattle have been reported. To assess exposure, 2,000 cattle sera, collected between 2014 and 2015 as part of the U.S. brucellosis surveillance program, were tested for antibodies against BVDV-1, BVDV-2, and HoBi-like viruses. In addition, RNA was extracted and tested by reverse transcription–polymerase chain reaction for the presence of pestiviruses; all samples tested negative. The percent of VN-positive samples was 91.3% for BVDV-1, 89.3% for BVDV-2, and 84.9% for HoBi-like viruses. Because the 3 bovine pestiviruses are antigenically cross-reactive, the comparative level of antibody against each pestivirus species was determined. Based on comparative titers, samples were segregated into 6 categories: no titers (7.6%), titers clearly higher against BVDV-1 (22.2%), titers substantially higher against BVDV-2 (9.1%), BVDV-1 and BVDV-2 titers equivalent but substantially higher than HoBi titers (25.7%), titers substantially higher against HoBi-like viruses (0%), and equivocal (35.4%). Titers tended to be higher against BVDV-1 than BVDV-2. However, the overall percentage of animals with titers below levels considered protective against acute bovine pestivirus infection were ~11% for BVDV-1, 12% BVDV-2, and 18% for HoBi-like virus.
Endosulfan poisoning in canids and felids in the Calabria region of southern Italy
Authors: De Roma Antonella , Rossini Carmela , Riverso Caterina , Galiero Giorgio , Esposito Mauro
Published: January 2017

Endosulfan, a highly toxic insecticide and acaricide, was globally banned under the Stockholm Convention in May 2011 because of its threats to human health and the environment. Despite the ban on its use, endosulfan is still present in the environment, causing poisoning events in domestic animals and wildlife. Toxicologic analysis of poisoned animals conducted by the Istituto Zooprofilattico Sperimentale del Mezzogiorno revealed that in the past 3 y, this pesticide has not disappeared in the regions of interest. More than 650 samples (baits and animal organs) collected from 2013 to 2015 were analyzed through solid-phase extraction followed by gas chromatography–electron capture detection. This methodology allowed us to identify 45 positive samples from the Calabria region of southern Italy (10.2 % of the total samples). Most were samples of gastric content (alpha-endosulfan range: 1.27–3,800 mg/kg) and baits (alpha-endosulfan range: 92–1,497 mg/kg). Lower concentrations of pesticide were found in samples of stomach (alpha-endosulfan: 6.7–118 mg/kg) and liver (alpha-endosulfan: 0.38–14.2 mg/kg).
Using Padlet to Increase Student Interaction With Music Concepts
Authors: Dunbar Laura
Published: January 2017

Padlet, an easy-to-use app, can be used to enhance student discussions and interactions with music content.
Modeling microcapsule-enabled self-healing cementitious composite materials using discrete element method
Authors: Zhou Shuai , Zhu Hehua , Ju J Woody , Yan Zhiguo , Chen Qing
Published: January 2017

Concrete with a micro-encapsulated healing agent is appealing due to its self-healing capacity. The discrete element method (DEM) is emerging as an increasingly used approach for investigating the damage phenomenon of materials at the microscale. It provides a promising way to study the microcapsule-enabled self-healing concrete. Based on the experimental observation and DEM, a three-dimensional damage-healing numerical model of microcapsule-enabled self-healing cementitious materials under compressive loading is proposed. The local healing effect can be simulated in our model, as well as the stress concentration effect and the partial healing effect. The healing variable of the DEM model is developed to describe the healing process. We examine the dependence of the mechanical properties of the microcapsule-enabled self-healing material on (a) the stiffness of the solidified healing agent, (b) the strength of the solidified healing agent, (c) the initial damage of specimens, and (d) the partial healing effect. In particular, the proposed numerical damage-healing model demonstrates the potential capability to explain and simulate the physical behavior of microcapsule-enabled self-healing materials on the microscale.
Setting Confidence Intervals for Drug Concentrations from Pharmacokinetic Parameters
Authors: Inciardi John F. , Willits Neil H.
Published: January 2017

OBJECTIVE:

To describe and illustrate a convenient method of forecasting drug concentrations with confidence intervals (CIs) using the means and standard deviations of relevant pharmacokinetic parameters (e.g., clearance and volume of distribution).

DESIGN:

Using summary statistics from previously published reports, a Monte Carlo technique employing a SAS random number generator creates an arbitrarily large “sample” of each pharmacokinetic parameter. A related “sample” of drug concentrations is provided by inserting the parameters into the appropriate model. A point estimate of the mean drug concentration with a CI is calculated using standard statistical methods. Both the one- and two-compartment body models are illustrated using previous investigations of gentamicin and lidocaine, respectively.

RESULTS:

One-compartment simulations describe CIs for gentamicin concentrations that vary widely depending on the source of the clearance and volume of distribution parameters. Lidocaine CIs using a two-compartment analysis indicate a range of concentrations quite different from the expected mean.

CONCLUSIONS:

CIs provide a perspective of drug therapy that is considerably more informative than a simple point estimate of the mean concentration.
Lack of in Vitro Inactivation of Tobramycin by Imipenem/Cilastatin
Authors: Ariano Robert E. , Kassum Diamond A. , Meatherall Robert C. , Patrick Ward D.
Published: January 2017

OBJECTIVE:

Inactivation of aminoglycosides by beta-lactam antimicrobials both in vitro and in vivo has been documented. Such an interaction has not previously been documented between carbapenems and aminoglycosides. Examination of serum concentrations of tobramycin in a patient receiving both agents suggested that this interaction might exist. The purpose of this study was to look at this question in an in vitro model.

METHODS:

Low concentrations of tobramycin (10 μg/mL) were incubated with imipenem/cilastatin (concentrations of 10, 20, and 40 μg/mL) in human serum at 37°C. Aliquots of these solutions were withdrawn at 0, 6, 24, 72, and 120 hours and assayed for tobramycin concentrations using a fluorescence polarization immunoassay. Aliquots of tobramycin 10 μg/mL and carbenicillin 200 μg/mL were analyzed in the same manner, as a positive control. High concentrations of tobramycin (800 μg/mL) and imipenem (5000 μg/mL)/cilastatin were incubated together at 21°C and sampled at 0, 6, 24, and 72 hours for tobramycin concentrations.

RESULTS:

The degradation rates for low-concentration tobramycin and the various concentrations of imipenem/cilastatin were not statistically different from those of the controlled incubations. In contrast, carbenicillin significantly enhanced the degradation rate of tobramycin at this concentration (half-life 72 hours and a 34 percent loss at 24 hours, p=0.0028). Higher in vitro concentrations of imipenem (5000 μg/mL)/cilastatin and tobramycin (800 μg/mL) resulted in significant, but moderate degradation over controlled incubations (half-life 80 hours and 10 percent loss at 12 hours, p=0.0031).

CONCLUSIONS:

These results suggest that inactivation of tobramycin is not a problem at common clinically achievable imipenem serum concentrations in patients.
Chemical Compatibility of Regional Anesthetic Drug Combinations
Authors: Christie Joan M. , Jones Clifton W. , Markowsky Susan J.
Published: January 2017

OBJECTIVE:

To define the physical and chemical compatibilities of several classes of drugs that may be used in combination for peridural anesthesia.

DESIGN:

Morphine, fentanyl, bupivacaine, lidocaine, tetracaine, ketamine, and clonidine were admixed for one hour in five groups of three-drug combinations, plus one group of all seven drugs. The combinations were inspected macroscopically and microscopically to determine physical compatibility. The admixtures were evaluated by gas chromatography/mass spectroscopy (GC/MS) and compared with known standards to determine chemical compatibility.

RESULTS:

The admixtures showed no physical incompatibility on microscopic or macroscopic evaluation. Chemical compatibility of all mixtures was confirmed by GC/MS. Ion chromatograms of the drugs in admixtures were identical to previously established standards.

CONCLUSIONS:

The agents evaluated demonstrated physical and chemical compatibility under conditions that would be observed during the administration of peridural anesthesia. Combinations of these drugs therefore could be safely admixed for use in anesthesia.
Hypersensitivity and Anaphylactoid Reactions to Ciprofloxacin
Authors: Deamer Robert L. , Prichard John G. , Loman Geoffrey J.
Published: January 2017

OBJECTIVE:

To report three cases of life-threatening hypersensitivity reactions to the oral administration of ciprofloxacin.

CASE SUMMARY:

Life-threatening hypersensitivity reactions to oral ciprofloxacin, characterized by diffuse, erythematous, nonpruritic, blanching rash, with fever and hypotension, occurred in two HIV-infected patients. One of these reactions was considered anaphylactoid. A similar hypersensitivity reaction was documented in a non—HIV-infected patient.

DISCUSSION:

Premarketing clinical trials described no reports of life-threatening anaphylactoid hypersensitivity reactions to ciprofloxacin. However, postmarketing surveillance studies have documented their occurrence. Seven cases of anaphylactoid reaction to ciprofloxacin have now been documented in HIV-infected patients.

CONCLUSIONS:

As with trimethoprim/sulfamethoxazole, HIV-infected people treated with ciprofloxacin may be at special risk for hypersensitivity reactions.
Case Report of a Syncopal Episode Associated with Fluoxetine
Authors: McAnally Laura Engles , Threlkeld Kathy R. , Dreyling Charles A.
Published: January 2017

OBJECTIVE:

To report a syncopal episode associated with fluoxetine in a young, relatively healthy man.

DESIGN:

Single case report.

SETTING:

585-bed private hospital.

PATIENT:

A 30-year-old man with hypertension, esophageal ulcers, and syncope of recent onset.

RESULTS:

Fluoxetine was started six weeks prior to the syncopal episode in this patient, and is the medication most temporally associated with the event. Because the patient had a normal neurologic examination and electroencephalogram, but an abnormal electrocardiogram on admission and one month after discharge, the syncopal episode was most likely caused by cardiovascular effects of fluoxetine.

CONCLUSIONS:

Fluoxetine has been reported to cause cardiac conduction abnormalities in otherwise normal individuals. Bradycardia secondary to a direct effect of fluoxetine, or to a drug interaction among fluoxetine, ranitidine, and enalapril is the most likely explanation for this patient's syncopal episode.
Profuse Diarrhea after Misoprostol Use in a Patient with a History of Crohn's Disease
Authors: Johnson Julie S. , Karboski James A. , Williams Glenys O.
Published: January 2017

OBJECTIVE:

To report a case of profuse diarrhea after misoprostol use in a patient with a history of Crohn's disease and to discuss the role of eicosanoids in Crohn's disease.

DATA SOURCES:

Patient medical records, case reports, review articles identified by MEDLINE, and personal communication with the physician, patient, and manufacturer.

DATA EXTRACTION:

From interviews, the manufacturer, and pertinent published sources by one author and reviewed by the others.

DATA SYNTHESIS:

A 55-year-old woman presented to clinic complaining of multiple joint pains. Her medical history was significant for peptic ulcer disease, hypertension, and Crohn's disease in remission since May 1989. Her joint pains were treated with ibuprofen 600 mg po qid and misoprostol 200 μg po qid (after meals and at bedtime). Following the administration of three doses of ibuprofen and misoprostol, the patient experienced abdominal cramps, pain, and voluminous, watery diarrhea for two days. Upon discontinuation of the ibuprofen and misoprostol, all of her gastrointestinal symptoms resolved within 12 hours. Rechallenge with ibuprofen alone failed to produce a recurrence of symptoms. Enhanced synthesis of intestinal eicosanoids has been demonstrated in Crohn's disease. Misoprostol, a synthetic analog of one of the eicosanoids, could induce a flare-up of Crohn's disease as suggested in this patient.

CONCLUSIONS:

Misoprostol should be used with caution in patients with known inflammatory bowel disease.
The Triglyceride Connection in Atherosclerosis
Authors: Geurian Kristi , Pinson Julianne B. , Weart C. Wayne
Published: January 2017

OBJECTIVE:

To examine the proposed mechanism of triglyceride-induced atherogenesis, to address the controversy surrounding serum triglycerides as a coronary heart disease (CHD) risk factor, and to recommend an appropriate therapeutic approach to hypertriglyceridemia.

DATA SOURCES:

Studies, review articles, and editorials published since 1976. A MEDLINE search of English-language literature was conducted using the terms triglyceride and hypertriglyceridemia.

STUDY SELECTION:

Studies, review articles, and editorials were selected for detailed review if they addressed the pathogenesis of triglyceride-induced atherosclerosis, the controversy associated with elevated serum triglyceride as a CHD risk factor, and hypertriglyceridemia treatment options.

DATA EXTRACTION:

Data were reviewed that described the atherogenicity of chylomicron and very low-density lipoprotein (VLDL) remnants, the inverse relationship that exists between high-density lipoprotein (HDL) and serum triglyceride, the hypertriglyceridemia treatment controversy, and the treatment options of diet, exercise, weight control, alcohol restriction, and medication.

DATA SYNTHESIS:

Hypertriglyceridemia is a well-known risk factor for pancreatitis. However, its role in atherogenesis is less well defined. Several proposed connections appear to exist between hypertriglyceridemia and atherosclerosis, including the inverse correlation between triglycerides and HDL, the presumed atherogenicity of triglyceride-rich lipoprotein remnant particles, the potential resultant increase in the serum concentration and atherogenicity of low-density lipoprotein (LDL), and the proposed interaction between serum triglyceride and the fibrinolytic/coagulation system. Clinical trials addressing this issue offer mixed results that are subject to interpretation. Diet, exercise, weight control, alcohol restriction, and certain lipid-lowering medications are effective at reducing serum triglyceride.

CONCLUSIONS:

Hypertriglyceridemia is a theoretical risk factor for CHD because of the increased production of atherogenic chylomicron and VLDL remnants, the inverse relationship present between serum triglyceride and HDL, the possible resultant increase in LDL attributable to remnant-reduced hepatic LDL-receptors as well as the formation of more dense and, therefore, more atherogenic LDL, and to the interaction between serum triglyceride and the fibrinolytic/coagulation system. However, most clinical trials that have found hypertriglyceridemia to be a risk factor for CHD do not include other CHD risk factors in their analyses. Therapeutic intervention to lower serum triglyceride with diet, exercise, and/or drugs is definitely recommended in the treatment and/or prevention of pancreatitis; however, the role of triglyceride-lowering to reduce CHD risk remains controversial.
Where the Kidney is Concerned, How Much Mannitol is Too Much?
Authors: Rabetoy Gary M. , Fredericks Michael R. , Hostettler Charles F.
Published: January 2017

OBJECTIVE:

To report a case of mannitol-induced acute renal failure (ARF).

CASE SUMMARY:

A 31-year-old woman who had been on long-term warfarin therapy for atrial fibrillation was admitted to the hospital with hemoptysis. Following reversal of her anticoagulation, she had a tonic-clonic seizure nine days after admission. An emergency computed tomography scan revealed cerebral edema, which was initially treated with hyperventilation and steroids. Two days later, a repeat scan showed progression of the cerebral edema with midline shift. Mannitol 550 g was infused over the next 28 hours, precipitating ARF. Despite prompt hemodialysis to reverse the renal failure, the patient died. This case of apparent mannitol-induced ARF illustrates several pathophysiologic effects of this agent.

DISCUSSION:

Case reports in the literature discussing mannitol-induced ARF are reviewed and compared. A relationship between dose and ARF and its reversal with hemodialysis is postulated.

CONCLUSIONS:

It is likely that sufficient doses of mannitol may lead to ARF. Limitation of dose may prevent and treatment with hemodialysis may reverse ARF in these instances.
Gastric Ulcer Perforation Associated with the Use of Injectable Ketorolac
Authors: Estes Lynn L. , Fuhs David W. , Heaton Alan H. , Butwinick Conrad S.
Published: January 2017

OBJECTIVE:

To report a case of a perforated gastric ulcer associated with the use of injectable ketorolac tromethamine.

DATA SYNTHESIS:

A 77-year-old woman with no previous history of peptic ulcer disease developed a perforated gastric ulcer after four days of treatment with ketorolac. To date, six other cases of gastrointestinal (GI) perforation associated with the use of ketorolac have been reported to the manufacturer.

CONCLUSIONS:

Although ketorolac is an effective analgesic, it is a nonsteroidal antiinflammatory agent and thus has the propensity for causing GI ulceration. Caution should be used when administering this drug and patients should be monitored for GI adverse effects.
Antenatal Phenobarbital to Prevent or Minimize Intraventricular Hemorrhage in the Low-Birthweight Neonate
Authors: Barnes Eddilisa R. , Thompson Dennis F.
Published: January 2017

OBJECTIVE:

To review the evidence that antenatal phenobarbital can reduce the incidence or severity of periventricular-intraventricular hemorrhage (PIVH) in low-birthweight neonates.

DATA SOURCES:

MEDLINE searches were conducted with fan searches of all papers.

STUDY SELECTION:

Emphasis was placed on human data supplemented by relevant animal data.

DATA SYNTHESIS:

The barbiturates have been used to reduce hypoxic-ischemic cerebral events. Giving phenobarbital to high-risk pregnant women allows the drug to be in therapeutic concentrations during the critical period when PIVH occurs in low-birthweight infants. Current data suggest that antenatal phenobarbital can decrease the severity of PIVH; fewer data are available stating that it can decrease the incidence of PIVH.

CONCLUSIONS:

Evidence supports the hypothesis that antenatal phenobarbital is effective in decreasing the severity of PIVH in low-birthweight neonates. Further data are necessary regarding the incidence of low Apgar scores and respiratory depression in neonates given antenatal phenobarbital.
Venlafaxine: A Structurally Unique and Novel Antidepressant
Authors: Morton W Alexander , Sonne Susan C , Verga Michael A
Published: January 2017

Objective:

To introduce the new antidepressant venlafaxine. Basic pharmacokinetic data and clinical trials are reviewed, as well as adverse reactions, drug interactions, dosing guidelines, and therapeutic considerations. The article also discusses several pharmacotherapy issues and how venlafaxine compares with other available antidepressants.

Data Sources:

A MEDLINE search was used to identify pertinent literature, including reviews.

Study Selection:

As this is a relatively new agent, all available clinical trials were reviewed.

Data Extraction:

All clinical trials that were available prior to submission for publication were reviewed. Preliminary trials and unpublished reports were not reviewed.

Data Synthesis:

Venlafaxine hydrochloride is a structurally novel agent that has recently been approved in the US for the treatment of depression. This unique antidepressant blocks neuronal reuptake of norepinephrine, serotonin, and, to a lesser extent, dopamine. Venlafaxine and its major active metabolite, O—desmethylvenlafaxine, exhibit linear kinetics with an elimination half-life of 5 and 11 hours, respectively. Venlafaxine has been evaluated in 7 clinical trials for the treatment of depression. These have consisted of 2 open trials, 3 double-blind, placebo-controlled trials, and 2 double-blind trials where venlafaxine was compared with trazodone and imipramine. All 7 trials have established efficacy for venlafaxine using standard psychiatric rating scales to measure change of depressive symptoms. The usual daily dosage ranges from 75 to 225 mg/d in 2 to 3 divided doses, with a maximum daily dosage of 375 mg/d. The drug's adverse effect profile differs somewhat from other more specific serotonin reuptake inhibitors in that it appears to cause dry mouth, somnolence, and elevated blood pressure as well as nausea, headache, and dizziness.

Conclusions:

Although venlafaxine has recently become available for use as an antidepressant in the US, few clinical trials have been conducted to help the practitioner evaluate its place in the treatment of depression. There are no comparative trials of venlafaxine with the serotonin specific reuptake inhibitor antidepressants, which are rapidly becoming the newest comparative standard. The clinical place for venlafaxine in the treatment of depression has yet to be determined.
Bisoprolol: Is This Just Another Beta-Blocker for Hypertension or Angina?
Authors: Johns Thomas E , Lopez Larry M
Published: January 2017

Objective:

To review the pharmacology, pharmacokinetics, and clinical experience with bisoprolol and make recommendations regarding its potential clinical usefulness, as well as considerations for formulary inclusion. To review the clinical pharmacology of torsemide and to compare it with currently available loop diuretics, particularly furosemide.

Data Sources:

Reference citations were sought from Index Medicus and Science Citation Index. Data were collected from abstracts and articles describing experimental studies or blind clinical trials.

Study Selection:

Studies designed in a randomized, blind, and placebo-controlled manner were emphasized. Studies also were included if bisoprolol was evaluated comparatively with other agents in a randomized, blind fashion.

Data Extraction:

Data from human studies published in English were evaluated. Studies were assessed by sample size and the clarity of descriptions of methods and results.

Data Synthesis:

Bisoprolol reduces systolic and diastolic blood pressures in patients with hypertension for a 24-hour dosing interval and is associated with beneficial hemodynamic effects in patients with myocardial ischemia. It is devoid of intrinsic sympathomimetic activity and membrane-stabilizing effects at therapeutic dosages. In patients with hypertension, bisoprolol diminishes plasma renin activity, platelet aggregation, effective renal plasma flow, and creatinine clearance. Bisoprolol has minimal effects on glucose tolerance and plasma lipid profiles. Monotherapy with bisoprolol is as effective as with atenolol, nitrendipine, or nifedipine. Low-dose combination therapy with hydrochlorothiazide is at least as effective as either bisoprolol or hydrochlorothiazide alone. Preliminary experience in the management of angina pectoris suggests that bisoprolol is at least as efficacious as atenolol or verapamil. Thus far, reported adverse effects are similar to those of other beta-blockers. No clinically important drug interactions have been reported at this time.

Conclusions:

Bisoprolol, alone or in combination with hydrochlorothiazide, is safe and effective for the short-term management of hypertension. Its efficacy in the management of stable angina requires further investigation. There is little clinical evidence that distinguishes bisoprolol from other beta-blockers; therefore, its inclusion on an institutional formulary is not recommended.
Propofol Compatibility with other Intravenous Drug Products—Two New Methods of Evaluating IV Emulsion Compatibility
Authors: Michaels Michele R , Stauffer Gene L , Haas Daniel P
Published: January 2017

OBJECTIVE:

To determine the physical compatibility of propofol injection with 77 other drug products using two methods not previously reported.

DESIGN:

Each of 77 drug products were mixed with (1) an equal volume of propofol injection, (2) an equal volume of propofol injection with methylene blue added, and (3) an equal volume of the separated aqueous phase of propofol injection. The mixtures were observed for physical changes, and the turbidity of the aqueousphase mixtures was measured by nephelometry.

SETTING:

A university-affiliated urban teaching hospital.

MAIN OUTCOME MEASURES:

Observed physical changes or changes in turbidity.

RESULTS:

Of the 77 drugs tested, 69 showed immediate evidence of physical change, and the other 8 were found incompatible within 72 hours.

CONCLUSIONS:

Practitioners should not mix the immediately incompatible products with propofol by administering them in the same intravenous line. Caution should be used in simultaneous administration of the other drugs. The new methods were useful in detecting incompatibilities in emulsions.
Comparative Bioavailability and Safety of Two Intramuscular Ceftriaxone Formulations
Authors: Suárez Encarnación C , Grippi Jana R
Published: January 2017

OBJECTIVE:

To determine if two ceftriaxone solutions of different concentrations are bioequivalent when administered intramuscularly.

DESIGN:

Double-blind, single-dose, two-period, randomized crossover study.

SETTING:

A clinical research center.

SUBJECTS:

Seventeen healthy volunteers.

INTERVENTION:

Ceftriaxone 500 mg administered in either 2 or 1.4 mL of lidocaine 1% solution, with final ceftriaxone concentrations of 250 and 350 mg/mL, respectively.

MAIN OUTCOME MEASURES:

Blood samples were assayed for ceftriaxone concentrations with HPLC and pharmacokinetic parameters were calculated from the resulting plasma—concentration time profiles: maximum plasma concentration (Cmax) of ceftriaxone and areas under the concentration-time curve (AUC) from 0 to 36 h and 0 to infinity were the primary parameters considered in the determination of bioequivalence.

RESULTS:

The two solutions were generally well tolerated and had similar safety profiles. Administration of both solutions resulted in similar mean values for all pharmacokinetic parameters. Statistical analysis showed no significant differences between the two solutions in any pharmacokinetic parameter, indicating that the two solutions are statistically bioequivalent (p ≤ 0.05). The 90% CI for the ratio of the means for AUC0-36 (0.86 to 1.11), AUC0-∞. (0.89 to 1.14), and Cmax (0.84 to 1.12) are within the Food and Drug Administration range of bioequivalence (0.80 to 1.25).

CONCLUSIONS:

These results demonstrate that the more concentrated solution of ceftriaxone (350 mg/mL) is bioequivalent to the currently marketed solution of 250 mg/mL.
Sterility of Filgrastim (G-CSF) in Syringes
Authors: Jacobson Pamala A , West Nina J , Spadoni Virginia , Maksym Christopher J , Pierson Carl
Published: January 2017

OBJECTIVE:

To determine if the sterility of filgrastim (G-CSF) is maintained for up to 7 days when aseptically transferred from the vial to tuberculin syringes in a laminar air flow environment.

DESIGN:

The study was conducted in two phases: a validation and an experimental phase. The method was validated by inoculating samples of sterile filgrastim solution with common bacterial and fungal skin contaminants. Samples were aseptically drawn into syringes in a class 100 horizontal laminar air flow hood and refrigerated. The samples were equally divided and transferred to microbiology culture media at times 0,24 hours, 48 hours, and 7 days; incubated; and the organisms identified and quantitated. In the experimental phase, samples of filgrastim were aseptically drawn into syringes, separated into three groups, and refrigerated. At 24 hours, 48 hours, and 7 days, the samples were transferred to broth, incubated, and observed for the development of turbidity.

SETTING:

A class 100 laminar air flow hood in a pediatric hospital pharmacy and a home-infusion pharmacy class 100 000 clean room.

MAIN OUTCOME MEASURES:

The sterility of filgrastim in syringes was determined by comparing experimental broth culture tubes to a control tube and observing for the development of turbidity.

RESULTS:

Filgrastim demonstrated the ability to support the growth of intentionally inoculated skin contaminants, both qualitatively and quantitatively. However, when aseptically transferred to syringes and refrigerated, all tested filgrastim samples remained sterile for at least 7 days.

CONCLUSIONS:

Syringes of filgrastim remain sterile for 7 days when prepared in a class 100 laminar air flow hood, using aseptic technique, and stored under refrigeration. This change in practice can result in significant cost savings.
Management of Otitis Media with Effusion in Young Children
Authors: Paap Christopher M
Published: January 2017

OBJECTIVE:

To summarize and critique the Agency for Health Care Policy and Research (AHCPR) Clinical Practice Guideline for the management of otitis media with effusion (OME) in children.

DATA SOURCES:

The AHCPR Clinical Practice Guideline, Otitis Media with Effusion in Young Children; the Quick Reference Guide for Clinicians, Managing Otitis Media with Effusion in Young Children; and the Parent Guide, Middle Ear Fluid in Young Children, were the primary data sources. The AHCPR developed the Guideline based on a comprehensive literature review from multiple bibliographic databases, including the National Library of Medicine. Data were also collected during open hearings and from unpublished sources derived from a call in the Federal Register. Additional citations from the biomedical literature were used for supporting evidence.

STUDY SELECTION:

Peer-reviewed reports of controlled, randomized studies were preferred, but other study designs were considered. Over 3000 abstracts were identified, of which 378 articles were used for data extraction, and an additional 100 articles were included from bibliography review and panel recommendations. An expert panel reviewed the data and incorporated clinical expertise into the development of consensus statements.

DATA EXTRACTION:

Data were extracted to apply to a base case with OME to narrow the scope of the Guideline. The base case was defined as a child who is 1–3 years old, is otherwise healthy, and has no underlying craniofacial, neurologic, or sensory conditions. Multiple meta-analyses were done to help the panel come to conclusions on several issues.

DATA SYNTHESIS:

The Guideline documents carefully outlined treatment algorithms for the management of OME in otherwise healthy children. The main areas that need to be further clarified are the role of more aggressive identification of causative pathogens, when antimicrobial therapy should be initiated, and which antimicrobial agents are preferred for the treatment of OME. There are many vague areas in the Guideline that allow for multiple interpretations. Data regarding the use of corticosteroids were influenced heavily by the expert opinion of the panel rather than the literature-based evidence and potential cost implications. The Guideline provided specific recommendations for the surgical management of OME. Confounding patient factors that would affect decisions on management of OME, such as underlying disease states and physical or mental abnormalities, were not addressed in the Guideline.

CONCLUSIONS:

The documents were well organized and provide detailed explanation of the recommendations. The Guideline provides specific criteria for the surgical management of OME, but is vague in its recommendations on the medical management of OME with antibiotics, corticosteroids, and the use of invasive tympanocentesis in the evaluation of OME in otherwise healthy children.
Closing the Research to Practice Gap in Therapeutic Residential Care
Authors: Thompson Ronald W. , Duppong Hurley Kristin , Trout Alexandra L. , Huefner Jonathan C. , Daly Daniel L.
Published: January 2017

Residential care has been criticized for its high cost and limited research evidence. While recent studies and reviews of the literature suggest that a number of evidence-based practices are being implemented in residential care settings, more research is needed to develop and test empirically based practices that can be successfully implemented in residential care. In this article, we offer a promising strategy to address this issue: a long-term research partnership between a large service provider agency and a university-based research center to conduct a program of research which has resulted in translation of evidence-supported practices into service provider programs, contributions to the science of residential care, and training opportunities for young applied scientists to specialize in this important work. This evolving program of research includes four core applied research topic areas in which this collaboration has had some ongoing success: program and practice implementation fidelity, therapeutic process factors, aftercare, and psychotropic medication use. We suggest that this type of long-term collaborative research partnership is an approach for others to consider for conducting research that informs effective residential care practices.
How the Flattened Costs of Grassroots Lobbying Affect Legislator Responsiveness
Authors: Cluverius John
Published: January 2017

Leading theories of grassroots lobbying assert that legislators should respond positively to the volume of grassroots lobbying messages because volume indicates the salience of an issue among constituents. This notion rests on the idea that the costs of producing a large volume of grassroots lobbying signals the value of the information to legislators. Advances in technology and strategy, however, have flattened the costs associated with producing such information—it costs much less to generate one additional e-mail message than before. In this environment, the volume of grassroots lobbying no longer signals the value of the information it contains. Instead, I believe trust becomes the critical factor in evaluating grassroots lobbying. I test this theory using a survey of state legislators. I find that lobbying message volume has no effect on legislator responses to higher salience issues, and a negative effect on lower salience issues.
Design Criteria for Rigid Rocker Shoes
Authors: van Schie Carine , Ulbrecht Jan S. , Becker Mary B. , Cavanagh Peter R.
Published: January 2017

In this study nine different rigid rocker shoe designs were tested in 17 symptom-free male subjects and compared with the control condition of a flexible, non-rockered extra-depth shoe with the same flat insole. Effects of both rocker height and axis location were explored. Peak pressure was reduced at most forefoot locations by rocker shoes, but increased in the midfoot and heel. Axis location was found to have an important effect, particularly on hallux pressures. On average the best axis location for reducing metatarsal head (MTH) pressure was in the region of 55-60% of shoe length, while for the toes it was 65%. There was a mean trend towards optimal reduction of pressure in one of the rocker shoe conditions at each anatomical location, but the axis position for this optimal placement was variable across subjects and anatomical locations. While most configurations of the rocker shoes were superior to the control shoe, no single configuration was optimal for all subjects at all sites or even for all subjects at the same site. Therefore, some form of plantar pressure measurement in conjunction with gait training to ensure correct use of the rocker shoes would appear to be essential if the pressure reducing effect of the rigid rocker bottom shoe is to be optimized.
Combining Microfractures, Autologous Bone Graft, and Autologous Matrix-Induced Chondrogenesis for the Treatment of Juvenile Osteochondral Talar Lesions
Authors: D’Ambrosi Riccardo , Maccario Camilla , Ursino Chiara , Serra Nicola , Usuelli Federico Giuseppe
Published: January 2017

Background:

The purpose of this study was to evaluate the clinical and radiologic outcomes of patients younger than 20 years, treated with the arthroscopic-talus autologous matrix-induced chondrogenesis (AT-AMIC) technique and autologous bone graft for osteochondral lesion of the talus (OLT).

Methods:

Eleven patients under 20 years (range 13.3-20.0) underwent the AT-AMIC procedure and autologous bone graft for OLTs. Patients were evaluated preoperatively (T0) and at 6 (T1), 12 (T2), and 24 (T3) months postoperatively, using the American Orthopaedic Foot & Ankle Society Ankle and Hindfoot (AOFAS) score, the visual analog scale and the SF-12 respectively in its Mental and Physical Component Scores. Radiologic assessment included computed tomographic (CT) scan, magnetic resonance imaging (MRI) and intraoperative measurement of the lesion. A multivariate statistical analysis was performed.

Results:

Mean lesion size measured during surgery was 1.1 cm3 ± 0.5 cm3. We found a significant difference in clinical and radiologic parameters with analysis of variance for repeated measures ( P < .001). All clinical scores significantly improved ( P < .05) from T0 to T3. Lesion area significantly reduced from 119.1 ± 29.1 mm2 preoperatively to 77.9 ± 15.8 mm2 ( P < .05) at final follow-up as assessed by CT, and from 132.2 ± 31.3 mm2 to 85.3 ± 14.5 mm2 ( P < .05) as assessed by MRI. Moreover, we noted an important correlation between intraoperative size of the lesion and body mass index (BMI) ( P = .011).

Conclusions:

The technique can be considered safe and effective with early good results in young patients. Moreover, we demonstrated a significant correlation between BMI and lesion size and a significant impact of OLTs on quality of life.

Level of Evidence:

Level IV, retrospective case series.
From Dynamics to Function
Authors: Dishion Thomas J.
Published: January 2017

A vast majority of psychological science focuses on snapshots of individuals. Clinical outcome studies may integrate multiple snapshots, typically with yearly intervals. However, there is much to learn about psychological processes as they unfold over real time, including minutes, days, weeks, and months. This special issue contains several articles that make significant advances in real-time assessment of psychological processes using state-of-the-art measurement. This is a brief summary of the specific innovations of this special issue. The summary includes suggestions for applying these measurement innovations to the study of functional dynamics that lead to clinically and socially significant events. Several examples provide ways in which a dynamical analysis of function may be revealing. Most important, the assessment of dynamic mechanisms underlying the amplification of psychopathology seems especially useful for tailoring clinical interventions to meet clients’ specific needs.
Stress and Posttraumatic Stress in Mothers of Children With Type 1 Diabetes
Authors: Rechenberg Kaitlyn , Grey Margaret , Sadler Lois
Published: January 2017

The onset of acute and chronic illness in children frequently triggers episodes of stress and posttraumatic stress symptoms (PTSS) in mothers. Mothers of children with type 1 diabetes (T1D) consistently report high levels of stress and PTSS. The purpose of this integrative review was to review and synthesize the published empirical research. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to conduct this integrative literature review. A total of 19 studies were identified from a sample of 128. Stress and PTSS were prevalent in mothers of youth with T1D. While PTSS was most severe at disease onset, symptoms often persisted 1 to 5 years after diagnosis. The diagnosis of T1D in a child was traumatic for mothers. Stress and PTSS in mothers adversely affected children’s health. Management of stress symptoms in mothers may lead to improved behavioral and metabolic outcomes in children.