bluuebunny/crossref_metadata_2025 huggingface dataset:
The Frontier of Telecommunications Deregulation: Small Countries Leading the Pack
Authors: Spiller Pablo T , Cardilli Carlo G
Published: August 2011

Interconnection, equal access, unbundling, and industry structure are four key determinants of facilities-based competition in telecommunications. Using these building blocks, this paper analyzes the differences in telecommunications regulatory regimes in Australia, Chile, Guatemala, and New Zealand, assessing the effect on competition and consumer welfare. Some regulation is necessary as incumbents can prolong their market power after demonopolization by exploiting positive externalities inherent to telecommunications networks. The authors emphasize the superiority of market mechanisms over traditional regulatory processes to achieve efficient transactions among operators. Such market mechanisms need clear rules and credible enforcement.
Austrian Economics, Neoclassicism, and the Market Test
Authors: Yeager Leland R
Published: August 2011

Professor Sherwin Rosen correctly suggests that the Austrian and neoclassical schools can be complementary, each accepting much from the other. However his recognition of Austrian strengths needs to be amplified and his criticisms need softening. His appeal to the market test risks encouraging anti-intellectual attitudes and practices
Progress in Behavioral Game Theory
Authors: Camerer Colin F
Published: August 2011

Behavioral game theory aims to predict how people actually behave by incorporating psychological elements and learning into game theory. With this goal in mind, experimental findings can be organized into three categories: players have systematic 'reciprocated social values,' like desires for fairness and revenge. Phenomena discovered in studies of individual judgments and choices, like 'framing' and overconfidence, are also evident in games. Strategic principles, like irrelevance of strategy labels and timing of moves, iterated elimination of dominated strategies, and backward induction, are violated. Future research should incorporate these findings, along with learning and 'pregame theory,' into formal game theory.
Classroom Games: Voluntary Provision of a Public Good
Authors: Holt Charles A , Laury Susan K
Published: August 2011

This paper describes a simple public goods game, implemented with playing cards in a classroom setup. Students choose whether to contribute to the provision of a public good in a situation where it is privately optimal not to contribute, but socially optimal to contribute fully. This exercise motivates discussion of altruism, strategies for private fund-raising, and the role of government in resolving the public good problem.
The Political Economy of the European Economic and Monetary Union: Political Sources of an Economic Liability
Authors: Feldstein Martin
Published: August 2011

EMU would be an economic liability. A single currency would cause, at most, small trade and investment gains but would raise average cyclical unemployment and possibly raise inflation, perpetuate structural unemployment, and increase the risk of protectionism. EMU is nevertheless being pursued in order to create a political union. Fundamental disagreements among member states about economic policies, foreign and military policies, and the sharing of political power are likely to create future intra-European conflicts. A United Europe would be a formidable participant in the twenty-first century's global balance of power, with uncertain consequences for world stability and peace.
Devolution, Grants, and Fiscal Competition
Authors: Musgrave Richard A
Published: August 2011

Following half a century of fiscal activism and federal leadership, the call now is for downsizing the federal budget and a devolution of fiscal responsibilities to states and localities. The call for "federalism," meant to secure a stronger center in James Madison's time, now seeks to decentralize. This paper outlines the main features of fiscal federalism as I see them, sketching a vision which differs in major respects from that offered by the lead paper in this symposium. First I highlight the role of distribution, which I see as a central function. Then, I focus attention on grants-in-aid and their role in the federal system. Finally I consider competition, cooperation, and coordination between jurisdictions.
Meddling Through: Regulating Local Telephone Competition in the United States
Authors: Harris Robert G , Jeffrey Kraft C
Published: August 2011

After a brief history of telecommunication policies and the development of local competition in the United States, this paper analyzes the Telecommunications Act of 1996 and subsequent FCC and state regulatory decisions. Unfortunately, these recent policy changes have generated pervasive, intrusive regulations, undermining the objectives the Telecom Act was intended to promote: competition, innovation, and investment in telecommunications infrastructure. States should allow incumbent local carriers to rebalance their retail rates and set interconnection prices based on actual costs. Federal policymakers should reduce and liberalize regulations, allowing market forces more freedom to allocate resources and shape industry structure.
Job Displacement
Authors: Kletzer Lori G
Published: August 2011

The past decade and a half has seen tremendous research growth in the area of job displacement. This paper discusses the state of knowledge on the issues and questions of job loss. The 1984-96 Displaced Worker Surveys are used to describe how the characteristics of displacement are changing to include more college educated, white collar, and nonmanufacturing workers. For many workers, the long-term earnings losses following displacement are large due to the loss of firm-specific human capital. More research is needed on the questions of the causes of job displacement and on the efficacy of employment and training programs.
Policy Watch: The Introduction of Indexed Government Debt in the United States
Authors: Wilcox David W
Published: August 2011

This article describes the early phases of the development of the market for indexed government debt in the United States. The first such bonds were issued in 1997--one set with a maturity of ten years, the other with a maturity of five years. In the wake of the Treasury issuance, several non-Treasury borrowers have issued indexed debt and several new index-linked products for retail customers have been introduced. As expected, the new indexed notes have 'outperformed' conventional nominal notes in the secondary markets for Treasury debt when bad news has become available about inflation and conversely.
Consumer Prices, the Consumer Price Index, and the Cost of Living
Authors: Boskin Michael J , Dulberger Ellen R , Gordon Robert J , Griliches Zvi , Jorgenson Dale W
Published: August 2011

After presenting major findings and recommendations, the CPI Commission reiterates the estimate of a 1.1 percentage point per annum upward bias. It rejects the contention that the BLS already makes substantial corrections for quality change; that quality improvements and new products accrue only to the rich; and that procedures to make more extensive quality adjustments, valuations of new products, and adjustments for commodity and outlet substitution are impractical. The bias in the CPI can be sharply reduced, as the authors detail in this paper. Coauthors are Ellen R. Dulberger, Robert J. Gordon, Zvi Griliches, and Dale W. Jorgenson.
Getting Prices Right: What Should Be Done?
Authors: Deaton Angus
Published: August 2011

Much of the profession accepts that the CPI likely overstates the rate of increase of the cost-of-living. It is less clear that there are sound and feasible steps that the BLS can adopt to improve matters in the short run. There are unresolved conceptual and identification problems in the measurement of quality. Superlative price indexes are not feasible, and feasible approximations are not superlative, and may not even be better. The need for a single index that aggregates over heterogeneous consumers with different incomes, tastes, and needs casts serious doubt on the cost-of-living approach.
Urban Diversity and Economic Growth
Authors: Quigley John M
Published: August 2011

This paper considers the heterogeneity and diversity of cities as sources of economic growth. It links modern notions of economic growth to the distinguishing characteristics of cities and to the external effects on consumption and production produced by the internal diversity of urban areas. The paper reviews the role of traditional scale economies as well as the importance of diversity in economizing on shared inputs and transactions costs, and efficiencies arising from the operation of the law of large numbers in metropolitan areas. The authors also review recent empirical evidence on the importance of these elements of heterogeneity in conditioning economic growth.
Are Cities Dying?
Authors: Glaeser Edward L
Published: August 2011

This paper organizes a discussion of the costs and benefits of cities around the question: Are cities becoming obsolete? While minimizing transport costs for manufactured goods no longer justifies the existence of cities, they still facilitate the division of labor and the flow of ideas. Cities' higher housing, commuting, and pollution costs seem stable over time. Only the costs associated with urban poverty may increase and these costs do not effect many newer cities. Although many older cities will continue their decline, the future of the urban form seems surprisingly bright.
The Past, Present, and Future of Macroeconomic Forecasting
Authors: Diebold Francis X
Published: August 2011

Broadly defined, macroeconomic forecasting is alive and well. Nonstructural forecasting, which is based largely on reduced-form correlations, has always been well and continues to improve. Structural forecasting, which aligns itself with economic theory and hence rises and falls with theory, receded following the decline of Keynesian theory. In recent years, however, powerful new dynamic stochastic general equilibrium theory has been developed and structural macroeconomic forecasting is poised for resurgence.
Distinguished Lecture on Economics in Government: The Private Uses of Public Interests: Incentives and Institutions
Authors: Stiglitz Joseph
Published: August 2011

[Joseph Stiglitz was a member of the Council of Economic Advisers from 1993–95, and chairman of the CEA from 1995 through February 1997.] Today, I want to share with you some of my thoughts about the possibilities and limitations of government. These thoughts are focused around a simple question: Why is it so difficult to implement even Pareto improvements? Working in Washington, I quickly saw that although a few potential changes were strictly Pareto improvements, there were many other changes that would hurt only a small, narrowly defined group (for example, increasing the efficiency of the legal system might hurt lawyers). But if everyone except a narrowly defined special interest group could be shown to benefit, surely the change should be made. In practice, however, “almost everyone” was rarely sufficient in government policy-making and often such near-Pareto improvements did not occur. My major theme will be to provide a set of explanations for why this might be so. I shall put forward four hypotheses in this lecture, each of which provides part of the explanation for the failure in at least one instance of a proposed Pareto improvement. These hypotheses, like much of the literature on government failures, focus on the role of incentives: how misaligned incentives can induce government officials to take actions that are not, in any sense, in the public interest.
Recent Trends in the Size Distribution of Household Wealth
Authors: Wolff Edward N
Published: August 2011

Based on the Survey of Consumer Finances, the distribution of wealth in the United States became much more unequal in the 1980s and that trend continued, albeit at a slower pace, in the 1990s. The only households that saw their mean net worth rise in absolute terms between 1983 and 1995 were those in the top 20 percent and the gains were particularly strong for the top one percent. All other groups were particularly strong for the top one percent. All other groups suffered real wealth losses, including the median household, and declines were particularly precipitous at the bottom. Racial disparities widened, and young households also lost out over this period.
What Can We Learn from the Grand Policy Experiment? Lessons from SO2 Allowance Trading
Authors: Stavins Robert N
Published: August 2011

The most ambitious application ever attempted of a market-based approach to environmental protection has been for the control of acid rain under the Clean Air Act amendments of 1990, which established a sulfur dioxide allowance trading program. This essay identifies lessons that can be learned from this grand experiment in economically oriented environmental policy. The author examines positive political economy lessons, asking why this system was adopted from acid-rain control in 1990, and he considers normative lessons that can be learned from the program's structure and performance, focusing on lessons for the design and implementation of future systems.
Incentives in Organizations
Authors: Gibbons Robert
Published: August 2011

In this paper, the author summarizes four new strands in agency theory that help him think about incentives in real organizations. As a point of departure, The author begins with a quick sketch of the classic agency model. He then discusses static models of objective performance measurement that sharpen Kerr's argument; repeated-game models of subjective performance assessments; incentives for skill development rather than simply for effort; and incentive contracts between versus within organizations. The author concludes by suggesting two avenues for further progress in agency theory: better integration with organizational economics, as launched by Coase (1937) and reinvigorated by Williamson (1975, 1985), and cross-pollination with other fields that study organizations, including industrial relations, organizational sociology, and social psychology.
CSWEP: 25 Years at a Time
Authors: Bartlett Robin L
Published: August 2011

The history and achievements of the American Economic Association's (AEA) Committee on the Status of Women in the Economics Profession (CSWEP) over the past twenty-five years are reviewed. A picture of women's standing in the economics profession in 1972 is drawn with statistics on the number of women on economics faculties, on prestigious editorial boards, and on the AEA program at its national meeting. While 1997 statistics reveal considerable progress for women in the profession, several questions and challenges for the next twenty-five years are outlined with suggestions as to how CSWEP hopes to address them.
A Comment on CSWEP
Authors: Friedman Milton
Published: August 2011

Milton Friedman corresponded with Carolyn Shaw Bell about the Committee on the Status of Women in the Economics Profession (CSWEP) in 1973. What follows is a distillation of those remarks.
Retrospectives: Was the Monetarist Tradition Invented?
Authors: Tavlas George S
Published: August 2011

In 1969, Harry Johnson charged that Milton Friedman 'invented' a Chicago oral quantity theory tradition, the idea being that in order to launch a monetarist counter-revolution, Friedman needed to establish a linkage with pre-Keynesian orthodoxy. This paper shows that there was a distinct pre-Keynesian Chicago quantity-theory tradition that advocated increased government expenditure during the Great Depression in order to put money directly into circulation. This policy stance distinguished the Chicago economists from other quantity theorists, leaving them less susceptible to the Keynesian revolution. Those who have been critical of Friedman's claim that his work derives from the earlier Chicago tradition have focused exclusively on Friedman's long-run empirical specification of money demand. Friedman's cyclical analysis is shown to be very much in the Chicago tradition. Other connections between Friedman's views and the Chicago tradition are also discussed.
Globalization, Labor Markets and Policy Backlash in the Past
Authors: Williamson Jeffrey G
Published: August 2011

The late nineteenth and twentieth centuries have many things in common. Both periods recorded fast growth, convergence, and labor-market integration between OECD members. Both periods witnessed intense debate about who gained and who lost from globalization. Furthermore, the earlier period saw a retreat from global liberalism long before the interwar deglobalization disaster. Did globalization of that time plant seeds of its own destruction? Are there lessons for the present?
The Global Capital Market: Benefactor or Menace?
Authors: Obstfeld Maurice
Published: August 2011

This paper reviews the theoretical functions, history, and policy problems raised by the international capital market. The goal is to offer a perspective on both the considerable advantages the market offers and on the genuine hazards it poses, as well as on avenues through which it constrains national policy choices. A duality of benefits and risks is inescapable in the real world of asymmetric information and imperfect contract enforcement. The author argues, however, that, in confronting the global capital market, the way to maximize net benefits is to encourage economic integration while attacking concomitant distortions and unwanted side effects at, or close to, their sources.
Mechanism Experiments and Policy Evaluations
Authors: Ludwig Jens , Kling Jeffrey R , Mullainathan Sendhil
Published: August 2011

Randomized controlled trials are increasingly used to evaluate policies. How can we make these experiments as useful as possible for policy purposes? We argue greater use should be made of experiments that identify the behavioral mechanisms that are central to clearly specified policy questions, what we call “mechanism experiments.” These types of experiments can be of great policy value even if the intervention that is tested (or its setting) does not correspond exactly to any realistic policy option.
Internal Migration in the United States
Authors: Molloy Raven , Smith Christopher L , Wozniak Abigail
Published: August 2011

This paper examines the history of internal migration in the United States since the 1980s. By most measures, internal migration in the United States is at a 30-year low. The widespread decline in migration rates across a large number of subpopulations suggests that broad-based economic forces are likely responsible for the decrease. An obvious question is the extent to which the recent housing market contraction and the recession may have caused this downward trend in migration: after all, relocation activity often involves both housing market activity and changes in employment. However, we find relatively small roles for both of these cyclical factors. While we will suggest a few other possible explanations for the recent decrease in migration, the puzzle remains. Finally, we compare U.S. migration to other developed countries. Despite the steady decline in U.S. migration, the commonly held belief that Americans are more mobile than their European counterparts still appears to hold true.
The Role of Theory in Field Experiments
Authors: Card David , DellaVigna Stefano , Malmendier Ulrike
Published: August 2011

We classify all published field experiments in five top economics journals from 1975 to 2010 according to how closely the experimental design and analysis are linked to economic theory. We find that the vast majority of field experiments (68 percent) are Descriptive studies that lack any explicit model; 18 percent are Single Model studies that test a single model-based hypothesis; 6 percent are Competing Models studies that test competing model-based hypotheses; and 8 percent are Parameter Estimation studies that estimate structural parameters in a completely specified model. We also classify laboratory experiments published in these journals over the same period and find that economic theory has played a more central role in the laboratory than in the field. Finally, we discuss in detail three sets of field experiments—on gift exchange, on charitable giving, and on negative income tax—that illustrate both the benefits and the potential costs of a tighter link between experimental design and theoretical underpinnings.
Narrowing the Equity Gap: The Impact of Organized versus Opportunistic Cancer Screening in Catalonia (Spain)
Authors: Espinas Josep A , Aliste Luisa , Fernández Esteve , Argimon Josep M , Tresserras Ricard , Borras Josep M
Published: August 2011

Objectives

To assess the impact on equity of access of an organized breast cancer screening programme, compared with opportunistic breast and cervical cancer screening activities.

Methods

Two cross-sectional health interview surveys conducted in 1994 and 2006 in Catalonia (Spain), with 6382 and 7653 women participating in both surveys. The main outcome measures were having undergone regular mammography, and regular cytology. Age-standardized prevalence rates for both screening tests were computed using the direct method. The relative inequality index was computed to measure changes over time in inequality on screening utilization.

Results

Participation among women aged 50-69 has increased after the introduction of the organized breast screening programme; the greatest impact has been observed among those women with lower educational levels (from 17% in 1994 to 79% in 2006). Equity of access by education was particularly increased in the target group for breast cancer screening.

Conclusion

This study indicates that an organized screening programme could improve participation and equity of access.
Universal Antenatal Screening for Group B Streptococcus in Emilia-romagna
Authors: Berardi Alberto , Di Fazzio Giorgia , Gavioli Sara , Di Grande Ezio , Groppi Alessandra , Papa Irene , Piccinini Giancarlo , Simoni Angela , Tridapalli Elisabetta , Volta Alessandro , Facchinetti Fabio , Ferrari Fabrizio
Published: August 2011

Background

Group B streptococcus (GBS) is a leading cause of severe infections in newborns. Intrapartum antibiotic chemoprophylaxis (IAP) reduces the rate of early-onset disease. The aim of this study is to determine the degree of clinicians’ compliance with the suggested protocol for GBS prevention in Emilia-Romagna (Italy).

Methods

Characteristics of each delivery were prospectively recorded in the period between October 2005 to December 2005. Standardized proforma were used to collect data.

Results

Among 5118 babies, 7.2% (369) were preterm and 92.3% were born at term (4749). Antenatal screening was performed in 86.6% of women who delivered at term, of which 18.1% were GBS culture-positive. Information regarding culture site was available in 93.2% of women screened and recto-vaginal cultures were documented in 42.7%. IAP was administered to 28.7% of 3937 women at term who had either spontaneous delivery or emergency caesarean section. In this cohort, 15.9% were diagnosed GBS culture-positive, of which 92.6% received IAP. Prophylaxis was also administered to 8.4% (331) of women for no apparent reason. Compared with tertiary level hospitals, women delivering in primary/secondary hospitals were more likely to be both GBS screened ( P < 0.0001; OR 3.04; CI 2.33-3.97) and to receive prophylaxis ≥4 hours before delivery ( P = 0.0025; OR 1.57; CI 1.17-2.12).

Conclusions

GBS screening was performed in > 85% of women and > 90% of culture-positive women received prophylaxis. However, there is a need to educate clinicians about protocol adherence, as most cultures were suboptimal and cases of unnecessary IAP were administered. The screening was more effective in hospitals with fewer deliveries.
High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening Programme
Authors: Lee Thomas J W , Clifford Gayle M , Rajasekhar Praveen , Rutter Matthew D , Kometa Simon , Ritchie Mary C , Waddup Greg , Nylander David , Mcnally Richard J Q , Rees Colin J
Published: August 2011

Objectives

The UK National Health Service Bowel Cancer Screening Programme (BCSP) is based on a strategy of biennial faecal occult blood (FOB) testing. Positive results are classified as ‘abnormal’ or ‘weak positive’ based on the number of positive windows per kit or need for repeat testing. Colonoscopy is offered to both groups. We evaluate the relationship between FOB test positivity and clinical outcome in the BCSP.

Setting

The South of Tyne and Tees (UK) Bowel Cancer Screening Centres.

Methods

Data were collected prospectively on all individuals who were offered FOB testing and colonoscopy between February 2007 and February 2009. Univariable and multivariable analyses were performed to investigate the relationship between FOB test positivity and clinical outcome.

Results

Following FOB testing, 1524 individuals underwent colonoscopy, 1259 (83%) after a ‘weak positive’ and 265 (17%) an ‘abnormal’ result. Cancer was detected in 180 (11.8%) and adenomas in 758 (49.7%). Individuals with an ‘abnormal’ result were more likely to have cancer or be ‘high risk’ for the development of future adenomas (110/265, 41.5%) than those with ‘weak positive’ results, (236/1259, 18.7%, P < 0.0001). Those with Dukes stage B, C or D cancers or cancers proximal to the splenic flexure were more likely to have an ‘abnormal’ result.

Conclusions

The majority of colonoscopies were performed following ‘weak positive’ FOB results. Those with an ‘abnormal’ result were more likely to be diagnosed with cancer. The high yield of pathology in both the ‘abnormal’ and ‘weak positive’ groups justifies the need for colonoscopy in both.
Alcohol hand abuse: a cross-sectional survey of skin complaints and usage patterns at a large UK teaching hospital
Authors: Mckenzie Shireen N , Turton Philip , Castle Keri , Clark Sheila M , Lansdown Mark R , Horgan Kieran
Published: August 2011

Objectives

To investigate whether the regular use of alcohol hand gel was having a detrimental effect on hands of healthcare professionals and, if so, to what extent. The study also aimed to establish a link between individuals who felt their hands were suffering from persistent exposure to the gel and those who actively avoided using the gel.

Design

A short descriptive questionnaire was distributed to healthcare professionals and those working within clinical areas within one trust (two teaching hospitals).

Setting

Staff that worked or had duties within clinical areas that necessitated the use of alcohol hand gel.

Participants

The survey was sent via email to all staff on the email database.

Main outcome measure

To determine the number of staff that developed new onset skin conditions since the introduction of alcohol hand gel and of what proportion of this number actively or considered avoiding the hand gel.

Results

Questionnaires were returned for analysis by 399 respondents. Eighty-eight percent of respondents felt that they had developed new onset skin conditions as a consequence of maintaining hand hygiene protocols. Nurses were the highest users of the hand gel, but interestingly were also the highest group to avoid or consider avoiding the hand gel (52% compared with 28%, 26% and 44% in the doctors, secretaries and healthcare assistants groups, respectively) . Thus indicating more frequent use may cause increased problems.

Conclusion

This study demonstrated that 88% of respondents stated that they had new-onset skin problems, of which half-felt that alcohol gel was the main contributing factor. There was a detrimental effect on compliance with alcohol gel hand hygiene protocols in this group. This reflects the real life difficulties of staff in their endeavour to reduce hospital-acquired infections. Action is needed to improve the compliance with such a simple task and ensure that all is done to reduce nosocomial infection and reduce the potential financial burden.
Benefits of knowledge-based interprofessional communication skills training in medical undergraduate education
Authors: Buczacki Simon , Shalhoub Joseph , George Peter M , Vearncombe Laura M , Byrne Patrick D , Alazawi William
Published: August 2011

Objectives

Good interprofessional communication is fundamental to effective teamworking in medicine. Finalmed is a private course that teaches the principles and methods of clinical presenting as an iterative technique of reasoning though clinical data. We have tested the efficacy of this technique using a questionnaire-based study.

Design

An anonymized 10-point Likert scale questionnaire was designed.

Setting

Questionnaires were distributed at five UK courses and two UAE courses.

Participants

Questionnaires were given to all students attending these courses.

Main outcome measures

The questionnaire included pre- and post-course questions addressing self-reported confidence in clinical presenting (CCP) and effectiveness in clinical presenting (ECP). We also asked whether attendees felt that clinical presenting should be integrated formally into medical school curricula.

Results

A total of 331/395 questionnaires were returned. Median improvement in CCP was 50% ( P< 0.0001) and in ECP was 40% ( P<0.0001), irrespective of country of study, graduate entry status and whether the student felt that they had been exposed to these techniques previously. Students recorded a strong opinion in favour of integrating the content and style of the Finalmed course into their medical school curriculum, with 286 students (86%) recording a score of ≥8.

Conclusion

Our study suggests that after a two- or three-day dedicated course, both self-reported confidence and effectiveness in clinical presenting significantly improve. Furthermore, students in the UK and the UAE returned a desire for integration into medical school curricula of IPC through the teaching of clinical presenting.
A Note on Bar-Gera's Algorithm for the Origin-Based Traffic Assignment Problem
Authors: Nie Yu (Marco)
Published: August 2011

Recently, Bar-Gera (Bar-Gera, H. 2002. Origin-based algorithm for the traffic assignment problem. Transportation Sci. 36(4) 398–417) proposed a quasi-Newton method for the origin-based formulation of the user equilibrium traffic assignment problem. This note shows that Bar-Gera's algorithm may generate negative second-order derivative, leading to a “wrong search direction,” which compromises the overall convergence performance. We prove that this shortcoming can be overcome by approximating the second-order derivative with an upper bound. The revised algorithm not only fixes a theoretical flaw but indeed demonstrates more satisfying computational performance in numerical experiments. This note also offers a rigorous derivation of optimality conditions that synthesizes the results of the literature.
Dapsone-Induced Methemoglobinemia: a Primer for Clinicians
Authors: Barclay James A , Ziemba Stamatina E , Ibrahim Rami B
Published: August 2011

Objective:

To present a comprehensive review of dapsone-induced methemoglobinemia and its management.

Data Sources:

Literature retrieval was accessed through MEDLINE (1966-March 2011), Cochrane Library, and EMBASE, using the terms dapsone and methemoglobinemia.

Study Selection And Data Extraction:

All case reports, small case series, and randomized controlled trials published in English were evaluated. Because of the absence of comprehensive updates on this topic since 1996, publications between 1997 and March 2011 were included in this review.

Data Synthesis:

Between 1997 and March 2011, the majority of publications describing methemoglobinemia associated with dapsone use reported this adverse effect at therapeutic doses. Excluding overdose situations, 18 described symptomatic dapsone-associated methemoglobinemia and clinical presentation ranging from cyanosis to dyspnea. In almost all of the accounts, patients had a concurrent event such as anemia or pneumonia, suggesting an interplay between these comorbidities and the onset of symptomatic methemoglobinemia. Delayed hemolytic anemia was seen in patients with high methemoglobin levels at presentation. Management in most cases consisted of administration of methylene blue. Overall, most reports described a successful outcome, and no mortality resulted from methemoglobinemia associated with therapeutic use.

Conclusions:

Clinicians should recognize methemoglobinemia as an adverse effect associated with dapsone use and the potential factors that precipitate it. They should also know how to promptly and effectively manage this event.
P2Y12 Receptor Inhibitors: Integrating Ticagrelor into the Management of Acute Coronary Syndrome
Authors: Crouch Michael A , Colucci Vince J , Howard Patricia A , Spinier Sarah A
Published: August 2011

Acute coronary syndrome (ACS) is a continuum of disease that includes non–ST-segment elevation ACS and ST-segment elevation myocardial infarction. The purpose of this article is to define the developing role of ticagrelor in ACS and compare it to currently available P2Y12 receptor inhibitors. While Clopidogrel remains the “workhorse” P2Y12 receptor inhibitor for many patients with ACS and prasugrel has an established role in select situations, clinicians must now assimilate the evolving role of ticagrelor. Although ticagrelor offers important advances in the management of ACS (eg, reversibility), there are also notable clinical considerations (eg, unique adverse effects such as dyspnea). Based on the current evidence, we propose an algorithm to aid clinicians in the selection of a P2Y12 receptor inhibitor for patients with ACS in various clinical situations.
Lubiprostone for Constipation in Adults with Cystic Fibrosis: A Pilot Study
Authors: O'Brien Catherine E , Anderson Paula J , Stowe Cindy D
Published: August 2011

Background

Constipation is prevalent in the cystic fibrosis (CF) population and yet there are few data demonstrating the effectiveness of currently used treatments. Lubiprostone is a laxative that works by activating the type 2 chloride channel in the gastrointestinal tract and thus has the potential to be especially effective for constipation associated with CR

Objective:

To evaluate the effectiveness of lubiprostone for the treatment of constipation in adults with CF.

Methods:

In this pilot study, participants acted as their own controls and comparisons were made between run-in and treatment periods. During the 2-week run-in period, participants continued their usual treatment for constipation; during the 4-week treatment period, participants received lubiprostone 24 μg twice daily. Efficacy outcomes Included spontaneous bowel movement frequency, Bristol Stool Scale scores, and Patient Assessment of Constipation Symptoms (PAC-SYM) survey scores. Outcomes were assessed during both the run-in and treatment periods (0, 2, and 4 weeks of treatment). Safety outcomes included spirometry, body weight, and serum chemistry.

Results:

Seven participants completed the study. Mean (SD) baseline forced expiratory volume in 1 second was 83.0% (9.4) of predicted and body mass index was 24.0 (2.8) kg/m2, indicating an overall healthy, well-nourished group of adults with CR Lubiprostone improved overall symptoms of constipation as measured by PAC-SYM survey scores (1.18 [0.56], 0,54 (0.27], and 0.44 [0.36] at 0, 2, and 4 weeks, respectively; p < 0.001). Spontaneous bowel movement frequency and Bristol Stool Scale scores were not statistically significantly different between periods. There were no differences in safety measures. Transient chest tightness and shortness of breath were reported by 2 separate participants, although neither participant withdrew due to these adverse effects.

Conclusions:

Lubiprostone may be an effective option for the treatment of constipation in adults with CF
Immediate-Release Oxybutynin for the Treatment of Clozapine-Induced Sialorrhea
Authors: Leung Jonathan G , Puri Neil V , Jacobson Michael J
Published: August 2011

Objective:

To describe a case of clozapine-induced sialorrhea alleviated by immediate-release oxybutynin.

Case Summary:

A 53-year-old female with schizoaffective disorder–bipolar type was admitted to a psychiatric unit and initiated on clozapine. During titration to a dose of 300 mg daily and despite taking concomitant oral benztropine 1 mg twice daily, the patient began to experience mild sialorrhea. The sialorrhea became profuse when the clozapine dose reached 400 mg daily, and the patient was routinely seen with a saliva-soaked shirt. Additionally, she had become self-conscious and wanted to stop clozapine therapy. Immediate-release oxybutynin 5 mg daily was started, resulting in significant reduction of the sialorrhea within 24 hours. The patient was discharged on clozapine 300 mg daily, risperidone 6 mg at bedtime, immediate-release oxybutynin 5 mg twice daily, and oral benztropine 1.5 mg daily, with only mild sialorrhea.

Discussion:

It is unknown why clozapine induces sialorrhea. One speculation is that clozapine interrupts muscarinic receptor homeostasis. Immediate-release oxybutynin is an anticholinergic agent with high affinity for salivary gland M, receptors that may have restored muscarinic receptor imbalance in our patient. N-Desethyl-oxybutynin, an active metabolite of oxybutynin, is largely responsible for oxybutynin's anticholinergic activity. The activity of oxybutynin and its metabolite may result in dry mouth in over 80% of patients taking the immediate-release formulation, while producing dry mouth in only 40% and 7.5% of patients taking the extended-release and topical formulations, respectively.

Conclusions:

To our knowledge, this is the first report of immediate-release oxybutynin successfully reducing clozapine-induced sialorrhea. If oxybutynin is considered for this indication, use of the immediate-release formulation seems prudent. Additional data, including randomized controlled trials, are needed to confirm whether immediate-release oxybutynin has a significant role in the management of this stigmatizing adverse effect.
Ample vector bundles and polarized manifolds of sectional genus three
Authors: Benzo Luca , Lanteri Antonio
Published: August 2011

Let ℰ be an ample vector bundle of rank r ≥ 2 on a smooth complex projective variety X of dimension n having a global section whose zero locus Z is a smooth subvariety of dimension n – r ≥ 3 of X. Let H be an ample line bundle on X such that its restriction HZ
to Z is generated by global sections. The structure of triplets (X, ℰ, H) is determined under the assumption that (Z, HZ
) has sectional genus g(Z, HZ
) = 3.
Quotients of hypersurfaces in weighted projective space
Authors: Bini Gilberto
Published: August 2011

In [Bini, van Geemen, Kelly, Mirror quintics, discrete symmetries and Shioda maps, 2009] some quotients of one-parameter families of Calabi–Yau varieties are related to the family of Mirror Quintics by using a construction due to Shioda. In this paper, we generalize this construction to a wider class of varieties. More specifically, let A be an invertible matrix with non-negative integer entries. We introduce varieties XA
and in weighted projective space and in , respectively. The variety turns out to be a quotient of a Fermat variety by a finite group. As a by-product, XA
is a quotient of a Fermat variety and is a quotient of XA
by a finite group. We apply this construction to some families of Calabi–Yau manifolds in order to show their birationality.
Quasigeodesics and farthest points on convex surfaces
Authors: Ieiri K. , Itoh J. , Vîlcu C.
Published: August 2011

We prove a quadrilateral comparison result for convex surfaces, involving projections onto quasigeodesics. As an application, we locate the set of all farthest points (i.e., points at maximal intrinsic distance from some point) in a convex surface, with respect to a simple closed quasigeodesic.
Relative fungal efficacy results from the soil block test with a long incubation period of three commercial copper wood preservatives
Authors: Schultz Tor P. , Nicholas Darrel D.
Published: August 2011

Development of new wood preservative systems is a lengthy and expensive endeavor. This study examined soil block experiments with a longer incubation time than typical to make the test harsher, using commercial particulate copper azole (PCA), soluble copper azole (CA-C), and soluble alkaline copper quaternary (ACQ-D) systems. Both the CA-C and PCA systems performed poorly compared to ACQ-D with two copper tolerant fungi, even at retentions well above the specified ground-contact residential level, i.e., Use Category 4A (UC4A). With the one copper sensitive fungus examined, PCA and ACQ-D prevented decay at about half the UC4A retention. To compare these laboratory efficacy results, data from an outdoor accelerated post test with a copper tolerant fungus gave efficacies of ACQ > CA-C >> PCA, with PCA having significantly more decay than the two soluble copper systems. Further confirmation was obtained from recently published E7 stake data conducted at a site with extensive copper tolerant fungi, which suggested that ACQ performed better than PCA and CA-B after about 3 years of exposure in agreement with the harsh soil block results with the two copper-tolerant fungi. Conversely, results from four other sites without a history of extensive copper tolerant fungi are interpreted that all three systems generally performed adequately, which is compatible with the soil block test with the one copper sensitive fungus examined.
Development of DNA-based methods to identify CITES-protected timber species: a case study in the Meliaceae family
Authors: Michael Höltken Aki , Schröder Hilke , Wischnewski Niko , Degen Bernd , Magel Elisabeth , Fladung Matthias
Published: August 2011

Violation of CITES regulations in tropical timber trade necessitates the development of accurate species identification systems. The application of available methods, mostly based on visual illustrations and descriptions of wood anatomical characteristics, proved to be difficult or even impossible, particularly on lower taxonomic levels. Further, because most of the chain-of-custody documents are externally applied marks which can easily be manipulated, control methods should be based on wood features which are inherent in the wood itself. In a case study on five closely-related genera of the Meliaceae (mahogany) family, including Swietenia sp. (listed on CITES appendix II), Khaya, Entandrophragma, and Carapa sp. (legal trade timbers), this study demonstrates the process of developing DNA markers for identification purposes. A detailed sequence analysis of several non-coding cpDNA regions resulted in an assay of seven genus-specific SNP (single nucleotide polymorphism) markers. Tools have been designed that could be applied with low-cost equipment on the basis of PCR-RFLPs without the need for sequencing or capillary electrophoresis techniques. In addition, the application of the method to wood material with degraded DNA of low overall quantity is highlighted.
The Incidence of Anterior Knee Pain and Crepitation After Total Knee Replacement: A Matched Pair Analysis between Rotating Platform and Fixed Bearing Posterior Stabilized Designs
Authors: Ranawat Amar S. , Meftah Morteza , Rodriguez-Elizalde Sebastian , Ranawat Chitranjan S.
Published: August 2011

Persistent pain, especially anterior knee pain, with or without crepitation, has been a persistent complaint after total knee arthroplasty in both rotating platform posterior stabilized (RP-PS) and fixed bearing posterior stabilized (FB-PS) designs. Because PFC Sigma RP-PS and FB-PS designs have identical femoral components, we hypothesized that the incidence of post-operative pain, anterior knee pain, asymptomatic crepitation, painful crepitation, and painful crepitation requiring scar excision is similar in both designs. Between March 2000 and May 2004, 81 near-consecutive RP-PS Total Knee Replacements (TKRs) were matched to 81 FB-PS knees based on gender, age, and body mass index. Radiographic analysis included alignment, fixation, and patellar tilt. Clinical assessments were performed at the time of follow-up using the Knee Society Scores. The incidence of anterior knee pain and crepitation was investigated using a detailed patient administered questionnaire. The incidence of post-operative pain, anterior knee pain, asymptomatic crepitation, and painful crepitation was similar in both groups (20.9 %, 19.7 %, 1.2 %, and 8.6 % in the RP-PS; and 20.9 %, 18.5 %, 0 %, and 6.1 % in the FB-PS, respectively). The severity of painful crepitation was also similar in both groups. None was excruciating. The incidence of painful crepitation requiring scar excision was slightly higher in the RP-PS group (6.1 % versus 2.4 %) but it was not statistically significant. In conclusion, there is a trend of increased incidence of painful crepitation requiring scar excision in the RP-PS TKR, although it was not statistically significant in this study.
Pluripotency-associated stem cell marker expression in proliferative cell cultures derived from adult human pancreas
Authors: White Michael G , Al-Turaifi Hussain R , Holliman Graham N , Aldibbiat Ali , Mahmoud Aiman , Shaw James A M
Published: August 2011

The source of new β-cells in adult human pancreas remains incompletely elucidated with recent studies on rodents providing evidence for neogenesis from progenitor cells in addition to self-replication. The aim of this study was to investigate the expression of pluripotency-associated stem cell markers in proliferative cultures derived from adult human pancreas. Human pancreatic tissue was obtained from deceased donors following ethical approval and relative consent. Islet-enriched fraction was separated from the retrieved organ by digestion and density gradient centrifugation. Dissociated cells were seeded in adherent culture forming proliferative ‘islet survivor cells’ (ISCs). These were characterised at fifth passage by RT-PCR, immunofluorescence staining, FACS, western blot and transfection studies with an OCT4 promoter-driven reporter. Nuclear expression of the pluripotency-associated stem cell marker complex OCT4/SOX2/NANOG was confirmed in ISCs. The phenotype constituted ∼8% of the overall population. OCT4 biosynthesis was confirmed by western blot and activation of an exogenous OCT4 promoter. Co-expression of pluripotency-associated markers has been confirmed in proliferative primary cells derived from adult human pancreas. Further studies are required to elucidate whether these cells possess functional stem cell characteristics and assess potential for differentiation into pancreatic cell lineages including new β-cells.