bluuebunny/crossref_metadata_2025 huggingface dataset:
Labour Law
Authors: Butt Simon , Lindsey Tim
Published: October 2018

Indonesian labour law was transformed after the fall of Soeharto, with workers granted many freedoms they had been denied under his rule. This chapter explains the rights and duties of workers and employers in Indonesia today, including those relating to conditions of employment, minimum wages, overtime, leave, social security, anti-discrimination and equal opportunity guarantees, and termination of employment (including severance pay). Attention is paid to the rules applicable to women, children, and foreign workers, and to unions, collective bargaining, and the right to strike (including the requirements for legal industrial action). Case studies are provided and sub-contracting rules are covered. The chapter closes with an evaluation of Indonesia’s problematic industrial dispute resolution process, including the much-criticized Industrial Relations Court.
Foundational Principles of Contract Law
Authors: Eisenberg Melvin A.
Published: October 2018

Foundational Principles of Contract Law is similar to a hornbook—that is, a one-volume treatise on a given legal subject that is intended primarily for law-school students—in length, but differs from a hornbook in two critical respect. First, hornbooks are primarily devoted to setting out the principles and rules of a given legal subject, with some attention to the rationale of those principles and rules, only occasional attention to critiquing those principles and rules, and little or no attention to considering whether those principles and rules should be modified or replaced. In contrast, while Foundational Principles sets out the principles and rules of contract law it places more emphasis on what the principles and rules of contract law should be, based on policy, morality, and experience. A major premise of Foundational Principles is that the best way to grasp contract law is to understand it from a critical perspective as an organic, dynamic subject. When contract law is approached in this way it is much easier to grasp and learn than when it is presented simply as a static collection of principles and rules. Second, Foundational Principles is intended for all members of the profession—law-school students, judges, practicing lawyers, and academics—and more generally for all persons interested in the law, including students in pre-law courses and members of the public.
Bargain Promises and the Bargain Principle
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 5 concerns bargains. A bargain is an exchange in which each party views what he gives as the price of what he gets. Bargain promises are the paradigm case of a promise that should be legally enforceable. The substantive reasons for enforcing bargain promises are extremely strong. To begin with, bargains between actors who act voluntarily and are capable and fully informed increase wealth by producing gains through trade, because normally each party to a bargain values what he gets more highly than what he gives. Bargain promises also present few problems of process. Such promises are typically self-regarding and therefore are likely to be deliberatively made and finely calculated. For all these reasons, under the bargain principle in contract law a bargain promise is enforceable according to its terms in the absence of a defense such as fraud, duress, incapacity or unconscionability.
The Theory of Efficient Breach
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 6 concerns the theory of efficient breach. This theory claims that breach of contract is efficient, and therefore desirable, if the promisor’s gain from breach after payment of the promisee’s expectation damages will exceed the promisee’s loss after recovering expectation damages. The theory rests on two factual predicates: that the expectation measure makes a promisee indifferent between performance and breach and that the promisor knows the value that the promisee places on the promisor’s performance and therefore can make the calculation the theory requires. Both predicates are incorrect. The predicate that expectation damages makes a victim of breach indifferent between performance and breach is incorrect because the expectation measure systematically fails to achieve that objective. The predicate that a promisor knows the value that the promise puts on the promisor’s performance is incorrect because rarely if ever will a promisee quantify for a promisor the gain he expects to make from a contract.
The Unconscionability Principle
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 7 concerns one of the most important developments in modern contract law: the emergence of the principle that an unconscionable contract is unenforceable. Two elements should figure in the determination whether a contract is unconscionable. The first element is the nature of the market on which the contract was made: contracts made on competitive markets are seldom unconscionable, but when contracts are made off-market or on noncompetitive markets the stage is set for unconscionability. The second element is whether the contract involved moral fault: regardless of the nature of the market on which a contract is made, a contract is not unconscionable without that element.
The Mitigation Principle
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 10 concerns cases in which two parties, A and B, are in a contractual relationship, A is at risk of incurring a significant loss caused by her breach, and B could prevent or reduce A’s loss by taking a low-cost, low-risk action. Under the mitigation principle B should take that action. The mitigation principle is a special case of the duty to rescue in contract law. In the area of contract-law remedies the principle is supported by fairness, causation, and efficiency. The discussion in this Chapter concerns the mitigation principle of contracts, as reflected in the case law, Restatement Second Section 350, and U.C.C. Section 2-203(1).
Behavioral Economics and Contract Law
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 11 concerns behavioral economics. Classical contract law was implicitly based on a rational-actor or expected-utility model of psychology. Under this model, actors who make decisions in the face of uncertainty rationally maximize their expected utility, with all future benefits and costs properly discounted to present value. Rationality, in turn, requires that when consequences are uncertain their likelihood must be evaluated without violating the basic rules of probability theory. Within the last half century a great body of theoretical and empirical work in cognitive psychology, known as behavioral economics, has shown that due to the limits of cognition the expected-utility model often diverges from the actual psychology of choice. Some of the decision-making rules that people use yield systematic errors, and other aspects of peoples’ cognitive capabilities are also systematically defective.
The Cover Principle
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 17 concerns cover. The concept of cover embraces two separate but intimately related ideas: First, cover is an act—a buyer’s act of purchasing a commodity in the market to replace a contracted-for commodity that the seller failed to deliver. Second, cover is a remedy—a judgment for the difference between the contract price and the cost of cover. As a remedy cover has the look and feel of damages because the buyer ends up with a money judgment. As an act, however, cover constitutes virtual specific performance: by covering the buyer finds a replacement performance that, together with cover damages, is close to what he would have received if the seller had been ordered to specifically perform.
The Theory of Overreliance
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 21 concerns the theory of overreliance. That theory is as follows: frequently a promisee can increase the profit he will make from a contract by investing in goods or services (for example advertising) that will make the contract more profitable. In the absence of institutional considerations this theory could have significant consequences in formulating the legal rules that govern damages. When institutional considerations are taken into account, however, the theory, although illuminating, has few real-world consequences, especially considering the cases where overreliance is normally impossible, or theoretically possible but very unlikely to occur, or when any reliance would hold its value after breach.
The Role of Restitution in Contract Law
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 25 concerns the role of restitution in contract law. There are three basic types of case in which a contract-law plaintiff is awarded restitutionary damages. In the first type, the defendant has breached the contract but the plaintiff elects to recover restitutionary damages rather than expectation or reliance damages because restitutionary damages are higher. In the second type, the plaintiff has breached a contract after rendering partial performance, the defendant has not paid the plaintiff for the benefit conferred by his performance because the plaintiff has breached, and the plaintiff requests restitutionary damages for that benefit. In the third type the plaintiff rendered a performance pursuant to a contract that is unenforceable on some ground, and therefore is unable to bring a claim on the contract. Accordingly, the plaintiff requests restitutionary damages.
The Disgorgement Interest in Contract Law
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 26 considers the disgorgement interest. This is a promisee’s interest in requiring the promisor to disgorge a gain that was made possible by her breach but did not consist of a benefit conferred upon her by the promisee. The disgorgement interest and the corresponding disgorgement measure are the mirror images of the expectation interest and the expectation measure. The expectation measure is intended to place a promisee in the position he would have been in if the contract had been performed. In contrast, the disgorgement measure is intended to place a promisor in the position that she would have been in if the contract had been performed. Accordingly, perfect disgorgement makes the promisor indifferent between performing, on the one hand, and paying damages, on the other.
The Elements of a Contract
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 27 concerns the elements of a contract. Contracts consist in large part of expressions, that is, manifestations consisting of words, acts, or both, which are either communicated by an addressor to an addressee or jointly produced by two (or occasionally more) contracting parties. It is sometimes assumed that where contractual expressions are embodied in a single writing the writing is the contract. That assumption is incorrect because contracts almost invariably include a number of additional elements—in particular, the implications of the parties’ expressions and any relevant usage, course of dealing, and course of performance. The context and purpose of a contract are not, strictly speaking, elements of a contract, but bear on its interpretation.
Objective and Subjective Elements of Interpretation
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 29 concerns objective and subjective elements of interpretation. A deep difference between classical and modern contract law is that the standards of classical contract law were almost entirely objective, whereas the standards of modern contract law include subjective elements. This difference is particularly striking in the area of interpretation. Classical contract law adopted a standard of interpretation that was almost purely objective. However just as the aim of contract law should be to effectuate the objectives of contracting parties, subject to applicable conditions and constraints, so the aim of interpretation should be to ascertain those objectives, subject to those conditions and constraints, and subjective understandings often play a crucial role in this ascertainment process.
The Termination of an Offeree’s Power of Acceptance
Authors: Eisenberg Melvin A.
Published: October 2018

An offer vests in the offeree the power to conclude a bargain, that is, the power of acceptance. Much of the law of offer and acceptance concerns the question: What kinds of events terminate that power? One such event is lapse of the offer. Another is revocation. Normally an offeror may revoke the offer at any time before acceptance. However, often an offeror will promise to hold the offer open for a given period of time. If the offeree gives consideration for such a promise the promise is referred to as an option and is enforceable. If the offeree does not give consideration for such a promise the offer is referred to as a firm offer and normally is revocable unless relied upon. This rule is unjustified. If an offeror promises to hold an offer she does so to further her own interests. Failure to enforce such promises is therefore against the interests of offerors as a class.
Evaluative Mistakes
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 40 concerns evaluative mistakes. A bargain promise requires and embodies two choices by the promisor. First, the promisor must choose to achieve a certain objective. Second, she must choose to achieve that objective by making a bargain. The promisor must then evaluate the relation between her preferences and the performances that will be due from and to her under the bargain contract. In this book, where a well-informed and capable actor chose to make a bargain contract, and later comes to believe that her choice was a mistake as a result of a change in her preferences, or in the subjective or objective value of the performances due under the contract, the mistake is referred to as an evaluative mistake. Some types of mistakes should provide relief to a mistaken promisor. Evaluative mistakes are not one of these types, in large part because the prospect that a counterparty will make an evaluative mistake is often just what the nonmistaken bargains for.
Introduction to Problems of Performance
Authors: Eisenberg Melvin A.
Published: October 2018

This chapter provides an introduction to problems of performance, which for the most part concern post-contract formation issues, such as a promisee’s rights where the promisor has rendered a performance that is imperfect but substantial. Generally speaking, problems of performance concern sanctions for breach other than damages or specific performance, such as suspension of performance or termination of the contract by the aggrieved party. These sanctions are often much more severe than damages. For example, if a promisee has the right to terminate a contract the promisor may lose the profits she would have earned if the contract had continued in force, as well as the value, or at least the contract price, of the performance she rendered before the contract was terminated.
The Principle of Adequate Assurance of Performance
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 49 concerns cases in which although a promisor does not explicitly repudiate a contract, the promisee has justifiable insecurity about whether the promisor will perform. There are several kinds of cases of this sort. They include an apparent repudiation, an apparent material breach, and a breach by the promisor of other contracts with the promisee or comparable contracts with third parties. The governing principle in such cases is that the promisee can require the promisor to provide adequate assurance that her performance will be forthcoming, and the promisor’s failure to provide such assurance is a breach.
The Principle of Good Faith in Contract Law
Authors: Eisenberg Melvin A.
Published: October 2018

It is a settled principle of contract law that a contracting party must perform her contractual duties in good faith. The meaning of the duty of good faith is complex. At a minimum, to be in good faith an actor must have acted in a way that she believed was proper, which is a subjective test. This subjective test is overlaid with several objective tests. First, it is not enough that an actor actually believed that her conduct was proper; her belief must be honest in the sense that it has some basis in morality. Next, although an actor's belief need not be reasonable to be in good faith, it must at least be rational. Finally, the duty of good faith includes the observance of reasonable standards of fair dealing—another objective test.
Relational Contracts
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 54 concerns relational contracts. Classical contract law was implicitly based on a paradigm consisting of a bargain made between strangers transacting on a perfect market, and focused on the static instant of contract formation, rather than dynamic processes such as the evolution of a contractual relationship. Relational-contract theory rejects the stranger-in-a-perfect-market paradigm and the static conception of contract law. Instead, it is based on a paradigm of a contractual transaction between actors who are in an ongoing and dynamic relationship. The identification of relational contracts as an economic and sociological entity is desirable. However, a theory of relational contracts requires the formulation of a body of legal rules applicable to, and only to, relational contracts. This is a place to which relational-contract theory has not gone and cannot go.
The Statute of Frauds
Authors: Eisenberg Melvin A.
Published: October 2018

Chapter 56 concerns the statute of frauds. The law does not require contracts as a class to be in writing. However, the Statute of Frauds, adopted in England in 1677 and in force in almost every American state, provides that certain kinds of contracts are unenforceable against the party sought to be held liable unless the contract is evidenced by a writing or, today, an electronic equivalent, signed by that party. Section 4 of the Statute provides that no action shall be brought upon any contract or sale of land, or any agreement that is not to be performed within one year from the making thereof, unless the agreement or some memorandum or note thereof is in writing and signed by the party to be charged. Section 17 of the original Statute covered contracts for the sale of goods. That section has been superseded by the UCC.
Diversities and Minorities
Authors: Egorova Yulia
Published: October 2018

The chapter provides an outline of the history of Jews and Muslims in South Asia focusing on the multiplicity of definitions of both groups. While highlighting the diversity of Indian Jews and Indian Muslims, it discusses how in the British period the colonial authorities constructed and sedimented the boundaries both around and within the two groups, depicting them simultaneously as foreign to the subcontinent in ways that would minoritize them in British India and, subsequently, in independent India, and as indigenous, in ways that proved to be detrimental to their position vis-à-vis the Hindu majority in the case of Indian Muslims and vis-à-vis overseas Jewish organizations in the case of Indian Jews.
Conclusion
Authors: Egorova Yulia
Published: October 2018

The chapter revisits the main theoretical premises and conclusions of the book and reflects on their applicability to contexts that go beyond South Asia. In doing so, it points out how the very blueprints of anti-Muslim discrimination in India trace their genealogy back to European anti-Jewish prejudice and proposes that anti-Muslim discourses and practices have in their turn been read back at Indian Jews. The chapter also summarizes the way the book has interrogated both those accounts that inscribe Jews and Muslims as each other’s enemies and those that imagine them as “brothers” linked by a commonality of theologies, rituals, and narratives, and suggested that rather than being considered as a category of analysis, Jewish-Muslim relations would be best thematized as a construct produced by the very processes of minoritization, stigmatization, and othering that have been applied to Jews and Muslims in Europe and then globalized at the turn of the twenty-first century.
“The Triumph of Jimmy Scott”
Authors: Eidsheim Nina Sun
Published: October 2018

Jazz singer Jimmy Scott’s ambiguously gendered voice became the stuff of legend and was reviled by some and revered by many. His singular vocal timbre fell in a liminal space between black and white, young and mature, male and female. He first gained a cult following and the respect of other prominent singers because of his unique voice and nuanced vocal stylings. His unusual timbre, however, presented marketing challenges. Scott labored in near obscurity for much of his career; his photograph was not included on his own album covers, and he was often unlisted or misidentified in recording credits with other singers. This chapter explores the motivations behind these problems, including gender, sexuality, and racial politics, and how they impacted the reception of Scott.
Hearing Luxe Pop
Authors: Howland John
Published: October 2018

This chapter examines the concept of the “luxe pop” production practices and their evolution over the last several decades. It traces the connection between modern luxe pop, 1970s symphonic soul, and 1920s symphonic jazz. Each case features the timbre of a lush string orchestra as a stand-in for highbrow or elevated culture, while the overlaid genres of jazz, soul, and hip-hop function as a symbol of lowbrow culture. This juxtaposition of black/white, lowbrow/highbrow, street/luxury functions as musical irony and subversive sarcasm. This chapter traces specifically the connection between Jay-Z’s symphonic hip-hop production “Can I Live,” which samples Isaac Hayes’s cover of Burt Bacharach’s “The Look of Love,” a recording that was featured in the movie Casino Royale (1967). Pop music’s tendency to borrow samples from its own history (“retromania”) leads to an interconnected web of artists spanning decades of popular music.
Clash of the Timbres
Authors: Butler Jan
Published: October 2018

This chapter explores the conflict between live- and studio-centered aesthetics in the context of the San Francisco and Los Angeles rock scenes in the late 1960s. Bands such as Jefferson Airplane, who had spent their careers playing live concerts, were faced with new challenges of working in a more technical setting. By the same token, the technological capabilities of studio recording practice allowed for increased creative opportunities. Contributors to nascent rock magazines such as Crawdaddy often disagreed about the true meaning of “authentic” rock and roll, some advocating for a more polished and produced sound while others argued that rock should imitate live performance, even in a recording studio. Over time, artists and producers developed means to oscillate between live and recorded styles depending on their artistic intention.
The Sound of Nowhere
Authors: Théberge Paul
Published: October 2018

This chapter traces the development of reverb in music production. Reverberation implicates acoustic space with musical and social places; thus, genres can come to be associated with different locations (e.g., Gregorian chant with cathedrals, orchestras with large concert halls). Sound recordings relocate music to other locales, however, superimposing the reverberant characteristics of one space upon another. Since the 1930s, audio-recording engineers increasingly disengaged recorded sounds from their acoustic environments and replaced them with artificial reverb: through the use of chambers, plates and digital devices, popular recording practices create a complex, multilayered musical space. The chapter traces these developments and links them to contemporary listening practices associated with headphone use, arguing that reverb serves to create an imaginary sonic space for the mobile listener.
Survival predictors in biopsy-proven giant cell arteritis: a northern Italian population-based study
Authors: Macchioni Pierluigi , Boiardi Luigi , Muratore Francesco , Restuccia Giovanna , Cavazza Alberto , Pipitone Nicolò , Catanoso Mariagrazia , Mancuso Pamela , Luberto Ferdinando , Giorgi Rossi Paolo , Salvarani Carlo
Published: October 2018

Objective

To evaluate the influence of disease-related findings and treatment outcomes on survival in a population-based cohort of Northern Italian patients with GCA.

Methods

A total of 281 patients with incident temporal artery biopsy (TAB)-proven GCA, diagnosed over a 26-year period (1986–2012) and living in the Reggio Emilia area, were retrospectively evaluated. We analysed clinical, imaging and laboratory findings at diagnosis, pathological patterns of TAB, CS treatment and therapeutic outcomes, and traditional cardiovascular risk factors as factors predictive of survival.

Results

Univariate analysis showed that increased mortality was associated with large vessel involvement at diagnosis [hazard ratio (HR) 5.84], while reduced mortality was associated with female sex (HR 0.66), PMR (HR 0.54), higher haemoglobin levels (HR 0.84) at diagnosis, long-term remission (HR 0.47) and inflammation limited to adventitia or to the adventitial vasa vasorum (HR 0.48) at TAB examination. Multivariate analysis confirmed the association between increased mortality and large vessel involvement (HR 5.14) at diagnosis, between reduced mortality and PMR (HR 0.57) at diagnosis and adventitial inflammation (HR 0.31) at TAB.

Conclusion

PMR at diagnosis and inflammation limited to the adventitia at TAB appear to identify subsets of patients with more benign disease, while large vessel involvement at diagnosis is associated with reduced survival.
Genetic Connectivity Between Papaya Ringspot Virus Genomes from Papua New Guinea and Northern Australia, and New Recombination Insights
Authors: Maina Solomon , Barbetti Martin J. , Edwards Owain R. , Minemba David , Areke Michael W. , Jones Roger A. C.
Published: October 2018

Isolates of papaya ringspot virus (PRSV) were obtained from plants of pumpkin (Cucurbita spp.) or cucumber (Cucumis sativus) showing mosaic symptoms growing at Zage in Goroka District in the Eastern Highland Province of Papua New Guinea (PNG) or Bagl in the Mount Hagen District, Western Highlands Province. The samples were sent to Australia on FTA cards where they were subjected to High Throughput Sequencing (HTS). When the coding regions of the six new PRSV genomic sequences obtained via HTS were compared with those of 54 other complete PRSV sequences from other parts of the world, all six grouped together with the 12 northern Australian sequences within major phylogroup B minor phylogroup I, the Australian sequences coming from three widely dispersed locations spanning the north of the continent. Notably, none of the PNG isolates grouped with genomic sequences from the nearby country of East Timor in phylogroup A. The closest genetic match between Australian and PNG sequences was a nucleotide (nt) sequence identity of 96.9%, whereas between PNG and East Timorese isolates it was only 83.1%. These phylogenetic and nt identity findings demonstrate genetic connectivity between PRSV populations from PNG and Australia. Recombination analysis of the 60 PRSV sequences available revealed evidence of 26 recombination events within 18 isolates, only four of which were within major phylogroup B and none of which were from PNG or Australia. Within the recombinant genomes, the P1, Cl, NIa-Pro, NIb, 6K2, and 5′UTR regions contained the highest numbers of recombination breakpoints. After removal of nonrecombinant sequences, four minor phylogroups were lost (IV, VII, VIII, XV), only one of which was in phylogroup B. When genome regions from which recombinationally derived tracts of sequence were removed from recombinants prior to alignment with nonrecombinant genomes, seven previous minor phylogroups within major phylogroup A, and two within major phylogroup B, merged either partially or entirely forming four merged minor phylogroups. The genetic connectivity between PNG and northern Australian isolates and absence of detectable recombination within either group suggests that PRSV isolates from East Timor, rather than PNG, might pose a biosecurity threat to northern Australian agriculture should they prove more virulent than those already present.
Association Between Concomitant Hysterectomy and Repeat Surgery for Pelvic Organ Prolapse Repair in a Cohort of Nearly 100,000 Women
Authors: Dallas Kai , Elliott Christopher S. , Syan Raveen , Sohlberg Ericka , Enemchukwu Ekene , Rogo-Gupta Lisa
Published: October 2018

OBJECTIVE:

To evaluate the association of hysterectomy at the time of pelvic organ prolapse (POP) repair with the risk of undergoing subsequent POP surgery in a large population-based cohort.

METHODS:

Data from the California Office of Statewide Health Planning and Development were used in this retrospective cohort study to identify all women who underwent an anterior, apical, posterior or multiple compartment POP repair at nonfederal hospitals between January 1, 2005, and December 31, 2011, using Current Procedural Terminology and International Classification of Diseases, 9th Revision procedure codes. Women with a diagnosis code indicating prior hysterectomy were excluded, and the first prolapse surgery during the study period was considered the index repair. Demographic and surgical characteristics were explored for associations with the primary outcome of a repeat POP surgery. We compared reoperation rates for recurrent POP between patients who did compared with those who did not have a hysterectomy at the time of their index POP repair.

RESULTS:

Of the 93,831 women meeting inclusion criteria, 42,340 (45.1%) underwent hysterectomy with index POP repair. Forty-eight percent of index repairs involved multiple compartments, 14.0% included mesh, and 48.9% included an incontinence procedure. Mean follow-up was 1,485 days (median 1,500 days). The repeat POP surgery rate was lower in those patients in whom hysterectomy was performed at the time of index POP repair, 3.0% vs 4.4% (relative risk [RR] 0.67, 95% CI 0.62–0.71). Multivariate modeling revealed that hysterectomy was associated with a decreased risk of future surgery for anterior (odds ratio [OR] 0.71, 95% CI 0.64–0.78), apical (OR 0.76, 95% CI 0.70–0.84), and posterior (OR 0.69, 95% CI 0.65–0.75) POP recurrence. The hysterectomy group had increased lengths of hospital stay (mean 2.2 days vs 1.8 days, mean difference 0.40, 95% CI 0.38–0.43), rates of blood transfusion (2.5% vs 1.5, RR 1.62, 95% CI 1.47–1.78), rates of perioperative hemorrhage (1.5% vs 1.1%, RR 1.32, 95% CI 1.18–1.49), rates of urologic injury or fistula (0.9% vs 0.6%, RR 1.66, 95% CI 1.42–1.93), rates of infection or sepsis (0.9% vs 0.4%, RR 2.12, 95% CI 1.79–2.52), and rate of readmission for an infectious etiology (0.7% vs 0.3%, RR 2.54, 95% CI 2.08–3.10) as compared with those who did not undergo hysterectomy.

CONCLUSION:

We demonstrate in a large population-based cohort that hysterectomy at the time of prolapse repair is associated with a decreased risk of future POP surgery by 1–3% and is independently associated with higher perioperative morbidity. Individualized risks and benefits should be included in the discussion of POP surgery.
The Value in Doing Something
Authors: Wendler David
Published: October 2018

Objectives:

Evaluate the reasons why attempts at redirection, especially at the end of life, often fail, and patients and families insist on treating the underlying illness.

Setting:

Conflicts between patients and caregivers regarding the appropriate course of treatment.

Main Results:

Clinicians typically understand requests for treatment merely as means to obtain effective care. However, patients and families often request treatment as a way to exert their agency, avoid a sense of responsibility for unwanted outcomes, and express compassion.

Conclusions:

In response to devastating illness, patients and families are frequently motivated by factors that go beyond obtaining effective care. Awareness of these factors can help clinicians to identify sources of potential conflict and continue to provide compassionate care.
Challenges in Estimating the Impact of Vaccination with Sparse Data
Authors: Shioda Kayoko , Schuck-Paim Cynthia , Taylor Robert J. , Lustig Roger , Simonsen Lone , Warren Joshua L. , Weinberger Daniel M.
Published: October 2018

Background:

The synthetic control model is a powerful tool to quantify the population-level impact of vaccines because it can adjust for trends unrelated to vaccination using a composite of control diseases. Because vaccine impact studies are often conducted using smaller, subnational datasets, we evaluated the performance of synthetic control models with sparse time series data. To obtain more robust estimates of vaccine impacts from noisy time series, we proposed a possible alternative approach, STL+PCA method (seasonal-trend decomposition plus principal component analysis), which first extracts smoothed trends from the control time series and uses them to adjust the outcome.

Methods:

Using both the synthetic control and STL+PCA models, we estimated the impact of 10-valent pneumococcal conjugate vaccine on pneumonia hospitalizations among cases <12 months and 80+ years of age during 2004–2014 at the subnational level in Brazil. We compared the performance of these models using simulation analyses.

Results:

The synthetic control model was able to adjust for trends unrelated to 10-valent pneumococcal conjugate vaccine in larger states but not in smaller states. Simulation analyses showed that the estimates obtained with the synthetic control approach were biased when there were fewer cases, and only 4% of simulations had credible intervals covering the true estimate. In contrast, the STL+PCA analysis had 90% lower bias and had 95% of simulations, with credible intervals covering the true estimate.

Conclusions:

Estimates from the synthetic control model might be biased when data are sparse. The STL+PCA model provides more accurate evaluations of vaccine impact in smaller populations.
Choosing the Right Delirium Assessment Tool
Authors: Mulkey Malissa A. , Roberson Donna W. , Everhart D. Erik , Hardin Sonya R.
Published: October 2018

Delirium is an increasing concern with current combined annual costs for the United States and Europe of approximately $350 billion. Although standardized definitions and diagnostic criteria exist, more than 80% of delirium in the acute care setting is overlooked or misdiagnosed. Delays in identification result in increases in severity and mortality and a reduction in quality of life. Selecting an assessment tool is the first step toward improving recognition.
Endovascular treatment for atherosclerotic stenosis within V3 segment of a hypoplastic vertebral artery
Authors: Wei Ming , Ma Yuxiang , Yin Long
Published: October 2018

Introduction

The endovascular treatment of intracranial atherosclerotic stenosis has become a common intervention. However, few reports are available regarding stenting performed for hypoplastic vertebral artery (HVA) with multiple atherosclerotic lesions. Combining multiple neuroendovascular devices provides more possibilities for technical success. We describe a stenting technique using a distal intracranial catheter (Navien) for providing an approach to an HVA with multiple existing atherosclerotic lesions. The technique involves a coaxial system comprising a 6F 70-cm long sheath and 5F 115-cm Navien catheter, which provides a stable support and a shorter distance for the navigation of a balloon-mounted stent. Thus, a stent can be easily delivered avoiding any obstacles such as curves or tortuosity in the VA without distal advancement of the microwire.

Conclusion

The procedure was completed successfully with neither arterial perforation nor injury of the vessel wall. To the best of our knowledge, this is the first study that has reported the use of a Navien catheter in an HVA as an adjunctive technique for the delivery of an Apollo intracranial stent. The combination of the Apollo stent and Navien catheter is an alternative technique that may improve the safety of intracranial stenting procedure.
A cluster randomized controlled trial to test the feasibility and preliminary effectiveness of a family dementia caregiver intervention in Vietnam
Authors: Nguyen Tuan Anh , Nguyen Huong , Pham Thang , Nguyen Trong Hung , Hinton Ladson
Published: October 2018

Background:

Resources for Enhancing All Caregivers Health in the Department of Veterans Affairs (REACH VA) is an evidence-based intervention supporting family dementia caregivers that has been shown to improve caregiver outcomes for culturally diverse populations in the United States. However, this model has not been tested in low- and middle-income countries (LMICs) including Vietnam, where community-based psychosocial interventions are urgently needed. The objectives of this study are to assess the feasibility and preliminary effectiveness of a culturally adapted version of the Resources for Enhancing All Caregivers Health in Vietnam (REACH VN).

Methods:

A cluster randomized controlled trial (RCT) will be conducted over a 6-month period in Soc Son district located in Hanoi. An expected sample of 10 to 12 communes, representing approximately 50 dementia primary caregivers, will be randomized to either the REACH VN intervention or an enhanced control condition. Inclusion criteria for the caregiver include age ≥18, family member who provides the most day-to-day care for person with dementia, and a total score for the brief (4 item) Zarit Burden Scale of ≥6. Over the course of 2 to 3 months, each participant in the intervention group will receive the REACH VN intervention comprised of 4 core sessions on problem solving, mood management/cognitive restructuring, stress management, and communication, and up to 2 additional sessions based on caregiver's needs. The enhanced control group will receive a single session that provides verbal and written information on dementia. Caregiver outcomes will be assessed at baseline (i.e., time of enrolment) and 3 months. The feasibility will be assessed with regard to recruitment, retention, treatment adherence, treatment fidelity, and assessment processes. For preliminary effectiveness, we will examine caregiver burden as the primary outcome and changes in caregiver depressive symptoms and in Alzheimer disease knowledge as secondary outcomes.

Discussion:

This is the first study to test community-based family dementia caregiver intervention in Vietnam. Results from this study will provide the foundation for a larger effectiveness trial and broader dissemination in Vietnam and may help inform efforts to develop similar community-based family dementia caregiver support programs in other LMICs.

Trial registration:

ClinicalTrials.gov, ID: NCT03587974. Published online July 16, 2018
An unusual location of squamous cell carcinoma and a rare cutaneous infection caused by serratia marcescens on the tumoral tissue
Authors: Sevencan Nurhayat Ozkan , Cakmakliogullari Elcin Kal , Ozkan Aysegul Ertinmaz , Kayhan Burcak
Published: October 2018

Rationale:

Serratia marcescens (S. marcescens) is an opportunistic pathogen of the Enterobacteriaceae family. Although S. marcescens is known to cause sepsis, meningitis, endocarditis, urinary system and ocular infections, skin infections are sporadic. Squamous cell carcinoma (SCC) is the most aggressive skin cancer type that is often located in the head and neck region, and rarely in the scalp tissue.

Patient concerns:

An 89-years-old male patient was diagnosed with SCC three years ago. The frontal region of the skull showed an ulcerated tumor, irregular borders, and exophytic growth pattern. The destruction of the frontal bone made the vibrating brain tissue visible, and the lower part had haemopurulent flow.

Diagnoses:

Gram staining showed the proliferation of gram (-) bacilli. Bacteria were identified as non-pigmented S. marcessens in the wound culture. To the best of our knowledge, there have not been any cases reported with S. marcescens causing cutaneous infections on SCC. Therefore, our report is the first case in the literature.

Interventions:

According to the culture antibiogram, S. marcescens was ciprofloxacin sensitive. Consequently, 1000 mg/day ciprofloxacin was initiated for 14 days.

Outcomes:

Purulent exudate in skin cancers may be caused by the nature of carcinoma tissue as well as the colonization of opportunistic pathogen microorganisms as seen in our patient.

Lessons:

Examination of the wound cultures and elimination of infections are critical in these cases.
Predictive power of a single body temperature at different cutoff values for neonates in the nursery transferring to special care nursery
Authors: Lee En-Pei , Yu Meng-Kung , Lee Shu-Chun , Gao Feng-Xia , Wu Han-Ping
Published: October 2018

The aim of this study was to identify the clinical parameters indicative of serious etiology of neonatal hyperthermia and to determine the appropriate cutoff value of body temperature (BT) for predicting the need to transfer the newborn to the special care (SC) nursery.

The nursery records of newborns diagnosed with hyperthermia between 2007 and 2013 were retrospectively reviewed. The clinical characteristics of newborns with hyperthermia remained in the nursery were compared with those transferred to the SC nursery. In addition, the receiver operating characteristic analysis was used to determine the appropriate cutoff BT for predicting further septic workup in the SC nursery.

Among the 92 newborns with hyperthermia evaluated, 30 (32.6%) were transferred to the SC nursery and 62 (67.4%) remained in the nursery. Clinical characteristics associated with transfer to the SC nursery included the highest BT, BT at first measurement during hyperthermia, frequency of hyperthermia, duration of hyperthermia, irritable crying, decreased appetite, poor activity, vomiting with abdominal distension, tachypnea, and tachycardia (all P < .05). BT for predicting the need for transferring newborns with hyperthermia to the SC nursery had an area under the curve of 0.976 (P < .001). A BT of 38 °C was determined as the optimal cutoff value for predicting the need to monitoring for suspicious clinical symptoms (sensitivity (Sn), 93%; specificity (Sp), 87%). Furthermore, BT≥38.2 °C (Sn, 70%; Sp 100%) and BT≤37.8 °C (Sn, 100%; Sp, 61%) respectively were determined as the cutoff values for transferring newborns to the SC nursery or allowing them to remain in the regular nursery.

Our results suggest a BT of 38 °C represents the optimal cutoff indicating newborns for close monitoring for suspicious clinical presentations including irritable crying, decreased appetite, poor activity, vomiting with abdominal distension, tachypnea, and tachycardia. Newborns with BT < 37.8 °C may remain in the nursery but should be transferred to the SC nursery for septic workup and empiric antibiotics if the BT is above 38.2 °C.
Intra-arterial chemotherapy for unilateral advanced intraocular retinoblastoma
Authors: Wang Liang , Han Minglei , Zhao Junyang , Wu Changhua , Wang Zhongqi , Li Jing , Song Dan , Wang Changfeng , Yang Yang , Guo Lei
Published: October 2018

Intra-arterial chemotherapy (IAC) has become an essential technique for the management of advanced intraocular retinoblastoma (RB). In this study, the aim of this article is to describe the clinical results and the short-term complications of IAC performed in our hospital.

We retrospectively analyzed patients with newly diagnosed unilateral advanced intraocular (group D or E) RB undergoing IAC from October 2016 to December 2017 in our hospital. We recorded the data including age, gender, cycles of IAC, pathway of arteries approached (ophthalmic artery or middle meningeal artery), ocular and systematic complications, globe salvage.

Sixty-one patients underwent IAC performing 189 procedures with a median of 3.1 sessions per eye (range, 1–5 sessions). The overall globe salvage rate is 78.7% (Group D (84.2%), and Group E (69.6%) and followed-up. Short-term ocular complications include eyelid edema (15 cases), ptosis (5 cases), forehead congestion (3 cases), retina hemorrhage (5 cases), choroid atrophy (2 cases), phthisis bulbi (1 case), bradycardia and hypotension during the procedure (7cases), myelosuppressions (6 cases), and nausea and vomiting (5cases).

IAC is safe and effective for the treatment of unilateral advanced intraocular RB with a very low complication rate.
Effects of alendronate for treatment of glucocorticoid-induced osteoporosis
Authors: Wang Ya-Kang , Zhang Yu-min , Qin Si-Qing , Wang Xu , Ma Tao , Guo Jian-Bin , Zhu Chao , Luo Zhuo-Jing
Published: October 2018

Background:

Alendronate has been used to prevent or treat glucocorticoid-induced osteoporosis (GIO), data regarding its efficacy are inconsistent. We conducted the current systematic review and meta-analysis to evaluate both efficacy and safety of alendronate in the treatment of GIO.

Methods:

PubMed, Embase, the Cochrane Controlled Trials Registry, and the China Academic Journal Network Publishing Databases were searched up through March 1, 2018. Randomized controlled trials (RCTs) involving patients which received alendronate treatment were included. Outcome measures were bone mineral density (BMD) changes, bone fractures, and adverse reactions. Data from the individual studies were pooled using random or fixed effect models based on heterogeneity. Effect size was reported as standardized mean differences (SMD) for continuous outcomes and pooled odds ratios (OR) for dichotomous outcomes, with 95% confidence interval (CI).

Results:

Overall, 10 studies involving 1002 patients were included in the present investigation. Alendronate treatment significantly increased BMD of the lumbar spine and femoral neck during 6 to 24 months. These beneficial effects were apparent at 12 months after treatment for the lumbar spine but not the femoral neck BMD. Alendronate treatment did not significantly change fracture risk nor induce significant differences in adverse gastrointestinal effects.

Conclusion:

Alendronate significantly increases BMD of the lumbar spine and femoral neck in patients with GIO, but does not appear to reduce the risk of fractures. As relatively insufficient data regarding the GIO fracture incidence has been reported, more RCTs need to be carried out to determine the efficacy of alendronate in the prevention of GIO fracture.