bluuebunny/crossref_metadata_2025_split huggingface dataset:
Could Sociocracy be the Way to MSME Governance?
Authors: Saxena Anand , Jagota Rajni 
Published: January 2017

In an earlier article, we addressed the question: Should the MSMEs, that is, the micro, small and medium enterprises, be governed the corporate way? Drawing on (a) the contribution of the MSMEs to the economic and social development in their respective settings, (b) systemic nature of their ailments, (c) institutional and organisational contingency theory of corporate governance and (d) the theory of articulation (upward delegation) of decision-making, we suggested a model of articulation of the MSME governance ( Saxena & Jagota, 2015 ). In this article, we delve deeper into the issue of the MSME governance with reference to the emerging paradigm of dynamic governance that is known in Europe and other parts of the world as sociocracy. The word sociocracy is derived from the Latin and Greek words socius (companion) and kratein (to govern). It implies the rule by the ‘socios’, people who have a social relationship with each other—as opposed to the democracy rule by the ‘demos’, the general mass of people. As a system of governance, it relies on consent-based decision-making through active self-disclosure and feedback. It is stated to streamline decision-making, kindle creativity, innovation and entrepreneurial spirit and heighten productivity via individual engagement, commitment and empowerment. We posit that such a system of governance is particularly suitable for ethnic entrepreneurship, natural business clusters and the social and solidarity economy that many a country in Asia and Africa typify. In this article, we penetrate deeper into the functioning of representative clusters and communities and delineate principles and practices that could provide the edifice of the sociocratic architecture and dynamics of the MSME governance.
The Interaction of Salivary Secretions with the Human Complement System — A Model for the Study of Host Defense Systems on Inflamed Mucosal Surfaces
Authors: Boackle Robert J. 
Published: January 2017

When complement first contacts salivary secretions, as when gingival crevicular fluid first meets saliva at the gingival margin, complement function is enhanced. The immediate potentiation of the complement system at equal volume ratios of serum to saliva is due to several factors, including the lower ionic strength of saliva when compared with serum and the presence of certain salivary glyproteins such as the nonimmunoglobulin agglutinins that appear to simultaneously activate Cl and affect (sequester) certain complement control proteins, such as Factor H. This initial potentiation of the complement cascade by saliva may aid in defending the area immediately above the gingival crevice from oral microbiota that are being coated with a combination of serous exudate components and salivary components. As serum becomes much more diluted with saliva (i.e., crevicular fluid moves away from the supragingival area), the acidic proline-rich salivary proteins (APRP) begin to disrupt the unbound Clq-Clr2-Cls2 macromolecular complexes. Thus, the APRP along with other C1 fixing substances in saliva appear to restrict complement function, but only when the ratios of saliva to serum exceed 250 :1. Since certain salivary glycoproteins bind to viruses, the potentiation of the complement system by saliva may also play a role in neutralizing certain viral infections on mucosal surfaces where tissue transudates containing complement begin to contact mucosal secretions such as saliva. Again, the ratio of serous fluid to mucosal secretion appears to be an important factor. This article also discusses some of our preliminary data and speculations concerning the binding of the self-associating high-molecular-weight nonimmunoglobulin salivary agglutinins (NIA) with the envelope of the human immunodeficiency virus (HIV) and the possible cooperative role of Clq and fibronectin in aiding neutralization of HIV infectivity.
Tooth Movement
Authors: Davidovitch Zeev 
Published: January 2017

This article reviews the evolution of concepts regarding the biological foundation of force-induced tooth movement. Nineteenth century hypotheses proposed two mechanisms: application of pressure and tension to the periodontal ligament (PDL), and bending of the alveolar bone. Histologic investigations in the early and middle years of the 20th century revealed that both phenomena actually occur concomitantly, and that cells, as well as extracellular components of the PDL and alveolar bone, participate in the response to applied mechanical forces, which ultimately results in remodeling activities. Experiments with isolated cells in culture demonstrated that shape distortion might lead to cellular activation, either by opening plasma membrane ion channels, or by crystallizing cytoskeletal filaments. Mechanical distortion of collagenous matrices, mineralized or non-mineralized, may, on the other hand, evoke the development of bioelectric phenomena (stress-generated potentials and streaming potentials) that are capable of stimulating cells by altering the electric charge on their membrane or their fluid envelope. In intact animals, mechanical perturbations on the order of about 1 min/d are apparently sufficient to cause profound osteogenic responses, perhaps due to matrix proteoglycan-related "strain memory". Enzymatically isolated human PDL cells respond biochemically to mechanical and chemical signals. The latter include endocrines, autocrines, and paracrines. Histochemical and immunohistochemical studies showed that during the early places of tooth movement, PDL fluids are shifted, and cells and matrix are distorted. Vasoactive neurotransmitters are released from periodontal nerve terminals, causing leukocytes to migrate out of adjacent capillaries. Cytokines and growth factors are secreted by these cells, stimulating PDL cells and alveolar bone lining cells to remodel their related matrices. This remodeling activity facilitates movement of teeth into areas in which bone had been resorbed. This emerging information suggests that in the living mammal, many cell types are involved in the biological response to applied mechanical stress to teeth, and thereby to bone. Essentially, cells of the nervous, immune, and endocrine systems become involved in the activation and response of PDL and alveolar bone cells to applied stresses. This fact implies that research in the area of the biological response to force application to teeth should be sufficiently broad to include explorations of possible associations between physical, cellular, and molecular phenomena. The goals of this investigative field should continue to expound on fundamental principles, particularly on extrapolating new findings to the clinical environment, where millions of patients are subjected annually to applications of mechanical forces to their teeth for long periods of time in an effort to improve their position in the oral cavity. Recently developed research tools such as cell culture techniques and immunologic probes, are the best hope for enhancing this development.
Aminoglycoside-Associated Nephrotoxicity in the Elderly
Authors: Baciewicz Anne M , Sokos Denise R , Cowan Ronald I 
Published: January 2017

OBJECTIVE: To determine whether there was an increased incidence of nephrotoxicity in elderly patients (≥65 y) prescribed single-dose (SD) versus multiple-dose (MD) aminoglycosides and whether aminoglycoside-induced nephrotoxicity was associated with length of therapy and other risk factors. METHODS: A prospective, observational audit at a university teaching hospital was conducted. Physician prescribing was used to stratify subjects according to dosing regimen: MD (n = 60) or SD (n = 26). Nephrotoxicity was defined as an increase in the serum creatinine level of 0.5 mg/dL sustained over 2 days. RESULTS: Eighty-six patients were included; 9.3% developed nephrotoxicity, of whom 62.5% received SD therapy. The incidence of nephrotoxicity did not differ between regimens (p = 0.051). There was an increased length of therapy in those who developed nephrotoxicity (mean ± SD 6.1 ± 6.2 vs. 3.7 ± 2.8 d; p = 0.044). Additionally, patients who developed nephrotoxicity had an increased length of hospitalization (20.3 ± 16.1 vs. 8.4 ± 5.4 d; p < 0.001). Nephrotoxicity correlated with a diagnosis of diabetes mellitus (OR 15.1; 95% CI 1.11 to 205), concomitant angiotensin-converting enzyme (ACE) inhibitor therapy (OR 28.0; 95% CI 2.15 to 365), and SD therapy (OR 20.7; 95% CI 1.45 to 297). CONCLUSIONS: Our overall incidence of nephrotoxicity is consistent with that reported in the literature. A diagnosis of diabetes mellitus, concomitant use of ACE inhibitors, and SD regimens were risk factors for the development of nephrotoxicity. An adequately powered, randomized trial is needed to assess whether a difference in the incidence of nephrotoxicity exists between SD and MD therapy in the elderly.
Antifungal Susceptibility Testing in Teaching Hospitals
Authors: Pai Manjunath P , Pendland Susan L 
Published: January 2017

BACKGROUND: An assessment of antifungal susceptibility testing (AST) has not been conducted since the introduction of the National Committee for Clinical Laboratory Standards (NCCLS) M27-A document. OBJECTIVE: To determine AST practices in teaching hospitals. METHODS: A questionnaire was mailed to the heads of 386 randomly assigned microbiology departments from teaching hospitals identified through the 2000 American Hospital Association Guide. Identifiers were used to delineate responders from nonresponders. A reminder letter was mailed 3 weeks after the initial mailing to all nonresponders. The hospital bed-size and number of inpatient days for respondents were obtained through the American Hospital Directory. RESULTS: The questionnaire was returned by 171 (44.3%) institutions. The total and median (range) number of candida isolates were 137 088 and 8.5 (1–145)/1000 inpatient days for the year 2000, respectively. Approximately 1% (1300) of candida isolates, from predominantly blood specimens, underwent AST. AST was reported by 115 (67.2%) hospitals, with testing on site at 27 hospitals and off site for 88 hospitals. NCCLS methodology (80% broth microdilution) was used by 75% of the hospitals performing on-site AST. The median time to obtain AST results was significantly lower when testing was performed on site (3 d) compared with off site (7–10 d). SUMMARY: A large number of candida bloodstream isolates undergoes AST annually. AST results are obtained sooner when performed on site compared with off site.
Acute Liver Failure with Concurrent Bupropion and Carbimazole Therapy
Authors: Ai-Leng Khoo , Lai-San Tham , Kang-Hoe Lee , Gek-Kee Lim 
Published: January 2017

OBJECTIVE: To report a case of fatal liver failure possibly associated with concurrent use of bupropion and carbimazole. CASE SUMMARY: A 41-year-old Chinese man with a history of hyperthyroidism had been treated with carbimazole and propranolol for the past 5 years. He received a 10-day course of bupropion as an aid for smoking cessation 10 weeks prior to presentation. He developed acute liver failure with rapid deterioration of renal function. Liver biopsy showed evidence of nonspecific drug-induced acute liver injury. His condition was further complicated by sepsis and coagulopathy. Death resulted 19 days after the onset of symptoms. The likelihood that bupropion induced hepatotoxicity in our patient was possible, based on the Naranjo probability scale. DISCUSSION: Although there is increasing evidence of hepatotoxicity induced by bupropion, this is the first case of fatality that could have resulted from acute liver failure in a patient receiving bupropion while on concomitant treatment with carbimazole. CONCLUSIONS: Clinicians should be aware of the possibility of acute liver insult induced by bupropion given concurrently with other hepatotoxic drugs.
Fulminant Hepatic Failure Associated with Propylthiouracil
Authors: Ruiz Jorge K , Rossi Giorgio V , Vallejos Humberto A , Brenet Rosemarie W , Lopez Isabel B , Escribano Alfonso A 
Published: January 2017

OBJECTIVE: To report 2 fatal cases of fulminant hepatic failure associated with propylthiouracil treatment against hyperthyroidism. CASE SUMMARY: Two women, 30 and 32 years old with no previous liver disease, were treated with propylthiouracil against Graves' disease. Both patients developed jaundice after a 4- and 5-month treatment period, respectively. The disease was similar to viral hepatitis, with a progressive course to severe liver dysfunction and death, along with multisystem organ failure despite extensive therapeutic measures. One of the patients was pregnant and subsequently miscarried. Neither patient had a history of alcoholism, drug abuse, blood transfusion, or exposure to hepatitis A, B, or C. Extrahepatic obstruction was ruled out with an abdominal ultrasonogram. Serologic studies and immunologic tests were negative. A submassive necrosis was shown in a postmortem histologic study. DISCUSSION: Naranjo probability scale criteria applied to both cases confirm the adverse reactions as probable. These cases fit the requirements of drug hepatotoxicity proposed by Hanson and the Council of the International Organization of Medical Sciences. Eight deaths associated to propylthiouracil were found in our review of the medical literature up to December 2000. CONCLUSIONS: Despite the widespread use of propylthiouracil, fulminant hepatitis with death is exceptionally rare; these 2 cases could be added to the fatal outcomes published to date.
Factors Influencing Consumer Use of Written Drug Information
Authors: Koo Michelle M , Krass Ines , Aslani Parisa 
Published: January 2017

OBJECTIVE: To provide an overview of the use and impact of written drug information (WDI) on consumers, and to review the literature on the factors influencing the use of WDI by consumers. DATA SOURCES: Relevant articles published in English since the late 1970s were identified based on searches of on-line databases, texts, and cited references in published articles. STUDY SELECTION: Articles reporting findings on the origin, use, and impact of WDI were included. Due to limited literature, articles reporting findings on factors influencing the use of written drug as well as disease information were included. DATA EXTRACTION: Due to the lack of design consistency between studies and the comparatively small volume of work, subjective assessment rather than a criteria-based objective review was deemed more appropriate. DATA SYNTHESIS: To date, research on WDI has focused on its use and impact. WDI has the potential to increase patients' knowledge, compliance, and satisfaction. However, there is also the potential for anxiety or premature cessation of therapy due to fear of possible adverse effects. Multiple factors may potentially influence the use of WDI by consumers including those associated with the written information document (readability, presentation), the patient (health literacy, role of caregiver, demographic factors, health locus of control, coping style, health belief model), and the environment (timing of provision, experience). CONCLUSIONS: WDI has the potential to impact consumers positively and negatively. Although not widely investigated, a number of factors can potentially influence the use of WDI by consumers. The findings of this review can form the basis for much needed further research.
The Dose of Epinephrine during Cardiopulmonary Resuscitation in Humans: What Should it Be?
Authors: Gonzalez Edgar R. , Ornato Joseph P. 
Published: January 2017

The objective of vasopressor therapy during closed-chest cardiopulmonary resuscitation (CPR) is to augment coronary perfusion pressure so that spontaneous circulation can be reestablished. Epinephrine, an endogenous catecholamine with both alpha- and beta-adrenergic activity, is the vasopressor of choice for use during CPR. Epinephrine's potent alpha,- and alpha2-adrenergic effects improve cerebral and myocardial blood flow by preventing arterial collapse and by increasing peripheral vasoconstriction. The optimal dose of epinephrine in humans during closed-chest CPR is unknown. Studies suggest that the dose of epinephrine currently recommended during CPR may be five to ten times lower than the dose required to produce the beneficial pharmacologic effects observed in animal models of closed-chest CPR. Data from patients with prehospital cardiac arrest indicate that a 5-mg dose of epinephrine may be required to increase diastolic blood pressure above 30 mm Hg. Until additional data are available, our clinical experience suggests that all patients should receive at least one 1-mg dose of epinephrine. If the patient fails to respond, the administration of 3–5 mg of epinephrine every five minutes or the use of continuous infusions of epinephrine (0.2–0.6 mg/min) may be indicated. The results of ongoing clinical trials comparing conventional epinephrine regimens with high-dose regimens will provide valuable information and will assist clinicians in establishing an optimal dosage range for epinephrine during CPR in humans. What is the best vasopressor regimen to use during CPR in humans? Although dopamine, methoxamine, phenylephrine, or norepinephrine have been used during resuscitation, epinephrine is still the vasopressor agent of choice.5 The optimal dose of epinephrine during CPR in humans remains to be determined. It is likely that a range of dosages will be needed to account for differences in vascular reactivity between prehospital cardiac arrest victims with prolonged down-times and inpatients with witnessed cardiac arrest and immediate ACLS. The use of high-dose epinephrine is not without risks. Epinephrine may precipitate myocardial ischemia, tachyarrhythmias, hypertensive crisis, pulmonary edema, digitalis toxicity, and cardiac arrest.5 Antidepressants, anesthetics, sympathomimetics, bretylium, and phosphodiesterase inhibitors potentiate epinephrine's arrhythmogenic effect.50 Until definitive data are available, our clinical experience suggests that all patients should receive at least one dose of epinephrine 1 mg. If the patient fails to respond, the administration of epinephrine 3–5 mg every five minutes or the use of continuous infusions of epinephrine (0.2–0.6 mg/min) may be indicated. Whenever possible the administration of epinephrine, especially at a higher dose or by continuous infusion, should be accomplished through an indwelling central venous catheter.
Parenteral and Oral Fluconazole for Acute Cryptococcal Meningitis in Aids: Experience with Thirteen Patients
Authors: Stern John J. , Pietroski Nancy A. , Buckley R. Michael , Braffman Michael N. , Rinaldi Michael G. 
Published: January 2017

OBJECTIVE: Cryptococcus neoformans infections of the central nervous system affect up to ten percent of AIDS patients. Standard therapy with amphotericin B with or without 5-flucytosine has a high rate of failure, relapse, and toxicity. Fluconazole is a new triazole antifungal agent available in both oral and intravenous forms that has shown efficacy in the primary and maintenance treatment of cryptococcal meningitis in AIDS patients. In this open, noncomparative trial, we evaluated the safety and efficacy of intravenous fluconazole followed by oral fluconazole in the treatment of acute cryptococcal meningitis in AIDS patients. METHODS: Thirteen AIDS patients with acute cryptococcal meningitis, or relapse after successful primary therapy, received 400 mg of intravenous fluconazole daily for 12–16 days followed by oral fluconazole 400 mg/d for the duration of primary therapy. If cerebrospinal fluid (CSF) cultures converted to negative within 32 weeks of treatment, the fluconazole dose was decreased to 200 mg/d as maintenance therapy. RESULTS: Fluconazole therapy was successful in six patients (46 percent) and unsuccessful in seven (54 percent). Of the seven patients considered unsuccessful, one demonstrated clinical improvement but remained CSF-culture positive, five were clinical failures and were switched to amphotericin B therapy, and one died after two weeks secondary to cryptococcal meningitis. No patient experienced any adverse reactions necessitating discontinuation of therapy. CONCLUSIONS: In this small group of patients, moderate doses of parenteral and oral fluconazole for acute cryptococcal meningitis in AIDS patients demonstrated failure rates similar to those reported in other studies with fluconazole and with amphotericin B. As there was no difference in initial Karnofsky scores or the severity of disease in treatment successes versus failures, it is difficult to determine who might respond to fluconazole as initial therapy or who should be treated initially with another agent. Further studies and clinical experience are needed.
Possible Correlation between Glycemia and Blood Pressure in Black, Diabetic, Hypertensive Patients
Authors: Jaber Linda A. , Melchior Wayne R. , Rutledge David R. 
Published: January 2017

OBJECTIVE: To determine if there is any association between glycemia and blood pressure in black patients with hypertension and diabetes mellitus whose antihypertensive medications had been unchanged for six months. DESIGN: Retrospective, from March 1990 through February 1991. SETTING: Internal medicine ambulatory clinic at Detroit Receiving Hospital/University Health Center. PATIENTS: Patients seen during this period with hypertension and type II diabetes. Of the 639 possible subjects, 124 met the following criteria: (1) no change in antihypertensive medications for six months, (2) absence of secondary hypertension, and (3) weight change (if any) was less than five percent. Changes in antihypertensive medication(s) excluded 388 patients, secondary hypertension excluded 3, weight changes of more than five percent excluded 94, and lack of matching postprandial capillary blood glucose (PCBG) values excluded 30. The mean age of the subjects was 66.8 years, mean diabetes duration was 12.0 years, mean PCBG was 10.7 mmol, mean systolic blood pressure (SBP) was 154.3 mm Hg, mean diastolic blood pressure (DBP) was 90.1 mm Hg. There were 28 men in the study and 96 women; 90 were obese (body mass index >25 kg/m2) and 34 were nonobese. The diabetes was managed with insulin in 67 patients, with sulfonylureas in 50, and with diet in 7. intervention: None MAIN OUTCOME MEASURES: SBP and DBP versus PCBG at matching times both at baseline and at six months. RESULTS: There was a positive association between blood pressure measurements and glycemia. Overall change in SBP was strongly correlated with PCBG changes (r=0.745, p<0.0001). Improved glycemia correlated with improved SBP control (r=0.330, p<0.0024). Deterioration of glycemia correlated with a worsening of SBP control (r=0.445, p<0.0053). The method of blood glucose control had no statistically significant effect (ANOVA) on these results. CONCLUSIONS: Glycemia is positively associated with blood pressure.