bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efavirenz Severe Hypersensitivity Reaction: Case Report and Rapid Desensitization Protocol Development
Authors: Khalili Hossein , Farasatinasab Maryam , Hajiabdolbaghi Mahboobeh 
Published: April 2012

Objective: Long-term efavirenz desensitization protocols have been reported; however, publication of a rapid desensitization protocol has not been noted to date. We report a case of severe hypersensitivity reaction that was successfully managed using a rapid desensitization protocol. Case Summary: In a 52-year old HIV-positive woman, antiretroviral therapy was started with lamivudine 150 mg twice daily, zidovudine 300 mg twice daily, and efavirenz 600 mg daily. Nine days after starting antiretroviral therapy, she developed a generalized maculopapular rash. Despite concomitant chlorpheniramine administration, the rash did not improve. With suspicion of efavirenz hypersensitivity reaction, efavirenz was discontinued for 5 days and when the patient's rash resolved, the drug was restarted at 600 mg daily. The patient developed a severe generalized pruritic rash the next day and all antiretroviral agents were discontinued. One week later, lamivudine and zidovudine were restarted and were well tolerated. An objective causality assessment revealed that an efavirenz hypersensitivity reaction was probable. A 7-hour efavirenz desensitization protocol, starting with a 1:20,000 solution of the target therapeutic dose, was successful. The patient was followed for 6 weeks and had no further signs or symptoms of a hypersensitivity reaction. Discussion: Efavirenz hypersensitivity reactions typically include cutaneous reactions that are observed in the first 2 weeks of treatment, are often mild to moderate without systemic manifestation, and improve with continued therapy. Previously, successful desensitization protocols have been described in patients receiving efavirenz who developed rash without systemic symptoms, but these protocols were carried out over 7 or 14 days. This case report indicates a rapid desensitization protocol that may be an available option for some patients. Conclusions: Considering that efavirenz can be the cornerstone of many antiretroviral therapy regimens and hypersensitivity reactions can restrict regimen options, effective desensitization protocols are valuable, especially in the developing countries with limited available antiretroviral drugs.
External Economic Exploitation in the DRC: 1990–2005
Authors: Kabamba Patience 
Published: April 2012

In his conclusion to his seminal book,Politics in the Congo(1965), Crawford Young wrote the following:Belgium … constructed in Africa a colonial state which stood out by the thoroughness of its organization, the formidable accretion of power through an interlocking alliance of state, church, and capital, and the ambition of its economic and social objectives. The very strength of the system as a colonial structure, and its steadfast refusal to face effectively the problem of political adaptation until it began to disintegrate, made an ordered transfer of power peculiarly difficult. A colonizer who suddenly lost the profound conviction of the righteousness of his policy was confronted with a revolution by the colonized which lacked both structure and ideology. Total colonialism was replaced by total independence virtually overnight, yet the very completeness of the victory of the colonized had as its concomitant an impotence which emptied success of its substance. (1965:572)
The Political Economy of Reforms in Kenya: The Post-2007 Election Violence and a New Constitution
Authors: Kanyinga Karuti , Long James D. 
Published: April 2012

Abstract:This article explores the package of “Agenda item 4” reforms undertaken by the Kenyan government in the mediation process following the 2007–8 postelection violence, including those relating to long-standing issues over constitutional revision. It situates the previous lack of reforms within Kenya's political economy and demonstrates how political and economic interests thwarted progress and produced the postelection crisis. It also examines the more recent attempts to address reforms following the signing of the National Accord and the creation of a power-sharing government, and finds strong public support for constitutional revision. It concludes that these pressures from below, along with a realignment of political interests and institutional change from power-sharing, helped support reform.
The Continuing Process of Decolonization in the Congo: Fifty Years Later
Authors: Newbury David 
Published: April 2012

IntroductionWhile independence negotiations in the Congo were succinct, decolonization was a long and tortuous process. Indeed, in some respects it continues today, at least in the eyes of many people in eastern Congo, who feel that the formal demands of the colonial state are reflected in the informal impositions of the current state—and of neighboring states. Certainly many Congolese today feel that they have no adequate state structure to address their collective needs as a people, or to represent them on an international stage, or even to protect them from invasion, extraction, and occupation. Lacking effective state structures to protect their interests is not new: the colonial state in the Congo was marked by its intrusive presence in mobilizing labor, requiring crop production, and imposing taxes, among many other demands. But the character of life in the Congo today does not reflect anyone's vision of what independence would bring. At best, the last fifty years can be seen as a process of an aborted decolonization, and in some ways the violence now present in the Congo can be seen as the result of the unfulfilled aspirations of decolonization—or as the deferred violence of a decolonization gone awry (see Newbury 2009).
Reform and Political Impunity in Kenya: Transparency without Accountability
Authors: Gīthīnji Mwangi wa , Holmquist Frank 
Published: April 2012

Abstract:Kenya has been going through a period of political reform since 1991, when section 2A of the constitution, which had made Kenya a de jure one-party state, was repealed. This reform followed a prolonged struggle on the part of citizens both inside and outside the country, and their call for democracy was one that, after the fall of the Berlin Wall, was embraced by Western countries. Via diplomatic pressure and conditionality on aid, Western donors played an important role in the repeal of section 2A, the return of multiparty elections, and the creation and reform of a number of political institutions and offices via a separation of powers. But although these changes were supported by the political opposition and much of civil society in Kenya, they did not rise organically from the national struggle over political power. Nor did these reforms lead to a determination in the country to hold the political elite accountable for their transgressions. This article argues that modern Kenya's history of economic and political inequality has resulted in a population whose very divisions make it difficult for politicians to be disciplined. Accountability has two dimensions: the horizontal accountability among branches of government that is assured by checks and balances, and the vertical accountability of the state to its citizens. Vertical accountability depends on a constituency of like-minded citizens defending broad national interests, or an electorate with a collective identity or set of identities attached to the Kenyan nation. But in the absence of such shared goals and demands, narrow personal and local interests prevail, and politicians remain unaccountable to the nation as a whole.
China in Ethiopia: Diplomacy and Economics of Sino-optimism
Authors: Adem Seifudein 
Published: April 2012

Abstract:This article examines the motive behind China's increased activities in Ethiopia in recent years and concludes that it lies in Ethiopia's perceived diplomatic usefulness. If China's relations with many African countries could be described as one of “infrastructure for natural resources,” the Sino-Ethiopian relationship can be described “infrastructure for diplomatic support.” After exploring the nature and scope of Ethiopia's relations with China and highlighting areas of divergence of interest, the article seeks to demonstrate how the convergence of interests between the two countries has ushered in a period of Sino-optimism among Ethiopia's elite and rising expectations among ordinary Ethiopians.
Land Conflict and Distributive Politics in Kenya
Authors: Boone Catherine 
Published: April 2012

Abstract:This paper argues that even with the incorporation of land policy provisions into Kenya's new constitution, there is every reason to believe that in the near future, highly politicized land conflict will continue. This is because land politics in Kenya is a redistributive game that creates winners and losers. Given the intensely redistributive potential of the impending changes in Kenya's land regime—and the implications of the downward shift in the locus of control over land allocation through decentralization of authority to county governments—there is no guarantee that legislators or citizens will be able to agree on concrete laws to realize the constitution's calls for equity and justice in land matters. This article traces the main ways in which state power has been used to distribute and redistribute land (and land rights) in the Rift Valley, focusing on post-1960 smallholder settlement schemes, land-buying companies, and settlement in the forest reserves, and it highlights the long-standing pattern of political contestation over the allocation of this resource. It then traces the National Land Policy debate from 2002 to 2010, focusing on the distributive overtones and undertones of the policy and of the debate over the new constitution that incorporated some of its main tenets.
Changing Strategies in Marketing Kenya's Tourist Art: From Ethnic Brands to Fair Trade Labels
Authors: Mahoney Dillon 
Published: April 2012

Abstract:This article explores recent changes in Kenya's curio or handicrafts industry. In addition to a crisis in access to raw materials and a diversifying tourist market, the rise in the use of cell phones and the Internet during the early 2000s present unique challenges. Nonetheless, innovative Kenyan entrepreneurs are using these challenges to market and brand products in new ways—by representing modern global interconnectedness as “fair trade” or creatively promoting the authenticity of their products in other ways. Kenya's artisans and traders have also adapted to diverse and complex tastes beyond the desire for an invented tradition of ethnic and “tribal” art.
Introduction: Decolonization in the Congo (DRC)—Fifty Years Later
Authors: Kapanga Kasongo M. 
Published: April 2012

Fifty years after the occurrence of a major event, a golden jubilee, is often an opportunity for celebration and reminiscing over fond memories. Conventional wisdom would project such an event as a landmark likely to serve as a stepping stone toward greater achievements.As in most African countries on Independence Day, there were formalities in Kinshasa on June 30, 2010. But while the political establishment— flanked with foreign dignitaries, including King Albert II and Queen Paola of Belgium—watched a military parade to showcase the existence of political institutions, unusually large numbers of ordinary people went about their normal daily business. The general mood in both the capital city and elsewhere was one of indifference, reflecting the hardships of daily life and the challenges of mere survival: over the course of fifty years, the per capita income had been halved. The whole atmosphere had an eerie feeling, suggesting a tamed anxiety and a simmering anger from unfulfilled promises. The euphoria of the 1960s has withered into the obvious gloom made visible in the tattered infrastructure of the capital city. InJune 2010, the mood was more somber than celebratory.
Land and the Quest for a Democratic State in Kenya: Bringing Citizens Back In
Authors: Harbeson John W. 
Published: April 2012

Abstract:Kenya's current constitutional moment has included both the first pop ularly ratified constitution and its first postindependence comprehensive land reform policy. The roughly temporally parallel processes that brought about these two signal achievements have inserted the interests of ordinary Kenyans into this constitutional moment in a way that elections and constitutional ratification alone would not have, reflecting more than two decades of civil society pressure. The new democratized land tenure policy removes land allocation decisions from pervasive executive branch abuse and vests them in a democratically elected Parliament. In this fundamental respect, the Kenya constitutional implementation process appears to privilege procedural and deliberative democracy as the source of substantive democratic land tenure outcomes, and by extension, the terms on which Kenyans relate to each other and their leaders. Upon the outcomes of these deliberations may well hinge the future stability as well as the democratic quality of the Kenyan state.
Perceptions of Family Members of Children with Cleft Lip and Palate in Hyderabad, India, and Its Rural Outskirts regarding Craniofacial Anomalies: A Pilot Study
Authors: Naram Aparajit , Makhijani Sumeet N. , Naram Depack , Reddy Srinivas Gosla , Reddy Rajgopal R. , Lalikos Janice F. , Chao Jerome Donald 
Published: April 2012

Objective This pilot study aimed to understand cultural perspectives on cleft anomalies in the community of Hyderabad, India, and its rural outskirts. Design Interviews focusing on perceptions of cleft lip and palate were conducted using a 21-item interview guide approved by the director of the Gosla Srinivas Reddy Institute of Craniofacial Surgery (GSR). Settings Interviews were conducted at GSR, a specialty surgical center located in Hyderabad, India. Patients and Participants All patients who presented to GSR with either cleft lip, cleft palate, or cleft lip and palate at the time of this study were included. Results Of the 23 families interviewed, 12 mothers believed the cleft was caused by an eclipse, and two believed the scientific explanation their physician offered. Fourteen families were offered no explanation for the cleft lip and/or palate at the time of their first physician visit. No families practiced non-Western methods for treatment of the cleft. One family identified beliefs held in the community that their child with a cleft lip was bad luck. Conclusion A commonly held belief in this community in India is that cleft lip, cleft palate, or cleft lip and palate are caused by an eclipse. Physicians appear to be providing families with insufficient education on cleft impairments. Data generated from studies similar to this can be used to design educational protocols that address this gap in community understanding of orofacial clefting.
A Novel Expression of Exercise Induced Pulmonary Hypertension in Human Immunodeficiency Virus Patients: A Pilot Study
Authors: Doukky Rami , Lee Won Y , Ravilla Mahindhar , Lateef Omar B , Pelaez Victor , French Audrey , Tandon Rajive 
Published: April 2012

Background:Patients with the human immunodeficiency virus (HIV) are at risk for multiple pulmonary complications including pulmonary hypertension. Exercise induced pulmonary hypertension (EIPH) has been previously described in patients with scleroderma, sickle cell disease and chronic obstructive pulmonary disease, yet has not been associated with the HIV population.Methods:A prospective case-control study design was implemented. Four HIV patients with unexplained dyspnea and four healthy controls underwent symptom-limited stationary bicycle exercise. Transthoracic Doppler Echocardiography was used to measure tricuspid regurgitation velocity which was used to calculate the right ventricular to right atrial pressure (RV-RA) gradient at rest and at peak exercise using the simplified Bernoulli’s equation. Change in RV-RA gradient between rest and peak exercise was calculated and considered to represent change in pulmonary arterial systolic pressure.Results:The mean age was 41.25 years (±8.7) for patients and 33.5 years (±6.0) for controls. The mean CD4 count of patients was 191.5 cells/μL (±136.2). Patients had a significantly higher increase in RV-RA gradient as compared to controls (180.2% vs. 27.5%, p = 0.03).Discussion:This pilot study suggests that it is feasible to use recumbent bicycle and transthoracic Doppler echocardiography for the evaluation of EIPH among HIV patients with dyspnea of unknown etiology. The study is too small to draw any broad conclusion. Further evaluation of this concept with a larger study is warranted.
Soluble ST2 as a Diagnostic and Prognostic Marker for Acute Heart Failure Syndromes
Authors: Henry-Okafor Queen , P. Collins Sean , A. Jenkins Cathy , F. Miller Karen , J. Maron David , J. Naftilan Allen , Weintraub Neal , J. Fermann Gregory , McPherson John , Menon Santosh , B. Sawyer Douglas , B. Storrow Alan 
Published: April 2012

Objectives:
We investigated the association of sST2 with diagnostic and prognostic outcomes and assessed whether it aids B-natriuretic peptide (BNP) in diagnosing and predicting outcomes in emergency department (ED) patients with suspected AHFS.

Methods:
We recruited patients who presented to the ED of 3 tertiary hospitals with signs or symptoms of AHFS and met modified Framingham criteria for AHFS. Outcome measures were a final diagnosis of AHFS and 5-and 30-day adverse events.

Results:
In the 295 subjects with sST2 available, the median sST2 was 0.20 ng/ml (IQR=0.10, 0.34). Although unadjusted analyses indicated sST2 was significantly associated with the diagnosis of AHFS (p=0.02), this was not so in the adjusted analysis (p=0.33). Moderately low diagnostic utility was noted with an AUC of 0.62 (95% CI=0.56, 0.69). Similar sST2 test characteristics were seen when BNP was restricted between 100 and 500 pg/ml. While sST2 was associated with AHFS readmission at 30-days (p=0.04), in the adjusted analyses it was not associated with adverse events.

Conclusion:
In patients with signs or symptoms of AHFS, unadjusted analyses indicated that sST2 was significantly asso-ciated with the diagnosis of AHFS and with 30-day AHFS recidivism. However, the associations did not carry over to ad-justed analyses, and sST2 did not add significant information with regard to explaining the diagnostic and prognostic vari-ability of BNP.
The Effect of Hedge Fund Activism on Corporate Tax Avoidance
Authors: Cheng C. S. Agnes , Huang Henry He , Li Yinghua , Stanfield Jason 
Published: April 2012

ABSTRACT
This paper examines the impact of hedge fund activism on corporate tax avoidance. We find that relative to matched control firms, businesses targeted by hedge fund activists exhibit lower tax avoidance levels prior to hedge fund intervention, but experience increases in tax avoidance after the intervention. Moreover, findings suggest that the increase in tax avoidance is greater when activists have a successful track record of implementing tax changes and possess tax interest or knowledge as indicated by their Securities and Exchange Commission (SEC) 13D filings. We also find that these greater tax savings do not appear to result from an increased use of high-risk and potentially illegal tax strategies, such as sheltering. Taken together, the results suggest that shareholder monitoring of firms, in the form of hedge fund activism, improves tax efficiency.
JEL Classifications: G32; G34; H26.
Data Availability: Data are available from sources identified in the text.
Cerebral dural arteriovenous fistulas and aneurysms
Authors: Gross Bradley A. , Ropper Alexander E. , Du Rose 
Published: April 2012

Object
The association of aneurysms and cerebral arteriovenous malformations is well established in the literature. Aside from a small number of case reports and small patient series, this association has not been well explored with cerebral dural arteriovenous fistulas (DAVFs). This study was designed to elucidate this relationship in the authors' own patient cohort with DAVFs.

Methods
Cerebral angiograms of 56 patients with 70 DAVFs were reviewed for the presence of cerebral aneurysms. Background patient demographics, mode of presentation, and DAVF and aneurysm angiographic characteristics were noted.

Results
Twelve patients (21%) had aneurysms in addition to their DAVF. Three patients had multiple aneurysms. Of a total of 15 aneurysms, 5 (33%) occurred on DAVF feeding arteries and 10 (67%) were in remote locations. These patients more commonly presented with hemorrhage (58% vs 20% for those without aneurysms). Aneurysms were associated with DAVFs in any location (feeding artery or remote), but flow-related feeding artery aneurysms were more likely to be associated with Borden Type III DAVFs.

Conclusions
Twenty-one percent of patients with cerebral DAVFs also had aneurysms in this patient cohort. It is thus prudent to perform 6-vessel digital subtraction angiography on patients with DAVFs to rule out potential feeding artery and remote aneurysms. This association may be explained by flow-related phenomena, the initial inciting event leading to DAVF formation, as well as a potential genetic component or predisposition to develop these lesions.
Rotational angiography for diagnosis and surgical planning in the management of spinal vascular lesions
Authors: Ropper Alexander E. , Lin Ning , Gross Bradley A. , Zarzour Hekmat K. , Thiex Ruth , Chi John H. , Du Rose , Frerichs Kai U. 
Published: April 2012

Object
The management of spinal vascular malformations has undergone significant evolution with the advent of advanced endovascular and angiographic technology. Three-dimensional rotational spinal angiography is an advanced tool that allows the surgeon to gain a better appreciation of the anatomy of these spinal vascular lesions and their relation to surrounding structures. This article describes the use of rotational angiography and 3D reconstructions in the diagnosis and management of spinal vascular malformations.

Methods
The authors present representative cases involving surgical treatment planning for spinal vascular malformations with focus on the utility and technique of rotational spinal angiography. They report the use of rotational spinal angiography for a heterogeneous collection of vascular pathological conditions.

Results
Eight patients underwent rotational spinal angiography in addition to digital subtraction angiography (DSA) for the diagnosis and characterization of various spinal vascular lesions. Postprocessed images were used to characterize the lesion in relation to surrounding bone and to enhance the surgeon's ability to precisely localize and obliterate the abnormality. The reconstructions provided superior anatomical detail compared with traditional DSA. No associated complications from the rotational angiography were noted, and there was no statistically significant difference in the amount of radiation exposure to patients undergoing rotational angiography relative to traditional angiography.

Conclusions
The use of rotational spinal angiography provides a rapid and powerful diagnostic tool, superior to conventional DSA in the diagnosis and preoperative planning of a variety of spinal vascular pathology. A more detailed understanding of the anatomy of such lesions provided by this technique may improve the safety of the surgical approach.