In vitro drug causality assessment in Stevens-Johnson syndrome - alternatives for lymphocyte transformation test

BACKGROUND Patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are often exposed simultaneously to a few potentially culprit drugs. However, both the standard lymphocyte transformation tests (LTT) with proliferation as the assay end-point as well as skin tests, if done, are often negative. OBJECTIVE As provocation tests are considered too dangerous, there is an urgent need to identify the relevant drug in SJS/TEN and to improve sensitivity of tests able to identify the causative drug. METHODS Fifteen patients with SJS/TEN with the ALDEN score ≥ 6 and 18 drug-exposed controls were included. Peripheral blood mononuclear cells (PBMC) were isolated and cultured under defined conditions with drugs. LTT was compared to the following end-points: cytokine levels in cell culture supernatant, number of granzyme B secreting cells by ELISpot and intracellular staining for granulysin and IFNγ in CD3(+) CD4(+), CD3(+) CD8(+) and NKp46(+) cells. To further enhance sensitivity, the effect of IL-7/IL-15 pre-incubation of PBMC was evaluated. RESULTS Lymphocyte transformation tests was positive in only 4/15 patients (sensitivity 27%, CI: 8-55%). Similarly, with granzyme B-ELISpot culprit drugs were positive in 5/15 patients (sensitivity 33%, CI: 12-62%). The expression of granulysin was significantly induced in NKp46(+) and CD3(+) CD4(+) cells (sensitivity 40%, CI: 16-68% and 53%, CI: 27-79% respectively). Cytokine production could be demonstrated in 38%, CI: 14-68% and 43%, CI: 18-71% of patients for IL-2 and IL-5, respectively, and in 55%, CI: 23-83% for IFNγ. Pre-incubation with IL-7/IL-15 enhanced drug-specific response only in a few patients. Specificities of tested assays were in the range of 95 (CI: 80-99%)-100% (CI: 90-100%). CONCLUSIONS AND CLINICAL RELEVANCE Granulysin expression in CD3(+) CD4(+) , Granzyme B-ELISpot and IFNγ production considered together provided a sensitivity of 80% (CI: 52-96%) and specificity of 95% (80-99%). Thus, this study demonstrated that combining different assays may be a feasible approach to identify the causative drug of SJS/TEN reactions; however, confirmation on another group of patients is necessary.

Star scientists and institutional transformation: Patterns of invention and innovation in the formation of the biotechnology industry

The most productive (“star”) bioscientists had intellectual human capital of extraordinary scientific and pecuniary value for some 10–15 years after Cohen and Boyer’s 1973 founding discovery for biotechnology [Cohen, S., Chang, A., Boyer, H. & Helling, R. (1973) Proc. Natl. Acad. Sci. USA 70, 3240–3244]. This extraordinary value was due to the union of still scarce knowledge of the new research techniques and genius and vision to apply them in novel, valuable ways. As in other sciences, star bioscientists were very protective of their techniques, ideas, and discoveries in the early years of the revolution, tending to collaborate more within their own institution, which slowed diffusion to other scientists. Close, bench-level working ties between stars and firm scientists were needed to accomplish commercialization of the breakthroughs. Where and when star scientists were actively producing publications is a key predictor of where and when commercial firms began to use biotechnology. The extent of collaboration by a firm’s scientists with stars is a powerful predictor of its success: for an average firm, 5 articles coauthored by an academic star and the firm’s scientists result in about 5 more products in development, 3.5 more products on the market, and 860 more employees. Articles by stars collaborating with or employed by firms have significantly higher rates of citation than other articles by the same or other stars. The U.S. scientific and economic infrastructure has been particularly effective in fostering and commercializing the bioscientific revolution. These results let us see the process by which scientific breakthroughs become economic growth and consider implications for policy.

Societal transformation and climate change adaptation : PAR experiences in Portugal

Tese de doutoramento, Alterações Climáticas e Políticas de Desenvolvimento Sustentável (Sociologia), Universidade de Lisboa, Instituto de Ciências Sociais, 2016

Initiatives d’activisme en formation initiale de professeurs: préparer à l’action et à la transformation.

L’action collective raisonnée, connue sous le nom d’activisme, orientée vers la résolution de problèmes de la société, offre des possibilités d'apprentissage tout au long de la vie et permet aux étudiants de développer des connaissances du domaine de la science et de la technologie. Dans une société où les découvertes scientifiques et les progrès technologiques sont constants, les potentialités de cette approche sont également reconnues dans la formation de citoyens responsables, capables d'agir et de résoudre des problèmes, tout en essayant d'influencer d'autres citoyens à prendre des décisions sur les problèmes complexes tels que ceux que présentent les questions socialement vives. Considérant que la formation de jeunes et d’adultes plus responsables et scientifiquement informés est fondamentale, cette recherche-action visait: a) à munir les futurs enseignants de compétences dans la conception, la mise en oeuvre et l'évaluation des activités orientées vers l'action sociopolitique sur les questions socialement vives; b) promouvoir chez les participants les valeurs de citoyenneté et de sensibilisation à l'environnement; c) identifier les difficultés et le potentiel de ces initiatives; d) comprendre l'impact de ce type d'expérience éducative chez les futurs enseignants. Les participants à l'étude étaient des étudiants préparant une licence en éducation élémentaire (futurs professeurs des écoles primaires et maternelles) dans le contexte de la discipline d’Éducation à l’Environnement. L'analyse des narratives produites par les futurs enseignants a permis de constater que tous avaient développé des compétences au niveau de la planification et de l'intervention dans la société, en recourant à différents types d'initiatives. Cette expérience de formation a ainsi permis, aux participants le développement de capacités à l'action et à la transformation sociale et environnementale. Il a également été possible de sensibiliser le public-cible des actions réalisées par les futurs enseignants à agir de façon plus responsable sur l'environnement.

Digital Humanities: Challenges of the Transformation of Tools and Objects of Knowledge in Contemporary Humanities

This paper aims to sketch some bases for the problematization of digital tools as objects of knowledge for Social Sciences and Humanities (SSH). Our purpose is to raise some relevant questions about the Digital Humanities (DH) and how SSH and Computer Sciences (CS) can work together to face new challenges. We discuss some tension points and propose a model for SSH and CS collaboration for joint projects in cultural digitization.

What cases on lean hospital transformation tell us?

The scientific knowledge about the lean transformation of hospital processes is at best in its “emerging” phase; neither related international, nor Hungarian literature offers a systematic, comprehensive description of the phenomenon (Brandao de Souza, 2009). In this paper empirical evidences concerning the lean transformation of hospital processes are researched and systemized. Thus it provides a new insight of existing knowledge in order to provide solid base for further researches and practical actions.

The Affordable Care Act and the Transformation of US Health Care

The neoliberal period was accompanied by a momentous transformation within the US health care system.  As the result of a number of political and historical dynamics, the healthcare law signed by President Barack Obama in 2010 ‑the Affordable Care Act (ACA)‑ drew less on universal models from abroad than it did on earlier conservative healthcare reform proposals. This was in part the result of the influence of powerful corporate healthcare interests. While the ACA expands healthcare coverage, it does so incompletely and unevenly, with persistent uninsurance and disparities in access based on insurance status. Additionally, the law accommodates an overall shift towards a consumerist model of care characterized by high cost sharing at time of use. Finally, the law encourages the further consolidation of the healthcare sector, for instance into units named “Accountable Care Organizations” that closely resemble the health maintenance organizations favored by managed care advocates. The overall effect has been to maintain a fragmented system that is neither equitable nor efficient. A single payer universal system would, in contrast, help transform healthcare into a social right.

The magical transformation contest in the ancient storytelling tradition

El concurso de transformación mágica, esquema narrativo difundido en la tradición popular, se presenta en dos variantes principales: los hechiceros que compiten pueden metamorfosearse en varios seres o crear esos seres por medios mágicos. En cualquier caso el concursante ganador da a luz criaturas más fuertes que superan las de su oponente. La segunda variante fue preferida en el antiguo Cercano Oriente (Sumeria, Egipto, Israel). La primera se puede encontrar en algunos mitos griegos sobre cambiadores de forma (por ejemplo, Zeus y Némesis). El mismo esquema narrativo puede haber influido en un episodio de la Novela de Alejandro (1.36-38), en el que Darío envía regalos simbólicos a Alejandro y los dos monarcas enemigos ofrecen contrastantes explicaciones de ellos. Esta historia griega racionaliza el concurso de cuento de hadas, transfiriendo las fantásticas hazañas de creaciones milagrosas a un plano secundario pero realista de metáfora lingüística.

SMART social science? Examining the nature and role of social scientific expertise in institutional design

Daniel Bromley argues against Oran Young’s FIT model as a basis for environmental governance, on the grounds that humans cannot manage nature and that attempts to do so are based on a scientistic, modernist conceit. At issue is the role of natural and social scientists in adjudicating questions about what we ought to do to close governance gaps and address unsustainable behaviors. If Bromley is right, then the lessons of the American pragmatist tradition recommend against attempts to “fit” social institutions to the natural world. The first objective of this paper is to argue that Bromley’s view is not in keeping with the pragmatism of C. S. Peirce and John Dewey, which actually places a high value on natural and social scientific modes of inquiry in the service of social ends. I argue that Young’s proposal is in fact a development of the pragmatist idea that social institutions must be fit in the sense of fitness, i.e., resilient and able to navigate uncertainty. Social institutions must also evolve to accommodate the emerging values of the agents who operate within them. The second objective of this paper is to examine the role of social science expertise in the design of social policies. Governance institutions typically rely on the testimony of natural scientists, at least in part, to understand the natural systems they operate within. However, natural systems are also social systems, so it seems pertinent to ask whether there is a role for social systems experts to play in helping to design environmental governance institutions. I argue that social scientists can make a unique contribution as experts on social institutions, and as such, are necessary to bring about a transformation of the unsustainable institutions that are preventing us from achieving stated sustainable development goals.

Resilience and development: mobilizing for transformation

In 2014, the Third International Conference on the resilience of social-ecological systems chose the theme “resilience and development: mobilizing for transformation.” The conference aimed specifically at fostering an encounter between the experiences and thinking focused on the issue of resilience through a social and ecological system perspective, and the experiences focused on the issue of resilience through a development perspective. In this perspectives piece, we reflect on the outcomes of the meeting and document the differences and similarities between the two perspectives as discussed during the conference, and identify bridging questions designed to guide future interactions. After the conference, we read the documents (abstracts, PowerPoints) that were prepared and left in the conference database by the participants (about 600 contributions), and searched the web for associated items, such as videos, blogs, and tweets from the conference participants. All of these documents were assessed through one lens: what do they say about resilience and development? Once the perspectives were established, we examined different themes that were significantly addressed during the conference. Our analysis paves the way for new collective developments on a set of issues: (1) Who declares/assign/cares for the resilience of what, of whom? (2) What are the models of transformations and how do they combine the respective role of agency and structure? (3) What are the combinations of measurement and assessment processes? (4) At what scale should resilience be studied? Social transformations and scientific approaches are coconstructed. For the last decades, development has been conceived as a modernization process supported by scientific rationality and technical expertise. The definition of a new perspective on development goes with a negotiation on a new scientific approach. Resilience is presently at the center of this negotiation on a new science for development.

Malignant Transformation Of An Odontogenic Cyst In A Period Of 10 Years.

Primary intraosseous carcinoma of the jaws (PIOSCC) might arise from odontogenic epithelium, more commonly from a previous odontogenic cyst. The aim of this case is to illustrate that the clinician should consider that an apparent benign dentigerous cyst can suffer malignant transformation and that all material removed from a patient must be evaluated histologically. A 44-year-old man presented in a routine periapical X-ray an impacted lower left third molar with radiolucency over its crown. Ten years later, the patient complained of pain in the same region and the tooth was extracted. After one month, the patient still complained of pain and suffered a fracture of the mandible. A biopsy was performed and carcinoma was diagnosed. The patient was treated surgically with adjuvant radio- and chemotherapy and after 8 years, he is well without signs of recurrences. This report describes a central mandibular carcinoma probably developed from a previous dentigerous cyst.

A quantitative and qualitative evaluation of reports of clinical trials published in six Brazilian dental journals indexed in the Scientific Electronic Library Online (SciELO)

INTRODUCTION: Open access publishing is becoming increasingly popular within the biomedical sciences. SciELO, the Scientific Electronic Library Online, is a digital library covering a selected collection of Brazilian scientific journals many of which provide open access to full-text articles.This library includes a number of dental journals some of which may include reports of clinical trials in English, Portuguese and/or Spanish. Thus, SciELO could play an important role as a source of evidence for dental healthcare interventions especially if it yields a sizeable number of high quality reports. OBJECTIVE: The aim of this study was to identify reports of clinical trials by handsearching of dental journals that are accessible through SciELO, and to assess the overall quality of these reports. MATERIAL AND METHODS: Electronic versions of six Brazilian dental Journals indexed in SciELO were handsearched at www.scielo.br in September 2008. Reports of clinical trials were identified and classified as controlled clinical trials (CCTs - prospective, experimental studies comparing 2 or more healthcare interventions in human beings) or randomized controlled trials (RCTs - a random allocation method is clearly reported), according to Cochrane eligibility criteria. CRITERIA TO ASSESS METHODOLOGICAL QUALITY INCLUDED: method of randomization, concealment of treatment allocation, blinded outcome assessment, handling of withdrawals and losses and whether an intention-to-treat analysis had been carried out. RESULTS: The search retrieved 33 CCTs and 43 RCTs. A majority of the reports provided no description of either the method of randomization (75.3%) or concealment of the allocation sequence (84.2%). Participants and outcome assessors were reported as blinded in only 31.2% of the reports. Withdrawals and losses were only clearly described in 6.5% of the reports and none mentioned an intention-to-treat analysis or any similar procedure. CONCLUSIONS: The results of this study indicate that a substantial number of reports of trials and systematic reviews are available in the dental journals listed in SciELO, and that these could provide valuable evidence for clinical decision making. However, it is clear that the quality of a number of these reports is of some concern and that improvement in the conduct and reporting of these trials could be achieved if authors adhered to internationally accepted guidelines, e.g. the CONSORT statement.

Innovation and entrepreneurship in scientific research

This research wants to lay emphasis on topics that historicize and rescue concepts, in addition, shows the relation between innovation and socioeconomic development resulted; reviews the legal framework to stimulate new innovation into Brazilian society; considers the definition and the entrepreneur university's new paradigm; and finally, this research highlights the importance of teaching entrepreneur at universities, with straight society benefits. The results suggests that innovation is directly enrolled with a successful development of certain society, as well, is actually the biggest business competitive differential into corporative universe. In one way of getting results of social advancement to inform entrepreneur research practice, it appears that entrepreneurs concepts, necessarily, must be incorporated into the array of Science/Technology/Innovation for the effective development of supported formula. This article develops a thought about actual scientific researches paradigm, the way that is built on today, and if it's sufficient to effectively get the results that society expects from main bodies to create human resource and researches, especially those with innovation aspects, at Brazilian economic improvement.