In vitro assays and clinical trials in red blood cell aging: Lost in translation.

The age of erythrocyte concentrates (EC) in transfusion medicine and the adverse outcomes when transfusing long-term-stored EC are highly controversial issues. Whereas the definition of a short-term-stored EC or a long-term-stored EC is unclear in clinical trials, data based on in vitro storage assays can help defining a limit in addition of the expiration date. The present review merges together these data in order to highlight an EC age cut-off and points out potential misleading consideration. The analysis of in vitro data highlights the presence of reversible and irreversible storage lesions and demonstrates that red blood cells (RBC) exhibit two limits during storage: one around 2 weeks and another one around 4 weeks of storage. Of particular importance, the first lesions to appear, i.e. the reversible ones, are per se reversible once transfused, whereas the irreversible lesions are not. In clinical trials, the EC age cut-off for short-term storage is in general fewer than 14 days (11 ± 4 days) and more disperse for long-term-stored EC (17 ± 13 days), regardless the clinical outcomes. Taking together, EC age cut-off in clinical trials does not totally fall into line of in vitro aging data, whereas it is the key criteria in clinical studies. Long-term-stored EC considered in clinical trials are not probably old enough to answer the question: "Does transfusion of long-term-stored EC (older than 4 weeks) result in worse clinical outcomes?" Depending on ethical concerns and clinical practices, older EC than currently assayed in clinical trials should have to be considered. These two worlds trying to understand the aging of erythrocytes and the impact on patients do not seem to speak the same language.

Endoscopic biliary procedures: studies on cannulation and stenting

Deep cannulation is a prerequisite for successful endoscopic retrograde cholangiopancreatography (ERCP) procedures. Of the biliary procedures, stenting is one of the most common. This study was carried out to investigate current and controversial issues regarding biliary cannulation and stenting. The double guidewire (DGW) technique was studied to analyze its safety and feasibility in biliary cannulation as a single procedure and as a part of the novel three-step cannulation protocol. Female gender was evaluated in regard to difficult cannulation. The use of an angled and a straight tipped guidewire in biliary cannulation was studied in a prospective, randomized trial. Additionally, the patency of the novel antireflux plastic biliary stent was compared to the patency of the conventional plastic biliary stent in a prospective, randomized setting. The DGW method seems safe and feasible as an alternative cannulation technique in biliary cannulation. Female gender was not associated significantly with difficult biliary cannulation in our study, although the cannulation times seemed to be longer and the alternative cannulation techniques seemed to be needed more often in females than males. According to the results of this thesis, an angled tipped guidewire may facilitate biliary cannulation. In controversy to the previous result presented in the literature, the antireflux plastic biliary stent tested herein should not be used, as the patency of the stent was significantly shorter compared to the conventional plastic stent.

The brain decade in debate: III. Neurobiology of emotion

This article is a transcription of an electronic symposium in which active researchers were invited by the Brazilian Society of Neuroscience and Behavior (SBNeC) to discuss the advances of the last decade in the neurobiology of emotion. Four basic questions were debated: 1) What are the most critical issues/questions in the neurobiology of emotion? 2) What do we know for certain about brain processes involved in emotion and what is controversial? 3) What kinds of research are needed to resolve these controversial issues? 4) What is the relationship between learning, memory and emotion? The focus was on the existence of different neural systems for different emotions and the nature of the neural coding for the emotional states. Is emotion the result of the interaction of different brain regions such as the amygdala, the nucleus accumbens, or the periaqueductal gray matter or is it an emergent property of the whole brain neural network? The relationship between unlearned and learned emotions was also discussed. Are the circuits of the former the underpinnings of the latter? It was pointed out that much of what we know about emotions refers to aversively motivated behaviors, like fear and anxiety. Appetitive emotions should attract much interest in the future. The learning and memory relationship with emotions was also discussed in terms of conditioned and unconditioned stimuli, innate and learned fear, contextual cues inducing emotional states, implicit memory and the property of using this term for animal memories. In a general way it could be said that learning modifies the neural circuits through which emotional responses are expressed.

The effects of language complexity in a counterattitudinal appeal to laypeople : an application of the elaboration likelihood model of persuasion to a legal issue

The effects of a complexly worded counterattitudinal appeal on laypeople's attitudes toward a legal issue were examined, using the Elaboration Likelihood Model (ELM) of persuasion as a theoretical framework. This model states that persuasion can result from the elaboration and scrutiny of the message arguments (i.e., central route processing), or can result from less cognitively effortful strategies, such as relying on source characteristics as a cue to message validity (i.e., peripheral route processing). One hundred and sixty-seven undergraduates (85 men and 81 women) listened to eitller a low status or high status source deliver a counterattitudinal speech on a legal issue. The speech was designed to contain strong or weak arguments. These arguments were 'worded in a simple and, therefore, easy to comprehend manner, or in a complex and, therefore, difficult to comprehend manner. Thus, there were three experimental manipulations: argument comprehensibility (easy to comprehend vs. difficult to comprehend), argumel11 strength (weak vs. strong), and source status (low vs. high). After listening to tIle speec.J] participants completed a measure 'of their attitude toward the legal issue, a thought listil1g task, an argument recall task,manipulation checks, measures of motivation to process the message, and measures of mood. As a result of the failure of the argument strength manipulation, only the effects of the comprehel1sibility and source status manipulations were tested. There was, however, some evidence of more central route processing in the easy comprehension condition than in the difficult comprehension condition, as predicted. Significant correlations were found between attitude and favourable and unfavourable thoughts about the legal issue with easy to comprehend arguments; whereas, there was a correlation only between attitude and favourable thoughts 11 toward the issue with difficult to comprehend arguments, suggesting, perhaps, that central route processing, \vhich involves argument scrutiny and elaboration, occurred under conditions of easy comprehension to a greater extent than under conditions of difficult comprehension. The results also revealed, among other findings, several significant effects of gender. Men had more favourable attitudes toward the legal issue than did women, men recalled more arguments from the speech than did women, men were less frustrated while listening to the speech than were ,vomen, and men put more effort into thinking about the message arguments than did women. When the arguments were difficult to comprehend, men had more favourable thoughts and fewer unfavourable thoughts about the legal issue than did women. Men and women may have had different affective responses to the issue of plea bargaining (with women responding more negatively than men), especially in light of a local and controversial plea bargain that occurred around the time of this study. Such pre-existing gender differences may have led to tIle lower frustration, the greater effort, the greater recall, and more positive attitudes for men than for WOlnen. Results· from this study suggest that current cognitive models of persuasion may not be very applicable to controversial issues which elicit strong emotional responses. Finally, these data indicate that affective responses, the controversial and emotional nature ofthe issue, gender and other individual differences are important considerations when experts are attempting to persuade laypeople toward a counterattitudinal position.

University Faculty Members’ Understanding of Their Role: Identity, Power, and Silence

This qualitative study was conducted to explore tenured faculty members’ understandings of their roles as professors. Tenure is an institutional means to enact academic freedom, which allows tenured faculty members to investigate topics of their choosing free from external influence. Academic freedom also enables faculty members to be public intellectuals who shape and critique social policies and make knowledge assertions. In effect, the faculty members are institutionally protected to speak truth to power. Purposeful sampling of 9 participants from 2 universities yielded 3 major themes: professorial identity (shaped by such factors as career stage, university culture, and faculty affiliation), professorial power (powers that participants experienced as well as the ways in which they exercised power), and professorial silencing (as a response to fiscal realities coupled with numerous governance issues). While participants were cognizant of the powers that affected their freedoms, they were less aware of the ways in which their position afforded them powers. Subtle but more potent forms of power were at play for tenured professors, but the participants saw themselves as having to work within institutional and financial constraints that limited their freedom to speak out on controversial issues. Faculty members were, thus, silenced and at times chose to self-silence. The context of the present-day university, governance models, and the financial issues affecting universities and departments worked in concert to silence this critical voice in society.

Surface display of proteins by Gram-negative bacterial autotransporters

Affiliation: Faculté de Médecine Vétérinaire, Université de Montréal

L'oxygénothérapie hyperbare dans le traitement de la paralysie cérébrale : arnaque ou traitement approprié?

L'oxygénothérapie hyperbare (OTH) consiste à soumettre un patient à des taux de pression plus élevés que la pression atmosphérique normale et de lui faire respirer 100 % d'oxygène. Cette approche a été mise à l'essai pour le traitement de nombreuses conditions médicales avec succès dans certains cas alors pour d'autres sa validité reste encore à démontrer. Dans le cas de la paralysie cérébrale son utilisation a soulevé de nombreuses controverses et les études conduites jusqu'alors n'ont pas encore convaincu tous les membres de la communauté scientifique et ce, malgré certains effets positifs mis en évidence. Une récente étude qui a montré des améliorations notables chez des enfants atteints de paralysie cérébrale (PC) traités avec de l'air légèrement pressurisé, de même que chez ceux traités avec un protocole standard pour l'oxygénothérapie hyperbare (l'OTH), est invoquée pour nier l'efficacité de l'OTH. Des considérations politiques et économiques, plutôt que purement scientifiques, jouent un rôle important dans cette controverse. Des recherches systématiques supplémentaires sont requises, mais entre-temps, comme les effets thérapeutiques de cette approche semblent plus importants que ceux des thérapies actuellement acceptées dans le traitement de la paralysie cérébrale, les enfants atteints de cette condition ne devraient pas se faire refuser l'accès à l'OTH.

Multiple sclerosis: evidence and controversies

Introduction: Multiple sclerosis is a chronic recurrent inflammatory disorder of the central nervous system. The pharmacological treatment of multiple sclerosis has been evaluated with multiple controlled clinical trials that allow the clinician to count with evidence based information to decide the more indicated treatment for each patient. Methodology: A review of the scientific literature was conducted to clarify controversial issues in a clinical relevant topic. Development: The diagnostic criteria and different treatments available are reviewed, in order to consider the clinical utility of the disease modifying agents such as the immunomodulatory treatments. The three used types of interferon are well tolerated and reduce in approximately a third the number of bouts in the remitent recurrent form; there is no significant difference between the three of them.

The role of competition and state aid policy in financial and monetary law

During the financial crisis, companies and lenders found themselves in distressed situations. Competition authorities across the globe had to deal with controversial issues such as the application of the failing firm defence in merger transactions as well as assessment of emergency aid granted by states. This article considers competition policy in periods of crisis, in particular the failing firm defence in merger control and its state aid policy.

Developing new components for variable flow distribution system modelling in TRNSYS

This study attempts to fill the existing gap in the simulation of variable flow distribution systems through developing new pressure governing components. These components are able to capture the actual ever-changing system performance curve in variable flow distribution systems together with the prediction of controversial issues such as starving, over-flow and the lack of controllability on the flow rate of different branches in a hydronic system. The performance of the proposed components is verified using a case study under design and off-design circumstances. Full integration of the new components within the TRNSYS simulation package is another advantage of this study, which makes it more applicable for designers in both the design and commissioning of hydronic systems.

Soft money : private foundations of party politics

In the area of campaign financing in federal elections, one of the most controversial issues is that of soft money. Soft money refers to those funds raised by the national party organizations for use on various grassroots and party-building activities. but which are not subject to the restraints of federal campaign finance law. Critics contend that these party-building activitie, such as generic television advertising, voter registration and get-out-the vote drives, provide ancillary benefits to federal candidates and should, therefore, be subject to federal contribution and expenditure limits. Critics further argue that because these funds are not subject to federal law and do benefit federal candidates, the national parties raise monies in amounts and from sources, such as corporations and unions, that are prohibited under federal law. Efforts to gain a better understanding of soft money have been hampered by a lack of data, as the national parties were not required to disclose their soft money receipts and transactions until 1991. The purpose of this study is to analyze data recently made available in an attempt to add the import of empirical evidence to the debate over soft money. The nature, size and timing of soft money contributions are investigated and national party soft money disbursements are examined. The findings suggest that any attempts to reform the soft money system must first consider its compensatory benefits. Most prominently, this includes the extent to which soft money has promoted the resurgence of the national party organizations in the context of election politics.

O regime brasileiro de tributação de lucros auferidos por sociedades controladas e coligadas no exterior: uma visão do atual regime por meio da ótica da teoria do rent seeking

O presente trabalho tem por objetivo analisar, pela ótica da teoria do rent seeking, a evolução da legislação e da jurisprudência administrativa e judicial acerca do regime da tributação dos lucros, ganhos de capital e rendimentos auferidos por sociedades controladas e coligadas no exterior. Observar-se-á a hipótese da legislação e das suas diversas interpretações refletirem interesses predominantemente de apropriação de renda, tanto por parte da Administração Pública quanto dos agentes privados. Nesse sentido, após uma exposição da teoria do rent seeking e da sua relação com a teoria do patrimonialismo no Brasil, ela será aplicada no tema tributário proposto. Para tanto, verificar-se-á a evolução da legislação até o último diploma normativo relevante sobre o tema: a Medida Provisória nº 2.158-35/01. Neste momento, serão identificadas as principais controvérsias e os possíveis interesses nas diversas interpretações dadas às regras em questão, associando-os com os diversos problemas de rent seeking observáveis. A seguir, verificar-se-á, nas decisões do Superior Tribunal de Justiça (STJ), do Supremo Tribunal Federal (STF), e do Conselho Administrativo de Recursos Fiscais (CARF) qual a evolução do entendimento dos tribunais a respeito das referidas interpretações, verificando se algum consenso foi atingido e quais interesses estariam atingidos pelo rumo tomado pela jurisprudência sobre o tema. Neste contexto, a análise da evolução legislativa e jurisprudencial abordará os seguintes pontos controversos: (1) caracterização das regras brasileiras como CFC rules (característica antielisiva); (2) tributação de distribuição ficta ou de lucro da própria controladora ou coligada no Brasil; (3) constitucionalidade do artigo 43, parágrafo 2º, do Código Tributário Nacional, bem como do artigo 74 da Medida Provisória nº 2.158-35/01; e (4) a compatibilização com os Tratados contra a Dupla Tributação. Por fim, far-se-á uma conclusão, a partir dos resultados verificados, a respeito de como a evolução das regras tributárias em questão pode representar uma apropriação de renda sem benefícios públicos que pode favorecer indevidamente tanto o setor público como o privado.

O modelo do Conselho Nacional de Autorregulamentação Publicitária e o direito brasileiro

O presente trabalho procura examinar o funcionamento do Conselho Nacional de Autorregulamentação Publicitária (“CONAR”), visando descobrir como este modelo regulatório se conforma com o Direito brasileiro. Neste sentido, explica-se, inicialmente, a origem do Conselho, como ele se estrutura e como se dão os julgamentos das denúncias que lhe são apresentadas. Em seguida, faz-se uma análise da relação entre a legislação publicitária vigente e as normas do Código Brasileiro de Autorregulamentação Publicitária, donde se conclui que ambas não são excludentes. Parte-se, então, para um estudo da jurisprudência dos tribunais brasileiros acerca da atuação do Conselho, afim de se verificar em que medida é aceita a autorregulação da publicidade pelo Poder Judiciário. Por fim, pretende-se analisar como se dá, na prática, a atuação do CONAR diante de questões polêmicas, como a inflação legislativa no meio publicitário e a censura da publicidade.

Hip fracture in the elderly: does counting time from fracture to surgery or from hospital admission to surgery matter when studying in-hospital mortality?

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Alfabetização no Brasil: conjecturas sobre as relações entre políticas públicas e seus sujeitos privados

As complexas e polêmicas questões relativas a formulação, implementação e avaliação de políticas públicas para a educação no Brasil, nas últimas décadas, vêm sendo objeto de importantes estudos e pesquisas. Como resultado, tem-se acumulado significativo corpo de conhecimentos a esse respeito, o que propicia avanços no debate e possibilita novos estudos e pesquisas a respeito de aspectos cada vez mais específicos da temática. Com o objetivo de contribuir para esse debate, apresentam-se neste artigo conjecturas a respeito da relação entre setores públicos estatais decorrente especificamente do novo tipo de parceria entre órgãos públicos do Estado e docentes pesquisadores das universidades públicas para formulação, implementação e avaliação de políticas públicas para a alfabetização, iniciada na década de 1980 e enfatizada a partir da década de 1990, com a reforma do Estado brasileiro.