20 research outputs found

    Book Review: J. Reid, \u3cem\u3eIn a Defiant Stance\u3c/em\u3e

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    The uses and abuses of law in prerevolutionary Massachusetts is the subject of this scholarly, yet eminently readable book. The manipulation of law and legal process by both the colonists and the Crown was, of course, a response to political conditions. A major strength of Professor Reid\u27s analysis is the exposition of how political policies can determine the parameters of peaceful opposition. He accomplishes this by comparing the colonial experience in America with the success of British imperial law in eighteenth-century Ireland. The book is far more than a contribution to comparative legal historiography however; it presents a conception of law which transcends, and therefore challenges the concept of law as simply that which is set by political superiors to political inferiors

    Book Review: J. Reid, \u3cem\u3eIn a Defiant Stance\u3c/em\u3e

    Get PDF
    The uses and abuses of law in prerevolutionary Massachusetts is the subject of this scholarly, yet eminently readable book. The manipulation of law and legal process by both the colonists and the Crown was, of course, a response to political conditions. A major strength of Professor Reid\u27s analysis is the exposition of how political policies can determine the parameters of peaceful opposition. He accomplishes this by comparing the colonial experience in America with the success of British imperial law in eighteenth-century Ireland. The book is far more than a contribution to comparative legal historiography however; it presents a conception of law which transcends, and therefore challenges the concept of law as simply that which is set by political superiors to political inferiors

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Toward sustainable harvesting of Africa’s largest medicinal plant export (Prunus africana): a case study in Tanzania

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    Global demand for treating prostate disorders with Prunus africana bark extract has made P. africana Africa’s largest medicinal plant export. Unsustainable harvesting practices can lead to local extirpations of this multipurpose tree. Survey research targeting P. africana harvesters in a Tanzania forest reserve revealed that 78% of them used unsustainable harvesting practices. This research focused on establishing a socioeconomic profile of the harvesters, the profitability of their business operations, and identifying the factors that influence their selection of harvesting practices. Results indicate that harvesters have above-national-average education, double the average family size, and generate income exceeding government's minimum wages. Large family size and high earning potential imply increased future harvesting activity. Logistic regression results indicate that education and training level could predict the likelihood that a harvester would use unsustainable harvesting practices. Local- and district-level government organisations could implement a resource assessment as a basis to design and implement harvesting schedules and ensure that the harvesters receive appropriate training, regardless of their education level. Keywords: medicinal plant; Prunus africana; net income; sustainable harvestingSouthern Forests 2009, 71(4): 303–30

    First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer (ASCEND-4): a randomised, open-label, phase 3 study

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    Background The efficacy of ceritinib in patients with untreated anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC) is not known. We assessed the efficacy and safety of ceritinib versus platinum-based chemotherapy in these patients. Methods This randomised, open-label, phase 3 study in untreated patients with stage IIIB/IV ALK-rearranged non-squamous NSCLC was done in 134 centres across 28 countries. Eligible patients were assigned via interactive response technology to oral ceritinib 750 mg/day or platinum-based chemotherapy ([cisplatin 75 mg/m(2) or carboplatin AUC 5-6 plus pemetrexed 500 mg/m(2)] every 3 weeks for four cycles followed by maintenance pemetrexed); randomisation was stratified by World Health Organization performance status (0 vs 1-2), previous neoadjuvant or adjuvant chemotherapy, and presence of brain metastases as per investigator's assessment at screening. Investigators and patients were not masked to treatment assignment. The primary endpoint was blinded independent review committee assessed progression-free survival, based on all randomly assigned patients (the full analysis set). Efficacy analyses were done based on the full analysis set. All safety analyses were done based on the safety set, which included all patients who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, number NCT01828099. Findings Between Aug 19, 2013, and May 11, 2015, 376 patients were randomly assigned to ceritinib (n=189) or chemotherapy (n=187). Median progression-free survival (as assessed by blinded independent review committee) was 16.6 months (95% CI 12.6-27.2) in the ceritinib group and 8.1 months (5.8-11.1) in the chemotherapy group (hazard ratio 0.55 [95% CI 0.42-0.73]; p<0.00001). The most common adverse events were diarrhoea (in 160 [85%] of 189 patients), nausea (130 [69%]), vomiting (125 [66%]), and an increase in alanine aminotransferase (114 [60%]) in the ceritinib group and nausea (in 97 [55%] of 175 patients), vomiting (63 [36%]), and anaemia (62 [35%]) in the chemotherapy group. Interpretation First-line ceritinib showed a statistically significant and clinically meaningful improvement in progression-free survival versus chemotherapy in patients with advanced ALK-rearranged NSCLC
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