Dangerous Separation: An Ecosystem and Way of Life in the West Bank at the Brink of Destruction

Israel is currently planning to build the separation wall on the edge of Battir, separating farmers from their fields. If the wall is constructed, residents face the specter of abandoning their way of life and severely restricting their movement, while at the same time the hydrology and ecology of the area will become severely imperiled. In early December, the Israeli Supreme Court (ISC) issued an interim decision ordering the Israeli Defense Ministry (IDM) to submit plans for an alternate route for the wall within ninety days, indicating that the Court is not willing to let Israeli’s security interests override consideration of environmental impacts and the rights of Battir’s residents

Carceral framing of human rights in Russian prisons

This paper introduces to punishment and society scholarship a new carceral framing of human rights in Russian prisons. Russian imprisonment remains elusive to prisons scholars and ethnographers around the world. Moreover, on the subject of prisoners’ rights specifically, the scholarship is dominated by legal discourse. The empirical and theoretical scholarship that has developed over the last twenty years has argued that Russian imprisonment is exceptional in the study of world penal systems with the research seeking to gain a sense of this exceptionality through looking at the inertial legacies of Gulag penal culture on present day punishment forms. This article attempts to challenge this claim and will argue that specifically in the area of human rights, Russia has followed a not dissimilar carceral formation to Western prisons. Through an interrogation of the cultural, political and historical factors underpinning how rights are framed in Russian prisons the article suggests that human rights are operationalised as a lever for legal and penal control. This is a significant new finding in the study of Russian imprisonment because of the questions that arise around penal resilience, how rights and penal power develop through discourse and how global penal norms converge across jurisdictions

The virtual reality of Russian prisons : the impact of social media on prisoner agency and prison structure in Russian prisons

Prison agencies around the world are reporting a rise in the use of illicit communication devices in prison. Nevertheless, there is very little prison sociological research into how prisoners themselves communicate online. Using Russia as a case study, this paper reports findings from new research on how prisoners are engaging with the internet and the effects of this on prisoner agency and prison structure. Our main finding is that Russian penality sits at the nexus of two processes. First, it is de-institutionalised in that the prison, discursively speaking, is no longer fixed to a built form. Second, it is reflexively re-territorialised in that it places prisoner agency onto a third space. The paper presents a new conceptual framework of ‘prisoners as absent’, which reflects penality in Russia as culturally contingent and politically resilient. The interplay between de-institutionalisation and re-territorialisation has produced on a new penal imaginary - a carceral motif for the twenty first century - in the form of a virtual world

Notes on stochastic (bio)-logic gates: the role of allosteric cooperativity

Recent experimental breakthroughs have finally allowed to implement in-vitro reaction kinetics (the so called {\em enzyme based logic}) which code for two-inputs logic gates and mimic the stochastic AND (and NAND) as well as the stochastic OR (and NOR). This accomplishment, together with the already-known single-input gates (performing as YES and NOT), provides a logic base and paves the way to the development of powerful biotechnological devices. The investigation of this field would enormously benefit from a self-consistent, predictive, theoretical framework. Here we formulate a complete statistical mechanical description of the Monod-Wyman-Changeaux allosteric model for both single and double ligand systems, with the purpose of exploring their practical capabilities to express logical operators and/or perform logical operations. Mixing statistical mechanics with logics, and quantitatively our findings with the available biochemical data, we successfully revise the concept of cooperativity (and anti-cooperativity) for allosteric systems, with particular emphasis on its computational capabilities, the related ranges and scaling of the involved parameters and its differences with classical cooperativity (and anti-cooperativity)

Decreasing Medical Complications for Total Knee Arthroplasty: Effect of Critical Pathways on Outcomes

BACKGROUND: Studies on critical pathway use have demonstrated decreased length of stay and cost without compromise in quality of care. However, pathway effectiveness is difficult to determine given methodological flaws, such as small or single center cohorts. We studied the effect of critical pathways on total knee replacement outcomes in a large population-based study. METHODS: We identified hospitals in four US states that performed total knee replacements. We sent a questionnaire to surgical administrators in these hospitals including items about critical pathway use and hospital characteristics potentially related to outcomes. Patient data were obtained from Medicare claims, including demographics, comorbidities, 90-day postoperative complications and length of hospital stay. The principal outcome measure was the risk of having one or more postoperative complications. RESULTS: Two hundred ninety five hospitals (73%) responded to the questionnaire, with 201 reporting the use of critical pathways. 9,157 Medicare beneficiaries underwent TKR in these hospitals with a mean age of 74 years (± 5.8). After adjusting for both patient and hospital related variables, patients in hospitals with pathways were 32% less likely to have a postoperative complication compared to patients in hospitals without pathways (OR 0.68, 95% CI 0.50-0.92). Patients managed on a critical pathway had an average length of stay 0.5 days (95% CI 0.3-0.6) shorter than patients not managed on a pathway. CONCLUSION: Medicare patients undergoing total knee replacement surgery in hospitals that used critical pathways had fewer postoperative complications than patients in hospitals without pathways, even after adjusting for patient and hospital related factors. This study has helped to establish that critical pathway use is associated with lower rates of postoperative mortality and complications following total knee replacement after adjusting for measured variables

Differences in Self-Reported Health in the Osteoarthritis Initiative (OAI) and Third National Health and Nutrition Examination Survey (NHANES-III)

Objective: To assess self-reported health status (SRHS) in two cohorts of participants with radiographic knee osteoarthritis (OA) and examine the extent that differences in SRHS are due to study design. Method: We used data from the Third National Health and Nutritional Examination Survey (NHANES-III; population-based national survey) and the Osteoarthritis Initiative (OAI; prospective cohort study). Inclusion criteria for this analysis were age 60–79 and presence of radiographic knee OA. SRHS, elicited as a five-item domain (excellent, very good, good, fair, poor), was analyzed by dichotomizing the general health status measure as ‘‘fair/poor’ ’ versus all other states. We estimated the proportion of participants in fair/poor health from each study. Propensity score methodology was used to adjust for the differences in sampling strategies between the two studies. Results: Thirty-four percent (N = 1,608) of OAI and 29 % (N = 756) of NHANES-III participants satisfied inclusion criteria. The proportion in fair/poor health was higher in NHANES-III (28%) than in OAI (5%). After adjusting for the propensity score, the proportion in fair/poor health was four times higher in NHANES-III than in OAI. Conclusion: SRHS was substantially better in OAI than in NHANES-III. Self-selection bias may contribute to overestimation o

Reliability of medical record abstraction by non-physicians for orthopedic research

Background: Medical record review (MRR) is one of the most commonly used research methods in clinical studies because it provides rich clinical detail. However, because MRR involves subjective interpretation of information found in the medical record, it is critically important to understand the reproducibility of data obtained from MRR. Furthermore, because medical record review is both technically demanding and time intensive, it is important to establish whether trained research staff with no clinical training can abstract medical records reliably. Methods: We assessed the reliability of abstraction of medical record information in a sample of patients who underwent total knee replacement (TKR) at a referral center. An orthopedic surgeon instructed two research coordinators (RCs) in the abstraction of inpatient medical records and operative notes for patients undergoing primary TKR. The two RCs and the surgeon each independently reviewed 75 patients’ records and one RC reviewed the records twice. Agreement was assessed using the proportion of items on which reviewers agreed and the kappa statistic. Results: The kappa for agreement between the surgeon and each RC ranged from 0.59 to 1 for one RC and 0.49 to 1 for the other; the percent agreement ranged from 82% to 100% for one RC and 70% to 100% for the other. The repeated abstractions by the same RC showed high intra-rater agreement, with kappas ranging from 0.66 to 1 and percent agreement ranging from 97% to 100%. Inter-rater agreement between the two RCs was moderate with kappa ranging from 0.49 to 1 and percent agreement ranging from 76% to 100%. Conclusion: The MRR method used in this study showed excellent reliability for abstraction of information that had low technical complexity and moderate to good reliability for information that had greater complexity. Overall, these findings support the use of non-surgeons to abstract surgical data from operative notes

The relationship between hand osteoarthritis and serum leptin concentration in participants of the Third National Health and Nutrition Examination Survey

Introduction: Leptin has been suspected to contribute to the development of osteoarthritis (OA). However, this hypothesis has not been tested in large-scale hand OA cohorts. Our study aimed to determine whether there is a cross-sectional relationship between serum leptin levels and hand OA in a population-based sample of US adults. Method: We used the Third National Health and Nutrition Examination Survey (NHANES III), a national cross-sectional population-based survey, to study the relationship between hand OA and serum leptin concentration. We applied previously established classification criteria for hand OA. Patients with rheumatoid arthritis were excluded. Potential confounders included sex, body mass index, the presence of polyarticular OA, diabetes, and total cholesterol. We estimated unadjusted mean leptin concentration by hand OA status and by all confounders. We further developed a linear regression model to assess mean leptin levels, adjusted for appropriate confounders. Results: Of 2,477 subjects in the NHANES III sample that had a hand examination and did not have rheumatoid arthritis, 1,056 (42.6%) had a leptin measurement and were included in the analysis. Subjects with and without leptin measurement had similar demographic characteristics. We did not find any significant differences in mean serum leptin levels in subjects with symptomatic hand OA (7.38 ng/ml in males (95% confidence interval (CI) = 5.31, 9.46) and 21.55 ng/ml in females (95% CI = 17.08, 26.02)), asymptomatic hand OA (6.69 ng/ml in males (95% CI = 5.19, 8.18) and 17.09 ng/ml in females (95% CI = 15.00, 19.18)), and no hand OA (8.22 ng/ml in males (95% CI = 7.47, 8.97) and 20.77 ng/ml in females (95% CI = 18.01, 23.53)) in the unadjusted analysis. In a multivariable linear regression model that included variables of hand OA status, age, race/ethnicity, and obesity status, we found no statistically significant association between serum leptin and hand OA status. Conclusions: In this cross-sectional study of a large representative US cohort, we did not find any evidence to support the hypothesis that serum leptin is associated with hand OA

The "ART" of Linkage: Pre-Treatment Loss to Care after HIV Diagnosis at Two PEPFAR Sites in Durban, South Africa

BACKGROUND. Although loss to follow-up after antiretroviral therapy (ART) initiation is increasingly recognized, little is known about pre-treatment losses to care (PTLC) after an initial positive HIV test. Our objective was to determine PTLC in newly identified HIV-infected individuals in South Africa. METHODOLOGY/PRINCIPAL FINDINGS. We assembled the South African Test, Identify and Link (STIAL) Cohort of persons presenting for HIV testing at two sites offering HIV and CD4 count testing and HIV care in Durban, South Africa. We defined PTLC as failure to have a CD4 count within 8 weeks of HIV diagnosis. We performed multivariate analysis to identify factors associated with PTLC. From November 2006 to May 2007, of 712 persons who underwent HIV testing and received their test result, 454 (64%) were HIV-positive. Of those, 206 (45%) had PTLC. Infected patients were significantly more likely to have PTLC if they lived =10 kilometers from the testing center (RR=1.37; 95% CI: 1.11-1.71), had a history of tuberculosis treatment (RR=1.26; 95% CI: 1.00-1.58), or were referred for testing by a health care provider rather than self-referred (RR=1.61; 95% CI: 1.22-2.13). Patients with one, two or three of these risks for PTLC were 1.88, 2.50 and 3.84 times more likely to have PTLC compared to those with no risk factors. CONCLUSIONS/SIGNIFICANCE. Nearly half of HIV-infected persons at two high prevalence sites in Durban, South Africa, failed to have CD4 counts following HIV diagnosis. These high rates of pre-treatment loss to care highlight the urgent need to improve rates of linkage to HIV care after an initial positive HIV test.US National Institute of Allergy and Infectious Diseases (R01 AI058736, K24 AI062476, K23 AI068458); the Harvard University Center for AIDS Research (P30 AI42851); National Institutes of Health (K24 AR 02123); the Doris Duke Charitable Foundation (Clinical Scientist Development Award); the Harvard University Program on AID

Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study

Background: The growing utilization of total joint replacement will increase the frequency of its complications, including periprosthetic fracture. The prevalence and risk factors of periprosthetic fracture require further study, particularly over the course of long-term follow-up. The objective of this study was to estimate the prevalence and risk factors for periprosthetic fractures occurring in recipients of total hip replacement. Methods: We identified Medicare beneficiaries who had elective primary total hip replacement (THR) for non-fracture diagnoses between July 1995 and June 1996. We followed them using Medicare Part A claims data through 2008. We used ICD-9 codes to identify periprosthetic femoral fractures occurring from 2006–2008. We used the incidence density method to calculate the annual incidence of these fractures and Cox proportional hazards models to identify risk factors for periprosthetic fracture. We also calculated the risk of hospitalization over the subsequent year. Results: Of 58,521 Medicare beneficiaries who had elective primary THR between July 1995 and June 1996, 32,463 (55%) survived until January 2006. Of these, 215 (0.7%) developed a periprosthetic femoral fracture between 2006 and 2008. The annual incidence of periprosthetic fracture among these individuals was 26 per 10,000 person-years. In the Cox model, a greater risk of periprosthetic fracture was associated with having had a total knee replacement (HR 1.82, 95% CI 1.30, 2.55) or a revision total hip replacement (HR1.40, 95% CI 0.95, 2.07) between the primary THR and 2006. Compared to those without fractures, THR recipients who sustained periprosthetic femoral fracture had three-fold higher risk of hospitalization in the subsequent year (89% vs. 27%, p < 0.0001). Conclusion: A decade after primary THR, periprosthetic fractures occur annually in 26 per 10,000 persons and are especially frequent in those with prior total knee or revision total hip replacements