Judicare Counsel and Public Defenders: Case Outcome Differences

AbstractThe human organ trade is proliferating globally. However, far fewer cases have been prosecuted than would be expected based on estimates of the crime. Research exploring the challenges to investigating and prosecuting organ trafficking cases is practically non-existent. Also no studies exist that explain these challenges utilizing a criminal justice framework. This article aims to explain the legal, institutional and environmental factors that affected the investigation and prosecution of two organ trafficking cases: the Netcare case, exposed in South Africa and the Medicus case, exposed in Kosovo. It analyzes these factors through a comparative, mixed-method design, utilizing a theoretical criminal justice framework. Both cases constituted globally operating criminal networks involving brokers and transplant professionals that colluded in organizing illegal transplants. Both cases contained human trafficking elements, however only the Medicus case was prosecuted as a human trafficking case. Legal uncertainty, a lack of institutional readiness and cross-border collaboration issues hampered investigation and prosecution of the Netcare case. The Medicus case also reported problems during cross-border collaboration, as well as a corrupt environment and institutional barriers, which impeded a successful case outcome. Recommendations to improve enforcement of organ trafficking include improving identification of suspicious transplant activity, strengthening cross-border collaboration and enhancing whistleblower protection laws.

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Sex-Specific Differences in Glioblastoma

Cells ◽

10.3390/cells10071783 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1783

Author(s):

Anna Carrano ◽

Juan Jose Juarez ◽

Diego Incontri ◽

Antonio Ibarra ◽

Hugo Guerrero Cazares

Keyword(s):

Sex Differences ◽

Immune System ◽

Molecular Level ◽

Deep Understanding ◽

Protective Role ◽

Men And Women ◽

Individualized Approach ◽

Male Patients ◽

Outcome Differences

Sex differences have been well identified in many brain tumors. Even though glioblastoma (GBM) is the most common primary malignant brain tumor in adults and has the worst outcome, well-established differences between men and women are limited to incidence and outcome. Little is known about sex differences in GBM at the disease phenotype and genetical/molecular level. This review focuses on a deep understanding of the pathophysiology of GBM, including hormones, metabolic pathways, the immune system, and molecular changes, along with differences between men and women and how these dimorphisms affect disease outcome. The information analyzed in this review shows a greater incidence and worse outcome in male patients with GBM compared with female patients. We highlight the protective role of estrogen and the upregulation of androgen receptors and testosterone having detrimental effects on GBM. Moreover, hormones and the immune system work in synergy to directly affect the GBM microenvironment. Genetic and molecular differences have also recently been identified. Specific genes and molecular pathways, either upregulated or downregulated depending on sex, could potentially directly dictate GBM outcome differences. It appears that sexual dimorphism in GBM affects patient outcome and requires an individualized approach to management considering the sex of the patient, especially in relation to differences at the molecular level.

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Transcatheter aortic valve replacement for bicuspid aortic valve stenosis with first- and new-generation bioprostheses: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.1927 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Ueshima ◽

L.N.F Nai Fovino ◽

S.J.B Brener ◽

A.P Pavei ◽

C.F Fraccaro ◽

...

Keyword(s):

Aortic Valve ◽

Bicuspid Aortic Valve ◽

Meta Analysis ◽

Pacemaker Implantation ◽

Vascular Complications ◽

Device Failure ◽

Paravalvular Leakage ◽

Transcatheter Aortic Valve ◽

Outcome Differences ◽

New Generation

Abstract Background Subjects with bicuspid aortic valve (BAV) have been excluded from transcatheter aortic valve re- placement (TAVR) randomized trials. Methods With this meta-analysis of observational studies we first compared TAVR outcomes of BAV vs. tricuspid aortic valve (TAV) patients, stratifying the results by device generation. Then, we looked for differences between balloon-expandable (BE) and self-expandable (SE) bioprostheses in BAV patients. Primary outcome was 30-day mortality. Secondary outcomes were 30-day stroke, moderate-severe paravalvular leakage, new pacemaker im- plantation, vascular complications and 1-year mortality. Results Thirteen studies (11,032 patients, 7291 TAV and 3741 BAV) and seven studies (706 patients, 367 treated with BE, 339 with SE valve) met inclusion criteria. Thirty-day (OR=1.13; 95% CI: 0.88–1.46, p=0.33) and 1-year mortality (OR=1.02; 95% CI: 0.77–1.37, p=0.87) were similar between patients receiving TAVR for BAV or TAV. Subjects treated for BAV were at higher risk of conversion to conventional surgery (OR=2.35; 95% CI: 1.30–4.23, p=0.005), implantation of a second valve (OR=2.06; 95% CI: 1.31–3.25; p=0.002), moderate/severe paravalvular leakage (PVL) (OR=1.67; 95% CI: 1.29–2.17; p=0.0001) and device failure (OR=1.26; 95% CI: 1.02–1.56; p=0.04). Rates of adverse events decreased significantly with the use of new-generation devices, but outcome differences remained consistent. BAV patients treated with BE vs. SE valves had similar 30-day and 1-year mortality, stroke and moderate-severe PVL. Balloon-expandable valves were associated with lower rates of a second valve and new pacemaker implantation but carried higher risk of annular rupture. Conclusions BAV patients treated with TAVR had similar 30-day and 1-year mortality as well as stroke and new pacemaker implantation rates compared to TAV subjects, but carried higher risk of moderate/severe PVL, conver- sion to surgery and device failure. Event rates significantly decreased with the use of new-generation devices, but TAVR still showed better procedural results in TAV compared to BAV. Funding Acknowledgement Type of funding source: None

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The associations of birth outcome differences in twins with prenatal exposure to bisphenol A and its alternatives

Environmental Research ◽

10.1016/j.envres.2021.111459 ◽

2021 ◽

pp. 111459

Author(s):

Jie Wang ◽

Hong Mei ◽

Ai-Fen Zhou ◽

Li-Li Huang ◽

Zhong-Qiang Cao ◽

...

Keyword(s):

Bisphenol A ◽

Prenatal Exposure ◽

Birth Outcome ◽

Outcome Differences

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Treatment and outcome differences in patients with duodenal adenomas

HPB ◽

10.1016/j.hpb.2020.04.540 ◽

2020 ◽

Vol 22 ◽

pp. S73

Author(s):

N. Handy ◽

A. Crown ◽

A. Alseidi ◽

T. Biehl ◽

W.S. Helton ◽

...

Keyword(s):

Duodenal Adenomas ◽

Outcome Differences

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Police BWCs as ‘Neutral Observers’: Perceptions of public defenders

Policing A Journal of Policy and Practice ◽

10.1093/police/paaa067 ◽

2020 ◽

Author(s):

Janne E Gaub ◽

Carolyn Naoroz ◽

Aili Malm

Keyword(s):

Criminal Justice ◽

Focus Groups ◽

Qualitative Data ◽

Future Research ◽

End User ◽

Public Defenders

Abstract The research on police body-worn cameras (BWCs) has rapidly expanded to evaluate the technology’s impact on a range of police outcomes. Far fewer studies have addressed the various effects on downstream criminal justice actors, and those that do have focused almost entirely on prosecutors. Thus, public defenders have remained on the periphery of the police BWC discussion, despite playing an important role as an end-user of the technology. This study draws on qualitative data from focus groups with public defenders in the Commonwealth of Virginia to discuss the perception of BWCs as neutral observers in a police–citizen encounter. We then provide implications and recommend avenues for future research.

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HLA-haploidentical vs matched-sibling hematopoietic cell transplantation: a systematic review and meta-analysis

Blood Advances ◽

10.1182/bloodadvances.2019000614 ◽

2019 ◽

Vol 3 (17) ◽

pp. 2581-2585 ◽

Cited By ~ 5

Author(s):

Mohamad A. Meybodi ◽

Wenhao Cao ◽

Leo Luznik ◽

Asad Bashey ◽

Xu Zhang ◽

...

Keyword(s):

Systematic Review ◽

Cell Transplantation ◽

Hematopoietic Cell Transplantation ◽

Meta Analysis ◽

Hematopoietic Cell ◽

Free Survival ◽

Relative Contribution ◽

Haploidentical Hematopoietic Cell Transplantation ◽

Matched Sibling ◽

Outcome Differences

Abstract HLA haploidentical hematopoietic cell transplantation (haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) is an alternative strategy when a matched sibling donor (MSD) is not available. We performed a systematic review and meta-analysis to compare the outcomes of MSD vs haplo-HCT. Eleven studies (1410 haplo-HCT and 6396 MSD recipients) were meta-analyzed. All studies were retrospective and high quality, and 9 were multicenter. Haplo-HCT was associated with ~50% lower risk of chronic graft-versus-host disease (GVHD) (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.41-0.74), but higher risk of nonrelapse mortality (HR, 1.36; 95% CI, 1.12-1.66). Relapse, survival, acute GVHD, and GVHD-free relapse-free survival were not significantly different between the groups. Deciphering the relative contribution of PT-Cy and HLA disparity to the observed outcome differences between the groups requires further research.

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Restrictive Transfusion Strategy Is More Effective in Massive Burns: Results of the TRIBE Multicenter Prospective Randomized Trial

Military Medicine ◽

10.1093/milmed/usy279 ◽

2019 ◽

Vol 184 (Supplement_1) ◽

pp. 11-15 ◽

Cited By ~ 7

Author(s):

Tina L Palmieri ◽

James H Holmes ◽

Brett Arnoldo ◽

Michael Peck ◽

Amalia Cochran ◽

...

Keyword(s):

Wound Healing ◽

Burn Injury ◽

Total Body Surface Area ◽

Inhalation Injury ◽

Transfusion Strategy ◽

Restrictive Transfusion ◽

Blood Utilization ◽

Outcome Differences ◽

Total Body ◽

Restrictive Transfusion Strategy

Abstract Objectives Studies suggest that a restrictive transfusion strategy is safe in burns, yet the efficacy of a restrictive transfusion policy in massive burn injury is uncertain. Our objective: compare outcomes between massive burn (≥60% total body surface area (TBSA) burn) and major (20–59% TBSA) burn using a restrictive or a liberal blood transfusion strategy. Methods Patients with burns ≥20% were block randomized by age and TBSA to a restrictive (transfuse hemoglobin <7 g/dL) or liberal (transfuse hemoglobin <10 g/dL) strategy throughout hospitalization. Data collected included demographics, infections, transfusions, and outcomes. Results Three hundred and forty-five patients received 7,054 units blood, 2,886 in massive and 4,168 in restrictive. Patients were similar in age, TBSA, and inhalation injury. The restrictive group received less blood (45.57 ± 47.63 vs. 77.16 ± 55.0, p < 0.03 massive; 11.0 ± 16.70 vs. 16.78 ± 17.39, p < 0.001) major). In massive burn, the restrictive group had fewer ventilator days (p < 0.05). Median ICU days and LOS were lower in the restrictive group; wound healing, mortality, and infection did not differ. No significant outcome differences occurred in the major (20–59%) group (p > 0.05). Conclusions: A restrictive transfusion strategy may be beneficial in massive burns in reducing ventilator days, ICU days and blood utilization, but does not decrease infection, mortality, hospital LOS or wound healing.

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