O presente artigo procura desenvolver uma análise descritiva e crítica sobre a situação do instituto da prova de direito estrangeiro e seu tratamento no art.376 CPC, procurando comprovar a hipótese ...de que a manutenção da redação do revogado art.337 CPC/73 causa uma estagnação na matéria não compatível com a dinâmica. Com este escopo, o estudo se divide na compreensão da natureza processual do Direito estrangeiro e o significado do termo “prova” quando associado àquele; e, posteriormente, analisa-se como essa natureza influenciou na fórmula legislativa que hoje ainda se manifesta no art.376 CPC, em especial, nas na estagnação da legislação brasileira sobre a matéria.
El presente trabajo propone, a través de una comparación entre el sistema jurídico argentino y español, evidenciar la insuficiencia de la indemnización como régimen de tutela de un trabajador ...despedido injustificadamente toda vez que esta; no solo no protege ni repara integralmente los daños causados; si no que además no se corresponde con el sistema de derecho internacional de los derechos humanos reconocido en las Constituciones Nacionales de ambos países. De acuerdo al objetivo propuesto, la metodología escogida será fundamentalmente analítica porque está dirigida a realizar un análisis jurídico de diferentes posturas doctrinarias y de legislación nacional e internacional del trabajo, las cuales constituirán nuestra principal fuente de información. Palabras clave: Despido injustificado; indemnización; Derecho internacional de los derechos humanos. The present paper propuse, through a comparison between the Argentine and Spanish legal system, evidence the inadequacy of the compensation provided by law, as a system of guardianship of unjustifiably dismissed worker since, this not only does not protect and fully repair the damages caused; otherwise, it does not correspond to the international rights law system. According with the aim proposed, the methodology choosen will be mostly analytical because is going to analyze different doctrine positions and national and international labour regulations, which be the main source of information. Keywords: Unjustified dismissal; compensation; International Law of human rights.
The immunostimulatory monoclonal antibody elotuzumab plus lenalidomide and dexamethasone has been shown to be effective in patients with relapsed or refractory multiple myeloma. The immunomodulatory ...agent pomalidomide plus dexamethasone has been shown to be effective in patients with multiple myeloma that is refractory to lenalidomide and a proteasome inhibitor.
Patients with multiple myeloma that was refractory or relapsed and refractory to lenalidomide and a proteasome inhibitor were randomly assigned to receive elotuzumab plus pomalidomide and dexamethasone (elotuzumab group) or pomalidomide and dexamethasone alone (control group). The primary end point was investigator-assessed progression-free survival.
A total of 117 patients were randomly assigned to the elotuzumab group (60 patients) or the control group (57 patients). After a minimum follow-up period of 9.1 months, the median progression-free survival was 10.3 months in the elotuzumab group and 4.7 months in the control group. The hazard ratio for disease progression or death in the elotuzumab group as compared with the control group was 0.54 (95% confidence interval CI, 0.34 to 0.86; P=0.008). The overall response rate was 53% in the elotuzumab group as compared with 26% in the control group (odds ratio, 3.25; 95% CI, 1.49 to 7.11). The most common grade 3 or 4 adverse events were neutropenia (13% in the elotuzumab group vs. 27% in the control group), anemia (10% vs. 20%), and hyperglycemia (8% vs. 7%). A total of 65% of the patients in each group had infections. Infusion reactions occurred in 3 patients (5%) in the elotuzumab group.
Among patients with multiple myeloma in whom treatment with lenalidomide and a proteasome inhibitor had failed, the risk of progression or death was significantly lower among those who received elotuzumab plus pomalidomide and dexamethasone than among those who received pomalidomide plus dexamethasone alone. (Funded by Bristol-Myers Squibb and AbbVie Biotherapeutics; ELOQUENT-3 ClinicalTrials.gov number, NCT02654132 .).
Meta-analysis has been widely used to synthesize evidence from multiple studies for common hypotheses or parameters of interest. However, it has not yet been fully developed for incorporating ...heterogeneous studies, which arise often in applications due to different study designs, populations, or outcomes. For heterogeneous studies, the parameter of interest may not be estimable for certain studies, and in such a case, these studies are typically excluded from conventional meta-analysis. The exclusion of part of the studies can lead to a nonnegligible loss of information. This article introduces a meta-analysis for heterogeneous studies by combining the confidence density functions derived from the summary statistics of individual studies, hence referred to as the CD approach. It includes all the studies in the analysis and makes use of all information, direct as well as indirect. Under a general likelihood inference framework, this new approach is shown to have several desirable properties, including: (i) it is asymptotically as efficient as the maximum likelihood approach using individual participant data (IPD) from all studies; (ii) unlike the IPD analysis, it suffices to use summary statistics to carry out the CD approach. Individual-level data are not required; and (iii) it is robust against misspecification of the working covariance structure of parameter estimates. Besides its own theoretical significance, the last property also substantially broadens the applicability of the CD approach. All the properties of the CD approach are further confirmed by data simulated from a randomized clinical trials setting as well as by real data on aircraft landing performance. Overall, one obtains a unifying approach for combining summary statistics, subsuming many of the existing meta-analysis methods as special cases.
AbstractObjectiveTo evaluate rates of serious organ specific immune-related adverse events, general adverse events related to immune activation, and adverse events consistent with musculoskeletal ...problems for anti-programmed cell death 1 (PD-1) drugs overall and compared with control treatments.DesignSystematic review and meta-analysis.Data sourcesMedline, Embase, Cochrane Library, Web of Science, and Scopus searched to 16 March 2017 and combined with data from ClinicalTrials.gov.Study selectionEligible studies included primary clinical trial data on patients with cancer with recurrent or metastatic disease.Data extractionThree independent investigators extracted data on adverse events from ClinicalTrials.gov and the published studies. Risk of bias was assessed using the Cochrane tool by three independent investigators.Results13 relevant studies were included; adverse event data were available on ClinicalTrials.gov for eight. Studies compared nivolumab (n=6), pembrolizumab (5), or atezolizumab (2) with chemotherapy (11), targeted drugs (1), or both (1). Serious organ specific immune-related adverse events were rare, but compared with standard treatment, rates of hypothyroidism (odds ratio 7.56, 95% confidence interval 4.53 to 12.61), pneumonitis (5.37, 2.73 to 10.56), colitis (2.88, 1.30 to 6.37), and hypophysitis (3.38, 1.02 to 11.08) were increased with anti-PD-1 drugs. Of the general adverse events related to immune activation, only the rate of rash (2.34, 2.73 to 10.56) increased. Incidence of fatigue (32%) and diarrhea (19%) were high but similar to control. Reporting of adverse events consistent with musculoskeletal problems was inconsistent; rates varied but were over 20% in some studies for arthraligia and back pain.ConclusionsOrgan specific immune-related adverse events are uncommon with anti-PD-1 drugs but the risk is increased compared with control treatments. General adverse events related to immune activation are largely similar. Adverse events consistent with musculoskeletal problems are inconsistently reported but adverse events may be common.
The effect of delivering nutrition at different calorie levels during critical illness is uncertain, and patients typically receive less than the recommended amount.
We conducted a multicenter, ...double-blind, randomized trial, involving adults undergoing mechanical ventilation in 46 Australian and New Zealand intensive care units (ICUs), to evaluate energy-dense (1.5 kcal per milliliter) as compared with routine (1.0 kcal per milliliter) enteral nutrition at a dose of 1 ml per kilogram of ideal body weight per hour, commencing at or within 12 hours of the initiation of nutrition support and continuing for up to 28 days while the patient was in the ICU. The primary outcome was all-cause mortality within 90 days.
There were 3957 patients included in the modified intention-to-treat analysis (1971 in the 1.5-kcal group and 1986 in the 1.0-kcal group). The volume of enteral nutrition delivered during the trial was similar in the two groups; however, patients in the 1.5-kcal group received a mean (±SD) of 1863±478 kcal per day as compared with 1262±313 kcal per day in the 1.0-kcal group (mean difference, 601 kcal per day; 95% confidence interval CI, 576 to 626). By day 90, a total of 523 of 1948 patients (26.8%) in the 1.5-kcal group and 505 of 1966 patients (25.7%) in the 1.0-kcal group had died (relative risk, 1.05; 95% CI, 0.94 to 1.16; P=0.41). The results were similar in seven predefined subgroups. Higher calorie delivery did not affect survival time, receipt of organ support, number of days alive and out of the ICU and hospital or free of organ support, or the incidence of infective complications or adverse events.
In patients undergoing mechanical ventilation, the rate of survival at 90 days associated with the use of an energy-dense formulation for enteral delivery of nutrition was not higher than that with routine enteral nutrition. (Funded by National Health and Medical Research Institute of Australia and the Health Research Council of New Zealand; TARGET ClinicalTrials.gov number, NCT02306746 .).
This work presents a detailed description of remains of dogs (Canis lupus familiaris) from the Pucará de Tilcara site (Jujuy Province, Argentina), which were recently recovered from two ...archaeological contexts (MNI = 5). The purpose of this article is to define the chronology and reconstruct the morphology of these dogs, as well as to inquire about their social status and possible roles. To accomplish the first objective, a first taxon-date in northwestern Argentina, carried out on a sample from Midden 1, has established an age of has established an age of 610±27 years 14C BP (1383-1424 years cal. AD) as a minimum absolute date for the presence of pre-Hispanic dogs in the region. In turn, the analysis of the archaeological evidence from the second context (Acrópolis) suggests their presence during the Inca domination of the site. Morphological reconstruction lends support to a previously observed pattern, consisting of a predominance of medium to small sized dogs. Our analysis suggests that the Acrópolis dogs could have been pets, as well as prestige goods, of the Inca elite or of specialized craft workers, whereas the specimens from Midden 1 were used as food and possibly fur resources. This is the first time that undeniable evidence of dog consumption among the pre-Hispanic societies of northwestern Argentina has been recorded.
Deaths due to COVID-19 are associated with risk factors which can lead to prolonged grief disorder, post-traumatic stress, and other poor bereavement outcomes among relatives, as well as moral injury ...and distress in frontline staff. Here we review relevant research evidence and provide evidence-based recommendations and resources for hospital clinicians to mitigate poor bereavement outcomes and support staff. For relatives, bereavement risk factors include dying in an intensive care unit, severe breathlessness, patient isolation or restricted access, significant patient and family emotional distress, and disruption to relatives' social support networks. Recommendations include advance care planning; proactive, sensitive, and regular communication with family members alongside accurate information provision; enabling family members to say goodbye in person where possible; supporting virtual communication; providing excellent symptom management and emotional and spiritual support; and providing and/or sign-posting to bereavement services. To mitigate effects of this emotionally challenging work on staff, we recommend an organizational and systemic approach which includes access to informal and professional support.
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