bluuebunny/crossref_metadata_2025_split huggingface dataset:
ADVANCE CARE PLANNING FOR DEMENTIA PATIENTS
Authors: McGee Andrew 
Published: April 2013

BackgroundThere is currently some debate about the extent to which advance decisions, advance statements of wishes and preferences, or other forms of advanced care planning should be followed when they are undertaken by a patient who subsequently loses capacity. Two main arguments commonly advanced to support the claim that these forms of advanced planning are problematic are: (a) the person who loses capacity is not the same person as the one who had capacity; and (b) the person retains certain autonomy in addition to welfare interests and so cannot be bound by priorly taken decisions or expressed wishes.AimThis paper re-examines these two main arguments in the context of dementia patients. It rejects the first argument. However, it argues that the second argument is important and is often correct. Its correctness can only be determined in a case by case basis, taking into account all relevant circumstances. Nonetheless, this has implications for how we ought to draw up an advance decision that is to be legally binding, and for whether we ought to consider alternative forms of advance care planning. One alternative put forward in theNuffield Dementia Report 2009is a form of proxy decision making. This paper examines that proposal.MethodsConceptual analysis of arguments (a) and (b), with some reference to the relevance of a recent English case to advance statements of wishes and preferences.ResultsThe paper concludes that argument (a) can be rejected, but that argument (b) is sound and has implications for the forms of advance care planning we ought to adopt in the case of dementia patients, and for the shape that current advance decisions now take.DiscussionA form of proxy decision making might be the best way of resolving the dilemma about how to respect autonomy and welfare interests that survive the loss of capacity in dementia patients.ConclusionThe form of proxy decision making proposed in theNuffield Dementia Report 2009is the best way of solving the dilemma and might be preferable to legally binding advance decisions.
IMPLEMENTATION OF ADVANCE CARE PLANNING (ACP) IN GENERAL PRACTICE THROUGH THE PROVISION OF OUTREACH ACP FACILITATORS
Authors: Mann J , Milner R 
Published: April 2013

BackgroundFollowing the success of the smaller 2010 pilot study, this initiative was 12 month collaboration between Barwon Health's Respecting Patient Choices (RPC) program, 18 General Practice Clinics from within the Barwon region and the Barwon Medicare Local.Table 1General Practice ACP Activity 2012ActivityGP Project ActivityOverall Program Activity (Total Activity)Referrals13452071Completed Plans11741531Declined2561Deceased16139AimTo engage with General Practitioners in providing advance care planning (ACP) to their patients demonstrating a sustainable ACP model for general practice.MethodsFunding provided by Barwon Health for 2.0 EFT ACP Facilitator positions.Key stakeholders were engaged and Memorandum of Understanding developed.Participating practices were identified through an expression of interest and GPs were encouraged to complete their own ACP. Patients with chronic or life limiting illness and aged were the target population including other interested individuals. This was achieved via the >75 Health Assessment, Chronic Disease Management Planning and routine consultations. Engagement with GP staff occurred collaboratively with Barwon Medicare Local throughout the project period.ResultsProviding trained staff from a funded ACP program to 18 practices in the Geelong region has resulted in 1350 referrals for ACP and a completion rate of 87% (1174). From this cohort, there have been 295 in-patient episodes of care with a number of ACP's implemented as required.DiscussionSimilar findings to the smaller 2010 pilot study have been demonstrated through patients exhibiting a high rate of acceptance, participation, document completion and satisfaction when ACP is provided through GP's.ConclusionThis larger study has demonstrated that General Practice is integral to the commencement of ACP discussions in the community, where there is established trust and confidence and whilst patients are ‘relatively well’, in the absence of acute illnesses. Barwon Health's catchment includes a higher proportion of older persons in comparison to the state average and is therefore significant that the general awareness of ACP is raised routinely within the community.Table 2Barwon Health's Respecting Patient Choices program data2006–2007 (2 years)20082009201020112012Referrals5004405347368012045Contacts10341473198126524521Completed plans2481972693634061509Declined2219302358Reviews24214433711912Deaths683689106135135
ADVANCED CARE PLANNING WITHIN JEWISH ETHICAL PRINCIPLES
Authors: Rousso R , Lefebure M 
Published: April 2013

BackgroundAdvanced care planning requires ethno-specific organisations to balance the local regulations concerning respect for individual decision making and respect for cultural guidance regarding service provision. Unfortunately, these guidelines often do not agree. At Jewish Care, an ethno-specific organisation, this is particularly significant because secular end of life care provisions will more often than not conflict with the values guiding the medical and nursing care within the organisation.AimTo develop an ethno-specific Advanced Care Plan that takes into account government guidelines and is respectful of religious imperatives guiding end of life care.MethodsUtilising an external survey and an internal interview process, statistical data and results were collected identifying a gap between a cultural imperative and present contemporary thoughts of the dynamic community we serve.ResultsA person-centred advanced care has was developed to enable our ethno-specific organisation to support residents/clients and their families with care that meets their needs whilst also providing support within a Jewish ethical framework. This new model has successfully bridged the gap between cultural imperatives and respecting individual resident and client choice.DiscussionWe have found that this new model overcomes the boundary of confliction and assists to alleviate many if not all fears and uncertainties pertaining to accommodating residents' and clients' personal wishes regarding their future medical preferences and end of life care.ConclusionIt is proposed that the model developed by Jewish Care Victoria may be helpful for other ethno-specific organisations facing similar challenges regarding a conflict between respecting individual wishes within a national secular framework, whilst having regard to ethnic-religious guiding principles.
A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS
Authors: Muto Carmine , Solimene Francesco , Gallo Paolo , Nastasi Maurizio , La Rosa Concetto , Calvanese Raimondo , Iengo Raffaele , Canciello Michelangelo , Sangiuolo Raffaele , Diemberger Igor , Ciardiello Carmine , Tuccillo Bernardino 
Published: April 2013

Background—
Current recommendations require a QRS duration of ≥120 ms as a condition for prescribing cardiac resynchronization therapy (CRT). This study was designed to test the hypothesis that patients with heart failure (HF) of ischemic origin, current indications for defibrillator implantation, and QRS <120 ms may benefit from CRT in the presence of marked mechanical dyssynchrony.

Methods and Results—

Patients with intraventricular dyssynchrony on echocardiography were randomly assigned to CRT or dual-chamber defibrillator implantation (CRT defibrillator and dual-chamber implantable cardioverter-defibrillator arm, respectively). The primary end point was the HF clinical composite response, which scores patients as improved, unchanged, or worsened. The secondary end point was the cumulative survival from HF hospitalization and HF death. An additional secondary end point was the composite of HF hospitalization, HF death, and spontaneous ventricular fibrillation. Twenty-three of 56 patients with CRT defibrillator showed an improvement in their clinical composite response at 1 year, compared with 9 of 55 patients with dual-chamber implantable cardioverter-defibrillator (41% versus 16%;
P
=0.004). After a median follow-up of 16 months, the CRT defibrillator arm showed a nonsignificant higher survival from HF hospitalization and HF death (
P
=0.077), and a significantly higher survival from the combined end point of HF hospitalization, HF death, and spontaneous ventricular fibrillation (
P
=0.028).

Conclusions—
In this comparison of CRT defibrillator and dual-chamber implantable cardioverter-defibrillator, CRT improved clinical status in some patients with ischemic cardiomyopathy, mild-to-moderate symptoms, narrow QRS duration, and mechanical dyssynchrony on echocardiography.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique identifier: NCT01577446.
Determining a “Reasonable” Implementation Timeline for Developing Countries in WTO Disputes: An Appraisal of Special Treatment Commitments in DSU Article 21.3 (c) Arbitrations
Authors: Zaman Khorsed 
Published: April 2013

Abstract
The Understanding on Rules and Procedures Governing the Settlement of Disputes (DSU) prescribes three different types of arbitration which are ancillary to the Panel and Appellate Body functions of the WTO dispute settlement system (DSS). These are the arbitrations for determining the implementation timeline under Article 21.3 (c) of the DSU and two other types of arbitration under Articles 21.5 and 22.6. This article focuses on some specific approaches and functions of Article 21.3 (c) arbitrations and examines the procedural actions which are related to determining a suitable implementation time for developing countries. It investigates the consistency and coherence of practice in selected arbitral awards in which developing countries claimed “particular attention” either as complainant or as implementing parties. This article points out that the lack of specific guidelines in the DSU is the substantial cause for arbitrators’ noncompliance with Article 21.2 provisions in Article 21.3 (c) arbitrations, which questions the procedural fairness of such arbitrations. This situation, amongst others, reiterates the urgent necessity to amend the relevant DSU rules.
The Argumentative Dimension to the EU-Africa EPAs
Authors: Hurt Stephen R. , Lee Donna , Lorenz-Carl Ulrike 
Published: April 2013

Abstract
Not only is the participation of developing countries in international trade negotiations growing, so is their influence over the global trade agenda. This article highlights the increasing activism and impact of African states through a detailed study of the current Economic Partnership Agreement (EPAs) negotiations with the European Union (EU). In examining African resistance to EPAs, the article develops a constructivist approach to North-South trade negotiations that pays close attention to the role of development discourses. We argue that the growing willingness of African states to challenge the EU to deliver on its development promises during the decade-long EPA process was crucial to informing their sustained opposition to the EU’s goal of completing a comprehensive set of sub-regional economic agreements. We document African resistance to EU trade diplomacy in the EPAs, exploring how these otherwise weak countries were able to pursue normative-based negotiation strategies by recourse to the EU’s promise of a ‘development partnership.’
Using CFD to Understand Multiphase and Wet Gas Measurement
Authors: Barton Neil , Parry Andrew 
Published: April 2013

Computational fluid dynamics (CFD) flow modelling has proved to be a useful tool in single-phase flow metering. More recently, the increase in computer power has made multiphase models viable. However, there is a range of modelling approaches, which makes practical simulation of the behaviour of multiphase and wet gas flows in metering and/or sampling devices as much an art as a science. This paper introduces alternative modelling approaches to show what can be achieved using CFD modelling and to highlight the limitations of the technique. A series of case studies are presented in which CFD analysis has been used to study the following issues in multiphase and wet gas measurement or sampling: Effects of heavy oil multiphase flow in a Venturi Behaviour of multiphase swirl flow in a Venturi Modelling of wet gas flows in Venturis, cone meters, and orifice plates Effective sampling methods
A theory of freedom
Authors: Edge Matt 
Published: April 2013

The traditional dispute over whether there are one or two ‘concepts’ of freedom has recently been reignited. Despite this, Isaiah Berlin’s distinction between positive and negative freedom retains a significant amount of influence over academic and popular disputes about freedom, continuing to withstand recent attempts, in Eric Nelson’s words, to ‘lift the shadow’ of Berlin’s famous dichotomy. Berlin’s distinction has traditionally been assailed by two separate schools of thought. One line of argument, propounded by Quentin Skinner and Philip Pettit, has suggested that Berlin’s account includes (at least) one concept of freedom too few. Another line of attack, however, propounded by the likes of Nelson, Efraim Podoksik and Gerald MacCallum, has suggested that, to the contrary, Berlin’s account contains one concept of liberty too many. In this article, I will attempt to clear up this confusing picture by discussing how both of these lines of attack have a role to play in helping to dismantle Berlin’s ultimately misleading account of freedom. In the second half of the article, I then go on to explore the implications of this for contemporary political theory in the construction of a theory of freedom for modern political communities, discussing how the ‘spectrum’ of liberty I explore in the first half leads, naturally, to a social model of individual liberty.
Transvaginal Ultrasound Simulation and its Effect on Trainee Confidence Levels: A Replacement for Initial Clinical Training?
Authors: Williams C J , Edie J C , Mulloy B , Flinton D M , Harrisont G 
Published: April 2013

Introduction The ScanTrainer transvaginal ultrasound simulator has been developed to facilitate initial training of transvaginal ultrasound skills without patient contact. Due to the intimate nature of the examination and in some cases, limited training opportunities, the need for simulation-based education in ultrasound has gained momentum. Currently, research into the effectiveness of the ScanTrainer is limited. Methods A mixed method study was conducted in a single institution between October 2011 and January 2012. Participants were recruited using convenience sampling and allocated to the control (clinical training) or experimental (simulation training) group following a pre-test. After 10 hours of their allocated transvaginal ultrasound training method a post-test assessment was conducted and the results statistically analysed. Participants then experienced the alternative method of training and completed questionnaires. The results were used to inform semi-structured interviews for each group. Interview transcripts were interpreted using theme analysis. Results A small number of doctors completed the study, nine (82%) out of the 11 recruited. The majority of participants (89%) felt that practice on the ScanTrainer can increase confidence prior to attempting a real transvaginal ultrasound scan. Average scores showed that the simulation training group outperformed the clinical training group on overall score and each of the five post-test components. No statistically significant differences were demonstrated for overall score ( U = 13, P = 0.556) or the five components ( P = 0.190–1). Conclusions Transvaginal ultrasound training on the ScanTrainer has the potential to replace initial clinical training; however, further larger trials are required to evaluate. Clinically significant outcomes exist if the ScanTrainer training is proven to be more effective than initial clinical training. The ScanTrainer prepares a trainee and builds confidence to progress to clinical scanning, which has the potential to improve the patient experience.
Usage of Complementary and Alternative Medicine among Severe Hemophilia A Patients in India
Authors: Jadhav Uma , Mukherjee Kanchan , Thakur Harshad 
Published: April 2013

Documented evidence of the usage of complementary and alternative medicine among patients with rare disease such as hemophilia is limited. Therefore, we explored the types of complementary and alternative medicines used, the associated sociodemographic and clinical factors, and the cost and reasons for usage among severe hemophilia A patients in India. Our study demonstrates an increased usage of complementary and alternative medicine (42.3%) among hemophiliacs. Significant factors associated with usage of these therapies were economic status, comorbidity status, and education of head of households. Among users of complementary and alternative medicine, cost of these therapies was found to be higher (17.22%) compared with hemostatic drugs (5.63%) from the average cost of treatment (Rs 29 029). The findings of this study warrant multicenter research to explore different dimensions of complementary and alternative medicine and also incorporate it in comprehensive hemophilia care programs to address issues of treatment gap and quality of life of hemophiliacs.
MicroRNA-17∼92 regulates effector and memory CD8 T-cell fates by modulating proliferation in response to infections
Authors: Khan Arif A. , Penny Laura A. , Yuzefpolskiy Yevgeniy , Sarkar Surojit , Kalia Vandana 
Published: April 2013

Key Points
miR-17∼92 promotes proliferation and terminal effector differentiation in CD8 T-cells by upregulating PI3K-AKT-mTOR signaling.
Revised response criteria for polycythemia vera and essential thrombocythemia: an ELN and IWG-MRT consensus project
Authors: Barosi Giovanni , Mesa Ruben , Finazzi Guido , Harrison Claire , Kiladjian Jean-Jacques , Lengfelder Eva , McMullin Mary F. , Passamonti Francesco , Vannucchi Alessandro M. , Besses Carlos , Gisslinger Heinz , Samuelsson Jan , Verstovsek Srdan , Hoffman Ronald , Pardanani Animesh , Cervantes Francisco , Tefferi Ayalew , Barbui Tiziano 
Published: April 2013

Key PointsEvidence exists that ELN criteria for response in ET and PV issued in 2009 do not provide relevant measures of benefit for patients. Revised recommendations for assessing response are provided.
Gemtuzumab ozogamicin in acute myeloid leukemia: a remarkable saga about an active drug
Authors: Rowe Jacob M. , Löwenberg Bob 
Published: April 2013

Abstract
Despite living in an era of unprecedented progress in the understanding of the genetic and molecular biology of acute myeloid leukemia (AML), this has not translated into significant advances in therapy. Never before have so many potential targets been studied. Yet most have not advanced beyond the phase 1 and, occasionally, phase 2 studies. The few ongoing phase 3 studies seem unlikely to have more than a marginal benefit, if at all. Thus, it is not surprising that in past few decades almost no new drugs for AML have received regulatory approval. In 2000, gemtuzumab ozogamicin (GO) was granted accelerated approval by the US Food and Drug Administration based on promising phase 2 data in relapsed older adults with AML. GO held promise as a new agent that also could be efficacious in newly diagnosed AML with acceptable toxicity. Several phase 3 studies were designed to test GO in this setting. The results of a randomized study by the Southwest Oncology Group led in 2010 to the voluntary withdrawal of this agent when improved efficacy could not be demonstrated and toxicity appeared excessive. Since then, 4 randomized studies have been completed that, in aggregate, strongly support the efficacy of this agent in newly diagnosed AML with acceptable toxicity. There is a very plausible explanation for this discrepancy, making a compelling case for reapproval of GO in AML.
Visualising single molecules of HIV-1 and miRNA nucleic acids
Authors: Jones Kate L , Karpala Adam , Hirst Bevan , Jenkins Kristie , Tizard Mark , Pereira Cândida F , Leis Andrew , Monaghan Paul , Hyatt Alex , Mak Johnson 
Published: April 2013

Abstract

Background
The scarcity of certain nucleic acid species and the small size of target sequences such as miRNA, impose a significant barrier to subcellular visualization and present a major challenge to cell biologists. Here, we offer a generic and highly sensitive visualization approach (oligo fluorescent in situ hybridization, O-FISH) that can be used to detect such nucleic acids using a single-oligonucleotide probe of 19–26 nucleotides in length.

Results
We used O-FISH to visualize miR146a in human and avian cells. Furthermore, we reveal the sensitivity of O-FISH detection by using a HIV-1 model system to show that as little as 1–2 copies of nucleic acids can be detected in a single cell. We were able to discern newly synthesized viral cDNA and, moreover, observed that certain HIV RNA sequences are only transiently available for O-FISH detection.

Conclusions
Taken together, these results suggest that the O-FISH method can potentially be used for in situ probing of, as few as, 1–2 copies of nucleic acid and, additionally, to visualize small RNA such as miRNA. We further propose that the O-FISH method could be extended to understand viral function by probing newly transcribed viral intermediates; and discern the localisation of nucleic acids of interest. Additionally, interrogating the conformation and structure of a particular nucleic acid in situ might also be possible, based on the accessibility of a target sequence.
Worldwide population distribution of the common LCE3C-LCE3B deletion associated with psoriasis and other autoimmune disorders
Authors: Bassaganyas Laia , Riveira-Muñoz Eva , García-Aragonés Manel , González Juan R , Cáceres Mario , Armengol Lluís , Estivill Xavier 
Published: April 2013

Abstract

Background
There is increasing evidence of the importance of copy number variants (CNV) in genetic diversity among individuals and populations, as well as in some common genetic diseases. We previously characterized a common 32-kb insertion/deletion variant of the PSORS4 locus at chromosome 1q21 that harbours the LCE3C and LCE3B genes. This variant allele (LCE3C_LCE3B-del) is common in patients with psoriasis and other autoimmune disorders from certain ethnic groups.

Results
Using array-CGH (Agilent 244 K) in samples from the HapMap and Human Genome Diversity Panel (HGDP) collections, we identified 54 regions showing population differences in comparison to Africans. We provided here a comprehensive population-genetic analysis of one of these regions, which involves the 32-kb deletion of the PSORS4 locus. By a PCR-based genotyping assay we characterised the profiles of the LCE3C_LCE3B-del and the linkage disequilibrium (LD) pattern between the variant allele and the tag SNP rs4112788. Our results show that most populations tend to have a higher frequency of the deleted allele than Sub-Saharan Africans. Furthermore, we found strong LD between rs4112788G and LCE3C_LCE3B-del in most non-African populations (r2 >0.8), in contrast to the low concordance between loci (r2 <0.3) in the African populations.

Conclusions
These results are another example of population variability in terms of biomedical interesting CNV. The frequency distribution of the LCE3C_LCE3B-del allele and the LD pattern across populations suggest that the differences between ethnic groups might not be due to natural selection, but the consequence of genetic drift caused by the strong bottleneck that occurred during “out of Africa” expansion.