bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication errors: definitions and classification
Authors: Aronson Jeffrey K. 
Published: June 2009

1. To understand medication errors and to identify preventive strategies, we need to classify them and define the terms that describe them.2. The four main approaches to defining technical terms consider etymology, usage, previous definitions, and the Ramsey–Lewis method (based on an understanding of theory and practice).3. A medication error is ‘a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient’.4. Prescribing faults, a subset of medication errors, should be distinguished from prescription errors. A prescribing fault is ‘a failure in the prescribing [decision‐making] process that leads to, or has the potential to lead to, harm to the patient’. The converse of this, ‘balanced prescribing’ is ‘the use of a medicine that is appropriate to the patient's condition and, within the limits created by the uncertainty that attends therapeutic decisions, in a dosage regimen that optimizes the balance of benefit to harm’. This excludes all forms of prescribing faults, such as irrational, inappropriate, and ineffective prescribing, underprescribing and overprescribing.5. A prescription error is ‘a failure in the prescription writing process that results in a wrong instruction about one or more of the normal features of a prescription’. The ‘normal features’ include the identity of the recipient, the identity of the drug, the formulation, dose, route, timing, frequency, and duration of administration.6. Medication errors can be classified, invoking psychological theory, as knowledge‐based mistakes, rule‐based mistakes, action‐based slips, and memory‐based lapses. This classification informs preventive strategies.
The epidemiology of medication errors: the methodological difficulties
Authors: Ferner Robin E. 
Published: June 2009

1. Medication errors should be amenable to epidemiological analysis, giving insights into the causes of error and the effects of interventions to prevent them or reduce harm from them.2. There are formidable difficulties in establishing the rates of medication errors.3. There is no agreement on a clear operational definition of the condition.4. The methods used to enumerate cases so far have been unreliable or incomplete or both.5. There is disagreement about whether cases of error that do not cause harm should be included in calculations of error rates.6. When harm occurs in association with drug therapy, it is often unclear whether the harm might have been prevented, and its occurrence should therefore be considered to result from error.7. The denominator for calculating the rate of error is both ill‐defined and inconsistently measured.Better definitions, more complete evaluation, and more thorough impact assessment may improve matters.
The epidemiology of medication errors: how many, how serious?
Authors: Schachter Michael 
Published: June 2009

1. Errors will always occur in any system, but it is essential to identify causes and attempt to minimize risks.2. Although it is difficult to quantify precisely the extent of medication errors, they are clearly frequent and often avoidable, representing a major threat to patient safety.3. Many of the consequences of these errors can be prevented by the intervention of pharmacists.4. Some errors are due to the conditions under which prescribers work; where possible these should be improved (for example, low staffing levels).5. Computerized prescribing can help but can also generate its own inherent errors.6. Improved training of prescribers at the undergraduate and postgraduate levels is vital, a fact that is now being belatedly recognized.
Medication errors: the importance of safe dispensing
Authors: Cheung Ka‐Chun , Bouvy Marcel L. , De Smet Peter A. G. M. 
Published: June 2009

1. Although rates of dispensing errors are generally low, further improvements in pharmacy distribution systems are still important because pharmacies dispense such high volumes of medications that even a low error rate can translate into a large number of errors.2. From the perspective of pharmacy organization and quality assurance, pharmacists should intensify their checking of prescriptions, in order to reduce prescription errors, and should implement strategies to communicate adequately with patients, in order to prevent administration errors. More and better studies are still needed in these areas.3. More research is also required into: dispensing errors in out‐patient health‐care settings, such as community pharmacies in the USA and Europe; dispensing errors in hospitals and out‐patient health‐care settings in middle‐ and low‐income countries; and the underlying causes of dispensing errors.
Vaccines modulating lipoprotein autoimmunity as a possible future therapy for cardiovascular disease
Authors: Nilsson J. , Fredrikson G. N. , Björkbacka H. , Chyu K.‐Y. , Shah P. K. 
Published: June 2009

Abstract.Current strategies for prevention of cardiovascular disease focus on risk factor intervention. Although these have been proven both safe and effective results from randomized clinical trials suggest that it is difficult to achieve relative risk reductions exceeding 40% with this approach. To further improve efficacy future therapies must aim at targeting the actual disease process in the arterial wall. Emerging evidence have identified an important role of the immune system in atherosclerosis and suggest that modulation of autoimmune responses against oxidized LDL and other antigens in the atherosclerotic plaque represent one possible new approach to disease prevention. Oxidized LDL is targeted by both antibody‐mediated and cellular immune responses and as much as 10% of the T cells in atherosclerotic plaques are oxidized LDL‐specific. Immune activation in the atherosclerotic plaque is primarily of the pro‐inflammatory Th1‐type and inhibition Th1 immunity reduces atherosclerosis in experimental animals. Atherosclerosis vaccines based on antigens derived from LDL have been developed to modulate these processes. Their mechanisms of action remain to be full characterized but may involve expression of protective antibodies that facilitate the removal of oxidized LDL and antigen‐specific regulatory T cells that counteract Th1 autoimmunity against oxidized LDL. In this review we will discuss the possibilities and challenges encountering the translation of immune‐modulatory therapy for atherosclerosis from the experimental stage into the clinic.
Maternal IgM anti‐D, borderline foetal Doppler middle cerebral artery velocities and absent neonatal haemolysis
Authors: Badami K. G. , Vanhecke C. , Bingham J. 
Published: June 2009

summary.Anti‐D was detected for the first time at 36 weeks gestation in a group A RhD‐negative primigravida without prior sensitizing events or anti‐D administration. Simultaneously, foetal ultrasound showed middle cerebral artery maximum velocity (MCA Vmax) at the 95th centile but no hydrops. Labour was induced at 37 weeks. Although neonatal anaemia was anticipated, the baby, who was group O RhD‐positive, was born with a normal haemoglobin and negative direct antiglobulin test and antibody screen. Retrospectively, the maternal anti‐D proved to be exclusively immunoglobulin M (IgM), which does not cross the placenta. Foetal Doppler MCA Vmax measurements can give false positive results especially late in the third trimester. Thus, antibody class, especially in first pregnancies without prior sensitizing events, and the timing of foetal Doppler MCA velocity measurements should be considered when evaluating the likelihood and severity of haemolytic disease of the foetus and newborn.
Coral assemblages and reef growth in the Commonwealth of the Northern Mariana Islands (Western Pacific Ocean)
Authors: Houk Peter , Van Woesik Robert 
Published: June 2009

AbstractReef development varies considerably around the high, raised‐limestone islands of the Commonwealth of the Northern Mariana Islands (CNMI). Here we examine the modern assemblages at 30 sites for coral composition, colony density, colony size, and fidelity. We defined four reef types and hypothesize the presence of environmentally driven ecological stasis, whereby the environment continuously selects for coral species membership, defines colony sizes, and over time creates the noted reef types. Our results show that constructional spur‐and‐groove reefs supported significantly larger coral‐colony sizes and higher coral species richness compared with high‐relief interstitial framework, low‐relief incipient, and non‐constructional coral assemblages. Non‐constructional reefs supported much smaller coral colony sizes, despite similar population densities, and were consistently found in association with high wave exposure. The distinct coral assemblages found on interstitial framework and low‐relief incipient reefs were not affiliated with any wave exposure regime, but were located adjacent to large watersheds and on islands with unique geological history. These assemblages were nested within the spur‐and‐groove species pool. Overall, modern coral cover was well predicted by bathymetric slope and watershed size, while species richness was additively influenced by two proxies of pollution, suggesting the latter is better suited for establishing management targets. In contrast with previous studies that suggested modern assemblages were biologically controlled in the CNMI, we show reef assemblages and reef development are highly influenced by long‐term environmental forcing.
Lineage analysis of quiescent regenerative stem cells in the adult brain by genetic labelling reveals spatially restricted neurogenic niches in the olfactory bulb
Authors: Giachino Claudio , Taylor Verdon 
Published: June 2009

AbstractThe subventricular zone (SVZ) of the lateral ventricles is the major neurogenic region in the adult mammalian brain, harbouring neural stem cells within defined niches. The identity of these stem cells and the factors regulating their fate are poorly understood. We have genetically mapped a population of Nestin‐expressing cells during postnatal development to study their potential and fate in vivo. Taking advantage of the recombination characteristics of a nestin::CreERT2 allele, we followed a subpopulation of neural stem cells and traced their fate in a largely unrecombined neurogenic niche. Perinatal nestin::CreERT2‐expressing cells give rise to multiple glial cell types and neurons, as well as to stem cells of the adult SVZ. In the adult SVZ nestin::CreERT2‐expressing neural stem cells give rise to several neuronal subtypes in the olfactory bulb (OB). We addressed whether the same population of neural stem cells play a role in SVZ regeneration. Following anti‐mitotic treatment to eliminate rapidly dividing progenitors, relatively quiescent nestin::CreERT2‐targeted cells are spared and contribute to SVZ regeneration, generating new proliferating precursors and neuroblasts. Finally, we have identified neurogenic progenitors clustered in ependymal‐like niches within the rostral migratory stream (RMS) of the OB. These OB‐RMS progenitors generate neuroblasts that, upon transplantation, graft, migrate and differentiate into granule and glomerular neurons. In summary, using conditional lineage tracing we have identified neonatal cells that are the source of neurogenic and regenerative neural stem cells in the adult SVZ and occupy a novel neurogenic niche in the OB.
Priority effects in experimental populations of the cyanobacterium Microcystis
Authors: Van Gremberghe Ineke , Vanormelingen Pieter , Van der Gucht Katleen , Souffreau Caroline , Vyverman Wim , De Meester Luc 
Published: June 2009

SummaryThe arrival order of colonists in developing populations can have a lasting influence on community and population structure, a phenomenon referred to as priority effects. To explore whether such priority effects are important in determining strain composition of populations of the cyanobacterium Microcystis, four Microcystis strains, isolated from a single lake and differing in functional traits, were grown during 4 weeks in the laboratory in all possible pairwise combinations, with the two strains either inoculated at the same time or with a time lag of 1 week, in the presence or absence of grazing Daphnia magna. The relative abundance of strains in the mixtures was assessed using denaturing gradient gel electrophoresis, and the growth rate of each strain in the mixtures was determined for the last 2 weeks of the experiment. We observed strong effects of inoculation order on the final population structure, and these effects were influenced by grazing Daphnia. The priority effects were strain‐specific and occurred in two directions: some of the strains grew slower while others grew faster when inoculated second compared with when inoculated first. Our results indicate that priority effects may have a profound impact on strain composition of Microcystis populations.
Role of ATP and related purines in inhibitory neurotransmission to the pig urinary bladder neck
Authors: Hernández Medardo , Knight Gillian E , Wildman Scott SP , Burnstock Geoffrey 
Published: June 2009

Background and purpose: As adenosine 5′‐triphosphate (ATP) is one of the inhibitory mediators of the bladder outflow region, this study investigates the possible release of ATP or related purines in response to electrical field stimulation (EFS) and the purinoceptor(s) involved in nerve‐mediated relaxations of the pig urinary bladder neck.Experimental approach: Urothelium‐denuded and intact phenylephrine‐precontracted strips were mounted in organ baths containing physiological saline solution at 37°C and gassed with 95% O2and 5% CO2for isometric force recordings.Key results: EFS, in the presence of atropine, guanethidine and NG‐nitro‐L‐arginine, and exogenous purines, produced frequency‐ and concentration‐dependent relaxations respectively. Adenosine 5′‐diphosphate (ADP) and adenosine were more potent than ATP in producing relaxation, while uridine 5′‐triphosphate, uridine 5′‐diphosphate and α,β‐methylene ATP were less effective. The non‐selective P2 antagonist suramin, and the P2Y1and P1 receptor blockers 2′‐deoxy‐N6‐methyladenosine 3′,5′‐bisphosphate tetrasodium and 8‐(p‐sulphophenyl)theophylline, respectively, inhibited the responses to EFS and ATP. The P1 agonist's potency was: 5′‐N‐ethylcarboxamidoadenosine (NECA)>4‐2[[6‐amino‐9‐(N‐ethyl‐b‐D‐ribofuranuronamidosyl)‐9H‐purin‐2‐yl]amino]ethyl]benzene propanoic acid hydrochloride>2‐chloro‐N6‐cyclopentyladenosine>‐2‐chloro‐6‐[[(3‐iodophenyl)methyl]amino]‐9H‐purin‐9‐yl]‐1‐deoxy‐N‐methyl‐b‐D‐ribofuranuronamide = adenosine. 4‐(‐[7‐amino‐2‐(2‐furyl)[1,2,4]triazolo[2,3‐a][1,3,5]triazin‐5‐ylamino]ethyl) phenol, an A2Aantagonist, reduced the relaxations to EFS, adenosine and NECA. In urothelium‐intact samples, relaxations to EFS and purines were smaller than in urothelium‐denuded preparations. Neuronal voltage‐gated Na+channels blockade failed to modify ATP relaxations. At basal tension, EFS‐ and ATP‐induced contractions were resistant to desensitization or blockade of P2X1and P2X3receptors.Conclusions and implications: ATP is involved in the non‐adrenergic, non‐cholinergic, non‐nitrergic inhibitory neurotransmission in the pig bladder neck, producing relaxation largely through muscle A2Areceptors after breakdown to adenosine, and P2Y1receptors after breakdown to ADP. Antagonists of these receptors may be useful for urinary incontinence treatment produced by intrinsic sphincteric deficiency.
On the Phenomenology of the Perforating Vein of the Elbow
Authors: Lomonte Carlo , Basile Carlo 
Published: June 2009

AbstractThe perforating veins, as the name suggests, are the veins that perforate the muscular aponeuroses ensuring communication between the superficial and the deep veins. Located at the bend of the elbow, almost constantly, there is a vein, named perforating vein of the elbow, which is of great interest to the nephrologist who is responsible for the management of vascular access for hemodialysis (HD). It represents, in fact, because of its intrinsic characteristics and topographical reasons, a valuable resource for the creation of a vascular access for HD, especially in obese patients, elderly patients, diabetics, and patients affected by peripheral vasculopathy. Arterio‐venous fistulae (AVF) constructed with the perforating vein of the elbow are relatively easy to perform, have an excellent patency rate, a low incidence of early thrombosis, adequate flows, and a low incidence of the steal syndrome. In other types of AVFs, the perforating vein of the elbow subtracts flow to the superficial veins slowing or preventing their full maturation, and can become a problem in measuring the blood flow of the AVF. But still, its presence can maintain patent a fistula in case of poor compliance of the superficial veins, while awaiting for interventional procedures able to accelerate a subsequent maturation. This review intends to explore the role that the perforating vein of the elbow plays in the physiology and pathology of the AVF, in relation to the issues that most frequently occur in clinical practice.
Can Advances in Hemodialysis Machine Technology Prevent Intradialytic Hypotension?
Authors: Davenport Andrew 
Published: June 2009

AbstractIntradialytic hypotension remains a frequent problem in routine outpatient hemodialysis. Although hypotension can be reduced by more frequent dialysis sessions and longer session duration, these options are not available for many patients. Advances in hemodialysis machine technology have led to the development of relative blood volume monitoring. However, multicenter trials seeking to document a reduction in the frequency of intradialytic hypotension have been disappointing. Further technological advances using “fuzzy” logic systems have been introduced; they track the fall in relative blood volume and then adjust either or both the ultrafiltration rate and dialyzate sodium concentration to maintain a preprogrammed fall in relative blood volume that is likely to be hemodynamically uneventful. Although these systems have been reported to reduce the frequency of serious intradialytic hypotensive episodes, they have not been successful in preventing them probably due to underlying issues with the use of relative blood volume monitoring. More attention needs to be focused on reducing ultrafiltration rates by reducing interdialytic weight gains. Successfully improving patient motivation and education, emphasizing dietary sodium restriction, lowering dialyzate sodium concentrations will all go a long way toward this goal. Technology has much to offer but will not solve this persistent problem.
Effect of Age on Survival Benefit of Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer
Authors: Zuckerman Ilene H. , Rapp Thomas , Onukwugha Ebere , Davidoff Amy , Choti Michael A. , Gardner James , Seal Brian , Mullins C. Daniel 
Published: June 2009

OBJECTIVES: To estimate the modifying effect of age on the survival benefit associated with adjuvant chemotherapy receipt in elderly patients with a diagnosis of Stage III colon cancer.DESIGN: Observational, retrospective cohort study using two samples: an overall sample of 7,182 patients to provide externally valid analyses and a propensity score–matched sample of 3,016 patients to provide more internally valid analyses by reducing the presence of treatment endogeneity. An interval‐censored survival model with a complementary log‐log link was used. Hazard ratios and 95% confidence intervals were obtained for all regressions.SETTINGS: Data from the National Cancer Institute's Surveillance, Epidemiology and End Results database and the linked Medicare enrollment and claims database were used.PARTICIPANTS: Selected patients were aged 66 and older and had a diagnosis of Stage III colon cancer. Patients were followed from surgery to time of death or censorship.MEASUREMENTS: The outcome was colon cancer–specific death during the follow‐up period. Receipt of adjuvant chemotherapy was measured according to the presence of a claim for 5‐fluorouracil or leucovorin within 6 months after surgery.RESULTS: All elderly patients had a significant survival benefit associated with adjuvant chemotherapy receipt, although the survival benefit of adjuvant chemotherapy was not uniform across all age groups.CONCLUSION: These findings have important clinical and policy implications for the risk–benefit calculation induced by treatment in older patients with Stage III colon cancer. The results suggest that there is a benefit from chemotherapy, but the benefit is lower with older age.
Crise mondiale, emplois et protection sociale
Authors: STIGLITZ Joseph 
Published: June 2009

Résumé.Les intérêts nationaux conditionnent les réactions à la crise financière mondiale et aggravent l'effondrement de la demande. La résurgence du protectionnisme, le renflouement des banques et les plans nationaux de relance distordent la concurrence et les incitations au détriment des pays en développement, de l'indispensable protection sociale et d'une reprise rapide. Mettant en garde contre la sous‐estimation du potentiel de destruction d'emplois de la crise, l'auteur plaide pour un plan de relance mondial, une révision des paradigmes économiques et des politiques réglementaires, l'aide aux pays en développement, un FMI moins intrusif et plus de protection sociale, stabilisateur automatique de l'économie.
L'«externalisation» du droit du travail
Authors: OJEDA AVILÉS Antonio 
Published: June 2009

Résumé.L'intense réajustement du droit du travail qui, pendant trois décennies, a consisté aux yeux des spécialistes en une fragmentation et, pire encore, une désagrégation en domaines de plus en plus éloignés les uns des autres commence à devenir une tendance générale qui pourrait prendre sous peu une dimension structurelle. Un mouvement d'expansion le conduit à gagner des territoires étrangers, ce qui semble mettre en péril son identité et ses délimitations traditionnelles, en échange néanmoins d'une symbiose qui découle d'influences réciproques. Sont analysées ici six lignes d'expansion observées en Europe mais aussi dans certains pays d'Amérique et d'Asie.