bluuebunny/crossref_metadata_2025_split huggingface dataset:
How I treat myelofibrosis
Authors: Tefferi Ayalew 
Published: January 2011

AbstractIt is currently assumed that myelofibrosis (MF) originates from acquired mutations that target the hematopoietic stem cell and induce dysregulation of kinase signaling, clonal myeloproliferation, and abnormal cytokine expression. These pathogenetic processes are interdependent and also individually contributory to disease phenotype–bone marrow stromal changes, extramedullary hematopoiesis, ineffective erythropoiesis, and constitutional symptoms. Molecular pathogenesis of MF is poorly understood despite a growing list of resident somatic mutations that are either functionally linked to Janus kinase (JAK)–signal transducer and activator of transcription hyperactivation (eg JAK2, MPL, and LNK mutations) or possibly involved in epigenetic dysregulation of transcription (TET2, ASXL1, or EZH2 mutations). Current prognostication in primary MF is based on the Dynamic International Prognostic Scoring System-plus model, which uses 8 independent predictors of inferior survival to classify patients into low, intermediate 1, intermediate 2, and high-risk disease groups; corresponding median survivals are estimated at 15.4, 6.5, 2.9, and 1.3 years. Such information is used to plan a risk-adapted treatment strategy for the individual patient, which might include observation alone, conventional or investigational (eg, JAK inhibitors, pomalidomide) drug therapy, allogenic stem cell transplantation with reduced- or conventional-intensity conditioning, splenectomy, or radiotherapy. I discuss these treatment approaches in the context of who should get what and when.
In the twilight zone: adolescent capacity in the criminal justice arena
Authors: Sarkar Sameer P. 
Published: January 2011

SummaryThe rights and duties of an adolescent has been the focus of much controversy, especially in the field of capacity and consent, and to a lesser extent in youth justice. Society is constantly reviewing how to ensure fairness to all, while not denying anyone their rights. Developments in neurobiology have forced us to rethink age-old concepts about adolescent development within competence and culpability. This article focuses on the theoretical foundations of capacity or competence and provides guidance on how to negotiate common clinical pitfalls when assessing capacity in an adolescent.
Mental health in children with severe hearing impairment
Authors: Gentili Nicoletta , Holwell Andrew 
Published: January 2011

SummaryDeafness does not in itself cause emotional/behavioural or cognitive problems or psychiatric disorders. However, children with hearing impairment are at greater risk of developing emotional/behavioural problems and neurodevelopmental disorders. The incidence of both seems to be higher in deaf children from hearing families. Most prelingual deafness is caused by recessive genes; hence, most deaf individuals come from hearing families, the majority of whom do not use sign language. Numerous studies, in both hearing and deaf populations, show how the lack of access to language has an impact on the emotional development of children. This article focuses on the mechanisms by which early language deprivation mediates emotional/behavioural difficulties and consequent emotional dysregulation, and may produce behaviours and symptoms that can be misdiagnosed as neurodevelopmental disorders in deaf children and adolescents (from infancy to 18 years of age).
Mode of action of electroconvulsive therapy: an update
Authors: Scott Allan I. F. 
Published: January 2011

SummaryIt has become acceptable for psychiatrists to say that they simply do not know how electroconvulsive therapy (ECT) works. This frame of mind runs the risk that there will be no expectation that psychiatrists remain familiar with seminal studies on the mode of action of ECT. This article is intended as a reminder of these studies and illustrates how the original theories have evolved. This evolution has been brought about largely by modern brain imaging techniques in human studies and in patients treated with ECT. These new findings will be set in the context of contemporary ideas about the neuroanatomy of mood disorders and the cellular mechanisms of the long-term effects of antidepressant treatments.
Clozapine and blood dyscrasia
Authors: Latif Zahid , Jabbar Faraz , Kelly Brendan D. 
Published: January 2011

SummaryClozapine is an effective antipsychotic medication but is associated with agranulocytosis, neutropenia and leucopenia. The reintroduction of clozapine improved management of treatment-resistant schizophrenia, yet resulted in a paradoxical situation whereby the risk of blood dyscrasias is rigorously managed but other adverse effects (e.g. seizures, cardiovascular complications) are less well monitored. Monitoring of weight, lipids, plasma glucose and other metabolic parameters is recommended. There is also a need to reconsider routine haematological monitoring with other medications associated with blood dyscrasia (e.g. phenothiazines, carbamazepine). In particular, individuals who develop clozapine-induced blood dyscrasia may require haematological monitoring during treatment with other antipsychotics.
Validity, utility and acceptability of borderline personality disorder diagnosis in childhood and adolescence: survey of psychiatrists
Authors: Griffiths Mark 
Published: January 2011

Aims and methodTo establish the views of child and adolescent psychiatrists (n= 52) regarding the conceptual and empirical validity, clinical utility and acceptability of the diagnosis of borderline personality disorder in child and adolescent populations. A questionnaire survey was carried out.ResultsThe child and adolescent psychiatrists' perception of the validity of borderline personality disorder for adult populations was relatively high (82% felt it to be valid). Significantly fewer of those considered borderline personality disorder to be valid for adolescent populations (37%). Strikingly different results were obtained when the questions related to child (<12 years) populations (2%).Clinical implicationsGiven the views expressed by these consultant child and adolescent psychiatrists, it would seem appropriate to approach with caution suggestions that the borderline personality disorder category should have extended use with adolescent and child populations.
Global Burden of Disease estimates of depression – how reliable is the epidemiological evidence?
Authors: Brhlikova Petra , Pollock Allyson M , Manners Rachel 
Published: January 2011

Summary Objectives To re-assess the quality of the epidemiological studies used to estimate the global burden of depression 2000, as published in the GBDep study. Design Primary and secondary data sources used in the global burden of depression estimate were identified and assigned to country of origin. Each source was assessed with respect to completeness and representativeness for national/regional estimates and against the inclusion criteria used by the scientific team estimating GBDep. Setting Not applicable. Participants Not applicable. Main outcome measures Not applicable. Results First, National estimates: The 28 scientific sources cited in the GBDep study related to 40 of the 191 WHO member countries. The EURO region had studies relating to 15 of 52 countries whereas AFRO region had studies for only three of 46 countries. Only six of the 40 countries had data drawn from a nationally representative population: the three AFRO country studies were based on a single village or town and, likewise, SEARO region had no nationally representative data; second, GBDep criteria: GBDep inclusion criteria required study sample size of more than 1000 people; 19 (45%) of the 42 studies did not meet this criterion. Sixteen (44%) of 36 studies did not meet the requirement that studies show a clear sample frame and method. GBD estimates rely on estimates of incidence; only two of the 42 country studies provided incidence data (Canada and Norway), the remaining 34 studies were prevalence studies. Duration of depression is based on three studies conducted in the USA and Holland. Conclusions Most studies exhibit significant shortcomings and limitations with respect to study design and analysis and compliance with GBDep inclusion criteria. Poor quality data limit the interpretation and validity of global burden of depression estimates. The uncritical application of these estimates to international healthcare policy-making could divert scarce resources from other public healthcare priorities.
How can we reduce the number of coroner autopsies? Lessons from Scotland and the Dundee initiative
Authors: Pounder Derrick , Jones Matthew , Peschel Heiko 
Published: January 2011

Summary Currently the medicolegal dissection rate for England and Wales is 22% (110,000 coronial autopsies for 500,000 deaths per annum), yet there is a general lack of evidence about the utility of and justification for such a high level of activity, which is between double and triple the rate in other jurisdictions. The government is currently consulting on how to reduce the numbers, and the Coroners and Justice Act 2009 is permissive of external examinations as an alternative to dissections. We describe the philosophy and practice of the Scottish system of postmortem external examinations, and the 20-year experience of a local initiative to maximize use of such external examinations. Currently our regional medicolegal dissection rate is 6%, which if applied to England and Wales would reduce the number of dissections from 110,000 to 30,000 per annum, with all of the social, resource and management implications. While the autopsy is an important tool in modern death investigation, an almost automatic recourse to it is inappropriate. In our view external examinations are not only cost-effective but also a necessary element in any death investigative system which wishes to strike an appropriate balance between intrusion by the state and the rights of the bereaved.
Effects of Immune-Enhancing Enteral Nutrition on Mortality and Oxygenation in Acute Lung Injury and Acute Respiratory Distress Syndrome: A Meta-Analysis
Authors: Dee Brian M. , Bruno Jeffrey J. , Lal Lincy S. , Canada Todd W. 
Published: January 2011

Purpose The contribution of the immune system to the pathogenesis of acute respiratory distress syndrome (ARDS) has led to a recent interest in the use of immune-enhancing enteral nutrition as a treatment modality. The purpose of this meta-analysis was to determine the effectiveness of immune-enhancing enteral nutrition as compared with standard enteral nutrition, with respect to mortality and change in oxygenation status, in patients with acute lung injury (ALI)/ARDS. Methods A systematic review was conducted of randomized controlled trials comparing immune-enhancing enteral nutrition with standard enteral nutrition in adult intensive care unit (ICU) patients with ALI/ARDS. Data were combined in a meta-analysis with STATA SE version 9.2 (StataCorp) using a random effects model. Results Three studies fulfilled inclusion criteria, totaling 411 patients. These studies demonstrated a statistically significant relative risk (RR) for in-hospital mortality, favoring patients who received immune-enhancing enteral nutrition (RR, 0.58; 95% confidence interval [CI], 0.42-0.79). With respect to change in oxygenation status, a statistically significant standardized mean difference (SMD) was observed at day 4 (SMD, 1.97; 95% CI, 0.27-3.67), favoring the immune-enhancing enteral nutrition group. At study day 7, the SMD did not reach statistical significance (SMD, 1.71; 95% CI, −0.13 to 3.56). Conclusions Oxygenation and mortality benefits of immune-enhancing enteral nutrition in adult ICU patients with ALI/ARDS have been shown in individual trials and meta-analyses. Subsequent clinical trials and meta-analyses are required to fully elucidate the role of immune-enhancing enteral nutrition in this patient population.
Pegloticase
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E. 
Published: January 2011

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. Subscribers to The Formulary Monograph Service also receive access to a pharmacy bulletin board, The Formulary Information Exchange (The F.I.X.). All topics pertinent to clinical and hospital pharmacy are discussed on The F.I.X. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service or The F.I.X., call The Formulary at 800-322-4349. The January 2011 monograph topics are on dabigatran etexilate mesylate, ceftaroline fosamil, lurasidone hydrochloride tablets, acetaminophen intravenous, and dextromethorphan/quinidine sulfate. The DUE/MUE is on ceftaroline fosamil.
Weathering the Storm: Managing the Drug Shortage Crisis; Pharmacist Supervision is Critical for Proper Preparation of Clinimix Multichamber Bags
Authors: Cohen Michael R. , Smetzer Judy L. 
Published: January 2011

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications.
Genetics of Type 1 Diabetes
Authors: Steck Andrea K , Rewers Marian J 
Published: January 2011

BACKGROUND
Type 1 diabetes, a multifactorial disease with a strong genetic component, is caused by the autoimmune destruction of pancreatic β cells. The major susceptibility locus maps to the HLA class II genes at 6p21, although more than 40 non-HLA susceptibility gene markers have been confirmed.

CONTENT
Although HLA class II alleles account for up to 30%–50% of genetic type 1 diabetes risk, multiple non-MHC loci contribute to disease risk with smaller effects. These include the insulin, PTPN22, CTLA4, IL2RA, IFIH1, and other recently discovered loci. Genomewide association studies performed with high-density single-nucleotide–polymorphism genotyping platforms have provided evidence for a number of novel loci, although fine mapping and characterization of these new regions remain to be performed.
Children born with the high-risk genotype HLADR3/4-DQ8 comprise almost 50% of children who develop antiislet autoimmunity by the age of 5 years. Genetic risk for type 1 diabetes can be further stratified by selection of children with susceptible genotypes at other diabetes genes, by selection of children with a multiple family history of diabetes, and/or by selection of relatives that are HLA identical to the proband.

SUMMARY
Children with the HLA-risk genotypes DR3/4-DQ8 or DR4/DR4 who have a family history of type 1 diabetes have more than a 1 in 5 risk for developing islet autoantibodies during childhood, and children with the same HLA-risk genotype but no family history have approximately a 1 in 20 risk. Determining extreme genetic risk is a prerequisite for the implementation of primary prevention trials, which are now underway for relatives of individuals with type 1 diabetes.
Earliest Arenig radiolarians from the Cow Head Group, Western Newfoundland
Authors: Won Mun-Zu , Iams William J. 
Published: January 2011

Radiolarians have been recovered from lowermost Arenigian rocks of the Cow Head Group in Gros Morne National Park, Newfoundland. Two new faunal assemblages include eight families, 13 genera, and 25 species. Among these, the family Neoaspiculumidae, the genusNeoaspiculum, and 11 species,Beothuka aitchisoni, B. grosmornensis, B. stougei, B.?stellata, Neoaspiculum cancellium, N. headense, N. transformum, N. laxum, N.?amplum, Proventocitum cylindricum, andP. piriforme, are new.This study elucidates the reason for the significant difference in species composition between pre-Arenigian and Arenigian radiolarian faunas. This difference does not appear to be due to mass extinction, but rather to phylogenetic evolution: most radiolarian families that flourished during pre-Arenig time were gradually but significantly reduced by the earliest Arenig. Characteristic features of the earliest Arenig assemblages that distinguish them from their Tremadocian predecessors are 1) the development of a distinctive skeletal constructional element referred to as “bandage” structure that evolved through modification of a mesh of thin bars and 2) the appearance of multiple concentric shells including a proloculus (or a microsphere), which developed from a primitive three-dimensionally interwoven meshwork or spongy shell wall. These forms, represented by beothukids, antygoporids, and inaniguttids, are rare but they appear to originate in the earliest Arenig. Transitional characteristics among those forms are developed in the Neoaspiculumidae, which flourished during the earliest Arenig.The precise biostratigraphic age of one of the assemblages was determined with the recovery of the index condontPrioniodus adamiStouge and Bagnoli, 1988 from strata belonging to theTetragraptus approximatusGraptolite Zone, which is at the base of the Arenigian.
Effective Choice and Boundedness Principles in Computable Analysis
Authors: Brattka Vasco , Gherardi Guido 
Published: January 2011

AbstractIn this paper we study a new approach to classify mathematical theorems according to their computational content. Basically, we are asking the question which theorems can be continuously or computably transferred into each other? For this purpose theorems are considered via their realizers which are operations with certain input and output data. The technical tool to express continuous or computable relations between such operations is Weihrauch reducibility and the partially ordered degree structure induced by it. We have identified certain choice principles such as co-finite choice, discrete choice, interval choice, compact choice and closed choice, which are cornerstones among Weihrauch degrees and it turns out that certain core theorems in analysis can be classified naturally in this structure. In particular, we study theorems such as the Intermediate Value Theorem, the Baire Category Theorem, the Banach Inverse Mapping Theorem, the Closed Graph Theorem and the Uniform Boundedness Theorem. We also explore how existing classifications of the Hahn–Banach Theorem and Weak Kőnig's Lemma fit into this picture. Well-known omniscience principles from constructive mathematics such as LPO and LLPO can also naturally be considered as Weihrauch degrees and they play an important role in our classification. Based on this we compare the results of our classification with existing classifications in constructive and reverse mathematics and we claim that in a certain sense our classification is finer and sheds some new light on the computational content of the respective theorems. Our classification scheme does not require any particular logical framework or axiomatic setting, but it can be carried out in the framework of classical mathematics using tools of topology, computability theory and computable analysis. We develop a number of separation techniques based on a new parallelization principle, on certain invariance properties of Weihrauch reducibility, on the Low Basis Theorem of Jockusch and Soare and based on the Baire Category Theorem. Finally, we present a number of metatheorems that allow to derive upper bounds for the classification of the Weihrauch degree of many theorems and we discuss the Brouwer Fixed Point Theorem as an example.
Cardinal characteristics on graphs
Authors: Haverkamp Nick 
Published: January 2011

AbstractA cardinal characteristic can often be described as the smallest size of a family of sequences which has a given property. Instead of this traditional concern for a smallest realization of the given property, a basically new approach, taken in [4] and [5], asks for a realization whose members are sequences of labels that correspond to 1-way infinite paths in a labelled graph. We study this approach as such, establishing tools that are applicable to all these cardinal characteristics. As an application, we demonstrate the power of the tools developed by presenting a short proof of the bounded graph conjecture [4].
A complicated ω-stable depth 2 theory
Authors: Koerwien Martin 
Published: January 2011

AbstractWe present a countable complete first order theory T which is model theoretically very well behaved: it eliminates quantifiers, is ω-stable, it has NDOP and is shallow of depth two. On the other hand, there is no countable bound on the Scott heights of its countable models, which implies that the isomorphism relation for countable models is not Borel.
Computability of Fraïssé limits
Authors: Csima Barbara F. , Harizanov Valentina S. , Miller Russell , Montalbán Antonio 
Published: January 2011

AbstractFraïssé studied countable structures through analysis of the age of , i.e., the set of all finitely generated substructures of . We investigate the effectiveness of his analysis, considering effectively presented lists of finitely generated structures and asking when such a list is the age of a computable structure. We focus particularly on the Fraïssé limit. We also show that degree spectra of relations on a sufficiently nice Fraïssé limit are always upward closed unless the relation is definable by a quantifier-free formula. We give some sufficient or necessary conditions for a Fraïssé limit to be spectrally universal. As an application, we prove that the computable atomless Boolean algebra is spectrally universal.
Double-exponential inseparability of Robinson subsystem Q+
Authors: Egidi Lavinia , Faglia Giovanni 
Published: January 2011

AbstractIn this work a double exponential time inseparability result is proven for a finitely axiomatizable first order theory Q+. The theory, subset of Presburger theory of addition S+, is the additive fragment of Robinson system Q. We prove that every set that separates Q+ from the logically false sentences of addition is not recognizable by any Turing machine working in double exponential time. The lower bound is given both in the non-deterministic and in the linear alternating time models.The result implies also that any theory of addition that is consistent with Q+—in particular any theory contained in S+—is at least double exponential time difficult. Our inseparability result is an improvement on the known lower bounds for arithmetic theories.Our proof uses a refinement and adaptation of the technique that Fischer and Rabin used to prove the difficulty of S+. Our version of the technique can be applied to any incomplete finitely axiomatizable system in which all of the necessary properties of addition are provable.