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International Consensus (international + consensus)
Selected AbstractsInternational Consensus on Nomenclature and Classification of Atrial Fibrillation: A Collaborative Project of the Working Group on Arrhythmias and the Working Group of Cardiac Pacing of the European Society of Cardiology and the North American Society of Pacing and ElectrophysiologyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 4 2003SAMUEL LÉVY M.D. No abstract is available for this article. [source] Detection of Right-to-Left Shunts: Comparison between the International Consensus and Spencer Logarithmic Scale CriteriaJOURNAL OF NEUROIMAGING, Issue 4 2008Annabelle Y. Lao ABSTRACT BACKGROUND International Consensus Criteria (ICC) consider right-to-left shunt (RLS) present when Transcranial Doppler (TCD) detects even one microbubble (,B). Spencer Logarithmic Scale (SLS) offers more grades of RLS with detection of >30 ,B corresponding to a large shunt. We compared the yield of ICC and SLS in detection and quantification of a large RLS. SUBJECTS AND METHODS We prospectively evaluated paradoxical embolism in consecutive patients with ischemic strokes or transient ischemic attack (TIA) using injections of 9 cc saline agitated with 1 cc of air. Results were classified according to ICC [negative (no ,B), grade I (1-20 ,B), grade II (>20 ,B or "shower" appearance of ,B), and grade III ("curtain" appearance of ,B)] and SLS criteria [negative (no ,B), grade I (1-10 ,B), grade II (11-30 ,B), grade III (31100 ,B), grade IV (101300 ,B), grade V (>300 ,B)]. The RLS size was defined as large (>4 mm) using diameter measurement of the septal defects on transesophageal echocardiography (TEE). RESULTS TCD comparison to TEE showed 24 true positive, 48 true negative, 4 false positive, and 2 false negative cases (sensitivity 92.3%, specificity 92.3%, positive predictive value (PPV) 85.7%, negative predictive value (NPV) 96%, and accuracy 92.3%) for any RLS presence. Both ICC and SLS were 100% sensitive for detection of large RLS. ICC and SLS criteria yielded a false positive rate of 24.4% and 7.7%, respectively when compared to TEE. CONCLUSIONS Although both grading scales provide agreement as to any shunt presence, using the Spencer Scale grade III or higher can decrease by one-half the number of false positive TCD diagnoses to predict large RLS on TEE. [source] Beta-catenin status in paediatric medulloblastomas: correlation of immunohistochemical expression with mutational status, genetic profiles, and clinical characteristics,THE JOURNAL OF PATHOLOGY, Issue 1 2009Sarah Fattet Abstract Medulloblastoma is the most frequent malignant paediatric brain tumour. The activation of the Wnt/,-catenin pathway occurs in 10-15% of medulloblastomas and has been recently described as a marker for favourable patient outcome. We report a series of 72 paediatric medulloblastomas evaluated for ,-catenin protein expression, CTNNB1 mutations, and comparative genomic hybridization. Gene expression profiles were also available in a subset of 40 cases. Immunostaining of ,-catenin showed extensive nuclear staining (>50% of the tumour cells) in six cases and focal nuclear staining (<10% of cells) in three cases. The other cases either exhibited a signal strictly limited to the cytoplasm (58 cases) or were negative (five cases). CTNNB1 mutations were detected in all ,-catenin extensively nucleopositive cases. The expression profiles of these cases documented strong activation of the Wnt/,-catenin pathway. Remarkably, five out of these six tumours showed a complete loss of chromosome 6. In contrast, cases with focal nuclear ,-catenin staining, as well as tumours with negative or cytoplasmic staining, never demonstrated CTNNB1 mutation, Wnt/,-catenin pathway activation or chromosome 6 loss. Patients with extensive nuclear staining were significantly older at diagnosis and were in continuous complete remission after a mean follow-up of 75.7 months (range 27.5,121.2 months) from diagnosis. All three patients with focal nuclear staining of ,-catenin died within 36 months from diagnosis. Altogether, these data confirm and extend previous observations that CTNNB1 -mutated tumours represent a distinct molecular subgroup of medulloblastomas with favourable outcome, indicating that therapy de-escalation should be considered. International consensus on the definition criteria of this distinct medulloblastoma subgroup should be achieved. Copyright © 2009 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. [source] A report from the international consensus on diagnosing and treating the infected diabetic foot,DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue S1 2004Benjamin A. Lipsky Chairman Abstract In persons with diabetes, foot infection, that is, invasion and multiplication of microorganisms in tissues accompanied by tissue destruction or a host inflammatory response, usually begins with skin trauma or ulceration 1. While most foot infections remain superficial, they can spread to subcutaneous tissues, including muscle, joints, and bone. Many diabetic foot ulcers eventuate in an amputation; infection plays a role in approximately 60% of cases 2,4. Neuropathy is the main factor leading to skin breaks, while arterial perfusion largely affects infection outcome. Among the factors predisposing diabetic patients to foot infections are ill-defined immunological perturbations 5, 6; foot anatomy may foster proximal spread of infection and ischemic necrosis 7, 8. Copyright © 2004 John Wiley & Sons, Ltd. [source] Principles and approaches to abate seabird by-catch in longline fisheriesFISH AND FISHERIES, Issue 1 2005Eric Gilman Abstract Mortality in longline fisheries is a critical global threat to most albatross and large petrel species. Here we identify key principles and approaches to identify and achieve broad use of effective seabird by-catch avoidance methods. Despite the availability of highly effective and cost-saving seabird avoidance methods, few longline fleets employ them. Given the political context and capacity of management authorities of the majority of longline fisheries, it is critical to identify seabird avoidance strategies that are not only highly effective, but are also economically viable and commercially practical. Adoption of an international performance standard for longline baited hook,sink rate, and prescribing minimum gear weighting designs that meet this standard that are achievable by all longline fisheries, would be an important step forward towards resolving low use of seabird avoidance methods by vessels, including those in illegal, unregulated and unreported fisheries. Due to differences between fleets, no single seabird avoidance measure is likely to be effective and practical in all longline fisheries. Therefore, testing of seabird avoidance methods in individual fleets is needed to determine efficacy and economic viability. Longline fishers should directly participate in these trials as they have a large repository of knowledge and skills to effectively develop and improve seabird by-catch avoidance techniques, and this provides industry with a sense of ownership for uptake of effective by-catch reduction methods. Establishing protected areas containing seabird colonies and adjacent waters within a nation's EEZ can be an expedient method to address seabird by-catch. However, establishing high seas marine protected areas to restrict longline fishing in seabird foraging areas, which would require extensive and dynamic boundaries and large buffer zones, may not be a viable short-term solution because of the extensive time anticipated to resolve legal complications with international treaties, to achieve international consensus and political will, and to acquire requisite extensive resources for surveillance and enforcement. Analysis of results of research on seabird avoidance methods reveals that the most reliable comparisons of the efficacy of alternative strategies are from comparing the effectiveness of methods tested in a single experiment. Benefits from standardizing the reporting of seabird by-catch rates to account for seabird abundance are described. To provide the most precise inputs for seabird population models, estimates of seabird mortality in longline fisheries should account for seabird falloff from hooks before hauling, delayed mortality of seabirds caught but freed from gear, and mortality caused by hooks discarded in offal. [source] The American national interest and global public goodsINTERNATIONAL AFFAIRS, Issue 2 2002Joseph S. Nye Jr Since the end of the Cold War, Americans have been divided over how to be involved with the rest of the world. In the wake of the 11 September terrorist attacks, the debate between those who favour a unilateral foreign policy and those who advocate a multilateral approach has been brought to the fore in American politics and the media. In this article, Joseph Nye proposes a conception of the American national interest grounded in multilateralism. He argues that, although the United States remains the world's leading power, it cannot act alone to solve global problems such as transnational terrorism, the proliferation of weapons of mass destruction and global warming. Although the United States is the only country in a position to take the lead in protecting ,global public goods', such as an open international economic system and international stability, it will maintain its current predominance only if it works to establish international consensus on issues of global importance. [source] Risking Security: Policies and Paradoxes of Cyberspace SecurityINTERNATIONAL POLITICAL SOCIOLOGY, Issue 1 2010Ronald J. Deibert Conceptualizations of cyberspace security can be divided into two related dimensions, articulated as "risks": risks to the physical realm of computer and communication technologies (risks to cyberspace); and risks that arise from cyberspace and are facilitated or generated by its technologies, but do not directly target the infrastructures per se (risks through cyberspace). There is robust international consensus, growing communities of practice, and an emerging normative regime around risks to cyberspace. This is less the case when it comes to risks through cyberspace. While states do collaborate around some policy areas, cooperation declines as the object of risk becomes politically contestable and where national interests vary widely. These include the nature of political opposition and the right to dissent or protest, minority rights and independence movements, religious belief, cultural values, or historical claims. The contrast between the domains has led to contradictory tendencies and paradoxical outcomes. [source] Anthropological race psychology 1820,1945: a common European system of ethnic identity narrativesNATIONS AND NATIONALISM, Issue 4 2009RICHARD McMAHON ABSTRACT. This article examines ethnic stereotypes in biological race classification of Europeans between the 1830s and 1940s as part of political discourse on national identity. Anthropologists linked physical-psychological types to nations and national character stereotypes through ,national races', achieving an often quite enduring international consensus on each race's mentality. The article argues that race mentality narratives were therefore partly dictated by their place within a dynamic interlocking European system. I focus on two key interacting elements that structured this system: the central role of the Germanic-Nordic blond and the geographically uneven process of modernisation. I consider the spatiality of socio-cultural and political factors ,external' to the stereotype system, such as geopolitics and modernisation, but also emphasise that discursive relationships between national stereotypes helped structure the international stereotype system. My conclusion argues for greater consideration of the influence of both scientific and international systemic factors in research on national identity. [source] Pale, poor, and ,pretubercular' children: a history of pediatric antituberculosis efforts in France, Germany, and the United States, 1899,1929NURSING INQUIRY, Issue 3 2004Cynthia Connolly An international consensus emerged in the years between 1900 and 1910 regarding the need to refocus antituberculosis efforts away from treating tuberculosis in adults and toward preventing active disease in children. This paper uses social history as a framework to explore pediatric health experiments in France (foster placement of city children with rural farm families), Germany (open-air schools), and the United States (preventorium) for children considered ,pretubercular'. The scientific, social, and political variables that reshaped prevailing ideas and practice with regard to TB prevention during those years are described. The creation of the first preventorium in the United States is explained and the way in which French and German pediatric prevention strategies were adapted to address a specific population considered at high risk in the United States, indigent immigrants, is detailed. For each of these three nations, nurses were central actors. Their efforts provide a unique vantage point to study the cultural dimensions of risk and prevention embedded in nursing care and the interplay between science, culture, nurses, and the state. [source] The Creeping Politicisation of the World Bank: The Case of CorruptionPOLITICAL STUDIES, Issue 3 2004Heather Marquette This paper looks at the increasing politicisation of the World Bank through its work on corruption. Historically, the Bank's Articles of Agreement, which forbid it from involving itself in the politics of its recipient countries, have excluded work on corruption. In the 1990s, internal and external demands grew for the Bank to address the problem of corruption, despite earlier reticence. Much research done over the past decade, often commissioned by the Bank or done in-house, has worked to turn corruption into an economic and social issue, rather than a political one, in order to conduct anti-corruption work while evading accusations that it is violating this non-political mandate. Now this pretence is gradually slipping away and the Bank is becoming overtly political, despite its Articles and a lack of international consensus that this is the direction in which it should be heading. [source] | |||||||||||||